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New global guidelines launched to reduce surgical site infection and antimicrobial resistance

The Global Surgery Guideline for the Prevention of Surgical Site Infection has identified practical steps that all hospitals should urgently take to both reduce avoidable infections and the spread of antimicrobial resistance.

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International surgical guidelines launched today (25 March) will help to save thousands of lives in Low- and Middle-income Countries (LMIC) countries by standardising and improving practice in surgery.

An international collaboration funded by the NIHR led by the University of Birmingham sets out nine essential recommendations that should be implemented as a priority across all hospitals world-wide in the fight against Surgical Site Infection (SSI).

SSI is the most common complication following abdominal surgery, affecting 9% of patients in high-income countries and 17% of patients in low- and middle-income countries (LMICs) – causing patients to experience pain and delays return to normal activities such as work.

At least 4·2 million people worldwide die within 30 days of surgery each year, and half of these deaths occur in LMICs. This number of postoperative deaths accounts for 7·7% of all deaths globally, making it the third greatest contributor to deaths, after ischaemic heart disease and stroke.

More people die within 30 days of surgery annually than from all causes related to HIV, malaria, and tuberculosis combined (2·97 million deaths). It is estimated that failure to improve surgical care will cost the world economy $12.3 trillion in lost GDP by 2030.

Additional SSI-related health costs can cause financial hardship, particularly for the most vulnerable patients in LMICs. SSI is associated with a three-fold increase in the risk of death after surgery. Treatment of SSI is increasingly challenging due to the rise of antibiotic resistance, which occurs in up to 46% of LMIC patients. This places a strong focus on preventing SSI from occurring in the first place

Published in the British Journal of Surgery, the new Global Surgery Guideline for the Prevention of Surgical Site Infection will support surgeons in putting into practice key interventions that are proven to reduce the SSI risk.

Expert surgeons representing 14 countries across Africa, Europe, Latin America, and South Asia identified nine evidence-based interventions which can be feasibly implemented worldwide at low cost.

Aneel Bhangu, Consultant Surgeon and Senior Lecturer at the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham commented: “We’ve estimated that around 20 million patients develop surgical site infections worldwide each year following abdominal surgery, including 14.7 million LMIC patients.

“The Global Surgery Guideline for the Prevention of Surgical Site Infection has identified practical steps that all hospitals should urgently take to both reduce avoidable infections and the spread of antimicrobial resistance.”

Dr. Adewale Adisa, Senior Lecturer in Surgery at the Obafemi Awolowo University in Ile-Ife, Nigeria and co-lead author commented: “High rates of SSI and antimicrobial resistance are a real worry for surgeons, particularly in LMICs. Although guidelines for prevention of SSI have previously been published, they were developed in high income countries with little thought for the specific needs of LMIC patients.

“Many of their recommendations were impractical for resource-limited hospitals, and few LMIC surgeons put them in to practice. This is the first guideline to have been led by LMIC surgeons and I believe our recommendations can be implemented immediately to benefit all patients across the world.”

The recommendations encourage medical professionals to boost patient safety by:

  • Ensuring patients have had a full body wash with clean water and soap before operation.
  • Selecting antibiotic prophylaxis according to published antibiotic prescribing guidelines.
  • Administering antibiotic prophylaxis to all patients undergoing clean-contaminated, contaminated or dirty surgery.
  • Administering antibiotic prophylaxis intravenously within 60 minutes before skin incision.
  • Administering a repeat dose of antibiotic prophylaxis if the duration of operation is longer than the half-life of the antibiotic given.
  • Not routinely continuing prophylactic antibiotics beyond 24 hours after operation.
  • Ensuring scrub teams decontaminate their hands before surgery using antiseptic surgical solution.
  • Preparing the skin at the surgical site immediately before incision, using antiseptic preparation.
  • Providing supplemental oxygen during surgery under general anaesthetic

In addition, a further three ‘desirable’ recommendations are made in the guideline. It is recognised that worldwide some hospitals may lack the necessary resources to immediately implement these interventions, in which case they should plan strategies to introduce these interventions in the future.

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What you eat could contribute to your menstrual cramps

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

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Despite the fact that menstrual pain (dysmenorrhea) is the leading cause of school absences for adolescent girls, few girls seek treatment. An analysis of relevant studies suggests that diet may be a key contributor, specifically diets high in meat, oil, sugar, salt, and coffee, which have been shown to cause inflammation.

