How Pregnancy Changes a Runners Body

By GRETCHEN REYNOLDS

New research suggests that the biomechanical changes that occur during pregnancy can linger long afterward and significantly affect a womans running stride. Theres never been any doubt, of course, that pregnancy drastically changes a womans body. She gains weight, her center of gravity shifts and connective tissues become looser. These changes are desirable and necessary for birth. But they also affect how a woman moves. A study published in March in the journal BMC Pregnancy and Childbirth, for instance, documented how womens walking strides grew wider and shorter as their pregnancies progressed. They began, in essence, to waddle. But there has been little science available about how pregnancy affects running form, in part because relatively few women have run during and after their pregnancies. That situation is changing, though, thanks in part to strong evidence that running throughout pregnancy does not harm a womans fetus, together with well-publicized success stories like those of the marathoners Kara Goucher and Paula Radcliffe, who trained throughout their pregnancies and returned to competition soon after. But while more pregnant women and new mothers run today, many also experience unaccustomed aches and pains and a niggling feeling that somehow their stride is different now. Such complaints drive many new mothers to the doctors office. And they also sent some to the running clinic at the University of Wisconsin in Madison, whose director, Bryan Heiderscheit, a professor of orthopedics and rehabilitation, could find no studies examining running biomechanics in the pregnancy and postpartum periods. So he and his colleagues set out to conduct their own. So far, only a handful of women have been studied in depth, but the early results, presented at a 2013 sports medicine scientific meeting and published in The Journal of Orthopaedic & Sports Physical Therapy, are among the first to track biomechanical changes in a pregnant runners body and how those changes might effectively be managed. One of the cases involved a 27-year-old runner who, beginning in the sixth month of her pregnancy, began visiting the universitys exercise lab every four weeks. There, she ran on a treadmill while the scientists used 3-D motion-capture technology to study her form. Her final visit while pregnant came two days before she went into labor. Six months later, she returned to the lab for a follow-up run. By then, she was running on her own about 15 miles a week. The scientists found that as her pregnancy progressed, her pelvis began tilting forward more and more, altering to some degree how she landed with each stride. Six months postpartum,

much of that forward tilt remained. She also displayed more side-to-side pelvic motion while running than she had when she began the study six months into her pregnancy. She didnt report any appreciable pain while running. But that wasnt the case for another postpartum runner studied by Dr. Heiderscheits group a 33-year-old mother of two who visited the running clinic 14 months after her second child was born because of considerable hip and low back pain while running. After she ran on the lab treadmill, the researchers determined that her pelvis tilted abnormally far forward during running and moved too much from side to side. In effect, her pelvis remained unstable a year after her last pregnancy. Partly in consequence, her right leg struck the ground harder than the left, absorbing about 30 percent more force with each stride. None of this was surprising, Dr. Heiderscheit says. Pregnancy and labor stretch the muscles and connective tissues in the abdomen, which allows the slightly unmoored pelvis to tilt and sway. Unless a woman strengthens the affected muscles after pregnancy, the tissues remain stretched. Relying on that gym standby, crunches, wont do the trick, though, Dr. Heiderscheit says. They dont activate the small muscles deep within the abdomen. Instead, he suggests pulling the belly up and in multiple times and also imagining that youre trying to cut off the flow of urine. Using those techniques, together with traditional abdominal exercises like squats, planks and bridges (instructions for these can be found on The Journal of Orthopaedic & Sports Physical Therapys Web site), can help stabilize the pelvic area. They also suggested that the woman shorten her stride by about 10 percent to reduce the pounding that she experienced as she ran. After seven weeks, the woman reported that her feelings of pain while running had dropped from a constant 9, on a scale of 1 to 10, to an occasional 3. She returned to running about 20 miles a week. Reaction I think its time that we acknowledge that having a baby is going to change how you run. The changes are not necessarily dangerous. There is no evidence that a majority of mothers are slower runners or more injury-prone after giving birth. But things are likely to feel different if you are already a motherIn Medicine, Falling for Fake Innovation

