All posts by Turacoz Group

Hepatitis Awareness Month

Awareness Day/Month, ,

“For Hepatitis, Prevention is the Best Intervention”

The month of May is titled as “Hepatitis Awareness Month”, as a proactive step to bring together various federal, non-federal, social groups, and public health care groups across the world for spreading awareness about hepatitis infection. As described by the World Health Organization (WHO), hepatitis is an inflammation of the liver caused by drugs, alcohol use, or certain medical conditions. But in most cases, it is caused by a virus. This is known as viral hepatitis. Currently, there are 5 main hepatitis viruses, referred to as types A, B, C, D and E, but the most common forms are hepatitis A, B, and C.  Hepatitis is a global concern as it leads to more than1.4 million deaths every year.  Hepatitis is a relatively silent disease in its acute phase, its symptoms often go unnoticed till the disease is progressed to a chronic and often a fatal stage. In its advanced stage, hepatitis can result in fatal complications like liver cirrhosis, liver cancer, or liver failure. Bridging the knowledge gap about hepatitis (its causes, symptoms, and prevention) among the masses as well as healthcare professionals is the key to reduce the global burden of the disease.

Hepatitis awareness month is an initiative to bring in all stakeholders of the healthcare industry to alliance together in spreading awareness about hepatitis. Enabling the people to identifyviral hepatitis as a critical health concern and providing better healthcare facilities to all the patients with hepatitis are the prime objectives of this collation. The key strategies that are promoted for spreading the awareness are:

  • Campaigns: As an age-old method of spreading awareness, campaigning about hepatitis is a dynamic tool in spreading the word.Patient stories, supporting videos, fact sheets, posters, templates, infographics, customizable flyers, infographics, promotional badges and bands, on the spot quizzes, and street plays are few modalities that could be used for campaigning at institutional and community levels.
  • Digital tools: Using digital media like television, radio,ormobile messagesfor sharing informationabout hepatitis, its risk factors, and vaccines.
  • Social Media: Various social media platforms are used to share information about various campaigns, resources, publications, news updates, and latest updates on hepatitis. This acts as an open platform for masses and healthcare professionals to share knowledge and experience about the disease. Any user can easily join the conversation by using hashtags #HepAware, #HepTestingDay, and #hepatitis.
  • Proclamations: Atinstitutional and community level,several proclamations related to hepatitis such as hepatitis awareness day, hepatitis awareness week, or hepatitis screening day can be initiated to generate awareness among people at the specific level.
  • Free hepatitis risk assessments and testing: Various healthcare institutions, public health care centres, community health groups, and private hospitals run a day/week long free hepatitis risk assessment and testing camps. The sole idea of these camps is to enable the masses to identify the risk factors for hepatitis infection and prevention strategies for the same.Self-assessment forms and professional diagnostic checks are the components for this risk assessment and testing programs.

Viral hepatitis is a preventable disease. Effective and timely vaccination among the high-risk group and all infants is highly recommended by healthcare professionals. Providing cheap vaccination and encouraging people to get vaccinated are crux steps in halting the endemic of hepatitis across the globe.

As said earlier, prevention is the best treatment; the statement holds true for hepatitis. The best way to combat this lethal disease is to make people aware about how it spreads, what are the early signs, what can be done to prevent it, and what should be done if one gets hepatitis. As a member of healthcare industry, we all should actively take up the responsibility to spread awareness about hepatitis in our own way. Remember to be informed is to be safe!

Awareness is the first step towards prevention of viral hepatitis. As a part of their Corporate Social Responsibility (CSR) activity,Turacoz Healthcare Solutions wants to raise awareness for prevention of this disease through this blog. We are a medical communication company in Delhi. Our medical writers are 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 Malaria Day : Understanding Malaria

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Malaria is a serious life-threatening parasitic disease caused by parasites known as Plasmodium vivax (P.vivax), Plasmodium falciparum (P.falciparum), Plasmodium malariae (P.malariae) and Plasmodium ovale (P.ovale). Its transmission takes place through the infective bite of Anopheles mosquito. Man develops this disease after 10–14 days of being bitten by an infective mosquito.

Every year April 25 is celebrated as “World Malaria Day” across the globe in an effort to provide effective control of the disease. This occasion also provides a common platform for the affected countries to share experiences, showcase technologies and collaborate in programs in the fight against malaria.

SIGNS AND SYMPTOMS OF MALARIA

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Infection with one type of malaria, P. falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death.

POPULATION AT RISK

In 2015, approximately 3.2 billion people—nearly half of the world’s population—were at risk of malaria.

Maximum number of malaria cases and deaths occur in sub-Saharan Africa. However, Asia, Latin America, and, to a lesser degree, the Middle East, are also at risk. In 2015, 97 countries and territories had ongoing malaria transmission.

DISEASE BURDEN

  • According to the latest WHO estimates, released in December 2015, there were 214 million cases of malaria in 2015 and 438,000 deaths.
  • Between 2000 and 2015, malaria incidence among populations at risk reduced by 37% globally; during the same period, malaria mortality rates among populations at risk registered a decline by 60%. An estimated 6.2 million malaria deaths have been averted globally since 2001.
  • Sub-Saharan Africa continues to contributethe highest share of the global malaria burden. In 2015, the region accounted for 88% of malaria cases and 90% of malaria deaths.

