4th Oct 2015, 12:56 PM #2161
Re: Health Bulletin
Anti-cancer drug may help treat Alzheimer's, improve memory
A team of researchers has found that an anti-cancer drug may make it easier to learn a language, sharpen your memory and help those with dementia and Alzheimer's disease by rewiring the brain and keeping neurons alive.
New Rutgers research found that a drug - RGFP966 - administered to rats made them more attuned to what they were hearing, able to retain and remember more information, and develop new connections that allowed these memories to be transmitted between brain cells.
Memory-making in neurological conditions like Alzheimer's disease is often poor or absent altogether once a person is in the advanced stages of the disease, said lead author Kasia M. Bieszczad, adding that this drug could rescue the ability to make new memories that are rich in detail and content, even in the worst case scenarios.
What happens with dementias such as Alzheimer's is that brain cells shrink and die because the synapses that transfer information from one neuron to another are no longer strong and stable. There is no therapeutic treatment available that reverses this situation.
The drug being tested in this animal study is among a class known as HDAC inhibitors - now being used in cancer therapies to stop the activation of genes that turn normal cells into cancerous ones. In the brain, the drug makes the neurons more plastic, better able to make connections and create positive changes that enhance memory.
The study is published in the Journal of Neuroscience.
4th Oct 2015, 01:08 PM #2162
Re: Health Bulletin
Dealing with dengue the traditional way
Every year, dengue wreaks havoc in Tamil Nadu. And this time too, the state did not fare any better; it recorded over 2,000 cases, one of the highest in the country. Because of this rampant incidence and with no specific allopathic drug to cure this fatal fever, people are increasingly looking for alternative methods to keep the ailment at bay . And one of the most common remedial measures that people opt for is the papaya in its varied forms -juice made from the leaf extract or pills prepared from it.
Capitalising on this demand, Micro Labs, a private phar maceutical company launched Caripill, a tablet made from carica papaya leaf extract.Priced at `25 per tablet, the company claims the drug can increase platelet counts in a patient suffering from dengue.Senior vice-president P Jawahar Babu said they conducted a pilot study on 30 patients where they were each given three 110mg pills for five days."We got encouraging results based on which we procured a licence. We are now conducting an extensive study with 250 patients," he said.
Although Ayurveda and Siddha doctors admit that they have no scientific proof and formulas to prove the efficacy of these traditional and herbal concoctions to treat dengue, they claim to have enough experimental studies to back their medicines and remedies.
While there has been a debate over the effectiveness of papaya helping combat dengue, ayurveda doctors support the state government's recommendation to consume papaya fruit or juice when one is affected by the virus. Dr T Thirunarayanan, secretary , Centre for Traditional Medicine and Research said, "Papaya contains pappin, a protiolytic enzyme, which can destroy proteins bound to the virus. When the virus dies, the platelet count automatically improves." Pappin is mainly found in unripe papaya and also in its leaves. Assistant chief medical officer of Arya Vaidya Pharmacy , Dr Raghavendran, said, "Though papaya is popularly used to treat dengue, it is a part of herbal medicine and its components have not been published anywhere."
Prof T Rajamani, head of department of medicinal and aromatic plants at Tamil Nadu Agricultural University , said another popular concoction called nilavembu kashayam has andrographolide properties, making it effective against dengue. "Nilavembu kudineer is Andrographis paniculata.The andrographic compound in this plant inhibits the pathogen and stops it from multiply ing further. It also slowly starts killing it," said Rajamani.
Nilavembu kudineer is available in siddha clinics in all government hospitals and primary health centres. The decoction is available for two hours from 7.30 am in all 110 centres across the state and the stalls erected at the Government General Hospital distributes the concoction to more than 300 people a day . However, he pointed out that goat's milk, which many claim can curb dengue, is a food supplement, which is easy to digest. "The important thing about traditional medicine is that it is dose dependent.One should never resort to selfmedication," said the doctor.
