Latest news with #NICHD
Express Tribune
23-05-2025
- Health
- Express Tribune
Measles claims territory in District East
The future of a nation relies heavily on the health and well-being of its children, who must be protected from childhood diseases through rigorous vaccination drives. Unfortunately, in Sindh, where routine immunization remains a challenge, diseases like measles continue to nip the buds of the country. According to the Expanded Program on Immunization (EPI) of the Sindh Health Department, over 5,000 children have been brought with symptoms of measles across hospitals in Sindh, where 31 children have died between January and April 2025. Furthermore, across seven districts of Karachi, 2,242 children were brought to different hospitals with symptoms of measles, the presence of which was confirmed through a laboratory test in 948 children. While speaking of the recent epidemic, Dr Raj Kumar, Project Director of the EPI at the Ministry of Health, confirmed that the outbreak was concentrated in District East, where out of 407 suspected cases, 247 children were confirmed to have measles. "Conversely, in the Central district, 476 children were brought with symptoms of measles, out of which 100 children were confirmed carriers. Five deaths occurred in Karachi, all of which were reported from District East," claimed Dr Kumar, while speaking of the area where no vaccination drive against measles has been conducted this year. One such grieving parent was Amer Ali, father of 4-year-old Hasnain, who succumbed to measles. "My son was under treatment at a private hospital since the past 15 days. When his condition worsened, he was brought to the NICHD hospital, where he passed away. He had developed pneumonia along with measles, which caused him severe respiratory distress. Although we had administered both doses of the measles vaccine to our son, we still could not save his life," cried Ali. Similarly, parents of another child brought to the emergency ward at Lyari Hospital revealed that their son had been experiencing fever and a rash on his body for several days. "When the child was brought to the emergency ward, the doctor informed that he had contracted measles. Our boy received medical treatment at the emergency ward, and luckily his condition has improved," said the parents. According to Dr Waseem Jamalvi, President of the Pakistan Paediatric Association Sindh, even today many children in the province remain unvaccinated against measles. "If routine vaccination is ensured, the incidence of measles can be reduced. Parents are not getting their children vaccinated against measles. While some get the initial vaccinations, many miss out on the measles vaccine. The Health Department has a sufficient supply of the measles vaccine and has made it available at every EPI centre. Children who are not vaccinated against measles are more likely to contract the disease. Therefore, all parents are urged to get their children vaccinated against measles and complete the full course of protective vaccinations against 12 diseases," implored Dr Jamalvi. Likewise, Dr Ikram Sultan, a health expert also attributed the rapid spread of measles to the low vaccination rate. "Measles is highly contagious, and despite vaccination, the number of children affected by measles is increasing. However, not vaccinating children against measles is a major reason behind the spread of this epidemic. Some affected children are those who were vaccinated, but due to weak immunity, they fell ill. Babies who are not breastfed or are suffering from nutritional deficiencies have weakened immunity and are at risk of acquiring measles. In Pakistan, children are administered measles vaccine at 9 and 15 months of age. If a child receives both doses of the vaccine, they can be effectively protected against measles," said Dr Sultan. "The Health Department of Sindh will launch a special campaign in October, in which 8,226,945 children will be administered the measles vaccine. Under the EPI program, children are given two doses of the MMR vaccine to protect against measles, mumps, and rubella," announced Dr Kumar.