PREVENTIVE MEASURES FOR CONTROLLING MALARIA

  • Taking antimalarial drugs to kill the parasites
  • Eliminating places where mosquitoes breed
  • Spraying insecticides to kill adult mosquitoes that come inside
  • Sleeping under bed nets—especially effective if they have been treated with insecticide, e.g. insecticide-treated mosquito nets (ITNs) and
  • Wearing insect repellent and long-sleeved clothing if out of doors at night.

CURRENT SCENARIO OF MALARIA VACCINE

  • Effective malaria vaccine could helpeliminate and eradicate malaria; there are currently 63 vaccine candidates, 41in preclinical and clinical stages of development.
  • Vaccines are being designedto target pre-erythrocytic stages, erythrocytic stage or the sexual stages ofPlasmodium taken up by a feeding mosquito, or the multiple stages
  • Twovaccines in preclinical and clinical development target falciparum; and themost advanced candidate is the pre-erythrocytic vaccine RTS,S which is inphase-III clinical trials.
  • RTS,S/ASO1 is the first malaria vaccine to have completed pivotal Phase 3 testing and obtained a positive scientific opinion by a stringent medicines regulatory authority.
  • Collaborators of RTS,S Clinical Trials Partnership showed that RTS,S/AS01 prevented a substantial number of cases of clinical malaria over a 3–4-year period in young infants and children when administered with or without a booster dose. Efficacy was enhanced by the administration of a booster dose in both age categories. Thus, the vaccine has the potential to make a substantial contribution to malaria control when used in combination with other effective control measures, especially in areas of high transmission.

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.

Medical Writing Workshop at Bangalore

News

5b79d27d-7530-4423-be85-44dc1dc89c0d-originalTuracoz Healthcare Solutions conducted a medical writing workshop on 16th April, 2016 at Country Inn and suites by Carlson, Bangalore. The workshop primarily focused on publication where subjects like grammar, guidelines, biostatistics, referencing etc. were the topics of discussion. Doctors from the reputed hospitals, medical writers, medical managers and advisors from the pharmaceutical industry were the main audience. Live assignments and case studies made the session highly interactive where people came forward with their queries. The workshop was highly appreciated and valuable feedbacks were received.

World Hemophilia Day

Awareness Day/Month

Let’s Join Hands to Fight Against Hemophilia

Hemophilia is one of the oldest known genetic bleeding disorder which is caused by deficiency of the genes responsible for synthesis of clotting factors. Clotting factors are special type of proteins required for blood clotting. If a person does not have enough clotting factor VIII, then the condition is known as “hemophilia A”, while deficiency of clotting factor IX is known as “hemophilia B”.

Misconception                Individuals with hemophilia bleed faster than normal people

    Fact                             Individuals with hemophilia bleed longer than normal people

 

The major symptoms of hemophilia are: prolonged bleeding, spontaneous bleeding, bleeding into joints and muscles, excessive bleeding following trauma or surgery, easy bruising, swelling, pain, and stiffness. Left untreated, it can lead to various life-threatening complications like deep internal bleedings, joint damage, and intracranial hemorrhage. However, there are various treatment options available for the disorder like replacement therapy with clotting factors, gene therapy and anti-fibrinolytic medicines. Unfortunately, a large population of hemophilic patients is unable to receive adequate treatment due to its high cost.

Although the incidence of hemophilia is low and is estimated to affect approximately 1 in 10,000 people, only 25 % of those living with hemophilia get proper care.

 

World Hemophilia Day (WHD) is, therefore, a day to consider those hemophilic patients who are unable to access the care and treatment they require to live a healthy life.

History: WHD was established in 1989 with the help of the World Federation of Hemophilia (WFH). Since 1989, WHD is observed globally on April 17 in order to honor Frank Schnabel, the founder of WFH, whose birthday falls on the same date. Today, WHD has grown into a global event which is celebrated across 113 WFH member countries.

 

“Treatment for all is the vision of all” is the main goal of WHD.

The main aim of WHD is to increase public awareness, educate patients, attract volunteers, and advocate for improved treatment and care of hemophilia. This day provides an opportunity to talk to your family, friends, and colleagues to raise awareness and increase support for the patients living with hemophilia and other bleeding disorders.

A patient with hemophilia must be encouraged to think and act positively. Since hemophilia is a lifelong condition, requires expensive treatment, and affects patient’s family life, therefore, it is important that parents, spouses, and other family members of the patient should be educated in all aspects of the patient’s care. Besides, general information and education should also be given to the community where hemophilic patient lives.

Today, someone born with hemophilia can live a normal life if he/she has access to adequate treatment. Although access to adequate treatment is a big challenge but the WFH has a vision and is trying hard to provide treatment for all the people with hemophilia.

