Baby food manufacturer Nestlé has been accused of “unjustifiable” double standards after an investigation found that it added high levels of sugar to cereals for children sold in lower income countries.In contrast, infant formula and cereal sold in Switzerland, where the company has its headquarters, contained no added sugar, the investigation by Public Eye and the International Baby Food Action Network (IBFAN) found.1The campaigning organisations examined Cerelac and Nido products marketed in lower income countries. Cerelac is the world’s number one baby cereal brand, with sales exceeding $1b ..read more

The Royal College of Paediatricians and Child Health (RCPCH) has called for the removal of the “reasonable punishment” defence that allows parents in England and Northern Ireland to justify physical punishment of their child.Any kind of physical abuse inflicted by an adult on an adult is not tolerated in law, but children in England and Northern Ireland do not have the same legal protection. Scotland removed the reasonable punishment defence from law in 2020, followed by Wales in 2022. Around the world 65 countries now ban the physical punishment of children.The RCPCH makes the case for equal ..read more

A man in his late 50s with a history of regular cocaine use reported dysphagia, weight loss, and sticking chewing gum to his hard palate to stop food entering his nose (fig 1). On examination he had a nasal voice and a large oronasal defect. Computed tomography showed extensive destruction of the nasal septum and the left sided paranasal sinuses. An endoscopy was performed for visualisation and biopsy. Laboratory findings showed an atypical pattern of positive serum antineutrophil cytoplasmic antibodies (ANCA), perinuclear antineutrophilic cytoplasmic antibody (p-ANCA), and antihuman elastase ..read more

An 11 year old girl was referred to the dermatology clinic with circular urticarial lesions mainly on the forearm of the non-dominant arm (fig1, left panel). The lesions appeared every morning and lasted for 2-3 hours accompanied by pain. During hospital admission two weeks previously, the patient had been told the lesions were due to vasculitis. She received a course of systemic glucocorticoid treatment (40 mg/day methylprednisolone intravenous injection for 12 days), but the lesions did not improve. Routine tests for complete blood count, blood glucose, liver and renal function tests, antine ..read more

When Parth Sharma, a community medicine doctor at the Maulana Azad Medical College in New Delhi, travelled to Tandi, a Himalayan village in the northern Indian state of Himachal Pradesh, he noticed the strong internet connectivity. The roads were well built, even in far flung corners of the state, and most vendors accepted payment with mobile apps. But when it came to medical care, the situation was incomparable.An elderly man told him that the nearest primary healthcare centre was 20 km from where he lived—and once there, all that was available was antacid. If someone was very sick, they’d ha ..read more

Deaths of despair—from drug overdoses, alcoholic liver disease, and suicide—are now higher among black and Native Americans aged 45-54 since the trend was identified in 2015, a study from the University of California in Los Angeles (UCLA) has found.1Deaths of despair were first identified among middle aged white Americans without a college degree nearly 10 years ago2 but that study did not include Native Americans. It suggested that people dying from deaths of despair were white Americans without a college degree who experienced declining social and economic conditions.The new data analysis fo ..read more

Key messagesThe World Health Organization’s Model List of Essential Medicines promotes equitable access to medicines for the priority health needs of the populationBut an increasing number of applications for very expensive and highly specialised medicines is challenging its global reputationWHO should reconfirm the original goals of the model list as a globally relevant model process with, as a practical example, a model list specifically geared to the needs of low and middle income countriesWHO should enhance the functionality of the publicly accessible searchable electronic database of all ..read more

Working in clinical research alongside clinical practice can make for a rewarding and worthwhile career.123 Building research into a clinical career starts with research training for early and mid-career doctors. Traditional research training typically involves a dedicated period within an integrated clinical academic training programme or as part of an externally funded MD or PhD degree. Informal training opportunities, such as journal clubs and principal investigator (PI)-mentorship are available (box 1), but in recent years several other initiatives have launched in the UK, meaning there ar ..read more

Despite tremendous advances in breast cancer research and treatment over the past three decades many groups are systematically left behind, ignored, or even forgotten, an international group of experts has concluded.1The Lancet Breast Cancer Commission says progress in cancer management has led to a decrease of over 40% in breast cancer mortality in some high income countries. At the end of 2020, 7.8 million people were alive having been diagnosed in the previous five years. Some 685 000 women died from the disease in 2020, however, and physical symptoms, emotional despair, and financial burde ..read more

Ten out of 14 members of a US Food and Drug Administration (FDA) advisory panel that recommended the approval of a device designed to repair heart valves had received payments in recent years from its maker Abbott Laboratories, but these potential conflicts of interest were not disclosed in the documents reviewed or produced at the panel’s public meeting.The large number of payments was discovered by journalists at KFF Health News, a publication of the Kaiser Family Foundation.1 Payments made by US companies to doctors and researchers since 2016 are listed on the publicly available Open Paymen ..read more