|
Drug Watch
Lateral thinking: Scientists have come up
with a delightful new strategy to beat an old disease. In
hemophilia the deficiency of factors VIII or IX is overcome with
plasma products or infusions of the recombinant protein factor.
The drawbacks are need for frequent transfusions and development
of antibodies against the foreign protein. An ingenious solution
would be to introduce activated factor VII which directly
activates factor X obviating the need for factor VIII and IX. But
factor VII has a short half life. The answer would be to infuse
factor XIIa or Xa. But these would also activate fibrinogen and
cause disseminated intravascular coagulation. So Pollard et al.
from Bethseda, Maryland, fixed factor XIIa directly, onto a solid
matrix and placed it in a capsule with pores. This capsule was
surgically implanted into the peritoneum of rhesus monkeys. This
allowed factor VII to diffuse in, get activated and hence activate
factor X without activating fibrinogen. This produced
therapeutically effective levels of activation of the coagulation
system (Nature Biotechnology 2000; 18: 289-295, eBMJ 11 March
2000).
Woman Watch
Real life heroes: There are probably many
unsung heroes in war torn countries all around the world. One of
them is Florina Brovina a pediatrician in Kosovo who had started a
center for rehabilitation of displaced women and children. Last
year she was imprisoned and given a 12 year sentence for having
medically assisted Albanian combatants and patients. Her response
was that she had dedicated her life to the care of children who
did not know their ethnicity and would not know it unless their
parents taught them of it.
Their are many other Kosovo Albanian physicians
who are being targeted to destroy the health system in Kososvo.
All this in flagrant defiance of the Geneva Convention of which
Yugoslavia is a signatory, which states that patients, no matter
whether combatant or civilian, "shall receive, to the fullest
extent practicable and with the least possible delay, the medical
care and attention required by their condition. Under no
circumstances shall any person be punished for having carried out
medical activities compatible with medical ethics, regardless of
the person benefiting therefrom." (The Lancet Interactive 4
March 2000).
Bug Watch
Changing colors: A new mutant of the
hepatitis B virus with the mutation in the "a"
determinant of the surface antigen was recently reported by
Locarnini from Melbourne, Australia and Oon from Singapore. This
is not picked up by the standard immunobased assays for diagnosing
HBV nor does routine vaccina-tion against hepatitis B protects
against it. It has been found in vaccinated individuals and
carriers of hepatitis B after receiving antiviral drugs and is
probably transmitted both horizontally and vertically. Scientists
working in this field warn of a need for epidemiological
surveillance of new hepatitis B mutants (The Lancet Interactive 4
March 2000).
Economics
Budget blues: In the area of health, the
biggest economic boost (an increase of Rs. 600 crore) in this
years national budget was to family welfare, to translate into
action the plans in the newly announced population policy. The
pulse polio program was not ignored and was granted Rs. 46 crore.
An attempt is being made to promote the Indian system of medicine,
to standardize it’s drugs, modernize it’s college and improve
quality control of laboratories and formulation, by doubling it’s
budget to Rs. 100 crore. Tuberculosis and AIDS control is
emphasized in this budget though the grants for malaria have gone
down. A national illness assistance fund for hospital expenses of
the poor is also in the pipeline. In a budget where the most
massive increase is for defence, the health of the people is low
down in the priorities (The Times of India 2 March 2000).
Public Health
A time to act: Alarm bells should be
ringing in the corridors of the Ministries of Health and Family
Welfare. For the first time after several years of progressive
decline, infant mortality rates in several states in India has
shown a rise. The data for 1998 was recently released from the
Sample Registration System from the Registrar General’s office.
The national IMR was 72/1000 live birth in 1996, 71 in 1997 and
again 72 in 1998. The worst news is from Kerala where it has risen
from a low of 12 in 1997 to 16 in 1998. Karnataka, Andhra Pradesh,
Assam, Gujarat, Haryana, Madhya Pradesh, Maharashtra, Himachal
Pradesh, Orissa and Punjab are other states where this dangerous
trend is being copied (The Times of India 6 March 2000).
