Category Archives: Awareness Day/Month

Autism Awareness Month: The Challenges and Promises of Childhood Neurodisability

Awareness Day/Month

Autism is a serious, lifelong developmental disability characterized by considerable impairments in social interactions and communication skills, as well as a restricted/repetitive pattern of interests and/or behaviors. The term autism is also confused with the other autism spectrum disorder (ASD) including classic autism, Asperger syndrome and high-functioning autism. Autism used to be considered rare, but it is increasingly recognized as a relatively common condition.
Both genetic and epidemiological research findings have forced a change in concept as a result of the evidence that autistic like abnormalities are common and often occur in individuals with normal intelligence, particularly in first degree relatives of individuals with autism.

Autism and other forms of disability are part of the human experience that contributes to human diversity. An integral approach in the design, implementation, monitoring and evaluation of policies and programme in all political, economic and societal spheres, so that inequality is not perpetuate

Neurodevelopment Course of Autism at a Glance

  • Recent neurobiological data suggests that autism is caused by late disruption of the central nervous system (CNS) just prior to birth, perinatally, or postnatally.
  • The limbic system plays a significant role in various aspects of emotion, memory and learning, and motivation. Studies indicate that the neural cells of the limbic system in autism are small in size and more densely packed per unit volume as compared with age and sex-matched controls.
  • The second major area of abnormality found was in the cerebellum and its many circuits and interconnections. Basically they found a substantial loss of Purkinje cells throughout the cerebellum, especially in the posterior regions. The loss of Purkinje cells helps establish the timing of the abnormalities.

 

Reader’s Interest

  • Autism is one of the fastest-growing developmental disorders in the U.S.
  • Autism costs a family $60,000 a year on average.
  • There is no medical detection or cure for autism.
  • Total 2012 National Institute of Health (NIH) budget: $30.86 billion, only $169 million goes directly to autism research. This represents 0.55% of total NIH funding.
  • ASD is reported to occur in all racial, ethnic, and socioeconomic groups.
  • ASD is about 4.5 times more common among boys (1 in 42) than among girls (1 in 189).
  • The total costs per year for children with ASD in the United States were estimated to be between $11.5 billion – $60.9 billion.

 

Symptoms

The characteristic behaviors of ASD may be apparent in infancy (18 to 24 months), but they usually become clearer during early childhood (24 months to 6 years). The National Institute of Child Health and Human Development (NICHD) lists five behaviors that warrant further evaluation:

  • Does not babble or coo by 12 months
  • Does not gesture (point, wave, grasp) by 12 months
  • Does not say single words by 16 months
  • Does not say two-word phrases on his or her own by 24 months
  • Has any loss of any language or social skill at any age?

2 % of children in the U.S. are living with autism. The earlier they have access to care, services and treatment, the more likely they are to progress

Diagnosis Tests

Early identification is associated with dramatically better outcomes for people with autism. The Centers for Disease Control and Prevention’s (CDC) National Center on Birth Defects and Developmental Disabilities (NCBDD) recommends that all children be screened for autism by their family pediatrician three times by the age of 3, 9, 18, and 24 or 30 months. Treatment should start when an autism diagnosis is suspected, rather than when a formal diagnosis is made.

  • Behavioral assessments: Guidelines and questionnaires are used to help a doctor determine the specific type of developmental delay.
  • Diagnostic guidelines for autism: The American Association of Childhood and Adolescent Psychiatry (AACAP) have established guidelines for diagnosing autism. The criteria are designed so a doctor can assess a child’s behavior relating to core symptoms of autism such as:
    • Clinical observations: The parents may be asked to interpret whether certain developmental delayed behaviors are usual for the child in those circumstances.
    • Developmental and intelligence tests: To evaluate whether a child’s developmental delays affect his or her ability to think and make decisions.
    • Physical examination: Head circumference, weight, and height measurements, to determine whether the child has a normal growth pattern.
    • Hearing tests: To determine whether hearing problems may be causing developmental delays, related to social skills and language use.
    • Testing for lead poisoning: Children with developmental delays usually put items in their mouth after this stage has passed in normally developing children, which should be identified and treated.
    • Chromosomal analysis, if intellectual disability is present or there is a family history of intellectual disability.
    • An electroencephalograph (EEG), if there are symptoms of seizures, such as a history of staring spells or if a person reverts to less mature behavior (developmental regression).
    • Magnetic Resonance Imaging, if there are signs of differences in the structure of the brain.

 

According to Volkmar et al., Autism Spectrum may be distinguished from autism and pervasive developmental disorder- not otherwise specified (PDD-NOS) on the basis of higher verbal IQs, greater social deficit, higher rates of the disorder in first-degree relatives, and different patterns of co-morbidity, especially higher rates of depression.

Risk Factors

  • In identical twins, if one child has ASD, then the other will be affected about 36-95% of the time whereas in non-identical twins, if one child has ASD, then the other is affected about 0-31% of the time.
  • Almost half (about 44%) of children identified with ASD has average to above average intellectual ability.
  • A small percentage of children who are born prematurely or with low birth weight are at greater risk for having ASD.
  • ASD commonly co-occurs with other developmental, psychiatric, neurologic, chromosomal, and genetic diagnoses.
  • Children born to older parents are at a higher risk for having ASD.

The best evidence suggests that early, intensive behavioral and educational interventions can improve outcomes for many children with ASD. While there are no medications that target the primary social or repetitive behavior symptoms

Research Gaps

  • Following the emphasis on early identification and early intervention, question has been arising what are the earliest emerging signs of autism? what are the internal and external factors associated with outcomes? What are the emerging early intervention approaches for which the best evidence-base exists? Despite the increase in well-controlled intervention studies, further such trials are required to improve the evidence-base for established and newer interventions.
  • Only recently have longitudinal studies begun to examine the trajectories of social development beyond midchildhood into adolescence and adulthood.
  • Mechanistic studies that employ experimental and neuroscientific methodologies, where possible embedded within genetic and familial designs, are required to elucidate the neurodevelopmental processes that lead to the social difficulties in autism.
  • Such studies will also help us to understand the associations between social difficulties and common comorbidities in adaptive function, sensory difficulties and mental health problems.

