Indian Twin Kids Joined At The Skull Have Been Successfully Separated

Toddler twins joined at the head have been successfully separated today following an 11-hour operation by a team of 30 doctors, 20 nurses and many other paramedical staff.

Medics from around the world came together in New Delhi, India, for the risky surgery on Jaga and Kalia, who amazed the health profession by surviving to the age of two-and-a-half.

The twins were born in a village in the eastern state of Odisha with shared blood vessels and some shared brain tissue.

They had undergone the first phase of the separation surgery in August.

"The most challenging job after the separation was to provide a skin cover on both sides of the brain for the children as the surgery had left large holes on their heads," said Maneesh Singhal, a plastic surgeon who was a part of the operating team.

"The skin was generated from the expansion of two balloons which were placed inside their heads during the first surgery in August,"

The huge operation, their second had to be brought forward after Jaga's health deteriorated in recent months.

The boys who were originally named Honey and Singh have survived against the odds as twins fused at the cranium have an 80 per cent risk of dying by the age of two if they are not separated.

Odisha health minister Pratap Jena said: 'Their health is stable, but they will be kept under observation for 72 hours.

Plastic surgeons are on their job after they were separated surgically.'

Nigerian Government Confirms Six Fresh Cases of Monkeypox as Disease Hits Abuja

The Federal Government has confirmed six fresh cases of monkeypox including one in Abuja, the Federal Capital Territory.

 

The Minister of State for Health, Dr. Osagie Ehanire, made the announcement in his office in Abuja on Friday, according to a statement by the Director of Media, Mrs. Boade Akinola.

 

Ehanire said apart from Abuja, there are two new cases of the disease in Bayelsa and Akwa Ibom states each and one in Enugu.

 

This brings the total number of confirmed monkeypox cases to nine. Ehanire noted that investigations were ongoing to see if any of the new cases had a link with the Bayelsa cluster, where the outbreak started.

 

He called for calm among members of the public, as the Nigeria Centre for Disease Control is working with all affected states to ensure case finding and adequate management.

 

The minister explained that as frightening as the manifestation of the ailment may seem, “no fatality has been recorded till date. As of October 25, 2017, a total of 94 suspected cases have been reported from 11 states (Akwa Ibom, Bayelsa, Cross River, Delta, Ekiti, Enugu, Imo, Lagos, Nasarawa, Niger, Rivers and the FCT).”

 

He noted that the newly confirmed cases were patients already being managed by public health authorities and have been receiving appropriate clinical care since the onset of the illness.

 

Ehanire stated that the Federal Ministry of Health, through the NCDC, was in close contact with all state epidemiology teams, as well as the health facilities providing clinical care to both suspected and confirmed cases.

 

The minister said health commissioner across the 36s states had been advised to place all health care facilities and disease surveillance and notification officers on alert, to ensure early case detection, reporting and effective treatment.

 

He said the NCDC had also deployed rapid response teams in the four states with confirmed cases.

 

Ehanire said an interim national guideline for monkeypox had been developed and disseminated to all states for coordination of response activities. This is also available via http://ncdc.gov.ng/themes/common/docs/protocols/50_1508912430.pdf.

 

He explained that monkeypox is a largely self-limiting disease i.e. a disease that resolves itself. Generalised vesicular skin rashes, fever, and painful jaw swelling are characteristic symptoms associated with an infection. Although there is no specific medicine to treat the disease when intensive supportive care is provided virtually all patients recover fully, as we have seen with the current outbreak.

 

It is thought that people could get monkeypox if they are bitten or scratched by an animal, or come in contact with animal blood in preparing bushmeat or have contact with an infected animal’s body fluids or sores.

 

“Monkeypox may also be spread between people through prolonged face-to-face contact, or through contact with body fluids or sores of an infected person, or items that have been contaminated with fluids or sores (clothing, bedding, etc.),” Ehanire said.

 

Measures that can be taken to prevent infection with Monkeypox virus include avoiding contact with animals that could carry the virus such as rodents or other animals that appear sick or were found dead in areas where monkeypox occurs.

Nigerian Professor Invents HIV/AIDS Drug, Calls for Clinical Trial

A researcher, Prof. Madubuike Ezeibe, has called on the Federal Government to carry out a clinical trial of the drug he invented for the treatment of HIV/AIDS, Aluminum-Magnesium Silicate, reports Punch.

 

Ezeibe who is a professor of Veterinary Medicine, Michael Okpara University of Agriculture, Umudike, made the call in Umuahia on Monday.

