Marasmus: Causes, Symptoms, and Treatment

Malnutrition is a condition in which a lack of nutrients in the body causes health problems. This is most often the result of a very poor diet that doesn't contain all the vitamins and nutrients needed for the body to function properly. Marasmus is one form of malnutrition.

When a person doesn't get the right nutrients, their bodies __have difficulty going through normal motions like growing or fighting disease. These difficulties can then lead to more serious health problems.

Contents of this article:

1. What is marasmus?
2. Other forms of severe malnutrition
3. Treatment of marasmus
4. Prevention of marasmus

What is marasmus?

Marasmus is a severe form of protein-energy malnutrition caused by a shortage of protein and calories in the body. Without these vital nutrients, the body becomes dangerously low in energy and important functions begin to stop.

Around 20 million children under the age of 5 __have severe forms of malnutrition.

Both adults and children can be affected by marasmus, but young children in developing countries are affected most often.

It is estimated that 20 million children under the age of five have severe forms of malnutrition like marasmus at some point in their lives, according to UNICEF. About 500,000 to 2 million children die as a result of it.

Marasmus is not always a direct result of a lack of nutrients. It can also be caused by the wrong nutrients, or an inability to absorb or process nutrients properly because of infection.

One study suggests that there are four main causes that lead to marasmus:

1. Improper feeding
2. Infection, such as syphilis or tuberculosis
3. Congenital weakness of disease, such as congenital heart disease
4. Very poor sanitary and hygienic conditions that spread disease

Marasmus is also referred to as wasting. It is most often identified by the affected person's physical appearance, which becomes skeletally thin. The loss of body fat and muscle tissue leads to a withered appearance, often described as looking like "skin and bones."

Other symptoms of marasmus include:

• Thin face
• Ribs and shoulders clearly visible through the skin
• Very loose skin that sometimes hangs in folds in the upper arms, thighs, and buttocks
• Persistent dizziness
• Sunken eyes
• Diarrhea
• Active, alert, or irritable behavior
• Frequent dehydration
• Frequent infections that don't show external signs like fever or lesions

Other forms of severe malnutrition

Marasmus is not the only form of severe malnutrition.

Kwashiorkor

Kwashiorkor is another very severe form of protein-energy malnutrition. Very serious cases of marasmus can lead to kwashiorkor. The main difference between the two is that kwashiorkor causes the affected person's body to hold large amounts of fluid in places like the lower legs, feet, arms, hands, and face.

Unlike marasmus, someone affected by kwashiorkor may look like they are of a healthy body weight, or even plump. They may not lose weight, but this is because the fluid buildup is making up for the loss in body fat and muscle tissue.

Dermatosis is one of the symptoms of kwashiorkor.

Other symptoms of kwashiorkor include:

• Loss of appetite
• Lack of energy
• Irritability
• Changes in hair color to yellow or orange
• Dermatosis - a condition in which patches of skin turn abnormally light or dark, the skin sheds, skin ulcers develop, and lesions begin to leak or bleed

It's critical that kwashiorkor is diagnosed and treated immediately. It is even more life-threatening than marasmus and can lead to death quickly.

Marasmic-kwashiorkor

Marasmic-kwashiorkor is the third form of protein-energy malnutrition. Those affected by this condition experience a combination of marasmus and kwashiorkor. As such, they will show symptoms of both conditions as well.

For example, someone with marasmic-kwashiorkor may:

• Be extremely thin and show signs of wasting
• have excessive fluid buildup in other parts of their body
• Be severely dehydrated

Like with kwashiorkor, it is extremely important that someone showing marasmic-kwashiorkor receives immediate medical treatment. It is more difficult to recover as time goes on, and they face a high risk of death as the condition worsens.

Treatment of marasmus

Marasmus is life-threatening medical emergency, so it's very important to treat it at the onset of symptoms. Other forms of malnutrition may look different but are just as dangerous if left untreated.

Although severe malnutrition is uncommon among children in developed countries, it's important to look out for symptoms that may signal malnourishment. Rapid weight loss, infections, and sudden changes in behavior or appetite could be signs of a bigger problem.

It's a good idea to visit a doctor right away if someone notices any of these symptoms. The longer marasmus goes untreated, the less chance there is of a full recovery.

Research suggests that successfully treating marasmus depends on four factors:

1. The patient's age - the younger the patient, the greater chance of death
2. How much body weight the patient has lost
3. The nutritional treatment given
4. The ability of the patient to resist infection

In order to treat marasmus, a treatment plan must be set up by medical professionals if possible.

A rich, carbohydrate-filled diet is a good form of treatment, but full recovery can still take months.

There is great difficulty in treating marasmus because the patient needs significantly more calories than a normally nourished person their age. Because their body has lost its fat supply and most of the tissue has been starved, their body no longer has the ability to digest or tolerate a normal amount of food on their own, let alone enough to bring them back to health.

As a result, feeding is usually done in small amounts and through tubes to the veins and stomach. These tubes allow for food and fluid to be delivered quickly and directly to the body.

A diet treatment rich in nutrients, carbohydrates, and calories is very important. It can still take months for a full recovery, even with the right treatment plan.

The complications linked with marasmus such as infections and dehydration must also be treated and prevented to help the patient regain their health.

Prevention of marasmus

The best way to prevent marasmus is to have a well-balanced diet. Foods rich in protein like skimmed milk, fish, eggs, and nuts are important for energy and growth. Vegetables and fruits are important for providing other nutrients and minerals and for preventing malnutrition in general.

Ensuring that complications like dehydration and diarrhea don't reoccur for those who have been malnourished before or affected by marasmus are very important.

Good sanitation and hygiene also play a big role in spreading disease for people in developing countries. Poor sanitation and hygiene can lead to infections that may take a toll on someone who is already close to malnutrition.

Cooking foods at high heat to destroy bacteria can help, as can freezing food and reheating it before eating. Boiling water before drinking, cooking, or bathing in areas where clean water is difficult to access is important to prevent spreading waterborne diseases.

New mothers can also help prevent malnourishment in their newborns by breastfeeding as much as possible.

Written by Foram Mehta

Depression After Abortion: Understanding and Coping

There is some controversy about depression after abortion, and not just in the medical profession. It is not clear that abortion depression is a specific condition, although it is clear that women do __have emotional responses to abortion.

Depression itself is a well-recognized medical condition. But can depression be caused by abortion?

There is only limited research into the psychological effects of abortion. A lot of the research has been complicated by technical problems such as not being able to control for other factors that could be behind a case of depression, rather than the abortion itself.

The experience of abortion is different for each woman and varies widely. Feelings after an abortion can be mixed. Women may __have both positive and negative feelings.

In general, abortion may be followed by feelings of sadness, grief, loss or regret. If these feelings do occur and are severe enough, or last for long enough, they may amount to depression.

Contents of this article:

1. First feelings about abortion
2. What is depression?
3. Treatment of depression

First feelings about abortion

Abortion can be a stressful life event for some women who choose to terminate their pregnancy.

The pregnancy in the first place may be a source of stress itself. It may have been an unwanted pregnancy or linked with other problems.

Following an abortion, women can have unexpected reactions and emotions. The topic can be difficult to talk about for cultural and religious reasons. Some women may feel greater guilt and emotional distress because of religious influences that create stigma around abortion.

Abortion may be followed by feelings of sadness, grief, loss, or regret.

Many of the psychological and emotional responses to abortion are normal. Most should not be persistent or severe enough to badly affect a woman's daily life, and should go away.

The range of typical feelings experienced with abortion might include:

• Grief, a sense of loss
• Guilt
• Remorse or regret
• Stress, reduced ability to cope
• Loss of self-esteem
• Relief, reduced anxiety

Not all women have negative emotional responses to abortion. Most who do will not have any lasting mental health problems.

Many women have positive responses to abortion, including feelings of relief. Some women feel no regret, instead having a sense of confidence about having made "the right choice."

What is depression?

Depression is a psychological or mental health condition. It is a mood disorder.