 

Current research: Holds new hope for the treatment of autism

  • Researchers have identified a number of genes associated with the disorder and brain-imaging studies have found differences in the development of several regions of the brain. Findings suggest that ASD can result from disruptions in genes that control aspects of brain development or control how brain cells communicate with each other.
  • New and novel approaches began enrolling participants in a clinical trial to test oxytocin (via a nasal spray) for individuals with autism. For nearly 10 years, there have been studies showing that administering oxytocin, a medication and hormone used to start and increase the speed of labor in pregnancy, may change response to social cues in the laboratory setting.
  • The clinical trial at NewYork-Presbyterian (NYP/Westchester Division), which will test individuals between the ages of 3 and 17, will evaluate whether oxytocin may offer benefit as a potential treatment for those on the autism spectrum, while paying careful attention to whether oxytocin is safe for repeated administration.
  • The currently available instruments like Autism Diagnostic Interview – Revised, Autism Diagnostic Observational Schedule, and Childhood Autism Rating Scale are not specific to these criteria. So, there is also a need to develop an instrument with high fidelity to international classification of diseases (ICD-10)/ diagnostic and statistical manual of mental disorders (DSM-IV) description/criteria

Turacoz Healthcare Solutions is passionate to spread the awareness on such social or healthcare related issues as a part of their Corporate Social Responsibility (CSR) activity. CSR is at the very heart of everything we do at Turacoz. It is exclusive in a way we deal with our communities, our people, our clients and our environment. Our medical writing team is well versed with recent advances in various therapeutic areas which give them a head start in various publication, clinical research and regulatory writing projects.

World Parkinson’s Disease Day: Shatter the Myths with Hope

Awareness Day/Month,

World Parkinson’s Disease Day: 11th April, 2016:

World Parkinson’s disease day is celebrated every year on 11th April to commemorate Dr. J Parkinson on his birthday. He was the first to describe the disease in “An Essay on the Shaking Palsy”, as a disorder with a pattern of lessened muscular power and involuntary tremulous motion. On this day, efforts are made to increase the public awareness of this terrible disease.

 

What Is Parkinson’s Disease?

Parkinson’s disease (PD) is a neurodegenerative disorder which affects the nerve cells in the brain that produce dopamine. As a result, these nerve cells are reduced in numbers. As cell death spreads to larger parts of the brain more centers are affected which results in an aggravated motor and non-motor functional impairments. It is a progressive disorder and the symptoms gradually worsen.

Symptoms of PD begin gradually, often on one side of the body and later, they affect both sides of the body. The disease is characterized by:

  • Trembling of hands, arms, legs, jaw and face
  • Stiffness of the arms, legs and trunk
  • Slowness of movement and trouble in walking and/or talking
  • Poor balance and coordination
  • Sleep problems and depression

People with the disease may have trouble doing simple tasks as the symptoms get worse. They may also have trouble chewing, swallowing, or speaking.

 

Screening and Diagnosis

PD usually begins around age 60, but it can start earlier. It is more common in men than in women. There is no laboratory test for PD, so it can be difficult to diagnose. Doctors use a medical history and a neurological examination to diagnose it. There is no cure for PD

 

Lifestyle Remedies and Health Care Solution

  • Exercise: It may increase your muscle strength, flexibility and balance. Exercise can also improve your well-being and reduce depression or anxiety
  • Medications: They may help you manage problems with walking, movement and tremor. Medications can help control the PD- symptoms by substituting/increasing for dopamine in the brain.
  • Healthy diet: A balanced diet provides nutrition. Foods such as fish which contain omega-3 fatty acids are also recommended for persons with PD.
  • Training for daily activities: An occupational therapist can show techniques that make daily life easier.
  • Be careful while walking: At later stages of the disease, movement can become difficult. Distribute your weight evenly between both feet, and don’t lean. Avoid walking backward.

 

Create Awareness to Find a Cure:

Many people are not fully aware of how to identify PD. In the interest of promoting awareness of this disease, we can:

  • Organize larger events at local parks, or even with local schools for the cause of PD
  • Work together to create a day where there are educational courses about the disease
  • Arrange for musical performances, conduct marathons and walk-a-thons to help generate donations to support the ongoing research into this condition.
  • Work together with friends and family to help organize refreshment stands or bake sales to produce more funds to donate to research groups

Turacoz Healthcare Solutions is committed to spread the awareness on such social or healthcare-related issues as a part of their Corporate Social Responsibility (CSR) activity. Our medical writing team is well-versed in various therapeutic areas which gives them a head start in various publication, clinical research and regulatory writing projects.

World Tuberculosis Day: Present Scenario and Future Prospects

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Tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium tuberculosis. It usually affects the lungs (pulmonary TB), but can affect other sites as well (extra-pulmonary TB). The disease usually spreads through air, for example by coughing. Overall, a relatively small proportion (5–15%) of the people infected with M. tuberculosis will develop TB disease during their lifetime.

World TB Day is celebrated every year on March 24 to commemorate Dr. Robert Koch, who announced his discovery of M. tuberculosis, on the same date in the year 1882

Incidence:

  • There were an estimated 9.6 million incident cases of TB globally, equivalent to 133 cases per 100,000 populations in the year 2014.
  • India, Indonesia, and China had the largest number of cases: 23%, 10% and 10% of the total cases, respectively.
  • An estimated 480,000 people developed multidrug-resistant TB (MDR-TB) globally in 2014.
  • The absolute number of incident cases has fallen over last few years; an average rate of reduction was 1.5% per year between 2000 and 2014, and 2.1% between the year 2013 and 2014. The cumulative reduction in the TB incidence rate from 2000 to 2014 was 18%.

