Multi-country trial ups hope of recovering from TB in 6 months
In the light of India’s ambitious goals to eliminate tuberculosis by 2025, patients cured from clinical trials of combination therapy including crucial drugs Bedaquiline and Delamanid holds promise. Majority of the drug-resistant patients subjected to this combination regimen became negative for TB within six months, a study published in The Lancet stated.
Multi-national trials were conducted by Medecins Sans Frontières (Doctors without Borders) in three countries – South Africa, India and Armenia. While 14 patients were enrolled in SA, seven each hailed from Mumbai in India and Armenia. While half of the cohort had multi-drug resistance (MDR) another half had extensively drug-resistant TB (XDR)
Of 28 patients that were enrolled, it was possible to carry out trials till the end in 23 patients. 17 (74%) of these patients converted to TB negative by the end of six months. . “The proportion of patients with culture conversion in our study (74%) was considerably higher than those previously reported in patients with XDR tuberculosis in South Africa (55–58%),”stated the study.
For close to 50 years, the treatment landscape for TB has largely remained unchanged.
MDR-TB patients have to consume 14,000 pills for two years plus daily injections for six months at the moment. This is a path-breaking finding as MDR-TB and XDR-TB treatments usually stretch beyond two years and are extremely painful.
16 adverse events were reported in seven patients including gastrointestinal, nervous system and psychiatric troubles. Of seven patients who had serious adverse events, one patient died. The patient who died was also HIV positive.
“Although the number of patients treated in the cohort was quite small, our preliminary results show that the use of the combination of bedaquiline and delamanid appears to be safe and can lead to high rates of culture conversion in patients who have historically had very little treatment success,”the study said.
In India, patients are in dire need of these life saving drugs and innovative therapies such as the combination of Bedaquiline and Delamanid. Inspite of National Strategic Plan of India aiming to make Bedaquiline, a drug used to treat MDR-TB available at 140 sites, it is currently given to only a handful, only 728 people in all of India, in six sites are receiving the life saving drug. The gap in availibility of drug to needy patients is huge.
The WHO TB report 2017 estimates that 1,47,000 patients in India were grappling with Multi-drug resistant TB – that in which the first line drugs of Rifampacin, Isoniazid, Ethambutol and Pyrazinamide do not work. However, the Indian government has records of only 37, 258 MDR-TB patients, which means that over a lakh drug-resistant patients are going untreated.
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Experimental obesity drug may prevent kidney stones
Tokyo: Japanese scientists have found that an experimental obesity drug can potentially prevent the formation of kidney stones in mice, a finding that paves the way to develop medications to prevent the condition in at-risk individuals.
The findings showed that mice who were administered 1mg/kg of the beta3- agonist CL316243 for 12 days, showed a 17 percent decrease in the number of kidney stones than those who were not given the drug.
“This is an experimental work for now. But I believe that this may open the way to the development of the new drugs which can stop the development of kidney stones in at-risk people,” said lead researcher Teruaki Sugino from the Nagoya City University Graduate School of Medical Sciences, Japan.
“So far we have only tested this on mice, but in mice it seems to work.
“We were able to analyse the biochemical differences between the control and experimental group, and discovered that the beta3-agonist reduced the expression of adipocytokine molecules, which are associated with inflammation,” Sugino added.
Beta3-agonists are known to cause white fat cells — found in excess in overweight and obese persons — into beige fat cells, which burn extra calories. This is why the molecules are also being considered for anti-obesity uses.
These beige cells consume free fatty acids, which cause inflammation in the kidneys leading to kidney stones.
This means that beta3-agonists have the potential to prevent not only obesity but also kidney stones, the researchers explained.
The findings were presented at the European Association of Urology Conference in Copenhagen.
Currently, potassium-sodium citrate drugs are used to restrict the development of kidney stones, but some people cannot use these drugs because they have to limit their potassium or sodium intake.
Since the drug was administered to mice, it cannot yet be directly applied to humans, the researchers noted.
Source: http://zeenews.india.com/health/experimental-obesity-drug-may-prevent-kidney-stones-2091358
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Karnataka Introduces 48-Hour Free Treatment For Accident Victims
Earlier this year, a young man, Harish Nanjappa, died in a road accident on a highway outside Bengaluru. As he lay dying, without any treatment, he spoke of his wish to donate his organs.Today, the Karnataka state government named a new scheme to ensure treatment to accident victims after him.
Under the scheme, accident victims will receive care for the first 48 hours regardless of their ability to pay. For the treatment of each accident victim, Rs. 25,000 will be assured — the government has earmarked Rs. 80 crore for the scheme.
The scheme is applicable to anyone, Indian or foreign national, who meets with an accident in Karnataka.
Karnataka is the first state to implement such a scheme. The government hopes it will encourage more people to help accident victims and people won’t be turned away when they are desperate for treatment.
Speaking at the launch of the scheme, Harish’s mother Geethamma said, “What happened to my son should not happen to anybody. This scheme in my son’s name… will be a useful scheme to help everyone.”
Karnataka chief minister Siddaramaiah also paid tribute to Harish. “That man, even though he was dying, he thought of the society,” he said.
Leading cardiac surgeon Dr Devi Shetty welcomed the scheme.
“Most of the time they (accident victims) are allowed to die on the road. Whether he is a millionaire or a pauper, nobody cares,” he said. “With this scheme there is an incentive for hospitals to pick them up from the road and give them proper care.”
Health minister UT Khader said people do not hospitalise an accident victim for two reasons – the fear of a legal problem and question of money.
“Whenever one goes to the hospital, they are asked to pay first. On humanitarian grounds, he can’t leave him also… on that basis we have planned this programme,” he said.
