Category: Technology for Doctors

Neuro and Spine

Novel Antimalarial drug from India completes Phase I trials

The dwindling efficacy of commonly used antimalarials has contributed substantially to the resurgence of
malaria during last three decades. Although new antimalarials have appeared in the market during this time, none has yet supplemented chloroquine. Thus there has been a need for continued efforts on new antimalarial drug development.

The Central Drug Research Institute has developed a novel antimalarial drug which was given an in house name “Compound 97/78”. CDRI 97/78 has shown efficacy in animal models of falciparum malaria. Recently, it was tested for the first time in-human phase I trial in healthy volunteers. In the study, the compound was found to be well tolerated by healthy volunteers. The few adverse events noted were of grade 2 severity, not requiring intervention and not showing any dose response relationship.

Compound CDRI 97/78, a fully synthetic 1,2,4 trioxane derivative has been identified for development as a viable alternative to artemisinine derivatives for use against drug resistant P. falciparum and cerebral malaria cases. Clinical development of this compound is being pursued under Licensing agreements with IPCA Pharmaceuticals Ltd., Mumbai

The Central Drug Research Institute (CDRI) is a multidisciplinary research laboratory in Lucknow, India which has been the leader in new antimalarial drug development. Its objective is to develop new blood schizontocidal antimalarials / drug combinations for control of drug resistant parasites, development of new safer Gametocytocidal, Prophylactic and Anti-relapse agents, harnessing of malaria parasite genome for identification of new drug targets, molecular mechanism of drug action, biochemical markers for characterization of resistant parasites, evaluation of immuno-prophylactic agents, development of newer in vitro assay / tests for parasiticidal activity.

References:
http://www.ncbi.nlm.nih.gov/pubmed/24800100
http://www.cdriindia.org/parasitic2.htm
http://www.cdriindia.org/malaria.htm

The Arogyada
www.arogyada.in
May 17, 2014 / by drsandeep.net

Biomarker for Glioblastoma Multiforme identified

SAN DIEGO – March 19, 2014

Researchers from Aethlon Medical, Inc. (OTCBB:AEMD), and its diagnostic subsidiary, Exosome Sciences, Inc. (ESI), have identified a biomarker for  Glioblastoma multiforme (GBM), an aggressive cancer of the brain.

The team was able to identify, quantify, and characterize circulating Glioblastoma multiforme (GBM) exosomes, which hold promise as
both a disease biomarker and therapeutic target as GBM exosomes are shed into the circulatory system to promote tumor growth and stimulate angiogenesis.

Glioblastoma multiforme (GBM), WHO classification name “glioblastoma”, is the most common and most aggressive malignant primary brain tumor in humans, involving glial cells.  Median survival with standard-of-care radiation and chemotherapy with temozolomide is just 15 months.

The ability to characterize disease specific exosomes in circulation will enable improved diagnosis to identify type and grade of these aggressive brain tumors and may additionally help to advance novel treatment strategies.

Read More: http://www.investorideas.com/CO/AEMD/news/2014/03191.asp

The Arogyada
www.arogyada.in
March 20, 2014 / by drsandeep.net

eVaidya.com : Virtual doctor consultations in India


e Health Access Pvt Ltd., a telemedicine company recently announced launch of their new Healthcare webportal eVaidya.com. This will provide virtual Doctor Consultation to patients apart from providing free personal health record storage. Company already provides a similar service via ehealthaccess.com, eVaidya.com will be considered as the main brand going forward.

According to Jayadeep Reddy, CEO “eVaidya.com is more user friendly and works on all mobile devices and platforms. Apart from consulting our panel doctors via phone and email, we want our customers to store and check their Health trends on our portal and adopt more preventive measures to stay fit & healthy. Health record storage is a free service from eVaidya.com and going forward we will be working to sync multiple health gadgets for storing data and giving valuable health advice to the users.”

Developed with latest technology, a user will be able to create consultation with a doctor in less than 45 seconds. eVaidya mobile application will be available shortly for Android, iPhone and Windows smartphones. eVaidya app will help users to have quick and instant connectivity with doctors apart from storing valuable health data for notification and alerts from our virtual health center. Company is aimed at helping users in understanding their health trends with the network of specialists across India. Company believes that Health analytics is going to be an important tool in constantly encouraging users to adapt a healthy living. Also people adapting to preventive health care in India is increasing at a constant pace and it is expected to grow faster with internet and mobile penetration and via health gadgets.

