Health Ministry to set up ‘model lab’ in each district to fast-track diagnosis
The move follows a health ministry review of diagnostic facilities in four states– Gujarat, Tamil Nadu, Madhya Pradesh and Jharkhand.
The Union health ministry has decided to upgrade and modernise at least one diagnostic laboratory in each district across India to fast-track diagnosis, especially during an epidemic.
These “model labs” can then be replicated across health centres and hospitals across states, which will help reduce overcrowding of tertiary care hospitals due to referrals.
“The lab of one district hospital will be upgraded with a focus on strengthening microbiology, pathology and biochemistry. States can select and choose the one they want to upgrade first and can later replicate the model in other district hospitals,” said Dr Jagdish Prasad, director general of health services (DGHS).
The move follows a health ministry review of diagnostic facilities in four states– Gujarat, Tamil Nadu, Madhya Pradesh and Jharkhand.
“The assessment report found some labs didn’t have equipment while the others did not have adequately trained staff to handle those sophisticated machines. Maintenance is also a big problem, as a result many expensive equipment lie unused and people are referred to far-off places for tests,” said Prasad.
On October 25, the DGHS reviewed technical advisory group meeting for integrated laboratories at the district level, and asked for response from the states.
The project is expected to take about six months to complete, and will be spearheaded by director National Centre for Disease Control (NCDC) and his team.
“Health is a state subject, so the project can’t materialise without taking the states on board. We have asked the states to choose districts as per their requirement. We will show them it is possible to create facilities with a limited budget and produce high-class test reports,” he says.
As part of the greater plan, the health ministry will also mentor a medical college in each state and train doctors, nurses, paramedical and technical staff, who can further train their peers in other hospitals.
“We want to standardise medical colleges and hospitals attached to them. This will be a good way to ensure all of them follow a standard protocol. All these hospitals and labs will gradually be integrated to benefit patients in the long run,” said Prasad
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Why heart attacks are more prevalent in winters
According to a study seasonal-dependent behaviours such as reduced physical activity and dietary changes could also play a role in the increased occurrence of heart attack during colder weather.
The body responds to cold by constricting superficial blood vessels, which decreases thermal conduction in the skin and subsequently increases arterial blood pressure. Other responses are shivering and increased heart rate, which raise the metabolic rate and in turn increase body temperature.
The risk of suffering a heart attack is more likely to peak in the winter season and decline in summers because air temperature acts as an external trigger for the life threatening disease, an analysis has shown. The findings revealed that the average number of heart attacks per day was significantly higher during colder temperatures as compared to warmer.
When the daily temperature dropped to less than zero degree Celsius, the average rate of heart attacks a day peaked to four, as compared to when it was above 10 degrees. Furthermore, the occurrence of heart attacks increased with higher wind velocities, limited sunshine duration and higher air humidity.
“There is seasonal variation in the occurrence of heart attack, with incidence declining in summer and peaking in winter,” said lead author Moman A. Mohammad, from the Lund University in Sweden. “Our results consistently showed a higher occurrence of heart attacks in sub-zero temperatures. The findings were the same across a large range of patient subgroups, and at national as well as regional levels, suggesting that air temperature is a trigger for heart attacks,” Mohammad added.
The body responds to cold by constricting superficial blood vessels, which decreases thermal conduction in the skin and subsequently increases arterial blood pressure. Other responses are shivering and increased heart rate, which raise the metabolic rate and in turn increase body temperature, the researchers explained.
“In the majority of healthy people these mechanisms are well tolerated. But in people with atherosclerotic plaques in their coronary arteries they may trigger a heart attack,” Mohammad noted. Respiratory tract infections and influenza are also known risk factors for heart attack that have a clear seasonal variation.
“In addition, seasonal-dependent behaviours such as reduced physical activity and dietary changes could also play a role in the increased occurrence of heart attack during colder weather,” Mohammad said.
The results were presented at the European Society of Cardiology Congress in Barcelona. For the study, the team investigated the association between heart attack incidence and weather conditions such as air temperature, sunshine duration, precipitation, and air pressure in more than 2,80,000 patients.
Source: http://indianexpress.com/article/lifestyle/health/why-heart-attacks-are-more-prevalent-in-winters-4817558/
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Knee implants to cost up to 69% less as government caps prices
Acting swiftly on PM Narendra Modi’s Independence Day promise to take steps to rein in healthcare costs, the government on Wednesday said it is placing knee implants under price control.