People with depression may have these signs and symptoms:

• Feeling low or sad
• Reduced thinking abilities
• Poor concentration, and difficulty making decisions
• Guilt
• Feeling irritable
• Lack of energy, tiredness
• Loss of interest in sex
• Loss of interest in activities that were previously enjoyed
• Disturbed sleep patterns

Depression comes with different levels of severity. People with mild depression are able to carry on with their usual daily activities.

Severe depression affects life so badly that it may prove difficult to work. Severe depression can also lead to more serious mental health symptoms such as psychosis.

Suicidal feelings or self-harm are serious symptoms that need urgent help.

Depression does not cause physical changes, although people who are depressed may talk more slowly.

The effects of depression on levels of interest can also have a secondary effect. Depression that causes loss of interest in food may lead to weight loss.

Depression, or grief about abortion?

Grief after the death of a partner, for example, is a natural reaction that should not lead to long-term depression.

Grief has the symptoms of depression but is clearly related to the loss.

Feelings of loss are also natural after the unplanned termination of a pregnancy, such as caused by illness or injury. These symptoms in response to spontaneous abortion should also not be lasting.

Even when a woman has chosen to terminate her pregnancy with an abortion, there can still be natural feelings of loss, sadness, grief, guilt, and regret afterward.

Some women may have been greatly influenced by people around them when making their decision. Feelings that are similar to symptoms of depression should normally improve.

Spontaneous abortion

An aborted pregnancy can be spontaneous. This means an abortion that has not been chosen by the woman but has been caused by illness or injury. Problems with the placenta, for example, can cause loss of pregnancy.

Other terms used for spontaneous abortion are stillbirth and miscarriage. Stillbirth generally refers to loss of later pregnancies, while miscarriage means termination happening in the first 24 weeks.

Depression risk factors

Women who have a mental disorder before having an unwanted pregnancy and then an abortion may experience the event differently than mentally healthy women. They may be more at risk, but the scientific evidence is not strong that there are particular depression risk factors related to abortion itself.

There is a higher risk of depression if the woman has a history of alcohol or drug abuse.

Women who already have a psychiatric disorder may be more likely than others to experience feelings of doubt before having an abortion. They are more likely to rate the experience of an abortion as having been an emotional burden, too.

The American Psychological Association Task Force on Mental Health and Abortion found in 2008 that some women are at a higher risk of depression. This higher risk was the same for women who opted for abortion as for the range of other pregnancy outcomes. The risk factors included:

• Poverty
• History of violence or emotional problems
• History of drug or alcohol use
• Previous unwanted childbirth

More general risk factors behind depression beyond any specific effects that might result from pregnancy and abortion are not well understood. The exact causes of depression are not known.

A higher risk of depression is linked to genetics. People with a first-degree relative who have depression are more likely to have it themselves, too.

Life events can trigger episodes of depression, but these are usually temporary. It is not clear why some people are triggered into lasting, more severe depression. Major life stresses include separation and loss.

Other risk factors are a poorer ability to cope with life's pressures, being female, and having more exposure to things that cause stress daily.

What is post-abortion stress syndrome?

Post-abortion stress syndrome (PASS or PAS) is a controversial name. Neither psychologists nor psychiatrists agree that the term should be used.

The term might have been created by groups who are against abortion. Scientists have also used the phrase, but in relation to poorly designed research.

The features allotted to PASS have been compared to those of PTSD (posttraumatic stress disorder).

Talking therapy is a great way to treat depression.

It may be more appropriate to consider that some women might develop a form of PTSD following the trauma of an abortion, but such a level of distress is very rare.

The consensus, including from the American Psychological Association, is that the risk of mental ill health following abortion is no worse than following a decision to continue a pregnancy. Many agree that there is no reliable research to show that PASS exists.

One study following 500 women from birth until the age of 30 years found that mental health after abortion was slightly worse than for other courses of pregnancy. The effect was small, however, and would not amount to a trauma-related syndrome.

Treatment of depression

Depression is a treatable mental health condition. Three broad options are used to treat depression:

• Support
• Talking therapy
• Drugs

A mild case of depression may benefit from the support of a doctor in the form of monitoring. The symptoms may clear up on their own, and later follow-ups with the doctor can confirm this.

Talking therapies are available for all severities of depression. These include talking to a trained psychologist for psychotherapy or cognitive behavioral therapy (CBT). CBT helps the person to understand their thoughts and how they respond to them.

Counseling may also be available with non-specialist counselors or through group activities.

Talking to someone about abortion may be helpful. Healthcare providers often offer someone to talk to after an abortion as well as leading up to the decision.

Drug options for depression are numerous. There are dozens of antidepressant drugs that may be tried with the help of a doctor. These are usually used for moderate or severe cases of depression.

Having depression can be a long-term problem. Living with the disorder and recovering from it may be helped by improving diet and taking exercise.

More physical activity can lift mood and has wider health benefits. It may also prove to be a good way to get away from depressing, worrying, or stressful thoughts, and to make new social contacts.

Other options for coping with depression include activities such as yoga and mindful meditation.

Written by Markus MacGill

Sauna: What are the Health Benefits?

Saunas __have been used for hundreds of years and still continue to be popular today. Many people enjoy sitting in a sauna to unwind and relax.

Spending time in a sauna can feel good, and there may be additional health benefits to be had beyond relaxation.

Contents of this article:

1. What is a sauna?
2. Potential health benefits of using a sauna
3. Health risks and precautions
4. Health myths about saunas, hot tubs, and steam rooms

What is a sauna?

Many people enjoy relaxing and unwinding in a sauna.

A sauna is typically a room heated to between 70 to 100°C. Traditional Finnish saunas usually involve dry heat.

The relative humidity is often between 10 and 20 percent, but there are also sauna types where moisture is higher. Turkish-style saunas involve a greater level of humidity, for example.

Sauna use can raise the skin temperature to roughly 40°C. As the skin temperature rises, heavy sweating also occurs. The heart rate soars as the body attempts to keep cool. It is not uncommon to lose about a pint of sweat while spending a short time in a sauna.

Types of saunas

There are several types of saunas based on how the room is heated. These types include the following:

• Wood burning: Wood is used to heat the sauna room and sauna rocks. Wood-burning saunas are usually low in humidity and high in temperature.
• Electrically heated: Similar to wood-burning saunas, electrically-heated saunas __have high temperatures and low humidity. They use an electrical heater, which is attached to the floor to heat the sauna room.
• Infrared room: Infrared saunas are different to wood-burning and electrically-heated saunas. Special lamps use light waves heat a person's body, not the entire room. The sauna room still gets warm, but temperatures are typically lower than other saunas. Usually, infrared saunas are about 60°C.
• Steam room: Steam rooms are not traditional saunas but are still sometimes referred to as a sauna because of similar effects. Instead of using dry heat, a steam room involves high humidity and moist heat.

Potential health benefits of using a sauna

Regardless of how a sauna is heated or the humidity level, the effects on the body are similar. When a person sits in a sauna, their heart rate increases and blood vessels widen. This increases circulation.

The effects on the body from sauna use may have some potential health benefits. Increased circulation may help reduce muscle soreness, improve joint movement, and ease arthritis pain. The heat in a sauna may also promote relaxation, which can improve feelings of well-being.

A potential health benefit from sauna use may be a reduced risk of death from cardiovascular disease. One study conducted in Finland followed 2,315 men ages 42 to 60 over the course of 20 years.

Of these participants, a total of 929 died from cardiac disease, coronary artery disease, or sudden cardiac death. Participants were also categorized by how often they used a sauna, including once a week, two to three times a week, and four to seven times a week.

Steam rooms involve high humidity and moist heat as opposed to the dry heat of traditional Finnish saunas.

After the researchers had adjusted for cardiovascular risk factors, increased sauna use was linked with a reduced risk of fatal cardiovascular-related diseases.

Participants who used the sauna two to three times a week experienced sudden cardiac death 22 percent less than those who only used it once a week.

The results were even greater for men who used a sauna more often. Those who used a sauna four or more times a week experienced sudden cardiac death 63 percent less often than those who only used a sauna once a week.

