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Health Bulletin


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  1. #1141
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    Re: Health Bulletin

    ‘Overuse of antibiotics kills good bacteria’

    We all know the painstaking measures people take to get better when they fall ill. But doctors now say overuse of antibiotics can affect different types of good bacteria in the stomach that help in digestion and boost our immunity.

    Prolonged use of antibiotics will kill good bacteria and let harmful bacteria thrive, causing infections, says senior gastroenterologist Dr R Surendran. "We see a lot of patients who come to us with a condition called clostridium difficile infection (CDI) where all the good bacteria in the gut are destroyed. This happens when there is a drastic change in the diet or heavy use of antibiotics," he said.

    Patients with CDI show symptoms of tenderness in the abdomen, painful cramps, diarrhoea, loss of appetite and weight loss. "The infection could range from moderate to intense. This mainly happens to patients who are either on antibiotics for a long time or patients in the post operative or intensive care ward as they are pumped with heavy antibiotics," said Dr Surendran. He explained that any antibiotic, whether oral or IV gets secreted into the gastrointestinal system and kills all the bacteria in the stomach. "Once all the good bacteria are destroyed, clostridium difficile, a microbe that causes harm proliferates," he said. He also said general practitioners should judiciously prescribe antibiotics as too much of it could cause a lot of damage to the stomach lining.

    Dr Ramachandran, medical gastroenterologist at Global Health City said people should stop popping pills even for mild fevers," he said. The doctor said there were nearly 1500 different species of good bacteria in the gut and consuming pro-biotic food and lots of curd will boost them. "Apart from going easy on the medication, people should go back to eating traditional food instead of fast food to ensure there is a balance," he added.

    In an attempt to neutralize the good bacteria in patients with CDI, doctors in India are also considering fecal transplants for those who suffer from recurrent gastrointestinal infections. During this procedure, fecal matter from another person is transplanted into the gut of the sick person to restore balance of the gut flora. "It is widely done in the West and the objective is to transplant good bacteria in the gut of those who cannot produce their own. We have several patients who call to enquire about the procedure here but it is yet to take off in India," said Dr Ramachandran.


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  2. #1142
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    Re: Health Bulletin

    Cholera vaccine is 86 percent effective: Study

    A cheap and easy to deliver oral vaccine against cholera is 86 percent effective in preventing the infection which causes severe diarrhea and can be fatal, researchers said on Thursday.

    Some 1.4 billion people around the globe were at risk for cholera in 2012, according to World Health Organization (WHO).

    Cholera is caused by a bacterium, Vibrio cholerae, which can spread through the water supply in places where sanitation and hygiene are poor.

    The study in the May 29 edition of the New England Journal of Medicine was the first to measure the effectiveness of a vaccine called Shanchol in response to a cholera outbreak under field conditions in Guinea.

    Previously, the vaccine had been tested only under experimental conditions in Kolkata, India.

    The research in Guinea, carried out by Doctors Without Borders (Medecins Sans Frontieres), involved more than 300,000 doses of the two-dose vaccine, administered during a cholera outbreak in 2012.

    It was 82 to 86 percent effective, and carried few side effects.

    However, researchers were unable to compare one versus two doses in preventing cholera, and it remains unknown how the long the vaccine can remain effective at room temperature.

    "Furthermore, can Shanchol be used in pregnancy and in children younger than one year of age?" asked a pair of doctors in Haiti and the United States, in an accompanying Perspective article in the journal.

    "Although WHO recommendations suggest targeting pregnant women at high risk for cholera, the manufacturer has not approved use of the vaccine in pregnancy, and there are no guidelines for children under one year old."
    There are three cholera vaccines currently on the world market.

    Shanchol is less expensive and easier to store than another leading vaccine, Dukoral, and the two are comparable in terms of effectiveness.

    Shanchol costs $1.85 per dose, compared to Dukoral at $5.25 per dose. Both may offer some protection against cholera for up to five years.

    The two vaccines have been approved by the World Health Organization for purchase by UN agencies. A third vaccine, mORCVAX, is licensed and produced only in Vietnam.

    More than 1.6 million doses of Shanchol have already been distributed worldwide in the past three years.

    The WHO has stockpiled two million doses and the Global Alliance for Vaccines and Immunization (GAVI) has pledged support for 20 million doses over the next five years, said the editorial, warning that millions more doses are needed.


  3. #1143
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    Re: Health Bulletin

    Cancer-causing worm heals wounds: Study

    Spit produced by a cancer-causing worm which damages the human liver can be used to treat non-healing wounds, a scientist has claimed.

