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The findings show that even babies born at 39 weeks — the point at which many women who choose to have a Caesarean section delivery — have an increased risk of a developing a learning disability compared with babies born a week later at 40 weeks.
Scientists in Scotland, analysing the birth history of more than 400,000 schoolchildren, found that while babies born at 40 weeks have a 4 per cent risk of learning difficulties, those born at 37 to 39 weeks of gestation have a 5.1 per cent risk.

“There was an increasing risk of special educational needs as the gestation date fell, so as deliveries got earlier, the risk went up,” said Jill Pell, an expert in public health and health policy Glasgow University, who led the study.

“Even being just a week early put the risk up”.

It is already known that a baby born prematurely — for example at 24 weeks of gestation — is more likely to have learning difficulties. But the risks for babies born in the 24 to 40 week range had not previously been studied.

According to the World Health Organisation, more and more women worldwide are delivering by caesarean section and a “significant proportion” of these surgical procedures are performed without any clear medical need.

Around a third of babies are born between 37 and 39 weeks of gestation, either by caesarean section or natural vaginal delivery.

Rates of autism have also been rising, with worldwide prevalence estimated at between 1 to 2 people in every thousand, although experts say this may be partly due to better diagnosis.

Pell noted this rise but said it would be “a leap too far” to link her findings directly to rates of autism, since autism was only one of a range of learning difficulties considered.

Pell, whose study was published in the Public Library of Science Medicine journal, stressed that caesarean sections were not the only factor behind early-term births, since some women go into labour naturally before 40 weeks of gestation.

But she said doctors and women should consider the risks of learning difficulties when thinking about a caesarean.

“It is now normal policy (in caesarean section) to deliver women a week early,” she said in a telephone interview. “But if you make a decision…for an elective pre-term delivery, then it has to be a balance, weighing up the risks and potential benefits”.

“What this study shows is that special education needs are another factor that need to be considered”.

Children with special educational needs may have either a learning difficulty such as dyslexia or autism, or a physical difficulty such as deafness or poor vision.

Pell found that although the risk of educational difficulties was much higher in preterm than in early term babies, the absolute numbers of children with difficulties in the 37 to 39 week group were higher, because many more babies are born at this time than before 37 weeks.

In her study, early term births accounted for 5.5 per cent of cases learning disabilities, while pre-term deliveries

(CNN)

She desperately wanted to scream or even move a finger to signal to doctors that she was awake, but the muscle relaxant she’d received prevented her from controlling her movements.

“I was doing a combination of praying and pleading and cursing and screaming, and trying anything I could do but I knew that there was nothing that was working,” said Weiher, of Reston, Virginia.

Weiher is one of few people who have experienced anesthesia awareness. Although normally a patient does not remember anything about surgery that involves general anesthesia, about one or two people in every 1,000 may wake up during general anesthesia, according to the Mayo Clinic. Most of these cases involve the person being aware of the surrounding environment, but some experience severe pain and go on to have psychological problems.

The surgical tools didn’t cause Weiher pain — only pressure — but the injections of a paralytic drug during the operation “felt like ignited fuel,” she said. “I thought, well, maybe I’ve been wrong about my life, and I’m in hell,” she said. The entire surgery lasted five-and-a-half hours. Sometime during it she either passed out or fell unconscious under the anesthetic. When she awoke, she began to scream.

“All I could say to anyone was, ‘I was awake! I was awake!’ ” she said.

The use of general anesthesia is normally safe and produces a state of sedation that doesn’t break in the middle of a procedure, doctors say. The patient and anesthesiologist collect as much medical history as possible beforehand, including alcohol and drug habits, to help determine the most appropriate anesthetic.

You may think of it as “going to sleep,” but in terms of what your body is doing, general anesthesia has very little in common with taking a nap.

During sleep, the brain is in its most active state; anesthesia, on the other hand, depresses central nervous system activity. On the operating table, your brain is less active and consumes less oxygen — a state of unconsciousness nothing like normal sleep.

Doctors do not know exactly how general anesthesia produces this effect. It is clear that anesthetic drugs interfere with the transmission of chemicals in the brain across the membranes, or walls, of cells. But the mechanism is the subject of ongoing research, Dr. Alexander Hannenberg, anesthesiologist in Newton, Massachusetts, and president of the American Society of Anesthesiologists.

Patients who remember falling unconscious under the anesthesia generally have a pleasant experience of it, Hannenberg said, and the period of “waking up” is also a relaxed state, Hannenberg said.

Anesthesia awareness may relate to human error or equipment failure in delivering the anesthetic, Hannenberg said.