The government has slashed the prices of knee implants by between 59% and 69% using a special provision in the drug pricing law that enables it to intervene in “extraordinary circumstances” in public interest.
The move is expected to benefit over three crore arthritis patients in India needing knee replacement surgery.
Official sources said hip implants and intraocular lenses are the next items likely to attract the attention of the regulatory scanner.
The standard, widely used cobalt chromium in knee replacement surgery will now cost Rs 54,720 as against an earlier MRP of Rs 1,58,324. Similarly, the price of special metals like titanium and oxidised zirconium have been slashed by almost 70%, to Rs 76,600 from Rs 2.49 lakh. In case of revision knee replacement, which is usually done if the primary replacement fails, prices of implants have been cut by 59%.
The government said there was “unjustified, unreasonable and irrational” profiteering and trade margins on these devices, leading to exorbitant prices that push up patients’ out-of-pocket expenses. In fact, the high costs make treatment unaffordable for many who need arthroplasty procedures.
The regulator national pharmaceutical pricing authority finds that it is urgently necessary to act in public interest and has fixed and notified ceiling prices of orthopaedic knee implants for knee replacement systems, the order issued by the department of pharmaceuticals said.
“The government will not be a mute spectator to illegal and unethical profiteering,” chemicals and fertilisers minister Ananth Kumar said. He added the government would take stringent action against hospitals, importers and retailers if they charged in excess of the MRP fixed by the government.
According to government estimates, the price regulation of knee implants alone will lead to a saving of about Rs 1,500 crore annually for patients.
The new prices come into effect immediately and will also apply to all available stocks for sale in trade channels.
“The success of the order will depend on what steps are taken by the government to ensure that the overall procedure costs come down as a result of this price fixation,” Malini Aisola of the All-India Drug Action Network said.
“We hope this is just the tip of the iceberg and the government will go on to regulate prices of all other critical medical devices where similar market conditions prevail,” said Gurinder Grewal, former president of the Punjab Medical Council.
A price cap on implants is expected to benefit millions of patients with orthopaedic problems. Industry data, which experts say does not fully capture the picture, shows over three crore arthritic patients in India in need of knee replacement surgery. Since this is not a life-threatening disease, the number of patients opting for surgery is comparatively low.
Even then, estimates show that over 1,20,000 knee replacement procedures, and about 70,000 hip procedures, take place every year in India. And the costs are not low. Preliminary analysis by the NPPA shows the MRP of the total knee system ranges between Rs 59,091 and Rs 4,13,059. Add to this hospital costs, surgeon charges, time in the operation theatre, and several other miscellaneous charges. The latest price regulation by government is seen, in this context, as a step towards rationalising healthcare costs.
Source: http://timesofindia.indiatimes.com/india/knee-implants-to-cost-up-to-69-less-as-government-caps-prices/articleshow/60094167.cms
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Immunotherapy found safe for type 1 diabetes in landmark trial
Type 1 diabetes is believed to be an autoimmune disorder, so does this mean that immunotherapy could be used to treat it? A landmark trial has investigated the safety of such a therapeutic approach.
The Centers for Disease Control and Prevention (CDC) report that up to 1.05 million people in the United States – or 5 percent of the country’s diabetic population – have type 1 diabetes.
The condition is thought to be an autoimmune disorder in which the body’s immune system – its T cells, specifically – does not recognize the pancreas’ insulin-producing beta cells and mistakenly attacks them. At present, there are no treatments for preventing T cells from killing off the body’s beta cells.
Despite the belief that type 1 diabetes is an autoimmune condition, few studies have tested the possible benefits of immunotherapies in treating the condition, perhaps due to concerns that they might make it worse.
For type 1 diabetes, immunotherapies consist of molecules that imitate a proinsulin peptide. In this context, researchers based in the United Kingdom set out to examine the benefits of immunotherapy in a landmark trial that included a placebo control group.
The study’s first author is Dr. Mohammad Alhadj Ali, of the Cardiff University School of Medicine in the U.K., and the corresponding author is Mark Peakman, Ph.D., a professor of clinical immunology at King’s College London, also in the U.K.
