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US FDA approves first AI device to detect diabetic eye disease

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In a first, the US Food and Drug Administration (FDA) has permitted marketing of an Artificial Intelligence (AI)-based device to detect certain diabetes-related eye problems.

The device, called IDx-DR, is a software programme that uses an artificial intelligence algorithm to analyse images of the eye taken with a retinal camera.

The FDA permitted marketing of IDx-DR to Iowa-based medical device company IDx LLC on Wednesday to detect greater than a mild level of the eye disease diabetic retinopathy in adults who have diabetes.

Diabetic retinopathy, a common cause of vision loss among people living with diabetes, occurs when high levels of blood sugar lead to damage in the blood vessels of the retina, the light-sensitive tissue in the back of the eye.

“Early detection of retinopathy is an important part of managing care for the millions of people with diabetes, yet many patients with diabetes are not adequately screened for diabetic retinopathy since about 50 percent of them do not see their eye doctor on a yearly basis,” Malvina Eydelman of FDA’s Center for Devices and Radiological Health said in a statement.

“Today’s decision permits the marketing of a novel artificial intelligence technology that can be used in a primary care doctor’s office,” Eydelman said.

IDx-DR provides a screening decision without the need for a clinician to also interpret the image or results, which makes it usable by health care providers who may not normally be involved in eye care.

A doctor uploads the digital images of the patient’s retinas to a Cloud server on which IDx-DR software is installed.

If the images are of sufficient quality, the software provides the doctor with one of two results, either “more than mild diabetic retinopathy detected: refer to an eye care professional” or “negative for more than mild diabetic retinopathy: re-screen in 12 months.”

If a positive result is detected, patients should see an eye care provider for further diagnostic evaluation and possible treatment as soon as possible.

The FDA evaluated data from a clinical study of retinal images obtained from 900 patients with diabetes at 10 primary care sites.

In the study, IDx-DR was able to correctly identify the presence of more than mild diabetic retinopathy 87.4 per cent of the time and was able to correctly identify those patients who did not have more than mild diabetic retinopathy 89.5 per cent of the time, FDA said.

The FDA, however, said that IDx-DR should not be used in patients with diabetes who are pregnant as diabetic retinopathy can progress very rapidly during pregnancy and the device is not intended to evaluate rapidly progressive diabetic retinopathy.

Source: http://zeenews.india.com/health/us-fda-approves-first-ai-device-to-detect-diabetic-eye-disease-2099321

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Suffering from cavities? This new technique can treat and rebuild teeth

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Are dental treatments burning a hole in your pocket? Researchers have now designed a convenient and natural product that uses proteins to rebuild tooth enamel and treat dental cavities. “Remineralisation guided by peptides is a healthy alternative to current dental health care,” said lead author Mehmet Sarikaya at the University of Washington.

The new biogenic dental products can — in theory — rebuild teeth and cure cavities without today’s costly and uncomfortable treatments. “Peptide-enabled formulations will be simple and would be implemented in over-the-counter or clinical products,” Sarikaya said.

Cavities are more than just a nuisance. According to the World Health Organization, dental cavities affect nearly every age group and are accompanied by serious health concerns. Additionally, direct and indirect costs of treating dental cavities and related diseases have been a huge economic burden for individuals and health care systems.

“Bacteria metabolise sugar and other fermentable carbohydrates in oral environments and acid, as a by-product, will demineralise the dental enamel,” said co-author Sami Dogan. Although tooth decay is relatively harmless in its earliest stages, once the cavity progresses through the tooth’s enamel, serious health concerns arise. If left untreated, tooth decay can lead to tooth loss.

This can present adverse consequences on the remaining teeth and supporting tissues and on the patient’s general health, including life-threating conditions. Taking inspiration from the body’s own natural tooth-forming proteins, the UW team has come up with a way to repair the tooth enamel. The researchers accomplished this by capturing the essence of amelogenin — a protein crucial to forming the hard crown enamel — to design amelogenin-derived peptides that biomineralize and are the key active ingredient in the new technology. The bioinspired repair process restores the mineral structure found in native tooth enamel.