5th Oct 2015, 01:57 PM #2163
Re: Health Bulletin
Spinal implant brings hope for paralytics
Four months ago, Roger, a 55-year-old construction worker from Mooresville, NC, fell out of a deer stand and was left with a damaged spinal cord and no sensation from the middle of his chest down. Patients with his condition typically have less than a 1-in-20 chance of recovering any feeling in or control over the paralyzed areas. A new kind of implant aims to change that.
At Carolinas Medical Center in Charlotte, Roger, who doesn't want to disclose his last name to protect his privacy, allowed doctors to perform an experimental procedure that involved cutting directly into his spinal cord to insert a sort of bridge for surviving nerve cells. Within a month, he regained feeling in his abdomen, some feeling in his legs, and some bladder control. While he's not walking, he says he's determined to get there and is getting leg braces so he can move with a walker.
Roger was the third patient to receive the implant, made by InVivo Therapeu tics in Cambridge, Mass., and the second with markedly improved bodily function. The chance of that happening was below 1%, according to InVivo CEO Mark Perrin, and it's welcome news for the 8,000 Americans who suffer spinal cord related paralysis each year.
Conventional treatment focuses on repairing a fractured spine with rods and screws, but it doesn't address the spinal cord itself, which relays electrical impulses from the brain to the body.
Imaging studies show that cell death in the spinal cord generally spreads even as patients recover. InVivo's device, called the neuro-spinal scaffold, is a tiny cylindrical implant made of biodegradable plastic fibers. It sup ports nerve cells like a trellis, directing their growth where needed.
6th Oct 2015, 12:29 AM #2164
Re: Health Bulletin
Rare hip transplant done on 44-yr-old affected by dwarfism
A 44-year-old man affected by dwarfism has doctors at a city hospital to thank after they performed a rare procedure to implant the smallest hip cup which has enabled him to walk freely and without any pain.
For almost 10 years, Deep Pradhan suffered from the effects of a rare disorder associated with dwarfism called hip dysplasia or misalignment of the hip joint.
When the pain became impossible to bear, the electrical engineer from Gangtok in Sikkim decided to travel to Delhi for treatment.
"At 4'3" of height, Pradhan suffers from dwarfism, a condition that made him susceptible to this disorder. Patients with small stature are prone to bone disorders such as dysplasia or degenerative hip disease and arthritis. This happens because of development disorders and abnormal load distributions through the hip joint.
"Pradhan was in extreme pain and found it difficult to walk. A total hip replacement was the only solution. However, this presented another challenge as the patient's acetabulum or hip cup was very small," said Dr Rajeev K Sharma, Senior Consultant, Orthopaedic, and Joint Replacement Surgeon at Indraprastha Apollo Hospital.
Given that Pradhan was only 44-years-old, doctors wanted to ensure that the implant used for him was good enough to last a few decades to ensure he did not need a revision surgery due to wear and tear of the prosthesis.
"Hip replacements are most commonly done in elderly patients who suffer fracture or displacement of bone. In older patients, implants lasting even 15 years often suffice for a lifetime.
However, performing a joint replacement -- hip or knee - in patients like Deep was a challenge in itself because a young patient can easily outlive the normal life of an artificial prosthesis.
"That is why we had to carefully choose the implant for the procedure," said Sharma.
Doctors used 'Delta motion ceramic-on-ceramic Total Hip Replacement' implant, which is specifically used for young patients as it has low wear rate and high longevity.
The smallest available hip prosthesis, of 42mm, was used for Pradhan to achieve the best assimilation with the hip joint. Also, doctors used a special ceramic monoblock implant that has long durability and can last almost 40 years.
Within a few days of his surgery, Pradhan was on his feet, walking without any support or pain.
"I am much relieved after the surgery," said Pradhan, who was operated on last week and is set to return to Sikkim.
6th Oct 2015, 11:15 AM #2165
Re: Health Bulletin
Doctors 'reattach' toddler's head
In a miraculous surgery , doctors in Australia were able to successfully reattach a 16-month-old boy's head to his neck after it was pulled apart in an internal decapitation during a car accident.
Jackson Taylor was travelling with his mother and sister when their car crashed head on with another vehicle on September 15.
The force from the injury led Taylor's head to be pulled apart from his neck in an internal decapitation.