 

A clinical trial is a study that explores whether a medical strategy, treatment, or device is safe and effective for humans. It shows which medical approaches that work best for certain illnesses or groups of people.

 

The don who presented a paper on the potential of the drug as both antiviral and raw material, at a world conference on Ethnopharmacology in Chicago, United States, on May 2, 2016, said that more than one year after he invented and presented his findings at different international conferences, no authority anywhere in the world had disputed the research findings.

 

“I, therefore, appeal to the federal government to institute an inter-ministerial committee to carry out clinical trial of the drug in six centres across the country without further delay.

“The committee should comprise federal Ministries of Health, Education, Environment as well as Science and Technology, with, at least, 1000 sample patients from each state of the federation.

“Some of the findings of the research include that silicates have molecules that are 0.96 nanometre in size while HIV has molecules as big as 110 nanometres.

“The particles of AMS are positively and negatively charged, while HIV-infected cells are positively charged.

“The AMS are immune stimulants; one can use simple sugar (glucose) to transport charged molecules across the mucous membrane to the blood.

“Glucose helps to transport the drug to any part of the body, including ‘the sanctuary’, where other drugs cannot reach to attack the HIV-infected cells.

“So, if these findings are true and nobody has challenged the claims of the research, let the federal government set up an inter-ministerial committee to conduct clinical trial of the medicine,’’ he said.

 

Ezeibe expressed joy that the Vice Chancellor of MOUAU, Prof. Francis Otunta and the University Senate had investigated his claims and given their approvals.

 

He said that aside from the support from the university, the Abia Government also sponsored the publication of the book on AMS which, according to him, is now available for sale.

 

The researcher said that no fewer than 500 HIV cases within and outside Nigeria had been referred to him which he treated.

 

“All the HIV cases were referral from a medical doctor to the Medical Director of MOUAU. I have also handled referrals from different parts of African and Asian continents,’’ Ezeibe said.

Bayelsa’s 7 Monkey Pox Patients Discharged From Hospital

Seven out of the 13 monkey pox patients on admission at the Niger Delta University Teaching Hospital, Okolobiri in Bayelsa have fully recovered, the state Commissioner for Information, Mr Daniel Iworiso-Markson, has said.

A patient of Monkey Pox The commissioner said in a statement on Wednesday in Yenagoa, that the seven patients had been discharged from the hospital. The News Agency of Nigeria (NAN) reports that the contagious disease broke out three weeks ago in Agbura area of Yenagoa following reports that a family manifested symptoms of monkey pox after eating monkey meat.

He said the six other patients under medical surveillance at the teaching hospital were responding positively to treatment. “The government has been able to successfully contain the spread of the disease as no new case has been reported in the last few days.

“With the way and manner government deployed its machinery and with the team of dedicated health and medical personnel, monkey pox will soon be fully kicked out of Bayelsa state,” he added. Iworiso-Markson commended the state Ministry of Health and National Centre for Disease Control for their efforts in containing the disease. The commissioner also appreciated people in the state for taking preventive measures against further spread of the disease and urged them to maintain healthy lifestyle, environmental and personal hygiene.

According to him, feedback received from various channels in the state indicates that public enlightenment campaign, especially in local languages, have succeeded in alerting people to avoid actions that would further spread the disease.

No Syringe, X-ray Machine & More: Aisha Buhari Calls for Probe of Aso Rock Clinic After N3.2b Budget

The wife of the President, Mrs Aisha Buhari, has called for a probe of how the N3.2billion budget for the State House Medical Centre in Aso Rock is utilized after finding out that it doesn't have an x-ray machine or even a syringe.

 

While speaking at the opening of a 2-day stakeholders meeting on Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition organised by her pet project, Future Assured in Abuja, wife of Nigeria’s president, Aisha Buhari called for a probe of the State House Medical Centre over poor health facilities in the hospital despite the huge budgetary allocation to it.

 

According to Vanguard, Mrs. Buhari who condemned the “lack of facilities” at the hospital during a programme in Abuja on Monday, equally lamented the total or dearth of some necessary hospital facilities such as syringe, drugs and equipment needed for saving lives. 

 

Wife of the President, Mrs Aisha Buhari, who lamented that she wanted to do an x-ray at the clinic few weeks ago but was told the X-ray machine was not functional, said the ongoing renovations at the clinic was baseless because the hospital lacked the equipments to save lives.

