Sunday, April 30, 2017

Ted talk by Katie Hinde: What we don't know about mother's milk

Breast milk grows babies' bodies, fuels neurodevelopment, provides essential immunofactors and safeguards against famine and disease — why, then, does science know more about tomatoes than mother's milk? Katie Hinde shares insights into this complex, life-giving substance and discusses the major gaps scientific research still needs to fill so we can better understand it.


In case you missed it: Here are the top 5 posts this month.



Ethicon STRATAFIX™ Spiral Plus Devices transforms wound closure experience for surgeons.

Ethicon has launched Stratafix Spiral PDS Plus and Stratafix Spiral Monocryl Plus Knotless Tissue Control Devices that provides a unique edge over traditional suturing.
Stratafix sutures enables more strength, consistency, security and efficiency over its predecessors because the surgeon can manage tension and control tissue approximation with each pass. It also eliminates the need to tie knots.


Mayo Clinic Tampon Test for detecting Endometrial Cancer at early stage.

There is no standard screening test to identify endometrial cancer, hence it is often detected late when the disease has already advanced.
Mayo clinic expert Jamie N. Bakkum-Gamez, M.D. and her team are in the process of developing a simple screening test that can be done at home using a tampon. It is based on the concept of detecting tumor DNA hypermethylation in vaginal pool DNA picked up by ordinary tampon.

At last, a no surgery, no knife, noninvasive treatment for uterine fibroid receives European approval.

Mirabilis Medical, a Seattle based company received CE Mark authorization for marketing of the Mirabilis System for treatment of uterine fibroids throughout the European Union.  It also announced that it had received a green signal from US-FDA to begin its clinical studies in US.
The Mirabilis system is a High-Intensity Focused Ultrasound (HIFU) system consists of an ultrasound system that has two parts: the imaging part and the therapy part.

Synthetic progestogens, but not natural progesterone, lowers miscarriage risk among women with unexplained RPL: Systematic review and meta-analysis.

Women taking progestogens have a 28% lower risk of miscarriage (RR 0.72; 95% CI 0.53-0.97).  and 7% higher chances of live births as compared to women who did not receive any supplementation. (RR 1.07, 95% CI 1.02–1.15).
The Meta-analysis included 10 trials comprising a total of 1,586 women with history of recurrent miscarriage.

Sperms used as vehicle for targeted drug delivery in gynecological cancers.

Sperms are not just for baby-making anymore, but can be used as cargo agents for delivering drugs inside the body.
Getting the chemotherapeutic agent to only kill the tumor cells without affecting the normal cells is a dream come true in area of cancer therapeutics because of Targeted drug delivery systems(TDDS).
Targeted drug delivery systems using polymeric nanoparticles have opened up new avenues in cancer chemotherapy.  Liposomes have shown to be effective among an array of nano- and microcarriers but have the drawback of dilution by body fluids, decreased penetration and uptake by non-target tissues.


Friday, April 28, 2017

Video of the day: DNA-Past to Present 2017




National DNA Day is a unique day when students, teachers and the public can learn more about genetics and genomics! The day commemorates the completion of the Human Genome Project in April 2003, and the discovery of DNA's double helix in 1953.

Virtual reality adds a new dimension to pain management in labor.

appliedVR

Virtual Reality is no longer just a part of Sci-Fi movies but it has moved from realm of fiction to world of reality. Besides being used in virtual reality gaming, the technology holds endless potential for application in healthcare industry.

It finds its application in numerous areas of medicine like medical education, training young surgeons for reality of OR, treating patients with mental health problems and relieving acute and chronic pain, including the pain during labor.

Virtual Reality ability to distract mother from pain during labor could redefine the need of epidural in childbirth.

Dr. Ralph Anderson, an obstetrician-gynecologist at Orange Regional Medical Center in Middletown, New York found that by giving expectant mothers VR headsets that immerse them in specially designed 3D environments, anxiety and pain were often reduced.

“I wanted to make their experience better,” Anderson said of his patients. “I started using this device mainly around the office with my staff, but my idea all along was to find a way to use it in the hospital.”

He got the first opportunity to use VR during labor when one of his patient Erin Martucci refused to have an epidural shot and asked for an alternative.


She was given a pre-programmed Samsung Gear VR headset, with instructions like “focus on the birds” and “remember to breathe” delivered by a pre-recorded narrator.