Jackson was airlifted to a ho spital in Brisbane where top medics were able to reattach the boy's vertebrae using wire and a piece of his rib during a six-hour operation, Daily Express reported. "A lot of children wouldn't sur vive that injury in the first place, and if they did and they were resuscitated then they may never mo ve or breathe again," said spinal surgeon Geoff Askin, known as Australia's "godfather of spinal surgery", who led the operation, which involved attaching a halo device to Jackson's skull, holding him completely still while reattaching his vertebrae.
Askin told a news station that Jackson's condition was the worst injury of its kind that he'd seen.
Jackson was evidently lucky that vital nerves were not dama ged irreparably or severed by the force of the collision. His healing will also be facilitated by the fact that he is an infant. Young children's bodies have greater regenerative capacities than the bodies of older people. The toddler is now wearing an apparatus to keep his body stable and it will be removed in eight weeks.
After that Taylor would be able to live a normal and healthy life again, doctors said.
Taylor's parents, Andrew and Rylea, have described the surgery and their son's recovery as a "miracle".
6th Oct 2015, 11:15 AM #2166
Re: Health Bulletin
Choose wisely for breast cancer care
Shruti (39) was operated upon at a hospital in another city for a lump in the right breast by a local surgeon. The doctor did an adequate job of removing the tumour and the lymph nodes. She then came to Pune for further treatment, including chemotherapy and radiation.
Halfway during the radiation, the treating doctor realised that mammogram of both breasts were not done. On ordering one, the doctor discovered there was a tumour in the other breast. The patient had to undergo a second surgery.
Shruti's is not a case in isolation. There are many who could not get the benefit of correct and timely treatment.
Experts are in favour of a drive similar to the 'Choose wisely' campaign — started by the Canadian government against unnecessary medical tests and procedures — in India for correct and timely treatment of breast cancer.
Its objective, experts say, would be to emphasise that all breast tumours are different and what may be prescribed as treatment for one woman with breast cancer may not be advisable or even effective for another.
But how then do we choose wisely while managing women with breast cancer? "First, make sure of a correct and complete diagnosis. A lot can go wrong at this first and vital step. The diagnosis has to be both accurate and complete," said breast surgeon Pranjali Gadgil of Jehangir Hospital and Breast Centre.
Gadgil said: "It is imperative to have high quality imaging in the form of a good mammogram and/ or breast ultrasound prior to treatment. This helps look for a second focus of cancer in the same or opposite breast, which can occur in 3% of cases."
Sharing his view, surgical oncologist Snita Sinukumar said: "Core biopsies are the standard of care today. They provide more accurate information over a needling procedure (FNAC) and are also useful in guiding treatments if chemotherapy has to be given first."
Second, choose the right surgical procedure. Patients have several choices in breast surgery today, experts say.
Surgical options for breast cancer are removal of the breast lump only with lymph nodes in the armpit. It is called breast conservation surgery. Removal of the entire breast with lymph nodes is called mastectomy. Sometimes after a mastectomy, breast reconstruction can be performed with or without an implant.
In some cases, instead of all the lymph nodes in the armpit only the main ones can be removed — this is a sentinel node procedure. The surgeon should be able to discuss all these options with the patient.
"We encourage women to save their breasts by opting for the first option, only if they will take radiation later, as this is a must in such cases," Sinukumar said.
Savita is a 65-year-old woman with heart disease and uncontrolled diabetes. She was diagnosed with a small breast lump on the right side. After much discussion, she decided with her surgeon to undergo a mastectomy with immediate reconstruction.
Unfortunately, the diabetes was not well controlled and the wound took eight weeks to heal. Her chemotherapy thus got delayed, increasing the chance of recurrence.
Breast surgeon Anupama Mane of Ruby Hall Cancer Centre, said: "While choosing a surgical procedure, it is very important to match the treatment to the patients' physical and mental condition. This patient may not have been the ideal candidate for reconstruction; however, it was her informed choice to go ahead with the procedure."
Correct decisions for chemotherapy and hormonal therapy are equally important. A large number of women with breast cancer in India require chemotherapy either before or after the surgery, simply because the tumour is diagnosed when it is bigger than 2 cm in most cases.
