The nation's most influential pediatricians group says the health benefits of circumcision in newborn boys outweigh any

risks and insurance companies should pay for it.

In its latest policy statement on circumcision, a procedure that has been declining nationwide, the Elk Grove Village, Ill.,-based American Academy of Pediatrics moves closer to an endorsement but says the decision should be up to parents.

Recent research bolstering evidence that circumcision reduces chances of infection with HIV and other sexually spread diseases, urinary tract infections and penis cancer influenced the academy to update their 13-year-old policy. Their old stance said potential medical benefits were not sufficient to warrant recommending routinely circumcising newborn boys. The new one says, "The benefits of newborn male circumcision justify access to this procedure for those families who choose it." The academy also says pain relief stronger than a sugar-coated pacifier is essential, usually an injection to numb the area.

The federal Centers for Disease Control and Convention has estimated circumcision costs range from about $200 to $600 nationwide. Coverage varies among insurers and several states have stopped Medicaid funding for circumcisions.

The new policy was published online Monday in Pediatrics. It comes amid ongoing debate over whether circumcision is medically necessary or a cosmetic procedure that critics say amounts to genital mutilation. Activists favoring a circumcision ban made headway in putting it to a vote last year in San Francisco but a judge later knocked the measure off the city ballot, ruling that regulating medical procedures is up to the state, not city officials.

Source: http://www.nbcchicago.com/news/health/Circumcision-Pluses-Outweigh-RisksPediatricians-167556665.html#ixzz2DL26HxAd

Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with headache, fever, exhaustion, severe joint and muscle pain , swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) are particularly characteristics of dengue. Dengue fever and dengue hemorrhagic fever (DHF) are acute febrile diseases caused by four closely related virus serotypes of the genus Flavivirus family Flaviviridae. The geographical spread is similar to malaria. Each serotype is sufficiently different that there is no crossprotection and epidemics caused by multiple serotypes (hyperendemicity) can occur. Dengue is transmitted to humans by the Aedes aegypti (rarely Aedes albopictus) mosquito, which feeds during the day. Typically, people infected with dengue virus are asymptomatic (80%) or only have mild symptoms such as an uncomplicated fever. Others have more severe illness (5%), and in a small proportion it is life-threatening. The incubation period (time between exposure and onset of symptoms) ranges from 314 days, but most often it is 47 days. Therefore, travelers returning from endemic areas are unlikely to have dengue if fever or other symptoms start more than 14 days after arriving home. Children often experience symptoms similar to those of the common cold and gastroenteritis (vomiting and diarrhea) and have a greater risk of severe complications, though initial symptoms are generally mild but include high fever The primary method of controlling A. aegypti is by eliminating its habitats. This is done by emptying containers of water or by adding insecticides or biological control agents to these areas although spraying with organophosphate or pyrethroid insecticides is not thought to be effective. Reducing open collections of water through environmental modification is the preferred method of control, given the concerns of negative health effect from insecticides and greater logistical difficulties with control agents. People can prevent mosquito bites by wearing clothing that fully covers the skin, using mosquito netting while resting, and/or the application of insect repellent (DEET being the most effective).

Typhoid fever, also known as typhoid, is a common worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella typhi, serotype Typhi. The disease has received various names, such as gastric fever, abdominal typhus, infantile remittant fever, slow fever,nervous fever or pythogenic fever. The name "typhoid" means "resembling typhus" and comes from the neuropsychiatric symptoms common to typhoid and typhus. Despite this similarity of their names, typhoid fever and typhus are distinct diseases and are caused by different species of bacteria Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. In the first week, the temperature rises slowly and fever fluctuations are seen with relative bradycardia, malaise, headache, and cough. A bloody nose (epistaxis) is seen in a quarter of cases and abdominal pain is also possible. There is leukopenia, a decrease in the number of circulating white blood cells, with eosinopenia and relative lymphocytosis, a positive reaction and blood cultures are positive

for Salmonella typhi or paratyphi. The classic Widal test is negative in the first week. The fever is still very high and oscillates very little over 24 hours. Dehydration ensues and the patient is delirious (typhoid state). By the end of third week the fever starts subsiding (defervescence). This carries on into the fourth and final week. The rediscovery of oral rehydration therapy in the 1960s provided a simple way to prevent many of the deaths of diarrhealdiseases in general. Where resistance is uncommon, the treatment of choice is a fluoroquinolone such as ciprofloxacin otherwise, a third-generation cephalosporin such as ceftriaxone or cefotaxime is the first choice. Cefixime is a suitable oral alternative. Typhoid fever in most cases is not fatal. Antibiotics, have such been

as ampicillin, chloramphenicol, sulfamethoxazole,amoxicillin and ciprofloxacin,

commonly used to treat typhoid fever in microbiology. (Baron S et al.) Treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%

Malaria is a mosquito-borne infectious disease of humans and other animals caused by protists (a type of microorganism) of the genus Plasmodium. It begins with a bite from an infected female mosquito, which introduces the protists via its saliva into thecirculatory system, and ultimately to the liver where they mature and reproduce. The disease causes symptoms that typically include fever and headache, which in severe cases can progress to coma or death. Malaria is widespread in tropical andsubtropical regions in a broad band around the equator, including much of Sub-Saharan Africa, Asia, and the Americas Five species of Plasmodium can infect and be transmitted by humans. The vast majority of deaths are caused by P. falciparumwhile P. vivax, P. ovale, and P. malariae cause a generally milder form of malaria that is rarely fatal The signs and symptoms of malaria typically begin 825 days following infection; however, symptoms may occur later in those who have taken antimalarial medications as prevention. Initial manifestations of the diseasecommon to all malaria speciesare similar to flu-like symptoms, and can resemble other conditions such as septicemia, gastroenteritis, and viral diseases. The presentation may include headache, fever, shivering, arthralgia (joint pain), vomiting, hemolytic anemia,jaundice, hemoglobinuria, retinal damage, and convulsions. Approximately 30% of people however will no longer have a fever upon presenting to a health care facility. Owing to the non-specific nature of disease presentation, diagnosis of malaria in non-endemic countries requires a high degree of suspicion, which might be elicited by any of the following: recent travel history, splenomegaly (enlarged spleen), fever without localizing signs, thrombocytopenia, and hyperbilirubinemia combined with a normal peripheral blood leukocyte count. The treatment of malaria depends on the severity of the disease. Uncomplicated malaria may be treated with oral medications. The most effective strategy for P. falciparuminfection is the use of artemisinins in combination with other antimalarials (known as artemisinin-combination therapy, or ACT), which reduces the ability of the parasite to develop resistance to any single drug component. These additional antimalarials include amodiaquine, lumefantrine, mefloquine or sulfadoxine/pyrimethamine. Another recommended combination

is dihydroartemisinin and piperaquine. ACT is about 90% effective when used to treat uncomplicated malaria.