November 2, 2016: Thousands of people with failing kidneys may soon have a better chance of surviving with a transplanted kidney, but with added risk of receiving a potentially deadly disease. Some patients and doctors say it’s better to contract a disease that can be kept under control than to die while waiting for a healthy kidney.
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For almost 100,000 people in the US, finding a suitable kidney donor is their only hope of returning to a normal life without painful dialysis several times a week, but there are only about 17,000 healthy kidneys available each year. About 4 percent of patients on the transplant waiting list die each year before they receive a kidney. Doctors say the availability of kidneys can be increased but with some additional risk.
Dr Peter Reeves from the University of Pennsylvania says, “We are giving them the opportunity to have a transplant but we are also treating them for a new infection they didn’t have. So that is the trade-off.”
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In a pioneering experiment conducted jointly at the University of Pennsylvania in Johns Hopkins University, doctors are offering to transplant kidneys from disease donors infected with Hepatitis C, a virus-borne disease that attacks the liver but keeps kidneys intact.
Patients who receive such kidneys are no longer required to endure dialysis but have to start taking drugs to keep Hepatitis C in check. The drugs are not cheap and in a small number of cases may not work. After long talks with doctors about all possible outcomes of the procedure some patients accepted the risk.
According to Irma Hendricks, a kidney transplant recipient, “If they didn’t have this study, I wouldn’t be where I am today. So I am extremely grateful.”
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The concept has become popular after the discovery of a new and more effective drug that promises to cure ninety-five percent of Hepatitis C patients. Researchers say, if the clinical trials proves to successful, hundreds of available kidneys may become available for saving the lives of patients with incurable kidney disease.
London, Sep 16, 2017: Viral hepatitis with 1.34 million deaths globally has surpassed all chronic infectious diseases including HIV/AIDS, malaria and tuberculosis, according to a study by Global Burden of Disease.
The study reveals that in 2016, the total deaths caused by viral hepatitis, including liver cancer, acute cases, cirrhosis, hepatitis A, E, B, C and D account for 1.34 million globally, exceeding tuberculosis (1.2 million), HIV/AIDS (1 million) and malaria (719,000).
These staggering death rates occurred despite recent advances in hepatitis C medications that can cure most infections within three months and the availability of highly-effective vaccinations for hepatitis B.
“It’s outrageous, but not surprising, that the Global Burden of Disease Report found that deaths related to viral hepatitis have surpassed HIV, TB and malaria” said Charles Gore, President of the World Hepatitis Alliance — a not-for profit organisation based in London.
“This is largely due to a historic lack of political prioritisation coupled with an absent global funding mechanism,” Gore added, in the paper published in the journal the Lancet.
Further, viral hepatitis was found to be amongst the top ten leading global killers which include heart disease, road accidents, Alzheimer’s disease, amongst others.
If this trend has to be reversed, immediate action must be taken at both a regional and national level, said the report, while suggesting measures such as scaling up testing and diagnosis.
Viral hepatitis is a highly contagious liver infection caused by the hepatitis A virus and only 5 per cent of people living with the disease are aware of their conditions there are only few noticeable symptoms.
As a result, many people are either misdiagnosed or do not come forward for testing, increasing the chance of infecting others and missing the opportunity to access life-saving treatment.
Reducing hepatitis related deaths by 65 per cent by 2030 is a key component of the World Health Organization’s Global Hepatitis Strategy.
The strategy, which was adopted by 194 governments, sets out a list of key targets, which, if achieved, will eliminate viral hepatitis by 2030. (IANS)
The most common transmission route of Hepatitis in India is from mother to child. It has been said in a recent study that 3-5 % of Indian population is the carrier for Hepatitis B virus infection, the cause of viral hepatitis.
Some common symptoms of Hepatitis are low-grade fever, body ache, lethargy, anorexia and joint pain
In Western countries, Hepatitis is increasingly recognized as a cause of chronic liver damage
New Delhi, July 28, 2017: Hepatitis means inflammation of the liver. It can be caused by toxins, certain drugs, some diseases, heavy alcohol use, and bacterial and viral infections. Viral Hepatitis is a group of viral infections that affect the liver; the most common among these are Hepatitis A, B, C and E. Rarely other viruses like dengue, Chikungunya, herpes, and H1N1 can affect the liver. Although each can cause similar symptoms, they usually have different modes of transmission and can affect the liver differently.
