SELF-CARE HAS been defined as a multidimensional, multifaceted process of purposeful engagement in strategies that promote healthy functioning and enhance well-being. In simpler terms, self-care is all about caring for yourself, as the name...

View the full post New kitchen equipment for St Andrew’s RC Primary School on NOW Grenada.

View the full post Nutrition and Menopause on NOW Grenada.

As cholera continues to surge — and as vaccines remain in short supply — experts are warning about the global risk.

Cholera is a bacterial disease typically spread by food and water, leading to severe diarrhea and dehydration. It has been on the rise around the world since 2021.

Each year, there are some 1.3 to 4 million cases of cholera worldwide, according to the World Health Organization (WHO). Approximately 21,000 to 143,000 deaths occur as a result.

HIGH LEVELS OF RESISTANT BACTERIA FOUND IN UNCOOKED MEATS AND RAW DOG FOOD: ‘RED FLAG’

Around 473,000 cases were reported to WHO in 2022, which was twice as many cases as the prior year.

Reported cases for 2023 are expected to exceed 700,000.

"It is concerning to see an increase in the number of cholera cases worldwide, with the majority of the cases in Asia, Africa and Latin America," Dr. Renuga Vivekanandan, M.D., assistant dean and professor at the Creighton University School of Medicine in Omaha, Nebraska, told Fox News Digital.

The countries most affected include the Democratic Republic of the Congo, Ethiopia, Haiti, Somalia, Sudan, Syria, Zambia and Zimbabwe, according to UNICEF. 

Although cholera cases were prevalent in the U.S. in the 1800s, water treatment systems have largely eliminated the disease, per the CDC.

In rare cases, people in the U.S. have contracted the disease from consuming raw or undercooked shellfish from the Gulf of Mexico, the agency stated on its website.

AMID BIRD FLU SPREAD, EXPERTS REVEAL IF IT'S SAFE TO DRINK MILK: 'INDIRECT CONCERN'

"In the U.S., the cases have remained very small and are usually from travel exposure," Vivekanandan noted.

Cholera is typically spread when someone drinks water or eats food that is contaminated with the bacterium Vibrio cholerae, according to the CDC.

The disease can spread quickly in locations where there is insufficient treatment of drinking water and sewage, the agency warned.

It is not typically transmitted from person to person. 

UNICEF noted in a statement that the rise in cholera is driven by "persistent gaps in access to safe water and sanitation."

"I think the cases might be increasing due to climate change, displacements of homes due to disasters, and not having good sanitary conditions, such as poor water sources," Vivekanandan told Fox News Digital.

Around 10% of the people who are infected with cholera will develop severe symptoms, including watery diarrhea, vomiting and leg cramps, according to the U.S. Centers for Disease Control and Prevention (CDC).

Advanced symptoms include shock and dehydration. 

Without treatment, the disease can be fatal.

"Dehydration is the biggest concern with cholera, and rehydration is the most important component of treatment," said Vivekanandan.

"Most patients with cholera will have mild diarrhea, but 10% will have severe diarrhea and will need rehydration and treatment with antibiotics."

WITH WHOOPING COUGH CASES ON THE RISE, DO YOU NEED A BOOSTER VACCINE?

Some groups are more susceptible to the disease, according to the CDC.

"Individuals with achlorhydria (the absence of hydrochloric acid in digestive stomach juices), blood type O, chronic medical conditions, and those without ready access to rehydration therapy and medical services are more likely to have severe disease from cholera and suffer poor outcomes," the agency noted.

The most effective treatment for cholera is "immediate replacement of the fluid and salts lost through diarrhea," the CDC stated.

This is achieved by giving patients a mixture of sugar and salts mixed with 1 liter of water. 

In some severe cases, the patient may require intravenous (IV) fluids.

Some patients also receive antibiotics to make symptoms less severe.

"Persons who develop severe diarrhea and vomiting in countries where cholera occurs should seek medical attention promptly," per the CDC.