The idea is that sitting in a sauna may have cardiovascular effects similar to moderate exercise. Heart rate may increase to 150 beats a minute while using a sauna. When heart rate increases, it pumps more blood to the body. Circulation increases in a similar way to the effects of exercise.

Another theory is that sauna use may improve the function of cells in the heart. Cells that line the arteries play a role in the amount of blood that flows to the heart. Improving the function of these cells may also boost heart function.

The effects of lowering stress levels when using a sauna more may also help reduce cardiovascular events. The bottom line is that when it comes to the cardiovascular effects, more research is needed to find out if there is a definite link between sauna use and a decrease in deaths from heart disease.

While studies may be promising, sauna use should not replace an exercise program to keep the heart healthy. There is more evidence to support the benefits of regular exercise.

Health risks and precautions

It is vital to drink plenty of water after using a sauna.

According to the American Heart Association, sauna use in moderation appears to be safe for most people. Switching between the heat of a sauna and cold water in a swimming pool is not advisable, however, as it can raise blood pressure.

Since sauna use may cause a drop in blood pressure, people with low blood pressure should talk with their doctor to make sure sauna use is safe. People who have recently had a heart attack should also talk to their doctor before using a sauna.

One of the biggest risks of spending time in a sauna is dehydration due to fluid loss from sweating. People with certain conditions, such as kidney disease, may be at a higher risk of dehydration. The increased temperatures can also lead to dizziness and nausea in some people.

Steps that should be taken to avoid any negative health effects include the following:

• Avoid drinking alcohol: Alcohol can increase the risks of dehydration since it causes the body to lose more water through urinating more.
• Limit time spent in a sauna: Don't spend more than 20 minutes at a time in a sauna. People who have never used a sauna should consider limiting their time to about 5 to 10 minutes. As they get used to the heat, they can slowly increase the time to about 20 minutes.
• Drink plenty of water: Regardless of the type of sauna a person uses, it's important to replace the fluids lost from sweating. People spending time in a sauna should drink about two to four glasses of water after using a sauna.
• Avoid sauna use if ill: People who are ill should also wait until they recover before using a sauna. Women who are pregnant or those with certain medical conditions, such as low blood pressure, should ask their doctor before sauna use.

Health myths about saunas, hot tubs, and steam rooms

Although there may be some potential health benefits to spending time in a sauna, there are also a few myths. One myth involving sauna use is that sweating can remove toxins from the body.

It's true that sweating occurs during sauna use, but there is no scientific research that proves sweating detoxifies the body. Sweat is not made up of toxins, however. Toxins such as alcohol, mercury, and aluminum are mainly removed by the kidneys, liver, and intestines.

Another myth about the use of sauna is that it leads to weight loss. It is possible to lose about a pound after using a sauna, but weight loss is due to fluid loss, not fat. The weight will be replaced as soon as a person eats or drinks something.

Written by MaryAnn de Pietro

Cancer and Genetics: What's the Connection?

Genes control the way cells work, and in particular how they grow and divide. When something goes wrong with one or more of the genes in a cell, changes occur that can lead to cancer.

Such changes are commonly referred to as faults or mutations. Although cancer is mainly the result of life choices and not related to family gene pools, it can also be caused by these faults or mutations.

As a result, cancer can be inherited from parents and grandparents and passed on to future generations.

Contents of this article:

1. How do genetic changes lead to cancer?
2. What forms of cancer are hereditary?
3. Genetic testing for cancer

How do genetic changes lead to cancer?

A higher risk of some forms of cancer can be inherited from parents and grandparents.

A cell must typically contain six or more faults to become cancerous. Such faults can cause the cell to stop functioning normally, become cancerous, and grow and divide uncontrollably.

This may happen as people get older as a result of random mistakes when a cell is dividing. Changes can also occur due to exposure to substances that can cause cancer called carcinogens. These include cigarette smoke or sunlight.

Though potentially cancerous, these gene changes don't affect all body cells, are not inherited, and cannot be passed on to children.

Cancer is such a common disease that many families __have several members who __have had cancer. Certain types of cancer seem to run in some families, but only a small portion of all cancers are inherited.

How is cancer risk passed on?

Faulty genes that increase the risk of cancer can be passed on from parent to child. Such genes are called inherited cancer genes. They occur when there is a mistake or a fault in the genes contained in an egg or sperm cell.

Genes that increase the risk of cancer are known as cancer susceptibility genes. Their normal job is to correct DNA damage that naturally occurs when cells divide, protecting people against cancer.

Inheriting a faulty copy of one these genes means that it is unable to repair damaged DNA in cells. As a consequence, the cells may become cancerous.

People inherit genes from both parents. If a gene fault occurs in each parent, a child has a 1 in 2 chance of inheriting it. While some children will have the faulty gene and an increased risk of developing cancer, others won't.

What forms of cancer are hereditary?

Cancers caused by inherited faulty genes are much less common than cancers caused by gene changes due to aging or other factors.

Most cancers develop through a combination of chance and the environment rather than inheriting a specific cancer gene. However, about 5 to 10 percent of all cancer cases occur in people who have inherited genetic mutations that raise the risk of cancer.

Mutations and syndromes that can increase the risk of cancer include:

• BRCA1 and BRCA2 genetic mutations - raised risk of breast, ovarian, and prostate cancer
• Cowden syndrome - raised risk of developing breast, uterine, and thyroid cancer
• Familial adenomatous polyposis - raised risk of colorectal cancer, and soft tissue and brain tumors
• Li-Fraumeni syndrome - raised risk of developing many different types of cancer
• Lynch syndrome - raised risk of colorectal cancer, some skin cancers, and brain tumors
• Multiple endocrine neoplasia - raised risk of endocrine cancers
• Von Hippel-Lindau disease - raised risk of kidney and other cancers

Genetic testing for cancer

Tests are currently available for gene faults that increase the risk of breast, bowel, ovarian, womb, and prostate cancer. Tests are also available for rare gene faults that can increase the risk of kidney, skin, and thyroid cancer, and even a type of eye cancer called retinoblastoma.

Tests are available for some rare gene faults that lead to certain types of cancer.

Tests are not presently available for other types of cancer genes. Research is always being conducted, however, with tests being developed for more and more gene faults.

Predictive genetic testing refers to the type of testing done on genes that increase the risk of cancer. They do not usually give precise answers about inherited diseases. The tests will only show if there is a specific gene mutation, not whether cancer is present.

A positive result means there is a raised risk of developing cancer but does not mean that cancer is present or will develop. For example, a particular gene mutation may be found through testing, but it might not be clear if this raises the risk of cancer.

In short, the test can show what might happen, but it cannot show what will happen. A negative result does not mean there is no risk of getting cancer. The risk can change over time due to non-genetic reasons, such lifestyle choices or simply getting older.

Genetic tests may be flawed, and test results can be interpreted wrongly. Although this is not common, different labs may have different ways of interpreting changes because genetic testing is not tightly regulated.

The makers of tests often advertise and promote their tests to doctors and the public. In doing so, they can make the test sound more helpful and decisive than it actually is. This can be misleading as decisions about testing may be made on incomplete or wrong information.

Reputable genetics counselors should, however, be able to help people know what to expect from test results.

Who should get genetic testing?

Genetic tests may be flawed, and results can be interpreted incorrectly.

If a person has a strong family history of cancer and the genetic specialist thinks they could have inherited a faulty gene, they will offer that person a genetic test.

According to Cancer Research UK, the following scenarios signal what is considered to be a strong family history of cancer:

• If more than two close relatives on the same side of the family have had cancer
• The relatives have had the same cancer or different cancers that can be caused by the same gene fault
• The cancers appeared when the relatives were below the age of 50
• One relative has had a gene fault found by genetic tests

What to do if you think you may have a hereditary risk of cancer

People are advised to talk to their family doctor if they think that they may have a strong family history of cancer. Specialists will ask about their family in order to determine how many members have been diagnosed with cancer. If they think that a person has an increased risk, they will refer them to a genetics clinic for testing.