    "It's not a high-tech performance, but it's a good story," said Queensland-based parasitologist Michael Smout from James Cook university.

    He explained his latest study at a science competition by using a large teddy bear, an oversized worm and a velvet liver on how liver parasites cause cancer, and how they might also assist in the development of treatments for non-healing wounds.

    "Throughout Southeast Asia there's a very high rate of a particular form of liver cancer. It's caused by chronic infection with a parasitic worm, or liver fluke, which is found in one of the staple foods - uncooked fish," he said.

    One-sixth of infected people develop liver cancer, and in Thailand alone 20,000 people die of this cancer each year.

    "My research focuses on 'worm spit', molecules secreted by the parasites that cause cells to multiply faster than they normally would," Smout said adding, "That's a key factor in the initiation of many cancers, and I've been able to isolate a molecule, granulin, that causes excessive cell growth."

    By making worm granulin in the laboratory, Smout has found that it is not just a potent human cell growth stimulator - it also promotes wound healing.

    "We don't know yet how this works, but we suspect that as the worm feeds on the liver it also heals the wounds it creates. In the short term this would be beneficial to the human host, but the repeated wounding and healing over decades could lead to this form of cancer, which has a dismal prognosis."

    Smout is a member of the Queensland Tropical Health Alliance, based at James Cook university in Cairns.

    "Our work on this project is two-fold. Firstly, we aim to develop treatments or a vaccine to prevent liver fluke infection, which in turn will dramatically reduce the incidence of liver cancer in Thailand and surrounding countries," he said.

    "Secondly, we believe that an in-depth understanding of liver fluke biology, particularly focusing on how it heals the wounds it creates, could lead to new treatments for non-healing wounds which are an increasing problem with smokers, diabetics and an ageing population," Smout said.


  4. #1144
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    Re: Health Bulletin

    Exposure to light while sleeping can make you fat

    Women who are exposed to greater levels of light while sleeping are more likely to gain weight, a new study has claimed.

    Scientists at The Institute of Cancer Research, London, found body mass index , waist-hip ratio, waist height ratio and waist circumference , all increased with increasing exposure to light at night.

    These associations were seen after adjustments were made for confounding factors that could be associated with light exposure levels and weight in the study participants.

    The findings come from cross-sectional analyzes of data from the Breakthrough Generations Study, which followed over 113,000 women from across the United Kingdom for 40 years to find the root cause of breast cancer.

    "Metabolism is affected by cyclical rhythms within the body that relate to sleeping, waking and light exposure," said Anthony Swerdlow, a researcher from the institute.


  5. #1145
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    Re: Health Bulletin

    White bread consumption linked to obesity

    People who eat more than two portions of white bread daily are at 40% increased risk of being obese compared with those with its low consumption, a research presented at the ongoing European Congress on Obesity has found.

    In this study, researchers aimed to evaluate relationship between white and whole grain bread, and weight change in Spain where white bread is a major part of the diet.

    The researchers followed 9,267 Spanish university graduates for a mean period of five years. Dietary habits at baseline were assessed using a validated 136-item food frequency questionnaire. Average yearly weight change was evaluated according to categories of bread consumption.

    They assessed the association between bread consumption and the incidence of obesity using modeling to adjust for variables that could influence the results.

    The data showed total bread (white bread and whole-grain bread together) was not associated with higher weight gain.

    By contrast, white bread consumption only was directly associated with a higher risk of becoming obese.


  6. #1146
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    Re: Health Bulletin

    Too much porn can shrink brain: Study

    Watching sexually explicit videos regularly may cause the brain to shrink and work less effectively , a new study has claimed. The study suggests that the brains of heavy porn users show signs of degradation and shrinkage.

    Researchers at the Max Planck Institute for Human Development in Berlin found that men who watch a lot of porn tend to have a smaller striatum, an area of the brain "linked to rewards and motivation." They also found that the connection between the striatum and the prefrontal cortex — the part of the brain associated with behaviour and decision making — degraded with increased porn watching, 'The Telegraph' reported.

    For the study, sixty-four healthy male adults with a broad range of pornography consumption reported hours of pornography consumption per week. "We found a significant negative association between reported pornography hours per week and gray matter volume in the right caudate," researchers said.


  7. #1147
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    Re: Health Bulletin

    USFDA approves implantable heart failure monitoring device

    The US Food and Drug Administration recently approved an implantable heart failure monitoring device, CardioMEMS HF System, which has been designed to reduce hospital admissions.

    The goal of this first-of-its-kind implantable wireless device with remote monitoring of pulmonary artery (PA) pressure is to reduce heart failure-related hospitalizations.Heart failure (HF) is one of the most common reasons for hospitalizations for people aged 65 and older.

