เดือน: ธันวาคม 2023

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UN Humanitarian Official Condemns Ongoing Israel-Hamas Conflict on International Human Rights Day

On the occasion of International Human Rights Day, the United Nations Humanitarian Coordinator in the Occupied Palestinian Territory, Lynn Hastings, delivered a somber assessment of the Israel-Hamas conflict. Hastings criticized Israel’s response to Hamas’ October 7 attack, deeming it disproportionate and a violation of human rights.

While condemning the October 7 attack by Hamas on Israel, Hastings underscored the obligations of non-state armed actors under international law. She insisted that those responsible for the attacks must be held accountable for the deaths, sexual violence, and kidnappings that traumatized the affected populations.

Since October 7, Israeli forces have inflicted widespread destruction in Gaza, turning much of it into a wasteland. Airstrikes have resulted in the displacement of nearly 2 million people, with entire neighborhoods reduced to rubble, according to the UN.

Hastings vehemently criticized Israel’s actions, stating that the airstrikes against civilians and civilian infrastructure, as well as the ongoing siege depriving Gaza’s population of essential resources, cannot be justified. She expressed disbelief that in 2023, such statements had to be issued, remarking, “It is as if we have learned nothing in the past 75 years.”

Amid the ongoing conflict, the official Palestinian news agency, WAFA, reported dozens of Palestinian civilian casualties in Israeli airstrikes across Gaza on Sunday. The Jabalya refugee camp in northern Gaza witnessed violent air raids, resulting in the deaths of 45 civilians, with additional individuals reportedly trapped under rubble. Nine more civilians were killed in Jabalya al-Balad.

In southern Gaza’s Khan Younis, a series of airstrikes and artillery shelling targeted residential areas, resulting in casualties. Hospitals in Khan Younis faced increased pressure, with reports of wounded individuals lying on the ground due to a shortage of beds, medicines, and medical supplies.

The Israel Defense Forces had issued an urgent appeal for civilians to evacuate much of Khan Younis, citing it as a main stronghold of Hamas. However, the lack of communication networks and internet availability in Gaza raised questions about the effectiveness of the instruction.

As the conflict continues, the humanitarian situation in Gaza remains dire, with escalating casualties and strained medical facilities adding to the challenges faced by the affected population.

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Setback in Last-Ditch Effort for HIV Vaccine as PrEPVacc Trial Halts Vaccine Component

A highly anticipated HIV vaccine trial, known as this decade’s “last roll of the dice,” has halted its vaccine component due to disappointing results. Led by African researchers with European support, the PrEPVacc prevention study aimed to assess two experimental HIV vaccines alongside a new form of oral pre-exposure prophylaxis (PrEP).

The trial’s leadership emphasized that safety concerns were not an issue but cited the vaccine’s ineffectiveness in preventing HIV as the reason for halting the vaccine component. The oral PrEP component will, however, continue.

The failure of the experimental vaccines represents a significant setback for the medical community, which has faced challenges in developing an HIV vaccine for 36 years. Despite a decline in new HIV infections since the mid-1990s, UNAIDS reports that 39 million people worldwide currently live with the infection, with women and girls, particularly in sub-Saharan Africa, disproportionately affected.

The PrEPVacc trial, involving 1,500 volunteer participants in Uganda, Tanzania, and South Africa, focused on women, constituting 87% of the participants. Reflecting on the results, Chief Investigator Pontiano Kaleebu emphasized the need for a “new generation of vaccine approaches and technology” and urged the development of an HIV vaccine as a critical goal for Africa.

Director Dr. Eugene Ruzagira acknowledged the scientific challenges but expressed high hopes for future success, noting that important research like PrEPVacc is advancing the field. Participants, including Luwano Geofrey, the first trial participant in Masaka, Uganda, were commended for their courage despite community disinformation and social stigmas.

