Health & Wellness Community

Alzheimer’s disease experts have unveiled a ground-breaking development in the way doctors diagnose patients with this progressive brain disorder. At an Alzheimer’s Association conference in Amsterdam, they introduced a new rating system that mirrors the numerical staging system used in cancer diagnoses. This system replaces the previous guidelines issued in 2018 and aims to provide a more accurate and comprehensive assessment of the disease’s progression. The motivation behind this update stems from recent advancements in detecting key Alzheimer’s-related proteins, such as beta amyloid, in the blood. These advancements, along with the emergence of new treatments that require confirmation of disease pathology, prompted experts to revamp the diagnostic guidelines. The new system considers both cognitive changes and the presence of abnormal biomarkers, offering a more holistic view of the individual’s underlying disease. Gone are the terms “mild,” “moderate,” and “severe,” which were previously used to describe the stages of Alzheimer’s. Instead, patients will now receive a score ranging from 1 to 7, reflecting the extent of cognitive changes and the presence of abnormal disease biomarkers. Additionally, the system introduces four biological stages labelled a, b, c, and d. These stages provide further granularity in assessing the progression of the disease. The new rating system also includes a Stage 0 category for individuals who carry genes that guarantee the development of Alzheimer’s. This category encompasses people with Down Syndrome, as they have a significantly higher risk of developing Alzheimer’s later in life. By incorporating this additional stage, the guidelines acknowledge the diverse factors contributing to the development of the disease. Dr. Clifford Jack of the Mayo Clinic, the lead author of the report, emphasizes the similarity of the new system to cancer stages, highlighting that the goal is to provide a more precise understanding of the disease. The updated guidelines are particularly timely, as doctors prepare to identify and treat patients with recently approved drugs such as Leqembi and donanemab. The proposed guidelines are intended for doctors to utilize in clinical practice, equipping them with a more nuanced approach to diagnosing and treating Alzheimer’s patients. By enabling personalized medicine, which considers specific biomarkers and disease stages, doctors can now offer treatments that aim to slow down the progression of the disease, rather than solely managing its symptoms. These draft guidelines are currently open for expert review and comment, ensuring that the input of the Alzheimer’s research community is considered. The final version will reflect this feedback, marking a significant step forward in accurately diagnosing and managing Alzheimer’s disease. With its devastating impact on memory and cognitive abilities, Alzheimer’s presents a pressing challenge, and this new rating system represents a vital advancement in the fight against this debilitating condition.  

The Directorate General of Health Services’ (DGHS) Medical Counselling Committee (MCC) has announced that the counselling process for medical and dental courses in India will tentatively begin on July 20. The schedule released by the MCC pertains to the online counselling for NEET-UG in seats under the all-India quota, deemed universities, central universities, all AIIMS institutes, and JIPMER. While students can start registering from July 20 and filling their choices from July 22, participating institutes will verify the tentative seat matrix on July 20 and 21. Although the centralised counselling process was expected to include state seats as well, it will remain voluntary for the first year. The Ministry of Health and Family Welfare is in discussions with state counselling authorities to ensure a unified and transparent admission process. However, the notification lacks clarity on the schedule for state admissions, causing confusion and concerns among parents and students. The compressed timeline for the counselling process raises worries about the potential difficulties faced by parents and the possibility of meritorious students missing out on their preferred seats. The Ministry official clarified that DGHS handles only the all-India quota seats, and the NMC is expected to announce the state schedule separately.

The Indian government has taken strict measures against several pharmaceutical companies for failing to comply with quality control standards. Production of drugs has been halted at 31 firms, while the licenses of 50 firms have been cancelled or suspended. Additionally, 73 firms have received showcause notices, and 21 firms have been issued warning letters. These actions come as a result of a nationwide inspection of drug manufacturing units that were identified as being at risk of producing substandard, adulterated, or counterfeit drugs. The inspections were prompted by recent controversies involving the alleged adulteration of certain products, particularly cold and cough syrups exported abroad. To ensure compliance with the Drugs & Cosmetics Act, 1940 and its rules, a committee comprising two joint drug controllers has been established at the Central Drug Standard Control Organisation headquarters to oversee the inspection process, reporting, and subsequent actions. On the matter, Union Minister of Chemicals and Fertilisers, Mansukh Mandaviya, held a meeting with representatives from various pharmaceutical companies, stressing the importance of maintaining drug quality and urging small and medium-sized pharma companies to adopt good manufacturing practices through self-regulation. Mandaviya also instructed the Drug Controller General of India (DCGI) to take strong action against any companies involved in producing counterfeit drugs, emphasizing that the quality of drugs manufactured in India should not be compromised.

