The Guyana Cancer Society has partnered with GTT, Ministry of Health, the US Embassy and several cancer support organizations in holding a specialist medical outreach at the Bartica Regional Hospital in Cuyuni – Mazaruni (Region Seven).  A contingent of 15 specialist doctors including  two gynaecologists, one pediatrician, one urologist, five dentists, four ophthalmologists, and two ...

The study was led by Alberto Dominguez-Bali, MD, from the Miami Center for Obstetrics, Gynecology and Human Sexuality in Miami, Florida.

Starting in 2010, researchers in Antigua and Florida observed a rise in the number of perimenopausal women with no history of cervical abnormalities and low risk for sexually transmitted infections (STIs) presenting with abnormal Pap smears at their clinics.

The Papanicolaou test, also known as the Pap test or the Pap smear, was developed by Georgios Papanikolaou in the 1940s. It has been the mainstay of cervical cancer screening for the last 60+ years and involves exfoliating cells from the transformation zone of the cervix to enable the examination of these cells microscopically for the detection of cancerous or precancerous lesions.

They investigated 1500 women aged 30-70 from several clinics. The women had a low risk for sexually transmitted infections, a maximum of two sexual partners, and the presence of cervical dysplasia over 12 years.

The researchers reported the following findings:

• Nearly all (96.7%) of the women who received local estrogen treatment had a normal Pap smear following therapy.
• A high number of patients who initially presented with cervical dysplasia underwent interventions such as biopsies, colposcopies, cryotherapy, LEEP excisions, cone biopsies, and hysterectomies because of cervical atrophy.
• Local estrogen treatment could save patients money spent on treatments for cervical atrophy.
• Some women who underwent cone biopsies and hysterectomies and did not receive local estrogen still had vaginal dysplasia.

The researchers reported an early sign of genitourinary syndrome of menopause: false positive cervical dysplasia caused by cervicovaginal atrophy resulting from reduced estrogen levels during perimenopause.

"We also demonstrated how the use of local estrogen therapy can prevent a significant number of procedures and interventions, leading to significant cost savings," the researchers wrote. "This is particularly relevant as the number of Pap smears conducted in this population represents 50-60% of all Pap smears performed on women.

The authors of the study reported no limitations.

Reference:

The data were presented at the 2023 Menopause Meeting of the North American Menopause Society on September 27.

GTT is urging Guyanese to help that company raise GY$30 million to fight breast cancer and other cancers, amid staggering figures about that disease in this South American nation. GTT spokeswoman, Jasmin Harris says the money will be used raise awareness, screening and diagnosis. Key activities for the remainder of October/Pintokber are medical outreaches in ...

T'is
the season for…viral illnesses, the common cold, the bad flu, dengue. Among the many viral illnesses circulating this time of year is hand, foot and mouth disease (HFMDz). It affects mostly young children and causes fever and rash.

Transmission

Hand, foot and mouth disease is caused primarily by the coxsackie virus, and spreads through close contact and it is very contagious especially within the first week. It is spread by contact with an infected person's nose drippings from a runny nose, air droplets from sneezing/coughing, contact with their spit/saliva and stool then touching another person's eyes, mouth or nose, by touching their blisters, kissing and hugging an infected person, through sharing utensils, and contact with infected toys and other surfaces (think counters, door knobs, switches, etc). Children are most infectious at the beginning of the illnesses; even before the rash develops. Even though the illness lasts only seven to 10 days, the virus can survive in stool for many weeks. It affects mainly young children, age five years and under, but it can affect older children and rarely adults. Children in basic school/pre-school/kindergarten are more susceptible to being infected.

Symptoms

First, there is a fever; usually a high fever (101-103 degrees Celsius) which lasts one to two days. The child will be fussy, appetite is little to none, and they will likely have a sore throat. Your child may tell you their throat is hurting, and not want to eat because it may be painful to swallow. They could also have a stomach ache, vomiting, and runny nose. After a day or two, these symptoms will subside.