While the full results of the vaccine component are expected to be published in the summer of 2024, researchers remain optimistic about the ongoing pursuit of an effective HIV vaccine, underscoring the importance of continued research and community involvement.

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Study Reveals Disparities in Access to Kidney Transplant and Nephrology Care Among Patients with Pregnancy-Related End-Stage Kidney Disease

Introduction: A comprehensive cohort study involving 183,640 reproductive-aged women sheds light on the long-term outcomes of patients with pregnancy-related end-stage kidney disease (ESKD). The research uncovers significant racial disparities, emphasizing the urgent need for improved postpartum care.

Key Findings:

  1. Disproportionate Representation: Black patients constitute 31.9% of those with pregnancy-related ESKD, in contrast to 16.2% in the general birthing population.
  2. Survival Rates: Patients with pregnancy-related ESKD exhibit equivalent or better survival rates compared to those with other causes of ESKD, challenging conventional assumptions.
  3. Transplant Disparities: Despite comparable or superior survival rates, patients with pregnancy-related ESKD face significantly reduced access to kidney transplants. Notably, they are less likely to join the transplant waiting list or receive live donor transplants.
  4. Nephrology Care: Patients with pregnancy-related ESKD are significantly less likely to have access to nephrology care before ESKD onset, underlining potential gaps in early intervention and care planning.
  5. Pre-ESKD Care: Access to nephrology care or placement of a graft or arteriovenous fistula before ESKD onset is substantially lower in patients with pregnancy-related ESKD compared to other causes, highlighting disparities in pre-dialysis care.

Implications: The study suggests that the existing disparities in access to kidney transplant and nephrology care may exacerbate the health outcomes of a disproportionately Black population. The findings underscore the need for targeted interventions to improve access to comprehensive care and reduce the racial disparities observed.

Conclusion: While patients with pregnancy-related ESKD demonstrate promising long-term survival rates, the study calls attention to critical gaps in access to kidney transplant and nephrology care, particularly affecting the Black population. Addressing these disparities is crucial to enhancing the quality of life and overall health outcomes for this vulnerable demographic. The study’s authors advocate for prioritized efforts to improve postpartum care and reduce racial inequalities in maternal health.

Note: This summary is a concise representation of the study’s key points and implications. For more detailed information, readers are encouraged to refer to the complete study.

Credit: JAMA Network Open, Lauren M. Kucirka

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Groundbreaking Study Reveals Yoga’s Effectiveness in Treating Military Sexual Trauma-Related PTSD in Women Veterans

In a major breakthrough, a randomized clinical trial has found Trauma Center Trauma-Sensitive Yoga (TCTSY) to be as effective as first-line cognitive processing therapy (CPT) in treating post-traumatic stress disorder (PTSD) related to military sexual trauma (MST) in women veterans. The study, conducted within the US Department of Veterans Affairs (VA) health care systems, involved 131 women veterans with PTSD, revealing significant results.

Key Findings:

  1. Equivalent Effectiveness: TCTSY demonstrated large within-group effect sizes comparable to CPT, indicating its equivalence in reducing PTSD symptom severity.
  2. Higher Completion Rate: TCTSY boasted a 42.6% higher treatment completion rate than CPT, signifying greater acceptability among participants.
  3. Cost-Effective Treatment: The study suggests that TCTSY is a cost-effective means to expand the range of PTSD treatment options within the VA.

Implications:

  1. Broader Treatment Options: TCTSY’s success opens up new avenues for PTSD treatment, providing women veterans with an alternative that is both effective and acceptable.
  2. Improved Access: The higher completion rate of TCTSY suggests increased access to patient-driven and effective PTSD treatment for women veterans.
  3. Addressing Associated Symptoms: TCTSY not only reduces PTSD symptoms but also shows promise in improving associated symptoms like depression and anxiety.

Background:

  • Prevalence of PTSD in Women Veterans: PTSD poses a significant threat to the physical and mental health of women veterans, with one in five women patients in the VA experiencing PTSD.
  • Military Sexual Trauma (MST): MST, defined as threatening sexual harassment or assault during military service, is a leading cause of military service-related PTSD among women veterans.