DA VINCI ROBOT, HEALTH CARE COSTS, HEALTH CARE REFORM, MEDICINE AND HEALTH, PATIENT PROTECTION AND AFFORDABLE CARE ACT

Ezekiel J. Emanuel THE sleek, four-armed da Vinci robot has been called a breakthrough technology for procedures like prostate surgery. Imagine, the manufacturer says, having the benefits of a definitive treatment but with the potential for significantly less pain, a shorter hospital stay, faster return to normal daily activities. Thats just the kind of impressive-sounding innovation that critics of the health care reform act say will be stifled by the new law, with its emphasis on cost control and the comparative effectiveness of new pills and devices. Instead of encouraging innovation, wrote Senator Ron Johnson, Republican of Wisconsin, in The Wall Street Journal, it stifles creativity. The critics are right if theyre talking about innovations like the da Vinci robot, which costs more than a million dollars and yet has never been shown by a randomized trial to improve the outcomes of prostate surgery. Indeed, a 2009 study showed that while patients had shorter hospital stays and fewer surgical complications like blood loss when they underwent this kind of robotic surgery, they later experienced more incontinence and erectile dysfunction. Similar problems are occurring with robotic surgery for other cancers. In other words, this is a pseudoinnovation a technology that increases costs without improving patients health. The Affordable Care Act will not reward this kind of innovation. But by providing incentives for hospitals to reduce infections, errors and readmissions, giving doctors more information on the comparative effectiveness of medical interventions and emphasizing preventive care over expensive services, the act will stimulate a panoply of true medical innovations. These may not be flashy; they might not even be visible to patients. But they will improve health care and lower costs. For instance: checklists. A 2006 study showed that a five-item checklist including hand-washing and cleaning a patients skin could reduce infection rates from intravenous catheters to nearly zero. According to the study, these infections cost an average of $45,000 per patient, and cause as many as 28,000 deaths among intensive care unit patients each year. Reaction
These innovations are so expensive Affordable Care Act was not shown in these innovations. We will see many other true innovations small and large, high-tech and non-tech. We have benefited tremendously from medical innovations like M.R.I. scanners, cardiac stents and powerful new drugs, and should celebrate the fact that the United States is the leader in developing medical technologies. For me no matter how much it cost as long it prolongs life I will support it.

When Children Give Birth to Children

by Mallika Aryal (Champi, Nepal)Thursday, July 11, 2013Inter Press Service

CHAMPI, Nepal, Jul 11 (IPS) - Radhika Thapa was just 16 years old when she married a 21-year-old boy three years ago. Now, she is expecting a baby and is well into the last months of her pregnancy. This is not the first time she has been with child her first two pregnancies ended in miscarriages.

Teen mothers give birth to 81 out of every 1,000 children in Nepal. Credit: Mallika Aryal/IPS "The first time I conceived I was just 16, I didn't know much about having babies, nobody told me what to do," Thapa tells IPS in between assisting customers at the vegetable store she runs with her husband in the small town of Champi, some 12 km from Nepal's capital, Kathmandu. 3"The second time I wasn't ready either, but my husband wanted a baby so I gave in," she admitted.After the second miscarriage, Thapa's doctors urged her to wait a few years before trying again, but she was under immense pressure from her in-laws, who threatened to "find another woman for her husband if she kept losing her babies". What might seem like a horror story to some has become an accepted state of affairs in Nepal, the country with the highest child marriage rate in the world.

According to the 2011 Nepal Demographic and Health Survey (NDHS), 17 percent of married adolescent girls between 15 and 19 years are either pregnant or are mothers already. In fact, research shows that adolescent mothers give birth to 81 out of every 1,000 children in Nepal.The survey also shows that 86 percent of married adolescents do not use any form of contraception, meaning that few girls are able to space their births."You are talking about a child giving birth to another child," Giulia Vallese, Nepal's representative for the United Nations Population Fund (UNFPA), told IPS. Disturbed by trends in countries like Nepal, the UNFPA spotlighted teen pregnancy as the theme for this year's World Population Day, observed annually on Jul. 11."Globally there are 16 million girls aged 15-19 who give birth each year - they never had the opportunity to plan their pregnancy. It is a developmental issue that goes beyond health," Vallese stressed.

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Whether the teenage girls are married or unmarried, sex education plays a major role in decreasing the number of pregnancies.Sex education is a part of the national school curriculum from Grade 6 upwards, but teachers are not trained, and are uncomfortable talking about it. When the subject comes up in a classroom, most teachers simply skip that chapter, or defer to a health worker to explain the process of reproduction."There's a general (perception) that teaching about sexual health makes girls promiscuous, but we have found it to be exactly the opposite,

Pharmaceutical Corporations and Medical Research

by Anup Shah

Pharmaceutical companies have contributed to peoples improved health and prolonged life, generally speaking. Research and development of drugs that are brought to market can be costly and there are strict regulations and requirements that companies must follow in most countries. But the details reveal further concerns. For example, marketing practices and priorities of the pharmaceutical industry have come under scrutiny for many years. It seems that there is increasing emphasis on drugs that fit scare-mongering and over-medicalized problems. Testing and thorough clinical trials are fundamental to good medical drugs, but there are numerous accusations of shortcuts, including pressuring for favorable results, testing on people without their proper approval, using drugs for unapproved uses and much more.