Then, an itchy rash develops to the hands, feet, elbows, knees, palms (hand-middle) and soles (foot bottom), groin and buttocks. The rash can occur anywhere — I've even seen it on a patient's earlobe. It starts as tiny bumps, then turn into blisters that may burst/rupture and eventually a scab will form. The rash can be INCREDIBLY itchy causing significant discomfort to the little ones, and may be painful when they rupture.

They also develop painful sores in and around the mouth, so your child may not want to eat and prefer drinking.

For parents and caregivers, it's hard to watch your baby be so uncomfortable.

Treatment

As with most viral illnesses, there is no specific treatment to get rid of or cure the illness. It has to run its course and the body's immune system will do its work. The illness is usually mild, although uncomfortable and distressing for baby and parents, and will clear up in seven to 10 days on its own, We can treat the symptoms to alleviate pain and discomfort.

For fever and pain; give paracetamol/acetaminophen (that is Panadol or Tylenol). Follow the dosage chart on the side of the box or as directed by a doctor. Panadol should be given no more than every four hours. Tepid sponge baths can also help to reduce the fever. Ensure lots of hydration and rest. Even if they aren't eating, make sure they drink — water, fruit juices, coconut water, etc. Include foods/liquids rich in vitamin C and zinc which can help in boosting our immune system.

Of note, do NOT give any NSAIDS like Diclofenac (brand name Cataflam). During this time, any illness with fever could be dengue, and NSAIDs can lead to very severe dengue symptoms. Also, do not give aspirin as this may lead to Reye's syndrome.

For the mouth sores, if your child can swish and spit, let them do a warm salt water rinse. This can help to soothe the sores. Eating cold foods like popsicles, jello, yoghurt, etc can reduce their discomfort as well. Because the sores are usually painful, they may not eat, so ensure that they are at least drinking. Avoid salty, spicy and acidic foods. Those may irritate the mouth sores and cause more pain.

For the itchy rash, antihistamines (eg DPH, Histal, Aerius or Zyrtec) can alleviate itching. Calamine lotion may help as well. If you apply a cold object to the skin — like holding a bottle with frozen liquid to the foot bottom — it can ease the discomfort for a short while. Diaper cream with zinc oxide can help to "dry up" the rash as well. Oatmeal baths can soothe skin irritation. If the rash is extremely itchy, you can mix hydrocortisone cream with an antibiotic ointment and apply to the affected areas, but wait a few days after its onset. I have found good ol' aloe vera helps to soothe irritated skin.

Keep kids out of school and away from others for seven to 10 days, and until the rash is healed/dried up.

HFMDz is usually a mild illness, but there can be complications. Because of the painful mouth sores and decreased appetite, your child may not eat or drink much, which means they are at risk of becoming dehydrated. It is important that your child drinks enough fluids to prevent this.

There have been accounts of fingernails and toenails falling out after the virus, but they grow back. VERY rarely, a small number of people may develop an infection in the brain or spinal cord (meningitis and encephalitis).

If your child is severely dehydrated, lethargic or very droopy, or has a fever longer than three days, or having symptoms longer than 10 days, please seek medical attention.

It is important to remember that the virus that causes HFMDz is very contagious, and spreads at the very onset of the disease, even before you realise the children are sick. We can minimise the spread by ensuring effective and proper hygiene. Caregivers, including schools and daycares, should disinfect toys and frequently touched surfaces regularly, ensure hand washing for 20 seconds after taking care of babies — especially after diaper changes and cleaning up a runny nose or vomit, etc. Separate sick children from others and teach your children to cough and sneeze in their elbows, not their hands, followed by hand washing or using a hand sanitiser, encourage them not share food and drinks or utensils with others (this one will be hard, especially for toddlers), and teach them when and how to properly wash their hands.

Dr Tal's Tidbit

Hand, foot and mouth disease is a viral illness that brings fever and rash lasting about a week. The rash affects the hands and feet, including the palms and soles, but can affect the entire body. It is usually mild, but can cause lots of discomfort for your little one. It is very contagious so ensure good hygienic practices to limit and prevent its spread.