There are patients for whom doctors err on the side of a lower dose because of the nature of their condition, Hannenberg said. Someone who is severely injured and has lost a lot of blood, a patient with compromised cardiac function, or a woman who needs an emergency Caesarean section would all be at risk for serious side effects of high doses of anesthetic.

Heart or lung problems, daily alcohol consumption, and long-term use of opiates and other drugs may put patients at higher risk for anesthesia awareness, according to the Mayo Clinic.

Weiher started a campaign called the Anesthesia Awareness Campaign that seeks to educate people about the perils of waking up during surgery. She has spoken with about 4,000 people worldwide who have also had anesthesia awareness experiences.

The American Society of Anesthesiologists is engaged in an Anesthesia Awareness Registry, a research project through the University of Washington to examine cases of the phenomenon.

One of the goals of the Anesthesia Awareness Campaign is to make brain activity monitoring a standard of care.

There has been controversy about the use of brain function monitors in general anesthesia. Advocates such as Dr. Barry Friedberg, anesthesiologist and founder of the nonprofit Goldilocks Anesthesia Foundation, say brain monitoring is essential for ensuring the patient achieves the appropriate sedation so as to not wake up.

The monitors use a scale of 0 to 100 to reflect what’s going on in the brain: 0 is a total absence of brain activity, 98 to 100 is wide awake, and 45 to 60 is about where general anesthesia puts the patient, Friedberg said.

But a 2008 study in the New England Journal of Medicine found no benefit in using brain function monitoring to prevent anesthesia awareness. The American Society of Anesthesiology has said the monitoring is not routinely indicated for general anesthesia, but may have some value and be appropriate for specific patients. The downsides are that they are expensive, and should not be used in place of heart rate and breathing signals when regulating the anesthesia.

Research does not consistently demonstrate a benefit from using brain function monitors, and the decision to use them should be made on an individual basis, Hannenberg said.

The anesthesiologist carefully monitors the patient’s breathing and blood pressure, which can rise and fall, while the person is under the anesthetic, Hannenberg said. The treatment is tailored to the patient — a young, healthy athlete will tolerate fluctuations in blood pressure better than someone with a serious condition, Hannenberg said.

As with surgical procedures themselves, anesthesia can result in stroke, heart attack and death. Such complications are more likely in people who have serious medical problems, and elderly people. Over the last two decades, anesthesiologists have made significant strides in reducing those risks, Hannenberg said.

A 6-year-old boy in Richmond, Virginia, recently died after going into cardiac arrest during a routine dental procedure that involved general anesthesia, CNN affiliate WTVR reported.

Weiher had to have subsequent surgeries, including an operation on her other eye and a hysterectomy, and the experiences were terrifying. She is still taking medication for post-traumatic stress disorder as a result of her anesthesia awareness experience.

1. Stem and wash the spinach, keeping the stems and leaves separate. Trim off the ends of the stems and discard. Cut the stems into 1/2-inch lengths. Coarsely chop half the leaves, or stack and cut into strips. Refrigerate the remaining leaves to use elsewhere. Set the chopped leaves aside.

2. Heat the olive oil over medium heat in a large saucepan, a soup pot or Dutch oven, and add the garlic. Cook, stirring, just until it begins to smell fragrant, about 30 seconds. Add the tomatoes and paprika. Cook over medium heat, stirring often, until the tomatoes have cooked down slightly. Add the spinach stems, water and lemon juice, and bring to a gentle boil. Cover and cook for 10 minutes. Reduce the heat to low, and add the rice and salt to taste. Simmer uncovered until the rice is tender, 12 to 15 minutes. Stir in the chopped spinach, simmer one minute, remove from the heat and serve.

“For the past three nights I have exclusively been playing the role of a loving father, with no music, nothing. I want to sincerely thank all my friends and family members for their prayers and good wishes,” Rahman posted on his Twitter page.

“God has been kind and Raheema is recovering fast. I also want to thank all my friends from the media for their support and for respecting our privacy,” he added.

The 11-year-old was operated upon by doctors Wednesday night. Rahman has two more children – daughter Khatija, 14 and five-year-old son, Ameen.

Using the latest national data on what more than 16,000 Americans aged two and older eat, researchers investigated the contribution of each food group to the total vitamin D intake.

No other food item came close to the vitamin D contribution of milk. In fact, for kids aged two to 18, milk provided nearly two-thirds of all vitamin D in the diet.

“There are few true replacements for the nutrient package you find in one glass of fat free or low fat milk,” said Keith Ayoob, registered dietitian and paediatric nutrition expert.

“Without milk in the diet, it’s hard to meet a number of nutrient needs – most notably vitamin D,” he added.

Well known for its role in keeping bones strong, vitamin D is now being hailed for so much more.