Current PTSD Treatment Limitations:

  • Low Engagement: First-line trauma-focused therapies, though effective, face challenges with low treatment initiation, high dropout rates, and incomplete efficacy.
  • Growing Preference for Yoga: Veterans’ increasing preference for yoga as a PTSD treatment has prompted the VA to expand access to complementary and integrative health modalities.

Study Details:

  • Participants: 131 women veterans aged 22 to 71 years with MST-related PTSD were enrolled and randomized to TCTSY or CPT.
  • Interventions: TCTSY involved 10 weekly, 60-minute group sessions, while CPT comprised 12 weekly, 90-minute group sessions.
  • Outcome Measures: PTSD symptom severity was assessed using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and PTSD Checklist for DSM-5 (PCL-5).

Conclusion: This groundbreaking study establishes TCTSY as an effective and acceptable treatment for women veterans with PTSD related to MST. The results, with their potential to reduce treatment limitations and enhance accessibility, could mark a significant advancement in PTSD care for women veterans. The integration of Trauma Center Trauma-Sensitive Yoga into existing treatment options holds the promise of improving the lives of those affected by military sexual trauma-related PTSD.

Credit: JAMA Network Open, Belle Zaccari

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Pregnancy After Breast Cancer in BRCA Carriers Found Safe in International Study

In a groundbreaking international hospital-based cohort study involving 4732 BRCA carriers, researchers have found that pregnancy after breast cancer does not pose adverse risks for either maternal or fetal outcomes. The study, conducted at 78 participating centers worldwide, focused on young women with invasive breast cancer who carried germline pathogenic variants in the BRCA1 or BRCA2 genes.

Key Findings:

  • Cumulative Incidence: 22% of young BRCA carriers conceived within 10 years after breast cancer diagnosis.
  • Maternal and Fetal Outcomes: Pregnancy following breast cancer in BRCA carriers was not associated with adverse maternal prognosis or fetal outcomes.
  • Disease-Free Survival: No significant difference in disease-free survival was observed between patients with or without a pregnancy after breast cancer.
  • Secondary Outcomes: Patients who had a pregnancy showed significantly better breast cancer–specific survival and overall survival.

Study Details:

  • Duration: The study included data from patients diagnosed between January 2000 and December 2020, with the last follow-up conducted on February 20, 2023.
  • Pregnancy Rate: The cumulative incidence of pregnancy at 10 years was 22%, with a median time from breast cancer diagnosis to conception of 3.5 years.
  • Safety: Pregnancy was found to be safe in terms of disease-free survival, breast cancer–specific survival, and overall survival.
  • BRCA Gene Differences: While BRCA1 carriers showed reassuring results, caution is needed to counsel BRCA2 carriers, as a possible association with adverse disease-free survival outcomes was observed.

Implications: The study’s results challenge previous concerns about the safety of pregnancy in BRCA carriers after breast cancer treatment. It provides valuable insights for reproductive counseling of young BRCA carriers, highlighting the feasibility and safety of pregnancy in this specific population.

Future Directions: The study emphasizes the need for further research, especially in understanding the impact of specific BRCA genes on reproductive outcomes. The findings also suggest the importance of considering the evolving landscape of breast cancer treatment and its potential impact on fertility.

Conclusion: This international study offers hope to young BRCA carriers who aspire to start a family after overcoming breast cancer, assuring them that pregnancy does not compromise their long-term health outcomes. The results are expected to influence clinical guidance and support personalized counseling for this unique patient population.

Credit: JAMA Network Open, Matteo Lambertini

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Red Cross Faces Criticism Amid Escalating Israel-Hamas Conflict

In the midst of the recent flare-up between Israel and Hamas, the International Committee of the Red Cross (ICRC) came under scrutiny for its role in facilitating hostage releases. During a brief truce earlier this month, ICRC personnel, identifiable by their white vests and SUVs adorned with red and white livery, coordinated the transfer of hostages between masked Hamas gunmen and Israeli authorities.

