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Good Practices for Conference Abstracts and Presentation

Medical Writing, , , ,

Medicine is an ever-changing science. As new researches and clinical experience broaden our knowledge, changes in treatment, and drug therapy help in improvising patient care management. WHO describes research as being an imperative element for settling public health challenges – whether it be combating the diseases highly prevalent in developing countries, responding to the alarming rise of chronic conditions, or ensuring proper prenatal, natal and post-natal care for women and children. Research is a structured evaluation to present the facts and reach new conclusions. Medical and scientific conferences serve as a platform for research sponsored by various organizations. These conferences are of crucial importance to disclose and discuss potentially practice-changing data of on-going research studies. The variation in the practices of different organizations makes it difficult to adhere to the good publication practice guidelines and conference requirements. There are no specific guidelines or recommendations to describe the standards for conference presentations.

Company-Sponsored Research

The company-sponsored research is presented in the conferences in the form of abstracts and posters. The scientific committee of the conference review the abstracts. However, they are not included in the peer-review process, as are the journal articles. Further, reviewing the poster and oral presentations is rare. A systematic review reported < 50% were published in full, following presentation at a conference after being accepted as abstracts. It is of utmost importance to attain a high standard process for developing conference abstracts and presentations, mainly for company-sponsored research, since it may ultimately become the only source for a particular analysis. The Good Publication Practices (GPP), Consolidated Standards of Reporting Trials (CONSORT), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and recommendations are followed for the conference presentations. On the other hand, the International Committee of Medical Journal Editors (ICMJE), the most widely cited recommendations on authorship, is related exclusively to the publications in peer-reviewed journals. It is challenging to implement these guidelines in practice since they are not fully applicable to conference presentations.

Principles of Good Publication Practice for Company-Sponsored Medical Research

As per GPP guidelines, Good practice for conference abstract and presentation focuses on the presentation of all company-sponsored researches. GPCAP aims to provide guidance on good submission and presentation practice for scientific and medical congresses, explicitly addressing certain aspects where current publication guidelines are inadequate.

Some of the principles for practicing good publication are as follows

  • Ensure timely submissions of the study report guaranteeing complete transparency and accuracy.
  • Reporting and publication processes should follow the FDA, ICMJE, and EQUATOR guidelines.
  • Ethical guidelines should be followed to deliver originality in the abstract and avoiding redundancy.
  • The authorship, contributors (including the writing support), and the sponsorship should be mentioned clearly, ideally at the start of the research, and, in all cases, before publication preparation begins.
  • All the authors should have access to study data and other information; all named authors should review, approve the content of abstracts and presentations, and should take responsibility while being involved in the process of publication.
  • All authors and contributors should disclose any relationships or potential competing interests relating to the research and its publication or presentation.
  • The registration number of the study should be mentioned.

Recommendations for conference organizers

Conference organizers should:

  • Encourage and support the inclusion of contributor lists on posters and slides
  • Include the space for the trial registration number, medical writing support disclosure, sponsor details on abstract forms
  • Use Open Researcher and Contributor ID (ORCID) to uniquely identify scientific and other academic authors and contributors.

Encore Abstract

An encore abstract is typically defined as presenting the same study reports at different conferences to reach various audiences. Even though encore abstracts are not considered to be a superfluous presentation, some conferences accept only the additional findings that were not presented in any other scientific meetings. Presenting the same study to different conferences, the authors and the company sponsoring the research should consider submitting different parts of the studies to reach different audiences at various conferences. It should be noted, the addition of new data to a previously accepted abstract may not necessarily constitute a new abstract unless it is confirmed with the conference.

Encore Checklist

  • Ensure there is no overlapping in terms of the region, profession, etc.
  • Make sure there is no licensing difference between the two regions for the product/medicine of the study.
  • Ensure timely publication of the study even with multiple presentations.

Conclusion

Good publication practices are essential elements and the growing need for on-going and evolving researches in the field of medicine. The authorities and the committees around the world have put together the recommendations and guidelines for improving the accuracy and originality of the study presentations while decreasing the incidence of unethical writing practices; thus, preserving the authenticity of the study. Hence, following appropriate recommendations and guidelines can be helpful in putting forward the research in an effective manner.

Turacoz Healthcare Solutions aims at encouraging the researchers and the medical writers in following Good Publication Practices.

If you wish to contact us, click here.

Email us at : [email protected]

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Recent Advancements in Cancer Treatment

Cancer, , , , , , , ,

Cancer refers to a medical condition characterized by uncontrolled division of cells forming tumor. During normal cell cycle, the cells grow, divide and die and new cells take their place, whereas in cancer, the abnormal cells continue dividing and do not die. The cancerous cells may invade other body parts or tissues thereby spreading cancer to those parts which is known as metastatic cancer. On the other hand, the benign cancer does not spread or invade other body parts, it remains located to a specific organ.1, 2

Global prevalence of cancer

As per the estimates of GLOBOCAN 2018, the global cancer burden has increased to 18.1 million new cases and 9.6 million deaths. The global 5-year prevalence is estimated to be 43.8 million which is the total number of people alive within 5 years of a cancer diagnosis.3,4 On combining the global patterns for men and women in 2018, around half of the new cases and more than half of the cancer deaths globally are estimated to occur in Asia.4

Importance of early detection

Early diagnosis of cancer is important as it enhances the chances of successful treatment. Raising the awareness towards early signs and symptoms of cancer can help in targeting this deadliest disease at the earliest. Various tests are available for screening of different types of cancers such as mammography for breast cancer screening; cytology screening methods, including Pap smears for cervical cancer screening.5

Treatment of cancer

Cancer treatment is based on the type of cancer and its stage. It usually involves a combination of various treatment approaches including:6

  • Surgery
  • Chemotherapy
  • Radiotherapy
  • Hormonal therapy
  • Novel therapies

Latest Advances in the Treatment of Cancer

The advent of novel ideas and techniques of cancer treatment are showing promising results by improving the survival outcomes.7 Below mentioned are some recently introduced treatment modalities for cancer.

1. Nanomedicine

  • It has shown promising results in cancer therapy.7
  • It utilizes the principles of nanotechnology in which highly engineered nanoparticles (NPs) of sizes less than 100 nm are used to actively or passively target drugs to cancer cells.7
  • These are the target-drug delivery systems that utilizes drugs with high solubility, biocompatibility, bioavailability, and multifunctionality.7,8
  • They act as multi-target inhibitors and nano-imaging tools (Figure 1).7
  • The use of polymeric and lipid based nano systems are one of the best alternatives for the central delivery of drugs in brain tumour.8
  • The possible approach of the nanomedicine would be combining drug or gene delivery with external stimuli, like hyperthermal, photothermal, or photodynamic (PDT) treatments, thereby attacking the cancer cells with various mechanisms.7
  • Nanomedicine may overcome the common disadvantages of conventional cancer treatment by providing7 –
    • High selectivity
    • Differentiating among healthy and cancer cells
    • Early diagnosis and molecular imaging methods