According to the American Cancer Society, the most effective ways of reducing the risk of cancer are simple things, such as:

• Eating a healthy well-balanced diet
• Not smoking
• Exercising regularly
• Keeping to a healthy weight
• Staying safe in the sun

Written by Gareth Strachan

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Fox News In annual ritual, Delhi struggles with dengue, chikungunya

In this Tuesday, Sept. 27, 2016 photo, people wait to receive reports of their blood samples given to test mosquito-borne viral ailments, in Gurgaon, on the outskirts of New Delhi, India. The hospitals of New Delhi are crowded with patients writhing in pain as yet another round of mosquito-borne viral ailments sweep through this teeming city. It's a cycle that's played out every year after the monsoon rains __have filled puddles and open drains and the warm, damp weather is perfectly suited for swarms of mosquitoes. (AP Photo/Manish Swarup)  (Copyright 2016 The Associated Press. All rights reserved.)

NEW DELHI –  Poonam Devi moans in pain on the stretcher in the packed hospital emergency room, her ankles and wrists swollen, an IV hooked up to left arm to hydrate her.

Patients like her, fevered, aching, unable to walk or sit on their own, are packing hospitals across New Delhi because of chikungunya, a mosquito-borne viral illness. In the Indian capital alone, cases of chikungunya soared to 3,251 so far this year from just 64 last year, according to government data. Last year it was dengue, another viral ailment transmitted by mosquitoes, that infected thousands.

The cycle of illness and packed hospital "fever clinics" plays out every year as monsoon rains fill puddles and open drains in the teeming city, creating swarms of mosquitoes that thrive in the warm, damp weather.

Some years it's mainly dengue; in others, it's mostly chikungunya. The epidemics start promptly in August and stay for months, sickening tens of thousands and killing dozens, each year seeming to catch the government and population unprepared for it.

"Everyone in our neighborhood is getting it," said Devi's sister, Susheela, who goes by one name. She sat holding her sister's hand inside Ram Manohar Lohia Hospital, one of the city's largest government-run hospitals. A portion of the hospital's emergency room has been set aside for chikungunya patients like Devi.

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One day last week, Dr. Prerna Mor, who was supervising incoming patients at the hospital, had already seen nearly 300 patients with clinical symptoms of chikungunya in the first four hours of her shift. Mor, a fellow resident and a few nurses quickly assessed patients before other doctors took over.

Dengue and chikungunya __have killed at least 20 people in the capital so far this year, according to news reports. But statistics on the illnesses are likely conservative since the poorest people in this city of 16 million never see a doctor or a hospital. Both diseases are treated only for their symptoms, reducing the fever and relieving the aches, until the infection passes. As a result, tens of thousands of people are tested at private laboratories and treated at private clinics, which don't report on what made their patients sick unless the government specifically asks.

Just as predictable as the illnesses each year is the shifting of blame as soon as the public hears of the soaring number of cases. Each year the government goes into overdrive only after hundreds if not thousands have already been sickened.

This year is no different.

Stung by criticism that it has handled the outbreak so far very poorly, the local government has set up hundreds of clinics, like the one where Devi was diagnosed, to treat chikungunya, dengue and malaria patients. It has canceled all vacation for doctors and staff at government-run clinics and hospitals.

Hundreds of municipal workers rushed to trim knee-high grass in public parks and fog the city with anti-mosquito pesticides — after many had already gotten sick.

But experts say responsibility for controlling diseases spread by mosquitoes cannot be the government's alone. Officials conduct public-awareness advertising campaigns urging people to wear long sleeves, use mosquito repellent and get rid of standing water. But the advice is routinely ignored, even with municipal workers going from home to home in some neighborhoods on the lookout for mosquito breeding areas.

"There's no community participation here. People want the government to take the entire responsibility of keeping their neighborhoods clean," said Dr. A.K. Gadpayle, medical superintendent at Ram Manohar Lohia Hospital.

Without the communities coming together to ensure mosquitoes don't breed, "no government anywhere in the world can succeed," he added.

The annual outbreak comes as health experts and governments contemplate the potential for a global outbreak of another mosquito-borne illness, Zika. Like dengue and chikungunya, Zika is transmitted by the Aedes aegypti and Aedes albopictus mosquitoes.

A recent study published in medical journal Lancet says 2.6 billion people living in parts of Asia and Africa could be at risk of Zika infection, based on analysis of travel, climate and mosquito patterns in those regions.

But experts in India caution that the study may exaggerate the risks because the Zika virus has been around since the late 1940s and it's not clear if the virus had reached these countries sometime in the past, allowing people to build immunity.

Zika can cause fetal death and severe brain defects in the children of women infected during pregnancy. Yet the vast majority of people infected never get sick, and symptoms are mild for those who do, so surveillance systems may have missed cases.

No cases of Zika have been reported in India so far.

"In the times of rapid international travel, and international mass gatherings such as the FIFA World Cup and the Olympics, or religious gatherings like the hajj, there is always a potential threat of import of Zika infection," said Dr. Lalit Pant, an infectious diseases specialist at the Public Health Foundation of India.

But the country has facilities to test people for Zika if cases are reported, Pant added. "We know what to do. The challenge is how well can we do."

At Ram Manohar Lohia Hospital, Gadpayle isn't too concerned about Zika. He has his hands full with chikungunya this year.

Fox News Boy, 4, dies by suffocation at school

 (AsiaWire)

Staff at a nursery school in China are mourning the death of one of their children after the boy suffocated to death during his post-lunch nap.

Employees at Shuangqiao Mingzhu Kindergerten in East China’s Fujian Province found the boy, identified only by his surname, Lin, unconscious and not breathing one afternoon when naptime ended, AsiaWire (AWR) reported. At the hospital, doctors confirmed him dead.

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According to the school, the classroom’s quilts __have thin ropes attached to them to make the blankets easy to roll up and carry. The ropes were dangling above the boy when they somehow attached themselves to the boy’s neck as he slept on the lower of two platforms.

AWR reported the boy likely lost consciousness and died of asphyxiation shortly after.

The nursery school teacher claimed they were distracted by other students and didn’t pay attention to Lin. It is unknown whether the school has offered to compensate the family for their loss.
 

Fox News Identical girl triplets born in Poland are doing well

WARSAW, Poland –  A spokeswoman for a hospital in southwestern Poland says extremely rare identical girl triplets were born earlier this month through a cesarean section and are doing well.

Justyna Marcinska of the gynecology center in Opole said Thursday that the monozygotic sisters — Amelia, Laura and Olivia — were born Sept. 15 and can be told apart only by the wristbands with their names. On doctors' orders, they were delivered in the 32nd week of the high-risk pregnancy, and weighed some 1.5 kilograms (3 pounds, 5 ounces) each.

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Marcinska told The Associated Press the mother, Anna Pohler, and her daughters were doing fine and would be going home in three to four weeks when the girls were stronger and weighed over 2 kilograms (4 pounds, 6 ounces).

Monozygotic triplets are extremely rare, Marcinska said.

Fox News The cost of cheap drugs? Toxic Indian lake is 'superbug hotspot'

A boy prepares to jump off a rock into the waters of the Osman Sagar Lake near Hyderabad  (Copyright Reuters 2016)

HYDERABAD –  Centuries ago, Indian princes would bathe in the cool Kazhipally lake in Medak. Now, even the poorest villagers here in India's baking south point to the barren banks and frothy water and say they avoid going anywhere near it.

A short drive from the bustling tech hub of Hyderabad, Medak is the heart of India's antibiotics manufacturing business: a district of about 2.5 million that has become one of the world's largest suppliers of cheap drugs to most markets, including the United States.

But community activists, researchers and some drug company employees say the presence of more than 300 drug firms, combined with lax oversight and inadequate water treatment, has left lakes and rivers laced with antibiotics, making this a giant Petri dish for anti-microbial resistance.

"Resistant bacteria are breeding here and will affect the whole world," said Kishan Rao, a doctor and activist who has been working in Patancheru, a Medak industrial zone where many drug manufacturers __have bases, for more than two decades.