 

She said; “Before I commence my speech, I’ll like to be realistic to say a few words concerning health in Nigeria and health delivery system in Nigeria. It’s very very very poor, sorry to say that. I am happy the MD of Aso Clinic is here, is he around? Dr. Munir (Dr. Hussain Munir, consultant cardiologist and the chief medical director at state house medical centre) or his representative? Ok, he is around.

“Ok Dr. Munir, I’m happy you are here. As you are all aware for the last six months, Nigeria wasn’t stable because of my husband’s ill health, we thank God he has fully recovered now.

“If somebody like Mr. President can spend several months outside Nigeria, then you wonder what will happen to a common man on the street in Nigeria.

“Few weeks ago, I was sick as well, they advised me to take the first flight out to London, I refused to go. I said I must be treated in Nigeria because there is a budget for an assigned clinic to take care of us.

“If the budget is N100 million, we need to know how the budget is spent. Along the line, I insisted they call Aso Clinic to find out if the X-ray machine is working, they said it is not working. They didn’t know I am the one that was supposed to be in that hospital at that very time.

“I had to go to a hospital that was established by foreigners in and out 100 percent. What does that mean?

“So, I think is high time for us to do the right thing. If something like this can happen to me, no need for me to ask the governors’ wives what is happening in their states. This is Abuja and this is the highest seat of government, and this is presidential villa. One of the speakers have already said we have very good policies in Nigeria. In fact,we have the best policies in Africa. Yes. of course, we have, but the implementation has been the problem.

“So, we need to change our mindset and do the right thing. I’m sure Dr. Munir will not like me saying this but I have to say it out. As the Chief Medical Director, there are a lot of constructions going on in this hospital but there is no single syringe there what does that mean? Who will use the building? We have to be good in reasoning. You are building new building and there is no equipment, no consumables in the hospital and the construction is still going on.

“Going back to the same health issue in Nigeria, as a result of spending several months by the President outside Nigeria, a 40-year-old man who was still living in his father’s house, created a …. and that is a major set back for the country and the health sector did not benefit.”

Enugu State Ministry of Health Issues Warning to General Public Over Monkey Pox

Following the outbreak of Monkey Pox disease in Enugu state, the Ministry of Health in the state has warned people to stay away from wild animals.

The Enugu State Ministry of Health has urged residents of the state to be wary of touching or coming in contact with wild animals, for self protection against Monkey-pox virus.

 

The ministry’s Director of Public Health Services, Dr Okechukwu Ossai, gave the advice when he spoke with the News Agency of Nigeria on Tuesday, on measures taken by the ministry to prevent the disease in the state.

 

Ossai said the ministry had begun sensitisation in local radio and television stations about the disease, its signs and symptoms.

 

He said that the ministry had also gone ahead to orientate its disease surveillance officers in all the local governments and border areas on the disease.

 

The orientation, he said include the physical manifestations and signs of the disease.

“At the grassroots, we have alerted our health focal persons to monitor the environment and ensure that no one incubates any strange disease in his or her house,’’ he said.

 

The director said that personal, family and environmental hygiene especially hand washing, was key and necessary for all residents of the state to observe, to avoid any form of virus or contagious disease.

 

He said monkey-pox could be contacted through touching the body or body fluid of wild animals, adding that apart from monkeys, antelopes and wild rats could also harbour the virus.

 

“I will also urge hunters, butchers and those that prepare bush meat from these animals for consumption to be wary.

“However, if the meat from these animals mentioned are cooked very well beyond boiling point, the meat is safe as the virus is destroyed via proper boiling.’’

 

Health experts explain that Monkey-pox, a virus found in monkeys and other wild animals is, however, rare in humans, adding that  it belongs to the same family of Chicken-pox and Small-pox. 

 

-NAN

Monkey pox reportedly hits Lagos, two cases recorded

The dreaded but rare viral zoonotic disease (from animal to man) caused by Monkey pox virus that recently began in Bayelsa has reportedly hit Lagos state with two cases allegedly recorded. The first case of monkeypox in Bayelsa has been traced to a monkey, but the biology of the virus allows it to be transmitted from human to human once it gets into human populations 

A week ago, fear had griped residents of Yenagoa, the capital of Bayelsa State, following the outbreak of the viral epidemic, Monkey Pox, in the state, with report that 10 persons had already been infected while authorities in the state said they were tracking 49 persons alleged to have come in contact with the infected persons. 

Monkey-pox disease Monkey Pox is a viral illness caused by a group of viruses that include chicken pox and small pox. That the first case was noticed in the Democratic Republic of Congo and subsequently it had outbreaks in the West African region. The virus has two types, the Central African and the West African types with the West African type being milder and having no records of mortality. 