Researchers at Washington University in St. Louis have developed an innovative air monitor capable of detecting different variants of the SARS-CoV-2 virus in a room within approximately five minutes. This affordable device combines advanced aerosol sampling technology with an ultrasensitive biosensing technique. The monitor, described as the most sensitive detector available, has the potential to be used in hospitals, healthcare facilities, schools, and public spaces to detect SARS-CoV-2 and monitor other respiratory virus aerosols like influenza and respiratory syncytial virus (RSV). The research team published their findings in the journal Nature Communications, emphasizing the current lack of tools to assess room safety. The new device aims to provide real-time information, enabling individuals to know within minutes whether there is a live virus present. John Cirrito, a professor of neurology at Washington University, highlighted the importance of immediate knowledge, particularly in crowded settings where delayed confirmation of potential illness could have serious consequences. To develop the monitor, the researchers modified a micro-immunoelectrode (MIE) biosensor that was initially designed to detect amyloid beta, a biomarker for Alzheimer’s disease. They replaced the amyloid beta antibody with a nanobody derived from llamas that recognizes the spike protein of the SARS-CoV-2 virus. This nanobody-based electrochemical approach offers faster detection without requiring extensive processing steps or reagents, making it more efficient. The nanobody itself is small, easy to produce and modify, and cost-effective. The biosensor was integrated into an air sampler that utilizes wet cyclone technology. This sampler creates a surface vortex by mixing high-velocity air with fluid, effectively trapping virus aerosols. The sampler’s automated pump collects the fluid and sends it to the biosensor for seamless virus detection using electrochemistry. This wet cyclone sampler stands out due to its ability to sample a larger volume of air in just five minutes, significantly increasing virus recovery compared to other commercially available samplers. The team conducted tests in the apartments of two COVID-positive patients, comparing real-time PCR results of air samples from the bedrooms with those from a virus-free control room. The monitor successfully detected RNA from the virus in the bedroom air samples while yielding negative results for the control air samples. In laboratory experiments simulating a room-sized chamber with aerosolized SARS-CoV-2, the wet cyclone sampler and biosensor efficiently detected various levels of airborne virus concentrations after just a few minutes of sampling. This ground-breaking air monitor addresses the challenge of detecting diluted virus particles in indoor air, a task that even pushes the limits of polymerase chain reaction (PCR) detection. The research team’s innovation and use of advanced technology offer a promising solution for real-time monitoring of viral presence in various environments, facilitating timely interventions to mitigate transmission risks. Source: PTI

The Indian Ministry of Health announced on Wednesday that over 1.78 billion visits were recorded at the Ayushman Bharat Health and Wellness Centres (AB-HWCs) by June 30. These centers were established as part of the government’s Ayushman Bharat scheme. The ministry further disclosed that more than 1.22 billion screenings for non-communicable diseases had been conducted, including 418.1 million for hypertension, 361.6 million for diabetes, 247.5 million for oral cancer, 114.4 million for breast cancer, and 78.3 million for cervical cancer. Additionally, more than 216 million wellness sessions involving 238.3 million individuals were conducted. The AB-HWCs also utilized teleconsultation services through the e-Sanjeev platform, delivering specialist services to beneficiaries in remote areas. As of June 30, more than 122.1 million teleconsultations had been provided through the eSanjeevani portal. The AB-HWCs aim to provide comprehensive primary healthcare, including maternal and child health services, non-communicable disease management, and free essential drugs and diagnostics, thereby working towards achieving Universal Health Coverage. The initiative began with the operationalization of the first AB-HWC on April 14, 2018, in Jangla village, Chhattisgarh, and has since transformed numerous Sub-Health Centres and Primary Health Centres across rural and urban areas, with a total of 160,002 AB-HWCs being operational by June 30.

Wellcome and the Bill & Melinda Gates Foundation have joined hands to provide funding for the final stage of trials for a potentially ground-breaking tuberculosis (TB) vaccine. With an investment of approximately $550 million, they aim to support the Phase III trials of the M72 vaccine, which could mark the first new vaccine against TB in over a century. Despite being preventable and treatable, TB continues to affect 10 million individuals annually, leading to 1.6 million deaths in 2021, primarily in low and middle-income countries. TB has long held the position of the world’s deadliest infectious disease, although it was briefly overshadowed by the COVID-19 pandemic. Bill Gates recently criticized the lack of funding for new tools against TB. His foundation will contribute the majority of the financing for the trial, amounting to around $400 million. However, the organization is also seeking commercial partners to facilitate large-scale production and delivery of the vaccine in the event of trial success. Trevor Mundel, President of Global Health at the Gates Foundation, revealed that discussions are underway with potential vaccine manufacturers. He stated, “We have a couple of partners that are interested.” The trial, spanning 4-6 years, will involve over 26,000 participants across more than 50 sites in Africa and Southeast Asia. It will assess the vaccine’s effectiveness in preventing latent TB from progressing to active TB and causing illness, including among individuals with HIV. The existing TB vaccine, Bacille Calmette-Guerin (BCG), has been administered since 1921 and offers limited protection against the lung-invading form of the disease in adolescents and adults. While it is effective in protecting infants and young children against severe TB, its efficacy diminishes over time. The M72 vaccine, initially developed in the early 2000s by the Gates-backed non-profit Aeras and GSK, continues to utilize GSK’s adjuvant for immune enhancement. Recent Phase II trial data from 2018 demonstrated that the vaccine prevented TB development in approximately half of the recipients. Although the efficacy rate of 50% is relatively modest for vaccines, it has the potential to make a significant impact, potentially saving 8.5 million lives over 25 years, according to the World Health Organization.