Emerging evidence suggests vitamin D may also help protect against diabetes, hypertension, heart disease and certain cancers. It also supports a healthy immune system.

Despite a potential upside of boosting vitamin D levels, Americans of all ages still fall short of their vitamin D needs and this deficiency may put their health at risk.

Experts recommend 400 IU of vitamin D each day – the amount in four glasses of fat free or low fat milk, a release of the Federation of American Societies for Experimental Biology (FASEB) said.

It’s one more reason to grab another glass of milk, according to new research presented at the Experimental Biology conference in Anaheim, California.

22-year old Priya Tiwari was a healthy, energetic college student pursuing a degree in arts. One day she suddenly collapsed, after complaining of a sore throat and dizziness. When Priya woke up, she was in hospital with slurred speech and a loss of sensation in one side of her body. The doctors told her she had suffered a stroke which left the right side of her body paralysed.

Though she regained her speech in a few weeks, her muscles were too stiff to enable her to go to the toilet or bathe even after six months of medication and physiotherapy. Luckily, Priya’s father came across an article on the benefits of Botox in such situations.

He took her to a neurologist with expertise in administering botulinum toxin to stroke patients. After being injected with the drug, Priya experienced reduced stiffness in the muscles of the arm and leg after a few weeks, which made physiotherapy more effective. Thanks to this treatment, Priya can walk, paint and conduct her daily activities with considerable ease today.

BRAIN STROKE IS A KILLER

FEW know that the brain stroke Priya suffered is the third largest killer after heart attack and cancer in India. According to a WHO study released last year, the incidence of stroke in India is around 130 per 100,000 people every year and about 20 percent of heart patients are susceptible to it.

Strokes are a major cause of adult spasticity, which occurs when muscles fail to respond to the nervous system’s signal to relax. As a result, the muscle remains contracted, causing pain and restricted mobility. A clenched fist, flexed wrist and bent elbow are signs of this, and can interfere with a person’s ability to perform daily activities such as dressing and hygiene.

The use of botulinum toxin in these circumstances may prove to be hugely beneficial. Botulinum toxin is surely a wonder drug provided it is used judiciously. But, unfortunately, in our country due to the lack of awareness among doctors, some stroke patients who can benefit from botulinum toxin are never referred to a neurologist expert in administering the drug, says Delhi – based neurologist Dr Ashish Srivastava.

GAINS FDA APPROVAL

Though botulinum toxin has been successfully used in the management of adult spasticity the world over, the U. S. FDA accepted its efficacy to treat spasticity of the upper limb only this March. Muscles affected by spasticity have increased stiffness and tightness, which may lead to pain, difficulties with hygiene and other activities of daily living, and may affect a person’s appearance.

In clinical trials, treatment with Botox was found to be beneficial to patients with upper limb spasticity, said Russell Katz, M. D., director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research.

According to Dr Vinay Goyal, professor, Dept. of Neurology, AIIMS, who treats about 60 to 80 patients daily with botulinum toxin for different therapeutic indications, the FDA approval is welcome. One of the reasons why botulinum toxin has been approved for the treatment of upper limb spasticity and not lower limb is because treating lower limb spasticity is more challenging, due to thicker muscles that require a large amount of botulinum toxin. This is not so in upper limb spasticity, adds Dr Goyal.

Despite the official lack of approval, however, botulinum toxin has successfully used in the treatment of lower limb spasticity worldwide. Shashank Shekhar was just thirteen when an injury in the brain and spinal cord called AEDM left his lower leg paralysed.

After about five months Shashank received botulinum toxin injections thrice at a Delhi hospital at three months intervals, which showed marked improvement together with the help of physiotherapy. He was able to walk unaided after the first injection and his condition improved drastically after the second and third injection.

Shashank’s condition has improved dramatically in the past five years. But being a stubborn child he would not listen to us and was a bit lax on physiotherapy. If he had been more regular, I’m sure he would have been able to run too, says Shashank’s father Mr Singh.

MANAGING SPASTICITY

Before botulinum toxin was used in the management of spasticity, the usual treatment would be high – dose oral medications. These have side effects that range from weakness, drowsiness, dizziness and sedation to muscle degeneration.

Such treatment usually has a limited effect and improvement becomes visible after a long period. The use of botulinum toxin, however, has improved this situation for physiotherapists.

Nowadays doctors wait for a few months for the natural rehabilitation of the muscles poststroke or brain injury. If there isn’t much reduction in the tightness of the muscles, botulinum toxin is injected into the muscle to reduce stiffness by relaxing the muscles enough to allow a physiotherapist to strengthen and stretch them.

