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Drug-resistant tuberculosisa a 'blinking red' global threat – Times Now

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Tuberculosis is now the world’s most deadly infectious disease&nbsp | &nbspPhoto Credit:&nbspGetty Images

Deadly, drug-resistant tuberculosis — as lethal as Ebola and tough to treat in even the best hospitals — is a “blinking red” worldwide threat, the head of a global health fund warned in an interview with AFP.

The Global Fund to Fight AIDS, Tuberculosis and Malaria is on a mission to eradicate the three epidemics and plans to spend around $12 billion on it over the next three years.

“We should all be more worried about multidrug-resistant TB than we are. It gets nothing like the level of attention it should do,” Peter Sands, Global Fund’s head, told AFP during a visit to New Delhi.

Tuberculosis has become resistant to antimicrobials in an estimated 600,000 cases worldwide.

The disease “does not obey borders or need visas, nor pay attention to how wealthy you are. At the moment, about 25 per cent of those 600,000 cases are being diagnosed and treated”, said Sands, who became head of the organisation last year.

“If you look across the threats to global health security, this is one where the light should be blinking red.”

The UN has set the goal of eradicating AIDS, malaria and tuberculosis epidemics by 2030. 

“The blunt truth is that we are not on track for that ambition,” Sands said.

Earlier this week, US President Donald Trump called for a concerted push to end his country’s AIDS epidemic within 10 years, though he did not say how much money would be ploughed into the effort.

Sands said on Wednesday that despite his grave assessment of the risks ahead, significant progress has been made in the battle against the three epidemics.

The number of deaths caused by AIDS and malaria has decreased by about half since the start of the century, he said.

Tuberculosis — now the world’s most deadly infectious disease, killing some 1.3 million people each year (not including HIV co-infections) — caused about 20 per cent fewer deaths in 2016 than in 2000.

However, the 57-year-old said: “If you compare the trajectory in terms of new infections and deaths against what we need to do, we need to step up the fight.”

As health authorities slacken the pace, new variations of drug-resistant diseases are turning up, threatening progress already made and triggering a resurgence.

Soft drinks and medication

Global Fund was set up in 2002 as a partnership between the authorities, civil society, the private sector and patients. It aims to raise $14 billion from 2020-2022 — $1.8 billion more than the amount it brought in over the 2017-2019 period. Other non-profits have criticised the fund’s budget target as not being ambitious enough to achieve its goals.

Global Fund has a distinctive way of working — it builds partnerships with private companies that extend beyond financial donations, notably in sub-Saharan Africa where the organisation makes two-thirds of its investments.

The multinational Unilever uses the reputation of its brand of hygienic products, Dove, to work to prevent HIV in South Africa among those most vulnerable to the virus — teenagers and young women — through a school programme.

In several African nations, Global Fund also teams up with Coca Cola, tapping into the country’s distribution networks to deliver medicines to isolated clinics. 

“In the most remote parts of the most countries, you can get a Coca-Cola,” Sands said, adding his organisation can use “their trucks, their supply chain logistics, to help us get medicine to the places where people are who need them.”

The link-up is uncommon in the aid sector and regarded with some suspicion.

“I don’t think partnering with the private sector comes naturally to all the actors in the global health world. There is a fair amount of sort of distrust and misunderstanding” between the two, said Sands, who earlier headed Britain’s Standard Chartered bank.

A meeting will be held in the Indian capital on Friday to prepare for Global Fund’s next three-yearly conference — to take place in Lyon next October.

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How Kourtney Kardashian Became Known For Kooky Health Advice – Refinery29

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The 40-year-old Kardashian sister is known for living a strictly organic, gluten-free, non- GMO, vegan, dairy-free, ketognic, existence. While there are some funny vintage Keeping Up With The Kardashians clips of Kourtney working out casually or shaking a giant plastic salad container, her full-on wellness obsession began around the time that she had Mason. “I feel like once I had Mason, I just became more aware,” she told Refinery29 in 2016. “And then once you learn information, you can’t really make it go away.”

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DOH issues health tips for devotees going on Visita Iglesia – INQUIRER.net

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Young pilgrims pray before the altar of a Catholic church in Lumban, one of their Visita Iglesia (church visits) stops in Laguna province. VAUGHN ALVIAR

MANILA, Philippines — The Department of Health (DOH) issued on Thursday health tips for people who will visit churches during the Holy Week.

In a Facebook post, the DOH advised devotees to bring umbrellas, wear comfortable clothes, and to drink enough water.

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Below are the Health department’s tips for Holy Week observers. /cbb

DOH issues health tips for devotees going on Visita Iglesia

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Tips for better bowel control – Harvard Health – Harvard Health

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Try simple measures first, like using a fiber supplement and treating underlying conditions.

Nobody wants to talk about or even imagine it. But loss of bowel control — known as fecal incontinence — is a problem for millions of adults in the United States, especially women.

“It becomes more common with age. It’s socially isolating and takes away your dignity. You live in fear that you have stool in your pants and people can smell it. Some people won’t even tell their doctors about it,” says Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital.

Symptoms and causes

Feces can leak out of the rectum accidentally — in liquid form or as solid stool — for a number of reasons. One is that age tends to weaken muscles, including the anal sphincter (the muscle that holds in feces until you’re ready for a bowel movement).