Courtesy:  India PRwire

The Arogyada
www.arogyada.in
January 19, 2014 / by drsandeep.net

Gartner projects that Healthcare providers in India will spend Rs 57 billion on IT products in 2013

As per a press release by Gartner Inc., healthcare providers in India will spend 57 billion rupees on IT products and services in 2013, an increase of 7 percent over 2012 revenue of 53 billion rupees. This forecast includes spending by healthcare providers (includes hospitals and hospital systems, as well as ambulatory service and physicians’ practices) on internal IT (including personnel), hardware, software, external IT services and telecommunications.

In terms of spending categories Telecommunications, which includes telecommunications and networking equipment and services, will remain the largest overall spending category. Salaries and benefits paid to the information services staff will achieve the highest growth rate amongst the spending categories – forecast to be 18 percent in 2013.
Hospital information systems, picture archiving and communications systems, electronic health records and mobile technologies will be high on the agenda.

The Arogyada
www.arogyada.in
February 21, 2013 / by drsandeep.net

Emerging Device Based Approaches to Treat Hypertension

Need for new therapies to treat Hypertension

A very tight control of blood pressure is required to produce reduction in risk of developing complications especially in patients with comorbidities like Diabetes Mellitus which tend to accelerate the development of complications. Difficult to treat hypertension is a commonly observed problem world-wide.

Hypertension is classified as resistant if the blood pressure is ≥140/90 mm Hg and they reported using antihypertensive medications from 3 different drug classes or drugs from ≥4 antihypertensive drug classes regardless of blood pressure. Among US adults on antihypertensive therapy with drugs, 12.8% of the hypertensives had resistant hypertension as per above criteria [1].
Since multiple factors contribute to hypertension, achieving control using a single agent acting via one single path may not always be successful. Though single drug treatment may be effective in some, more than 50% will require more than one drug for appropriate control of their BP [2]. It is very common to see regimens with Fixed Dose Combinations (FDCs) or drugs being added sequentially.
The challenge of multidrug regimens is getting the patient to adhere to it; since for the patients the condition is largely asymptomatic and the perceived value of being on continuing long term therapy is low. Researchers have been focusing on innovative treatment modalities which can produce long lasting results while keeping it easy on compliance terms and low on side effects.
Novel Device based therapies on the anvil
Renal Denervation

It is a percutaneous, catheter-based radiofrequency ablation for renal sympathetic denervation.
Mechanism:
By applying radiofrequency pulses to the renal arteries, the nerves in the vascular wall (adventitia layer) can be denervated. This causes reduction of renal sympathetic afferent and efferent activity and blood pressure can be decreased [3].

Simplicity HTN1 Trials [4]:

  • Single Arm with extended cohort
  • 45-treated patients with treatment resistant hypertension (baseline BP of 177 /101 mmHg; +/- 20/15 ).
  • Mean office BPs after the procedure were reduced by -27/-17 at 12 months
  • Responder rates (defined as a >10 mm Hg reduction) among patients completing follow–up is 69 percent at one month to 82 percent at 24 months.

Simplicity HTN2 Trials [5]:

  • Randomized controlled trial
  • 106 patients with resistant hypertension (baseline BP of 178/96 mm)
  • Mean blood-pressure reductions of -32/-12 mm Hg six months [n=49] after the procedure in patients with drug-resistant hypertension as against controls where the change was +1/0(n=51) (p<0.0001).
  • The percentage of patients with at least 10 mm Hg drop in systolic blood pressure from the baseline following the procedure was 84%.
Chronic Baroreflex activation

It requires surgical implantation of a device, with leads that electrically stimulate the carotid baroreceptors in the carotid sinus. It is implanted just below the clavicle and delivers four to six volts to the carotid arteries, mimicking the carotid baroreflex, which prompts a fall in blood pressure.