Yahoo
07-05-2025
- Health
- Yahoo
Former NIH official says Trump admin cut government's 'Safe to Sleep' team that helped reduce infant deaths
In mid-2025, rumors spread online about the potential closure of the national campaign "Safe to Sleep," which educated parents on ways to reduce the risk of sleep-related infant deaths. The National Institutes of Health launched the public education initiative in 1994 alongside several private organizations, and the program helped slash deaths attributed to sudden infant death syndrome (SIDS). It is accurate to say that a former NIH spokesperson who worked at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that led Safe to Sleep, announced in April that her entire office was eliminated, effectively ending the federal government's participation in the campaign. As of this writing, Christina Stile, the spokesperson, is still listed as NICHD's public-facing contact on NIH's website. However, NIH would not confirm this report and said "no final decisions" had been made about the future of the program. Stile told Snopes that while there is no one left at NIH to lead Safe to Sleep, she suspects NIH's statement is truthful because the Trump administration's efforts to restructure the federal government is still ongoing as of this writing. Nonprofit organizations that collaborated on the Safe to Sleep campaign are looking to continue the program. But in an emailed update to Safe to Sleep partners from Dr. Rachel Moon, a pediatrics professor who worked on the program, Moon warned that while the American Academy of Pediatrics would "continue to be a leading voice," the organization cannot "dedicate as much time and resources as NICHD could." In late April and early May 2025, a rumor spread online that U.S. President Donald Trump's administration fired the National Institutes of Health (NIH) team behind "Safe to Sleep," a public awareness campaign to prevent babies from dying in their sleep. The program helped slash deaths attributed to sudden infant death syndrome (SIDS) by more than half when it first launched 30 years ago, according to the NIH and Centers for Disease Control and Prevention (CDP) data. Those rates have risen in recent years despite decreasing infant mortality, according to peer-reviewed research. Discussion about the federal government's alleged decision circulated on Bluesky, Facebook and Reddit. Meanwhile, Snopes readers searched the website for information on whether Trump's administration eliminated the Safe to Sleep team. It is accurate to say that according to former NIH spokesperson Christina Stile, Trump's administration eliminated the team that coordinated the Safe to Sleep campaign, effectively ending the federal government's participation in the wide-ranging public education initiative, as first reported by STAT News. However, in a statement sent via email, NIH said that "no final decision has been made regarding the future of the Safe to Sleep® campaign." "Safe to Sleep® campaign materials and tools remain available to the public, and we encourage individuals to visit to access these resources," NIH's statement said. When pressed to acknowledge that NIH fired the Safe to Sleep team, the agency said it was "unable to comment on personnel matters." Stile worked at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), which NIH oversees, until the White House eliminated the institute's communications office. That office led the Safe to Sleep initiative in partnership with various nonprofit organizations that shared Safe to Sleep educational resources with parents in local communities. Stile said in a LinkedIn direct message that she suspects the agency's statement about having "no final decision" on the program's future is truthful, as the Trump administration continues to restructure the federal government. "There is no certainty that NICHD will even exist if the NIH is reorganized, nor is it known whether its mission will include reducing infant mortality," said Stile, whose name was still on the institute's staff list webpage as of this writing. Due to the constantly changing situation, and because NIH declined to confirm the layoffs, we are not putting a truthfulness rating on this story — but here is what we know to be true as of this writing. White House eliminates the office in charge Stile said officials eliminated NICHD's entire communications office on April 1. "That action effectively ended NICHD's leadership of the campaign," Stile wrote. She said the decision "was made without warning or explanation by the administration under the purview of DOGE," or the Department of Government Efficiency. DOGE did not immediately return a request sent via X to confirm this; the department does not have a formal and public-facing media office. The federal government first launched "Safe to Sleep" under the name "Back to Sleep" in 1994 alongside private organizations. Back then, the public awareness campaign focused specifically on reducing the risk of sudden infant death syndrome, a type of sudden unexplained death that usually occurs when the baby is asleep. (The name "Back to Sleep" came from the recommendation that healthy babies be placed on their backs.) Deaths dropped in the years following the program — according to a 2012 news release, SIDS rates in the United States had dropped 50% since the start of the campaign; peer-reviewed research also indicates the program had a positive