Kidney Talk

‘The ratio of kidney diseases in Pakistan is higher as compared to other countries owing to ‘variable’ reasons and a deceased donor can save up to 17 lives by donating different organs with the consent of their families’, reflected Director of Sindh Institute of Urology and Transplant (SIUT) Prof Dr Adeeb Rizvi.

 

Professor Dr Adeeb told that the interior areas of Sindh and Punjab are ‘breeding grounds’ for diseases, owing to the poor hygine and healthy facilities, absence of maternity care and unavailability of safe drinking water. Here’s a brief interview with Dr Adeeb Rizvi on kidney issues and organ donations trend in Pakistan.

1) What are the underlying causes that contribute to renal failures and kidney ailments?

Dr. Adeeb: Diabetes, hypertension, obesity, malnutrition, unattended bacterial infections, self-medication and especially on- the-counter analgesic pills are ‘Kidney Killers’.

2) How can kidney diseases be prevented in the first place?

Dr. Adeeb: A healthy living guarantees prevention from almost all diseases especially this one. Balanced nutrition, clean drinking water, proper drainage system, adequate maternity care, routine check-ups combined with education and awareness structure a healthy society that safeguards people against kidney diseases.
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<3> Are kidney failures deathly?

Dr. Adeeb: In earlier days, kidney failure was considered to be a ‘ black death warrant’, but let me tell you, they are treatable. There are two ways to counter kidney failures. Transplant and `Dialysis. Both are expensive and are somehow meant only for those who can afford it. A normal person needs 10 dialysis to keep him alive and each dialysis cost around Rs.3500 to 5000, while a transplant costs around Rs. 700,000. How many people can afford this much?

4 What are the trends of organ donation in Pakistan? Do people respond to your call?

Dr. Adeeb: For a strange set of societal preconceptions, people are somehow reluctant in donating organs. Knowing a son may expire soon; the father shies away from donating his organ to save the son’s life. A lot needs to be done to change this patterned mindset. They need to understand, it is a Sadqa-e-Jariya which is encouraged in all religions, and has no legal restrictions as well.

5. Your message.

Dr. Adeeb: One deceased/brain-dead person can save 17 lives. So, people should feel encouraged to come forward and pledge their organs and save many precious lives.

Doctor looks to China for spinal injury 'cure'

HONG KONG: One of the world's leading researchers into spinal cord injuries says China could hold the key to a cure that he has been searching for since he met late actor Christopher Reeve in the 1990s.

US-based Doctor Wise Young first used the word "cure" in relation to his work after a conversation with Reeve, the "Superman" hero who became quadriplegic in an equestrian accident in 1995.

Reeve contacted him looking for help and the two became close friends. The actor died of heart failure in 2004 at the age of 52, having devoted his life to raising awareness about spinal cord injuries and stem-cell research.

But it was a star of a different sort, Chinese gymnast Sang Lan, who set Young on the path he believes has brought a cure closer than ever, thanks to ground-breaking clinical trials of stem-cell therapy he is conducting in China.

Sang crushed her spine during a routine warm-up exercise at the Goodwill Games in New York in 1998. She met Young as she underwent treatment and rehabilitation in the United States over the next 12 months.

"Her parents came to me and asked whether or not there would ever be a cure for her, and I said we're working very hard on it," recalled Young, who was by then one of the leading US experts on spinal cord injuries.

"When she went back to China after doing her rehabilitation in New York she cried and asked how would therapies go from the United States to China.

"In those days China was still relatively poor and backward so she didn't think that any therapy would be coming from China. So I started in 1999 to talk to all the spinal cord doctors in China."

He said the result was China Spinal Cord Injury Net, the world's largest clinical trial network for spinal cord therapies. Established in Hong Kong in 2005, it is about to expand into Europe, India and the United States

72 die from substandard medicine in Lahore

LAHORE: Substandard medicines dispensed by the Punjab Institute of Cardiology have claimed 72 lives.

Several patients are still being treated at various government hospitals and Chief Minister Shahbaz Sharif has ordered that all facilities be provided to them.