Damage to nerves or muscles can also lead to fecal incontinence. You may experience damage from rectal surgery, inflammatory bowel disease, multiple sclerosis, stroke, childbirth, or diabetes, for example.

Fecal incontinence can be an effect of chronic diarrhea from conditions such as irritable bowel disease. Impacted stool due to constipation can also cause fecal incontinence.

And sometimes, fecal incontinence is the result of an attempt to thwart constipation. “Older people frequently take laxatives and stool softeners because they’re worried about constipation. That creates loose stool. If age has weakened the muscles of the anal sphincter, fecal incontinence can occur,” says explains Dr. Jennifer Irani, a gastrointestinal surgeon with Harvard-affiliated Brigham and Women’s Hospital.

Try this at home

Both experts suggest trying simple fixes for fecal incontinence before seeking treatment from a doctor.

You can cut back on stool softeners and laxatives, if those are causing the problem. Or you can bulk up your stool (so it’s easier to hold on to) with an over-the-counter fiber capsule or a powder that you can add to a drink or food. Examples include Metamucil, Citrucel, FiberCon or Benefiber.

“Fiber won’t constipate you,” Dr. Irani says. “The rectum is smart and can sense bulkiness. When you have more sensation, you have more time to get to the bathroom,” she says.

You can also try bulking your stool with dietary fiber. Legumes such as beans and lentils are a go-to source. For example, a cup of canned low-sodium black beans has about 17 grams of fiber. A cup of cooked lentils has about 16 grams of fiber.

Taking a nonprescription antidiarrheal medication such as loperamide (Imodium) can work if you have incontinence with diarrhea. “It’s okay to take it every day under supervision, but it won’t work if you have a weakened sphincter,” Dr. Staller points out.

Pelvic floor exercises (Kegel exercises) may also help reduce fecal incontinence. These involve contracting (squeezing) the anal sphincter several times per day or whenever you feel fullness in the rectum. “Pelvic floor physical therapy will help, but it won’t always solve the problem. Also, you have to do the exercises every day or it doesn’t work,” Dr. Irani notes.

Pads that you tuck into your underwear or adult diapers can offer security when you have fecal incontinence. But pads and diapers can irritate the skin, as can a bowel movement that’s been near your skin for too long. Using a barrier cream such as zinc oxide can help protect the skin.

Dietary fiber linked to a lower risk for fecal incontinence

When fecal incontinence strikes, increasing your dietary fiber with foods like legumes can help get you back to normal. And a Harvard-led study published last September in Gastroenterology suggests that eating a high-fiber diet over the long term is associated with a lower risk for developing fecal incontinence in older women.

Researchers looked at questionnaire responses from more than 58,000 women who were followed for more than 20 years. Women in the study who ate the most fiber (25 grams per day) had an 18% lower risk for fecal incontinence, compared with women who ate the least amount of fiber (13.5 grams per day). The study is observational and doesn’t prove that eating fiber prevents fecal incontinence. But it’s reasonable that it should. “There are so many reasons why fiber can be helpful. It may help ward off heart disease and diabetes. A reduced risk for fecal incontinence adds another potential benefit,” says Dr. Kyle Staller, the lead author of the study and a gastroenterologist at Harvard-affiliated Massachusetts General Hospital.

Formal diagnosis

When simple fixes aren’t making a difference, it may be time to see your primary care physician or a specialist. You can expect a specialist to take a full medical history and conduct a digital rectal exam (feeling the inside of the anus with a gloved finger to assess how tight the anal sphincter is).

Further testing to look for damage to the anal canal, sphincter, or lower colon may include

  • anoscopy (insertion of a small, short scope into the anal canal)

  • sigmoidoscopy (insertion of a flexible viewing tube to examine the sigmoid or lower colon)

  • anal ultrasound (using sound waves to look at the sphincter structure)

  • anal manometry (insertion of a catheter and balloon to measure anal sphincter strength).

Treatment

Often, treatment of an underlying bowel condition, such as impacted stool or chronic diarrhea, solves the problem. “It’s much easier to fix a bowel disturbance than it is to tighten up the sphincter,” Dr. Staller says.

Beyond that, there are only a few treatment options for older adults whose fecal incontinence does not respond to simple measures.

One option is called sacral nerve stimulation. “It’s like a pacemaker for your anus,” Dr. Irani explains. “We implant wires into the sacral nerve in the spine to stimulate the sphincter muscle to contract. What’s key is that it will only work if incontinence involves solid stool, not liquid stool. Also, you have to be able to operate an external device and participate in your care.”

The other option is surgery to create a colostomy, bringing the end of the large intestine through a special opening in the abdomen so that it drains into an attached bag. “People rarely choose this option. They’d rather wear an adult diaper. But people who choose surgery seem to get their freedom back. They just empty the bag when it gets full,” Dr. Irani says. “Colostomy is especially helpful for people who are in a wheelchair and can’t get to the bathroom frequently,” Dr. Staller adds.

A ray of hope

Most people don’t have to resort to drastic measures like surgery. Bulking stool through diet or with fiber powders usually solves or greatly reduces the problem. But if that’s not working for you, don’t suffer in silence. Your doctor may be able to help.

“Just talking about it with someone who knows what you’re going through is a real benefit,” Dr. Staller says. “You may not be able to get rid of fecal incontinence, but you may be able to eliminate 50% of the episodes and many of the accidents you have. And we know that even one accident feels like it’s too many.”

Image: © GregorBister/Getty Images

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As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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