“These peptides are proven to bind onto tooth surfaces and recruit calcium and phosphate ions,” said Deniz Yucesoy, a co-author. The peptide-enabled technology allows the deposition of 10 to 50 micrometers of new enamel on the teeth after each use. Once fully developed, the technology can be used in both private and public health settings, in biomimetic toothpaste, gels, solutions and composites as a safe alternative to existing dental procedures and treatments.

The technology enables people to rebuild and strengthen tooth enamel on a daily basis as part of a preventive dental care routine. It is expected to be safe for use by adults and children. The research findings have been published in ACS Biomaterials Science and Engineering.

Source: https://www.hindustantimes.com/health/suffering-from-cavities-this-technology-can-help-treat-and-rebuild-teeth/story-KUwPxI92tCm3FRPunV35tJ.html

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Diabetes patients get hope for slow-healing wounds

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A new study by Yale University has given renewed hope to diabetic patients with slow-healing wounds.

The researchers found out about a certain protein for maintaining wounds and said that if its effects could be reversed then it could help in healing wounds in diabetes patients.

“We discovered that a specific protein, thrombospondin-2 (TSP2), is elevated in wounds of patients with diabetes as well as in animal models of diabetes,” said Britta Kunkemoeller, one of the researchers.

“To determine whether TSP2 contributes to delayed wound healing, we genetically removed TSP2 from a mouse model of diabetes and observed improved wound healing. Our study shows that TSP2 could be a target for a specific therapy for diabetic wounds,” she said.

Most of the work done before on diabetes wound healing had focussed on the kinds of cells which are involved in the healing of wounds such as immune cells, skin cells and the cells which form blood vessels. Compared to that, Kunkemoeller’s research focuses on TSP2, a component of the extracellular matrix.

Along with giving structural support, the extracellular matrix helps in regulating processes which are imperative for wound healing, including the behaviour of immune, skin and vessel-forming cells.

Currently, it is the standard wound care protocol which is observed, like moist bandages, removing damaged tissue and footwear which aids in reducing pressure on the wound. However, in spite of these measures, the wounds still remain at times. In extreme cases, it becomes imperative to amputate the affected foot or lower leg.

“Our focus on TSP2 therefore allowed us to study a single molecule that influences several wound-healing related processes,” said Kunkemoeller.

The research shall be presented at the American Society for Investigative Pathology yearly meeting during the 2018 Experimental Biology meet.

Source: https://www.hindustantimes.com/health/diabetes-patients-get-hope-for-slow-healing-wounds/story-HQDi7dHRFk45etvfuhpqqM.html

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LED bulbs can give you cancer, stay away from the blue light

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Reigniting the debate over exposure to the “blue light” emitted by outdoor LED screens and heightened risk of cancer, an international team of researchers have concluded that there is a “strong link” between the two. To reach this conclusion, the researchers from University of Exeter in Britain and the Barcelona Institute for Global Health (ISGlobal) determined indoor exposure to artificial light through personal questionnaires.

The outdoor levels of artificial light, such as emitted by street lights, were evaluated for Madrid and Barcelona, based on nocturnal images taken by astronauts aboard the International Space Station (ISS). The study included medical and epidemiological data of more than 4,000 people between 20 and 85 years of age in 11 Spanish regions.

Results obtained for both cities show that participants exposed to higher levels of blue light had a 1.5 and two-fold higher risk of developing breast and prostate cancer, respectively, as compared to the less-exposed population. The findings, published in the journal Environmental Health Perspectives, found that the “blue light” emitted by LED lights seems to affect circadian rhythms and sleeping patterns, which then impacts hormone levels. Both breast and prostate cancers are hormone-related.

The World Health Organisation’s International Agency for Research on Cancer (IARC) has classified night shift work as probably carcinogenic to humans. There is evidence pointing to an association between exposure to artificial light at night, disruption of the circadian rhythm, and breast and prostate cancers.

“With this study, we sought to determine whether night exposure to light in cities can affect the development of these two types of cancer,” explained Manolis Kogevinas, ISGlobal researcher and coordinator of the study.