The results were published in the journal Science Translational Medicine.
Proinsulin peptide immunotherapy is ‘safe’
Dr. Ali and team examined the effect of the peptide in 27 people who had been diagnosed with type 1 diabetes within the previous 100 days.
For 6 months, the participants received either shots of the immunotherapy or the placebo at 2- or 4-week intervals. Their C-peptide levels – which are markers of insulin – were tested at 3, 6, 9, and 12 months, and they were compared with baseline levels.
The trial found no evidence of toxicity or negative side effects, and beta cells were not impaired or reduced as a consequence of the therapy. The authors write, “Treatment was well tolerated with no systemic or local hypersensitivity,” which led the researchers to conclude that “proinsulin peptide immunotherapy is safe.”
Additionally, “Placebo subjects showed a significant decline in stimulated C-peptide (measuring insulin reserve) at 3, 6, 9, and 12 months versus baseline, whereas no significant change was seen in the 4-weekly peptide group at these time points,” say the researchers.
Importantly, over a period of 12 months, the daily insulin intake in the placebo group increased by 50 percent, whereas the treatment group kept stable levels of insulin use.
Although the effects of immunotherapies need to be tested in larger cohorts, the trial offers an encouraging safety profile for the treatment. Speaking to Medical News Today about the clinical implications of such results, Prof. Peakman broke down the findings.
The good safety profile means 3 things:
(i) that we can progress to the next stage, which is to perform an efficacy trial and we hope to start this in 2018;
(ii) that this therapy may be acceptable in children, which is the main group developing type 1 diabetes;
(iii) that we may be able to give the peptide repeatedly over long periods, which may be required to gain full effects.
– Mark Peakman, Ph.D.
Regarding the limitations of the research, Prof. Peakman told us that the small sample size meant that the researchers could not examine how efficacious the treatment was. Consequently, in the future, the researchers plan to conduct a larger study in order to investigate the immunotherapies’ effect on disease progression.
Source: http://www.medicalnewstoday.com/articles/318899.php
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Researchers discover MRI can predict future kidney function
Researchers from St. Michael’s Hospital have made what are believed to be two world first discoveries: an MRI can measure kidney damage and can predict future kidney function within one year while avoiding needle biopsies.
The researchers used a specific magnetic resonance imaging test called an elastogram to measure kidney scarring in 17 people who had kidney transplants, according to the study published online in the Clinical Journal of the American Society of Nephrology.
An elastogram maps the stiffness of tissue using MRI to determine the presence of scarring, according to Dr. Anish Kirpalani, the study’s lead author, a radiologist and a scientist in the Li Ka Shing Knowledge Institute of St. Michael’s.
Scarring is a major cause of kidney transplant failure.
“Healthy kidney is soft, whereas scar tissue is stiffer,” said Dr. Darren Yuen, a transplant nephrologist and scientist in the Keenan Research Centre for Biomedical Science of St. Michael’s.
“We needed a way to measure how soft or stiff your kidney is without actually going inside the body. Using the MRI elastogram, we were able to measure kidney stiffness, which gave us an indication of how much scarring there was.”
Scarring is irreversible and can cause progressive kidney injury that can eventually lead to kidney failure. Diabetes, high blood pressure and kidney transplant rejection all cause scarring.
Needle biopsy is the current “gold standard” way to assess kidney scarring. A long needle is inserted into the kidney and a sample about the size of a mechanical pencil tip is removed. The procedure requires pain medications, can be associated with bleeding and requires a day off of work, according to the authors.
The study found that the MRI results were not only comparable to the results of a kidney biopsy, but the test was able to detect a high variability in the amount and location of scarring throughout the entire organ.
“The MRI allowed us to get a full picture of the kidney, whereas with a biopsy we would only see a tiny piece,” said Dr. Kirpalani.
“We were able to tell that in some parts of the kidney it’s very stiff, and in others, it’s not stiff at all, which is information we couldn’t get from a biopsy.”
The researchers also found that kidney stiffness predicted how well the kidney would be working one year after the MRI. They found that those with higher levels of stiffness in their kidneys had a greater loss of kidney function, while those with softer kidneys did not.
This shows that MRI can accurately predict future kidney function, according to the authors, which may be particularly helpful for kidney transplant patients.