Figure 1: Nanotechnology in cancer therapy7

2. CAR-T cell therapy

  • Chimeric antigen receptor (CAR)-genetically modified T cells (CAR-T cells) have shown significant clinical responses and cancer remission in relapsed or refractory B-cell malignancies.9
  • This is a new form of adoptive T cell therapy (ACT), in which an artificial CAR redirects T cells endogenous antitumor activity towards a predefined tumor-associated antigen. This in turn eliminates a specific tumor.9
  • The US Food and Drug Administration (FDA) approved the first CAR-T cell therapy in 2017 for the treatment of CD19-positive leukemias and lymphomas.9
  • The associated drawbacks of CAR-T cell therapy are:9
    • Specific life-threatening toxicities
    • Lack of efficacy in the treatment of solid tumors because of strong immunosuppressive tumor microenvironment and lack of reliable tumor-specific targets

3. Radiomics and Pathomics

  • It is a systems-based approach developed to provide a better strategy to study and understand the complexity of cancer cell and related parameters.7
  • Tools have been developed that utilize computerized feature analysis methods for extracting sub-visual attributes for characterizing disease appearance and behaviour on radiographic (radiomics) and digitized pathology images (pathomics).7
  • It considers a large number of interrelated variables to identify a specific disease phenotype, such as:7
    • Gene expression profile
    • Tumour cellular architecture, and microenvironment (seen through histological image features)
    • Three-dimensional tissue architecture and vascularization (seen through dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI))
    • Metabolic features (seen through magnetic resonance spectroscopy (MRS) or PET)
  • Radiomics extracts high-dimensional information from clinical images and clinical data, with or without associated gene expression to support evidence-based clinical decision-making.10
  • Radiomics’ analyses can be performed in tumour regions, metastatic lesions, as well as in normal tissues.10

4. Advancements in radiotherapy

  • Radiotherapy has been a mainstay in cancer treatment. However, studies reported resistance to radiotherapy in some cancer cells which is found to be related to altered mitochondria structure and the size. 7
  • The therapies that can regulate mitochondria function and metabolism and induce apoptosis may be the most effective anti-cancer agents.7
  • A novel radiosensitizer with dual anti-metabolic and anti-angiogenic activity for oesophageal (OAC) cancer resistance has been identified and patented that can significantly reduce both metabolic and anti-angiogenic activity in real time and in parallel with increasing radio sensitivity in an isogenic model of radioresistance.7

5. Cancer treatment vaccines

  • Cancer treatment vaccines act by strengthening the body’s natural defenses against the cancer.11
  • They are designed to be used in cancer patients where they act against cancer cells.11
  • Cancer cells are comprised of tumor-associated antigens which are not present in normal cells. Treatment vaccines recognize and interact with these antigens thereby destroying the respective cancer cells.11
  • Sipuleucel-T is a vaccine used for prostate cancer.11
  • T-VEC is used to treat some patients with melanoma that relapses after surgery.11
  • These vaccinations are associated with some serious side effects which can vary from person to person. For e.g. Sipuleucel-T can lead to stroke. It is deemed important to know about the side effects and what to do if they occur.11
  • The common side effects associated with cancer vaccine are flu-like symptoms such as Fever, weakness, chills, dizziness, muscle or joint pain, nausea/vomiting, low or high blood pressure, fatigue, headache, difficult breathing.11

We, at Turacoz Healthcare Solutions join hands to fight against the cancer by spreading the awareness about timely diagnosis and treatment of cancer. If cancer is detected at an earlier stage, there are high chances of successful treatment which in turn increases the chances of survival compared to diagnosis at advanced stages. Let us be aware, strong and brave – life is beautiful, and cancer can’t change it.

If you have any queries, email us at [email protected]

References

  1. Available at https://www.who.int/news-room/fact-sheets/detail/cancer . As accessed on Feb 03, 2020.
  2. What is cancer. Available at https://www.cancer.gov/about-cancer/understanding/what-is-cancer . As accessed on Feb 03, 2020.
  3. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians 2018;68:394-424.
  4. WHO: latest global cancer data. Available at https://www.who.int/cancer/PRGlobocanFinal.pdf . Last accessed on Feb 03, 2020.
  5. Early screening of cancer. Available at https://www.who.int/cancer/detection/en/ . Last accessed on Feb 03, 2020.
  6. Cancer treatment. Available at https://www.cancer.gov/about-cancer/treatment . Last accessed on Feb 03, 2020.
  7. Charmsaz S, Prencipe M, Kiely M, Pidgeon GP, Collins DM. Innovative Technologies Changing Cancer Treatment. Cancers (Basel). 2018;10(6):208.
  8. Cano A, Espina M, García ML. Recent advances on anti-tumor agents-loaded polymeric and lipid based nano-carriers for the treatment of brain cancer. Curr Pharm Des. 2020 Jan 16.
  9. Abreu TR, Fonseca NA, Gonçalves N, Moreira JN. Current challenges and emerging opportunities of CAR-T cell therapies J Control Release. 2019 Dec 30;319:246-261.
  10. Rizzo S, Botta F, Raimondi S, et al. Radiomics: the facts and the challenges of image analysis. Eur Radiol Exp. 2018;2(1):36.
  11. Cancer treatment vaccines. Available at https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/cancer-treatment-vaccine . Last accessed on Feb 03, 2020.

Blood Donation: Significance

Awareness Day/Month, , , , ,

The gift of blood is the gift of life. There is no other substitute for human blood. According to statistics, every two seconds someone is in dire need for blood. And only one pint of blood can save up to three lives. Data collected over a span of many years suggests that the blood type most often requested by hospitals is Type O.

Sickle cell patients are required to have frequent blood transfusions throughout their lives. And for cancer patients (with an estimate of more than 1 million new patients every year), many of them require blood, sometimes on a regular basis, during their chemotherapy treatment.

FYI: A single car accident victim can require up to 100 units of blood to survive.

Things to know about the blood donation process:

  • Blood donation is safe! Hospitals/doctors/nurses make sure that a sterile needle is used only once for each individual donor and then discarded/destroyed.
  • The process is simple. Mainly consisting of four steps:
  1. Registration
  2. Physical & Medical history
  3. Donation
  4. Refreshments
  • A mini-physical is done for every donor, checking his/her temperature, blood pressure, pulse and hemoglobin count. Basically, to ensure that the donor is fit for donating, and if whether it is safe.
  • The real process takes around 10-12 minutes. It is crucial for you to stay calm if it is your first time donating.
  • The average human adult has approximately 10 units of blood in their body. At the time of donation, roughly one unit is given (don’t worry you still have enough).
  • Red blood cells can be donated every 56 days (by a healthy person).
  • Platelets can be donated every 7 days apart (a maximum of 24 times a year).
  • All blood donations are tested for HIV/AIDS, hepatitis B & C, syphilis and other diseases, before it is transfused.

General FYI:

  • Type O- red cells can be transfused to patients of all blood types.
  • Type AB+ plasma can be transfused to patients of all other blood types.