Co-epidemics of TB and HIV

  • The probability of developing TB is much higher among people infected with human immune-deficiency virus (HIV).
  • Out of 9.6 million incident TB cases in 2014, there were approximately 1.1–1.3 million (11–13%) people living with HIV.
  • Almost three-quarters of these cases were noted in the African Region.

Mortality:

  • In the absence of treatment, the death rate of TB is very high.
  • There were an estimated 1.5 million TB deaths in 2014, including 0.4 million among people who were HIV-positive.

Treatment:

  • Effective drug molecules for TB were first developed in the 1940s. The most effective first-line anti-TB drug, rifampicin, became available in the 1960s.
  • The currently recommended treatment for new cases of drug-susceptible TB is a six-month regimen of four first-line drugs: isoniazid, rifampicin, ethambutol, and pyrazinamide.
  • MDR-TB, defined as resistance to isoniazid and rifampicin (the two most powerful anti-TB drugs), requires more expensive and more toxic drugs such as kanamycin, levofloxacin, cycloserine etc.
  • The duration of the current regimen recommended by World Health Organization (WHO) for MDR-TB is 20 months; however, treatment success rate is much lower for most patients with MDR-TB.

 

In 2014, the cost per patient treated for drug-susceptible TB ranged from US$ 100−500 in most countries with a high burden of TB. The cost per patient treated for MDR-TB was typically US$ 5000−10,000.

Between 2000 and 2014, TB treatment alone saved an estimated 35 million lives among HIV-negative people. Among HIV-positive people, TB treatment supported by anti-retroviral therapy (ART) saved an additional 8.4 million lives.

Research Pipeline

  • WHO has issued an interim guidance on the use of bedaquiline (in 2013) and delamanid (in 2014), two new drugs that have recently been recommended for the treatment of MDR-TB under specific conditions.
  • Additionally, eight new or re-purposed anti-TB drugs are in advanced phases of clinical development; some new chemical entities are discussed below:
    • For the first time in six years, an anti-TB drug candidate (TBA-354) was in Phase I testing. However, on 11 March 2016, TB Alliance announced discontinuation of the clinical development program of TBA-354 based on its safety and pharmacokinetic data.
    • PA-824 (pretomanid), currently in Phase II, is a potential cornerstone of future TB and drug-resistant TB treatment regimens.
    • Sutezolid (PNU-100480) and SQ109 are under development for the treatment of both drug-resistant and sensitive tuberculosis, and are currently in early Phase II testing.
  • Recent observational studies of the effectiveness of short-term regimens for MDR-TB in Niger and Cameroon found that a 12-month regimen (instead of current 20 months) was effective and well-tolerated in patients not previously exposed to second-line drugs.
  • Currently, there are 15 vaccines in Phase I or Phase II trials. However, for the time being, a vaccine that is effective in preventing TB in adults remains elusive.

Turacoz Healthcare Solutions is committed to spread the awareness on such social or healthcare-related issues as a part of their Corporate Social Responsibility (CSR) activity. Our medical writing team is well-versed with recent advances in various therapeutic areas which gives them a head start in various publication, clinical research and regulatory writing projects.

Colorectal Cancer – Spreading Awareness

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Overview : Colorectal cancer is the abnormal growth of cells in the colon or rectum (parts of the large intestine) that has the ability to invade or spread to other parts of the body. Over 95% of colon cancers are adenocarcinomas and usually begin as polyp in the inner-lining of the colon or rectum.

Other names: Colon cancer, rectal cancer, or bowel cancer

Symptoms: The symptoms of colon cancer vary depending on the location of the tumor within the colon. Following are the symptoms of colon cancer:

  • Rectal bleeding or blood in the stool
  • Dark-colored stool
  • Change in bowel movements
  • Change in stool consistency
  • Constipation
  • Diarrhea
  • Narrow stools
  • Weight loss

Risk Factor: Although colon cancer is non-contagious, several environmental and inherent risk factors are responsible for the development of this cancer. Some common risk factors associated with colon cancer are:

  • Increasing age
  • Excessive alcohol use
  • Obesity
  • Being physically inactive
  • Cigarette smoking
  • History of inflammatory bowel disease
  • Geneticmutations
  • Colorectalpolyps
  • Family history of colorectal cancer

 

Diagnostic tests and Examination:

  • High-sensitivityfecal occult blood test (FOBT) : It checks for hidden (occult) blood in the stool (feces). The test does not directly detect colon cancer, but is often used in clinical screening for the cancer. FDA approved two types of FOBT: Guaiac (GFOBT) and Immunohistochemical (IFOBT) to detect heme. Studies have shown that early detection using GFOBT can reduce the number of deaths due to colorectal cancer by 15 to 33%.
  • Sigmoidoscopy : Sigmoidoscopy is a procedure performed using a shorter flexible scope to examine just the sigmoid colon and rectum. Polyp removal and cancer biopsy can be performed through the sigmoidoscope. Studies have shown that people who have regular screening with sigmoidoscopy after age 50 years have a 60 to 70% lower risk of death due to cancer of the rectum.
  • Colonoscopy : Colonoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue is used to examine the rectum and entire colon. Colonoscopy is generally considered to be more accurate than barium enema X-rays, especially in detecting small polyps. If colon polyps are found, they are removed through the colonoscope and sent to the pathologist. Studies suggest colonoscopy reduces deaths from colorectal cancer by about 60 to 70%.
  • Barium enema X-ray : When colon cancer is suspected, lower gastrointestinal (GI) series (barium enema X-ray) is performed to confirm the diagnosis and locate the tumor. The barium outlines the large intestines on the X-rays. Tumors and other abnormalities appear as dark shadows on the X-rays.
  • Advanced stool DNA technique/Cologuard ®   : This test is an advanced stool DNA technique that detects altered DNA and/or hemoglobin in cancer cells. This is done through identifying nine DNA biomarkers in three genes that have been found in colorectal cancer and precancerous advanced adenomas. People identified as positive with this test are advised to undergo a colonoscopy.