While the truce collapsed after just seven days, leaving the region engulfed in renewed conflict, the ICRC continues to stand by, ready to facilitate further exchanges between the two sides. However, criticism has emerged, with some accusing the organization of not doing enough to aid the remaining hostages in Gaza.

In response to the backlash, ICRC President Mirjana Spoljaric defended the organization’s actions, calling the criticism “profoundly unjust, unfair, and wrong.” ICRC officials emphasized the complexity of their role as a neutral intermediary and stressed the limits to what humanitarian efforts can achieve in the midst of ongoing hostilities.

The ICRC, founded in Geneva in 1863, boasts a long and esteemed history, having received the Nobel Peace Prize three times. Operating in over 100 countries, the organization’s humanitarian network supports those affected by war, natural disasters, and global crises.

The Red Cross’s involvement in conflict zones spans 160 years, and its volunteers have faced dangers to provide aid and support. Despite recent criticism, the ICRC remains committed to its fundamental principles of impartiality and neutrality, emphasizing its role as a mediator rather than a negotiator.

As the Israel-Hamas conflict intensifies, with Israeli bombardment focusing on Gaza’s south, the ICRC’s mission becomes increasingly challenging. The fate of the remaining 138 hostages is uncertain, and Palestinian hospitals are once again overwhelmed with the dead and wounded.

In the face of mounting challenges, the ICRC stands resilient, continuing its humanitarian efforts and navigating the complexities of facilitating exchanges between conflicting parties. The organization remains steadfast in its commitment to providing assistance to those affected by armed conflict, irrespective of political affiliations.

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UN-Israel Relations Plunge to Historic Low as Secretary-General Invokes Rare Article 99

In an unprecedented move, UN Secretary-General António Guterres has invoked Article 99 of the UN Charter, sending Israel-UN relations to an all-time low. The invocation, aimed at pushing for a ceasefire in Gaza, drew sharp criticism from Israeli diplomats, leading to a heated exchange between Guterres and Israeli Foreign Minister Eli Cohen.

Article 99 grants the UN chief the authority to bring issues threatening international peace and security to the attention of the Security Council. Guterres, in a letter to the council, urged for immediate action to avert a humanitarian catastrophe in Gaza and called for a comprehensive humanitarian ceasefire.

This marks the seventh time in the UN’s 78-year history that Article 99 has been invoked and the first since 1989. UN analyst Daniel Forti described Guterres’ move as a “symbolic punch,” a plea for diplomatic action to prevent Gaza from reaching a point of no return.

Israeli Foreign Minister Eli Cohen condemned Guterres, accusing him of endangering world peace and supporting Hamas. Cohen argued that Guterres’ call for a ceasefire equated to endorsing the October 7 attack.

As tensions escalate, the Security Council is set to convene an emergency meeting to address the crisis. The UAE has submitted a draft resolution calling for an urgent humanitarian ceasefire, with support from Arab and Islamic nations.

Former Israeli Ambassador to the UN, Gabriela Shalev, described the current state of Israel-UN relations as a “historic low.” She emphasized a perceived lack of understanding within UN organizations worldwide regarding Israel’s existential threat and its struggle as a Jewish and democratic state.

Meanwhile, US Secretary of State Antony Blinken met with Qatari Prime Minister Mohammed bin Abdulrahman Al Thani to discuss ongoing efforts to secure the release of hostages held by Hamas. Qatar, a key broker in a previous agreement, saw the release of an initial group of hostages, but the deal collapsed last week.

Blinken expressed gratitude for Qatar’s efforts in securing hostage releases and acknowledged the recent humanitarian pause in Gaza during his meeting with Al Thani. The discussions also touched upon preventing the conflict from spreading and ensuring continued humanitarian assistance to civilians in Gaza.