Top Ten Reasons Why You Should Donate Blood (there is no denying these):

  1. First of all, it saves lives! What else is there to know?
  2. It is one of your civic duties as a responsible citizen.
  3. Not everyone can donate blood, it’s a blessing to have the ability to save people.
  4. If one day you need blood, you won’t hesitate to take it, so why hesitate to give it?
  5. It gives the donors a free medical checkup.
  6. It helps maintain an adequate blood supply in the community for secure blood transfusions.
  7. The feeling of satisfaction of helping others is unreal.
  8. Even though the cure for cancer is not discovered, yet! But donating blood helps keep someone alive while they wait for the cure.
  9. The real question is, why not give blood?
  10. Excuses are always vague, there is no logical reason as to why a healthy person should not donate blood.

Advantages of donating blood:

Donating blood is not only beneficial for the person receiving it, but it is also highly beneficial for the donor’s health.

  • Lowers iron levels: The body needs iron to produce red blood cells. But too much iron in the blood can be harmful. Too much iron in one’s blood can lead to it being deposited in different organs of the body, such as the heart and the liver, and this could lead to a malfunction in the way those organs function. Donating blood can help control the level of iron in your system.
  • Checks your system: Each and every person who donates blood undergoes a simple physical examination and a blood test before they can move on to donating their blood. Through these tests, hospitals can assess a person’s internal fitness and health. It is highly possible that a person could identify unknown health issues as a part of the blood donation process. The donor is tested for HIV/AIDS, hepatitis B & C, and/or any other blood-borne diseases.
  • Burns calories: According to the University of California, San Diego, donating blood has been proven to burn around 650 calories per donation. Its like getting ripped without going to gym. But on a more serious note, donating blood cannot be considered as an alternative to exercise. Also, after donating blood try to hold off on going to the gym the very same day, take some rest.

Disadvantages of donating blood:

  • Dizziness
  • Feeling faint
  • Lightheadedness
  • Nausea

Note: These symptoms usually subside within 3 days of donating blood.

Turacoz Healthcare Solutions aims to spread awareness about the benefits and advantages of donating blood. We urge the people to take part in this noble act of saving lives. We wish that people would actively contribute in this ‘gift of life’ and are working hard towards achieving a healthier future for the masses.

If you wish to contact us, click here.

How to Prevent HIV/AIDS?

Disease and Treatment, , , , , ,

The world’s leading public health challenge is the HIV virus that leads to AIDS. In 2018, around 37.9 million people were infected with HIV/AIDS and approximately 1.7 million more joined the club worldwide. Only 79% of the affected numbers were aware of their HIV status and the remaining 21% did not even have access to HIV testing services. The death rate associated with AIDS has reduced from 1.7 million in 2004 to 770,000 in 2018 [1,2,3].

A brief summary on the HIV epidemic is presented in the Figure 1 [2]

Figure 1: Global HIV Epidemic [2]

Despite the advances in our healthcare sector and availability of a wide range of effective prevention tools, a large number of individuals with HIV or at risk of HIV do not have access to the prevention, care, and treatment [1]. A study reported that majority of the current HIV transmission is done via people who inject drugs, occurring in the majority of low and middle-income countries [4].

The advances in science have provided many tools to prevent HIV these days. However, to protect oneself from a disease one should be aware about the cause of the disease, with an understanding of how the virus spreads. HIV virus can be passed in the following ways [5]:

  • Having sexual intercourse with an HIV infected person
  • By sharing contaminated needles such as through blood transfusion or drug use
  • From an HIV infected mother to the foetus during pregnancy, or through breast feeding

Anyone and everyone is vulnerable to the HIV virus, but preventive measures can help one to reduce the risk of getting infected. Key approaches for the prevention of HIV are listed below:

HIV Prevention Medication [6,7]

Pre-exposure prophylaxis (prEP) and post-exposure prophylaxis (PEP) can greatly reduce the risk of contracting the HIV infection. According to the federal guidelines, prEP is considered for HIV-negative or people at a very high risk of HIV. It consists of daily medication and regular visits to a healthcare professional. This includes:

  1. Anyone who is in sexual contact with a HIV positive person
  2. A man who has sex with both women and men
  3. A heterosexual man or woman who have had sexual intercourse with partners of unknown HIV status.

PEP can prevent you from becoming infected with the virus once you are exposed to it. For this medication to work, it must be started within 72 hours after a possible exposure. It should be taken once or twice daily for 28 days. Use of condoms and safe injection practices is recommended during the medication.

An HIV-negative person has the following ways to protect himself/herself from getting infected:

Figure 2: Steps of Prevention for HIV-negative person

Treatment as Prevention [7]

This refers to the use of HIV medication to prevent transmission of the infection to others. An HIV infected person taking the medications as prescribed and has regular follow-ups to keep an undetectable viral load are at no risk of transmitting HIV to their HIV-negative partners. Antiretroviral therapy (ART) to suppress the virus should be taken regularly as it prevents the virus from growing in our body that keeps us healthy and prevents illness. Women infected with the virus are recommended to take the treatment to minimize the risk of transmission to the foetus during pregnancy or delivery. After conception, the new-born receives HIV medications for 4 to 6 weeks. Figure 2 shows the actions to be taken to prevent HIV from passing to others.

Figure 3: Steps for Prevention for HIV-positive person

The United Nations organized the Joint United Nations Programme on HIV/AIDS (UNAIDS) with an ambitious target to treat HIV with a 90-90-90 goal. By 2020, 90% of the people living with HIV will be aware of their HIV Status. 90% of the people diagnosed with HIV will receive a proper antiretroviral therapy (ART). 90% of people on ART will have viral suppression [1,7].

Turacoz Healthcare Solutions aims to spread awareness about HIV/AIDS. We urge the people to be aware about the condition. Following the preventive measures and seeking counseling is the best way to avoid this condition. However, for the HIV infected individuals it is best to continue with the ART and maintain a healthy diet. Nevertheless, with love and support from family and friends they can lead a happy and long life.

If you wish to contact us, click here.

References

  1. Retrieved from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics [Accessed on 26th December 2019]
  2. Retrieved from: https://www.who.int/hiv/data/en/ [Accessed on 26th December 2019]
  3. Retrieved from: https://www.unaids.org/en [Accessed on 26th December 2019]
  4. Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, Wodak A, Panda S, Tyndall M, Toufik A, Mattick RP. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. The Lancet. 2008 Nov 15;372(9651):1733-45
  5. Retrieved from: https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/hiv-aids/treatments/prevention.html [Accessed on 26th December 2019]
  6. Retrieved from: https://www.cdc.gov/hiv/basics/prevention.html [Accessed on 27th December 2019]
  7. Retrieved from: https://www.hiv.gov/hiv-basics/hiv-prevention/reducing-sexual-risk/preventing-sexual-transmission-of-hiv [Accessed on 27th December 2019]
  8. Retrieved from: https://www.unaids.org/en/resources/909090 [Accessed on 26th December 2019]
  9. Retrieved from: https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/hiv-treatment-as-prevention [Accessed on 27th December 2019]

HIV Awareness

Awareness Day/Month, , , , , , , , ,

The human immunodeficiency virus (HIV) invades the immune system and damages the host’s defense system and causes it to weaken against all kinds of minor and significant infections and cancers. Thus, gradually leading to immunodeficiency, which in turn makes the body susceptible to opportunistic infections. CD4 cell count typically measures immune function. As stated by global statistics about 37.9 million people were HIV infected in 2018, with a prevalence of 0.8% in adults.