Dr Taleya Girvan has over a decade's experience treating children at the Bustamante Hospital for Children, working in the Accident and Emergency Department and Paediatric Cardiology Department. Her goal is to use the knowledge she has gained to improve the lives of patients by increasing knowledge about the health-care system in Jamaica. Dr Tal's Tidbits is a series in which she speaks to patients and caregivers providing practical advice that will improve health care for the general population. E-mail: dr.talstidbits@gmail.com IG @dr.tals_tidbits

T
he
HEART/NSTA Trust and the United Nations Children's Fund (UNICEF) Jamaica signed a memorandum of understanding (MOU) to further strengthen human development in Jamaica.

Speaking at the signing ceremony, the heads of both entities welcomed the partnership and signalled their commitment in providing yet another initiative to empower and provide meaningful opportunities for youths.

The partnership, under the banner of UNICEF's FunDoo initiative, seeks to equip young individuals with essential life and employability skills and facilitate their seamless transition into the workforce. The WhatsApp-based FunDoo will be accessible through UNICEF's technological innovation, U-Report, which is operated in 95 countries.

Dr Taneisha Ingleton, managing director of HEART/NSTA Trust, expressed that the partnership signifies an unwavering commitment to the youth of Jamaica.

"It is a beacon of hope, a promise of transformation, and a testament to the power of collaboration. Together, we will make a difference in the lives of thousands of young people, equipping them with the skills and opportunities they deserve," she said.

In welcoming the collaboration, country representative, UNICEF Jamaica, Olga Isaza stated that the initiative seeks to target youth who are not employed, neither are they in school, nor enrolled in any form of training programme to help them to transition into these opportunities.

"We are working to help teens develop the skills they need to adapt to the various challenges they may face in the future through our 21st-Century Skills Framework on which FunDoo is based. In addition to free career guidance, other skills include time management, critical thinking, resume writing and budgeting," she added.

The MOU articulates areas of collaboration, including:

1. Career Development: HEART/NSTA Trust will provide career profiles and road maps to UNICEF for career guidance and life skills.

2. Try-a-Skill Programmes: HEART/NSTA Trust will supply bite-size training contents for FunDoo and manuals for execution. UNICEF will develop mini-courses on FunDoo using

HEART's provided training content.

3. Capacity Building: UNICEF will provide master trainer training for HEART/NSTA Trust instructors, ensuring high-quality delivery. HEART/NSTA Trust will supply teachers to be trained as master trainers.

4. Trainees' Participation: HEART/NSTA Trust will actively promote FunDoo to both new and existing trainees. UNICEF, in addition to FunDoo, will provide HEART/NSTA Trust's participants with access to U-Report services, including the U-Matter mental health chatline. UNICEF will also encourage FunDoo users to enrol as new HEART trainees.

5. Monitoring: HEART will closely monitor the progress of trainees who transition into our training programmes or job opportunities.

Dr Ingleton noted that the partnership is perfectly aligned with Jamaica's national priorities, as it supports the Jamaica Country Office's education programme goal of transitioning 3,000 unattached young people into education, employment, or training.

Additionally, she stated that the initiative will engage at least 13,500 young individuals in the FunDoo programme, equipping them with the skills they need to thrive.

Both heads of entities welcomed the impact that the initiative will have on youths during the period of the partnership. "Today, we are holding hands and taking an important step together on behalf of the next generation to equip and empower them to fulfil their potential," declared UNICEF's Country Representative Isaza.

The MOU was signed at the HEART/NSTA Trust's corporate office located on Oxford Road in Kingston, on October 4, 2023.

The Ministry of Health and Wellness has confirmed a dengue fever outbreak in Barbados.

Chief Medical Officer, Dr Kenneth George, disclosed that the threshold was reached at the end of September, where 518 cases were recorded compared to the same period in 2022, when there were 241 cases. The Ministry of Health and Wellness classifies a case of dengue fever as both suspected and confirmed.