    Dr Jay S Yadav, the founder and chief executive of US-based CardioMEMS and a consulting cardiologist at the Piedmont Heart Institute, told TOI the implantable wireless device allows healthcare professionals to monitor condition of their patients remotely, and creates a way to get heart catheterization type of information on a daily basis from the patient's home in order to prevent hospitalizations.

    Interestingly, Yadav who has Indian origins having spent his childhood years in Meerut (Uttar Pradesh), says St Jude Medical,a global medical device manufacturer, who had acquired an initial 19% stake in CardioMEMS four years ago, pumped an additional $375 million to acquire the balance 81% in the Atlanta-based manufacturer of heart failure monitors.

    The acquisition came just after CardioMEMS received FDA approval for its remotely-monitored miniature sensor.

    At present, patients who have been hospitalized with worsening HF undergo an invasive procedure called a right-heart catheterization to measure PA pressures. The CardioMEMS HF System provides the same information as a right-heart catheterization, but without the invasive procedure, the company claims.

    Heart failure, put simply is a condition in which the heart cannot pump enough blood to meet the body's needs. With proper treatment and lifestyle changes, people with heart failure can live longer and more active lives.

    Yadav, who is proud of his Indian roots, says that given the right conditions, he will be interested in bringing modern medical technology to India at an affordable cost. The device is available for about Rs 10 lakh in the US.
    Significantly, CardioMEMS which is being fully acquired by St Jude Medical -- the global devices maker -- will only be too willing to launch the device in India, but at a later stage, he added.

    The FDA believes that there is reasonable assurance that the device is safe and effective for heart failure management patients. However, it is requiring a thorough post-approval study to continue to learn about the device's performance when used outside the context of a clinical study.


  8. #1148
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    Re: Health Bulletin

    Scientists find compound to fight virus behind SARS and MERS

    An international team of scientists say they have identified a compound that can fight coronaviruses, responsible for the SARS and MERS outbreaks, which currently have no cure.

    Coronaviruses affected the upper and lower respiratory tracts in humans. They are the reason for up to a third of common colds.

    A more severe strain of the virus, thought to have come from bats, triggered the global SARS (Severe Acute Respiratory Syndrome) epidemic in 2002 that killed nearly 800 people.

    The Middle East Respiratory Syndrome (MERS) is a new strain discovered in Saudi Arabia in 2012 and thought to have originated in camels. More deadly but less contageous, it has so far killed 193 people across 636 confirmed cases.

    But now a team of scientists led by Edward Trybala from the University of Gothenburg in Sweden, and Volker Thiel from the University of Bern have discovered a compound called K22, which appears to block the ability of the virus to spread in humans.

    They first noticed that K22 was able to combat a weak form of coronavirus that causes mild cold-like symptoms, and went on to show that it can fight more serious strains, including SARS and MERS.

    In an article for specialist journal "PLOS Pathogens", the scientists explained that the virus reproduces in the cells that line the human respiratory system.

    The virus takes over the membranes that separate different parts of human cells, reshaping them into a sort of armour around itself in order to start its production cycle.

    But K22 acts at an early stage in this process, preventing the virus from taking control of the cell membranes.

    "The results confirm that the use of the membrane of the host cell is a crucial step in the life-cycle of the virus," the researchers wrote. Their work shows that "the process is highly sensitive and can be influenced by anti-viral medications."

    They said the recent SARS epidemic and MERS outbreak mean there should be urgent investment in testing K22 outside the laboratory and developing medicines.

    Earlier this month, experts gathered in Geneva by the World Health Organisation confirmed that MERS was spreading but had yet to reach the level of global emergency.

    Most of the MERS cases and deaths so far have been in Saudi Arabia, but the virus has been imported to more than a dozen other countries. All of those cases have involved people who became ill while in the Middle East.

    Iran registered its first death from MERS on Thursday, and has registered six cases of the infection.


  9. #1149
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    Re: Health Bulletin

    ‘Medicine not exact science, wrong diagnosis not necessarily negligence’

    There are times when a doctor's diagnosis turns out to be incorrect. Wrong diagnosis may or may not constitute negligence, but the patient usually jumps to the conclusion that the doctor has been negligent. Filing a case on the basis of a presumption causes heartburn to the patient as well as the doctor; while the patient loses money in litigation, the doctor is put through harassment to defend self, despite having done nothing wrong.