The VR headset took her out of hospital room and deposited her on a scenic overlook of California’s Big Sur. The crashing waves, soothing sounds and helpful instructions were able to help this mother manage her pain.

Minutes after taking off the device she gave birth to a beautiful baby girl.

Martucci is believed to be the first woman to use virtual reality (VR) for pain management during labor.

Besides its application in labor pain management Dr.Anderson has used this technology for managing  antenatal patients who are confined to bed for long to help them get over the boredom, cervical biopsies or in  difficult pelvic exams and placement of balloons for induction of  labor.   

The company that created the virtual environment for Dr Anderson is AppliedVR, it has partnered with Cedars-Sinai Medical Center in Los Angeles for clinical studies.

Childbirth is just one example of VR based pain management, it can be very useful in managing pain due to burns also.

VR has the potential to suppress pain in other medical procedures, too. “Because of its immersive and distractive nature, researchers believe that VR may be safer and more effective than traditional analgesic methods,” researchers from Shanghai’s Tongji University wrote in a June 2016 evaluation of the use of VR for pain management.

Researchers at Los Angeles-based Cedars-Sinai Medical Center are also further exploring the possibility of the use of VR for chronic pain management.

Patients having chronic pain are using Samsung Gear VR technology once during their inpatient stay and later completing a survey about the experience.

Dr. Brennan Spiegel, director of Cedars-Sinai Health Services Research, envisions the eventual need for VR pharmacies — libraries of different types of VR content that specialists can match to the needs of specific patients.

The basics of VR kit is the headset that looks like a thick pair of goggles which goes over your eyes, and a smartphone that is clipped in front of the handset.

More expensive high end headsets are connected to a computer to run the apps and games. There are other number of accessories to simulate the experience of being in another world.


VR devices have own app store where you can view the apps and download it.
                                                 
                                                               Virtual Reality | Cedars-Sinai

USPSTF final recommendation statement favor screening for preeclampsia throughout pregnancy.


The US Preventive Services Task Force (USPSTF) today issued its final recommendations for preeclampsia screening by monitoring the blood pressure throughout pregnancy with grade B, meaning there exists substantial net benefit for the mother and infant because of screening.

The recommendations, accompanying editorial and systematic review evidence was published online 25 April 2017 in JAMA.

USPSTF has earlier released a draft recommendation on September 27, 2016 which was open to public comments till October 2017.

The task force last full review of this topic was in 1996. The topic was again reviewed recently in light of new evidence and change in definition of preeclampsia.

The current recommendation states that Blood Pressure measurement should be done at each antenatal visit. No timing interval is mentioned.

The screening applies to all pregnant women without a known diagnosis of preeclampsia or being at high risk for the disease.

Conditions associated with increased risks are previous history of eclampsia or preeclampsia (particularly early-onset preeclampsia), medical morbidities associated includes DM 1 or 2, GDM, chronic hypertension, renal disease, and autoimmune diseases), previous history of adverse pregnancy outcome and multifetal gestation.

Other risk factors include nulliparity, obesity, African American race, low socioeconomic status, and advanced maternal age.

Evidence did not suggest point of care urine testing when screening for preeclampsia because it alone could not predict the health outcome.

Recently revised criteria for the diagnosis of preeclampsia include:
  • elevated blood pressure (≥140/90 mm Hg on 2 occasions 4 hours apart, after 20 weeks of gestation)
  • and either proteinuria (≥300 mg/dL on a 24-hour urine protein test, protein to creatinine ratio of ≥0.3 mg/mmol, or urine protein dipstick reading >1 if quantitative analysis is not available)
  • or, in the absence of proteinuria, thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or cerebral or visual symptoms.

The USPSTF further recommends low dose aspirin (81 mg/d) after 12 weeks of gestation for all women at high risk for preeclampsia.

Other Obstetrics and Gynecology societies like The Society of Obstetricians and Gynecologists of Canada, The National Institute for Health(NIH) and Care Excellence recommends urinalysis for proteinuria at each antenatal visit.

The ACOG only recommends B.P. measurements at every visit with detailed history to evaluate the risk.

“Preeclampsia and CVDs including hypertension are bound not only by common pathophysiology but also epidemiology” said Nisha I. Parikh, MD, and Juan Gonzalez, MD, PhD, from the University of California, San Francisco, in an accompanying editorial published simultaneously in JAMA Internal Medicine.