However, the Lagos state Commissioner for Health, Dr. Jide Idris said there is the need to sensitize members of the public and provide adequate information on measures for prevention and control of the disease. Dr. Idris said two cases have been reported in the state and that one of the victims has just returned to Lagos from Bayelsa State, where the incident was first recorded last week.

 He said there are thirty-two (31) reported cases across the country, with two (2) in Lagos. Dr. Idris told newsmen at a news conference on Monday that it has become necessary to sensitise residents about the viral disease which has been reported in some states. “Though no confirmed case has been recorded, there is the need to sensitize members of the public and provide adequate information on measures for prevention and control of the disease in line with the policy of the State Government,” he said. “I need to state that though there is no specific vaccine for the disease, vaccination against Smallpox has been proven to be 85 percent effective in preventing Monkeypox. 

There is also no specific anti-viral therapy for Monkey pox, however, the disease is self-limiting and could be managed conservatively.” “The symptoms in human is similar to those seen in the past in smallpox patient although less severe. “Monkey Pox Should be suspected in any person with rash, fever, chills, sweats, headache backache, lymphadenopathy, sore-throats, cough and shortness of breath. 

“Residents are urged to adequate measures in order to reduce the risk of contracting the diseases. “Health workers should have a high index of suspicion any person with the above symptoms in order to improve case detection. “I need to state that though there is no specific to a vaccine for diseases, vaccination against smallpox has been proven to be 85 percent effective in preventing Monkey pox. “There is also no specific anti-viral therapy for Monkey pox. “However the diseases are self-limiting and could be managed conservatively.” 
“The preventive measures to be taken against the spread of the disease include; avoiding close contact with infected people; avoiding consumption of bush meat and dead animals; cooking of meat and meat product thoroughly before eating and washing hands with soap and running water frequently and thoroughly.”

Monkeypox

Key facts

• Monkeypox is a rare disease that occurs primarily in remote parts of Central and West Africa, near tropical rainforests.
• The monkeypox virus can cause a fatal illness in humans and, although it is similar to human smallpox which has been eradicated, it is much milder.
• The monkeypox virus is transmitted to people from various wild animals but has limited secondary spread through human-to-human transmission.
• Typically, case fatality in monkeypox outbreaks has been between 1% and 10%, with most deaths occurring in younger age groups.
• There is no treatment or vaccine available although prior smallpox vaccination was highly effective in preventing monkeypox as well.

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Monkeypox is a rare viral zoonosis (a virus transmitted to humans from animals) with symptoms in humans similar to those seen in the past in smallpox patients, although less severe. Smallpox was eradicated in 1980.However, monkeypox still occurs sporadically in some parts of Africa.
Monkeypox is a member of the Orthopoxvirus genus in the family Poxviridae.
The virus was first identified in the State Serum Institute in Copenhagen, Denmark, in 1958 during an investigation into a pox-like disease among monkeys.

Outbreaks

Human monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo (then known as Zaire) in a 9 year old boy in a region where smallpox had been eliminated in 1968. Since then, the majority of cases have been reported in rural, rainforest regions of the Congo Basin and western Africa, particularly in the Democratic Republic of Congo, where it is considered to be endemic. In 1996-97, a major outbreak occurred in the Democratic Republic of Congo.

In the spring of 2003, monkeypox cases were confirmed in the Midwest of the United States of America, marking the first reported occurrence of the disease outside of the African continent. Most of the patients had had close contact with pet prairie dogs.

In 2005, a monkeypox outbreak occurred in Unity, Sudan and sporadic cases have been reported from other parts of Africa. In 2009, an outreach campaign among refugees from the Democratic Republic of Congo into the Republic of Congo identified and confirmed two cases of monkeypox. Between August and October 2016, a monkeypox outbreak in the Central African Republic was contained with 26 cases and two deaths.

Transmission

Infection of index cases results from direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. In Africa human infections have been documented through the handling of infected monkeys, Gambian giant rats and squirrels, with rodents being the major reservoir of the virus. Eating inadequately cooked meat of infected animals is a possible risk factor.
Secondary, or human-to-human, transmission can result from close contact with infected respiratory tract secretions, skin lesions of an infected person or objects recently contaminated by patient fluids or lesion materials. Transmission occurs primarily via droplet respiratory particles usually requiring prolonged face-to-face contact, which puts household members of active cases at greater risk of infection. Transmission can also occur by inoculation or via the placenta (congenital monkeypox). There is no evidence, to date, that person-to-person transmission alone can sustain monkeypox infections in the human population.
In recent animal studies of the prairie dog-human monkeypox model, two distinct clades of the virus were identified – the Congo Basin and the West African clades – with the former found to be more virulent.