Uniform Code of Pharmaceuticals Marketing Practices (UCPMP) – Code for Writing Promotional Material

Medical Writing

The Department of Pharmaceuticals (DoP), Government of India, released Uniform Code of Pharmaceuticals Marketing Practices (UCPMP) on 1st January 2015.
UCPMP is a voluntary code that should be adopted by pharmaceutical industry to curb unethical practices in the healthcare sector. UCPMP bears significance as pharmaceutical companies have been accused of massive enticements to secure prescriptions from the medical fraternity for a very long time.

UCPMP for promotional materials:

  • All promotional material issued by a product authorization holder or with his authority, must be consistent with the requirements of this Code.
  • Where the purpose of promotional material is to provide persons qualified to prescribe or supply with sufficient information upon which to reach a decision for prescribing or for use, then the following minimum information, must be given clearly and legibly and must be an integral part of the advertisement:
    • The relevant product authorization number and the name and address of the holder of the authorization or the business name and address of the part of the business responsible for placing the medicinal product on the market
    • The name of the product, and a list of the active ingredients, using the common name, placed immediately adjacent to the most prominent display of the name of the product
    • Recommended dosage, method of use and, where not obvious, method of administration
    • Adverse reactions, warnings and precautions for use, and relevant contraindications of the product
    • A statement that additional information is available on request
    • The date on which the above particulars were generated or last updated
  • Promotional material such as mailings and journal advertisements must not be designed to disguise their real nature. Where a pharmaceutical company pays for or otherwise secures or arranges the publication of promotional material in journals, such promotional material must not resemble editorial matter.
  • Promotional material must conform, both in text and illustration, to canons of good taste and must be expressed so as to recognize the professional standing of the recipients and not be likely to cause any offence.
  • The names or photographs of healthcare professionals must not be used in promotional material.
  • Promotional material must not imitate the devices, copy, slogans, or general layout adopted by other companies in a way that is likely to mislead or confuse.
  • Where appropriate (for example, in technical and other informative material), the date of printing or of the last review of promotional material must be stated.
  • Extremes of format, size, or cost of promotional material must be avoided.
  • Postcards, other exposed mailings, envelopes or wrappers must not carry matter which might be regarded as advertising to the lay public or which could be considered unsuitable for public view.
  • Audio-visual material must be accompanied by all appropriate printed material so that all relevant requirements of the Code are complied with.

Other key highlights of UCPMP are:

  • No gifts, pecuniary advantages or benefits in kind may be supplied, offered or promised to persons qualified to prescribe or supply drugs, by a pharmaceutical company or any of its agents i.e. distributors, wholesalers, retailers, etc.
  • Free samples of drugs shall not be supplied to any person who is not qualified to prescribe such products
  • Companies or their associations/representatives or any person acting on their behalf shall not extend any travel facility inside the country or outside, including rail, air, ship, cruise tickets, paid vacations, etc., to healthcare professionals and their family members for vacation or for attending conference, seminars, workshops, etc. as a delegate
  • Companies should not pay any cash or monetary grants to any healthcare professionals for individual purpose in individual capacity under any pretext
  • Funding for medical research, study etc., can only be extended through approved institutions by modalities laid down by law/rules/guidelines adopted by such approved institutions, in a transparent manner

Need for UCPMP – Self-regulation in pharma marketing has hardly worked anywhere

Many international pharmaceutical trade associations, which are primarily the lobbying bodies, strongly advocate self-regulations (such as following UCPMP) by the industry. They have also created many documents in this regard, which are also displayed in their respective websites. However, despite all this, the ground reality is that, the well-hyped self-regulation by the industry to stop the menace of pharma marketing malpractices is not working; few recent examples are cited below:

  • March 2014 – the anti-trust regulator of Italy reportedly fined two Swiss drug majors, Novartis and Roche 182.5 million euros (U$ 251 million) for allegedly blocking distribution of Roche’s Avastin cancer drug in favor of a more expensive drug Lucentis that the two companies market jointly for an eye disorder.
  • March 2014 -A German court fined 28 million euro (US$ 39 million) to the French pharma major Sanofi and convicted two of its former employees on bribery charges.
  • May 2013 – Sanofi was reportedly fined US$ 52.8 Million by the French competition regulator for trying to limit sales of generic versions of the company’s Plavix.
  • August 2012 – Pfizer Inc. was reportedly fined US$ 60.2 million by the US Securities and Exchange Commission to settle a federal investigation on alleged bribing of overseas doctors and other health officials to prescribe medicines.
  • April 2012 – a judge in Arkansas, US, reportedly fined Johnson & Johnson and a subsidiary more than US$1.2 billion after a jury found that the companies had minimized or concealed the dangers associated with an antipsychotic drug.

As per the recent information available, the government is planning to make the UCPMP practices mandatory, which have so far been voluntary. The DoP is working on to finalize the mandatory code practices. The move has been triggered by insufficient compliance to the existing voluntary code by pharmaceutical companies. The mandatory codes will also involve legal implications and invoking of marketing licenses.

Turacoz healthcare solutions fully believe in following ethical codes such UCPMP. Our medical writing team is well versed with these codes and tries to adapt to the same while providing promotional material content to our client.

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

Awareness Day/Month, , ,

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

Awareness Day/Month, , ,

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.