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Drugmakers in Medak, including large Indian firms Dr Reddy's Laboratories Ltd, Aurobindo Pharma Ltd and Hetero Drugs Ltd, and U.S. giant Mylan Inc, say they comply with local environmental rules and do not discharge effluent into waterways.

National and local government are divided on the scale of the problem.

While the Central Pollution Control Board (PCB) in New Delhi categorizes Medak's Patancheru area as "critically polluted", the state PCB says its own monitoring shows the situation has improved.

The rise of drug-resistant "superbugs" is a growing threat to modern medicine, with the emergence in the past year of infections resistant to even last-resort antibiotics.

In the United States alone, antibiotic-resistant bacteria cause 2 million serious infections and 23,000 deaths annually, according to health officials.

Thirteen leading drugmakers promised last week to clean up pollution from factories making antibiotics as part of a drive to fight the rise of drug-resistant superbugs, while United Nations member countries pledged for the first time to take steps to tackle the threat.

MAJOR EARNER

Patancheru is one of the main pharmaceutical manufacturing hubs in Telangana state, where the sector accounts for around 30 percent of GDP, according to commerce ministry data. Drug exports from state capital Hyderabad are worth around $14 billion annually.

Local doctor Rao pointed to studies by scientists from Sweden's University of Gothenburg that __have found very high levels of pharmaceutical pollution in and around Kazhipally lake, along with the presence of antibiotic-resistant genes.

The scientists have been publishing research on pollution in the area for nearly a decade. Their first study, in 2007, said antibiotic concentrations in effluent from a treatment plant used by drug factories were higher than would be expected in the blood of patients undergoing a course of treatment. That effluent was discharged into local lakes and rivers, they said.

"The polluted lakes harbored considerably higher proportions of ciprofloxacin-resistant and sulfamethoxazole-resistant bacteria than did other Indian and Swedish lakes included for comparison," said their latest report, in 2015, referring to the generic names of two widely used antibiotics.

Those findings are disputed by local government officials and industry representatives.

The Hyderabad-based Bulk Drug Manufacturers Association of India (BDMAI) said the state pollution control board had found no antibiotics in its own study of water in Kazhipally lake. The state PCB did not provide a copy of this report, despite several requests from Reuters.

"I have not seen any credible report that says that the drugs are no longer there," Joakim Larsson, a professor of environmental pharmacology at the University of Gothenburg who led the first Swedish study and took part in the others, told Reuters by email.

"There might very well have been improvements, but without data, I do not know."

WATER TREATMENT

Local activists and researchers say the Common Effluent Treatment Plant (CETP) built in Medak in the 1990s was ill-equipped to handle large volumes of pharmaceutical waste.

After protests and court cases brought by local villagers a 20-km (12-mile) pipeline was built to take effluent to another plant near Hyderabad. But activists say that merely diverted the problem - waste sent there, they say, mixes with domestic sewage before the treated effluent is discharged into the Musi river.

A study published this year by researchers from the Indian Institute of Technology, Hyderabad, found very high levels of broad-spectrum antibiotics in the Musi, a tributary of the Krishna, one of India's longest rivers.

Local government officials responsible for the plants did not respond to Reuters' requests for comment.

Nearly a dozen current and former officials from companies producing medicines in Patancheru told Reuters that factory staff from various firms often illegally dump untreated chemical effluent into boreholes inside plants, or even directly into local water bodies at night.

All the officials spoke on condition of anonymity and Reuters was unable to independently verify those allegations.

Major manufacturers in the area, including Dr Reddy's and Mylan, said they operated so-called zero liquid discharge (ZLD) technology and processed waste onsite.

"Mylan is not dumping any effluent into the environment, borewells or the CETP," said spokeswoman Nina Devlin.

Dr Reddy's said it recycled water onsite and complied with all environmental regulations.

The same industry officials who spoke to Reuters said the pollution control board rarely checked waste-treatment practices at factories, adding that penalties for breaches were meager.

The Telangana state government did not respond to requests for comment.

"We are aware some companies are releasing more than the allowed effluent, but they are profit-making companies," said state PCB spokesman N. Raveendher. "We do try and take action against the offenders, but we cannot kill the industry also."

Many smaller companies also lacked the funds to install expensive machinery for treating waste, he added.

COURT BATTLES

A series of local court cases have been filed stretching back two decades, accusing drug companies of pollution and local authorities of poor checks. In some cases, companies have been ordered to pay annual compensation to villagers, but many are still grinding through India's tortuous legal system.

Wahab Ahmed, 50, owns five acres of land near the shores of Kazhipally lake, where he grew rice until a decade ago. He says the worsening industrial pollution from several nearby pharmaceutical factories left his land barren.

"We have protested, sued, and done all sorts of things over the years ... that's how some of us are now getting around 1,700 rupees (roughly $20) a year from the companies," he said.

"But what can you do with that small sum today?"

More than 200 companies were named as respondents in the case he was referring to, filed by a non-profit organization on behalf of villagers.

While pollution of farmland is a serious problem for villagers who depend on it for their livelihood, the potential incubation of "superbugs" in Medak's waterways has wider implications.

The issue is particularly worrisome in India, where many waterways also contain harmful bacteria from human sewage. The more such bacteria are exposed to antibiotics, the greater the chances they will mutate and render such drugs ineffective against them.

The risk is that resistant bacteria would then infect people and be spread by travel.

So far, most of the focus worldwide on antimicrobial resistance has been on over-use of drugs in human medicine and farming.

"Pollution from antibiotic factories is a third big factor in causing antimicrobial resistance," the chairman of one of the world's largest drugmakers told Reuters. "But it is largely overlooked."

Fox News NJ commuter train crash patients at risk for head, chest injuries

 

EMTs and hospital staff in the New York-Metro area kicked into high gear on Thursday morning after a commuter train crash at a New Jersey station killed at least one and injured more than 100, many critically. Witnesses said a woman was pinned under concrete and other people were bleeding— some with severe head injuries.

While officials are investigating what may __have caused the train to crash through the station in Hoboken, slamming through barriers in the terminal’s reception area, sources told WNBC the crash appears to be accidental, not intentional.

“A type of accident like this is basically an impact situation similar to what you would see in a severe car crash where a car hits a tree,” said Dr. Manny Alvarez, chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey.

Alvarez, senior managing editor for health at FoxNews.com, said passengers in the first few cars toward the front of the train would be at a greater risk of injuries to the head, including intracranial bleeding, as well as impact to the chest, including lung injuries. Those passengers would also be at a greater risk of tears to their major blood vessels. Victims of impact accidents such as this may also run the risk of damage to the spleen, which in turn could lead to internal bleeding and possibly cardiovascular shock. If not treated immediately, this event can lead to significant injuries, he added.

Thursday morning, more than 20 ambulances sped to the terminal to transport injured passengers to hospitals. New Jersey Transit spokeswoman Jennifer Nelson told Fox 5 the train carried about 250 passengers.

Three hospitals surround the Hoboken train station: Hoboken University Medical Center, Jersey City Medical Center and Palisade Medical Center. The designated trauma center for Hoboken is Hackensack University Medical Center, Alvarez said.

A spokesperson from Hoboken University Medical Center said its hospital staff had seen some back and neck injuries among the 16 passengers transported to its facility so far.

“There is a count at the scene to determine who goes where,” the Hoboken University Medical Center spokesperson told reporters. “Right now, the additional patients that we’re seeing right now are actually walking wounded because we are only about six or seven blocks from the crash site, and so some people are self-referring here.”

The source said victims appear to be mostly adults, but there may be one pediatric patient.

“We are not expecting more patients from other hospitals,” the source said. “We may be receiving more patients from the scene based upon who needs to be at the hospital soonest, and because we are the closest hospital, if somebody needs to be stabilized and moved somewhere else, then that can happen.”

Dr. Kenneth Garay, chief medical officer of Jersey City Medical Center, told media Thursday that the hospital had treated 40 walk-in patients who suffered wounds in the crash and that nine to 11 patients were in the emergency room.