Sayali (32) has been diagnosed with breast cancer while breast feeding her second child. The tumour is quite large and if she is operated immediately she will need to have the whole breast removed.
She is very keen and rightly so, in saving her breast. In this case, chemotherapy can be administered upfront before the surgery in order to shrink the tumour, thereby allowing breast saving surgery.
Medical oncologist Shona Nag said: "Giving chemotherapy before surgery has allowed many women to save their breast. It is a very safe procedure and we currently have many young women on this treatment protocol. In 20-50% of cases, the tumour completely disappears and no disease is found after the surgery."
"These women do very well and have a high chance of cure. However, this approach needs a comprehensive team of a breast surgeon/ or oncosurgeon and medical oncologist working together closely as one needs to monitor shrinkage of the tumour very carefully and operate at the correct time," Nag said.
Hormone therapies are also of various types and there is recent evidence to show that some premenopausal women benefit from completely blocking their ovaries. In some cases, rather than five years of hormonal therapy, 10 years may be more beneficial.
Newer treatments must be offered — targeted therapy like Herceptin — although expensive for the 20% of all women who have Her2 positive breast cancer; can reduce the recurrence risk by half. The main issue is its cost — Rs 14 lakh for one year of treatment.
What a lot of people don't know is that giving the drug for as little as three months also has some benefit compared to none at all — this cuts the cost by 1/4th. Although it is not cheap, it is affordable for many women and many more lives can be saved. The standard of care at this time however, still remains one year.
Finally, being diagnosed with stage four breast cancer is no longer a death sentence. A lot depends on the type of breast cancer diagnosed and where all it has spread.
Aarti (40) was found to have a large breast tumour. She had kept it a secret from her family for over a year because her daughter had higher secondary certificate (HSC, class XII) exams.
This is common in India. Further tests showed that the cancer had spread to the bones. She was found to have the hormone positive type of breast cancer which has effective and safe oral targeted therapy.
Four years later, she is .doing well and the only issue is she has to continue with the treatment lifelong.
7th Oct 2015, 12:09 PM #2167
Re: Health Bulletin
UV light-enabled catheter to fix holes in heart without operation
Researchers have designed a specialised catheter for fixing holes in the heart using a biodegradable adhesive and patch, eliminating the need for open heart surgery.
Pedro delNido, contributing author on the study, said, "This method also avoids suturing into the heart tissue, because we're just gluing something to it," said delNido.
Catheterisations are preferable to open heart surgery because they don't require stopping the heart, putting the patient on bypass, and cutting into the heart.
Their newly designed catheter device utilises UV light technology, and can be used to place the patch in a beating heart. The catheter is inserted through a vein in the neck or groin and directed to the defect within the heart.
Once in place, the clinician opens two positioning balloons: one around the front end of the catheter, and one on the other side of the heart wall.
The clinician then deploys the patch and turns on the catheter's UV light. The light reflects off of the balloon's interior and activates the patch's adhesive coating. As the glue cures, pressure from the positioning balloons on either side of the patch help secure it in place. Finally, both balloons are deflated and the catheter is withdrawn.
Over time, normal tissue growth resumes.
9th Oct 2015, 12:52 AM #2168
Re: Health Bulletin
Antibiotic resistance a global health crisis: WHO
WHO director general Margaret Chan on Thursday said the rise of antimicrobial resistance is a global health crisis. Medicine is losing more and more mainstay as pathogens develop resistance and the second-line treatments are less effective, more costly, more toxic, and sometimes extremely difficult to administer, Chan added in her address at the G7 health ministers' meeting in Germany.
According to the WHO director general, superbugs haunt hospitals and intensive care units all around the world. "Gonorrhoea is now resistant to multiple classes of drugs. An epidemic of multidrug-resistant typhoid fever is rolling across parts of Asia and Africa. Even with the best of care, only around half of all cases of multidrug- resistant tuberculosis can be successfully cured," she said.
The WHO, in May this year, had come up with an action plan to deal with the crisis. It included increasing awareness, strengthening surveillance and research, to reduce infections, using medicines wisely, and to ensure sustainable investment, also in R&D for replacement products and better diagnostic tools.