The advancement to a stage of acquired immunodeficiency syndrome (AIDS), takes 2 to 15 years to occur if not treated, depending on the individual.

Signs and symptoms

The symptoms of HIV depend on the stage of infection. It’s noteworthy that people with HIV infection are highly contagious during the initial period. However, most individuals aren’t aware of this until the later stages. People may experience no symptoms or influenza-like illnesses, including headache, rash, fever, and sore throat. The progressing illness leads to advanced symptoms and signs, like diarrhea, fever, cough, without treatment; tuberculosis (TB), cryptococcal meningitis, severe bacterial infections, swollen lymph nodes, weight loss, and cancers such as lymphomas and Kaposi’s sarcoma.

Transmission

Transmission of this dreadful disease occurs through the exchange of a variety of bodily fluids such as blood, breast milk, semen, and vaginal secretions from infected people, and from a mother to her child during pregnancy and delivery. Individuals cannot become infected through regular day-to-day contacts such as kissing, hugging, shaking hands, or sharing personal objects, food, or water.

Risk factors

Behaviors and conditions that put individuals at higher risk of contracting HIV include:

  • Unprotected anal or vaginal sex
  • Drug abuse
  • Sexually transmitted infections (STI) like syphilis, gonorrhea, bacterial vaginosis, herpes, and chlamydia
  • Use of contaminated needles, syringes, and other injecting equipment and drug solutions when injecting drugs
  • Unsafe blood transfusions, injections, using contaminated and unsterilized needles, and tissue transplantation
  • Experiencing accidental needle stick injuries, including among health workers

Diagnosis

HIV diagnosis is made through rapid diagnostic tests that provide same-day results. These tests dramatically facilitate early diagnosis and treatment. There are self-diagnostic tests available to help test for HIV infection; however, a confirmatory test is always required, conducted by a qualified and validated health worker at a community center or clinic. The WHO pre-qualified tests are the most accurate for diagnosing HIV infection. These tests detect the antibodies produced from the infected individual. People develop antibodies within 28 days of infection. This period is called window period, during which a person does not experience any symptoms; however, he/she might transmit the disease to others.

All the HIV positive patients should be retested before enrolling for the prescribed treatment, to rule out any testing or reporting error.

While testing for babies born to HIV-positive mothers, the virology test is the test of choice and should be performed at birth or 6 weeks of age. New technologies are being available to help perform these tests more accurately along with delivering the results on same day.

HIV testing services

HIV testing should be voluntary and the right to decline testing should be recognized. Mandatory or coerced testing by a health care provider or authority, or by a partner or family member is not acceptable as it undermines good public health practice and infringes on human rights.

All HIV testing services must follow the WHO-recommended principles known as the “5 Cs”:

  • Informed consent
  • Confidentiality
  • Counseling
  • Correct test results

Connection (linkage to care, treatment and other services)

Prevention

Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Key approaches for HIV prevention, which are often used in combination, are listed below.

  • Male and female condom use
  • Testing and counseling for HIV and STIs
  • Testing for HIV and other STIs
  • Testing and counseling, linkages to tuberculosis (TB) care
  • Voluntary medical male circumcision (VMMC)

Prevention benefits of ART

WHO based on the results of a study conducted in 2011 recommended that all the HIV infected individuals should receive ART to prevent the transmission of this deadly condition. Also, a study conducted in 2019 reported negligible transmission risk of HIV in individuals on ART.

Pre-exposure prophylaxis (PrEP) for HIV-negative partner

Pre-exposure prophylaxis is recommended for all the individuals who are at a greater risk of HIV infection such as, trans-genders, hetero and homosexual couples, drug abusers, pregnant and lactating women.

Post-exposure prophylaxis for HIV (PEP)

Post-exposure prophylaxis should be used within seventy-two hours of being exposed to HIV. This includes testing, counseling, treatment with anti-retroviral for 28 days.

Harm reduction for people who inject and use drugs

Individuals who use the injections can follow the below-mentioned interventions as prevention:

  • needle and syringe programs
  • opioid substitution therapy for people dependent on opioids, and other evidence-based drug dependence treatment
  • risk-reduction information and education, and provision of naloxone to prevent opioid overdose

Elimination of mother-to-child transmission of HIV

HIV infection can be transmitted to the child or the unborn fetus through the mother during pregnancy or breastfeeding. This is called a vertical mother to child transmission (MTCT). However, this can be prevented with the treatment using antiretroviral therapy during pregnancy and breastfeeding.

Treatment

Treatment comprises of combination therapy with three or more anti-retroviral drugs. This therapy helps suppress the condition and does not completely cure it. Hence WHO recommends all the individuals suffering from HIV to take lifelong medication to lead a normal life.

The clinical research and health care system is continuously working to develop ARTs with better efficacy, tolerability. Use of dolutegravir-based or low-dose efavirenz for first-line therapy, and raltegravir and darunavir/ritonavir for second line as recommended by WHO.

Making the access to the treatment and prevention is the core goal for the upcoming year. And this aims to bring the world back on track to end the AIDS epidemic by 2030.

WHO response

The 69th World Health Assembly recommended a new “Global health sector strategy on HIV for 2016–2021”. The strategy comprises of five strategic directions that guide the countries and WHO to take necessary actions over six years.

The strategic directions are:

  • Information for concentrated action for the region/country
  • Interventions designed to have an impact on the variety of services needed
  • Delivering services equally to cover the population in need
  • Financing for the sustainability of the services in terms of cost
  • Innovation in acceleration towards future

WHO is a co-sponsor of the Joint United Nations Programme on AIDS (UNAIDS). Where it directs the activities on HIV treatment and care and the coinfection. It also jointly organizes with UNICEF, the work on elimination of MTCT of HIV.

Prevention is always better than cure! Follow these tips to notice a change in your lifestyle.

Turacoz Healthcare Solutions aims to spread awareness about HIV/AIDS. We urge the people to be aware about the condition. Following the preventive measures and seeking counseling is the best way to avoid this condition. However, for the HIV infected individuals it is best to continue with the ART and maintain a healthy diet. Nevertheless, with love and support from family and friends they can lead a happy and long life.

If you wish to contact us, click here.

 

World Diabetes Day | 2019 Awareness

Awareness Day/Month, , , , , ,

The campaign “World Diabetes Day (WDD)” was launched in 1991 jointly by International Diabetes Federation (IDF) and the World Health Organization (WHO) to address the growing concerns about the rising health issues posed by diabetes. It was officially recognized by United Nations in 2006 and is marked every year on November 14th, to commemorate the birth anniversary of Sir Frederick Banting, who along with Charles Best co‑discovered insulin in 1922 (1).

The condition

Diabetes is a metabolic disorder characterized by hyperglycemia which results from defects in insulin, secretion, insulin action, or both. A long‑term uncontrolled hyperglycemia can cause damage, dysfunction, and failure of the eyes, kidneys, nerves, heart, and blood vessels (2).