 

Prevention:

  • Early detection and removal of precancerous colorectal polyps before they turn into cancerous. Even in cases where cancer has already developed, early detection still significantly improves the chances of a cure by surgically removing the cancerous polyps before the disease spreads to other organs. Screening has the potential to reduce colorectal cancer deaths by 60%.
  • Regular physical activity is associated with lower risk of colon cancer, but not rectal cancer.
  • Current dietary recommendations to prevent colorectal cancer include increasing the consumption of whole grains, fruits and vegetables, and reducing the intake of red meat.
  • Use of medications such as aspirin also appears to lower the risk of colon cancer. The use of combined estrogen and progesteronein hormone replacement therapy lowers the risk of colon cancer in postmenopausal women.

 

Management: Depends on various factors, including the person’s health and preferences and most importantly the stage of the tumor. When colorectal cancer is caught early, surgery can be curative however, when it is detected at later stages this is less expected and the treatment is often directed at palliation, to relieve symptoms caused by the tumor and keep the person as comfortable as possible.

  • Surgery: If the cancer is detected at a very early stage, it may be removed during a colonoscopy. This can either be done by an open laparotomy or sometimes laparoscopically. The colon may then be reconnected or a person may have a colostomy. Robotic surgery, where a surgeon sits at a control panel and operates very precise robotic arms to perform the surgery. This type of surgery is also being studied to see if it is effective as standard surgery.
  • Chemotherapy: In colon and rectum cancer, chemotherapy can be used in addition to surgery in certain cases. The decision to add chemotherapy in management depends on the stage of the disease. New ways to combine drugs already known to be active against colorectal cancer, such as irinotecan and oxaliplatin, to improve their effectiveness.
  • Radiation therapy: Patients who have previously been treated with chemotherapy, there is evidence that selective internal radiation therapy (SIRT) can prolong time to progression of non-resectable colorectal metastases in the liver.Radiotherapy decreases 50% of recurrence of rectal cancer, improves quality of life and increases survival by 6-12 months for patients with advanced disease.
  • Palliative care: Palliative care is medical care which focuses on treatment of symptoms with serious illness for improving the quality of life. It is recommended for a person who has advanced colon cancer.

 

Latest in Colon Cancer Research

Current research into cancer immunology may lead to advances in gene therapy and prognostic markers may be useful in identifying those tumors with a high recurrence rate:

  • Colorectalpolyps and tumors can release cells and DNA into the bloodstream as well as into stool. Researchers are studying whether the presence of an altered geneSEPT9 in blood can be used to screen for early-stage colorectal cancer.
  • New approaches which avoid the need for thorough cleansing of the colon, required for ‘virtual colonoscopy’, are being studied and developed. One approach is ‘fecal tagging’ with a contrast agent that is ingested over several days before the procedure. This technique is known as electronic cleansing (EC) which allows fecal material in the colon to be differentiated from colon tissue and aids in removing fecal material that is tagged by the agent.
  • Following lab tests OncotypeDx™ Colon Cancer Assay, ColoPrint™, and ColDx™ were developed to help predict the recurrence of colorectal cancer even after treatment.
  • Colorectal cancers that have gene changes known as microsatellite instability (MSI) have been found to be more likely to respond to the anti-PD-1 drug pembrolizumab (Keytruda®). A large phase II registration study (KEYNOTE-164) is ongoing to evaluate the efficacy and safety of pembrolizumab based on MSI status in patients with previously treated advanced colorectal cancers, and a phase III study (KEYNOTE-177) in a treatment naive patient population is also planned.

 

Did You Know?

  • March is colon cancer awareness month and doctors across the country are trying to remind patients the importance of screening for cancer.
  • As per WHO, colon cancer is the third most common cancer in men (10.0% of the total) and the second in women (9.2% of the total) worldwide.
  • Colon cancer risk is tied to red meat consumption. European study reported that 478,000 men and women found those who ate about five or more ounces of red meat per day were about 33% more risk to develop colon cancer.
  • Research has shown that aspirin, fish oils, aloe vera garlic, ginger and vitamin D have strong protective influence. All these should be in your diet.
  • Japanese research has strongly implicated salt as a major cause. Doubling your salt intake doubles your risk.
  • It is the second leading cause of cancer-relatedmortality in the United States. In 2014, 136,830 individuals were newly diagnosed with colorectal cancer and 50,310 colorectal cancer deaths in the United States.
  • Over the past decade, colorectal cancerincidence and mortality rates have decreased in all racial/ethnic populations except American Indians/Alaska Natives.
  • The incidence rates of cancer in men and women are similar <40 years’ age and at and above age 40 years, rates are higher in men.

World Glaucoma Week

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World Glaucoma Week (March 6-12, 2016) : Be Informed, Be Safe

Each year the World Glaucoma Association (WGA) and the World Glaucoma Patient Association (WGPA) come together to raise awareness about Glaucoma across the world. This joint initiative of WGA and WGPA is marked as “World Glaucoma Week” which is observed from March 6-12 each year worldwide.

What is Glaucoma?