According to Alejandro Sainchez de Miguel from University of Exeter and a lead author on the study, blue light is also produced by smartphones and tablets but the current study looked only at blue light from outdoor LEDs. “That is a confusion for many journalists; we have not done anything in phones. But the same mechanism may be affecting the phones or the bulbs at home, because the physiology is the same,” CNN quoted SAinchez de Miguel as saying.

Given the ubiquity of artificial light at night, determining whether it increases or not the risk of cancer is a public health issue. “At this point, further studies should include more individual data using for instance light sensors that allow measuring indoor light levels. It would also be important to do this kind of research in young people that extensively use blue light emitting screens,” suggested Ariadna GarcAa, ISGlobal researcher and first author of the study.

“We know that depending on its intensity and wave length, artificial light, particularly in the blue spectrum, can decrease melatonin production and secretion,” added Martin Aub, Physics Professor at CEGEP in Sherbrooke, Canada and study co-author.

Source: https://www.hindustantimes.com/health/these-lights-are-harmful-for-health-may-trigger-breast-and-prostate-cancer/story-9loGV6AVpsfSAEhwWGNpzI.html

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New method to help diagnose, assess COPD and lung function

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Researchers have developed a new method of analysing X-ray images of lungs, which could help in the diagnosis and assessment of Chronic Obstructive Pulmonary Disease (COPD), and other lung diseases.

The team at the University of Southampton in the UK devised the method for numerically describing the complicated three-dimensional structure of the lung using topology – a part of mathematics designed specifically for the study of complex shapes.

Utilizing a combination of computed tomography (CT) scans, high-performance computing and algorithms, the researchers computed numerical characteristics, in three dimensions, of the entire bronchial trees of 64 patients categorised in four different groups.

The groups were: healthy non-smokers, healthy smokers, patients with moderate COPD and patients with mild COPD.

COPD is a complex lung condition that involves, to various degrees, the airways (bronchi) and the lung tissue (alveoli). It results in a progressive loss of lung function.

The condition affects more than 200 million people worldwide. It is the fourth leading cause of death worldwide, researchers said.

In the study, published in the journal Scientific Reports. the team analysed such features as the structure and size of the bronchial tree, the length and direction of its branches and the comparative changes in shape during deep inhalation and full exhalation.

They found that, typically, a larger more complex tree indicates better lung function and a smaller distorted tree, poorer lung function.

The researchers found that their novel method was able to accurately distinguish between the different groups of patients, the characteristics of their lung function and the different stages of their condition.

It was able to identify characteristics not detectable to the naked eye.

They hope that repeating this method across a much larger database of images and combining it with other data could lead to the real-world development of a valuable clinical tool for the early diagnosis of conditions like COPD and asthma.

This provides a more accurate way of identifying the severity of an individual patient’s condition, researchers said.

Until now, the severity of lung conditions has been assessed by using a spirometer – a device which measures the force and amount of air a patient can exhale.

Two-dimensional CT images, assessed by expert specialists, who have extensive experience of examining and interpreting CT imagery, and relatively simple measures of lung density and bronchial wall thickness are also used.

Our study shows that this new method, employing topological data analysis, can complement and expand on established techniques to give a valuable, accurate range of information about the lung function of individuals,” said Jacek Brodzki, a professor at the University of Southampton.

This method is a major advance in our ability to study the structural abnormalities of COPD, a complex disease that affects so many people and, sadly, results in significant morbidity and mortality,” said Ratko Djukanovic, a professor at the University of Southampton.

Source: http://www.dnaindia.com/health/report-new-method-to-help-diagnose-assess-copd-and-lung-function-2615717

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Heart travels from Bengaluru to Kolkata hospital under four hours for successful transplant

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In a historic moment in the medical field in India, the heart of brain dead patient from Karnataka was successfully transplanted into a patient at a private hospital in Kolkata.

The donor, who was admitted to Sparsh Hospital in Bengaluru, was declared brain dead after he had an accident in March this year. His family members had expressed their willingness to donate his heart.