Sharif has also announced compensation of Rs 500,000 for the victims’ families and Rs 200,000 for patients.

The investigation team formed by the Chief Minister has also confiscated the medicine record of the PIC after raiding the drug testing laboratory.

Teams are also visiting neighbourhoods across the city gathering the substandard medicine.

Conjoined twin babies shifted to NICH Karachi

KARACHI: The conjoined twin babies, born with one heart in Larkana, have been shifted to National Institute of Child Health (NICH) Karachi where decision of their surgery would be made after thoroughly checkup, Geo News reported.

Sindh Health Minister Dr Sagheer Ahmed had issued directives to shift the conjoined twin babies to Karachi after 'Geo News' aired the news of their birth at Shaikh Zaid Hospital Larkana.

Wajida wife of Mazhar Ali Lakhair, resident of Nau Goth of Mehar Taluka had given birth to conjoined twin babies at Shaikh Zaid Hospital for Women in Larkana on Thursday evening.

The mother said that due to poverty she was not capable of paying for the treatment.

Vitamin D has mixed effects on cancer, broken bones

NEW YORK: Extra vitamin D and calcium may offer some protection against fractures in elderly people, but have little or no impact on cancer risk, according to a fresh look at the medical evidence.

Some research has suggested that vitamin D, with or without calcium, might help stave off cancer, but recent trials have slashed those hopes.

"It turns out that as a group, all of the micronutrient supplements have been disappointing," said Dr. Michael Pollak, who heads the division of cancer prevention at McGill University in Montreal, Canada, and was not involved in the new work.

"Even one of the best candidates, which is vitamin D, is certainly no slam dunk," he told Reuters Health.

The new report, out Monday in the Annals of Internal Medicine, was commissioned by the government-backed U.S. Preventive Services Task Force to inform its public recommendations.

It pulls together 19 gold standard experiments -- so-called randomized controlled trials -- on vitamin D with or without calcium. The trials lasted anywhere from seven months to seven years and ranged in size from a few thousand participants to tens of thousands.

Only three of them reported on cancer, however. While one small study found some protection against cancer in postmenopausal women taking vitamin D and calcium, the larger studies found no benefits.

"I don't have confidence in any of the findings because they could be chance findings," lead researcher Mei Chung, of Tufts Medical Center in Boston, told Reuters Health.

Last month, another randomized controlled trial was published in the Journal of Clinical Endocrinology and Metabolism. Although it wasn't included in Chung's report, it confirms her results.

In that study, among seniors taking 800 IU of vitamin D daily for a few years, 32 out of every 100 died during the study, while 33 out of every 100 people who did not get the supplement died.

That small difference could easily have been due to chance, the researchers found. There were no differences in deaths from cancer or heart disease either, just as calcium also proved unhelpful.

According to Chung, one large U.S. study, known as the Women's Health Initiative, also showed that women taking the supplements had higher rates of kidney and bladder stones.

Marji McCullough, a nutritional scientist at the American Cancer Society, said her organization does not advise dietary supplements to prevent cancer.

"Various researchers have recommended that, but large consensus panels have not," she told Reuters Health. "There is no compelling evidence currently that taking supplements will lower your cancer risk."

The Institute of Medicine recommends that most adults get 1,000 to 1,200 milligrams (mg) of calcium per day and 600 to 800 IU of vitamin D. It sets a recommended upper limit at 2,000 mg of calcium and 4,000 IU of vitamin D.

However, Chung's team did find a small reduction in fracture risk among elderly people living in an institution such as a nursing home, with extra vitamin D and calcium preventing two out of every 100 expected fractures.

But the risk reduction was smaller for people living on their own, and might have been due to chance, she added.

Chung, who is assistant director of the Evidence-based Practice Center at Tufts, said that in an earlier report from 2009, which looked at several possible health benefits, only the fracture benefit was convincing.

Pollak said it's possible that a few people who have low levels of vitamin D may get some benefit from it, but that doesn't warrant everybody taking extra vitamins.

