World Health Organisation

During this work, a modified methodology for the separation of gross alpha and beta activity from potable water was established. Complete separation of gross alpha activity was carried out by Fe(OH)3 and BaSO4 precipitation whereas gross beta activity was scavenged by Ca-oxalate and AMP (ammonium molybdate phosphates). The validation of the results was carried out by laboratory spiked experiments, which

Previous small phase II trials have demonstrated that the combination of 5-fluorouracil (5FU) and cisplatin(CDDP) could have clinical activity in metastatic biliary tract cancer. This randomised phase II trial was designed to assess the activity and safety of a high-dose infusional weekly 5FU alone (HDFU) and the combination of 5FU, folinic acid (FA) and CDDP. Patients were included if they had histologically proven locally advanced or metastatic biliary tract carcinoma, World Health Organisation (WHO) performance status < or = 2, bilirubin <2 x upper normal limit, adequate haematological and renal functions and had not received prior chemotherapy, even in the adjuvant setting. Arm A (HDFU) consisted of cycles of 5FU 3 g/m(2) intravenously (i.v.), 24 h infusion, weekly, for 6 weeks, followed by 1 week rest, every 7 weeks; Arm B (5FU+FA+CDDP) consisted of cycles of 5FU 2.0 g/m(2) i.v. with folinic acid 500 mg/m(2), 2 h-infusion, weekly, for 6 weeks, followed by 1 week rest plus cisplatin 50 mg/m(2), once every two weeks, for 6 weeks, followed by 1 week rest, every 7 weeks. From February 1997 to June 1999, 58 patients were randomised (29 in each arm). Patients had a median age of 58 years in Arm A and 62 years in Arm B, locally advanced disease was present in 21% of the patients in Arm A and 11% in Arm B. WHO performance status of 0/1/2 was noted in 48%/45%/7% of the patients in Arm A and 54%/43%/4% in Arm B. In both arms, the most common metastatic sites were the liver and peritoneum. Twenty-eight patients were eligible in each arm and one patient did not start the allocated therapy in Arm B. The median number of cycles was 2 [range 1-12] in Arm A and 2 [range 1-6] in Arm B. Responses for the eligible patients who started their allocated therapy were as follows: Complete Response (CR) 0% in Arm A, 4% in Arm B, Partial Response (PR) 7% in Arm A, 15% in Arm B resulting in an overall response rate [95% CI] of 7.1% in Arm A [0.9-23.5%] and 19% [6.3-38.1%] in Arm B. Disease stabilisation was observed in 46% in Arm A and 44% in Arm B. National Cancer Institute of Canada (NCIC) grade 3-4 adverse events (% of patients in Arm A/Arm B) were neutropenia 4%/26%, thrombopenia 0%/7%, stomatitis 0%/4%, vomiting 7%/14%, diarrhoea 0%/11% and neurotoxicity 4%/0%. There was one early toxic death in Arm B. The median overall survival (OS) [95% CI] was in Arm A/Arm B: 5.0 [4.0-7.4] months/8.0 [5.8-11.8] months and the median progression-free survival (PFS) was 3.3 [1.7-4.7] months/3.3 [2.3-6.7] months. Cisplatin in combination with 5FU+FA showed a higher activity than HDFU, but was more toxic. These results are not sufficient to start a phase III trial. However, our group is planning a phase III trial comparing 5FU+folinic acid versus the same schedule+oxaliplatin a platinum analogue.

In 2010 the World Health Organisation dedicated the Word Health Day to urbanization and health, highlighting the impacts of urban living on physical and mental health. This is because it is increasingly acknowledged that cities face various problems that undermine the quality of urban life, e.g.social inequalities, urban crime, poor environment, and traffic congestion. Despite this fact, cities continue to

Die Einführung von Einheitsverpackungen (Plain Packaging) für Zigaretten ist derzeit in aller Munde. Von Australien über die EU bis hin zu mehreren südamerikanischen Staaten erwägt man die Einführung einer neutralen Verpackung für Tabakprodukte, die keinerlei Marke trägt und lediglich Warnhinweise enthält. Der nachfolgende Beitrag widmet sich der damit verbundenen verfassungsrechtlichen Problematik und kommt zu dem Ergebnis, dass die Einführung von Einheitsverpackungen, vor allem vor dem Hintergrund des Schutzes der Jugend und der Gesundheit der Bevölkerung, mit dem Grundgesetz vereinbar ist.