Dr. Vinit Shah, Consultant Hepatologist, BGS Global Hospitals, low-grade fever, body ache, lethargy, anorexia and joint pain are some common symptoms. This is commonly called prodromal symptoms as it precedes the phase of liver attack by a period ranging from 1-2 weeks, mentioned ANI report.
Hepatitis B virus infection is an extremely important cause of viral hepatitis, 3-5 % of Indian population is the carrier for hepatitis B infection, and some may be negative with virus damaging liver that is Occult hepatitis B and picking up viral DNA in blood or liver tissue. The most common route of virus transmission in India is from mother to a child.
Mostly there are chances that the virus can remain dormant in the body without any liver damage- asymptomatic carrier and is incidentally diagnosed during health checkups or pre operative checkups before any surgery. But, in some cases it can cause acute liver failure, chronic damage to the liver -chronic hepatitis, progression to chronic liver damage- cirrhosis or liver cancer –HCC in patients. The virus is known to have a tendency of suddenly returning to active multiplication from dormancy and causing severe liver damage (reactivation of hepatitis B).
The high-risk groups are- pregnant women, health care professionals, sex workers or prior to proposed organ transplantation or chemotherapy administration and screening of them is of paramount importance. Once a patient is diagnosed with hepatitis, he gets referred to a specialized liver care team, further investigations involve testing the replication state of virus and extent of the liver damage so that return of virus to active multiplication and worsening chronic liver damage, liver cancer development are not missed.
The preventive measures involves vaccination of the high risk groups especially, screening pregnant ladies and managing their infection properly during pregnancy and breast feeding with appropriate oral medications, proper delivery of the baby with immediate dual vaccination (vaccine plus hepatitis B immunoglobulin) to the child, screening blood and immunological products, safe needle and syringe practices, active screening of family members of infected patients and vaccination of those who are negative. Treatment involves early identification of a subset of people with liver damage and treating with oral antiviral medications and regularly checking them.
Hepatitis C virus has same modes of transmission as hepatitis B and can similarly cause chronic liver damage, liver cirrhosis, decompensation or liver cancer. No vaccine is available for hepatitis C so identifying infected patients and aggressively treating them to achieve complete viral response (SVR) is the only way to prevent progression to liver cancer and decompensation. With an advent of anti-viral oral medications (DAA’s) treating, hepatitis C is very easy, cost effective and highly successful now. But this should be done as soon as hepatitis C patient is identified and then referring him/her to a liver specialist.
Hepatitis A and E are the commonly transmitted hepatotropic viruses transmitted due to poor hygiene, contaminated food and drinking water, poor sanitation that may lead to fecal-oral transmission. Pediatric age group (0-16 yrs old) is at risk for hepatitis A infection, in some cases, liver damage may be very severe (acute liver failure) leading to loss of liver function requiring liver transplantation.
Hepatitis E virus infection also has a similar way of transmission and pregnant ladies constitute the high-risk group for this viral infection and it is the most common cause of the disease during pregnancy.
In Western countries, it is increasingly recognized as a cause of chronic liver damage especially in post solid organ transplant recipients and as a result of consumption of contaminated pork, which is regarded as an important source of transmission. Prevention is again by ensuring proper hygiene and sanitation and vaccination of higher risk groups is in the research stage.
– prepared by Kritika Dua of NewsGram. Twitter @DKritika08
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Depending on the location, the proliferation of IS has drawn varied resistance from the Afghan military, U.S. air support and ground troops, local militias, Taliban forces and other militant groups
Afghan army planes on Wednesday night accidentally air dropped vital supplies of food and water to IS militants in the Darzab district of northern Jouzjan province instead of to their own besieged troops
In the Tora Bora area, where IS has made a strong stand in recent days, local villagers and militias joined with Taliban to rout IS
June 25, 2017: The Islamic State group is rapidly expanding in parts of Afghanistan, advancing militarily into areas where it once had a weak presence and strengthening its forces in core regions, according to Afghan and U.S. officials.
Depending on the location, the proliferation of IS has drawn varied resistance from the Afghan military, U.S. air support and ground troops, local militias, Taliban forces and other militant groups.
Attacking IS has become such a priority in the country, that disparate forces sometimes join together in the ad-hoc fight, with Afghan and U.S. forces finding themselves inadvertently supporting the enemy Taliban in battling IS.
Confusion leads to mistakes
All too often, officials say, mistakes are made due to confusion on the ground.