"You can have too much of a good thing," he told Reuters Health.

For people interested in lowering their cancer risk, he added, there are better ways to go than supplements.

"Don't smoke and stay as close as you can to your ideal body weight," Pollak urged. "Those two things will definitely lower you cancer risk and they will have many other health benefits as well -- and there are no possible downsides."

The U.S. Preventive Services Task Force could not say when its new vitamin D guidelines will be released. (Reuters)

219-pound boy shows US obesity problem

CLEVELAND: The case of a 219-pound 8-year-old boy taken from his mother for health reasons spotlights a problem that has almost tripled in the U.S. in the last 30 years -- cases of extreme child obesity.

"Not only do we have a higher percentage of kids who are obese but a higher percentage of children who are severely obese," said Dr. Garry Sigman, director of adolescent medicine and associate professor of pediatrics at Loyola University Medical Center near Chicago, in an interview with Reuters.

According to the Centers for Disease Control and Prevention, approximately 17 percent or 12.5 million of children and adolescents aged 2 to 19 years are obese, as opposed to merely overweight.

Obesity in children is defined by the CDC as having a body mass index (BMI) at or above the 95th percentile for children of the same age and sex. "Overweight" is defined as a BMI at or above the 85th percentile.

About 2 million U.S. children have a BMI at or beyond the 99th percentile, according to a July article on childhood obesity in the Journal of the American Medical Association, co-authored by Harvard University child obesity expert Dr. David S. Ludwig. The article ignited controversy by saying that in some cases, removing a child from a home may be justified.

An average 8-year-old boy is about 55 pounds, making the boy in question approximately 165 pounds overweight or four times more than average, according to the CDC.

The Cleveland-area boy's mother petitioned a state court two weeks ago to regain custody. But on November 14, a judge agreed with the Cuyahoga County Department of Children and Family Services that the boy, an honor student who gained 60 pounds in about a year, should not be returned to his home due to concerns for his health. The next custody hearing is set for later this month.

Sigman said he usually only sees that sort of rapid weight gain in teenagers, and this along with the sleep apnea is "life threatening."

"That kind of weight gain is a very serious imbalance in both movement and calorie intake," in a younger child, he added.

This is the first time an Ohio child had been removed from a parent's custody primarily due to weight concerns. Court records show that the boy was seen by endocrinologists, nutrition experts, and a sleep clinic in efforts to decrease his weight and remedy his sleeping problems. Medical professionals concluded that the boy's weight gain was due to environmental reasons such as his diet, and there was no medical reason for the gain, according to court records.

Social workers became aware of the boy's situation in spring of 2010 when the 7-year-old was hospitalized for two weeks with severe breathing problems. The child has since been diagnosed with sleep apnea and uses a breathing device and monitor at night, according to court records.

Sam Amata, an attorney for the mother of the child, did not returned repeated calls for comment.

According to social worker reports, the boy had been diagnosed as morbidly obese and lost weight during his two-week hospitalization.

The boy's weight continued to decrease for a short period of time but he then began gaining again at "a rapid pace," according to court documents.

Sigman noted that weight-related health issues like heart and fatty liver disease, usually thought of as adult or end-stage diseases, are effecting children with severe weight problems.

The Cleveland boy, who has a Body Mass Index (BMI) of 60, was enrolled in a hospital program for overweight children. Social worker reports said he frequently missed weigh-ins and appointments, the court document said.

During the year-and-a-half protective supervision of the child, a social worker reported observing the boy out of breath after walking down the length of a short hallway and that some of the boy's breathing problems are, "due to extra skin in his throat."

An 8-year-old boy with a moderate activity level would require about 11,200 calories in one week to maintain his current weight, according to the University Hospitals Rainbow Babies & Children's Hospital in Cleveland. For the same child to gain one pound in a week, he would need to consume about 14,700 calories.

The boy is now living in a foster home close to his mother who is allowed weekly visits. He has lost weight while in foster care, according to Mary Louise Madigan, spokeswoman for the Cuyahoga County Department of Children and Family Services.