"Pregnancy is essentially a cardiovascular stress test, and the development of preeclampsia among other pregnancy complications is the earliest marker of patients at risk for future [cardiovascular disease].” They further added.

The full text of recommendation statement in JAMA can be assessed here.

The accompanying editorial in JAMA can be accessed here.

The accompanying editorial in JAMA cardiology can be accessed here.

The accompanying editorial in JAMA Internal Medicine can be accessed here.





Thursday, April 27, 2017

ACOG and AUGS issues recommendations for management of mesh and graft complications in gynecologic surgery.

Courtesy: Sanders firm 
The American College of Obstetricians and Gynecologists (ACOG) and the American Urogynecologic Society (AUGS) have jointly developed a committee opinion of the management of mesh and graft complications in gynecologic surgery.

The document provides surgeons with guidance for managing complications after mesh surgery. It also stresses the importance of good clinical history and detailed physical examination.

Knowledge of exact location of the mesh/graft is a must, and case notes/operative notes from the index procedure are best in providing the necessary information.

Diagnostic testing includes cystoscopy, proctoscopy, colonoscopy, or radiologic imaging.

The procedures most commonly associated with mesh complications are Midurethral Sling, Abdominal sacral colpopexy and transvaginal mesh.

The recommendations by American College of Obstetricians and Gynecologists and the American Urogynecologic Society includes the following:

  • Short-term voiding dysfunction after placement of a synthetic midurethral sling is common and, if improving, can be managed expectantly for up to 6 weeks. However, retention (inability to empty the bladder) or small-volume voids with large postvoid bladder residual volume should receive earlier intervention.
  • Long-term voiding dysfunction (typically 3 months or longer) after a midurethral sling placement are managed by referral to a clinician with appropriate training and experience, such as a female pelvic medicine and reconstructive surgery specialist.     
  • Asymptomatic exposures of monofilament macroporous meshes can be managed expectantly in the hope that spontaneous reepithelialization can occur.
  • A trial of vaginal estrogen can be attempted for small (eg, less than 0.5-cm) mesh exposures, if not successful primary reclosure is advised.
  • Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections (UTIs) after mesh placement should prompt an examination and possible further evaluation for exposure or erosion.
  • Pelvic pain (including dyspareunia), possibly related to nonexposed mesh, is complex, may not respond to mesh removal, and should prompt referral to a clinician with appropriate training and experience, such as a female pelvic medicine and reconstructive surgery specialist.
  • Mesh removal surgery should not be performed unless there is a specific therapeutic indication.


The full text of committee opinion of the management of mesh and graft complications in gynecologic surgery can be accessed here. 

‘One size fits all’ breast imaging is a thing of past with new personalized breast exams by Automated Breast Ultrasound (ABUS).

Mammography misses 30% of breast cancers in dense breast which means that nearly 40% of women have the chance of missing breast cancer by simple screening mammography. Now it is possible to individualize breast imaging for each patient using multimodality approach.

Starting with personal and family history, followed by gold standard screening mammography with new technology of breast tomosynthesis, we can know the personal biology of the patient.

 Knowing that the woman has dense breast after the initial screening Automated Breast Ultrasound (ABUS) can be performed which increases the chances of cancer detections even after negative mammography.  

Using all this tool synergistically it is possible to increase the breast cancer detection rate by 55 percent over mammography alone.


More information about the ABUS by GE healthcare can be found here: https://obgynupdated.blogspot.com/2017/03/innovative-breast-ultrasound-system-for.html


More information about screening modalities other than mammography can be found here: https://obgynupdated.blogspot.com/2017/04/looking-beyond-screening-mammography-in.html

Know more about personalized breast cancer screening by watching this video.

Wednesday, April 26, 2017

Autonomous sensors to detect UTI at early stage developed at Purdue.

courtesy: http://www.damngeeky.com/


Urinary Tract Infection now can be diagnosed at early stage with an autonomous sensor developed by researchers at Purdue University.