Of the 40 confirmed cases of dengue for the year, 28 were recorded in September.

“These recent increases signal the start of a dengue fever outbreak in Barbados in September 2023. There were no confirmed cases in 2022,” the Chief Medical Officer stated.

The Pan American Health Organization (PAHO) has also advised that there have been outbreaks in Martinique and Guadeloupe in the Eastern Caribbean, with dengue virus serotype 2 resulting in some hospitalisations.   There have also been recorded rising cases in the OECS, including Grenada. The World Health Organization recently indicated that increased cases of mosquito-borne disease were likely in Europe, the United States of America and Africa, as a result of climate change (warmer, wetter and less reliable climate).

Dengue fever is an acute mosquito-borne febrile illness caused by infection with one of the four known dengue serotypes.  It is endemic in Barbados with occasional outbreaks.

The public is reminded of the symptoms, which include headaches, muscle and joint pains, vomiting and a characteristic skin rash. Most cases are self-limiting and recovery generally takes two to seven days.

In severe cases, haemorrhagic symptoms and organ failure can occur, which may, on occasion, result in shock and death. The likelihood of adverse outcomes occurs when there are multiple strains circulating. The Best-dos Santos Public Health Laboratory has advised that serotypes 1, 2 and 3 are circulating in Barbados.

Dr George urged members of the public to take immediate protective actions. These include:

• Source reduction – removal of sites and receptacles where stagnant water can collect. For example, the overflow dishes of plant pots in homes, plant cuttings and discarded tyres,
• using mosquito repellent on the skin,
• wearing light-coloured, long-sleeved shirts and long pants, particularly during peak biting times – dusk and dawn,
• using mosquito nets over infant beds, cribs, carriers and strollers,
• and installing window and door screens to keep out mosquitoes.

Additionally, Dr George advised persons who have an unexplained fever or exhibit any of the other symptoms mentioned above, to seek medical attention.  A blood test will be required for confirmation of dengue fever.

The Chief Medical Officer said that the Ministry of Health and Wellness will use the location of reported suspected and confirmed dengue cases to inform its fogging campaign. He further advised that any unusual increases in mosquito sightings should be reported to the environmental health department of the nearest polyclinic. To date, there have been no deaths attributed to dengue fever.

(BGIS)

The post Dengue fever outbreak in Barbados, Health Ministry confirms appeared first on Barbados Today.

President of the Barbados Association of Medical Practitioners (BAMP) Dr Lynda Williams is suggesting that the revenues collected from the 20 per cent sugar-sweetened beverage excise tax and the soon-to-be-implemented tax on products high in salt content be used specifically within the health sector.

She told Barbados TODAY she would prefer if the money collected by the government from those taxes be set aside specifically to boost the budget for healthcare, rather than be placed into the Consolidated Fund – the government account into which all revenues are paid and from which all spending is made.

“If we just put it in the general funds and hope that you can increase your health fund, that most likely will not happen,” the prominent doctor said.

“My feeling about all those things is that it works as long as the money that is collected from this goes towards health expenditure. If you are just putting on a tax and put it in the general fund as just another collection of taxation, and you hope that it pans out to be more expenditure for health, that is less significant than knowing that [based] on this revenue, this is how much to increase health expenditure by.”

Barbados has one of the highest rates of overweight and obese populations within Latin America and the Caribbean, with about 30 per cent of children considered overweight and 14 per cent obese.

About one in every three Barbadian adults is considered overweight, and a similar number is obese.

In an effort to help reduce the intake of sugar-sweetened beverages among Barbadians and control non-communicable diseases (NCDs) such as diabetes, the government introduced a 10 per cent excise tax on sugar-sweetened beverages in 2015. This was designed to generate in excess of $10 million in its first year.

Effective April 1, 2022, the Mia Mottley administration increased the excise tax on sweetened drinks to 20 per cent.