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

This analysis was designed to study the effect of diet on menstrual pain and identify which foods contribute to it and which can reduce it. Research was conducted through a literature review that found multiple studies that examined dietary patterns that resulted in menstrual pain. In general terms, these studies found that diets high in omega-6 fatty acids promote inflammation and foods high in omega-3 fatty acids reduce it. The muscles in the uterus contract because of prostaglandins, which are active in inflammatory responses. When measuring the Dietary Inflammatory Index, it was found that those on a vegan diet (that excluded animal fat) had the lowest rates of inflammation.

“Researching the effects of diet on menstrual pain started as a search to remedy the pain I personally experienced; I wanted to understand the science behind the association. Learning about different foods that increase and decrease inflammation, which subsequently increase or reduce menstrual pain, revealed that diet is one of the many contributors to health outcomes that is often overlooked. I am hopeful that this research can help those who menstruate reduce the pain they experience and shed light on the importance of holistic treatment options,” says Serah Sannoh, lead author of the poster presentation from Rutgers University.

“Since menstrual pain is a leading cause of school absenteeism for adolescent girls, it’s important to explore options that can minimize the pain. Something like diet modification could be a relatively simple solution that could provide substantial relief for them,” said Dr. Stephanie Faubion, NAMS medical director.

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Cultivating well-being in today’s evolving digital world

Manulife invites Olympic gold medalist Hidilyn Diaz to share lessons amid digitalization at IMMAP DigiCon Valley 2022.

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As Filipinos navigate today’s evolving digital world and adjust to life-changing disruptions brought by the pandemic, Manulife shared key lessons on how to cope with changes and cultivate one’s overall well-being at this year’s DigiCon Valley 2022, the largest gathering of the digital marketing and advertising industry in the country organized by the Internet & Mobile Marketing Association of the Philippines (IMMAP).

Headlining Manulife’s segment were Melissa Henson, Chief Marketing Officer of Manulife Philippines and Hidilyn Diaz, Olympic Gold Medalist and one of Manulife’s brand ambassadors, while actor and stand-up comedian Victor Anastacio served as the host.

At the DigiCon’s special segment, Henson and Diaz shared their insights and personal takeaways based on Manulife’s recently released study, “The Modern Filipino Family: Exploring Family Dynamics in the new normal.” The study aimed to understand how Filipino families adapted to the new normal, as hyper-digitalization has impacted relationships, and has been deeply imbued in everyday decisions at home and in family life.

Make time for self-care and mental wellness

Victor Anastacio started the discussion on the challenges Filipinos faced at the height of the pandemic. “Sobrang daming challenges ang kinaharap natin noong nagsimula ang pandemic – physical, emotional and financial challenges. Lahat ito nakaapekto sa ating pamilya, dahil sa maraming hindi pagkakaintindihan.”

These challenges still impact majority of Filipinos today. While people across generations have said that their well-being has improved compared to during the peak of the pandemic, Generation Zs expressed that they are still grappling with negative pandemic effects. Henson shared: “Our study found that 65% of Gen Zs are dealing with digital fatigue, prompting them to seek more offline interactions with friends and family. They also shared that they are sleep-deprived, developed unhealthy eating habits and have increased occurrence of stress, fatigue, and depression. These younger Filipinos may need further guidance on reacquainting themselves in the real world as they have spent most of their time online in the past two years.”

Younger Filipinos may also look to Generation X and millennials for inspiration and ideas on how to deal with stressors. “Gens X and Y have learned to focus on self-care, mental well-being, and personal development, which helped empower them despite the many changes they’ve had to weather,” Henson added. 

Diaz agreed and emphasized that caring for one’s mental health has a tangible impact on one’s physical well-being too. “When I started training for the Tokyo Olympics, I needed to condition my mind that I could win at hindi ako nag-iisa sa pag-abot ng pangarap na ito. Naging malaking part ng aking preparations ang mental training at eventually, ang ‘”ma-manifest” ko na makakuha ng gold medal.”