“Current testing relies on time-consuming and costly urine culture tests performed at medical facilities and on at-home testing using store-purchased dipsticks that generally have high false alarm rates,” says Babak Ziaie, professor of electrical and computer engineering in Purdue’s School of Electrical and Computer Engineering. “Additionally, collecting urine samples for these methods can be challenging for infants and geriatric patients who suffer from neurodegenerative diseases. There’s also a privacy and dignity issue.”

UTI are common at extremes of age and is associated with significant morbidity and long-term medical consequences. In fact, they are most common infections in older adults specially in institutional settings. A woman’s lifetime risk for being diagnosed with UTI is more than 50%.

The researchers have developed bandage size disposable sensor, that is operated by battery which is activated after coming in contact with urine. The sensors detect nitrites, the chemical compound formed in UTI, and wirelessly sends the result to a smartphone app that keeps the data log and sends the results to the patient, caregiver, and/or health-care network if required.

The sensor can be easily embedded in the diaper.

“Ours is the only one that works fully autonomously,” Ziaie said. “Conventional methods require a certain level of patient or caregiver intervention.” This will be especially useful in infants and older adults who are not aware of symptoms or who do not have the ability to report the symptoms.

Work is now shifting to sizing, packaging, diaper embedding methods, smartphone app details and other efforts to prepare the technology for commercialization. A pilot study also is planned.

Several patents are already pending on this prototype but, this is the only one which is autonomous.  
“Once you detect a urinary tract infection in its early stage, it’s very easy to cure,” said team member Byunghoo Jung, associate professor of electrical and computer engineering in the School of Electrical and Computer Engineering. “You just need an antibiotic. Early detection is the key.”




Tuesday, April 25, 2017

Artificial womb keeps premature lamb alive for 4 weeks: Giant leap towards developing artificial wombs for extreme preemies.

CHILDREN'S HOSPITAL OF PHILADELPHIA

A group of clinicians and researchers at Children's Hospital of Philadelphia in US has taken a giant leap toward developing an artificial womb for humans—by building and testing one designed to keep very premature lambs alive outside the bodies of their mothers.

Lambs born at the equivalent of 23 weeks of human pregnancy were kept alive and appeared to develop normally while floating inside the transparent, womb-like device for four weeks after birth.

This pioneering approach could radically improve outcome for babies born so early that they cannot breathe, feed or fight infection without medical help.

The study was published in Journal Natures Communications online 25 April 2017.

Extreme prematurity is leading cause of neonatal morbidity and mortality. Over one-third of all infant deaths and one-half of cerebral palsy attributed to prematurity.

Taking a cue from nature, Alan Flake, a researcher and neonatal surgeon at the Children's Hospital of Philadelphia along with Emily A. Partridge, and Marcus G. Davey created this new incubator after 5 years of research. It mimics the fluid-filled milieu  of the mother's womb while still maintaining a connection to the outside world.

He said, “the proposed system could act as an urgently needed bridge between the mother’s womb and the outside world for babies born at between 23 to 28 weeks’ gestation.”

 “If we can support growth and organ maturation for only a few weeks, we can dramatically improve outcomes for extremely premature babies,” he said.

This concept of extracorporeal support of the fetus is very appealing which maintains the intrauterine milieu by providing gas exchange by ‘artificial placenta’. The system consists of 3 main components namely:
  1. a pumpless arteriovenous circuit,
  2. a closed fluid environment with continuous fluid exchange
  3. and a new technique of umbilical vascular access.  

The current device was created after identifying and rectifying many obstacles identified in series of pilot studies and years of tweaking.

A pumpless arteriovenous circuit
The blood flow is completely driven by pumping of the fetal heart  and is combined with a very low resistance oxygenator that most closely mimic the normal fetal/placental gas exchange interface.

A closed sterile fluid environment

The device uses a ‘Biobag’ design consisting of a single use completely closed system that houses and circulates fluid similar to amniotic fluid and that can closely replicate the size and shape of the uterus. The fluid's chemical composition is similar to amniotic fluid and contains electrolyte.

Umbilical vascular access

This closely approximate flow dynamics in utero because of double umbilical artery and single umbilical vein cannulation (abbreviated UA/UV) cannulation. The team devised adapters that helps to quickly cannulate the umbilical cord after birth, that is connected to external oxygenator, which serves the function of a lung. Umbilical cord spasm are avoided by adapting a number of techniques.

The study reported successful results with 8 lambs. They were in the ‘artificial womb’ for 1 month, with normal heart, lungs and brain development.