A recent study published in the Radiology journal of the Radiological Society of North America (RSNA) has revealed that the assistance of a highly accurate artificial intelligence (AI) algorithm significantly improves the detection of lung cancers in chest X-rays. Moreover, the study found that the integration of AI suggestions also enhances human acceptance of AI in the diagnostic process. While AI-based image diagnosis has made significant progress in medicine, there has been limited exploration of the factors influencing radiologists’ diagnostic decisions when utilizing AI-assisted image reading. Researchers from Seoul National University conducted a retrospective study involving 30 readers, including 20 experienced thoracic radiologists and 10 radiology residents. The readers assessed 120 chest X-rays without the aid of AI. Among the X-rays, 60 were from lung cancer patients, and 60 were controls. In a subsequent session, each group re-evaluated the X-rays with the assistance of either a high-accuracy or low-accuracy AI, without knowledge of the use of different AIs. The study found that the use of high-accuracy AI significantly improved the readers’ detection performance compared to low-accuracy AI. Additionally, the implementation of high-accuracy AI resulted in more frequent changes in the readers’ determinations, indicating their susceptibility to AI recommendations. Dr. Chang Min Park, the lead author of the study, suggested that the substantial sample size might have contributed to the readers’ confidence in the AI’s suggestions. The researchers observed that human trust in AI played a crucial role in their susceptibility to AI recommendations. Compared to the initial reading session, readers supported by the high-accuracy AI during the second session exhibited higher sensitivity and specificity in detecting lesions. However, there was no improvement in these measurements when readers were assisted by the low-accuracy AI. Dr. Park emphasized that AI can assist radiologists effectively only when the AI’s diagnostic performance equals or surpasses that of human readers. The study highlights the importance of utilizing high-performance AI in clinical practice. Nevertheless, Dr. Park acknowledged that the definition of “high diagnostic performance AI” may vary depending on the task and clinical context. The study underscores the need for the development of high-performance AI models tailored to specific tasks and the corresponding clinical settings. The researchers plan to expand their investigation of human-AI collaboration to detect other abnormalities in chest X-rays and CT images in the future.

Concerned about the issue of doctors and staff arriving late to government hospitals, state health authorities have implemented a solution. The health department has issued a directive making biometric attendance mandatory in all government hospitals. This follows similar orders recently issued by the medical education department, which made biometric attendance compulsory for faculty members. On Monday, Shubhra Singh, Additional Chief Secretary (Health), Govt. of Rajasthan issued the orders. Referring to previous orders from 2017, Singh instructed hospitals and office administrators to ensure that not only doctors but also nursing staff, paramedics, and other hospital personnel mark their attendance using the biometric system. Authorities have been given one week to install the necessary machines on hospital and office premises. The 2017 orders were implemented across district hospitals, sub-division hospitals, satellite hospitals, TB clinics, community health centres, primary health centres, and dispensaries. Although similar directives were issued in 2017, their implementation gradually weakened over the years. Now, the health department has prioritized the enforcement of this measure. Five days ago, SMS Medical College made biometric attendance mandatory for its faculty members.

The Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, announced on Wednesday that the organization is getting ready for a rise in the spread of viral diseases such as dengue, Zika, and chikungunya, which are associated with the El Nino weather phenomenon. El Nino, characterized by higher water surface temperatures in the eastern and central Pacific Ocean, has recently returned after three years of the La Nina climate pattern. This resurgence is expected to bring extreme weather conditions later this year, including tropical cyclones heading towards vulnerable Pacific islands, heavy rainfall in South America, and drought in parts of Australia and Asia. Ghebreyesus stated that the WHO is preparing for a high probability of an El Nino event in 2023 and 2024, which could lead to increased transmission of dengue and other arboviruses such as Zika and chikungunya. He also warned about the impact of climate change on mosquito breeding and highlighted the significant rise in dengue cases, particularly in the Americas, over the past few decades. This year, Peru has declared a state of emergency in most regions due to a surge in dengue cases, leading to the resignation of its health minister, Rosa Gutierrez. Dengue is transmitted through mosquito bites from the Aedes aegypti species and manifests symptoms such as fever, headache, muscle and joint pain, nausea, vomiting, and fatigue.