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"There are three serious patients with orthopedic injuries, internal injuries and deep lacerations; they are being treated by our trauma surgeons as we speak," Garay told the media. “They are under constant care and supervision by our trauma surgeons and our critical care nurses.”

Garay said all patients at his hospital are stable and that none of their injuries are life-threatening.

In instances like these, medics attend to three levels of triage based on patients’ needs, Alvarez said. At the first level, EMTs are tending to injuries on site, hospital staff are tending to patients who may be stable but need more care, and trauma centers tend to patients who __have significant injuries. Sometimes, patients may be transported from level I care to a trauma center after initial assessment.

“Since 9/11, more hospitals in the New York region have been constantly practicing for unexpected traumatic events,” Alvarez said. “We live in a world today where we get exposed not only to accidents but also some of these instabilities that we continue to see in our country.”
 

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Fox News CDC urges adults to get the flu shot amid declining vaccination rates

 (iStock)

Health officials are urging Americans not to delay getting their flu shot after vaccination rates fell by 1.5 percentage points from 2014 to 2015. In a media briefing Thursday morning, the Centers for Disease Control and Prevention (CDC) director Dr. Tom Frieden stressed that not getting vaccinated can be deadly.

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“Getting a flu vaccine is important for all of us, for our own protection and for the protection of those around us who may be more vulnerable to flu, such as young children, people with certain chronic health conditions and the elderly,” Frieden said during the press conference, which was held with the National Foundation for Infectious Diseases (NFID).

The CDC recommends everyone 6 months and older get the flu shot. Each year, 50 to 100 children die from the flu.

While 79 percent of health care personnel were vaccinated against the flu last year— a 1.7 percentage point increase from 2014— fewer adults overall got the flu shot in 2015 than in 2014. In 2015, 45.6 percent of adults got vaccinated, a 1.5 percentage point decrease from the previous year. Older people ages 50 to 64 saw the biggest drop in flu shot rates: a 3.3 percentage point decrease to 63.4 percent in 2015, according to the NFID.

“Adults age 65 years and older are disproportionally affected by flu,” Dr. William Schaffner, medical director of NFID and professor of preventive medicine at Vanderbilt University School of Medicine, said in the release. “During the severe 2014-2015 season, more than three-quarters of the nearly one million people hospitalized due to influenza were age 65 years and older. Vaccination not only reduces the chance that older adults will get the flu, it can help keep them out of the hospital by reducing the severity of the infection and related complications if they do get the flu.”

That recommendation contrasts news reports circulating earlier this month that suggested elderly people may want to wait to get the flu shot because it’s unclear how long vaccination protection lasts.

While officials are advising parents against using the nasal flu vaccine spray because it’s thought to be weaker than the flu shot, two new flu vaccine options are available this year, according to the NFID. One is a four-component flu shot made with virus grown in cell culture, which is different from the traditional egg-based vaccine. That vaccine is licensed for use among people 4 and older. The other is an adjuvant, an ingredient that helps create a stronger immune response, and is licensed for adults 65 and older. The immune system declines with age, and this vaccine may increase protection against the flu, Dr. Wilbur H. Chen, associate professor and chief of the Adult Clinical Studies section at the Center for Vaccine Development at the University of Maryland School of Medicine, said in the release.

As well as getting vaccinated, to prevent the flu, the CDC recommends avoiding close contact with visibly ill people, covering the nose and mouth when sneezing, washing hands, and taking antiviral drugs as prescribed.

Fox News Effort seeks to improve health of young people with HIV

A team of researchers led by Wayne State University expects to get $15.7 million over five years for work related to thehealth and well-being of adolescents and young adults with HIV or at risk for HIV infection.

The funding for the "Scale it Up" project is from the National Institute of Child and Human Development of the National Institutes of Health.

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Professor Sylvie Naar, division director of behavioral sciences in the Department of Family Medicine and Public Health Sciences at the Wayne State School of Medicine, leads the team. She'll collaborate with others around the country on the project.

HIV is the virus that causes AIDS. The program focuses on youth between the ages of 13 through 24. It emphasizes implementing ideas that are cost effective and sustainable.

Fox News NBTY to genetically test herbal supplements under NY accord

 (monticelllo)

NEW YORK –  NBTY Inc, one of the largest U.S. herbal supplement producers, has agreed to conduct an advanced form of genetic testing to ensure that its herbal products contain what their labels say they contain, New York's attorney general said on Wednesday.

The agreement followed a probe in which the office of Attorney General Eric Schneiderman found that products sold as herbal supplements at GNC, Target, Walgreen and Wal-Mart stores in New York lacked genetic material for plants shown on labels.

Instead, the products contained fillers, or ingredients such as nuts that could harm people with allergies, the probe found.

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NBTY, whose brands include Nature's Bounty and Solgar, is the third herbal supplement producer, following GNC Holdings Inc and Nature's Way Products Inc, to agree to tighter quality control under settlements with the attorney general.

Among the changes it will make is the phasing in over two years of DNA bar coding, an advanced means to identify organic material by generic sequences.

NBTY will also randomly test its herbal supplements for five allergens: eggs, milk, peanut, soy and wheat.

The agreement is effective for three years.

Carlyle Group LP, a large private equity firm, owns NBTY, which is based in Ronkonkoma, New York.

NBTY did not respond to several requests for comment.

Its agreement said NBTY is committed to promoting "the most accurate, reliable standards and testing methods" for herbal supplements, including DNA testing, to benefit consumers.

Fox News Bike lanes are a sound public health investment

A woman rides a bicycle along a designated bike lane on Queens Boulevard in the borough of Queens in New York, U.S., May 5, 2016.  (REUTERS/Shannon Stapleton)

Every $1,300 New York City invested in building bike lanes in 2015 provided benefits equivalent to one additional year of life at full health over the lifetime of all city residents, according to a new economic assessment.

That's a better return on investment than some direct health treatments, like dialysis, which costs $129,000 for one quality-adjusted life year, or QALY, said coauthor Dr. Babak Mohit of the Mailman School of Public Health at Columbia University in New York.

Our greatest public health intervention, vaccines, take about $100 investment to yield one QALY, Mohit told Reuters Health by phone.

New York built 45.5 miles of bike lanes in 2015, with an investment of about $8 million. This increased the probability that residents would ride a bike by 9 percent, the researchers calculated.

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Based on a population of 8.5 million, they compared the direct and indirect costs and benefits of building those additional miles of bike lanes versus maintaining the status quo before they were built.

Adding bike lanes to motor vehicle roadways reduces the risk of injury and raises the probability of ridership, which increases physical activity and decreases pollution from the vehicles riders would otherwise be using, they found.

Per person, bike lanes created an additional cost of $2.79 and a gain of .0022 quality-adjusted life years, according to the results published in Injury Prevention.

"For bike lanes the cost per QALY is $1,300, a little bit higher than vaccines but way lower than most medical interventions that we __have in healthcare," Mohit said. "We're finding more and more of these social interventions are not directly medically related but __have an extremely positive effect on giving us more life years."

Bike lanes increase both recreational and commuter biking, he added.

"I definitely think there's room for expansion of bike lanes, the city spends $67,000 per QALY for Medicaid and we think spending $1,300 per QALY buys you a lot more life for a lot less money," Mohit said.

The data here is unique to New York, but even in some European cities where there are bike lanes on practically every street, researchers are still seeing additional benefit to adding bike lanes to more rural roads, he noted.

The authors also point out that their model can be adjusted by other cities to calculate the benefits of making bike riding easier in those communities.

The study did not distinguish between bike lanes, bikeways, shared-use paths and other bike facilities, said Anne Lusk, a research scientist at the Harvard T.H. Chan School of Public Health in Boston who was not part of the new study.

One study, cited by Mohit and coauthors, found that bike lanes made the city safer for drivers and pedestrians but less safe for bicyclists, Lusk told Reuters Health by email.

"In sum, I am glad to read the conclusion that bicycle facilities are a worthwhile health investment but saddened that the author did not clearly specify that the facilities built in NYC starting in 2007 were primarily Class IV cycle tracks (barrier-protected bicycle-exclusive paths beside sidewalks)," she said.