impact. At the same time, however, non-SIDS sleep-related infant deaths rose, leading NICHD to expand the program to address those causes as well. "Safe to Sleep builds upon the success of the Back to Sleep campaign and includes messages about reducing the risk of SIDS and of other sleep-related causes of infant death, such as suffocation and entrapment," the 2012 release said. "Since the campaign began, U.S. SIDS rates have dropped by 50% overall and the rate of back sleeping has increased significantly," a 2012 news release from NICHD announcing the decision said. Ending the federal government's participation in Safe to Sleep does not necessarily mean the end of the campaign itself, at least informally — but it does mean it would require new leadership. "I think it's possible NICHD or NIH could support Safe to Sleep through other means in the future; but, for now, there is nobody at NICHD to lead the activities," Stile told Snopes. According to Shayna Raphael, who leads an organization raising awareness about SIDS called the Claire Bear Foundation, nonprofits formerly partnered with NICHD on Safe to Sleep are in discussions with each other regarding how to continue "the best version" possible of the campaign without participation from the federal government. In an email forwarded to Snopes by Raphael, Dr. Rachel Moon, a pediatrics professor who collaborated on the campaign, said staff members from the American Academy of Pediatrics (AAP) and First Candle, two organizations that co-founded the initial campaign with NICHD, met and "unanimously agreed that the Safe to Sleep campaign should continue." "The AAP will continue to be a leading voice in the campaign as resources and priorities allow within the evolving context of child health, safety, and wellness," Moon wrote. "However, it should be understood by all that the AAP will not be able to dedicate as much time and resources as NICHD could." Moon added that staff at First Candle volunteered to schedule the quarterly Safe to Sleep campaign partner meetings once led by NICHD, and that AAP would welcome "new partners who may be interested in taking a lead role." Snopes reached out to AAP to verify the information in Moon's email was accurate and up-to-date and await a response. In sum, it appears the program will likely continue, with or without the federal government's help — but as of this writing, the Trump administration appears to have terminated support of the Safe to Sleep campaign. Sources: Belkoura, Ismael M. "NIH Cancels Participation in Safe to Sleep Campaign That Decreased Infant Deaths." STAT, 30 Apr. 2025, Accessed 6 May 2025. "Campaign History | Safe to Sleep®." Accessed 6 May 2025. "Contacts." National Institutes of Health (NIH), 11 May 2015, Accessed 6 May 2025. "Contacts | National Institutes of Health (NIH)." 6 May 2025, Accessed 6 May 2025. Deng, Grace. "Trump's First 100 Days: 25 Rumors We've Investigated." Snopes, 29 Apr. 2025, Accessed 6 May 2025. "Homepage | Safe to Sleep." National Institutes of Health, Accessed 6 May 2025. "NICHD and Its Collaborators Launch Expanded Infant Mortality Awareness Campaign." 3 Oct. 2012, Accessed 6 May 2025. Rodgers, Linda. "Amid Decreasing Infant Mortality, Sleep-Related Infant Deaths Are on the Rise." JAMA, Mar. 2025, Accessed 16 Mar. 2025.
Medscape
07-05-2025
- Health
- Medscape
Sling and Botox Comparable for Mixed Urinary Incontinence
OnabotulinumtoxinA (Botox) injection and midurethral sling surgery yielded comparable symptom improvement in women with mixed stress-urgency urinary incontinence (MUI) at 6 months, a multicenter randomized study found. Surgery led to insignificantly better outcomes in the Mid-urethral Sling vs Botox A (MUSA) trial conducted by Heidi Harvie, MD, MBA, MSCE, associate professor of obstetrics and gynecology at Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues. Heidi Harvie, MD, MBA, MSCE '[Stress-urinary incontinence] SUI is most common, followed by MUI and [urgency urinary incontinence] UUI,' said Harvie. 'In the United States, MUI affects an estimated 30% of women by 60 years of age. Women with urinary incontinence typically report that UUI is more bothersome than SUI, and the combination of both is more bothersome than either UUI or SUI alone.' Of the two, MUI is the more challenging to treat. Published online in JAMA , the MUSA trial recruited 150 women (age, 27-87 [mean, 59] years; about 55% White) from seven clinical centers in the Pelvic Floor Disorders Network, National Institute of Child Health and Human Development (NICHD). All had moderate to severe MUI with an average of seven leakage episodes per day and had not responded to conservative treatments, such as lifestyle changes and exercise, or oral medications. From July 2020 to September 2022, participants were randomly assigned to receive either an intradetrusor injection of onabotulinumtoxinA 100 U (focusing on the urgency component) or midurethral sling (focusing on the stress urgency component). Of these, 137 received treatment, with last follow-up in December 2023. OnabotulinumtoxinA recipients could receive an additional injection between 3 and 6 months, and all participants could receive additional treatment (including crossover to the alternative intervention) between 6 and 12 months. The primary outcome was a change from baseline in Urogenital Distress Inventory (UDI) scores (range, 0-300) at 6 months. Secondary outcomes included a