“When we’re looking at a transplanted kidney, we’re dealing with a precious resource–these patients have waited a long time for a transplant, and have been on dialysis, which is a difficult and painful process,” said Dr. Kirpalani.
“Scarring is a big problem for transplant patients, and with MRI we may be able to better guide how kidney transplant patients are treated early on to improve their long-term outcomes.”
MRIs would not replace biopsies, said Dr. Yuen, but rather act as an additional test to give a more comprehensive understanding of kidney health.
“Clinicians are hesitant to send patients for a test that has risks such as internal bleeding unless a diagnosis can’t be made without it,” he said. “With this new MRI test, doctors can gather valuable information in the many patients for whom the risks of a biopsy are too high.”
He also emphasized that this new MRI test may help facilitate the testing of new anti-scarring treatments.
“There are currently no anti-scarring drugs on the market, in part because it is hard to rationalize doing multiple kidney biopsies as part of a pharmaceutical trial,” said Dr. Yuen.
“By providing a needle-free way to measure kidney scarring, we may create more opportunities for this crucial research into finding an effective anti-scarring treatment.”
The study was conducted in the hospital’s MRI research centre, which houses MRI equipment dedicated specifically to clinical research.
“The unique MRI research centre that we have created, including elastography equipment, is focused on research that will directly impact patient care, allowing us to do this important study in people with transplant kidneys,” said Dr. Kirpalani.
Source: http://www.medicalnewstoday.com/releases/319278.php
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5 Types of Cancer that May be Prevented by Beans
Beans, also known as legumes, are rich in three types of phytochemicals which fight against cancer. They are-Saponins: As per the lab tests, saponins are found with the ability to constrain the generation of cancer cells and slows the growth of tumors.
Protease Inhibitors: It releases a substance called proteases that destroy the nearby cells which help to prevent tumors. Also, it slows down the division of cancer cells.
Phytic Acid: Phytic acid slows down the progression of tumors
5 Types of Cancer that May be Prevented by Beans
1. Prostate Cancer
According to National Cancer Institute, prostate cancer is the second leading cause of death by cancer in men. Prostate cancer develops in a gland in male reproductive part, prostate. Beans contain antioxidant components which fight the free radicals that can lead to oxidative damage on a cellular level, including cancer. As per the BBC reports, inositol pentakisphosphate, a compound in beans block tumor growth.
2. Colorectal Cancer
Colorectal or colon cancer develops in the colon or rectum of large intestine. Beans rich with fibre and resistant starch enter large intestine where bacteria ferment them into a small chain of fatty acids such as butyrate. This acid performs number of cancer-preventive actions inside the colon such as increasing the production of detoxification enzymes and halting cancer cell growth. According to Polyp Prevention Trial, data indicated that eating more beans can prevent the recurrence of colon polyps.
3. Breast Cancer
Beans have flavonoids and compounds which contain anti-cancer properties. According to American Institute for Cancer Research, “for every 10 grams of fiber (about a half cup of beans), breast cancer risk is decreased by seven percent”. Data from Nurses Health Study of 2005 revealed that countries with the greatest consumption of beans had the lowest breast cancer mortality rates.
4. Renal (Kidney) Cancer
Kidney cancer is also known as renal cancer. People suffering from this cancer need to strictly follow a healthy diet. Their diet should involve the most basic and beneficial items such as the green vegetables and fruits. A few vegetables such as beans, particularly play a massive role in terms of preventing the possibility of cancer. They are very important because they provide sufficient energy and nutrients to prevent deficiencies, help in optimising health, and reduce the risk of various diseases.
5. Gastric Cancer
Gastric or stomach cancer are most common in our country. People with gastric cancer are recommended to have fiber and protein rich diet. As mentioned earlier, beans with more fiber can make gastric cancer patients feel full as suggested by doctors. Patients should avoid eating too much of it at a time. It is advisable to consume it with some soft and bland foods.
The versatile functioning of this food may actually prevent risks of these five kinds of cancer. It is a big source of protein for vegetarians. Enjoy your bean diet with salads, tacos and rice. According to a renowned health coach Shilpa Arora, “along with beans, one should include more green veggies which in totality prevent cancer cell growth and leads to a healthy DNA”.
Source: http://food.ndtv.com/health/the-power-of-beans-the-cancer-fighting-food-1740046
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