‘Glaucoma’ is a group of progressive optic neuropathies that damage the optic nerve thereby resulting in degeneration of retinal ganglion cells, vision impairment, and blindness. Though unusually high intraocular pressure is been identified as the most common cause for glaucoma, yet this may not always be the case. The two most prevalent types of glaucoma are primary open-angle glaucoma (diagnosed in 90% of cases) and closed angle glaucoma. The common symptom of open angle glaucoma is a gradual loss of peripheral vison (generally in both eyes) which progresses to having a tunnel vision. Whereas, eye pain, blurred vision, nausea and vomiting, vision issues in low light, halos around light sources and red eyes are the common symptoms of closed angle glaucoma.

What is the Global Burden of Glaucoma?

Worrisome is the fact that most of the time onset of glaucoma (particularly in open angle glaucoma) are asymptomatic and disease go unnoticed by patients and healthcare professionals until it progresses to advance stages. Due to the silent nature of the disease, glaucoma is often labelled as ‘silent thief of sight’. It is worth mentioning that, glaucoma is the second leading cause of blindness globally, after cataract. The silent nature of the disease and rapid progression adds up to the global prevalence of glaucoma. In the year 2010, about 60 million people were found to be affected by glaucoma globally, and it is expected that the toll will rise up to 79 million people worldwide by 2020.

Who is at risk of having Glaucoma?

Even though glaucoma can affect any individual, but the risk increases if the individual is; over 60 years of age, have a family history of glaucoma, African Americans or Mexican American, uses steroids, have diabetes, high blood pressure and hypothyroidism, and other eye conditions.

What are the treatment Options?

Treatment of glaucoma varies according to the type of glaucoma, patient history, and advancement of the condition. Usually, the healthcare professional may prescribe medical interventions like; prostaglandins, beta blockers, carbonic anhydrase inhibitors, cholinergic or miotic agents, and alpha-adrenergic agents to relive intraocular pressure. Surgery is considered as therapeutic options if the drugs are not well-tolerated by the patient or if drugs fail to stop the progression of the disease. In such cases, healthcare professionals opt for surgeries like; trabeculoplasy, viscocanalostomy, and aqueous shunt implant.

What are the Preventive Measures?

Even though glaucoma cannot be prevented, but early screening and management of symptoms do reduces the advancement of disease and chances of having a complication. Proper awareness about the disease increases the chances of glaucoma getting a screening in its earlier stage thereby helping healthcare professionals in the timely management of the condition and preserving eyesight of the patient. Regular eye check-ups are recommended in the high risk group. It is also recommended that an individual should immediately consult a health care professional if anything unusual is observed in vision.

What should be done to Spread Awareness about Glaucoma?

‘Awareness is the first step for prevention’, and spreading awareness about glaucoma is anticipated to considerably lower the global burden of disease and associated blindness. World Glaucoma Week is one such initiative to aware masses about glaucoma.  The World Glaucoma Association (WGA) and the World Glaucoma Patient Association (WGPA) runs a week long awareness campaign to make people aware about the disease. It is recommended that healthcare professionals should involve their glaucoma patients as they organize a screening event in their local institute/hospital, should give a lecture to a patient support group, should participate in radio & TV shows to talk about glaucoma and to answer questions, and should contact newspapers to publish information about glaucoma. Additionally, all the health care professional are also suggested to run public health campaigns, eye checks up camps, and patient education classes for the high risk group. As a member of healthcare industry, we all should actively take up the responsibility to spread awareness about glaucoma in our own way. Remember to be informed is to be safe!

World Kidney Day – Kidney Disease & Children Act Early to Prevent It!

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World Kidney Day (WKD) is a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF). The first campaign was initiated ten years ago. Since then, the day is observed every year to raise public awareness of kidney diseases which affect millions of people worldwide, including children who may be at risk of kidney disease at an early age.

Fast Facts:

  • 10% of the global population is affected by kidney disease, and it claims the lives of millions of people each year.
  • Acute kidney injury (AKI) develops in children when red blood cells are destroyed and block the kidneys’ filtering system, or due to trauma such as burns, dehydration, bleeding, injury or surgery.
  • Chronic kidney disease (CKD) in children can be caused by birth defects.
  • A person can lose up to 90% of kidney function before experiencing any signs of CKD.
  • From birth to age 4, birth defects and hereditary diseases are the leading causes of kidney failure.
  • The majority of children with kidney disease progress to end-stage kidney diseases in adulthood.

Mission Statement

The mission of World Kidney Day is to educate people about the importance of our kidneys to our health and to reduce the frequency of kidney disease and its associated health problems worldwide.

Kidney Disease & Children. Act Early to Prevent It

This year’s World Kidney Day campaign emphasizes the importance of following kidney function and blood pressure in children and babies. Kidney disease can affect children in various ways, ranging from treatable disorders without long-term consequences to life-threatening conditions. It is our responsibility to encourage education, early detection and a healthy lifestyle in children, starting at birth and continuing through to old age, to combat the increase of preventable kidney damage including acute kidney injury (AKI) and chronic kidney disease (CKD) and to treat children with inborn and acquired disorders of the kidney.

Objectives of World Kidney Day

  • Raise awareness about our “amazing kidneys”
  • Highlight that diabetes and high blood pressure are key risk factors for CKD
  • Encourage preventive behaviors and systematic screening of all patients with diabetes and hypertension for CKD
  • Educate all the doctors and health care professionals about their key role in detecting and reducing the risk of CKD, particularly in high risk populations
  • Emphasize the important role of local and national health authorities in controlling the CKD epidemic.

What can you do for your kidneys?

Kidney diseases are silent killers and largely affect the quality of life. There are a few easy ways to reduce the risk of developing kidney disease.