Ideologically, many drug companies support the position of less government involvement, yet in the developing world in particular, diseases and illnesses affect the poorest the most who cannot afford expensive (or even sometimes cheap) treatments. In the past decade or so, pharmaceutical companies have therefore also been criticized for ignoring this market because they cant pay. Public announcements of drug donations to poor countries are often welcome, but sometimes the details reveal murkier intentions; some of the drugs are close to, or even past, their expiry date (and are expensive to dispose, adding more costs to recipient countries) for example.

Poorer countries encourage their drug companies to make cheaper generic alternatives to expensive branded ones or use other tools available at their disposal to help bring the price of medicines down to more affordable levels. But they face immense pressure from international institutions and multinational pharmaceutical corporations, even when generics and other options pursued are legitimate under international rules. For these multinationals, theyve poured billions into some of these drugs and therefore want a patent system that will protect their investments for as long as possible. For the developing and poorer countries, as remote as these issues may seem, patents and intellectual property rights issues can mean life or death. (For example, at the end of the 1990s, the pharmaceutical industry lobbied the US government to threaten sanctions on South Africa for trying to produce generic drugs to fight its growing AIDS problem. It took huge public outcry to get the case dropped some 2 years later.)

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Drug companies spend more on advertising and marketing than on research, more on research on lifestyle drugs than on life saving drugs, and almost nothing on diseases that affect developing countries only. This is not surprising. Poor people cannot afford drugs, and drug companies make investments that yield the highest returns.

Obesity
by Anup Shah

Obesity is a growing global health problem. Obesity is when someone is so overweight that it is a threat to their health. obesity typically results from over-eating (especially an unhealthy diet) and lack of enough exercise.In our modern world with increasingly cheap, high calorie food (example, fast food or junk food), prepared foods that are high in things like salt, sugars or fat, combined with our increasingly sedentary lifestyles, increasing urbanization and changing modes of transportation, it is no wonder that obesity has rapidly increased in the last few decades, around the world. For the first time in human history, the number of overweight people rivals the number of underweight people. While the worlds underfed population has declined slightly since 1980 to 1.1 billion, the number of overweight people has surged to 1.1 billion. The population of overweight people has expanded rapidly in recent decades, more than offsetting the health gains from the modest decline in hunger. In the United States, 55 percent of adults are overweight by international standards. A whopping 23 percent of American adults are considered obese. And the trend is spreading to children as well, with one in five American kids now classified as overweight. Obesity cost the United States 12 percent of the national health care budget in the late 1990s, $118 billion, more than double the $47 billion attributable to smoking. Overweight and obesity are advancing rapidly in the developing world as well while 80 percent of the worlds hungry children live in countries with food surpluses. Technofixes like liposuction or olestra attract more attention than the behavioral patterns like poor eating habits and sedentary lifestyles that underlie obesity. Liposuction is now the leading form of cosmetic surgery in the United States, for example, at 400,000 operations per year. While billions are spent on gimmicky diets and food advertising, far too little money is spent on nutrition education. Chronic Hunger and Obesity Epidemic; Eroding Global Progress, World Watch Institute, March 4, 2000 As people eat more and more health and safety of the food production process become more important, too. Nursing Schools lists a number of concerning facts about food in the US:

40-50% of all food ready for harvest never gets eaten. Every year, over 25% of Americans get sick from what they eat. As few as 13 major corporations control nearly all of the slaughterhouses in the U.S. Americans eat 31% more packaged food than fresh food. The FDA tests only about 1% of food imports. (The US imports about 15% of what they eat.) A simple frozen dinner can contains ingredients from over 500 different suppliers so you have to trust all of those hundreds of companies along the way stuck to regulations about food safety. 50% of tested samples of high fructose corn syrup tested for mercury. Americans eat about six to nine pounds of chemical food additives per year. Food intolerance is on the rise, with as many as 30 million people in the U.S. showing symptoms. Fewer than 27% of Americans eat the correct ratio of meats to vegetables. 80% of the food supply is the responsibility of the FDA yet the number of inspections has decreased while the number of producers has increased. Keeping fields contamination-free can cost well over $250,000a discouraging sum to smaller farmers.