Classification:

Diabetes can broadly be classified into two main categories:

  • Type 1: In this case, body’s own immune system attacks and destroys the cells in pancreas that produce insulin. Although it can occur at any age, but it is prevalent more among children and young adults who require daily dose of insulin to stay alive.
  • Type 2: This situation arises when body does not make or use insulin efficiently. it is the most common type and can occur at any age, but middle‑aged and older people suffer from this condition mostly.

Other forms of diabetes include: Gestational diabetes, monogenetic diabetes, and cystic fibrosis related diabetes (3).

Symptoms

Symptoms associated with diabetes in general includes:

  • Increased thirst and urination
  • Increased appetite
  • Fatigue
  • Blurred vision
  • Numbness or tingling in the feet or hands
  • Sores that do not heal

Unexplained weight loss (4).

Causes

  • Type 1 diabetes is a result of auto immune destruction of beta cells of the pancreas. It may also occur due to certain genetic and environmental factors, such as viruses.
  • Several factors are involved in causing type 2 diabetes such as obesity, physical inactivity, insulin resistance, genes, and a history of diabetes in the family.
  • It is believed that gestational diabetes can be caused by hormonal changes during pregnancy along with genetic and lifestyle factors (4).

Prevalence and some statistics

  • People with diabetes have risen sharply from 108 million in 1980 to 422 million in 2014. Prevalence of diabetes among adults over 18 years of age has almost doubled from 4.7% to 8.5% within the same time period.
  • Prevalence of diabetes has become a serious health concern specially in middle‑and‑low‑income countries.
  • As of 2016, approximately 1.6 million deaths were attributed to diabetes only and in 2012, around 2.2 million deaths were reported globally due to high blood glucose.
  • As per an estimate by WHO, diabetes was the 7th leading cause of death in the year 2016 (5).

The campaign and the aim

At present WDD is the largest diabetes campaign having presence in more than 160 countries and a reach to more than 1 billion people. It is represented by a blue circle logo adopted by the UN resolution on diabetes on 2007. The color blue signifies the unity among global diabetes community against the epidemic (6).

WDD serves as:

  • Platform for promoting IDF advocacy efforts throughout the year.
  • Global driver to promote the importance of taking coordinated and concerted actions to confront diabetes as a critical global healthcare (1).

What’s in store for 2019?

WDD will be observed November 14th on Thursday this year which is just around the corner. On this day, millions of people around the globe organize events and activities raising awareness about diabetes (6). The campaign projects a dedicated theme every year which runs for one or more year. For the year 2019, the theme is ‘Family and Diabetes’ with an intent to raise awareness about the effect that diabetes has on the family and support network of those who are suffering as well as promoting the role of family in the management, care, prevention, and education (1).

Diabetes affecting family members

Diabetes can be considered as a family disease since the other members of the family somehow get affected if someone, specially a child is diagnosed with it. It is for this reason that it can be regarded as a form of chronic illness like any other chronic illnesses (7).

In a survey named DAWN2 involving 2000 family members of those affected by diabetes reported that 1/3rd of those experienced a notable burden and negative impact of diabetes, including effects on their emotional wellbeing, financial situation, leisure activities, and physical health (8).

Some of the risks, that family members of those affected by diabetes, experience, can be categorized as (9):

  • Biological risk: it has been shown that there exists a correlation (0.34 and 0.38) on BMI ranges of those suffering from diabetes and their partners. Partners of those with diabetes have been found to have higher BMI than their counterparts with non‑diabetic partner.
  • Health behavioral risk: a study involving multiethnic sample of > 500 patients suffering from type 2 diabetes and their partners showed that significant correlation exists between factors such as; consumption of fat, consumption of carbohydrates, total physical activity, and indulging in smoking and alcohol.
  • Affective/emotional risk: it is reported that female partners of diabetic patients have higher mean level of depressive effect. For male partner, the mean level of depressive effect was comparatively lower but still higher than that of the control subjects.

Role of family members in diabetes management

A family can play a crucial role in managing diabetes of the affected member. Having them involved in the self‑care interventions may help in achieving positive outcomes for the diabetics (10).

Families are required to share responsibilities and reconsider role of family as a result of diabetes. Reports have suggested that low level of conflicts, unity, and efficient organization patterns are linked with better treatment adherence (11).

The Family Approach to Diabetes Management (FADM) is a novel model that focusses on determining and exploring different ways of intra family communication having either positive or negative impact on clinical outcomes while keeping patient and family self‑management at forefront. It has been shown that engagement of entire family is easy to adjust as well as cost‑effective into standard diabetes care in addition to offering positive clinical outcome pertaining to general quality of life and A1C results (12).

Studies have shown that family members while participating in health interventions for diabetes care improves their own knowledge about the disease and inculcate skills necessary to support their loved ones. Family’s participation benefits their own health behaviors and health outcomes (10).

Turacoz Healthcare Solution is committed to raise awareness about diabetes management, prevention and educating people so as to make them help their near and dear ones suffering from this chronic lifestyle disorder to maintain and live a healthy life. Family’s engagement in diabetes care can significantly improve the outcomes and also make other family members learn about the management of diabetes.

If you have any queries, email us at [email protected]

 

References 

  1. About World Diabetes Day. International Diabetes Federation. Available at: https://worlddiabetesday.org/about/
  2. Diagnosis and classification of diabetes mellitus. American Diabetes Association; 2013: 36(S1). 67‑74. Available at:https://care.diabetesjournals.org/content/36/Supplement_1/S67
  3. What is diabetes? National Institute of Diabetes and Digestive and Kidney Disease. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
  4. Symptoms and causes of diabetes. National Institute of Diabetes and Digestive and Kidney Disease. Available at:https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes
  5. World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes
  6. Getting Ready for World Diabetes Day 2019. Diabetes self‑management. Available at: https://www.diabetesselfmanagement.com/blog/getting-ready-world-diabetes-day-2019/
  7. The family approach to diabetes management: Theory into practice toward the development of a new paradigm. Diabetes Spectrum. 2004; 17(1): 31‑36. Available at: https://spectrum.diabetesjournals.org/content/17/1/31
  8. Family matters in diabetes. The Lancet Diabetes and Endocrinology. 2018; 12(6): 911. Available at: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30317-6/fulltext
  9. Fisher L. Family relationships and diabetes care during the adult years. Diabetes Spectrum. 2006; 19(2): 71‑74. Available at: https://spectrum.diabetesjournals.org/content/19/2/71
  10. Baig AA, Benitez A, Quinn MT et al. Family interventions to improve diabetes outcomes for adults. 2015; 1353(1): 89‑112. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624026/
  11. Ahmed Z, Yeasmeen F. Active family participation in diabetes self‑care. A commentary. Diabetes Management. 2016; 6(5): 104‑107. Available at: https://www.openaccessjournals.com/articles/active-family-participation-in-diabetes-selfcare-a-commentary.pdf
  12. Solowiejczyk J. The family approach to diabetes management: Theory into practice toward the development of a new paradigm. Diabetes Spectrum. 2004; 17(1): 31‑36. Available at:  https://spectrum.diabetesjournals.org/content/17/1/31