  • Keep fit and active: Physical activities and exercises help you to keep fit. This will reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease.
  • Check your blood sugar level: People who have diabetes are more likely to develop kidney damage, so it is important for all to have regular tests for blood sugar level to check their kidney functions. Kidney damage from diabetes can be reduced or prevented if detected early. Keeping control of blood sugar levels with the help of doctors or pharmacists is very important.
  • Monitor your blood pressure: High blood pressure is also the most common cause of kidney damage. High blood pressure is especially likely to cause kidney damage when associated with other factors like diabetes, high cholesterol and Cardio- Vascular Diseases. The normal blood pressure level is 120/80. Between this level and 139/89, you are considered pre-hypertensive. At 140/90 and above, you need to consult your doctor and monitor your blood pressure level regularly.
  • Eat healthy and keep your weight under control: This can help many conditions associated with Chronic Kidney Disease such as diabetes and heart diseases. Reduce your salt intake. The recommended sodium intake is 5-6 grams of salt per day (around a teaspoon). Limit the amount of processed and restaurant food and do not add salt to food. Prepare the food yourself with fresh ingredients.
  • Maintain a healthy fluid intake: To maintain good health, one should consume 1.5 to 2 litres of water per day. Consuming plenty of fluid helps the kidneys clear sodium, urea and toxins from the body which, in turn, results in a “significantly lower risk” of developing chronic kidney disease. Moderately increased water intake may reduce the risk of decline in kidney function. The right level of fluid intake for any individual depends on many factors including gender, exercise, climate, health conditions, pregnancy and breast feeding. People who have had a kidney stone are advised to drink 2 to 3 litres of water daily to lessen the risk of forming a new stone.
  • Quit smoking: Smoking slows the flow of blood to the kidneys, which impairs their function Smoking increases the risk of kidney cancer by about 50 percent.
  • Do not take over-the-counter pills on a regular basis: Common drugs such non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney dysfunction if taken regularly. Such medications probably do not pose significant danger if your kidneys are relatively healthy and you use them for emergencies only, but if you are dealing with chronic pain, such as arthritis or back pain, ask your doctor to control your pain without putting your kidney at risk.

 

#WorldAIDSday- Getting to Zero

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World AIDS Day, 1 Dec was first declared by the World Health Organization and the United Nations General Assembly in 1988. Since then, it has progressively become one of the most successful ‘international days’ for raising awareness on a global issue.  Globally there are an estimated 34 million people who are infected with the HIV virus. Despite the virus only being identified in 1984, more than 35 million people have died of HIV or AIDS, making it one of the most destructive pandemics in history.

The day is marked by activities to unite people in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. Each year this day is observed with a different theme that focuses on diverse but significant dimension of AIDS. For year 2015, the theme is, “The Time to Act Is Now,” which calls us to act with urgency to implement the latest high-impact, evidence-based HIV prevention strategies.

Where do we stand?

In spite of years of sincere efforts by global healthcare organizations to generate awareness about AIDS, each year thousands of people are diagnosed with HIV. The possible reason for high incidence of AIDS could be that the people do not know the facts about how to protect themselves and others and stigma and discrimination for people living with the condition. World AIDS Day is important because it reminds the public and Government that HIV has not gone away – there is still a vital need to raise money, increase awareness, fight prejudice and improve education. World AIDS Day is an opportunity to show support to and solidarity with the millions of people living with HIV.

World fights AIDS

As a science-based public health and disease prevention agency, centers for disease control and prevention (CDC) provides support that helps more than 60 countries including India strengthen their national HIV/AIDS programs and build sustainable public health systems. CDC conducts these activities through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Recent scientific breakthroughs now point the way to achieving an AIDS-free generation, a goal championed by President Obama in his 2013 State of the Union address. CDC, through PEPFAR, is working to achieve that inspiring goal through proven science, smart investments, and shared responsibility with partner countries. Global efforts have resulted in approximately 13.5 million persons in low-income and middle-income countries receiving antiretroviral therapy (ART) for HIV infection in 2014, an increase from 2013. Globally, more than 15 million people are on ART.

CDC’s core activities focus on:

  • Providing proven combination prevention interventions, including prevention of mother-to-child HIV transmission, antiretroviral treatment, and voluntary medical male circumcision.
  • Reaching orphans and vulnerable children, as well as other neglected and hard-to-reach populations.
  • Building and enhancing health systems, including sustainable human resources for health (e.g., health care workers) and accurate, reliable laboratory systems.

India fights AIDS

Conducting outreach and communication campaigns through the Act against AIDS initiative, including the campaign Let’s Stop HIV Together, which fights stigma and seeks to ensure that all the people should know the facts about HIV.

  • Let’s Stop HIV Together includes many personal stories about living with HIV.
  • Providing training in HIV prevention and treatment.
  • Pleased to join our partners to take unified action to prevent the spread of HIV.
  • Providing funding and technical assistance for health departments.
  • Conducting surveillance and behavioural research.
  • Developing guidelines for HIV treatment, surveillance, and laboratory procedures.
  • Evaluating programs.

As an active member of healthcare industry, each one of us should take it as our moral responsibility to assist the healthcare organizations, NGOs, and social activists of our region in spreading awareness about AIDS. Theme “The Time to Act is Now,” says that everyone in the world should actively participate in teaching and guiding about HIV/AIDS to other fellow members.

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing. 

#DiabetesAwarenessMonth

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Reduce your risk today: Eat healthy, Walk more and Weigh less

Lifestyle modification for prevention of diabetes mellitus

Structured programs that emphasize lifestyle changes for preventing diabetes are recommended by the American Diabetes Association (ADA) for people at high risk for developing type 2 diabetes. These include:

  • Dietary strategies including low intake of dietary fat and reduced calories
  • Regular physical activity (150 min/week)
  • Moderate weight loss (7% body weight)

Individuals at high risk for type 2 diabetes should be encouraged to achieve the U.S. Department of Agriculture (USDA) recommendation for dietary fibre (14 g fibre/1,000 kcal) and foods containing whole grains (one-half of grain intake). Low–glycaemic index foods that are rich in fibre and other important nutrients are to be encouraged.