Sigman warns that any young child with a severe weight problem will need years of care. "Even under the best conditions, it is not always possible to maintain significant weight loss in these children," explains Sigman. "It is going to take years to get that child well."

Long-term study proves benefit of statins

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PARIS: Statins safely reduce the risk of cardiovascular illness even years after treatment is stopped, according to a probe into the popular cholesterol-busters published on Wednesday. Statins work by blocking a liver enzyme that makes fatty molecules which line arterial walls and boost the danger of heart disease and strokes. With worldwide annual sales of more than 20 billion dollars, the drugs have been dubbed "the aspirin of the 21st century" because of their benefit and wide use. But lingering questions persist about their long-term safety for the heart, liver and cancer risk. Researchers at the Heart Protection Study Collaborative Group in Oxford looked at 20,536 patients at risk of cardiovascular disease who were randomly allocated 40mg daily of simvastatins or a dummy look-alike over more than five years. During this period, those who took the statins saw a reduction in "bad" LDL cholesterol and a 23-percent reduction in episodes of vascular ill-health compared to the placebo group. (AFP)

Scanners could reduce number of autopsies

(BATKHELA.TK)PARIS: Hi-tech medical scanners could be used to probe causes of death, reducing the need for invasive autopsies that can upset bereaved families, a study published in The Lancet on Tuesday says.

In Britain, post-mortems are ordered in about a fifth of deaths, notably where crime is suspected. The procedure has changed little over the past century, entailing evisceration and then dissection of the major organs.

Keen to find whether a non-invasive alternative could be used, researchers tested frequency magnetic resonance imaging (fMRI) and computed tomography (CT) scanners in 182 adult deaths where the corpse was afterwards given an autopsy.

Autopsy was not needed in a third of cases that had been imaged by fMRI and in half of the cases imaged by CT, according to the study.

However, the scanners were not perfect.

They failed to spot, or misattributed, more than two dozen cases of heart disease as well as several dozen cases of embolism, pneumonia and intra-abdominal lesions.

Screening by scanners could identify some of the major causes of death and thus make some autopsies unnecessary, the paper suggests.

It could also identify suspect lesions that would enable pathologists to carry out only a minimal dissection to pinpoint the cause of death. (AFP)

Life-saving AIDS drugs push HIV numbers to new high

(batkhela.tk) LONDON: More people than ever are living with the AIDS virus but this is largely due to better access to drugs that keep HIV patients alive and well for many years, the United Nations AIDS programme (UNAIDS) said on Monday.

In its annual report on the pandemic, UNAIDS said the number of people dying of the disease fell to 1.8 million in 2010, down from a peak of 2.2 million in the mid-2000s.

UNAIDS director Michel Sidibe said the past 12 months had been a "game-changing year" in the global AIDS fight.

Some 2.5 million deaths have been averted in poor and middle-income countries since 1995 due to AIDS drugs being introduced and access to them improving, according to UNAIDS.

Much of that success has come in the past two years as the numbers of people getting treatment has increased rapidly.

"We've never had a year when there has been so much science, so much leadership and such results in one year," Sidibe said in a telephone interview from UNAIDS headquarters in Geneva.

"Even in this time of public finance crises and uncertainty about funding, we're seeing results. We are seeing more countries than ever before (achieving) significant reductions in new infections and stabilising their epidemics."

Since the beginning of the AIDS pandemic in the 1980s, more than 60 million people have been infected with the human immunodeficiency virus (HIV) that causes AIDS. HIV can be controlled for many years with cocktails of drugs, but there is as yet no cure. (Reuters) 

Medical researchers decoding the aging process

(batkhela-movies)WASHINGTON: Scientists are beginning to decode the complex biology of aging and are optimistic that recent advances in research may lead to treatments that can slow or even reverse degeneration and disease.

"We are seeing a major change, very important developments and real therapeutic efforts to try to treat age-related illnesses," said Norman Sharpless, professor of medicine and genetics at the University of North Carolina.