There is a single-dose vaccine for cholera, called Vaxchora (lyophilized CVD 103-HgR).

CDC WARNS OF INVASIVE BACTERIAL OUTBREAK AMID SPIKE IN CASES AND FATALITY RATES: 'RARE BUT SEVERE'

Those who are between the ages of 2 and 64 and who are traveling to "an area of active cholera transmission" are eligible to receive it.

There are three other cholera vaccines, but they are not available in the U.S.

There is a "severe gap" in the number of available vaccine doses compared to the level of current need, said UNICEF on its website.

"Between 2021 and 2023, more doses were requested for outbreak response than the entire previous decade," UNICEF noted.

While cholera vaccines used to be administered in two doses, the International Coordinating Group (ICG) changed the recommendation to a single dose in Oct. 2022 due to the ongoing shortage.

Vivekanandan called the vaccine shortage "very concerning."

NEW ANTIBIOTIC KILLS DEADLY, DRUG-RESISTANT BACTERIA IN ‘SCIENTIFIC BREAKTHROUGH’

"This is a serious infection, and we must invest financial and other resources to reduce the worldwide burden," he told Fox News Digital.

"International resources need to be committed, and partnerships with pharmaceutical companies need to happen to help produce more vaccines."

Vivekanandan also urged people who are traveling from the U.S. to other countries to review the CDC’s travel guidance and get any required vaccines.

"I would also recommend that people follow good travel medicine guidance, such as drinking bottled water, eating well-cooked food and making sure to have good hand hygiene," he added.

CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER

"As the WHO has stated, we need to have multi-pronged approaches, with a combination of surveillance, water, sanitation and hygiene, social mobilization, treatment, and oral cholera vaccines available for communities at high risk."

On the U.S. Food and Drug Administration (FDA) website, Vaxchora is listed as a "resolved shortage."

The FDA noted that Emergent Travel Health, manufacturer of the vaccine, announced in May 2021 the temporary discontinuation and distribution of Vaxchora, "due to a significant reduction of international travel caused by the COVID-19 pandemic."

The shortage is listed as having been resolved in May 2023.

Fox News Digital reached out to WHO, the FDA and Emergent requesting comment.

For more Health articles, visit www.foxnews.com/health. 

Announcing modifications in the exam patterns in all MCQ-based examinations, such as NEET-PG, NEET-MDS, NEET-SS, FMGE, DNB-PDCET, GPAT, DPEE, FDST, and FET, the NBE recently introduced mandatory time-bound sections. However, doctors under the Federation of All India Medical Association (FAIMA) have expressed concern over these last-minute revisions in the NEET-PG 2024 exam pattern opining that such significant changes require adequate time for adaptation and preparation, which the current timeline does not afford.

Medical Dialogues recently reported that through a notice dated 04.05.2024, NBE had announced that it introduced time-bound sections as a measure to enhance the security and sanctity of the exams in light of emerging threats during the examination process. Releasing details of the mandatory timed sections in MCQ-based examinations, NBE mentioned that the question papers in the examinations mentioned above including NEET PG would be divided into multiple time-bound sections.

"For example, in NEET-PG 2024, if there are five time-bound sections (A, B, C, D & E) in the question paper, each section will have 40 questions and 42 minutes of time allotted. Candidates will be restricted from proceeding to the next section until they complete the allotted time for the previous section. Additionally, candidates will not be allowed to review the questions or modify their responses for a section after the completion of its allotted time. The questions for the next section will start automatically after the completion of the allotted time for the previous section," NBE mentioned in the notice.

The natboard further informed that the candidates would be given the option to mark any question, whether attempted or not, for review. This means that the candidates can go through these marked questions in a section again before the allotted time for that section ends.  As per the NBE notice, the questions marked for review will be evaluated according to the marking scheme as mentioned in the Information Bulletin of the respective examination and the actual number of time-restricted sections in an examination may vary based on the total number of questions in the question paper and operational feasibility in creating such sections.