His heart was then transported 1,885 kilometres – 1,665 from Bengaluru airport to Kolkata airport, and 20 kilometres from the airport to Fortis Hospital at Anandapur in the eastern part of the city. Accordingly, authorities there contacted officials at Fortis Hospital for the transplant.

The beneficiary, 40-year-old Dilchand Singh from Jharkhand, had been suffering from a heart ailment for a few months.

The heart was brought in a special container, preserved with ice and cardioplegic solution. Doctors said that the heart needed to be transplanted within four hours of collecting it from the donor. The flight from Bengaluru to Kolkata took three hours.

At about 11.10 am the heart was taken out of the airport in Kolkata and then with the help of police authorities, it reached at the hospital in time.

Fortis officials had sought help from the state health department which in turn took the help of Bidhannagar Police Commissionerate had made arrangements for a green corridor for the ambulance carrying the heart and the doctors from the airport to Fortis Hospital. DCP (HQ) of Bidhannagar Police Commissionerate Amit Javalgi said that as soon as hospital authorities had told them about it, a pilot car escorted the ambulance and helped cover 18 kilometres in under 20 minutes.

The heart transplant was conducted under the supervision of Dr KR Balakrishnan, director, cardiac sciences and Dr Suresh Rao, chief cardiac anaesthetist from Fortis Malar Hospital in Chennai.

The team of doctors, who performed this surgery, included Dr Tapas Raychaudhury, director, cardio thoracic and vascular surgery, Dr KM Mandana, director, cardio thoracic and vascular surgery, and Dr Saikat Bandopadhyay, senior consultant, cardiac anesthesiologist and intensivist from Fortis Hospital, Anandpur.

Dr Raychaudhury said, “It is the first of its kind operation in eastern India. It is a history. Doctors from Chennai went to Bengaluru to collect the heart of a brain dead person. Then it is flown into Kolkata to be transplanted into a patient in Kolkata. It had never happened before,” he said.

The surgery began at about 12 noon and continued for three hours. After the surgery, doctors interacted with media persons and said they were happy about the operation which was a success but still the patient needed to be kept under supervision for 3-4 days.

“The patient is fine. Almost four hours have passed. He is stable, conscious. It was challenging because arranging the organ and transplanting here. Logisitics-wise it was challenging. We need to take care of the post operation heart surgery so that there is no infection,” said Dr Mandana

Dr Raychaudhury said that it was a pity that while in places like Bengaluru on an average two persons come ahead for organ donation every day in West Bengal there is a queue of 35,000 patients who are awaiting donors for a second lease of life.

Doctors said both the donor and the recipient being young, having more or less the same body weight and same blood group (A+), helped in the process.

Family members of Dilchand had registered his name for a transplant in 2016 and it could be done in not less than two years. Belonging to a below poverty level family, Dilchand was supported financially by the hospital.

Source: http://www.dnaindia.com/health/report-heart-travels-from-bengaluru-to-kolkata-hospital-under-four-hours-for-successful-transplant-2617423

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New smartphone-based tool may aid patients detect urine blockage

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Surgeons are developing a new smartphone-based tool that can detect urethral or urine blockage, potentially making it easier for patients to test themselves for the condition from the comfort of their own homes.

The novel technique could take high-speed photography which could capture subtle differences between a normal steady stream of liquid and a stream of liquid with an obstruction.

Urethral strictures are a slowing or blocking of the natural flow of urine due to an injury or infection. It is normally diagnosed by uroflowmetry, a test administered at a physician’s office.

“The problem is that patient follow-up after we treat this condition is very poor,” said Matthew Gretzer, Associate Professor at the University of Arizona in the US.
“But we need patients to come back to our clinic for a uroflow test to determine if the obstruction is still present,” he added.

In order to test Gretzer’s hypothesis on high-speed photography, the team created a model of a urethral structure using tubing hooked to a saline bag that could drain through.
Saline fluid was passed through the tubing with and without blockages, created using 3D printed strictures,placed within the tubing. High-speed photography captured both the regular and blocked stream of liquid exiting the tube.