However, it’s just a first step and doesn’t cure spasticity. Many patients have unrealistic expectations from this drug. They think it can restore mobility in a few months. The significance of this drug is that it reduces the stiffness of muscles by relaxing them. It doesn’t give power to the muscles, which can be restored only through intensive physiotherapy, says Dr P N Renjen, neurophysician, Apollo Hospital.

Several factors are considered by a neurologist before injecting botulinum toxin into a patient suffering from spasticity: Age, weight and the severity of spasticity. If the muscle power of the patient is very low, the use of botulinum toxin won’t result in any functional improvement. Only the appearance of the limb and the quality of life is likely to improve, as botulinum toxin will enable some basic movement. The drug is also of no use to a person whose muscles have developed contractures.

CEREBRAL PALSY

Some doctors believe botulinum toxin is even more effective in treating the symptoms associated with cerebral palsy than adult spasticity. However, treating the symptoms at the right age is of utmost importance as once the muscles become stiff they develop contractures.

Ideally, the treatment should be started between the age of two to six. This is the time when the child can show faster improvement with the drug coupled with intensive physiotherapy, says Dr Gupta.

The council states that now a day’s many new companies have introduced new methods of breast screening which they claim to be safe, non-invasive and comfortable. Women should not trust all the screening options as Professor Janet Hiller from the University of Adelaide says that there is less evidence attached to their safety.

She says that most of the commercially available technologies are new technologies and researches to support these new technologies are not substantial enough to confirm their safety and reliability as compared to the research evidence for the mammographic program that’s available free.

She also said that most efficient and successful method of detection is self-evaluation and mammography.

She said that all these companies should provide a firm evidence to show the safety attached to their screening process and it will not harm lives in near future. They should also provide training to the people and quality assurance programs, protocols for what you do when you find something wrong.

Citing “insiders,” the China Daily newspaper said the State Council, or Cabinet, decided on Monday it would make changes to laws barring foreign HIV carriers.

Under current regulations, those suffering from infectious diseases such as leprosy or HIV/AIDS or from mental disorders are not allowed in, the report said.

The changes could be announced before the start of Shanghai’s World Expo on May 1, Hao Yang, deputy director of the health ministry’s disease prevention and control bureau, was quoted as saying.

State Council officials were not immediately available for comment.

China introduced the ban in the late 1980s after reporting its first AIDS case in 1985, in a bid to limit the spread of the virus within its borders.

Authorities now estimate that up to 740,000 people in China live with HIV, while independent experts say the true number could be far higher.

“The ban imposed in the 1980s due to a lack of knowledge is obsolete and discriminatory,” He Xiong, deputy director of the Beijing centre for disease prevention and control, was quoted as saying.

“As HIV/AIDS cases have been seen in all provinces in China, a travel ban on foreigners will not help local public health.”

Travelling restrictions against HIV carriers, which are maintained by some 66 countries, have long been criticised as contributing to the discrimination and stigmatisation of sufferers.

According to the Global Database of HIV-related travel restrictions, China requires short-term visitors to declare their HIV status on their visa application form, while stays of six months or more require compulsory tests.

However there have been some exceptions. For major events such as the 2008 Beijing Olympics, the government has temporarily lifted the ban on HIV carriers entering the country, the report said.

Nityanand was arrested in Arki by the Bangalore Police, who had sought the help of the Himachal Police. Police said at the time of arrest, the swami had Rs 3 lakh in Indian currency and 2000 dollars in travellers’ cheques. (Read: Swamis in scandals – What keeps the faith?)

The self-styled swami would be produced before a local magistrate in Himachal Pradesh and then would be taken to Bangalore.

The controversial swami has been at large ever since television channels aired video clippings purportedly of him and a Tamil actress in a compromising situation. (Read: Swami’s alleged sex CD sells for Rs 1,000)

Cases of rape, criminal intimidation and cheating among others have since been filed against the Godman based on various complaints.  His ashram had been searched and hard disks seized were being examined, the police said. On allegations of rape against the swami, they appealed to victims to come out and give evidence.

The swami’s ashram has maintained that there is a “conspiracy” to malign Nityananda’s reputation and have said that the video footage telecast by TV channels was morphed.

After the sex tape surfaced, Nityananda’s supporters issued this statement:  “At this moment we feel that a mix of conspiracy, graphics and rumour are at play in these recent events that have unfolded. We are working on a legal course of action…In these trying times, we wish to reassure the lakhs of devotees and well-wishers whose sentiments have been deeply hurt by this conspiracy. We thank all the devotees and disciples for standing with us during these trying times.”

Nityananda had recently announced that he was quitting as the head of his ashram in Karnataka and associated trusts to lead a life of ‘spiritual seclusion’. Nithyananda’s Ashram is about 19 kilometres outside Bangalore, where he was based and was attacked by an angry crowd.