Learn to seek help when needed

According to Manulife’s study, more Filipinos have also explored various financial products during the pandemic. In the past 12 months, among those surveyed, 25% of Generation X and 33% of Millennials bought insurance products online, while 41% of Generation Z expressed a desire to purchase insurance in the next 12 months. To guide them in their financial journey and make more informed decisions, Henson emphasized the importance of seeking expert advice to help sift through the overwhelming wealth of information available.

“Seeing how more Filipinos are exploring various financial channels to diversify their portfolios is a good sign that they are actively seeking ways to grow their wealth. However, we will need to double down our efforts to provide them expert financial guidance, so they’ll also understand how to balance risk and reward,” Henson said. “Seeking advice from a financial advisor is one way to help Filipinos get a clearer picture of their financial goals and find ways to achieve them while being conscious of their risk appetites to yield better returns.”

To achieve the historic Olympic gold medal, Diaz also underscored the importance of asking for help, by having people around you whom you can rely on for support. “There is a team behind my success. Hindi ko kakayanin ito ng mag-isa. I needed the support of Team HD, Manulife, at ng aking mga kababayan.

Life has no guarantees, but we can get ahead of uncertainty

The pandemic showed how fast things can change, and Filipinos must be ready to keep up with the pace as it can accelerate further. Such mindset and attitude transcend to Filipinos’ heightened desire for protection and security. “The interest in insurance products and life protection increased during the pandemic because Filipinos became hyper aware of the physical and financial impact of falling ill, and the broader impact of other financial challenges. However, this has been a reactive stance. The power of insurance and financial planning is that it helps us prepare for the unexpected before it happens, so we continue to encourage and empower Filipinos to embrace the value of planning ahead and being financially prepared,” said Henson.

To help Filipinos better prepare for uncertainty, Manulife launched a series of flexible and highly customizable financial solutions that can be tailor-fit depending on needs and budget — HealthFlex, which provides protection coverage for critical illnesses, including heart disease, cancer, and stroke; and FutureBoost, which gives additional rewards on top of insurance protection coverage so Filipinos can grow their wealth simultaneously.

As change is inevitable and developments can be beyond our control, Henson noted that it helps to live by an attitude of lifelong learning. “We are all learning creatures. We always find ways to retool ourselves to better cope with the changes in our environment, which is crucial to making us more resilient.”

Diaz added that just as essential is acquiring knowledge on how to plan ahead. “Having a strong foundation sa kung paano mag-plano para ma-achieve ang financial goals ay crucial para sa kinabukasan natin. Mahalaga na maging mas aware ka sa mga financial options available as early as possible para mas maintindihan ang mga kailangang gawin to achieve your goals. Once you decide to grow your investments, you’ll be more consistent with your decisions to make every day better.”

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Pfizer had no idea if mRNA vaccine would prevent COVID-19 transmission

Pfizer, the pharmaceutical company expected to become a $100 billion giant this year thanks to COVID-19 drug and vaccine, has admitted that it actually had no idea if its mRNA vaccine would prevent transmission of the coronavirus when they released the same.

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Pfizer, the pharmaceutical company expected to become a $100 billion giant this year thanks to COVID-19 drug and vaccine, has admitted that it actually had no idea if its mRNA vaccine would prevent transmission of the coronavirus when they released the same.

One of Pfizer’s top executives, the company’s president of international development markets, Janine Small, stated this when she testified before the COVID committee of the European Parliament. Small was there in place of Pfizer CEO Albert Bourla who tested positive for COVID-19 again.

In the exchange that happened in the committee hearing, a Dutch member of the European Parliament asked Small if there is evidence from Pfizer that showed that the vaccine it developed would prevent transmission prior to its wide release in late 2020.

“Was the Pfizer COVID vaccine tested on stopping the transmission of the virus before it entered the market? If not, please say it clearly. If yes, are you willing to share the data with this committee?” the member of parliament specifically asked.

The executive answered: “Regarding the question around, did we know about stopping immunization before it entered the market? No.”

Small added that “we had to really move at the speed of science to really understand what is taking place in the market. And from that point of view, we had to do everything at risk.”

The Dutch politician said that messaging in the past focused on getting vaccinated to one does not spread COVID-19. “If you don’t get vaccinated, you’re anti-social! This is what the Dutch prime minister and health minister told us. You don’t get vaccinated just for yourself, but also for others — you do it for all of society. That’s what they said. Today, this turns out to be complete nonsense.”

The politician said he found the revelations “shocking, even criminal.”

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