The French research, led by Jean-Marc Lemaitre at the Functional Genomics Institute, published in October, shows cells from elderly donors can be rejuvenated as stem cells, erasing the ravages of age and proving that aging is reversible.

"It's a major advance," Sharpless said, noting that if many age-related diseases such as cancer, cardiovascular problems or Alzheimer's are to be defeated, regenerative medicine will be required.

But he stressed that "cellular therapy is very difficult to develop," and expectations must be kept in check.

At the end of 2010 an American study in Boston showed that aging could be reversed in mice that were treated with telomerase, a naturally occurring enzyme in the body that protects DNA sequences (telomeres) at the end of chromosomes and which shorten cellular aging. (AFP)

Big chink found in malaria's armour

(batkhela-movies)PARIS: Researchers said Wednesday they had discovered a unique microscopic channel through which malaria parasites must pass to infect red blood cells, a finding that opens up a highly promising target for a vaccine.

The doorway mechanism is common to all known strains of the deadliest mosquito-borne pathogen, Plasmodium falciparum, which means that a future vaccine could in theory work against all of them, according to the study published in the journal Nature.

The death toll from malaria has declined by a fifth over the last decade, but the disease still claims some 800,000 lives every year, mostly children under five in sub-Saharan Africa.

"Our findings were unexpected and have completely changed the way in which we view the invasion process," said Gavin Wright of the Wellcome Trust Sanger Institute and the study's senior co-author.

The breakthrough "seems to have revealed an Achilles' heel in the way the parasite invades our red blood cells."

Up to now, scientists assumed that P. falciparum had several options for piercing the defences of blood cells.

But in experiments, Wright and colleagues showed that intrusion depends on the interaction between a specific molecule on the parasite, called a ligand, and a specific receptor on the blood cell.

Blocking this interaction repels the pathogen's attempt to breach the cell's protective wall, they found.

"By identifying a single receptor that appears to be essential for parasites to invade human red blood cells, we have also identified an obvious and very exciting focus for vaccine development," said co-author Julian Rayner, also from the Sanger Institute.

Early results from clinical trials in Africa showed that the world's first malaria vaccine, reported in a study last month, cut infection rates by roughly half. The vaccine, made by the British pharmaceutical giant GlaxoSmithKline, works by triggering the immune system.

"These reports are encouraging," said Adrian Hill, a researcher at Oxford's Jenner Institute. "But in the future more effective vaccines will be needed if malaria is ever to be eradicated."

Hill added: "The discovery of a single receptor that can be targeted to stop the parasite infecting red blood cells offers the hope of a far more effective solution." 

More evidence obesity tied to colon cancer

 (BATKHELA-MOVIES)ENGLAND: Older adults who are heavy, especially around the middle, seem to have a higher risk of developing colon cancer than their thinner peers - and exercise may lower the incidence of the disease, especially for women, a European study said.

More than 120,000 adults in the Netherlands aged 55 to 69 were followed for 16 years by the study, published in the American Journal of Epidemiology.

During that time, about two percent developed colorectal cancer, tumors of the colon and/or rectum, though most were diagnosed with colon cancer.

The risk was 25 percent higher for men who were significantly overweight or obese at the outset, versus normal-weight men. (Reuters)

Air pollution tied to lung cancer in non-smokers

[batkhela-movies] NEW YORK: People who have never smoked, but who live in areas with higher air pollution levels, are roughly 20 percent more likely to die from lung cancer than people who live with cleaner air, researchers conclude in a new study.

"It's another argument for why the regulatory levels (for air pollutants) be as low as possible," said Francine Laden, a professor at the Harvard School of Public Health, who was not involved in the research.

Though smoking is the number one cause of lung cancer, about one in 10 people who develop lung cancer have never smoked.

"Lung cancer in 'never smokers' is an important cancer. It's the sixth leading cause of cancer in United States," said Michelle Turner, the lead author of the study and a graduate student at the University of Ottawa.

Previous estimates of how many non-smokers get lung cancer range from 14 to 21 out of every 100,000 women and five to 14 out of every 100,000 men.

The fine particles in air pollution, which can irritate the lungs and cause inflammation, are thought to be a risk factor for lung cancer, but researchers had not clearly teased apart their impact from that of smoking.

In this study, Turner and her colleagues followed more than 180,000 non-smokers for 26 years. Throughout the study period, 1,100 people died from lung cancer.

The participants lived in all 50 states and in Puerto Rico, and based on their zip codes, the researchers estimated how much air pollution they were exposed to -- measured in units of micrograms of particles per cubic meter of air.

Pollution levels in different locations ranged from a low of about six units to a high of 38. The levels dropped over time, however, from an average of 21 units in 1979 - 1983, to 14 units in 1999 - 2000, producing an overall average pollution level of 17 units across the study period.

After the team took into account other cancer risk factors, such as second-hand smoke and radon exposure, they found that for every 10 extra units of air pollution exposure, a person's risk of lung cancer rose by 15 to 27 percent.

The increased risk for lung cancer associated with pollution is small in comparison to the 20-fold increased risk from smoking.

And the study team didn't prove that the pollution caused the cancer cases, but "there's lots of evidence that exposure to fine particles increases cardiopulmonary mortality," Turner told Reuters Health.

Fine particles in air pollution can injure the lungs through inflammation and damage to DNA, Turner's team writes in its report, published in the American Journal of Respiratory and Critical Care Medicine.

Previous research has suggested similar conclusions. A study of people in China, for example, found an increased risk of lung cancer attributed to indoor air pollution from burning coal and wood to heat homes (see Reuters story of December 7, 2009). And several European studies have linked levels of soot and vehicle exhaust to lung cancer in non-smokers.

Laden noted that the pollution levels associated with the increased risk of cancer in the current study are not uncommon in the U.S.

"These levels are within the (regulatory) standards," Laden told Reuters Health. "We're not talking about people who live in a really polluted place with no pollution control.

HEALTH

HEALTH

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Tooth Loss Linked to Pancreatic Cancer in Smokers  The more teeth a smoker loses, the higher the risk that he will develop pancreatic cancer, according to a new study. The risk of developing pancreatic cancer was 63 percent higher in smokers who had lost all their teeth, compared with those who had lost fewer than 10 teeth, researchers reported in the American Journal of Clinical Nutrition. Overall, the risk of pancreatic cancer in the group was about 6 in 1000. The study doesn’t show that tooth loss causes pancreatic cancer, the study’s lead author Rachel Z. Stolzenberg-Solomon said in an interview. Tooth loss could simply be a marker for some other factor that leads to cancer, said Stolzenberg-Solomon, an investigator in the Nutritional Epidemiology Branch at the National Cancer Institute. For example, she said, tooth loss could simply be a marker for an unhealthy lifestyle. On the other hand, Stolzenberg-Solomon said, smokers who have lost all their teeth may have more bacteria in their mouths. And this higher level of bacteria in the mouth may lead to higher levels of bacteria in the gut. "There is a hypothesis that connects bacterial load with pancreatic cancer," Stolzenberg-Solomon said. "Bacteria in the stomach convert nitrates and nitrites into nitrosamines. And nitrosamines are carcinogens." For the new study, Stolzenberg-Solomon and her colleagues examined the medical records of 29,104 male smokers. The men, who were aged 50 to 69 at the start of the study, were followed from 1985 to 1997. They were asked about their dental health at the beginning of the study. By the end of the study, 174 men had developed pancreatic cancer. After taking age, education, and whether the men lived in a rural or urban environment into account, the researchers found that men were 63 percent more likely to develop pancreatic cancer if they had lost all their teeth. While the new study doesn’t prove that the conditions that promote tooth loss lead to an elevated cancer risk, it does underscore the importance of good dental hygiene, Stolzenberg-Solomon said. Studies have shown that the use of dental floss and toothpaste are linked with lower risk of cancers of the mouth and esophagus, she said.