Source: https://www.ndtv.com/bangalore-news/karnataka-introduces-48-hour-free-treatment-for-accident-victims-1285122
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One billion people may suffer from Glaucoma by 2030: AIIMS
As the World Glaucoma Week ends on March 17, with over 11.2 million persons aged 40 years and older suffering from Glaucoma in India, researchers say that despite it being the second largest cause of blindness, it is more problematic than cataract, because the blindness caused by Glaucoma is irreversible. Over 70 per cent of the Indian population is at the risk of developing Glaucoma, of which 2 lakh are likely to lose vision on an average.
Doctors from the All Indian Institute of Medical Sciences (AIIMS) have already proposed in their research papers that type four diabetes can occur in the brain and is the suspected cause of Glaucoma and related neuro-degenerative disorders. Due to it being considered one of the most complex human diseases, a majority of those suffering from Glaucoma go undetected and major challenges exist in detecting and treating those with the disease.
“There are striking similarities in genetic, biochemical, and molecular aspects which prove that Glaucoma is a form of brain-specific diabetes. There might be one billion people suffering of it across the world by 2030. It is sometimes uncontrolled even by medicines and requires multiple surgeries and lifelong therapies. It is known to be a silent ailment that can lead to blindness and hence creating awareness among the masses is necessary to prevent it from becoming an epidemic,” said Dr Muneeb Faiq, Clinical Researcher, AIIMS.
According to the World Health Organisation (WHO), it is the second largest cause of blindness in the world and fourth largest in India. The average age for the prevalence of Glaucoma is over 50 years, but with sedentary lifestyle and westernisation, the average age is getting reduced. It has recently been observed that of the total cases diagnosed with the condition, over 70 per cent of them were under the age of 35.
“It is important to get optic nerve examinations done regularly and further educate people about the disease. People with a family history of diabetes, hypertension, and poor blood circulation are at an elevated risk of getting the condition,” said Dr Ritika Sachdev, Additional Director Medical Services, Centre for Sight.
WHO REPORT
Glaucoma is the 2nd largest cause of blindness in the world and 4th largest in India. The average age for prevalence of Glaucoma is over 50 years. But, it has been observed that of the total cases diagnosed, over 70% were under the age of 35.
Source: http://www.dnaindia.com/health/report-one-billion-people-may-suffer-from-glaucoma-by-2030-aiims-2594549
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Lap-band surgery may lower chronic knee pain
Obese people who have a band surgically strapped around their stomach to restrict food intake not only lose weight but will also suffer less from arthritic knee pain, a new study suggests.
According to researchers, the pain proceeds from the deterioration and related inflammation in knee joints caused in part by the extra weight they bear.
While the pain relief seen with lap-band surgery applied to all patients with osteoarthritic knees, researchers found that it was most helpful in the young men and women who lost the most weight.
“Our study shows that extremely obese people seeking relief from their knee pain should consider lap-band surgery earlier because the benefits from it being successful — although significant for all ages — decrease with age,” said co-author Jonathan Samuels, Associate Professor at NYU School of Medicine.
For the study, published in the journal Seminars in Arthritis and Rheumatism, researchers examined 120 patients who underwent lap-band surgery between 2002 and 2015.
All were surveyed for what they remembered about their knee pain immediately before surgery, a year after their procedure, and for as long as 14 years later.
The main purpose of the survey was to find out why some extremely obese people showed more knee pain relief from lap-band surgery than others.
According to the survey results, men and women in their 40s experienced post-surgical knee pain reductions after one year of between 50 and 60 per cent; while those in their 50s, one year later, had pain reductions between 30 and 40 per cent; and those in their 60s, had reductions between 20 per cent and 30 per cent.
Pain relief persisted for a decade in all patients monitored.
People with BMIs in the upper 40s were just as likely to report decreased knee pain as people with BMIs in the lower 40s if they lost proportionally the same amount of total body weight.
Source: http://zeenews.india.com/health/lap-band-surgery-may-lower-chronic-knee-pain-2091873
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New hope for patients with hard-to-treat triple negative breast cancer
A team of researchers has identified a method for treating particularly aggressive forms of breast cancer that could potentially save thousands of lives each year.
According to results from a SWOG clinical trial, those with tough-to-treat triple negative breast cancer, whose tumors also don’t allow for double-strand DNA repair, fare better when treated with a common adjuvant breast cancer chemotherapy combination.
The trial results showed that a well-established drug combination – adjuvant doxorubicin and cyclophosphamide (AC) chemotherapy – works well in this patient population.
The results also showed the value of collecting and preserving cancer tumor tissue. University of Kansas Cancer Center’s Priyanka Sharma and her team used nearly 20-year-old tumour samples stored in SWOG’s biospecimen bank to conduct their analysis.
“We learned three interesting things from this trial,” Sharma said. “First, we showed that assays tested in our study worked well in very old tissue samples. We also learned that 25 % of triple negative breast cancer patients harbored BRCA 1 or BRCA2 mutations and tumors in these patients were HRD positive.”
“However, presence of HRD was not restricted to just patients with BRCA mutations, as among patients without BRCA mutations, 55 % also demonstrated tumor HRD. Finally, and most importantly, we learned that 67 % of triple negative breast cancer patients – a solid majority – respond well to a standard, backbone chemotherapy combination. So, while, AC chemo is an old treatment, for many, it’s still a good one. HRD status is a biomarker that, when identified, can potentially help a physician best tailor a chemotherapy treatment for that particular triple negative breast cancer patient.”
The study is published in Annals of Oncology.
Source: https://www.hindustantimes.com/health/new-hope-for-patients-with-hard-to-treat-triple-negative-breast-cancer/story-Jf5IFZA7Uqpru8d0j3Yu1I.html
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