Painting unprotected bike lanes into roads may not reduce injury and death, she said.

"Once considered desirable because they were 'low hanging fruit,' we need to stop painting door zone bike lanes and start creating barrier protected cycle tracks," Lusk said. Riding in the so-called door zone can be fatal if someone in a parked car opens their door at the wrong time, she said.

Fox News Dr. Manny: How to achieve a healthy pregnancy with celiac disease

 (iStock)

More than ever, evidence is piling up that indicates celiac disease may be linked to higher chances of pregnancy-related complications.

In a study published by researchers at Thomas Jefferson University Hospital in Philadelphia, women who had been diagnosed with celiac disease through a biopsy were compared with a control group made up of women without the disease. The groups filled out an online questionnaire about reproductive health such as the age menstruation began for them and the number of pregnancies they experienced, as well as birth details for babies delivered. The study found that about half of the pregnancies recorded by women who had celiac disease ended in miscarriage.

While celiac disease has, in the past, been linked to pregnancy complications, it's never been to the level recorded in this research paper. One of the potential reasons for the high-risk pregnancy complications is that patients with celiac disease are found to __have deficiencies in both vitamins and essential elements like zinc, selenium, iron and folate.

The rate of celiac disease seems to __have increased over the last 10 years, and although the mechanism is poorly understood, certainly we are seeing more patients experiencing a gluten sensitivity in their daily diets. It is stipulated that perhaps this increased gluten sensitivity may be an autoimmune response -- in other words, when your own immune system begins to create changes in your gut, making gluten -- which are found in grains -- difficult to absorb.

Now, the typical symptoms of celiac disease are bloating, gas pains, weight loss and irritable bowel. One of the proper ways to make the right diagnosis is of course by having a biopsy of the tissue. It is important to remember, that if you are diagnosed with celiac disease and are thinking about getting pregnant, to have a conversation with your doctor. A diagnosis may not only mean that you need to go on a gluten-free diet, but also that you may need to supplement some of the essential vitamins and minerals I mentioned above, so that you can minimize the risk of a complicated pregnancy or miscarriage.

The post Dr. Manny: How to achieve a healthy pregnancy with celiac disease appeared first on Ask Dr Manny.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. Click here for more information on Dr. Manny's work with Hackensack University Medical Center. Visit AskDrManny.com for more.

Fox News The 4 unhealthiest pumpkin spice lattes

Between the pumpkin-spice-flavored kale chips, vodka, candy corn, yogurt, beer, cream cheese, English muffins, Kahlúa, macarons, and the almonds, cookies, cereal, sausage, Twinkies, popcorn, Peeps, and water — it’s safe to say that America has aslight obsession with all things pumpkin spice.

The seasonal craze started with one item 13 years ago: Starbucks’ Pumpkin Spice Latte. It has without a doubt been the company’s most successful seasonal beverage. One could argue that summer hasn’t ended until the annual release of the PSL.

Other companies were rightfully envious of Starbucks’ success and created their own versions of the fall favorite. Now customers can buy a pumpkin spice latte at almost any fast-food chain that sells coffee.

Though the PSL craze seems innocuous, the drink is in actuality a nutritional nightmare. Sipping on one every morning of the fall season can throw a diet completely off course. All the pumpkin spice lattes on this list are high in fat and calories, and contain more sugar than a can of Coca-Cola. The nutritional information provided below is reflective of a 16-fluid-ounce serving that uses either 2-percent milk or whole milk. 

Here’s our ranking of the top 8 unhealthiest pumpkin spice lattes.  

#8 Peet’s Coffee & Tea: Pumpkin Latte With 2 Percent Milk

300 calories

8 grams of total fat

43 grams of sugar

Peet’s is the healthiest of the unhealthiest pumpkin spice lattes. The drink is sweet, but it doesn’t crush you with sugar, calories, or fat. It uses real espresso, steamed milk, and pumpkin spices. Ordering it with skim milk eliminates the fat and reduces the calories by a quarter. 

#7 Starbucks: Pumpkin Spice Latte With 2-Percent Milk and Whipped Cream

380 calories

14 grams of total fat

50 grams of sugar

Starbucks is the originator of the PSL movement, and now its pumpkin spice lattes actually contain real pumpkin. Unfortunately, the addition of real pumpkin doesn’t reduce the sugar or calorie content, but loyal fans will be relieved to know that it is far from the worst offender.  

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• Step Aside, PSL: Starbucks Has A New Festive Fall Drink

• Forget the PSL, Here’s Why Pear Should Be a Coffee Flavor

• PSL Returns to McDonald’s Nationwide for the First Time in Three Years

• Pumpkin Spice Latte Recipe

• Pumpkin Spice Margarita

#6 McDonald’s: McCafé Pumpkin Spice Latte With Whole Milk

340 calories

10 grams of fat

48 grams of sugar

The pumpkin spice latte from McDonald’s is rich in added sugar at 48 grams, but the drink also contains sucralose, an artificial sweetener, and xanthan gum, the same stuff used to give toothpaste its signature thick and slimy consistency. This one’s a little too artificial for my taste. 

#5 Panera Bread: Pumpkin Spice Latte

450 calories

12 grams of fat

51 grams of sugar

Panera Bread’s pumpkin spice latte uses reduced-fat milk, but this substitution becomes irrelevant when it’s topped off with whipped cream. Its “pumpkin spice flavored syrup” uses 12 different ingredients including glycerin, corn syrup, and three other types of sugar.  

Click Here For The Top 4 Unhealthiest Pumpkin Spice Lattes

Fox News Boy, 4, dies by suffocation at school

 (AsiaWire)

Staff at a nursery school in China are mourning the death of one of their children after the boy suffocated to death during his post-lunch nap.

Employees at Shuangqiao Mingzhu Kindergerten in East China’s Fujian Province found the boy, identified only by his surname, Lin, unconscious and not breathing one afternoon when naptime ended, AsiaWire (AWR) reported. At the hospital, doctors confirmed him dead.

More on this...

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• Study says more than half of all infants at risk for suffocation or SIDS when sleeping

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According to the school, the classroom’s quilts __have thin ropes attached to them to make the blankets easy to roll up and carry. The ropes were dangling above the boy when they somehow attached themselves to the boy’s neck as he slept on the lower of two platforms.

AWR reported the boy likely lost consciousness and died of asphyxiation shortly after.

The nursery school teacher claimed they were distracted by other students and didn’t pay attention to Lin. It is unknown whether the school has offered to compensate the family for their loss.
 

Fox News Zika travel advisory issued for 11 Southeast Asia countries

 

NEW YORK –  U.S. health officials are advising pregnant women to postpone travel to 11 countries in Southeast Asia because of Zika outbreaks in the region.

The advisory issued Thursday targets travel to Brunei, Cambodia, East Timor, Indonesia, Laos, Malaysia, the Maldives, Myanmar, the Philippines, Thailand and Vietnam.

The Centers for Disease Control and Prevention said Zika has been in some areas of Southeast Asia for years, and some residents may be immune. But a number of U.S. travelers __have become infected there in the last year, so there is a danger to visitors.

Most infected people suffer a mild and temporary illness, at worst. But infection during pregnancy can causes severe brain-related birth defects. The virus is spread primarily by bites from infected mosquitoes.

Is India in the throes of a fever outbreak?

Image copyright AP

Image caption Hospitals in Delhi are swamped with patients suffering from viral fevers

Every other day, the news arrives with depressing regularity: viral fevers are tormenting a city, or a town, or a cluster of villages in India. People are sick everywhere.

The capital, Delhi, is fighting an outbreak of chikungunya. Next door, Haryana is battling malaria. Down south, the info-tech hub of Bangalore is grappling with both. Dengue has returned with a vengeance in Kolkata and its neighbouring areas. Clinics in populous Uttar Pradesh are swamped with patients suffering from fever.

So, is India in the grip of a "fever outbreak"?

Research by the Delhi-based Indian Council of Medical Research (ICMR), one of the world's largest medical research bodies, offers some clues.