The aim of this study was to estimate the prevalence of smoking and to describe the habits, attitudes, and practices related to smoking among students of Jordan University of Science and Technology (JUST), Irbid, Jordan.Students (n=650) were recruited in randomly selected, cluster samples drawn from the medical and engineering colleges of JUST. They were made familiar with a modified Arabic

In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection occurred in Wuhan, Hubei Province, China and spread across China and beyond. On February 12, 2020, WHO officially named the disease caused by the novel coronavirus as Coronavirus Disease 2019 (COVID-19). On January 30, 2020, WHO declared COVID-19 as the sixth public health emergency of international concern. An outbreak has posed significant threats to international health and the economy. It has raised intense attention not only within China but internationally. It has been declared a pandemic by the World Health Organization. WHO calls for social distancing with several measures such as Isolation, Quarantine, Closing schools, working from home instead of at the office, Restricting movement of people and the cancellation of mass gatherings, Cancelling or postponing conferences and large meetings, and not taking public transportation, including buses, subways, taxis, and rideshares. This leads to lockdown. Smartphone installed with relevant app brings people together even when this coronavirus (COVID-19) pandemic forces us apart. Life has to go on. Students need education, people need food and medication, and economy has to be stable. Social distancing should not be complicated. These apps make your loved ones, team members and favourites accessible. It makes people not feeling as if they are jailed, but take social distancing as a social responsibility. The apps are categorized into video conferencing, social video chats, medical, entertainment, health & fitness, food & drinks, and apps for visual & hearing impairments.

In the face of the current proliferation of existential threats – the risk of nuclear war, anthropogenic climate change, COVID-19, and (arguably) disruptive technologies like artificial intelligence – it is imperative that Australia embrace the notion of shared responsibility in international politics. Individual states have limited capacities to effectively tackle such large-scale, complex emergencies on their own. Highlighting the moral implications of the philosophical notion of joint action, this commentary makes the case for a particular type of responsibility, which can only be discharged when states deliberate and coordinate their actions. Moreover, it explores what this notion of shared responsibility means for Australia – and its international relationships – with respect to responding to climate chaos and COVID-19. 

Even though Australia, acting on its own, can neither significantly mitigate climate change nor halt the current global pandemic, it nevertheless has demanding moral responsibilities to respond to both. This is because the capacities necessary to affect meaningful change can be created through collaboration with other institutional agents. In the absence of intergovernmental organizations able to respond effectively to such crises, Australia has shared responsibilities to contribute to establishing, and then acting as part of, informal, purpose-driven, climate change and COVID-19 ‘coalitions of the obligated’.

Objectives: Formulation of triplet combined solid dosage film coated
tablet  containing  amlodipine  besylate  (equivalent  to  5  mg
amlodipine), hydrochlorothiazide (12.5 mg) and losartan potassium
(50 mg) for the treatment of severe hypertension. Development and
validated of a simple, fast, precise, selective and accurate HPLC
method  for  the  simultaneous  determination  of  amlodipine  besylate,
hydrochlorothiazide and losartan potassium in the tablets.
Methods:  The  formulation  of  the  tablets  was  carried  out  as  per
standard  protocols. The  various  steps  involve  in  formulation  were
dispensing  of  raw  materials,  sieving,  preparation  of  granulating
solvent,  mixing,  granulation,  drying  (In  FBD),  lubrication,
compression and coating. The separation of these three drugs was
achieved on a Sun Shell C8 column (150 mm x 4.6 mm, 2.6 μm) with
phosphate  buffer-acetonitrile  (70:30%  v/v)  as  mobile  phase  at  1.0
mL/min flow rate and 230 nm detection.
Results  and  Conclusion: The  physical  parameters  of  tablets  were
satisfactory  with  average  weight  deviation  from  3.23  to  3.29%,
friability 0.04%, disintegration time 8.3 minutes, average hardness
85.43N and thickness from 3.92 to 4.01 mm. The assay was found to
be 99.89%, 99.99% and 99.97% of amlodipine, hydrochlorothiazide
and losartan potassium, respectively. The dissolution was found to be
98.8 to 99.70%, 97.85 to 98.95% and 97.98 to 99.99% of amlodipine,
hydrochlorothiazide  and  losartan  potassium,  respectively.  The
uniformity of content was 99.85 to 99.99% and 99.60 to 99.99% of
amlodipine  and  hydrochlorothiazide,  respectively.  The  retention
times  observed  were  to  be  7.338,  2.097  and  10.675  minutes  for
amlodipine  besylate,  hydrochlorothiazide  and  losartan  potassium,
respectively.  The  method  was  statistically  validated  for  linearity,
recovery,  limit  of  detection,  limit  of  quantification,  accuracy, precision,  robustness,  stability  of  drugs  in  pure  form  and  in
presence of matrices and forced degradation study. The method
was successfully applied for analysis of combined dose tablet.