Dr Williams said she supported the tax measure but stressed that it was important for the government to know exactly how much was being collected and put that towards the development of the health sector.

The government is currently in the process of reviewing a draft policy for similar taxation on products high in salt content. This could be ready for implementation as early as the first quarter of next year.

“We have had the discussion about sugar taxes and we have implemented sugar-sweetened beverage taxes; now there is the discussion about salt…. Taxes have been shown in other countries to cause a reduction in spending when people are purchasing,” said Williams.

A joint University of the West Indies and Cambridge University study released in 2019 concluded that Barbadians were buying fewer sweet drinks and getting more bottled waters and non-sugar alternatives.

It showed that consumption dropped by some 10 per cent one year after the tax was implemented, when compared to two years before.

marlonmadden@barbadostoday.bb

The post Use sugar and salt tax to fund healthcare, says BAMP head appeared first on Barbados Today.

The Phase III trials will soon open for recruitment.

Additional Phase II data, presented at the 59th Annual Meeting of the European Association for the Study of Diabetes (EASD), demonstrated reductions in absolute waist circumference (up to 16.0 cm), absolute body weight (up to 19.5 kg) and absolute systolic and diastolic blood pressure (up to 8.6 mmHg and 4.8 mmHg, respectively) over 46 weeks.

“As the prevalence of the disease of obesity continues to increase, it is imperative that we develop additional innovative approaches to address this serious, chronic disease,” said Carel le Roux, M.D., Ph.D., Professor at University College in Dublin, Ireland, and Principal Investigator of the trial. “Survodutide has a novel mechanism of action with the potential to reduce appetite while increasing liver energy expenditure. The promising Phase II data give us reason to be hopeful about the potential of survodutide as a treatment for people living with the disease of obesity.”

SYNCHRONIZE-1 (NCT06066515) and SYNCHRONIZE-2 (NCT06066528), now listed on clinicaltrials.gov, are Phase III studies investigating survodutide in people with obesity (BMI ≥30 kg/m2) or overweight (BMI ≥27 kg/m2) with comorbidities, including dyslipidemia, hypertension and obstructive sleep apnea. SYNCHRONIZE-1 will enrol people without type 2 diabetes (A1C <6.5%) and SYNCHRONIZE-2 will enrol people with type 2 diabetes (A1C ≥6.5%, <10%).

For both studies, the primary endpoints are percent change in body weight at week 76 and the proportion of people who achieve body weight loss of 5% or more at week 76. Secondary endpoints include body weight reductions of at least 10%, 15% and 20% at week 76. A total of 600 participants will be enroled in each of the two studies, randomized to receive weekly subcutaneous injections of either survodutide, reaching a maximum dose of 3.6 mg or 6.0 mg for maintenance treatment, or placebo.

The third study, SYNCHRONIZE-CVOT, is a Phase III trial that will enrol people with overweight or obesity with cardiovascular disease, chronic kidney disease, or risk factors for cardiovascular disease. In SYNCHRONIZE-CVOT, the primary endpoint is the time to first occurrence of any one of five major adverse cardiac events (5P-MACE): death, non-fatal stroke, non-fatal myocardial infarction, ischemia-related coronary revascularization and heart failure events.

“By implementing the valuable insights gained from the Phase II study, we are confident in the accelerated development of survodutide,” said Carinne Brouillon, Head of Human Pharma, Boehringer Ingelheim. “Obesity is a chronic disease associated with serious health complications that affects hundreds of millions worldwide. With these trial initiations, we continue to build on our heritage of bringing differentiated and innovative treatments to address cardiovascular, renal, and metabolic diseases.”

“We are excited that survodutide will shortly enter Phase III trials through the global SYNCHRONIZE program for people living with overweight or obesity,” said David Kendall, MD, Chief Medical Officer of Zealand Pharma. “With novel peptide therapeutics like survodutide, we are targeting key metabolic pathways, and these therapies have the potential to address one of the most significant healthcare challenges in medicine today.”

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