'Fever upsurge'

Each of ICMR's 40 laboratories across India test anything up to 1,000 blood samples a month. Some 12% of these __have tested positive for dengue since January, up from 5% last year. And 10% of the samples __have tested positive for the chikungunya virus since July. Blood samples for testing have also doubled at these labs since the onset of rains.

At the epicentre of Delhi's chikungunya epidemic

India battles dengue fever outbreak

Dealing with dengue: Lessons from the fever crippling Delhi

Both dengue and chikungunya are viral diseases spread by mosquitoes that bite during daylight hours. Prolonged monsoon rains provide more stagnant water for mosquitoes that carry these diseases to breed. Dengue can be fatal if not treated in time; and chikungunya cripples patients with excruciating joint pain.

"There has definitely been an upsurge of dengue and chikungunya cases across the country this year," Dr Soumya Swaminathan, director-general of ICMR tells me.

Image copyright AP

Image caption Chikungunya cripples patients with excruciating pains

That's not all.

Across India, 70 people have died and more than 36,000 people have been affected by dengue since January, according to the health ministry. Most of the infections have been reported from West Bengal and Orissa in the east and Kerala and Karnataka in the south.

Also, more than 14,650 cases of chikungunya have been detected so far this year. With 9,427 cases Karnataka is the worst affected, followed by Delhi and western Maharashtra.

The dreaded malaria's relentless march also continues: India has already recorded more than 800,000 cases and 119 deaths from the disease so far this year.

Epidemic?

Mind you, these grim numbers comprise officially recorded cases and fatalities. There could easily be thousands more cases and deaths that never go reported in a country this vast and with such a decrepit public health service.

So does this increase in cases point to a fever "epidemic" in the country?

One reason for the rise is the increased testing and reporting of fevers, at least in cities and towns. So, overall the number of infections continues to rise: recorded dengue cases alone, for example, have jumped from 28,292 in 2010 to nearly 100,000 cases in 2015. The number of "official" deaths from the disease every year during this period has ranged between 110 and 242.

Image copyright AP

Image caption India has traditionally tried to tackle mosquito-borne viruses by outdoor "fogging"

Also, India is no stranger to tropical fevers - dengue, malaria, typhoid, common influenza, leptospirosis - during monsoon rains. The temperature goes down, humidity rises, water collects, mosquitoes thrive and you get fever, the "disease of tropical depression", in the words of Polish journalist and author Ryszard Kapuściński. Patients crowd hospitals and clinics, complaining of fever, chills, headache, pains, rashes, delirium and cough, among other symptoms.

But experts believe that climate change and rapid urbanisation are also triggering outbreaks.

'Unpredictable rainfall'

"Rainfall has become unpredictable. Mosquitoes have adapted to urban environments. There is construction activity happening round the year, leading to accumulation of water in which mosquitoes breed easily," says Dr Swaminathan. Mosquito-borne viruses are also mutating and developing resistance to drugs.

India has traditionally tried to tackle these viruses by outdoor mobile "fogging" - creating a fine mist of insecticide. It is a visible control method, but is often ineffective as it attacks adult mosquitoes and not the larvae. Anything that reduces the survival rate of the mosquito - the fly has a lifespan of three weeks, so it needs to pick up the pathogen early in its life to pass it on - should be more effective.

So what India needs more are anti-larval programmes, where WHO-approved larvicides can be put in water tanks, garbage, toilets and open water sources. Officials say the health ministry has cleared public distribution of such pesticides to tackle larvae.

Image copyright AFP

Image caption More than a million people are affected by malaria in India every year

India also plans to hold trials with mosquitoes infected with bacteria that suppress dengue fever.

The intracellular bacteria, Wolbachia cannot be transmitted to humans and acts like a vaccine for the mosquito which carries dengue, Aedes aegypti, and stops the virus multiplying in its body. The hope is they will multiply, breed and become the majority of mosquitoes, thus reducing cases of the disease.

Until India manages to do all this on a large scale with wider community participation however, fever and malaria will continue to stalk the country.

The pigeon will see you now

Image copyright MOHD RASFAN

Image caption Pigeons __have amazing visual memories

A rat or pigeon might not be the obvious choice to tend to someone who is sick, but these creatures __have some superior skills that could help the diagnosis and treatment of human diseases.

Pigeons are often seen as dirty and an urban nuisance, but they are just the latest in a long line of animals that have been found to have abilities to help humans.

Despite having a brain no bigger than the tip of your index finger, pigeons have an impressive visual memory.

Recently it was shown that they could be trained to be as accurate as humans at detecting breast cancer in images.

Here are three more of our feathered and furry friends who could have a big impact in medicine.

From lab rats to lab technicians

Rats are often associated with spreading disease rather than preventing it, but this long-tailed rodent is a highly sensitive detector that can save lives.

Inside a rodent's nose are up to 1,000 different types of olfactory receptors, whereas humans only have a feeble 100 to 200 types. This gives rodents, such as rats, the ability to sniff out subtle scents.

As a result, African-pouched rats - commonly described as "kitten-sized rodents" - are being put to work in Mozambique to detect tuberculosis.

Image copyright ADRIEN BARBIER

Image caption The African pouched rats are highly accurate TB detectors

Their abilities are being studied at the Eduardo Mondlane University in Maputo, where trained rats can detect a specific scent produced by TB bacteria in human mucus samples.

When the rats detect the scent, they stop and rub their legs to indicate a sample is infected.

Traditionally, lab technicians prepare slides and examine each sample using microscopy. A hundred samples would take them more than two days, but for a rat it takes less than 20 minutes.

This rat detection method is affordable and doesn't rely on specialist equipment, which is often lacking in countries where TB is prevalent.

It is also more accurate - the rats are able to find more TB infections and, therefore, save more lives.

Doctor dog - the emergency seizure detector

Dogs have long been considered a human's best friend - but over the years they've really proved how skilful they can be.

Recently, there has also been a focus on dogs that seem to have the extraordinary ability to detect when people with epilepsy are about to have a seizure - even when the person has no idea themselves.

Sally Burton's epilepsy began as a child and affected every aspect of her life from a young age.

"I could never be left alone," she says. "I had to be home taught and making friends or meeting new people was difficult. I often felt very lonely."

Thirteen years ago she got her first seizure alert dog, Star.

"Having a seizure alert dog instantly made my life liveable," Sally explains.

Image copyright AmyLaw

Image caption Robbie warns Sally when she is going to have a seizure

"One of the first things I did when I first had Star was to make myself a cup of tea, something I had not been able to do in 30 years because of the risks of having a seizure when holding boiling water. I then went into town on my own - again a life-time first."

It is still not known how dogs can sense a seizure. It has been suggested that minute changes in a person's gestures or posturing could alert the dog, but people have also thought that a scent or auditory cue might also be involved.

After Star passed away, Sally teamed up with her second dog Robbie. Like Star, he was trained by a British charity, Support Dogs.

The charity has shown they are able to train dogs that are able to provide signals, such as persistently nudging someone's leg, between 15 and 45 minutes before their owner had a seizure.

Although there is still little other published evidence to back up their effectiveness, the anecdotal evidence for seizure dogs like Robbie is strong.

"When I am out it is reassuring to know that Robbie will give me a 100% reliable 50-minute warning prior to every oncoming seizure I have - so plenty of time to get somewhere safe," Sally says.

The secrets of cow saliva

Drool, dribble, or spit. Whatever you call it, saliva can be thought of as disgusting. But many animals lick their wounds, applying liberal amounts of the stuff to try and prevent infection.

Saliva across the animal kingdom can have antimicrobial properties - including saliva from the humble cow.

Studies have shown that there are proteins in a cow's bodily fluids, including its saliva and milk, that have bug-fighting properties.

Image copyright BORIS ROESSLER

Image caption Saliva across the animal kingdom has been shown to have antimicrobial properties

Salvia also contains proteins - called mucins - that can work to prevent further bacteria entering the wound.

Experts don't recommend letting an animal lick your wounds as they could introduce other bacteria, but if you don't fancy that then, luckily, your own spit also contains antibacterial properties.