Blinken is set to meet with a delegation of Arab ministers later, further underscoring the international efforts to address the escalating crisis.

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Cats: Comprehensive Information and Guidelines

Research has demonstrated that cats not only serve as companions but also provide emotional support, uplift moods, and contribute to the overall well-being of their owners. Additionally, cats are acknowledged for fostering socialization, particularly among older individuals and those with physical or mental disabilities. In the United States, almost 40 million households have pet cats.

However, it’s essential for cat owners to be aware that cats can sometimes carry harmful germs, leading to various illnesses in humans, ranging from minor skin infections to severe conditions. To mitigate these risks, practicing good hygiene, such as thorough handwashing after interacting with cats, is crucial. Regular veterinary care for cats, following Healthy People tips, further minimizes the likelihood of illness transmission through touch, petting, or ownership.

Diseases

  1. Campylobacteriosis (Campylobacter spp.)
    • How it spreads: Contact with infected animal feces, contaminated food, or water.
    • At-risk individuals: Children under 5, adults over 65, and those with weakened immune systems.
    • Signs in cats: May show no signs or have bloody diarrhea.
    • Symptoms in people: Diarrhea (often bloody), fever, stomach cramps.
  2. Cat Scratch Disease (Bartonella henselae)
    • How it spreads: Through flea bites, fights with infected cats, or contact with cat saliva.
    • At-risk individuals: Children, adolescents, and those with weakened immune systems.
    • Signs in cats: Often asymptomatic; may have fever or swollen lymph nodes.
    • Symptoms in people: Skin bump at the scratch site, lymph node swelling, fever.
  3. Cat Tapeworm (Dipylidium caninum)
    • How it spreads: Ingestion of infected fleas.
    • At-risk individuals: Rare, mainly children.
    • Signs in dogs: Detected through segments near the anus.
    • Symptoms in people: Rare; rice-like tapeworm segments in feces.
  4. Cryptosporidiosis (Cryptosporidium spp.)
    • How it spreads: Swallowing contaminated feces, water, or food.
    • At-risk individuals: People with weakened immune systems.
    • Signs in cats: Rare; can be asymptomatic.
    • Symptoms in people: Profuse diarrhea, abdominal pain, vomiting.
  5. Giardiasis (Giardia duodenalis)
    • How it spreads: Through contaminated water, food, or contact with infected individuals.
    • At-risk individuals: International travelers, those in contact with diapers, and those drinking untreated water.
    • Signs in cats: Diarrhea, greasy stools.
    • Symptoms in people: Diarrhea, gas, abdominal discomfort.
  6. Hookworm (Ancylostoma tubaeforme, Ancylostoma braziliense, Uncinaria stenocephala)
    • How it spreads: Contact with contaminated soil.
    • At-risk individuals: Anyone.
    • Signs in cats: Anemia, weight loss.
    • Symptoms in people: Itchy reaction, red squiggly line at the larval migration site.
  7. MRSA (Methicillin-Resistant Staphylococcus aureus)
    • How it spreads: Direct contact with infected individuals or animals.
    • At-risk individuals: Anyone.
    • Signs in cats: Often asymptomatic; potential for skin, respiratory, and urinary tract infections.
    • Symptoms in people: Skin infections; rarely, pneumonia or other severe issues.
  8. Plague (Yersinia pestis)
    • How it spreads: Flea bites, contact with infected animals.
    • At-risk individuals: People in the western US, hunters, those with animal contact.
    • Signs in cats: Fever, lethargy, swollen lymph nodes.
    • Symptoms in people: Fever, swollen lymph nodes, headache.
  9. Rabies
    • How it spreads: Primarily through bites.
    • At-risk individuals: Rare in the US; contact with infected wild animals.
    • Signs in cats: Sudden behavioral changes, paralysis.
    • Symptoms in people: Neurological symptoms; fatal once symptoms appear.
  10. Ringworm
    • How it spreads: Direct contact or from the environment.
    • At-risk individuals: Anyone.
    • Signs in cats: Hair loss, scaly skin.
    • Symptoms in people: Itchy, red, ring-shaped rash; potential nail infections.
  11. Roundworms (Toxocara spp.)
    • How it spreads: Swallowing roundworm eggs.
    • At-risk individuals: Anyone.
    • Signs in cats: Usually asymptomatic.
    • Symptoms in people: Ocular or visceral toxocariasis; eye, liver, lung, or central nervous system issues.
  12. Salmonellosis (Salmonella spp.)
    • How it spreads: Contaminated food or contact with animal feces.
    • At-risk individuals: Children, older adults, those with weakened immune systems.
    • Signs in cats: Often asymptomatic; kittens may have diarrhea.
    • Symptoms in people: Diarrhea, fever, abdominal cramps.
  13. Sporotrichosis (Sporothrix spp)
    • How it spreads: Environmental exposure or scratches/bites from infected animals.
    • At-risk individuals: Those handling plant matter or in contact with infected animals.
    • Signs in cats: Draining wounds, raised lumps.
    • Symptoms in people: Cutaneous, disseminated, or pulmonary forms; serious and potentially deadly.
  14. Tickborne Diseases
    • How it spreads: Through tick bites.
    • At-risk individuals: Those in tick habitat.
    • Symptoms in people: Fever, chills, body aches; severity varies.
  15. Toxoplasmosis (Toxoplasma gondii)
    • How it spreads: Contact with cat feces, undercooked meat, or contaminated water.
    • At-risk individuals: Those with weakened immune systems, pregnant women.
    • Signs in cats: Shedding of the parasite; often asymptomatic.
    • Symptoms in people: Generally mild; serious complications in immunocompromised individuals.
  16. Tularemia (Francisella tularensis)
    • How it spreads: Tick bites, contact with infected animals, contaminated food or water.
    • At-risk individuals: Those spending time outdoors, hunting, or handling wild game.
    • Signs in cats: Fever, lymph gland swelling, fatigue.
    • Symptoms in people: Fever, ulcers, lymph gland swelling, joint pain.