Reaction Healthy eating often being more expensive than less healthy options, despite global food prices having dropped on average, the market today especially company who advertise through television aims to persuade individuals particularly children that they desire foods high in saturated fats, sugars, and salt. As nurse we should partake in doing what it should be done. Promote healthy and affordable food.

Kenyas Mothers Shun Free Maternity Health Care

by Miriam Gathigah (Nairobi)

NAIROBI, Jul 09 (IPS) - It has been a month since the Kenyan government waived the maternity fee at public health facilities, but Millicent Awino is still one of the many expectant mothers in favour of a home birth. Beatrice Mudachi does not like delivering in hospital because she says her first baby was neglected by hospital staff. Courtesy: Miriam Gathigah "During childbirth my uterus comes out, a traditional birth attendant has the knowledge of how to push the uterus back into position, unlike at the hospital," Awino tells IPS. Alice Anyango, a traditional birth attendant from Nairobi's Mathare slums, tells IPS: "The uterus should not be touched with hands as they do in hospital, hence damaging it. One should throw a pitcher of cold water at it and it will retreat back to position." But her treatment is not medically sound. Professor Joseph Karanja, a gynaecologist and obstetrician, dismisses the treatment. "Indeed there are cases where the uterus can come out and it is a very serious situation."But medically, the uterus is simply pushed back to its position with hands," he explains.

Until now, Kenyan mothers had to pay anything from 12 dollars in rural clinics to 90 dollars in local hospitals for maternity care. If a woman had a caesarean section, it cost 150 dollars. But these fees were scrapped on Jun. 1 and hospitals, health centres and clinics across this East African nation are offering maternity services free of charge. But according to Teresia Wangai, a qualified midwife at a regional hospital, the fee waiver has not led to an increase in women giving birth at hospitals. "We expected to receive more expectant mothers, but I have delivered fewer babies this month. Many women seem to have stayed clear of government health facilities for fear that the fee waiver will worsen the quality of health care," she tells IPS. While medical doctors like Dr. Joachim Osur believe that scrapping the maternity fee is a step in the right direction, myths and misconceptions still held by mothers like Awino continue to influence their decision to use traditional birth attendants and deliver at home. Government
statistics show that in Kenya at least one in five babies born to HIV-infected mothers also have the virus.

"Delivering in hospital is very significant, precautions can be taken to prevent HIV transmission of motherto-child," says Karanja.Karanja adds that traditional midwives are also placing themselves at risk of contracting HIV "since they often do not have the necessary supplies required during delivery, not even gloves." But Angelas Munani, a traditional birth attendant, is not oblivious to this risk. "We wear two polythene bags and tie a string around the wrist to avoid coming into contact with a mother's blood during delivery," she tells IPS.

Reaction I understand that the feeling of an expectant mothers, wants to seek comfortable place to give birth. But for health reason a must think twice if she wants give birth at home or in the hospital. Delivering a baby is very risky for the mother and the child.

DNA test helps doctors avoid false positive cancer diagnoses

By Amanda Woerner Published July 12, 2013

DNA-Entnahme bei einer weiblichen Patientin / DNA-Test from a human mouth (Peter Jobst) Imagine being told you have cancer only to learn that your biopsy had been contaminated or mixed-up with someone elses. This scenario happens to approximately 3,000 women who undergo breast biopsies every year or one out of every 100 cases. And for every false positive theres a false negative, Dr. Andrew Kenler, an assistant clinical professor of surgery at Yale Medical School, told FoxNews.com. When you tell a woman she doesnt have breast cancer but she does, 6,000 patients a year (could) be under or over treated. So how exactly do these errors occur? The process of taking a biopsy, sending it to a lab for analysis and then getting the results back can be complex, often comprised of as many as 15 to 20 different steps. Because of these intricacies, specimens have the potential to be mislabeled or contaminated along the way. Pathology labs may do 40 or 50 breast cancer (tests) a day and they will use these k ind of vats where they place the slides all together, Kenler said. So there is the opportunity, as these cases are being analyzed, for cells and tissue from one patient to contaminate cells and tissue from another patients slides. Fortunately, Kenler said there is an easy method available to prevent these often devastating mistakes: DNA testing. The way we prevent these errors now is using this kit called the Know Error system where at the time of the core biopsies a swab is taken from the patients cheek, Kenler said. We use that swab as a reference sample. Its basically a DNA fingerprint of the patient. Using the Know Error test each patients biopsy can be compared to their DNA sample to ensure that the results are 100 percent accurate. Kenler saisIf theres a mismatch we now know, based on this sophisticated, intelligent and fairly inexpensive test, that there must have been an error or contamination, Reaction I actually like this because for a woman like me I dont want surgery until I know I truly have breast cancer. This test is easy and stress-free.

