Every four minutes, one child dies of pneumonia-causing diseases in India, before even reaching his fifth birthday.

Caused by Streptococcus pneumoniae and Haemophilus influenzae B or HIb -- two infamous bacteria -- pneumococcal disease are killing 140,000 Indian children every year.

According to a new study, every year, 1.2 million children under age five die from these infections.

Published in the `Lancet' medical journal on Saturday, the study found that in 2000, an estimated 14.5 million cases of pneumococcal disease such as pneumonia and meningitis were reported worldwide, most caused by Streptococcus pneumoniae with 826,000 deaths among children under five.

Besides India which recorded the greatest proportion of global pneumococcal cases -- 27% --, four other Asian countries featured on the list of top 10 nations with the greatest number of pneumococcal deaths in children aged 1-59 months. They were: Afghanistan, China, Pakistan and Bangladesh.

HIB, on the other hand, caused 8.1 million serious illnesses worldwide and 371,000 child deaths every year.

Here too, India tops the 10 countries list with the highest estimated number of HIb deaths in 2000. While India recorded 72,000 deaths, China saw 19,000 casualties, Afghanistan 14,000, Pakistan 13,000 and Bangladesh 12,000 deaths. Unfortunately, safe and effective vaccines exist to provide protection against both diseases. However, India is among many countries which are yet to start using the vaccine in its national immunization programme.

In 2000, only the USA had initiated routine use of pneumococcal vaccine. By August 2008, this expanded to include 24 high and two upper-middle income countries but did not include any from Africa or Asia, the regions with the highest numbers of pneumococcal deaths and cases.

According to the study, these 26 countries accounted for less than 0.2% of global childhood pneumococcal deaths in 2000 and the children in these countries, on average, had a 40-fold lower risk of pneumococcal death than the children in countries not yet using the vaccine.

Kate Brien, primary author of the pneumococcal study from Johns Hopkins Bloomberg School of Public Health, said, "The need for vaccination and treatment is particularly urgent in Africa and Asia, which together account for 95% of all pneumococcal deaths."

"Prevention of pneumococcal and HIb cases and deaths is imminently achievable, but countries must demonstrate the political will to prioritize prevention," said Orin Levine, executive director of PneumoADIP at the Johns Hopkins Bloomberg School of Public Health.

India, however, is finally waking up to the threat. The health ministry will soon take to the Cabinet for final approval the proposal to introduce a pentavalent vaccine (5X1) in its national immunization programme.

The vaccine, that received a go-ahead from the ministry's Expenditure Finance Committee (EFC) in June, will combine DPT (diphtheria, pertussis, tetanus) with Hepatitis B and Haemophilus Influenza Type B (HIb) that causes pneumonia and meningitis.

The ministry will first launch the vaccine in five states -- Himachal Pradesh, Kerala, Tamil Nadu, Jammu and Kashmir and Karnataka -- all of which have high routine immunization rates (80%-90%). An estimated 90.63 lakh children will be vaccinated with this five-in-one shot in the five states between 2009 and 2011. This will cost nearly Rs 408 crore.

The vaccine is expected to cost the government a little less than $2 per dose. At present, 85 countries across the world are using pentavalent vaccines.

Cancer and its treatment causes discomfort on many levels, but controlling pain can speed recovery for children battling the disease, say pain management experts at St. Jude Children's Research Hospital.

Tumors press on nerves, bones and organs; radiation can damage the skin and mucus membranes; and chemotherapy agents can inflict harsh side effects. Additionally, acute pain increases a patient's heart and respiratory rates, metabolism, blood pressure and stress hormones. Children who are hurting need more oxygen. They have trouble participating in physical therapy and also experience more depression, anger and insomnia.

In the past, medical professionals treated pain almost as an afterthought after all, eradicating disease was the primary goal. As childhood cancer cure rates increased, clinicians recognized the need to alleviate suffering. By controlling pain, health care workers could advance recovery.

"Chronic pain influences the immune system, so patients don't heal as well. Research also shows that patients don't breathe as well when in pain, causing a higher risk of pulmonary complications after surgery," said Doralina Anghelescu, M.D., Anesthesiology Division at St. Jude. "Patients in pain don't eat as well or sleep as well either. Pain management benefits the whole body."

"The more parents know about pain, the better they will be able to help their child," Anghelescu said. "It is important for them to understand the kind of pain the child is having, what influences the pain and the best way to cope with the pain."


When assisting a child in pain, parents should consider the following tips:

-- Parents know their child better than anyone, so it's important to tell the doctor or nurse if the child is acting differently than normal. Parents should talk to their children about what they are feeling and thinking.

-- Parents should inform the child about what is happening, if he or she wants to know about it.

-- Parents should not say "This won't hurt at all." It's important to acknowledge the pain and not minimize or deny it.

-- Parents can make physical contact with their child by holding hands or giving hugs.

-- If possible, parents should remain with their child until the pain is controlled.

-- Parents can talk about the positive steps that are being taken to reduce pain. Parents can remind their child that the doctors and nurses will reduce the pain as much as possible.

-- Parents should try to keep their own anxiety under control and remain calm. Parents should not show negative cues such as gasping, flinching and cringing.

-- Parents should support the child's way of coping. Children can employ techniques such as deep breathing for relaxation; counting, singing or watching television for distraction; or reframing thoughts by evaluating negative ideas and images and replacing them with more positive ones. ("I'm strong. I can do this. I've had similar pain, and it got better.")

-- Parents should not scold or punish their child for not cooperating.