Gouri Rao Passi,
Consultant, Pediatrics,
Department of Pediatrics,
Choithram Hospital and Research Center,
Indore, India.
E-mail: [email protected]
|
Pedscapes
|
|
Kids Health at
AMA - www.ama-assn.org/insight/h_focus/nemours/index.htm.
The Kids Health at the AMA was developed by the
American Medical Association and the Nemours
Foundation, and is one of the reliable sources of
children’s health information. This site is well
designed with ease of navigation. Though mainly
meant for parents and care-givers, pediatricians
would find this site of use for parent education.
This site contains sections on child development
where milestones and infant and child nutrition are
clearly explained. The other sections include
material on common childhood illnesses, emergencies
and first aid, safety and accident prevention and
child behavior.
National
Attention Deficit Disorder Association (USA) -
www.add.org/
This site provides information on research,
treatment, and legal issues in Attention Deficit
Disorder (ADD). It includes an extensive
bibliography on ADD and a listing of support groups.
Material for professionals includes guidelines for
management of ADD, family issues, legal issues and
schooling in ADD. There are pages devoted to kids
and teens with ADD. Links to ADD resources on the
internet are also listed.
British
Pediatric Surveillance Unit -
http://bpsu.rcpch.ac.uk.
This site, a part of Royal College of Pediatrics and
Child Health of UK contains information about
uncommon and new childhood diseases. Details about
ongoing and past research on uncommon diseases are
given here. In addition their newsletter is also
accessible from this site. Though the website’s
design is not flashy, it is easy to peruse, and a
site of this calibre should raise the profile of the
organization within the medical community.
Internet
Resources for Special Children - www.irsc.org/
The IRSC web site is dedicated to communicating
information relating to the needs of children with
disabilities on a global basis in order to enhance
public awareness and knowledge on children with
disabilities.
Publist
- www.publist.com/indexes/health.html.
This site is one of the most exhaustive listing of
medical and other scientific journals. It contains
useful information for doctors hoping to get papers
published. It lists publications (both conventional
print and online) and provides data about the names
of the journals, editors, contact details, etc.
Over 15000 medical titles are listed, conveninently
divided into specialities, and there is an in-house
search engine. Information about 15,000 scientific
journals can be accessed from their home page - www.publist.com.
Genetics
Education Center - www.kumc.edu/gec/
The Genetic Web Site at the University of Kansas
Medical Center contains a variety of clinical,
research and educational resources on genetics. The
site consists of three main home pages which are
linked: Information for Genetic Professionals -
www.kumc.edu/gec/geneinfo.html.
For genetic counselors, clinical geneticists, and
medical geneticists; Genetic Conditions and
Support Groups - www.kumc.edu/gec/support/
For individuals and families with genetic conditions
or birth defects, genetic counselors, clinical
geneticists, and medical geneticists; and Genetic
Educational Information - www.kumc.edu/gec/ For
science teachers.
Birth
defects Foundation -
www.birthdefects.
org/MAIN.HTM. The Association of Birth
Defect Children (ABDC) is a charitable organization
that provides information, written materials,
special reports and newsletters to parents and
professionals about all kinds of birth defects,
resources, support groups and environ-mental
exposures that may cause birth defects. ABDC also
sponsors the National Birth Defect Registry which is
an independent research and birth defect prevention
project. Their website has a download access section
with information on the most frequently reported
birth defects, environmental exposures and special
research reports.
American
Academy of Child and Adolescent Psychiatry (AACAP) -
www.aacap.org.
The website of this organization includes
summaries of the AACAP practice parameters, and the
full text of over fifty "Facts for
Families," fact sheets that provide concise and
up-to-date information on issues that affect
children, teenagers, and their families. The
abstracts and table of contents from Journal of the
American Academy of Child and Adolescent Psychiatry
are also available from this site - www.aacap.org/journal/journal.htm.
Note:
These
websites have been verified on 10th, March 2000. In
case of any change in the URL’s, readers are
requested to check the online version or contact the
author.
C.
Vidyashankar,
Department of Pediatrics,
Base Hospital, Delhi Cantonment.
Delhi 110 010, India
E-mail: [email protected].
|
|
|