Prawo do zdrowia jest podstawowym prawem człowieka, które czerpie swe źródło w przyrodzonej godności ludzkiej. W wymiarach: fizycznym, psychicznym, społecznym i duchowym zdrowie stanowi fundament możliwości zrealizowania innych wartości za pomocą środków indywidualnych i społecznych. W związku z tzw. dynamiką normatywizacji pojawiła się
potrzeba porządkowania i hierarchizowania pewnych kategorii praw człowieka, w tym prawa do zdrowia, według ściśle wyodrębnionych kryteriów. Określenie miejsca zdrowia pośród innych dóbr szczególnie cennych dla człowieka pozwala na uzyskanie skuteczniejszej jego ochrony. Opracowanie niniejsze wychodzi naprzeciw tej potrzebie.

There is enormous evidence that the initiation and growth of atherosclerosis is highly influenced by hemodynamic factors. In this study, hemodynamic factors in the following patient specific 3D carotid artery models were studied: i) normal, ii) stenosis (with plaque near to bifurcation of internal carotid artery (ICA)), and iii) surgical model (plaque with surgically fitted Palmaz–Schatz stent). The 3D model of the carotid artery was formed from CT image of a patient through a commercial software MIMICS. The geometrical measurement taken from the 3D model was used to form its CAD model using CATIA software. The CAD model was meshed in ANSYS ICEM CFD module. The inlet- and outlet- boundary conditions were defined and material properties were given in CFX-Pre module of ANSYS. Then the solver input file was given to CFX solver manager for performing computational fluid dynamics (CFD) on the model. The outputs of the CFD analysis were observed in CFD-Post. The wall shear stress and blood velocity were greater both at near the bifurcation and at bend of the carotid artery model. The abnormal model is characterized by high wall shear stress in the stenosed portion which indicates greater probability of growth of plaque. Disturbed flow patterns and oscillating velocity indicate that the vulnerability of plaque formation is high in such places. The hemodynamic values have come back near to normal values in the carotid model fitted with stent. The observed variations in hemodynamic factors in the carotid artery with plaque surgically fitted with stent were compared to its normal model. This information can be used to predict restenosis in future.

The construction of a tool for rating countries’ capacities to prevent, detect and respond to communicable diseases requires the identification of factors of epidemic risk as well as of government capacities to mitigate these. The Joint External Evaluation Tool (JEET) provides a set of indicators to monitor a country’s progress in the implementation of the International Health Regulations and for a rating of epidemic- related capacities. Therefore, the specification of the existing indicators to health emergencies caused by communicable diseases, the identification of additional or proxy indicators and the consideration of their potential quantification are required. The analysis includes a systematic review of the JEET according to criteria of objectivity, reliability and validity, and a literature research to identify related indicators and to discuss their relevance and potential integration into a rating tool.

Asian Medicines: Encounters, Translations and Transformations
Asian medicines are engaged in complex global networks of actors: conservators who watch the changing supplies of wild plants in Asian mountains, medical botanists who study the substitution practices of collectors and marketers in Asia, policy makers who control or prevent the entry of drugs into European countries, corporations who seek to exploit drugs based on Asian medical knowledge, professional associations who seek to regulate Asian medical practice.  ICTAMs VII and VIII both took place in Asia (2009 in Bhutan, 2013 in Korea). The European location of ICTAM IX will allow us to take stock of the current state of Asian medicine and to examine the global flows of medical knowledge, practice and materials from a different but equally significant vantage point.
Traditional Asian medicines play a significant role in improving the wellbeing of people worldwide, both as a health care system in their own right, and as a resource for bio-discovery projects. Their applications will only grow, and to reach a full understanding of traditional Asian medicine, it is crucial to integrate professionals from many disciplines, including medical anthropologists, traditional medicine practitioners, clinical trial specialists, ethnobotanists, ethnopharmacologists, ethnopharmacognosists, ethnochemists, herbalists, businessmen, historians, economists, political scientists, conservationists, botanists, translators and more. ICTAM IX will bring together these professionals to share their experience, findings and knowledge, and work out appropriate strategies and networking to enhance research on traditional medicines.