Diabetes Prevention Tips

Tips, , , , , , ,

According to statistics by the WHO, “The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.” Also, “In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.”
It is astounding how many people are affected by this chronic disease. Diabetes occurs when the pancreas does not produce enough amounts of insulin for the body or when the body cannot effectively make use of the insulin it produces. Insulin is essential to the body as it is responsible for regulating blood sugar. Unbalanced (high) blood sugar levels are what causes diabetes.
Diabetes is categorized into the following four types:

Figure 1: Types of diabetes

Insulin is the hormone which is highly essential for maintaining proper blood sugar levels, for the adequate functioning of the entire body. If, for some reason the body produces unbalanced levels of this hormone, over time, high blood glucose can lead to the following problems:

Figure 2: Problems due to high blood glucose levels

 

Diabetes imposes many restrictions on life and one can take several steps to prevent developing it. Here are some of the suggested diabetes preventions tips:

Exercise daily:

The most common advice anyone can give to stay mentally and physically fit is to workout daily. The applications of exercising daily are endless and when it comes to preventing diabetes, it is highly beneficial. Exercising regularly increases the insulin sensitivity of your cells. This basically means that less insulin is used up to keep your blood sugar levels under control.

A study published on NCBI found that people with prediabetes who trained under moderate-intensity experienced an increase in insulin sensitivity by 51%. And people who adopted high-intensity exercises measured an increase of 85%.

Even though the results vary, it’s totally up to you to choose what style of training program you wish to follow. Straining your body will do you no good, but also taking it casually will never be beneficial.

Quit Smoking:

Smoking has been associated with many major diseases and conditions. It has been proven to be the major cause of many health conditions, which includes heart diseases and cancer to various organs, such as the lungs, mouth, breast, digestive tract and prostate. Tobacco usage has no proven benefits and even second-hand exposure to tobacco smoke can be very harmful.

A research paper published in 2012 on the NCBI website states that smoking and second-hand smoke exposure is linked to type 2 diabetes.

An analysis of over one million people, showed that smoking was found to increase the risk of diabetes by 44% in average smokers.

Once you quit smoking, the effects on the body it had seem visible as they subside. Smoking is closely linked to the risk of diabetes, and quitting has been shown to reduce this risk.

Avoid processed foods:

Fitness cannot be achieved if you aren’t doing justice with your diet. Any experienced athlete or bodybuilder will always say one thing, 70% diet and 30% gym is what results in a fine toned body. Processed or “junk” food damages your body from both the inside and outside. It is linked to various heart diseases, obesity and to diabetes.

These food products are high in vegetable oils, refined grains and preservatives, which when consumed over a long period of time, increase the risk of developing diabetes. Cutting back on these unhealth packaged foods can prove to be very helpful.

To be healthier, from both the inside and outside, it is recommended to adopt a diet consisting of minimum amounts of carbs and a diet high in fiber. Also portion control is one thing that people should be conscious about. Believe it or not, eating an unhealthy amount of healthy food can also lead to many unwanted problems.

Visit your doctor from time to time:

Get yourself checked annually. One of the best ways to stay on top of any disease or ailment is to be aware of it before the symptoms start to set in. At your annual physical, make sure to get a blood pressure check, an eye exam, and screenings for other complications such as kidney damage, nerve damage, and heart disease. To make sure you aren’t developing diabetes, blood-glucose levels also need to be measured.

Prevention is always better than cure! Follow these tips to notice a change in your lifestyle.

Turacoz Healthcare Solutions aims to spread awareness about diabetes. We urge the people to exercise regularly and stay fit. Adopting a balanced diet and limiting the intake of sweet substances is highly beneficial and helps in cutting down the risk of developing diabetes. Smoking is one habit that should be dropped. Quitting the use of tobacco products not only helps with reducing the risk of diabetes but also other bodily diseases such as cancer and heart diseases.

If you wish to contact us, click here.

Medical Writing for Disease Management Platforms

Disease and Treatment, , , , ,

Disease management programs (DMPs) are defined as “structured treatment plans that aim to help people manage their chronic disease in a better way and to maintain as well as improve quality of life”. The main components of disease management programs are mentioned in Figure 1.

Figure 1: Components of Disease Management Software

By application, the care management solution is classified into chronic care management, disease management and utilization management.

Disease Management Software’s

According to Markets and Markets™ report, the disease management software market is expected to reach USD 37.94 billion by 2027 from USD 14.12 billion in 2019. This may be attributed to the rising geriatric population and burden of chronic diseases.

The disease management software is used to manage, monitor, and process patient data by connecting to electronic health record (EHR) and other healthcare data sources. It aims to reduce healthcare costs and promote government initiatives to assist patient-centric care. The high growth in this segment can be attributed to the ability of these solutions to reduce the cost of care with the help of protocol management and prevent episodes of ill health through comprehensive health management.

To be included in Disease Management Software category, a product must have the following characteristics as mentioned in Figure 2.

Figure 2: Characteristics of Disease Management Software

Some of the examples of disease management software are mentioned in Figure 3.

Figure 3: Examples of Disease Management Software

Mobile Health Apps for Disease Management

Due to widespread use of smart phones and tablet computers, disease management via mobile health apps is easy and is expanding rapidly. Around 3.7 billion apps were downloaded in 2017 and is expected to grow by 16% within the next year. Many apps are available in play store and iTunes for clinical disease management and patient self-management of conditions including asthma, diabetes, heart disease, cancer, and even autism and insomnia. These apps help both doctors and patients as money can be saved by patients and doctors can save on labour force. Some of the apps for chronic disease management are mentioned in Figure 4.

Figure 4: Examples of Disease Management Applications

Poor Usage of Disease Management Software’s and Mobile Apps

One of the reasons why the healthcare apps or software’s fail is because of the lack of understanding about the healthcare apps. Most of the health care apps get uninstalled either due to the highly scientific content which is difficult for the laymen to understand. Apps with very basic scientific content also fail to impress the audience. Therefore, it essential to involve a medical writer who has a scientific background and knows the subject comprehensively. The content for such software’s or apps must be developed based on patient’s requirement, target audience and should be specific to a region.

Role of Medical writing in Developing Health Related Software’s and Mobile Apps

According to Grand View Research, global medical writing industry is expected to reach USD 3.75 billion by 2026. Medical writers are involved in analysis and reporting of retrospective and prospective clinical trials, research methods (descriptive and predictive), health economics, and evaluation of disease management initiatives. Medical writers also play a key role in developing applications for mobile devices that are used in multiple ways, such as:

  • Disease management
  • Continuing education and training
  • Medical reference and information-gathering
  • Practice management and monitoring

The medical writer creates informational or instructional materials for use in health or medical context. These materials allow different audiences to understand health and medical situations or practices, perform certain health or medical-related activities, or use a health/ medical product/ mobile health apps or device. Medical writers must have the following skills to develop medical content:

  • They must possess medical and therapeutic knowledge, and must have understanding about the recent regulations and technical guidelines
  • They must have mastery in language and grammar, proof reading and editing skills, ethical and legal issues related to writing
  • They must have creative writing skills to articulate the scientific information in clear and approachable language
  • As scientific writers are involved in creating content for mobile medical apps and other disease management software’s, it is essential for them to possess instructional designing skills

Writer Groups Initiative in Developing Disease Management Programs

The heterogeneity of disease management programs has made it difficult to compare and evaluate different programs. The American Heart Association’s Disease Management Taxonomy Writing Group developed a taxonomy or system of classification to classify and compare different disease management programs and to inform efforts to identify specific factors associated with effectiveness.