CHILDREN'S HOSPITAL OF PHILADELPHIA


Clinical application will require further evolution and modification of the design, safety and scientific evaluation of the entire system. But the target population for which the device is being developed is 23–25-week extreme premature infants.

The researchers do not aim to extend the current limit of viability, but to improve outcomes for those already treated in neonatal intensive care units (NICU).

Other therapeutics applications include treatment of  fetal growth retardation, salvage of preterm infants threatening to deliver after fetal intervention or fetal surgery.

This innovative technology could play a role to save  infants who have  congenital malformations of the heart, lung and diaphragm.

Numerous applications related to fetal pharmacologic, stem cell or gene therapy could be facilitated by removing the possibility for maternal exposure and enabling direct delivery of therapeutic agents to the isolated fetus.

The next steps for the Philadelphia team include one more animal study , as well as creating a device with medical-grade plastics for eventual use on humans.

Article source:  Partridge, E. A. et al. An extra-uterine system to physiologically support the extreme premature lamb. Nat. Commun. 8, 15112 doi: 10.1038/ncomms15112 (2017).

The full text of the Nature Communication article can be accessed here .

Monday, April 24, 2017

Video of the day: Stethoscopes going digital.


Stethoscopes have become synonymous for Medical Profession. But in this era of portable ultrasound, smartphone apps about almost anything and everything most doctors still use analogue stethoscopes. 

But Hon Weng Chong, a physician in Melbourne have designed a simple, compact, portable device that can be paired with a smartphone in recording heartbeats and respiratory rates. Further this record can be stored on the smartphone, only to be recalled at later date or uploaded to a cloud based server.

The digital stethoscope is called Clinicloud. It comes with a digital thermometer that does not requires skin contact to check the temperature.

The data can be shared with your physician or healthcare provider. The physician also can easily compare it with your last reading.

Here is the video reviewing the Clinicloud


Evidence does not support adhesiolysis as a treatment of chronic pain after gynecological and general surgery: a systematic review and meta-analysis.

courtesy: laparoscopyindia.com
At present, there is little evidence to support the routine use of adhesiolysis to relieve post-operative chronic abdominal pain after gynecological and general surgery according to results of a systematic review and meta-analysis published in current issue of Journal of Human Reproduction Update.

Postoperative adhesions are cause of significant morbidity like bowel obstruction, chronic pelvic pain and infertility in females. Open gynecological surgeries are highest risk factor for adhesions formation.

Chronic pain leads to diminished quality of life post operatively and affects nearly 20-40% of patients who have undergone abdominal surgeries.

This systematic review and meta-analysis investigated the role of surgery in relieving the chronic pain immediately and after extended follow up. It also assessed the safety and complications associated with adhesiolysis.

After literature review a total of 4294 unique studies were identified, out of which 13 studies met the study criteria which included 2 RCTs.

After the pooled analysis of the data, 72% patients reported improvement in pain at follow-up of > 3 months. In about 20% of the patients no cause of pain was found while 4% patients suffered some complications because of laparoscopy.

The authors concluded that laparoscopic adhesiolysis relieves pain from adhesions in ~70% of patients for short term only. The evidence does not support adhesiolysis for relieving chronic pain in longer run. It also results in bowel injuries and many laparoscopies turn out to be negative amounting to unnecessary surgeries.


More research should be focused at techniques and materials designed to reduce and prevent postsurgical adhesions and to improve results of adhesiolysis. 

Sunday, April 23, 2017

Looking beyond screening mammography in the war against breast cancer.


Courtesy: MariaShriver.com 

Whenever we think of breast imaging, our first thought is mammography. The earliest record of mammography dates back to 1913 when German Surgeon Albert Salomon attempted to visualize cancer through radiogram but it was only in mid 60s that  mammography was introduced as a screening tool on mass scale for early diagnosis of breast cancer.

The technique has substantially evolved in last several decades, from direct-exposure films to digital. Digital mammography exposes the patient to much lower dose of radiation as compared to analog mammography and the images are clearer and can be viewed on computer.

New data analysis R. Edward Hendrick, Ph.D., shows nearly 275,000 breast cancer deaths have been averted since 1990, attributed to increased mammographic screening and improved therapies.