Medical nutrition therapy

Medical nutrition therapy (MNT) is a therapeutic approach for treatment of medical conditions and their associated symptoms via the use of a specifically tailored diet devised and monitored by a medical doctor, registered dietitian or professional nutritionist.

MNT goals for prevention of diabetes

  • Goals of nutrition therapy for individuals at risk for diabetes or with pre-diabetes

Decrease the risk of diabetes and cardiovascular disease (CVD) by promoting healthy food choices and physical activity leading to moderate weight loss that is maintained.

  • Goals of nutrition therapy that apply to individuals with diabetes
  1.  Maintenance of
  • Blood glucose levels in the normal range or as close to normal as is safely possible
  • Lipid profile that reduces the risk for vascular disease
  • Blood pressure levels in the normal range or as close to normal as is safely possible
  1. Prevention of, or decrease in, the rate of development of the chronic complications of diabetes by modifying nutrient intake and lifestyle.
  2. Consideration of individual nutrition needs and personal preferences with willingness to change.
  3. Maintenance of the pleasure of eating by only limiting food choices as indicated by scientific evidence.
  • Goals of MNT applicable to specific situations
  1. For youth with type 1 diabetes, or type 2 diabetes, pregnant and lactating women, and older adults with diabetes, meeting the nutritional needs for such specific times is important.
  2. For patients being treated with insulin or insulin-stimulating medication, self-management training is essential for safe conduct of exercise, including the prevention and treatment of hypoglycaemia, and diabetes treatment during acute illness.

Significance of weight loss in pre-diabetes and diabetic conditions

  • Weight loss is recommended for all such individuals who have or are at risk for diabetes. In obese insulin-resistant individuals, modest weight loss has been shown to improve insulin resistance.
  • Physical activity, exercise and behaviour modification are important and most helpful in reducing body-weight.
  • For weight management, either low-carbohydrate or low-fat calorie-restricted diets may be effective in the short term (up to 1 year).
  • For patients on low-carbohydrate diets, monitoring of lipid profiles, renal function, and protein intake (in those with nephropathy), and adjustment of hypoglycaemic therapy is recommended.
  • Weight loss medications may be considered in the treatment of overweight type 2 diabetes patients and can help achieve 5–10% weight loss when combined with lifestyle modification.
  • Bariatric surgery may be considered for some individuals with type 2 diabetes and BMI ≥35 kg/m2 and can result in marked improvements in glycaemia.

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing. 

#BreastCancerAwarenessMonth

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Knocking out Triple Negative Breast Cancer: A new paradigm in treatment

Triple negative breast cancer (TNBC) are the subtypes of breast cancer that are generally diagnosed based upon the presence, or lack of, three “receptors” known to fuel most breast cancers:

  • Estrogen receptors (ER)
  • Progesterone receptors (PR)
  • Human epidermal growth factor receptor 2 (HER2)

These receptor proteins are the “eyes” and “ears” of the cells, receiving messages from substances in the bloodstream and then giving instructions to the cells. The most successful treatments for breast cancer target these receptors.

About 10-20% of breast cancers test negative for both hormone receptors and HER2 in the lab, which means they are triple-negative.

Triple negative breast cancer

  • Tends to be more aggressive than other types of breast cancer
  • Tends to be at a higher grade than other types of breast cancer which makes them bear less resemblance to normal, healthy breast cells in their appearance and growth patterns
  • Cancerous cell type is mostly “basal-like” which can be linked to the family history

Hormonal therapies and HER2-targeted therapies work to interfere with the effects of hormones and HER2 on breast cancer, which can help slow or even stop the growth of breast cancer cells. A triple negative breast cancer diagnosis means that the tumour is oestrogen receptor-negative, progesterone receptor-negative and HER2-negative, thus giving rise to the name “triple negative breast cancer.” Since hormones are not supporting TNBC growth, the cancer is not likely to respond to hormonal therapies, including tamoxifen, Arimidex, Aromasin, Femara, and Faslodex. Triple-negative breast cancer also is unlikely to respond to medications that target HER2, such as Herceptin or Tykerb.

On a positive note, this type of breast cancer is typically responsive to chemotherapy. Because of its triple negative status, however, triple negative tumours generally do not respond to receptor targeted treatments. Depending on the stage of its diagnosis, triple negative breast cancer can be particularly aggressive, and more likely to recur than other subtypes of breast cancer.

New therapies in TNBC-management

  • Targeting androgen receptor in TNBC

Triple negative breast cancer is a heterogeneous disease composed of multiple subtypes and oncogenic drivers, including a subtype that may be driven by androgen receptor (AR) signalling. Enzalutamide is a potent AR -inhibitor, which significantly improves optimal strategy in metastatic castration-resistant prostate cancer and is currently being developed for patients with breast cancer who have an androgen-driven gene signature.

The AR pathway is a new target in triple-negative breast cancer in the androgen molecular subtypes. Clinical trials in molecularly selected patients should be designed to explore the combination of enzalutamide with other targeted agents such as PIK3CA (phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha) inhibitors. Enzalutamide may represent a novel therapeutic option in AR-positive patients who would otherwise receive cytotoxic chemotherapy.

