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Prepared as an outcome of ICMR Subcommittee on Breast Cancer |.This consensus document on management of breast cancers summarizes the
modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular markers and research questions. It also inter
...
weaves clinical, biochemical and epidemiological studies.
more
The guidelines reiterate that the general principles of ethics for biomedical research involving human participants shall also be applicable. In addition, the guidelines specify unique provisions for stem cells, because of their inherent property for unlimited proliferation, differentiation to cells
...
of the germ layers, oncogenic potential, unrecognised toxicities and possible involvement in pre-implantation stages of human development. The guideline therefore focuses on: 1. Monitoring mechanism and regulatory pathway for basic, clinical research and product development based on categories of research and level of manipulation. 2. Procurement of gametes, embryos and somatic cells for derivation and propagation of any stem cell lines, their banking and distribution. 3. Other important areas like international collaboration, exchange of cell/lines and education for stakeholders and advertisement.
more
WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i
...
n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
more
Available in English, French, Portuguese and Arabic
Successful immunization of a critical mass of the African population with one or several safe and efficacious COVID-19 vaccines.Key objectives1. Accelerate African involvement in the clin
...
ical development of a vaccine. 2. Ensure African countries can access a sufficient share of the global vaccine supply.3. Remove barriers to widespread delivery and uptake of effective vaccines across Africa.
more
This article is part two in a series of explainers on vaccine development and distribution. Part one focused on how vaccines work to protect our bodies from disease-carrying germs. This article focuses on the ingredients in a vaccine and the three clinica
...
l trial phases. Part three outlines the next part of the vaccine journey: the steps from completing the clinical trial phases through to distribution
Available in English, French, Spanish, Arabic, Chinese and Russian
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Ongoing Living Update of COVID-19 Therapeutic Options: Summary of Evidence, Rapid Review 22 February 2022
recommended
This document includes the results of a rapid systematic review of current available literature. The information included in this review reflects the evidence as of the date posted in the document. In recognition of the fact that there are numerous ongoing
...
clinical studies, PAHO will periodically update this review and corresponding recommendations as new evidence becomes available.
more
Cystic echinococcosis (CE) is a well-known neglected parasitic disease. However, evidence supporting the four current treatment modalities is inadequate, and treatment options remain controversial. The aim of this work is to analyse the available data to answer
...
clinical questions regarding medical treatment of CE.
more
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clini
...
cal) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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The recommendations in this guideline are intended to inform the development of relevant national- and local-level health policies and clinical protocols. Therefore, the target audience includes national and local public health policy-makers, implem
...
enters and managers of maternal and child health programmes, health care facility managers, nongovernmental organizations (NGOs), professional societies involved in the planning and management of maternal and child health services, health care professionals (including nurses, midwives, general medical practitioners and obstetricians) and academic staff involved in training health care professionals.
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Ivermectin is an antiparasitic drug approved for the treatment of parasitic infections, including strongyloidiasis and onchocerciasis in humans. There is a reported increase in the use of ivermectin for the prevention and treatment of COVID-19 by the public in African Union Member States.
Currently
...
, there is:
1. No scientific evidence from pre-clinical studies on the therapeutic effect of ivermectin for the management of COVID-19;
2. No evidence of its clinical efficacy for the management of patients with asymptomatic, mild, moderate or severe COVID-19; and
3. No safety data regarding the use of ivermectin for COVID-19 in the majority of the published studies.
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WHO Living guideline: Drugs to prevent COVID-19
recommended
Interim guidance 2 march 2021
Current use of drugs to prevent COVID-19 is variable, reflecting large-scale uncertainty. Numerous randomized trials of many different drugs are underway to inform practice. This first version of the Drugs to prevent C
...
OVID-19: A WHO living guideline contains new information and a recommendation on hydroxychloroquine. It follows the publication of six trials synthesized in a living network meta-analysis (NMA).
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc
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e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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The recommendations in this guideline are intended to inform development of national and subnational health policies, clinical protocols and programmatic guides. The target audience includes national and subnational public health policy-makers, impl
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ementers and managers of maternal, newborn and child health programmes, health-care facility managers, supervisors/instructors for in-service training, health workers (including midwives, auxiliary nurse-midwives, nurses, paediatricians, neonatologists, general medical practitioners and community health workers), nongovernmental organizations, professional societies involved in the planning and management of maternal, newborn and child health services, academic staff involved in research and in the pre-service education and training of health workers, and those involved in the education of parents.
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Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f
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or developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
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A practical manual - The book provides step by step guidance
to the process of rational prescribing, together with many illustrative examples. It teaches skills that are necessary throughout a clinical career.
2nd edition. This new edition provides policy-makers, programme managers and health-service providers with the latest evidence-based guidance on clinical care. It includes information on how to establish and strengthen services, and outlines a human
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-rights-based approach to laws and policies on safe, comprehensive abortion care. This guidelines is available in English; French, Spanish; Japanese; Russian; Portuguese; Romanian and Ukrainian
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Accessed: 02.05.2020
These consolidated guidelines provide recommendations for comprehensive prevention and case management strategies in Kenya
Scope of the Guidelines: Infection prevention and control Patient triage Emergency Medical Services Case management Laboratory testing algorithm
Target
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Audience: Health care workers taking care of patients suspected or confirmed to have COVID-19
These guidelines combine both preventive and clinical management of the disease in Kenyan context. The protocol borrows various international recommendations including the World Health Organization, from experience of other countries such as China that has struggled with the outbreak for a longer time and from principles of virology and infectious disease management.
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Prepared as an outcome of ICMR Subcommittee on Esophageal Cancer | This consensus document on management of esophageal cancers
summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular markers and research questions. It a
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lso interweaves clinical, biochemical and epidemiological studies.
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The purpose of these guidelines is to help health workers to participate in the process of continuous surveillance of safety and efficacy of the pharmaceutical products which are used in clinical practice, thus help to achieve the ultimate goal to m
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ake safer and more effective treatment available to patients. This guideline addresses specifically the issues on what to report, why to report, when to report, where to report and how to report.
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The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guideli
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nes and policies regarding optimal packages of care for high-risk patients give few or no recommendations about how, by whom, or where they should be delivered for optimal impact.
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