Mechanism:

  • It activates the baroreceptors located in the carotid sinus
  • Activation provides a signal to medullary brain centers that blood pressure is elevated
  • This triggers a reduction in sympathetic activation and promotes parasympathetic activation

    Rheos DEBuT-HT trial [6]

    • 45 patients from 4 European centers
    • 16 patients completed the 2-year follow-up
    N=16 Baseline 1 year 2 year 3 year
    Systolic BP (mmHg) 190 ± 30 -38 ± 8 -34 ± 8 -37 ± 10
    Diastolic BP (mmHg) 111 ± 22 -25 ± 5 -20 ± 6 -23 ± 7

     
    Pivotal Trials [7]

    • Prospective randomized double-blind trial
    • 322 patients at 49 sites
    • 55 roll-in patients / 265 randomized (2:1)
    • The average SBP drop at 12 months among responders was 44 mmHg
    • 81% of patients were responders (SBP ≥ 10 mmHg relative to preimplant)

     
     

    [1] Persell SD.; Prevalence of resistant hypertension in the United States, 2003-2008: Hypertension. 2011 Jun;57(6):1076-80. doi: 10.1161/HYPERTENSIONAHA.111.170308. Epub 2011 Apr 18.
    [2] Sanjay Kalra, Bharti Kalra and Navneet Agrawal- Combination therapy in hypertension: An update
    [3] Esler, MC; Krum, H, Sobotka, PA, Schlaich, MP, Schmieder, RE, Böhm, M (2010 Dec 4). “Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trian): a randomized controlled trial.”. Lancet 376 (9756): 1903-9
    [4] Simplicity HTN1 Trials

    [5] Thomas Unger, Ludovit Paulis, and Domenic A. Sica; Therapeutic perspectives in hypertension: novel means for renin–angiotensin–aldosterone system modulation and emerging device-based approaches
    [6] C Venkat S Ram; Baroreceptor activation therapy for treating resistant hypertension : a status report
    [7]http://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_425401.pdf

    View Dr Sandeep Moolchandani's profile on LinkedIn

    The Arogyada
    www.arogyada.in
    January 13, 2013 / by drsandeep.net

    Virtual Dissection Table: Dissection by Taps and Glides of Fingers

    Norbert von der Groeben (http://med.stanford.edu/ism/2011/may/dissection-0509.html)
    Remember your Anatomy dissection hall, the karma-bhoomi (action-arena) for every medical student in the first year of medical education. Remember that pungent smell of formalin mixed with foul smell of decomposing tissue that goes to the deepest parts of your brains, just to leave you intoxicated for rest of the day. I am sure, that is an unforgettable experience for every medical student. After dissection class of 2 hours, there is not much of human anatomy you can identify or appreciate that too with 20 of your classmates flocking around a single cadaver. We have a new solution which can change the anatomy of the anatomy dissection hall.
    I bet many of you will not have heard of the Virtual Dissection Table, a new innovative technology which takes studying anatomy to a whole new level. The Virtual Dissection Table, developed by Anatomage in collaboration with Stanford University’s Division of Clinical Anatomy, is a breakthrough in visualizing human anatomy. It is another example of how an ordinary technology can be used for an extraordinary purpose. This virtual dissection table is effectively a computer with powerful graphics using a 3D anatomy software coupled with a life size display. It has potential to revolutionize the study of anatomy and the practice of image guided surgery. Check out these videos.
    Video 1

    Video 2

    Features of Virtual Dissection Table
    Touch screen interface: You can rotate, drag, and slice through the subject with a finger tip and change between Hard tissue, Soft Tissue and X-Ray radiology images.
    Rendered 3D images: The skeletal structures, muscles, radiographic cross-sections, and textured soft tissue representations are all merged together into one data set that can be manipulated with virtual dissection tools.

    Virtual Dissection Table: What can it be used for?
    Teaching Anatomy: Complementary aid for cadaver based dissection courses. With its flexible annotation tools, institutions can create innovative programs, quizzes, and methods of study
    Source: Anatomage
    Clinical Practice: The table also can use real data from MRI and CT scans of patients. It can be used for diagnosis and treatment planning, and for patient education and consultation
    How much a Virtual Dissection Table costs?

    $60,000

    Further Reading…
    http://stanmed.stanford.edu/2011summer/article8.html
    http://www.anatomage.com/product-TheTable.html
    http://www.bbc.co.uk/news/world-radio-and-tv-16421866
    The Arogyada
    www.arogyada.in
    January 21, 2012 / by drsandeep.net