-- Parents should avoid helping to hold their child down during a procedure. Instead, they can hold their child's hand or offer ways to distract from the procedure.

"These techniques may not be a substitute for pain medication, but they can help the pain medicines work better," Anghelescu said. "Emotions can influence the amount of pain, and attitudes from other people play a role. It is important for parents to be careful not to reinforce negative thoughts, beliefs and emotions."

Scientists in China have discovered that roots of a plant used a century ago during the great Spanish influenza pandemic contains substances with powerful effects in laboratory experiments in killing the H1N1 swine flu virus that now threatens the world. The plant has a pleasant onion-like taste when cooked, but when raw it has sap so foul-smelling that some call it the "Dung of the Devil" plant. Their report is scheduled for the Sept. 25 issue of ACS' Journal of Natural Products, a monthly publication.

In the study, Fang-Rong Chang and Yang-Chang Wu and colleagues note that the plant, Ferula assa-foetida, grows mainly in Iran, Afghanistan and mainland China. People used it as a possible remedy during the1918 Spanish flu pandemic that killed between 20 to 100 million people. Until now, however, nobody had determined whether the plant does produce natural antiviral compounds.

Chang and Wu identified a group of chemical compounds in extracts of the plant that showed greater potency against influenza A (H1N1) than a prescription antiviral drug available for the flu. "Overall, the present study has determined that sesquiterpene coumarins from F. assa-foetida may serve as promising lead components for new drug development against influenza A (H1N1) viral infection," the authors write.

Swine flu can infect cells deeper in the lungs than seasonal flu, thus helping to boost the severity of the illness, a study released on Thursday said.

The paper provides the first laboratory corroboration of reports from front-line doctors that some patients with A(H1N1) virus suffer worse symptoms compared to those with run-of-the-mill seasonal flu.

Influenza viruses penetrate cells by attaching themselves to molecules called receptors, located on the outside of the cell wall.

The virus' docking spike and the receptor are like a key and a lock. Some viruses only open a few cells, while others have something rather closer to a pass key, making it possible to infect a larger cell variety.

Once inside, the virus uses the cell's machinery to replicate, eventually bursting the cell and going on to attack others.

Seasonal strains attach themselves almost exclusively to cells found in the nose, throat and upper airway, producing a some of influenza's signature symptoms: runny nose, scratchy throat, a dry cough.

But the new research, published in the journal Nature Biotechnology, shows that the new swine flu -- by sticking to a greater range of receptors -- can also breach cells deep in the lungs.

Lab-dish experiments were carried out by Ten Feizi of Imperial College London and colleagues in which 86 different receptors were exposed to both seasonal and pandemic flu.

The seasonal strains only locked onto the kind of receptors found in the upper respiratory track.

But the swine flu virus was also able to latch onto receptors found deep inside the lungs, albeit more weakly. The adhesion results in a more severe lung infection.

Feizi spelt out the risk of what could happen if natural selection encourages viral strains that favour this deep-lung penetration.

"If the flu virus mutates in the future, it may attach to the receptors deep inside the lungs more strongly, and this could mean that more people would experience severe symptoms," said Feizi.

"We think scientists should be on the lookout for these kinds of changes in the virus so we can try to find ways to minimise the impact."

Using a statistical technique, epidemiologists sifting through data from other countries have found similarly disquieting patterns.

French epidemiologist Antoine Flahault has reported a 100-fold increase, compared to seasonal flu, in the number of swine flu deaths in Mauritius and New Caledonia attributed directly to the virus itself rather than secondary bacterial infections or underlying conditions.

Many of those deaths were caused by acute respiratory disease syndrome (ARDS), which requires intensive-care treatment for an average of three weeks. Only 50 percent of ARDS patients survive.

Heavy drinkers of beer and spirits face a much higher risk of developing cancer than the population at large, says a group of Montreal epidemiologists and cancer researchers. Their findings show that people in the highest consumption category increased their risk of developing oesophageal cancer sevenfold, colon cancer by 80% and even lung cancer by 50%.

In all, the researchers found statistically significant relationships between heavy consumption of beer and spririts and six different cancers. Moderate drinking (i.e. less than daily) and wine consumption did not show the same effects, however.


"We looked at the data in two ways," said Benedetti, an assistant professor at McGill's Departments of Medicine and of Epidemiology, Biostatistics and Occupational Health. "We compared people who drank heavily to our reference group, who abstained or drank only very occasionally. We also looked for trends across our categories: non-drinkers, weekly drinkers and daily drinkers.

The results were astounding. "We saw increased risk for esophageal cancer, stomach cancer, colon cancer, liver cancer, pancreatic cancer, lung cancer and prostate cancer," Benedetti added. "The strongest risk was for esophageal and liver cancer."

"This study crystalizes many strands of evidence from different studies on different types of cancer and alcohol consumption," said Dr. Jack Siematycki, professor, Canada Research Chair and Guzzo Chair in Environment and Cancer, at the Université de Montréal.

The researchers used data originally collected for a large occupational cancer study conducted in Montreal in the 1980s. The information was a treasure-trove, said Benedetti.

"Lifetime interviews were conducted with people about their job histories, and detailed information about all the things they could have been exposed to was collected," she explained. "As it turns out, the data also included information about non-occupational factors such as drinking alcohol, smoking cigarettes, diet and socio-economic status, among others."

"For the most part we showed that light drinkers were less affected or not affected at all," said Benedetti. "It is people who drink every day or multiple times a day who are at risk. This adds to the growing body of evidence that heavy drinking is extremely unhealthy in so many ways. Cancer very much included."