However, expressing displeasure with the last-minute changes in the NEET PG 2024 exam pattern, FAIMA recently wrote to the NBE Executive Director. While the association acknowledged the importance of maintaining the security and sanctity of examinations and also appreciated the measures implemented to address the emerging threats, it also expressed concerns regarding the recent decision to introduce mandatory time-bound sections in NEET PG examinations.

"As you are aware, NEET PG aspirants already face Immense pressure and time constraints during the exam period. The sudden Introduction of mandatory time-bound sections adds an additional layer of stress and uncertainty, affecting the performance and well-being of the aspirants," FAIMA mentioned in the letter.

"We believe that such significant changes require adequate time for adaptation and preparation, which the current timeline does not afford. Therefore, we respectfully request reconsideration of the decision to implement mandatory time-bound sections In the upcoming NEET PG examinations. Instead, we propose that these changes be implemented gradually, allowing aspirants sufficient time to adapt and prepare effectively. We trust that you will give due consideration to our concerns and take necessary steps to address them. Your prompt action in this matter is highly appreciated and will contribute to the welfare and success of NEET PG aspirants across the country," it further added.

Meanwhile, sharing the NBE notice on X (formerly Twitter), the National Chairman of FAIMA, Dr. Rohan Krishnan also urged the authorities to cancel these changes. He wrote in an X post, "We are always against any kind of changes which are last minute. @NbeIndia should refrain from treating young aspirants who are graduates doctors like lab rats. @FAIMA_INDIA_ stands against this last minute modifications in exam/exam patterns. Requesting @NbeIndia to cancel this."

Commenting on the matter, Dr. Rohan Krishnan told Medical Dialogues, "It is a very last-minute step. The examinees are already very stressed and we are always very particular about this because this is an exam which has 40,000 to 60,000 seats and more than 3-4 lakh doctors who are appearing for this exam. This exam happens only once a year, so it is a very important day and it is going to happen pan-India. So, obviously, it is a very important examination."

"For any examination, the pattern should be declared before 6 months and after that, there should not be any changes. Now, the exam is going to happen in June itself and at present these changes are only going to create a lot of panic among the students and it is going to create more stress in the already stressful state of the NEET PG aspirants," he further added.

Also Read: NEET PG 2024 exam pattern revised! NBE introduces time-bound sections in all its computer-based tests- NEET SS, NEET MDS, FMGE and more

A 10-year-old girl in Pennsylvania is in dire need of a bone marrow transplant — and her mother is on a mission to find the perfect match.

Lani Walter suffers from a disease called DOCK8 deficiency (dedicator of cytokinesis 8 deficiency), an immunodeficiency syndrome that can cause recurrent, life-threatening infections. 

DOCK8 is very rare, with only 250 people worldwide currently diagnosed, statistics show. The only cure for DOCK8 is a bone marrow transplant — also known as a hematopoietic stem cell transplant (HSCT).

YOUNG GIRL SURVIVES CANCER THANKS TO LITTLE SISTER’S LIFESAVING DONATION: 'A PERFECT MATCH'

Ashleigh Walter, a kindergarten teacher, is pleading for people to join the bone marrow/blood stem cell registry to help her daughter find a donor by summer.

"Time is of the essence," she told Fox News Digital.

Walter’s daughter was diagnosed with DOCK8 when she was 7½ years old, the culmination of a long series of symptoms and illnesses.

"Lani’s health issues started at just a couple of months old," Walter told Fox News Digital during an interview. "As a baby, she had full-body eczema from head to toe and continuous ear infections."

At 11 months old, she was diagnosed with severe allergies to eggs, milk, peanuts, tree nuts and many other foods. She's also experienced continuous skin infections and staph infections.

In Jan. 2021, the family was invited to a clinic at the Children’s Hospital of Philadelphia (CHOP), where Walter’s daughter was able to see specialists from immunology, allergy and dermatology together in one appointment.