  • Designing nanoparticles to counter TNBC

To overcome resistance for chemotherapy in cancer patients, nanoparticles have been engineered that carry the cancer drug doxorubicin, as well as short strands of RNA that can shut off one of the genes that cancer cells use to escape the drug. This “one-two punch” disables tumours’ defences and makes them much more vulnerable to chemotherapy. The new nanoparticles will target a protein found on the surface of triple-negative breast cancer cells and will help to change that. The nanoparticles have three components: a core filled with doxorubicin, a coating of short interfering RNA (siRNA), and an outer layer that protects the particle from degradation in the bloodstream.

Doxorubicin is already used to treat breast cancer and other cancers. It kills cells by damaging their DNA, The researchers based their nanoparticles on the drug known as Doxil, which is packaged in a liposome, or fatty membrane. To improve Doxil’s effectiveness, the researchers combined it with another type of therapy known as RNA interference (RNAi), which uses very short strands of RNA to block the expression of specific genes inside a living cell. They used a technique called layer-by-layer assembly to coat the Doxil particles with one layer of siRNA mixed with a positively charged polymer that helps to stabilize the RNA. This layer contains up to 3,500 siRNA molecules, each targeted to block a gene that allows cancer cells to pump the drug molecules out of the cells.

One of the major challenges that researchers had faced in developing RNAi for cancer treatment is getting the particles to survive in the bloodstream long enough to reach their intended targets. To overcome this, they developed the nanoparticles with an outer coating of hyaluronic acid. These molecules absorb water, allowing the nanoparticles to circulate in the bloodstream undisturbed.

Hyaluronic acid also helps to target the particles to the tumours by binding to a protein called CD44, which is found in great abundance on the surface of triple-negative breast cancer cells.

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing. 

#LiverCancerAwarenessMonth

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Liver cancer: Treatment

Liver cancer treatment is generally based on the stage of disease and the patient response to treatment. Treatment is individualized as each patient respond differently. Based on the disease stage, the size, number, tumor location, other co-morbidities, overall health and well-being, the treatment is decided. Based on the complexity of the tumor a team of specialists are associated in the treatment. The team involves surgeons, oncologists, radiologists, gastroenterologists, radiation therapists, and pathologists.

Liver cancer is generally identified in patients who come to the hospitals with damaged livers. Also as the liver cancer stage increases the side effects also may become worse. Therefore, in order to be safe, best options to treat liver cancer should be chosen.

Treatment options

  • The best treatment option is to remove the liver surgically but only <10% of the patients are suitable for surgery. The reasons can be due to cirrhosis (due to bleeding, infection or liver failure), more tumors that are widespread to remove all. Even after successful surgery, there are some tiny deposits of tumors which are not even visible for the scans or surgery. The survival rate of patients having the surgery is >5 years.
  • Other option when there is no evidence of the spread of liver cancer includes liver transplantation. This method involves transplantation of a diseased liver with a healthy liver from a donor. Recent advances in transplantation techniques and immune medications have made transplantation the first choice for patients with cirrhosis and small tumors. The survival rate is >70% with >5 years.
  • Other possible options include injecting the liver with a toxic material such as pure alcohol or chemotherapy in order to destroy it, cryotherapy, radiofrequency ablation etc. These techniques are used in patients with only one or two small tumors, in general.
  • Chemoembolization which involves chemotherapy drugs which can be given directly into the blood vessel that feeds the liver and the tumors. This technique requires a hospital admission, and can cause pain, fever, nausea, and liver damage.
  • Radioembolization or selective internal radiation therapy (SIRT) which is almost similar to chemoembolization in which microscopic radioactive particles are used instead of chemotherapy injected into the blood vessels. This is as effective as chemoembolization for small and multiple tumors.
  • Radiation therapy which uses high-dose energy like X-rays aimed at a small part of the body and can frequently destroy cancer cells. In some cases other techniques like conformal or stereotactic radiation may be useful.

Liver cancer: outcomes

The best treatment options of all discussed above includes surgery and transplantation. Physicians with the help of several tests and scans determines the turmors. Although local treatments such as radiofrequency ablation, cryoablation, and chemoembolization can kill tumors that are visible, “new” tumors may develop which are invisible to the scan or tests. Also, the cirrhosis and conditions that gave rise to the initial cancers will still be there even after successful treatment, so more cancers might actually develop later.

Liver cancer: Prevention

For treating cancers, it not only depends on the type of treatment but also on financial strength. With the growing costs of the machines and drugs one should be able to overcome these. These kind of situations not effect at personal level of the patient.

Hepatoma can be a preventable disease. Hepatitis, alcohol abuse, and obesity can be avoided through

  • Social
  • Medical
  • Lifestyle changes

Also with this transition, there are some chances of improvement observed in the survival rates of liver cancer and hence there is a cause for optimisim.

Liver cancer: Prognosis

The outcome of hepatoma is extremely variable and depends as much upon the state of the liver and the person’s health as on any characteristic of the cancer itself. Therapies such as radiofrequency ablation, chemoembolization, cryoablation, radiosurgery, radioembolization, and systemic therapy are frequently performed sequentially over a patient’s lifetime, depending upon the changes as the disease progresses. Average survival for patients who are able to be treated with these methods is between one and two years.

Multiple techniques can be used in the extension of a patient’s life, while keeping them well and happy. Many drugs have been introduced for the treatment recognizing the molecular defects causing the cancer and few others are still under research. The evolution and improvement in radiologic and interventional technology has helped millions of people in prolongation of their lives. Also the survival rates was almost doubled since early 1990s. Increased and improved medical, scientific, and pharmaceutical areas helped to gain more attention for this disease and still make a better future.

Health tips:

  • Maintain a healthy weight
  • Regular exercise
  • Avoid fad diets (weight loss plans)
  • Limit in the intake of fat
  • Moderate alcohol consumption
  • Regular liver check-ups
  • Quit smoking
  • Be aware of drug risks
  • Vaccinations for hepatitis B

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing.