70% needy patients in India can't access dialysis: Study

February 25, 2017

New Delhi, Feb 25: In India, almost 200,000 new patients need dialysis every year, and it is estimated that less than 30 per cent of patients manage to receive this life-saving therapy mainly due to non-availability or unaffordability, says a study.kidney

Efforts to provide dialysis to those with end-stage kidney disease should be done in conjunction with more cost-effective efforts while maintaining minimum standards of quality and safety, the paper published in the journal Lancet said.

"As we in India embark on an ambitious national dialysis control program, we must ensure that minimum standards of quality and safety are established for dialysis units and regulations introduced where necessary to ensure standards are maintained," said lead author of the paper Vivekanand Jha, Executive Director of the George Institute for Global Health, a New Delhi-based health research facility.

"Audit systems should be designed to facilitate and encourage documentation of patient care and transparent reporting of costs and outcomes of care to provide an evidence base for decision making and objective evaluation of performance," Jha added.

The paper entitled "Ethical issues in dialysis therapy" argues that health systems should establish programmes of kidney disease prevention and health promotion in conjunction with dialysis and transplantation programmes.

Health professionals and policy makers should strive to reduce the costs of dialysis, using simple, safe and affordable modalities without compromising the quality of therapy provided to the patients, according to the researchers.

"The aim of equitable access to renal replacement therapy and best practice care for all patients with end-stage kidney disease presents major ethical, practical and economic challenges for health-care systems," Jha said.

"These challenges include increasing access to dialysis, helping patients and families to make the best decisions about management of advanced kidney failure and ensure that patients receive affordable high quality chronic dialysis that is based on standards accepted worldwide," Jha explained.

Dialysis access criteria and policy must be informed by an understanding of broader access issues relating to prevention and management of chronic kidney disease, supportive care, management of co-morbidities and complications, and general health-care services, the paper said.

"Physicians have an obligation to provide information about risk and benefits of dialysis and to support patients or their surrogate decision makers in qualitative evaluation of treatment options," co-authors of the paper Dominique Martin of Deakin University in Victoria, Australia, said.

According to a systematic review of worldwide access to treatment for end-stage kidney disease published in the Lancet in 2015, an estimated 2.28 million patients died in 2010 because of non-availability or unaffordability of dialysis, most of them in low-income and lower-middle income countries.

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Agencies
April 15,2020

Dear parents, if you want your children to have proper sleep, read this carefully. Joining a growing list of studies that tell parents to shun devices at bed-time, researchers say that children who use devices and decide what time they go to sleep, achieve less sleep and feel more sleepier the following day than their peers.

The study of children in this age-group (aged 11 to 13 years), published in the New Zealand Medical Journal, found most (72 per cent) of the 163 students interviewed by University of Otago researchers achieved recommended guidelines of an average 9 to 11 hours sleep nightly over one week.

"But that also means that almost one in four students did not achieve sleep within these guidelines, which highlights an area for improvement," said study researcher Kate Ford.

However, consistent with previous research in 15 to 17-year-old New Zealanders, the study results show less sleep on the nights where devices are used in the hour before bed.

According to the researchers, students who used devices before going to sleep were also more likely to report that they felt sleepy the following morning. Watching television before bed had no significant effect on sleep length.

There were also some interesting observations over the weekends where students went to bed later but woke later achieving similar sleep length to the school days, the researchers said.

A small group of students (six per cent) who reported less than seven hours of sleep, including a small number reporting not sleeping at all, according to the study,

Therefore, while the average across the week of 72 per cent of students reporting adequate sleep is reassuring, it is far from the goal of every child achieving sleep within the recommended guidelines," Ford said.

Dr Paul Kelly, head of the Sleep Health Service at Canterbury District Health Board, supervised the study and explained that the foundations for good health are based on proper nutrition, regular exercise and good sleep quality.

Sleep quality is often overlooked as a contributory factor to poor health.

"The study findings suggest the need for parental guidance around bedtimings and moderation of the use and availability of electronic devices before bed," Kelly said.