Signs and symptoms

The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 16 days but can range from 5 to 21 days.
The infection can be divided into two periods:

• the invasion period (0-5 days) characterized by fever, intense headache, lymphadenopathy (swelling of the lymph node), back pain, myalgia (muscle ache) and an intense asthenia (lack of energy);
• the skin eruption period (within 1-3 days after appearance of fever) where the various stages of the rash appears, often beginning on the face and then spreading elsewhere on the body. The face (in 95% of cases), and palms of the hands and soles of the feet (75%) are most affected. Evolution of the rash from maculopapules (lesions with a flat bases) to vesicles (small fluid-filled blisters), pustules, followed by crusts occurs in approximately 10 days. Three weeks might be necessary before the complete disappearance of the crusts.

The number of the lesions varies from a few to several thousand, affecting oral mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (eyelid) (20%), as well as the cornea (eyeball).
Some patients develop severe lymphadenopathy (swollen lymph nodes) before the appearance of the rash, which is a distinctive feature of monkeypox compared to other similar diseases.
Monkeypox is usually a self-limited disease with the symptoms lasting from 14 to 21 days. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications.
People living in or near the forested areas may have indirect or low-level exposure to infected animals, possibly leading to subclinical (asymptomatic) infection.
The case fatality has varied widely between epidemics but has been less than 10% in documented events, mostly among young children. In general, younger age-groups appear to be more susceptible to monkeypox.

Diagnosis

The differential diagnoses that must be considered include other rash illnesses, such as, smallpox, chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies. Lymphadenopathy during the prodromal stage of illness can be a clinical feature to distinguish it from smallpox.
Monkeypox can only be diagnosed definitively in the laboratory where the virus can be identified by a number of different tests:

• enzyme-linked immunosorbent assay (ELISA)
• antigen detection tests
• polymerase chain reaction (PCR) assay
• virus isolation by cell culture

Treatment and vaccine

There are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled. Vaccination against smallpox has been proven to be 85% effective in preventing monkeypox in the past but the vaccine is no longer available to the general public after it was discontinued following global smallpox eradication. Nevertheless, prior smallpox vaccination will likely result in a milder disease course.

Natural host of monkeypox virus

In Africa, monkeypox infection has been found in many animal species: rope squirrels, tree squirrels, Gambian rats, striped mice, dormice and primates. Doubts persist on the natural history of the virus and further studies are needed to identify the exact reservoir of the monkeypox virus and how it is maintained in nature.
In the USA, the virus is thought to have been transmitted from African animals to a number of susceptible non-African species (like prairie dogs) with which they were co-housed.

Prevention

Preventing monkeypox expansion through restrictions on animal trade

Restricting or banning the movement of small African mammals and monkeys may be effective in slowing the expansion of the virus outside Africa.
Captive animals should not be inoculated against smallpox. Instead, potentially infected animals should be isolated from other animals and placed into immediate quarantine. Any animals that might have come into contact with an infected animal should be quarantined, handled with standard precautions and observed for monkeypox symptoms for 30 days.

Reducing the risk of infection in people

During human monkeypox outbreaks, close contact with other patients is the most significant risk factor for monkeypox virus infection. In the absence of specific treatment or vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus. Surveillance measures and rapid identification of new cases is critical for outbreak containment.
Public health educational messages should focus on the following risks:

• Reducing the risk of human-to-human transmission. Close physical contact with monkeypox infected people should be avoided. Gloves and protective equipment should be worn when taking care of ill people. Regular hand washing should be carried out after caring for or visiting sick people.
• Reducing the risk of animal-to-human transmission. Efforts to prevent transmission in endemic regions should focus on thoroughly cooking all animal products (blood, meat) before eating. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues, and during slaughtering procedures.

Controlling infection in health-care settings

Health-care workers caring for patients with suspected or confirmed monkeypox virus infection, or handling specimens from them, should implement standard infection control precautions.
Healthcare workers and those treating or exposed to patients with monkeypox or their samples should consider being immunized against smallpox via their national health authorities. Older smallpox vaccines should not be administered to people with comprised immune systems.
Samples taken from people and animals with suspected monkeypox virus infection should be handled by trained staff working in suitably equipped laboratories.

WHO response

WHO supports Member States with surveillance, preparedness and outbreak response activities in affected countries.