NEW JERSEY WOMAN RECOVERING AFTER RECEIVING SUCCESSFUL PIG KIDNEY TRANSPLANT

"They all came together to try and figure out what might be going on," Walter said. "Each of the specialties ran their own special bloodwork to see what was going on with Lani."

The results showed some abnormalities in the immune system, and doctors recommended doing genetic testing.

A few months later, the family received the news that Walter’s daughter has two variants of the DOCK8 gene.

"If you have issues on both sides of the gene, that's when you present with the disorder," Walter said. "Testing showed that both my husband and I are recessive carriers to the DOCK8 variant, which we passed down to Lani."

She added, "So that was when we found out that all of the health issues Lani has experienced throughout her entire life were not unrelated."

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in Lani Walter’s care but commented on the condition.

"DOCK 8 is a rare immune condition where the bone marrow doesn't make enough immune cells and the immune cells that are made have trouble penetrating into dense tissue, like skin," he told Fox News Digital.

After the diagnosis, Walter’s daughter was invited to visit the National Institute of Health in Maryland, where researchers are studying DOCK8 deficiency. 

"We go there about every six months to see how Lani is doing, and what they recommend as she gets older," Walter said.

The symptoms of DOCK8 deficiency tend to get more severe as the child grows into late adolescence and early adulthood, doctors have said.

Some of the biggest concerns are respiratory difficulties and a higher risk of various cancers, along with the ongoing risk of infections.

FOUR TEXAS RESIDENTS FOREVER CONNECTED BY TWO KIDNEY DONATIONS IN DIFFERENT CITIES: 'SUPERBLY TIMED'

To help manage her condition, Walter’s daughter has been getting weekly intravenous immune globulin (IVIG) infusions, which add human antibodies to help fight off infections.

She also takes daily antibiotics to help prevent pneumonia, uses an inhaler to help her respiratory system and takes other medications to treat different illnesses she experiences as a result of her DOCK8 deficiency.

"That's probably one of the least favorite parts of her day, when I tell her that she needs to take her medicine," Walter said.

Since the only cure for her condition is a bone marrow transplant, "her doctors recommend that Lani has [the] transplant to help cure the DOCK8 before she gets older."

Dr. Brett Osborn, a Florida neurologist and longevity expert at Senolytix, described HSCT as a "transformative reset button" for patients suffering from DOCK8 deficiency.

Osborn is not involved in Lani Walter’s care.

"Imagine your immune system as a computer plagued by a virus," he told Fox News Digital.

"HSCT removes the compromised ‘software’ and installs new, functional cells. For individuals with DOCK8 deficiency — who typically face frequent infections, severe allergies and increased cancer risk — HSCT can mean a dramatic shift toward immunologic normalcy, providing a new lease on life."

Siegel also emphasized the procedure’s importance, calling it a "crucial life-saving procedure."

The average wait for a transplant is about three months, according to Siegel.

"They are very expensive — about $190,000," he said. "Insurance generally covers the procedure, but not the cost of finding a donor."

There is around a 25% chance that a sibling will be a match. In Lani Walter’s case, her 14-year-old sister was not a match.

PENNSYLVANIA MOTHER AND SON BOTH BORN WITH RARE GENETIC DISEASE: 'CLOSER BECAUSE OF THIS'

"The overall chance of finding a match in the world is 1/3 to 2/3," Siegel said.

The organization known as NMDP, formerly the National Marrow Donor Program/Be the Match, maintains a registry of people who are willing to donate. The Walter family found a 90% match on the registry, but the optimal situation would be to find a 100% match.

"There's much less risk with the bone marrow transplant if you can find that perfect match," Walter told Fox News Digital. 

Lani Walter’s doctors recommend that she receives the donation before she starts middle school. Next year, she will start fifth grade.

"Ideally, we would do it before Lani sees significant issues with other organs in her body," said Ashleigh Walter. 