"Respect and protect your sleep, as good daytime functioning is reliant on adequate sleep," Kelly added.

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Agencies
August 2,2020

Washington, Aug 2: Children under the age of five have between 10 to 100 times greater levels of genetic material of the coronavirus in their noses compared to older children and adults, a study in JAMA Pediatrics said Thursday.

Its authors wrote this meant that young children might be important drivers of Covid-19 transmission within communities -- a suggestion at odds with the current prevailing narrative.

The paper comes as the administration of US President Donald Trump is pushing hard for schools and daycare to reopen in order to kickstart the economy.

Between March 23 and April 27, researchers carried out nasal swab tests on 145 Chicago patients with mild to moderate illness within one week of symptom onset.

The patients were divided into three groups: 46 children younger than five-years-old, 51 children aged five to 17 years, and 48 adults aged 18 to 65 years.

The team, led by Dr Taylor Heald-Sargent of the Ann & Robert H. Lurie Children's Hospital, observed, "a 10-fold to 100-fold greater amount of SARS-CoV-2 in the upper respiratory tract of young children."

15 countries with the highest number of cases, deaths due to the Covid-19 pandemic

The authors added that a recent lab study had demonstrated that the more viral genetic material was present, the more infectious virus could be grown.

It has also previously been shown that children with high viral loads of the respiratory syncytial virus (RSV) are more likely to spread the disease.

"Thus, young children can potentially be important drivers of SARS-CoV-2 spread in the general population," the authors wrote.

"Behavioral habits of young children and close quarters in school and daycare settings raise concern for SARS-CoV-2 amplification in this population as public health restrictions are eased," they concluded.

The new findings are at odds with the current view among health authorities that young children -- who, it has been well established, are far less likely to fall seriously ill from the virus -- don't spread it much to others either.

However, there has been fairly little research on the topic so far.

One recent study in South Korea found children aged 10 to 19 transmitted Covid-19 within households as much as adults, but children under nine transmitted the virus at lower rates.

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Agencies
June 19,2020

While coughing, fever and difficulty in breathing are common symptoms of COVID-19, a new case study has found that pink eye is also a reason to be tested for the disease.

The study, published in the Canadian Journal of Ophthalmology, determined that conjunctivitis and keratoconjunctivitis can also be primary symptoms of COVID-19.

The researchers noted that in March, a 29-year-old woman arrived at the Royal Alexandra Hospital's Eye Institute of Alberta with a severe case of conjunctivitis and minimal respiratory symptoms.

After the patient had undergone several days of treatment with little improvement -- and after it had been determined that the woman had recently returned home from Asia -- a resident ordered a COVID-19 test.

The test came back positive, according to the researchers.

"What is interesting in this case, and perhaps very different to how it had been recognised at that specific time, was that the main presentation of the illness was not a respiratory symptom. It was the eye," said Carlos Solarte, an assistant professor at the University of Alberta in Canada.

"There was no fever and no cough, so we weren't led to suspect COVID-19 at the beginning. We didn't know it could present primarily with the eye and not with the lungs," Solarte said.

Academic studies at the outset of the pandemic identified conjunctivitis as a secondary symptoms in about 10 to 15 per cent of COVID-19 cases, he said.

Since then, scientists have gained greater knowledge of how the virus can transmit through and affect the body's mucous membrane system, of which the conjunctiva -- the clear, thin membrane that covers the front surface of the eye -- is an extension.

While the finding provides important new health information for the public, it also makes eye exams more complicated for ophthalmologists and staff, the researchers noted.

"The patient in this case eventually recovered well without any issues. But several of the residents and staff who were in close contact with the patient had to be under quarantine," said Solarte.

"Fortunately, none who were involved in her care also tested positive," he said.

Patients coming into an eye clinic with conjunctivitis and keratoconjunctivitis are now treated as potential cases of COVID-19 and extra precautions are taken by staff, according to the researchers.

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