Gretzer contended that photos can be a medium to diagnose blockages and he hopes that patients could send him these images to analyse and make the diagnosis. He plans to create a mobile app which can be downloaded by the patients.”All patients would need to do is take high-speed images of their urine flow using a strobe light,” Gretzer said.

“Strobe light apps are readily available right now for people to use on their phones”.
According to the researchers, as fluid exits an opening, a natural breakpoint occurs where the liquid stream forms droplets, but with obstructions in place, it changes.
The results showed that by analysing photos, they could measure the length to this point of droplet formation. This length then directly related to the presence of an obstruction in the tube.

Source: http://www.thehansindia.com/posts/index/Health/2018-05-22/New-smartphone-based-tool-may-aid-patients-detect-urine-blockage/383212

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New blood test to detect liver damage in minutes

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London: Scientists have developed a quick and robust blood test that can detect liver damage before the symptoms appear.

The test developed by researchers from the University College London in the UK could address a huge need for early detection of liver disease.
It distinguishes between samples taken from healthy individuals and those with varying degrees of liver damage, researchers said.
The study, published in the journal Advanced Materials, describes the new method of detecting liver fibrosis, the first stage of liver scarring that leads to fatal liver disease if left unchecked, from a blood sample in 30-45 minutes.
“We hope that our new test could be used on a routine basis in GP surgeries and hospital clinics to screen people who face an elevated risk of liver disease, but don’t yet show signs of liver damage to identify those with serious fibrosis, so that they can access treatment before it’s too late,” said William Rosenberg, a professor at UCL.
“This may open the door to a cost-effective regular screening programme thanks to its simplicity, low cost and robustness,” he said.
Researchers at the University of Massachusetts in the US designed a sensor that uses large molecules called polymers, coated with fluorescent dyes that bind to blood proteins based on their chemical properties.
The fluorescent dyes change in brightness and colour, yielding a different pattern of fluorescence depending on the protein composition of the blood sample.
The team at UCL tested the sensor by comparing results from small blood samples (equivalent to finger-prick checks) from 65 people, in three balanced groups of healthy patients and those with early-stage and late-stage fibrosis.
They found that the sensor could identify different patterns of protein levels in the blood serum of people in the three groups.
“By comparing the different samples, the sensor array identified a ‘fingerprint’ of liver damage,” said William Peveler, who completed the research at UCL.
“This method is known as a chemical nose, as it can recognise the difference between healthy and unhealthy blood samples without relying on known disease markers,” said Peveler. — PTI.

Source: http://www.tribuneindia.com/news/health/new-blood-test-to-detect-liver-damage-in-minutes/594788.html

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Don’t panic, these 2 simple measures can protect you from Nipah virus

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Simple good hygiene practices such as frequent washing of hands and cooking food properly before consuming it can help you avoid contracting the brain-damaging Nipah virus. The virus has claimed 13 lives in Kerala till now and led to quarantining of at least 40 others.

The Nipah virus is a zoonotic disease that is naturally transmitted from vertebrate animals to humans, while human-to-human transmission has also been documented. It was first identified among pig farmers in Malaysia, and the disease surfaced in Siliguri, West Bengal in 2001 and again in 2007.

Historically, the virus largely remained in a cluster, and affected those that came in close contact to the patients. The latest outbreak in India has so far affected mainly four districts of Kerala — Kozhikode, and its neighbouring districts of Malappuram, Kannur and Wayanad. People in other states do not have much to worry, unless they travel to the affected areas, or come in contact with someone who has contracted the virus.

“All the previous epidemics were reported to be in clusters and historical evidence shows no simultaneous outbreaks,” says Vidya Menon, clinical professor at the Department of Medicine, Amrita Institute of Medical Sciences, Kochi. “So people who come in close contact to the patients are usually the ones who acquire the disease. If that contact group increases or travels to other places, the disease is likely to spread,” Menon said.

Nipah virus can be transmitted by infected pigs, or by fruit bats, through their secretions of saliva, urine or faeces. The other mode of transmission is human to human, through body secretions and respiratory secretions. Contracting Nipah causes an upper respiratory infection, leading to fever, body ache, breathlessness and cough. “There is no need to panic, but if you have symptoms similar to this or if you have visited the state recently, visit a doctor at the earliest,” said Suranjit Chatterjee, Senior Consultant — Internal Medicine at the Indraprastha Apollo Hospitals, New Delhi.