If the family does not find a perfect match, Walter said she will donate to her daughter, as parents are always half-matches.

"Obviously, we would still love for her to be able to find a full match on the donor registry, which is much less of a risk," she said. "But if that's not possible, we can move forward with a half match."

With partial matches, there is a higher risk of "graft versus host disease," which is a complication that occurs when donor bone marrow or stem cells attack the recipient.

"It can cause different issues throughout the body, similar to an organ transplant rejection," Walter said.

If her daughter receives a successful bone marrow transplant, Walter said — she will be cured of DOCK8.

PENNSYLVANIA PARENTS HONOR THEIR DAUGHTER WHO DIED OF A RARE GENETIC DISEASE: 'SWEETEST GIRL IN THE WORLD'

"She won't have an immune deficiency anymore," she said. "She'll adopt the immune system of the donor, and we won't have to worry about any of those increased risks at all."

Walter is hopeful that her daughter — whom she describes as "a little kid at heart" — will soon be healthy and able to return to the activities she loves, including swimming.

"Lani has been on a swim team since kindergarten, and this will be her first summer not doing it," Walter said. 

She also enjoys bike-riding, crafting, and spending time with her friends and pets.

There are millions of potential donors on the bone marrow registry — with more than 300,000 Americans joining just last year — but Walter noted that the likelihood of someone finding a perfect match is very low. 

"The more people who join the registry, the more likely that a perfect match will be there for you," she said.

THE GIRL WHO CAN’T SMILE: HOW A RARE DISORDER BECAME A YOUNG WOMAN'S ‘GREATEST GIFT’

As a neurosurgical trauma surgeon, Osborn of Florida said he can attest to the dire need for blood and bone marrow donors.

"There is a critical shortage of both," he said. "In emergency and surgical settings, the availability of blood products can be the difference between life and death."

It’s "vital" to have diversity in the bone marrow registry, Osborn noted.

"A closely matched donor reduces complications and improves outcomes," he said.

"This emphasizes why everyone should consider joining the registry. We can all manufacture these potentially life-saving blood products, and by donating, we fulfill a crucial societal need."

CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER

While some have the misconception that donation is difficult, Osborn said that’s not the case.

"Donating bone marrow is a low-risk, outpatient procedure associated with only minor discomfort. It’s a great way to pay it forward."

People can join the bone marrow registry by visiting the NMDP’s website to order a test kit.

"It’s a really simple cheek swab kit that they'll send to your house and then you send it back," Walter said. "You don't have to pay any money for anything."

"The more people that join, the more people who can find their perfect match."

"For conditions like DOCK8 deficiency, a bone marrow transplant can offer a chance at a healthier life," Osborn added.

"Joining the bone marrow registry could be your most profound gift, potentially saving a life with your healthy cells."

For more Health articles, visit www.foxnews.com/health.

The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology is being used in this update of the 2008 Infectious Diseases Society of America (IDSA) and Society of Critical Care Medicine (SCCM) guidelines for the evaluation of new-onset fever in adult ICU patients without severe immunocompromise.

A panel was constituted by SCCM and IDSA in order to revise the 2008 recommendations for the assessment of new fever in critically sick adult patients. TThe panellve suggestions and nine best practice statements The panelre released by the group.

When these devices are in use or precise temperature readings are essential for diagnosis and treatment, central temperature monitoring techniques—such as thermistors for bladder catheters, esophageal balloon thermistors, or pulmonary artery catheter thermistors—are recommended. The panel recommend oral or rectal temperature taking over less accurate techniques (such tympanic or axillary membrane temperatures, noninvasive temporal artery thermometers, or chemical dot thermometers) for individuals who do not have these instruments.

The panel advised against routinely giving antipyretic drugs to severely sick individuals who have fevers only to loThe panelr their body temperature.

The panel rrecommended ntipyretic medicine over nonpharmacologic techniques of temperature reduction for critically sick individuals with fever who prioritise comfort via temperature reduction.