Afghan army planes on Wednesday night accidentally air dropped vital supplies of food and water to IS militants in the Darzab district of northern Jouzjan province instead of to their own besieged troops, provincial police chief, Rahmatullah Turkistani told VOA. The supplies were meant to help Afghan forces that are countering twin attacks by IS and Taliban militants but were used instead by IS.
“It’s not getting better in Afghanistan in terms of IS,” U.S. Chief Pentagon Spokeswoman Dana White told VOA this week. “We have a problem, and we have to defeat them and we have to be focused on that problem.”
Reinforcements for the IS cause reportedly are streaming into isolated areas of the country from far and wide. There are reports of fighters from varied nationalities joining the ranks, including militants from Pakistan, India, Iran, Iraq, Syria, Russia and Central Asian neighbors.
Still, the Islamic State-Khorasan (ISK) as IS is known in Afghanistan remains a fragmented group composed of differing regional forces with different agendas in different parts of the country.
“IS-K is still conducting low-level recruiting and distribution of propaganda in various provinces across Afghanistan, but it does not have the ability or authority to conduct multiple operations across the country,” a recent Pentagon report said. But where it operates, IS is inflicting chaos and casualties and causing confusing scenarios for disparate opponents.
In the Tora Bora area, where IS has made a strong stand in recent days, local villagers and militias joined with Taliban to rout IS. IS regained ground after a few days, leading to U.S. military air attacks on IS positions in conjunction with Afghan intelligence instructions and army operations.
IS fighters reportedly have fled from mountain caves of Tora Bora, where al-Qaida’s leader Osama bin Laden hid from U.S. attack in 2001.
IS fighters were also reportedly advancing in neighboring Khogyani district, displacing hundreds of families, according to district officials. It is one of several areas in Nangarhar province, near the Pakistani border, where IS has been active for over two years.
Fierce clashes in the Chaparhar district of Nangarhar last month left 21 Taliban fighters and seven IS militants dead, according to a provincial spokesman. At least three civilians who were caught in the crossfire were killed and five others wounded.
“IS has overpowered Taliban in some parts of Nangarhar because the Taliban dispatched its elite commando force called Sara Qeta (Red Brigade) to other parts of the country, including some northern provinces to contain the growing influence of IS there,” Wahid Muzhda, a Taliban expert in Kabul, told VOA.
IS has also expanded in neighboring Kunar province, where, according to provincial police chief, it has a presence in at least eight districts and runs a training base, where foreign members of IS, train new recruits.
Hundreds of miles from Nangarhar, IS is attempting to establish a persistent presence in several northern provinces where it has found a fertile ground for attracting militants and recruiting unemployed youths, mostly between the age of 13 and 20.
IS has been able to draw its members from the Pakistani Taliban fighters, former Afghan Taliban, and other militants who “believe that associating with or pledging allegiance” to IS will further their interests, according to the Pentagon report.
Hundreds of militants have joined IS ranks in northern Jouzjan and Sar-e-Pul province where local militant commanders lead IS-affiliate groups in several districts.
Qari Hekmat, an ethnic Uzbek and former Taliban militant who joined IS a year ago, claims to have up to 500 members, including around 50 Uzbek nationals who are affiliated with the Islamic Movement of Uzbekistan (IMU) — previously associated with al-Qaida and Taliban in Afghanistan.
IS and Taliban are reportedly fighting over the control of Darzab district in Jouzjan which they stormed this week from two different directions and besieged scores of government forces. The Taliban has reportedly captured the center of the district while IS militants control the city outskirts.
Afghanistan faces a continuing threat from as many as 20 insurgent and terrorist networks present or operating in the Afghanistan-Pakistan region, including IS, the Pentagon said.
“In areas where the government has limited influence and control, IS attempts to emerge and expand there,” Ateequllah Amarkhail, an analysts and former Army general in Kabul told VOA.
IS has also claimed responsibility for several recent attacks in urban areas, however, with a hit-and-hide strategy that is proving effective. And it is engaging too in more skirmishes with U.S. forces that initially were sent to the country to help Afghan forces halt the spread of Taliban.
Three American service members based in eastern Afghanistan were killed in April during operations targeting IS militants, according to the Pentagon.
“ISIS-K remains a threat to Afghan and regional security, a threat to U.S. and coalition forces, and it retains the ability to conduct high-profile attacks in urban centers,” the Pentagon said. (VOA)