The writers did a MEDLINE (Medical Literature Analysis and Retrieval System Online) search on the terms heart failure, diabetes, and depression, together with disease management, case management, and care management. English articles published between the time period 1987 and 2005 were considered for the program. The following studies were considered:

  • Interventions designed to improve outcomes and/or reduce medical resource utilization in patients with,
  1. Heart failure
  2. Diabetes
  3. Depression
  • Clearly defined protocols with at least two prespecified components traditionally associated with disease management

A taxonomy was developed by the writer’s group with eight domains. A graphic representation of the taxonomic structure and subdomains are found in the Figure 5.

Figure 5: Taxonomic Structure and Subdomains

Turacoz Healthcare Solutions understands its professional responsibility and takes an initiative to make authors and medical writers aware about their role in developing disease management programs. Turacoz is a medical communication company that provides scientific/medical writing support to the industry and academicians.

To contact us, click here.

 

 

 

Decoding breast cancer, its known facts and myths!

Cancer

Breast cancer is a growing concern as it is reported to be the most common cancer in women worldwide. About 1.7 million new cases and 5,22,000 deaths from breast cancer occur every year. The number of deaths due to breast cancer (3,24,000) are high, in low and middle-income countries.

Risk Factors of Breast Cancer

Risk factors of breast cancer can be divided in to 2 categories; non-modifiable and modifiable factors.

Non-modifiable factors

  • Older age: Women over 50 years are likely to suffer from breast cancer
  • Genetic mutations: Women who have inherited mutated genes such as BRCA1 and BRCA2 are at a higher risk of developing breast cancer
  • Family history: If a woman has a first degree relative (mother, sister, or daughter) or multiple family members on either her mother’s or father’s side of the family suffering from the disease, she has higher chance of developing the disease. Also, a woman’s risk of developing breast cancer is high if she has a first-degree male relative with breast cancer, though this happens rarely in males
  • Exposure to radiation therapy: The chance of developing breast cancer is higher among those women who have undergone previous treatment using radiation therapy to chest or breast before the age of 30
  • Race: White women are slightly more likely to develop breast cancer than African American women
  • Reproductive history: Women who have early menstrual periods before age 12 and starting menopause after age 55 are more likely to develop breast cancer due to long exposure to hormones
  • Health/Personal history: Women who have been diagnosed with breast cancer in one breast, have increased risk of being diagnosed with breast cancer in the other breast in the future
  • Other factors: Women who took diethylstilbestrol during 1940s through the 1960s, have slightly increased chance of developing breast cancer

Modifiable factors

  • Being overweight and Obese: Overweight and obese women are likely to suffer from breast cancer
  • Alcoholism and smoking: Frequent alcohol consumption and smoking are found to increase the risk of developing breast cancer in women
  • Physical inactivity: Lack of physical activity and sedentary lifestyle is linked to increased risk of breast cancer
  • Poor diet: Diet with high saturated fatty acids and lack of fruits, and vegetables increase the risk of breast cancer
  • Hormonal replacement therapies: These are usually taken during menopause and can raise the risk of breast cancer specifically if taken for more than 5 years
  • Oral contraceptives: Some of oral contraceptives increase the chance of developing breast cancer

Warning Signs and Symptoms of Breast Cancer

It is always best to reach out to your healthcare practitioner, if you are experiencing any signs or symptoms. During the early stages of cancer, the person may suffer from any one or two of the symptoms.

 

Figure 1: Warning Signs of Breast Cancer

Myth and Truth                                                                                                   

  • Dairy products or drinking milk causes breast cancer: The truth is till now no studies have reported any link between dairy products or drinking milk and increased risk of breast cancer
  • Finding lump in your breast means you have breast cancer: It is not always true that finding lump in your breast means you have breast cancer. But it is always the best to consult a doctor if you find any changes
  • Breast cancer only affects women: Though rare, the truth is, it is estimated that each year approximately 2190 men suffer from breast cancer and 410 die. Thus, it is recommended for men also to check themselves and look for any changes and report the same to their doctor
  • Mammogram can cause breast cancer to spread: Many people fear breast cancer can spread due to breast compression while getting a mammogram. Also, the exposure to radiation is very little and its benefit outweighs the harm from radiation. It is recommended for women above 40 to get annual mammographic screening
  • If you have family history of breast cancer, you are also likely to get it: Studies report that, though at high risk, only 10% of breast cancer patients have family history of breast cancer. However, it is advised that if you have a first degree relative (mother, daughter, sister) with breast cancer below the age of 50, you should get diagnosis done 10 years prior to the age of your relative’s diagnosis. Your chance of getting breast cancer slightly increases if you have a second degree relative (grandmother, aunt) with the disease. However, if there are multiple generations diagnosed with breast cancer on the same side of the family, it means a cancer gene runs through your family and it is advised to get regular check-ups
  • Breast cancer is contagious: Breast cancer is the result of uncontrolled cell growth of mutated cells that begin to spread into other tissues within the breast. It is not contagious
  • If gene mutation BRCA1or BRCA2 is detected in your DNA, then you will get breast cancer: Not every cancer in such families is linked to a harmful mutation in one of these genes, not every woman who has a harmful BRCA1 or BRCA2 mutation will develop breast and/or ovarian cancer. However, if these genes are detected in a woman, she is 5 times more likely to develop breast cancer compared to the normal one. If such mutations are detected in you, it is recommended to take proactive measures like taking hormonal therapy called tamoxifen or a surgical prevention approach
  • Antiperspirants and deodorants can cause breast cancer: No link has been reported between the use of antiperspirants/deodorants and development of breast cancer till now

What can you do to Prevent Breast Cancer?

  • Limit your alcohol consumption: It is recommended to limit the drinks to less than one drink a day, as even small amount increases risk
  • Don’t smoke: In premenopausal women, link between smoking and cancer has been found. Thus, it is advised to avoid smoking
  • Control your weight: Overweight and obese women tend to develop cancer, particularly after menopause. Thus, it is advised to be physically active and take healthy diet to minimize the risk of breast cancer or prevent it. Further, it is recommended to cut down on saturated fat and consume more fibre in your diet
  • Breast feeding: Recent studies reported that breast feeding tends to have a protective effect from cancer
  • Limit the dose and duration of hormonal therapy: Taking hormone combinations for more than 3 to 5 years can increase the risk of getting breast cancer. It is advised to replace the hormonal therapy with non-hormonal therapy. In case if it cannot be avoided, ask for low dose, and continue to visit your doctor to get monitoring of the length of time you are taking hormones.
  • Link between breast cancer and cumulative exposure to radiation over your lifetime are reported. Thus, such tests must be taken only when necessary
  • Chances of breast cancer decrease if you bear a child before 30 years of age

Thus, all women need to be aware of breasts cancer signs and symptoms. Self-examination will help to identify any changes in the breasts and if found consult healthcare professional at the earliest to confirm the diagnosis and initiate timely treatment.