UDI change at 3 and 12 months, irritative and stress subscores of the UDI, urinary incontinence episodes, predictors of poor treatment response, quality of life, and global impression outcomes. In addition, adverse events, use of additional treatments, and cost-effectiveness were evaluated. Both groups showed mean improvement in the UDI total score at 6 months with no significant difference in scores between groups. OnabotulinumtoxinA: −66.8 (95% CI, −84.9 to −48). Sling: −84.9 (95% CI, −100.5 to −69.3) for a mean difference of 18.1 points (95% CI, −4.6 to 40.7; P = .12). = .12). In secondary outcomes, there was a greater improvement in the UDI stress incontinence score with the sling at −45.2 (95% CI, −53.7 to −36.8) vs with onabotulinumtoxinA at −25.1 (95% CI, −34.1 to −16.1; P < .001). < .001). No significant difference emerged in the UDI irritative score with onabotulinumtoxinA at −32.9 (95% CI, −40.3 to −25.6) vs with the sling at −27.4 (95% CI, −34.6 to −20.3; P = .27). = .27). In the medication group, 12.7% and 28.2% received a second injection by 6 or 12 months, respectively. By 12 months, 30.3% in the sling group received onabotulinumtoxinA, and 15.5% in the onabotulinumtoxinA group received a sling. Overall adverse events did not differ between groups, but recurrent urinary tract infections were more common in the sling group at 17.6% vs in the onabotulinumtoxinA group at 6.9%. Rates of surgical revision (1.5%), vaginal mesh exposure (2.9%), and short-term postprocedural urinary catheter use (11.8%) in the sling group were similar to those reported in other studies. In the onabotulinumtoxinA group, 2.8% required intermittent self-catheterization 2 weeks post-procedure. 'Midurethral sling surgery and onabotulinumtoxinA are both good options for improving MUI symptoms. However, these patients can be difficult to treat with one therapy,' Harvie told Medscape Medical News . She hopes the findings will potentially help inform treatment decisions and shared decision-making based on patient preference in partnership with clinician recommendations. As for the economic side, her group is currently planning a cost-effectiveness analysis of the two approaches. Brittany L. Roberts, MD In an accompanying editorial on the study, obstetrician-gynecologist Brittany L. Roberts, MD, and colleagues at the Albany Medical Center in Albany, New York, agreed that shared decision-making should ultimately guide therapeutic strategy. 'Because 45% of patients had another therapy within a year, it underlines that mixed urinary incontinence is a chronic disease and may require new treatments over time,' they wrote. 'Future studies should explore this concept and examine the impact on the utilization of healthcare resources and patient satisfaction.' Roberts' group pointed out that the 'clinical conundrum' of this mixed condition affects 1 in 4 women older than 65 years. 'The personal and societal costs of incontinence are significant,' they wrote. By age 80, 20% will undergo surgery for SUI or MUI. While physical and behavioral therapies improve both types, medications are standard treatment for urgency. 'When conservative treatment fails, conventional guidance has been to treat the urgency before the stress component because anti-incontinence surgical procedures can worsen urgency incontinence and many urgency treatments are medical rather than surgical,' they wrote. Another strategy has been to treat whichever symptom is dominant. Results from the Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM) trial revealed that both groups, surgery with or without behavioral and physical therapy, reported improved urgency symptoms, findings substantiated in prior cohort studies. 'While the original hypothesis of ESTEEM was that treating both components of mixed urinary incontinence with behavioral and physical therapy plus sling would result in better patient outcomes, ESTEEM revealed that urgency symptoms can improve with the midurethral sling alone, challenging previously held beliefs about the impact of anti-incontinence surgeries worsening the urgency component of mixed incontinence,' Roberts and associates wrote. They further pointed out that combined findings from MUSA and ESTEEM revealed that the pathophysiology of stress and urge incontinence are likely intertwined. 'For example, both patients and clinicians have difficulty discerning which type of leakage patients have, particularly when the incontinence is severe.' With better diagnostic clarity on urgency and stress incontinence phenotypes, more specific advice maybe offered to individuals on what to treat first. While the MUSA trial positioned both interventions in equipoise, they have significant differences. OnabotulinumtoxinA can be administered in the clinic or operating room and requires no incision but insertion of a cystoscope. Sling surgery is performed in the operating room and typically requires three small incisions. Slings are meant to be a permanent intervention, while onabotulinumtoxinA injection must be repeated as its effects wear off. So why not perform a sling surgery and give onabotulinumtoxinA at the same time? A randomized trial of 78 patients posing this question found that compared with sling alone, combined therapy did not show greater symptom improvement at 3 months. Additionally, the combined therapy group engaged in more self-catheterization and had more urinary tract infections.