Depending upon the exposure to the virus, it can also lead to further complication like Encephalitis — inflammation of the brain. This can result in mental confusion and deteriorate into a coma. “The progression is very severe. While the incubation period is long for some, in an average in 90% of cases, the disease manifests itself within two weeks of exposure to the virus,” Menon said.

“Those infected should be isolated for at least 10-15 days, till the virulence of the virus settles and our immune system also starts fighting,” says Vikas Maurya, Head of Department — Pulmonolgy, Fortis Hospital — Shalimar Bagh, New Delhi. There is no treatment as such for it but supportive care is given to the affected patients, which means treating the symptoms differently.

“For example, people suffering from fever are treated for it, for those with breathlessness, support is provided to them with artificial ventilators, and for those with seizures or convulsions, anti-epileptic drugs are given as a support to the brain,” Menon said.

The Kerala government has now recommended using the anti-viral Ribavarin as a life-saving measure. It is not a proven treatment, but is approved because of a few studies that have proved the anti-viral’s benefits. “Beginning on Thursday, the Kerala government has recommended using Ribavarin but only in proven cases,” Menon said.

Besides maintaining hygiene, experts suggest you avoid eating fruits that have any paw marks on it or is contaminated. Food should be properly cooked before consuming. Restricting mobility to and from the affected areas can curtail the virus up to some extent, Chatterjee suggested. “If you are travelling to the infected area, use a general mask. While coughing, close your mouth with a handkerchief or cough on your sleeve, wash hands properly, and maintain hygiene,” Menon said.

Source: https://www.hindustantimes.com/health/don-t-panic-these-2-simple-measures-can-protect-you-from-nipah-virus/story-Fm94arKVlVMo8ojEJ8LJzL.html

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Private hospitals will need government nod for C-section

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With an aim to encourage normal deliveries, the Centre has planned to take caesarean deliveries in private hospitals under the its National Health Protection Mission (NHPM) only if the patient is referred from a government hospital specifying reasons for the need for a C-sec surgery. The base rate of C-section under the scheme has been fixed at Rs 9,000.

A caesarean surgery is used for delivery when normal vaginal delivery poses a medical risk to the mother or the child. However, in India, caesarean deliveries have become rampant, especially in private hospitals indicating commercialisation of deliveries.

“Caesarean sections will only be allowed in private hospitals under the scheme after they are referred there from public hospitals specifying the reasons, which could be bed or human resource shortage or other issues,” said Indu Bhushan, CEO of Ayushman Bharat National Health Protection Mission.

He said normal deliveries will not be covered under the scheme, which aims to provide a coverage of Rs 5 lakh per family annually and benefits more than 10 crore families belonging to the poor and vulnerable sections of the society.

“According to WHO, the ideal rate of C-section is 10-15 per cent for a country, but in India, caesarean deliveries have become rampant especially in private hospitals indicating commercialisation of deliveries,” he said.

According to the National Family Health Survey-4 (2015-16) data released by the Union health ministry in May last year, private hospitals carried out 40.9 per cent of caesarean sections as compared to 11.9 per cent performed in government health institutions.

The Centre has included 1,354 packages in the scheme and rates for over 20 specialties, including orthopaedics, cardiology, cancer and neurosurgery are included in the package.

The rates of packages have been finalised after analysing the Rashtriya Swasthya Bima Yojana (RSBY) and CGHS rates and are on an average 15-20 per cent lower than that of CGHS, Bhushan had said.

DELIVERY NOTES
As per WHO, the ideal rate of C-section is 10-15% for a country, but in India, C-section has become rampant. 
National Family Health Survey-4 (2015-16) data says private hospitals performed 40.9% C-sections & govt hospitals 11.9%

Source: http://www.dnaindia.com/health/report-private-hospitals-will-need-govt-nod-for-c-section-2619455

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