THAILAND: Scientists Race to Find Microspecies Useful for Medicine by Nantiya Tangwisutijit* - IPS/IFEJ (Bangkok)
He spends so much time immersed in water as if she were a mermaid. But Jariya Sakayaroj looks like she does not mind even if she ends up developing scales. A microbiologist with the Bioresources Technology Unit of the National Center for Genetic Engineering and Biotechnology (BIOTEC), Jariya knows that the hours she spends wading through Thailands coastal areas may result in discoveries that could one day help battle illnesses like heart disease, cancer, or osteoporosis. Jariya trawls the waters for fungi that may harbour bioactive compounds that could be used for medical treatments. She says that the unique ecology of mangroves, with their brackish water rising and falling twice daily, represents a particularly hostile environment for fungi, making their resilience especially attractive to pharmaceutical companies. She warns, though: 'We will never know which ones we might be losing as the seas warm and storm patterns shift, (taking) the benefits along with them. Yes, there are big changes taking place out there that we need to address, but the microscopic ones need attention too.' Indeed, while much of the world now considers the declining ice habitat of polar bears as the main harbinger of ecological losses from advancing climate change, Thai scientists have been working in relative obscurity as they race against time to document microspecies in aquatic ecosystems. Jariya says microorganisms represent one of the largest segments of the planets biological inventory. But she says that only about 10 percent of the worlds estimated 1.5 million microorganisms have been identified so far, and she fears that many may be disappearing before their compounds are known. 'Thailand is critical because about 10 percent of the worlds microorganisms and fungi can be found in here,' she sa ys. Of the 549 high marine fungi species known to exist in the world, 180 are found in this South-east Asian country. Forty of these are new species that Jariyas marine fungi unit has discovered over the past decade. More than 60 years ago, penicillin introduced the world to fungis value to medicine. But it has only been during the past 15 years that researchers have been more aggressive in combing the planet for new fungi and bacteria that can advance medical treatments. So far, 15 BIOTEC researchers probing marine, fresh water and forest ecosystems have identified 2,500 new microorganisms and 70 new bioactive compounds with new biochemical structures. These are now in the laboratories of the Swiss pharmaceutical giant Novartis, where they are undergoing further screening to identify substances that may be effective in treating diseases. Novartis came to Thailand in 2005 to partner with Jariya and other BIOTEC researchers in the quest for new microorganisms from which natural compounds to use in medicines might be found. According to BIOTEC about 20 percent of the microorganisms now being studied by Novartis come from Thailand. This is a development that has some Thai experts wary, however. For instance, pharmacologist and herbal medicine expert Supaporn Pitiporn of the Abhaibhubejhr Hospital in the eastern province of Prachin Buri points out that while Jariyas work is critical, Thailand must keep close tabs on the bioactive compounds discovered within its borders. 'The benefits of fungi in particular are invaluable, used in many traditional healings, including detoxification, and as nutrient supplements,' says Supaporn, who turned her hospitals herbal products into national best- selling healthcare products.

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Were just now beginning to really understand what microorganism can offer us. So we need to make efforts to protect the ecosystems because to sustain them are becoming increasingly important.

The dark side of diet drinks?

By Amanda Woerner

Zero-calorie beverages may seem appealing but a new paper argues that artificially sweetened drinks could actually throw off your metabolism, affecting the way your body processes regular sugars. Published in the journal Trends in Endocrinology and Metabolism, the report argues that artificially sweetened beverages are not only linked with ill health effects similar to those associated with consuming regular soda but they may even cause worse long term health outcomes. In lots of ways, (artificial sweeteners) have been given the benefit of the doubt just because they dont have any calories, lead author Susan Swithers, of the department of psychological sciences and ingestive behavior research center at Purdue University, told FoxNews.com. Researchers have noted a correlation between diet soda consumption and poor health for years, but Swithers maintained that the link has never been thoroughly examined. The typical response has been to dismiss this from the perspective of, its only people who are unhealthy or heavy who drink diet soda in the first place, Swithers said. However, Swithers and her colleagues hypothesize that behavioral explanations arent fully to blame. In fact, based on an analysis of research, they predict that artificial sweeteners may actually train peoples brains and bodies to react differently when they taste something sweet. What happens when you have a sweetener is you get that sweet taste but calories and sugar dont show up, Swithers said. Your body says, Wait, this isnt what I was expecting to happen, and over time you may not produce those same anticipatory responses. Blunting those responses could cause people to overeat and experience consistently higher blood sugar levels, which could potentially lead to the onset of Type 2 diabetes, according to Swithers. Overall, Swithers is calling for more research to be done into the connection between artificial sweeteners and poor health. Until we can recognize that these risks exist, we wont be able to figure out what is causing them and how to avoid them, Swithers said. In a statement regarding the paper, the American Beverage Association said, "This is an opinion piece not a scientific study. Low-calorie sweeteners are some of the most studied and reviewed ingredients in the food supply today. They are safe and an effective tool in weight loss and weight management, according to decades of scientific research and regulatory agencies around the globe