    Case Study: Badam Jyothi, down with fever, was brought to Pavan Nursing Home run by Dr Reddy. The doctor diagnosed her with dengue and admitted her. She was treated for six days. Though medicines were given and tests conducted, her condition deteriorated and she lost consciousness. Her family said they wanted to shift her to a better hospital, but that the doctor did not agree. When the family insisted, the doctor referred Jyothi to Rohini Hospital, where she was diagnosed with cerebral malaria. She was treated for 10 days at an expense of over Rs 1 lakh, but her condition did not improve. Rohini Hospital doctors advised her to be shifted to a hospital in Hyderabad, but she died on the way due to multiple organ failure.

    Jyothi's husband and sons filed a complaint against Dr Reddy before the Warangal district forum, alleging death due to medical negligence. They claimed that a platelet count test was performed to check for dengue, but a blood smear test for malaria was not done. So malaria remained undiagnosed and by the time Jyothi was shifted to Rohini Hospital, irreversible damage had been done. They claimed Rs 10 lakh as compensation.

    The doctor contested and claimed that Jyothi was treated on OPD basis for two days and then admitted for four days. Relevant test had been conducted and medicines were correctly administered. Dr Reddy said on the basis of clinical examination, test reports, and several reported cases of dengue, he suspected Jyothi to be suffering from viral infection and dengue. He produced medical literature and showed Jyothi had not exhibited any symptoms of Falciparum/cerebral Malaria. The doctor said the family had never made a request for shifting the patient. On the contrary, Dr Reddy said he had advised to shift Jyothi to a better-equipped hospital.

    The district forum held Dr Reddy guilty and ordered him to pay Rs 5 lakh. The doctor appealed to the Andhra Pradesh State Commission, which reduced the compensation to Rs 1 lakh. The doctor and the Badam family then approached the National Commission in revision. The commission noted that Jyothi's condition was already bad when she was admitted under Dr Reddy. The doctor had attended on the patient and acted with ordinary skill and competence. The failure to detect cerebral malaria might be an error of judgment, but would not constitute negligence. The commission noted that the Andhra Pradesh Medical Council had inquired and had concluded that Dr Reddy had not been negligent while treating Jyothi. Accordingly, in its May 23 judgment, the commission allowed the doctor's plea and dismissed the complaint.

    Conclusion: Patients must understand medicine is not an exact science. A doctor can be held negligent only if s/he does not exercise ordinary skill and prudence as expected of a reasonable professional.


  10. #1150
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    Re: Health Bulletin

    Forget root canal, laser to regrow and repair teeth

    Painful dental procedures, such as root canals, may soon become a thing of the past!

    In a first, scientists, including one of Indian-origin, have used light to coax stem cells to regrow parts of teeth.

    The study, led by David Mooney, a Core Faculty member at the Wyss Institute for Biologically Inspired Engineering at Harvard, is the first to demonstrate the ability to use low-power light to trigger stem cells inside the body to regenerate tissue.

    The researchers used a low-power laser to trigger human dental stem cells to form dentin, the hard tissue that is similar to bone and makes up the bulk of teeth.

    They outlined the precise molecular mechanism involved, and demonstrated its prowess using multiple laboratory and animal models.

    A number of biologically active molecules, such as regulatory proteins called growth factors, can trigger stem cells to differentiate into different cell types.

    Current regeneration efforts require scientists to isolate stem cells from the body, manipulate them in a laboratory, and return them to the body - efforts that face a host of regulatory and technical hurdles to their clinical translation.

    "Our treatment modality does not introduce anything new to the body, and lasers are routinely used in medicine and dentistry, so the barriers to clinical translation are low," said Mooney, who is also the Robert P Pinkas Family Professor of Bioengineering at Harvard's School of Engineering and Applied Sciences (SEAS).

    "It would be a substantial advance in the field if we can regenerate teeth rather than replace them," Mooney said.

    Lead author and dentist Praveen Arany, an Assistant Clinical Investigator at the National Institutes of Health (NIH), took rodents to the laboratory version of a dentist's office to drill holes in their molars.

    He treated the tooth pulp that contains adult dental stem cells with low-dose laser treatments, applied temporary caps, and kept the animals comfortable and healthy.

    After about 12 weeks, high-resolution x-ray imaging and microscopy confirmed that the laser treatments triggered the enhanced dentin formation.

    "It was definitely my first time doing rodent dentistry," said Arany, who at the time of the research was a Harvard graduate student and then postdoctoral fellow affiliated with SEAS and the Wyss Institute.

    The dentin was strikingly similar in composition to normal dentin, but did have slightly different morphological organisation.

    The typical reparative dentin bridge seen in human teeth was not as readily apparent in the minute rodent teeth, owing to the technical challenges with the procedure, researchers said.

    The study is published in the journal Science Translational Medicine.


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