Turacoz Healthcare Solutions aims at raising awareness about breast cancer to help women in early detection of breast cancer, if present. An early detection increases your chances for better treatment and recovery.

Opioid Crisis: How big is the problem, and what are the solutions?

Drugs and Disease

What are opioids?

Opioids (Figure 1) are a class of drugs naturally found in the opium poppy plant that acts on the nervous system to produce a variety of effects, including the relief in pain or pleasure.

Opioid Use Disorder: How big is the problem?

Figure 1: Opioids [2]

 

The clinical term opioid use disorder, also known as opioid abuse, is a multidimensional health issue with complicated causes and no appropriate solution [3]. Therefore, the world is in the midst of an unparalleled, self-inflicted opioid epidemic [1]. In 2016, approximately 275 million people globally used drugs at least once and 27 million people were estimated to be suffering from opioid abuse. In 2015, around 4,50,000 people died as a result of drug use, of which 160,000 were directly related to drug use disorders and about 118,000 with opioid abuse. Approximately, a third and a half of all drug-related deaths are contributed by drug overdose [4].

 

Drug abuse: What are the contributing factors?

Over-prescription: It is one of the significant factors of drug abuse that not only affects adults but also youngsters and children. People who depend on opioids are most likely to get addicted and experience an adverse event [5]. Opioids are responsible for high proportion of fatal drug overdoses around the world because of their ability to cause respiratory depression and death, which can be identified by a triad of signs and symptoms as depicted in Figure 2.

Figure 2: Signs and symptoms of drug overdoses

 

Non- genetic factors: Some non-genetic factors also play a role in opioid addiction such as psychiatric disorder, substance abuse, depression, child abuse, or neglect. Certain personality traits such as impulsivity and sensation-seeking also increase the risk of opioid addiction.

Opioid as pain relievers: Easy or unrestricted availability of opioid pain relievers (medications used for pain relief that falls under the category of opioids) is another reason for high opioid abuse. A survey demonstrated that 22% of the respondents had opioids from an active prescription at home and 21% had medications leftover from the previous prescription of which 66% deliberately kept the medications at home in case there is a requirement in the future. Another survey by Thiels et al. found that more than 60% of pills prescribed by healthcare professionals went unused [6]. Few contributing factors that led to the presence of opioids at home were high family income and high caregiver educations. However, some critics say that the prevalence of opioids in home was not affected by one’s relationship with the youth, race, household type or Medicaid insurance [7]. It is essential that a combination of health, social, economic and lifestyle factors interact with genetic factors to determine an individual risk [3].

 

Opioid abuse: How to resolve the problem?

Basic life support and antagonistic drugs: Fortunately, overdose of opioid can be prevented if the basic life support and naloxone (opioid antagonist) are administered on time. This approach is adopted by many countries and jurisdictions to reduce deaths resulting from an opioid overdose [4].

Appropriate prescription procedures: Emphasis should be made on the proper prescription procedures and expectations of the patient regarding postoperative pain management to bridge the gap of unused opioids. Several approaches are needed to ameliorate the opioid overdose and other problems caused by the opioid abuse if administered measurably (Figure 3) [8]:

Figure 3: Steps to prevent opioid crisis

 

All these measures are a necessity to abate the opioid crisis. However, only half of the countries provide access to the effective treatment of opioid dependence, and less than 10% of the people who need the treatment are receiving it [8].

Drug abuse: What does WHO recommend?

WHO recommendations to prevent opioid crisis [3] are given below:

  1. WHO supports countries to administer the treatment where it doesn’t exist and also helps in monitoring trends in drug use and related harm to have a better understanding of opioid dependence and overdose
  2. WHO supports countries to use the medications rationally, to make the appropriate use of the drug and minimize the misuse/ overuse
  3. WHO recommends to take measures to alleviate the risk of misuse by a careful patient selection and supervising the doses whenever necessary
  4. WHO recommends that naloxone should be made available in the rehabilitation centers to manage opioid overdose and the people who are probably to witness an opioid overdose
  5. WHO provides psychosocial support, promotes detoxification and opioid maintenance treatment (which involves administration of drugs such as methadone and buprenorphine)
  6. A stepped approach was highlighted to manage the pain in cancer patients namely- the WHO cancer pain ladder that recommends initial use of non-opioids, followed by weak opioids and then strong opioids

Although the appropriate use of opioids is a fundamental part of modern analgesia, but the drug abuse has led the problem spin out of control. While there are people suffering from chronic and acute pain, opiates shall remain an essential class of medication in healthcare facilities. Proper emphasis should be given to understand the reasons why people are using these drugs and offer fewer stigmatizing strategies to assist people who use opioids. A three-point approach emphasizing on the prevention, treatment, and rehabilitation of those already affected and who might be at risk in the future may be the holistic solution. Further investigation and success with the prevention approaches and some new strategies devoted to managing the crisis are required in order to respond effectively to such conditions in the future.

 

Turacoz Healthcare Solutions aims to provide information on the latest trends, updates, and advances in the field of clinical research, trials and regulatory affairs. Turacoz Healthcare offers end-to-end support for scientific communications, clinical trial documents and disclosures, regulatory documents writing and submissions, and medico-marketing writing along with e-modules & e-books on healthcare and research.

 

References

  1. Health resources and service administration: [https://www.hrsa.gov/opioids, Accessed on 16th sep, 2019]
  2. John Hopkins Medicine Retrieved from: [https://www.hopkinsmedicine.org/opioids/what-are-opioids.html, Accessed on 16th sep, 2019]
  3. US National Library of Medicine: [https://ghr.nlm.nih.gov/condition/opioid-addiction#resources, Accessed on 16th sep, 2019]
  4. World Health Organisation Retrieved from: [https://www.who.int/substance_abuse/information-sheet/en/, Accessed on 16th sep, 2019]
  5. Stoicea, N., Costa, A., Periel, L., Uribe, A., Weaver, T., & Bergese, S. D. (2019). Current perspectives on the opioid crisis in the US healthcare system: A comprehensive literature review. Medicine, 98(20).
  6. Ziegelmann, M. J., Habermann, E. B., & Gettman, M. T. (2019, May). In Reply—The Importance of Educational Interventions and Regional Analgesia in Tackling the Opioid Crisis in the United States. In Mayo Clinic Proceedings(Vol. 94, No. 5, pp. 921-922). Elsevier.
  7. Garbutt, J. M., Kulka, K., Dodd, S., Sterkel, R., & Plax, K. (2019). Opioids in Adolescents’ Homes: Prevalence, Caregiver Attitudes, and Risk Reduction Opportunities. Academic pediatrics, 19(1), 103-108.
  8. Saloner, B., McGinty, E. E., Beletsky, L., Bluthenthal, R., Beyrer, C., Botticelli, M., & Sherman, S. G. (2018). A public health strategy for the opioid crisis. Public Health Reports, 133(1_suppl), 24S-34S.