The panel advised doing a chest radiograph on patients who have fever throughout their stay in the intensive care unit.

If an aetiology is not easily established by the first workup, The panel advise doing CT (in coordination with the surgical department) as part of a fever workup for patients who have recently had thoracic, abdominal, or pelvic surgery.

When no other diagnostic test has been able to determine the cause of a fever in critically unThe panelll patients, The panel recommend doing an 18F-fluorodeoxyglucose (18F-FDG) PET or CT scan if the risk of transport is considered tolerable.

The panel concluded that there was not enough data to make a recommendation for WBC scans for individuals with fever who did not have a known cause.

The panel advised against routinely using a formal abdominal ultrasound or POCUS as a first assessment for critically sick patients with fever, no abdominal signs or symptoms, abnormal liver function, and no recent abdominal surgery.

The panel advised doing a formal bedside diagnostic ultrasound of the abdomen in patients with fever and recent abdominal surgery, as The panelll as in any patient with abdominal symptoms or suspicion of an abdominal source (e.g., abnormal physical examination/POCUS, increased transaminases, alkaline phosphatase, and/or bilirubin).

When enough experience is available to accurately diagnose pleural effusions and parenchymal or interstitial lung disease, The panel recommend a thoracic bedside ultrasonography for critically unThe panelll patients with fever and an abnormal chest radiograph.

Regarding the use of thoracic bedside ultrasonography for patients with fever who do not have abnormal chest radiographs, the panel determined that there was not enough data to make a recommendation.

In order to calculate the differential time to positive, The panel advise concurrent collection of peripherally obtained blood cultures and central venous catheter for ICU patients with fever who have no apparent cause.

The panel advise sampling at least two lumens from patients with fever in the intensive care unit (ICU) when central venous catheter cultures are necessary.

If quick molecular tests on blood are conducted for critically sick patients with a new fever of uncertain origin, The panel recommend that they be utilised only in conjunction with concurrent blood cultures.

It is recommended to collect blood cultures from adult ICU patients in a sequential manner, preferably using 60 mL of total blood from multiple anatomic locations, without a time lapse in betThe panelen.

Urine cultures should be obtained from the newly inserted urinary catheter in febrile ICU patients who have pyuria and are suspected of having a UTI.

The panel recommended employing viral NAAT panels to screen for viral pathogens in critically ill patients with new fever and probable pneumonia, as The panelll as new signs of upper respiratory infections (e.g., cough).

The panel concluded that there was not enough data to make a recommendation regarding regular blood testing for viral infections (such as adenovirus and herpesvirus) in immunocompetent ICU patients.

Based on levels of community transmission, The panel advise PCR testing for SARS-CoV-2 in critically ill patients with a new fever.

The panel recommends evaluating PCT in addition to bedside clinical examination against bedside clinical evaluation alone if the risk of bacterial infection is determined to be low to intermediate in a critically sick patient with a new fever and no obvious focus of infection.

The panel recommends not testing PCT to rule out bacterial infection if the chance of bacterial infection is considered high in a critically unThe panelll patient with a new fever and no obvious centre of infection.

The panel recommends evaluating CRP in addition to bedside clinical examination against bedside clinical evaluation alone if the risk of bacterial infection is determined to be low to intermediate in a critically sick patient with a recent fever and no obvious focus of infection.

The panel advise against testing CRP to rule out bacterial infection in critically ill patients with a new fever and unclear infection focus if the likelihood of bacterial infection is thought to be high.

The panel recommend evaluating either serum PCT or CRP to rule out bacterial infection if the chance of bacterial infection is considered low to intermediate in a critically unThe panelll patient with a new fever and no obvious focus of infection.

Reference –

O’Grady NP, Alexander E, Alhazzani W, et al. Society of Critical Care Medicine and the Infectious Diseases Society of America guidelines for evaluating new fever in adult patients in the ICU. Crit Care Med. 2023 Nov;51(11):1570-1586.