The experts warn if the current trends continue modern medicine will end. Sophisticated interventions, like organ transplantation, joint replacements, cancer chemotherapy, and care of pre-term infants, will become more difficult or even too dangerous to undertake.
"Overprescribing also occurs in animal husbandry and agriculture, and in the food industry, especially when massive quantities of antibiotics are used to promote growth, not to treat sick animals. Routine use of antibiotics at sub-therapeutic levels kills the weakest bacteria, but lets the more resistant ones survive. Farmers working with cattle, pigs, and poultry infected with drug-resistant bacteria are at much higher risk of being colonized or infected with these bacteria. In addition, human consumption of food carrying antibiotic-resistant bacteria can lead to the acquisition of a drug-resistant infection," said Chan.
11th Oct 2015, 04:40 PM #2169
Re: Health Bulletin
British journal cites mental health study in Sehore
New resources and collaborative care models need to be adopted to integrate mental health in primary care, cites a report by Programme for Improving Mental Health Care (PRIME), a research programme consortium by Public Health Foundation of India (PHFI) and city-based NGO Sangath. The research work, carried out in Sehore district, found mention in The British Journal of Psychiatry.
Only about 10% of people with mental disorders are receiving evidence-based interventions, highlights the report that studied district mental healthcare plans. It is culmination of more than three years of work and collaboration between a range of academic institutions, government and non-governmental organizations (NGOs).
PRIME principal investigator Dr Rahul Shidhaye said, "The piloting experience revealed that mental health service delivery can be strengthened with strong facilitation by an external resource team and additional human resources are essential to establish true collaborative models of care."
On Saturday, PRIME and Sangath along with National Health Mission (NHM) played host to a unique painting exhibition marking World Mental Health Day. Each of works stands on its own, sending out a clear message highlighting the need for equality and dignity for people with mental health issues.
"I have tried to depict how a mentally affected person's life can change if he or she gets proper care and treatment. It is a lesson of compassion we all can practice," said Simran Tiwari, a student. Some 65 children participated in the programme.
Sehore based Dr Rajendra Kumar said, "Mental health is being addressed at different levels. Free medicines are being provided in all government hospital. However, youngsters account for 40% to 50% of patients, primarily a result of substance abuse."
12th Oct 2015, 12:04 AM #2170
Re: Health Bulletin
Antioxidants may make cancer worse
A trial reported that daily megadoses of the antioxidant beta-carotene increased the risk of lung cancer in male smokers by 18 per cent
Antioxidants are supposed to keep your cells healthy. That is why millions of people gobble supplements like vitamin E and beta-carotene each year. Today, however, a new study adds to a growing body of research suggesting these supplements actually have a harmful effect in one serious disease: Cancer.
The work, conducted in mice, shows that antioxidants can change cells in ways that fuel the spread of malignant melanoma —the most serious skin cancer — to different parts of the body. The progression makes the disease even more deadly. Earlier studies of antioxidant supplement use by people have also hinted at a cancer-promoting effect.
A large trial reported in 1994 that daily megadoses of the antioxidant beta-carotene increased the risk of lung cancer in male smokers by 18 per cent and a 1996 trial was stopped early after researchers discovered that high-dose beta-carotene and retinol, another form of vitamin A, increased lung cancer risk by 28 per cent in smokers and workers exposed to asbestos.
More recently, a 2011 trial involving more than 35,500 men over 50 found that large doses of vitamin E increased the risk of prostate cancer by 17 per cent. These findings had puzzled researchers because the conventional wisdom is that antioxidants should lower cancer risk by neutralising cell-damaging, cancer-causing free radicals.
But scientists now think that antioxidants, at high enough levels, also protect cancer cells from these same free radicals. “There now exists a sizable quantity of data suggesting that antioxidants can help cancer cells much like they help normal cells,” says Zachary Schafer, a biologist at the University of Notre Dame, who was not involved in the new study.
Last year the scientists behind the melanoma study found that antioxidants fuel the growth of another type of malignancy, lung cancer.