Healthy People: How to Stay Healthy Around Pet Cats

Before Getting a Cat:

  • Ensure a cat is suitable for your family, considering the risk of diseases.
  • Adopt from reputable sources; ensure veterinary care.

Feeding:

  • Provide balanced, quality cat food.
  • Avoid raw diets to reduce the risk of bacterial contamination.

Hygiene:

  • Wash hands thoroughly after handling cats, litter, or feces.
  • Clean litter boxes daily; pregnant women should avoid this task.

Veterinary Care:

  • Regular check-ups, vaccinations, and parasite control.
  • Address signs of illness promptly.

Children and Pets:

  • Teach children proper hygiene.
  • Supervise interactions; avoid rough play.

Zoonotic Risks:

  • Be aware of potential diseases and symptoms.
  • Seek medical attention if symptoms occur.

Conclusion: Cats bring joy and companionship, but responsible ownership is crucial for a harmonious and healthy relationship. Through preventive measures, regular veterinary care, and awareness of zoonotic risks, pet owners can ensure a safe and fulfilling environment for both themselves and their feline friends.

Reference: CDC-Centers for Disease Control and Prevention

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Significant Surge in Pediatric Eating Disorder Hospitalizations in Ontario, Canada Over 17-Year Period

Ontario, Canada witnessed a 139% increase in pediatric eating disorder hospitalizations from 2002 to 2019, with alarming shifts in patient demographics and diagnoses.