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When it comes to artificial sweeteners, opinion appears to be divided. If you're accustomed to drinking sugar-sweetened beverages why not try the healthy options, such as skim milk, a small glass of 100 percent fruit juice and sparkling water flavored with a slice of citrus.

FDA Wants To Crack Down On Arsenic Levels in Apple Juice

Main Category: Public Health Article Date: 12 Jul 2013 - 8:00 PDT Written by Honor Whiteman The US Food and Drug Administration (FDA) has proposed an "action level" on the amount of inorganic arsenic in apple juice, based on findings from its latest data. The agency are looking to set a limit of 10 parts per billion (ppb) of arsenic in the fruit juice, which will reduce it to the same level the US Environmental Protection Agency (EPA) has set for the amount of arsenic in drinking water. Although previous tests by the FDA over the past 20 years have shown that arsenic levels in apple juice are low, the agency has used new tools in order to understand the breakdown between inorganic and organic arsenic levels. The latest FDA data analyzed 94 samples of apple juice containing arsenic. It found that 95% of the samples tested were below 10 ppb total arsenic and 100% of the samples were below 10 ppb for inorganic arsenic. The agency says the proposed level of 10 ppb takes this data into account, as well as a peer-reviewed assessment of inorganic arsenic in apple juice conducted by FDA scientists, based on lifetime exposure. The FDA says it is establishing this threshold to provide "guidance to industry." The agency takes into account the "action level" before proceeding with enforcement action if it finds a food product exceeds the threshold. Arsenic poisoning (arsenicosis), is caused by the ingestion, inhalation or absorption of dangerous levels of arsenic, a natural semi-metallic chemical found in groundwater. Arsenic can be a carcinogen, a direct cause of cancer, if consumed in large quantities.

Sources of arsenic in apple juice

According to the FDA, possible sources of inorganic arsenic in apple juice include processing aids, prior use of arsenic based pesticides in other countries, naturally high levels of arsenic in soil or water, and exposure to arsenic from industrial activities. Michael Taylor, the FDA's deputy commissioner for foods and veterinary medicine, adds:"While the levels of arsenic in apple juice are very low, the FDA is proposing an action level to help prevent public exposure to the occasional lots of apple juice with arsenic levels above those permitted in drinking water." In its proposal, the FDA says that the presence of inorganic arsenic exposure in apple juice is a greater risk for children, who consume more apple juice relative to their body weight. The proposal also points out that recent assessments from the Joint Food and Agriculture Organization (FAO) / World Health Organization (WHO) Expert Committee on Food Additives (JECFA), which also includes research from FDA scientists, conclude that food in general can be a major contributor to inorganic arsenic. The European Food Safety Authority (EFSA) concluded that exposure to inorganic arsenic in food needs to be reduced, and the FDA says that these findings "suggest a need to reduce exposure to inorganic arsenic from food." The FDA says it will accept public comments on the action level and the risk assessment for 60 days.

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The FDA is committed to ensure the safety of the American food supply and to do what is necessary to protect public health. Arsenic poisoning is a serious issue and if we consumed large quantities of this this may lead to cancer.