Recent days Computer-aided design and image processing techniques are one of the most emerging useful tools for analysis of models in various medical, industrial and research areas. In medical field for the diagnosis of various diseases in vivo techniques including biochemical test, enzymatic tests are needed for continuous monitoring of patients. These diagnosis procedures are time consuming and inconvenient for patients. Therefore Computer assisted designing and image processing techniques are most promising non invasive tools for faster diagnosis and useful tool for designing of biomedical implants. In this paper portal vein was segmented from patient’s Liver computed tomography (CT) image by dedicated software. A Liver’s CT image of 38 year old Indian male patient’s was collected and by using imaged based software MIMICS (Materialise’s Interactive Medical Image Control System, Belgium) 3D model of HPV (hepatic portal vein) was obtained and Solid Work Professional (Dassault Systems Solid Works Corporation, USA) software was used for designing of normal portal vein’s 3D model and various portal vein diseased models including minor right portal vein thrombosis ( 19-20% reduction in medial region of vein), severe right portal vein thrombosis (20-22% reduction in medial and distal region of vein), minor left portal vein thrombosis (19-20% reduction in medial region of vein, severe right portal vein
thrombosis(20-22% reduction in medial and distal region of vein), left aneurysm (150-200 % increase of medial region).These models can be used for designing for implants and analysis of portal vein’s disorder like portal thrombosis, and portal aneurysm which are main cause of portal hypertension and also useful for surgeon for planning surgery and also helpful for understanding of portal vein hemodynamic (pressure, velocity, wall shear force)

Introduction Equity and universal coverage currently dominate policy debates worldwide. Health financing approaches are central to universal coverage. The way funds are collected, pooled, and used to purchase or provide services should be carefully considered to ensure that population needs are addressed under a universal health system. The aim of this paper is to assess the extent to which the Kenyan health financing system meets the key requirements for universal coverage, including income and risk cross-subsidisation. Recommendations on how to address existing equity challenges and progress towards universal coverage are made. Methods An extensive review of published and gray literature was conducted to identify the sources of health care funds in Kenya. Documents were mainly sourced from the Ministry of Medical Services and the Ministry of Public Health and Sanitation. Country level documents were the main sources of data. In cases where data were not available at the country level, they were sought from the World Health Organisation website. Each financing mechanism was analysed in respect to key functions namely, revenue generation, pooling and purchasing. Results The Kenyan health sector relies heavily on out-of-pocket payments. Government funds are mainly allocated through historical incremental approach. The sector is largely underfunded and health care contributions are regressive (i.e. the poor contribute a larger proportion of their income to health care than the rich). Health financing in Kenya is fragmented and there is very limited risk and income cross-subsidisation. The country has made little progress towards achieving international benchmarks including the Abuja target of allocating 15% of government's budget to the health sector. Conclusions The Kenyan health system is highly inequitable and policies aimed at promoting equity and addressing the needs of the poor and vulnerable have not been successful. Some progress has been made towards addressing equity challenges, but universal coverage will not be achieved unless the country adopts a systemic approach to health financing reforms. Such an approach should be informed by the wider health system goals of equity and efficiency.

In India, number of people with type 2 Diabetes Mellitus (DM) would be 87 million by the year 2030. DM disturbs autonomic regulation of skin microcirculation, and causes decrease in resting blood flows through the skin. The skin blood flow has a major effect on its temperature. The aim of the study was to evaluate changes of skin temperature of all parts of the body and serum asymmetric dimethylarginine, ADMA (μmol/L) in type-2 DM Indian patients. Group-I: Normal (n=17; M/F: 10/15, mean±SD= 43.2±9.4 years); Group-II: Type-2 DM without cardiovascular (CV) complications (n=15; M/F: 10/7, mean±SD= 46.3 ± 14.0 years); Thermograms of all parts of the body were acquired using a non-contact infrared (IR) thermography camera (ThermaCAM T400, FLIR Systems, Sweden). Blood parameters and thyroid hormone were measured biochemically. Indian diabetic risk score (IDRS) was calculated for each subject. In type-2 DM patients without CV group (n=15), there was a statistically significant (p=0.01) negative correlations between HbA1c and skin temperature of eye and nose (r= -0.57 and r= -0.55 respectively). ADMA was correlated significantly (p=0.01) with HbA1c (r=0.65) and estimated average glucose, eAG (r=0.63). In normal subjects, mean minimum and maximum values of skin temperatures were observed at posterior side of sole (26.89°C) and ear (36.85°C) respectively. In type-2 DM without CV, mean values of skin temperature in different parts of the body from head to toe were lesser than those values in control group; but this decreases were statistically significant in nose (32.66 Vs 33.99°C, p=0.024) as well as in tibia (32.78 Vs 33.13°C, p=0.036) regions.