Key Findings:

  • Overall Increase: The study, encompassing 11,654 pediatric eating disorder hospitalizations, reveals a substantial surge of 139% in rates from 2.0 to 4.8 per 10,000 population over the 17-year span.
  • Demographic Shifts: Notably, the largest relative changes were observed among males (416% increase), individuals aged 12 to 14 years (196% increase), and those with eating disorders other than anorexia or bulimia nervosa (255% increase).
  • Gender Dynamics: Female patients still constitute the majority, with 91.4% of hospitalizations. However, the proportion of male patients has risen from 5.4% in 2002 to 11.8% in 2019.
  • Age Group Trends: While hospitalization rates increased across all age groups, the most significant relative change occurred among patients aged 12 to 14 years, with a 196% rise.
  • Diagnostic Group Impact: Hospitalizations for eating disorders other than anorexia or bulimia nervosa increased by 255%, emphasizing the evolving spectrum of these conditions.

Implications and Recommendations:

  • Tailored Treatments: The study underscores the urgent need for tailored treatment approaches and programs to address the diverse and increasing care needs within different subpopulations of pediatric patients with eating disorders.
  • Clinical Awareness: Healthcare practitioners need to be educated about the changing landscape of pediatric eating disorders to facilitate early identification and appropriate referrals, especially for male patients and younger individuals.
  • Program Adaptation: Existing eating disorder programs must adapt to accommodate changing patient presentations and increased volumes to ensure effective care delivery.

Conclusion:

The significant rise in pediatric eating disorder hospitalizations in Ontario signals a critical need for proactive measures, including tailored treatments, increased clinical awareness, and program adaptations. This study highlights the evolving nature of these disorders and emphasizes the importance of addressing the specific needs of diverse subpopulations to ensure the well-being of affected children and adolescents.

Credit: Sarah Smith, JAMA Network Open

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Humanitarian Crisis Deepens at Al-Aqsa Martyrs Hospital in Central Gaza Amidst Ongoing Conflict

Doctors Without Borders Urges Ceasefire and Unrestricted Aid Access as Critical Supplies Dwindle

The Al-Aqsa Martyrs Hospital in central Gaza is grappling with a dire shortage of essential supplies, as reported by Doctors Without Borders (MSF) on Wednesday. Fuel and medical resources have reached “critically low levels” due to ongoing road closures, exacerbating an already challenging situation.

Marie-Aure Perreaut Revial, the emergency coordinator for MSF in Gaza, expressed deep concern, stating, “There are 700 patients admitted in the hospital now, with new patients arriving all the time. We are running out of essential supplies to treat them.” The hospital, located in the central area, is the sole facility available, further complicating the situation.

MSF reiterated its urgent call for a ceasefire and appealed for aid to enter the entire Gaza Strip. The organization’s plea comes in the wake of multiple strikes in the Deir al-Balah area on Tuesday, leading to a significant influx of casualties at the Al-Aqsa hospital.

Hospital spokesperson Dr. Khalil Al Daqran highlighted the overwhelming challenges, stating, “Al Aqsa Martyrs Hospital is the only hospital in the central area and cannot accommodate such a large number of people, especially considering that massacres against our people are still ongoing.”

Meanwhile, the Israeli military reported a sustained offensive against Hamas targets, with approximately 250 airstrikes in Gaza over the past 24 hours. The strikes aimed at locating weapons, underground infrastructure, explosives, and military assets of the militant group. The IDF’s operations represent a slightly higher number than the previous day but are lower than the initial surge following the breakdown of a temporary truce with Hamas.

The IDF emphasized its focus on eliminating terrorist threats, citing specific instances where ground troops directed airstrikes against rocket launchers and an armed terrorist cell operating near a school in northern Gaza. The military asserted that these strikes resulted in the elimination of terrorists from both Hamas and the Palestinian Islamic Jihad organizations, along with the destruction of terrorist infrastructure.

The conflict has taken a severe toll on the civilian population, with numerous casualties reported in Deir al-Balah. Hospital records from the Palestinian Ministry of Health in the occupied West Bank, drawing on data from Gaza hospitals, reported nearly 16,000 people killed since October 7, underscoring the gravity of the situation.