Knowledge and attitude of women of childbearing age towards the legalization of abortion, Ethiopia
Shimelash Bitew *1, Samrawit Ketema1, Minyiehal Worku1, Mustefa Hamu1, Eskindir Loha1
INTRODUCTION

Each year half a million mothers die due to maternal causes, of which 99% occur in developing countries and from this 84%, is in sub- Saharan Africa and south Asia. The leading causes of maternal death include hemorrhage (25%), infection (15%) and unsafe abortion (13%).1 Each year greater than 42 million pregnancies are terminated due to various reasons. Of this 22 million occur in countries where abortion is legalized and in safe ways. The rest 20 million occur mostly in the developing countries where abortion is not legalized and in unsafe ways.2 Ethiopia is the 5th in maternal mortality according to the WHO 2005 report and unsafe abortion accounts for 32 % of the causes of maternal death. It is also one of the top 10 reasons for mothers to seek hospital admission in Ethiopia.3 Besides maternal mortality, unsafe abortion causes other serious complications like hemorrhage, sepsis, uterine perforation, lower genital tract trauma disseminated intra vascular coagulation, shock, renal and cardiac failure which may result in permanent disability and incapacitating condition like infertility and psychological problem.The main determinants of unsafe abortion are: prevalence of family planning, emergency contraceptive, legalization of abortion and the skill of the health professionals.2, 3 Unsafe abortion can be prevented and reduced by expanding and improving family planning services and choice. Many married women in developing countries do not have the access to the contraceptive methods of their choice. This situation is even more difficult for unmarried women particularly adolescents. Contraceptive services are often unable to meet the growing demand of couples for fertility regulation, resulting in an increased number of unplanned pregnancies some of which are terminated by inducing abortion. In Ethiopia the percentage of women aged 15-49 who currently use a modern method of contraceptive is very low, at only 9.7%, as is the percentage of married women using any modern method of contraception, estimated as 13.9%.5 The other determinant factor for unsafe abortion is the legalization of abortion. It reduced the probability of women to seek for traditional abortion practices which are performed by untrained professionals in a place that does not meet the minimal medical standards or both and also decrease the chance of gaining access to post abortion care, so that there will be a high incidence of complications. In legalizing abortion certain condition like culture, religion, educational status and poverty must be considered.6 Literature from developing countries show that legalization of abortion is

based on the right to life, the right of women, the right of liberty and the right of reproductive health.6 In our country before, May 2005 there was a strict rule against abortion which only considers maternal conditions to perform an abortion. After May 2005 there is a new provision of law regarding abortion which is stated in the criminal code of Ethiopia article 551/2005. This article considers abortion in certain cases such as pregnancy from rape, incest, congenital anomalies of the fetus which is incompatible with life and maternal physical and mental health.7 So as to decrease the maternal mortality from unsafe abortion and the immediate and late complications of abortion, our country put legislations on the abortion practices. To practices this legislations the knowledge and attitude of the population is important. This facilitates us to assess the knowledge and attitude of childbearing age women as these are the most stakeholders. Therefore the aim of this paper is to assess their knowledge and attitude of childbearing age women about abortion legalizations, in relation to their culture, religion, educational status and etc. Generally to know the most determinant factors which affect their knowledge and attitude?
Reaction: Every unborn child has the right live and experience the world we live in, any person who aborts or attempts to abort an unborn child is criminally and morally liable. It is the conscience of the mother who bares the child in her womb if she allows any person to have child aborted. Thus, the morality always contradicts the medical concept of abortion and therefore it should not be practiced.

Antibiotics- new tools in current and future drug therapy

Brijesh Gupta*1, Swapnil Singh1 1. SN medical college, agra-282002 [Email: brijeshgupta46@gmail.com]

Introduction: Historically, the

pharmaceutical industry capitalized on the discovery that many microbial secondary metabolites act as antibiotics.1-3The research and development of antibacterial agents during the past 50 years has been an immense success story. The rate of mortality caused by bacterial infections has dropped precipitously since the pre-penicillin days of the 1930s.4, 5As more antibiotics were discovered, manufacturing processes were simplified, and newer formulations developed, access to antibiotics eased considerably and their use became widespread. Antibiotics had truly become the panacea of medicine and were being used to treat even the most common and trivial types of infections, many of these non-bacterial in nature. Based on the work that he had done in his research laboratory, in an interview with The New York Times in 1945, Sir Alexander Fleming warned that the inappropriate use of penicillin could lead to the selection of resistant mutant forms of Staphylococcus aureus that could cause more serious infections in the host or in other people that the host was in contact with and thus could pass the resistant microbe. He was right and within 1 year of the widespread use of this drug a significant number of strains of this bacterium had become resistant to penicillin. Only a few years later over 50% were no longer susceptible to this new drug.6 Antibiotic Resistance: In order to be fit to survive, all living organisms strive to adapt to their environment. Part of this adaptation process includes adjusting to weather conditions, to food, water and in many cases to oxygen availability and also to the presence of

potentially dangerous or even lethal external agents. It is no secret that many insects have adapted remarkably well to their environment and so have microorganisms. Thus it should not be surprising to us that bacteria have shown a remarkable ability to endure and adapt to their environment including the development of different mechanisms of resistance to most old and new antimicrobial agents. The end result of this phenomenon is that many strains bacteria have become resistant, and in many cases multi-resistant to these therapeutic agents, thus rendering these drugs ineffective as treatments of choice for severe infections caused by this pathogens.711

The list of bacteria developing resistance is impressive, from sulfonamide and penicillin-resistant Staphylococcus aureus in the 1930s and 1940s11, 12 to penicillinresistant Neisseria gonorrhoeae (PPNG), and b-lactamase-producing Haemophilus influenzae in the 1970s13-16 methicillinresistant Staphylococcus aureus (MRSA) and the resurgence of multi-drug resistant (MDR) Mycobacterium tuberculosis in the late 1970s and 1980s.17-22 Mechanisms of Antibiotic Resistance: At least 17 different classes of antibiotics have been produced to date (Table 1). Unfortunately, for each one of these classes at least one mechanism of resistance (and many times more than one) has developed over the years. In fact, in some cases these bacteria have been able to develop simultaneous resistance to two or more antibiotic classes, making the treatment of infections caused by these microorganisms extremely difficult, very costly and in many instances associated with high morbidity and mortality.
Reaction: In the age of fast going medical innovation, production of various antibiotics is also rapidly growing. Thus, many research were being conducted to uncover new discoveries on preventing and curing illnesses.

Family history as a risk factor for herpes zoster

Sumit Kar* Herpes zoster is a common disease caused by Varicella Zoster Virus (VZV) which is characterized by multiple painful blisters distributed along the dermatome. VZV remains latent in the body in the dorsal root ganglion after the primary infection which commonly occurs in childhood as chickenpox, which presents itself as a completely different set of symptoms. Aim: We undertook this study to ascertain a positive family history as a risk factor for herpes zoster. The total number of cases of herpes zoster visiting our outpatient department probably outnumbered those of chickenpox. Even after the rash has disappeared patients are prone to develop a dreaded complication of excruciating pain in the form of post herpetic neuralgia. Thus it appeared very interesting to find if at all a correlation exists between a positive family history and the increased risk of developing herpes zoster which would reflect a genetic association for the same.

Reaction: Each and every diseases has its own history, background, and source, it is very important to know about it. Thus, medical institutions who conduct research on different diseases must be vigilant and careful in the implementation of their study.

Nanotechnologies for Alzheimer's disease (AD) treatment

Kshiti Soni SS Ayurvedic Medical College, Haveri, Karnataka-581110 Alzheimer's disease (AD) is a devastating neurodegenerative disorder and the most common form of dementia among people over the age of 65 years. This neuropathological condition is characterized by a progressive loss of cognitive function and presents two established pathophysiological hallmarks in the brain. These include extracellular acscumulations mainly composed of amyloid- (A) peptide (also referred to as senile plaques) and intracellular neurofibrillar tangles of hyperphosphorylated protein.1 Today, millions of people are affected by this neuropathology, posing a heavy economic and social burden. It is predicted that in the next few decades, AD will exert a huge societal and economic impact if no efficient therapeutic and/or early-diagnosis approaches become available. Moreover, considering the increase in population aging and survival, the impact of AD on the

health care systems will be even more pronounced. Therefore, strategies for early detection as well as treatment of AD are among the most challenging and timely areas in modern medicine. The blood-brain barrier (BBB) is a formidable gatekeeper in the body toward exogenous substances that maintains the chemical composition of the neuronal milieu for proper functioning of neuronal circuits and synaptic transmission. This barrier is formed at the level of the endothelial cells of the cerebral capillaries and essentially composes the major interface between the blood and the brain. The most important factor limiting the development of new drugs and biologics for the central nervous system (CNS) is the BBB. Generally, pharmaceuticals, including most small molecules, do not cross the BBB.2 During the past decade numerous attempts have focused on this pivotal problem by designing different strategies that aid drug passage across the BBB. Among these, nanotechnology-based strategies have gained tremendous importance as some of them are capable of overcoming the limitations inherent to BBB passage. These include various types of lipidic, polymeric, inorganic, and other types of anoparticles (NPs) for controlled drug delivery and release pertinent to various CNS conditions.3,4 Reaction: Experimentally, this drug has been shown at least to maintain-if not to improve cognitive function, global function, and behavior in AD patients. However, its clinical efficacy remains limited mainly due to poor brain translocation, which requires frequent injections, and its adverse cholinergic effects on peripheral organs.