However, like other techniques, mammography is also not perfect and has its own limitations. 
According to ACS screening mammograms do not find about 1 in 5 breast cancers. Chances of missing the disease is higher if the patient have dense breast.

A recent study has shown that nearly 43% patients in USA have dense breast.

Many US states have laws requiring the mammography centers to inform patients about dense fibroglandular breast tissue and its impact on cancer diagnosis and detection rates.

courtesy of Hologic


Digital breast tomosynthesis (DBT) or 3D mammography is a new technique for mammography especially useful for screening women with dense breast. It includes multiple low-dose full-field projection images of the breast obtained from different angles that form an arc. The images are then used to reconstruct a 3D image of the breast, resulting in a clearer view without the distraction of overlapping tissue.

Currently there are four tomosynthesis systems on the market. Hologic’s Selenia Dimensions mammography, GE’s SenoClaire 3-D breast tomosynthesis, Siemens Mammomat Inspiration Prime with Tomosynthesis Option and Fujifilm Medical Systems U.S.A.

Another screening technique is whole breast ultrasound and breast magnetic resonance imaging (MRI).

Whole breast ultrasound is used along with screening mammography to pick up lesions that cannot be felt by hands and also not seen on mammography. It is done in the same sitting as screening mammogram. It is specifically useful for patients whose mammogram reported “Extremely dense breasts” (or density score of 4) or “Heterogeneously dense breasts” (or density score of 3).
It can be performed manually or by using Automated Breast Ultrasound System(ABUS).

GE Introduced a new version of its automated breast ultrasound system ‘the Invenia Automated Breast Ultrasound System(ABUS)’.

Breast MRI is another screening tool, it is not recommended for routine screening because it results in more false positives leading to anxiety and unnecessary breast biopsies.  It is recommended for screening women who are at high risk for breast cancer, usually due to a strong family history and/or a mutation in genes such as BRCA1 or BRCA2.

The American Cancer Society (ACS) recommends that all high-risk women with greater than 20% lifetime risk of breast cancer should have a breast MRI and a mammogram every year. For most women, these combined screenings should start at age 30 and continue as long as the woman is in good health.

Combined these three techniques are able to find another 20-40 percent more cancers than screening mammography alone.

Major American medical organizations with expertise in breast cancer care, including the American Congress of Obstetricians and Gynecologists (ACOG), American College of Radiology (ACR) and Society of Breast Imaging (SBI) continue to recommend that women start getting annual mammograms at age 40 and continue screening till women is in good health or life expectancy is less than 10 years.  

USPSTF advises to start screening at age 50 till 74 years with an interval of 2 years between screening.






Saturday, April 22, 2017

Pregnant women should limit the use of cell phone: cautions results of largest study till date.

courtesy: research medical center 

Children born to mothers who frequently used cell phones prenatally were more likely to have hyperactivity/inattention problems as compared to those who used it less frequently.

The study was published online in Journal Environment International.

The lead author Laura Birks is not advising the mothers to stop using cell phones, but just be cautions and use it in moderation because the research has still not proved causation.

An earlier study published in Journal Epidemiology in 2008 also found that mothers who did use the handsets were 54 per cent more likely to have children with behavioral problems and that the likelihood increased with the amount of potential exposure to the radiation.

In the current study the researchers analyzed 83,884 mother-child pairs in five cohorts from Denmark, Korea, Netherlands, Norway and Spain during various time periods from 1996 to 2011.

The cell phone use was divided into none, low, medium, and high based on the usage reported by mother. 

The children were assessed for behavioral, hyperactivity/inattention or emotional problems between ages 5-7 years.

The earliest cohort from Denmark between 1996–2002 was the only cohort having enough women who did not use cell phones while pregnant.

Children born to mothers who were on cell phones for at least 4 calls/day or in another cohort for an hour/day were 28% more likely to be hyperactive as compared to children whose mothers made 1 or fewer call per day.

The association was found consistently across all cohorts, both for prospective and retrospective collected data.

Researchers are raising more questions after the results of study was published.

Dr. Robin Hansen, a pediatrician and professor at the University of California, Davis in Sacramento opines that the study does not answer the question whether it is the actual handset or your parenting behavior that causes the psychological problems.

She said in an interview with Medscape “Now we have to dig deeper and figure out why? Is it the electronic signals that go through your brain and your body, or how it changes your interactions with your child postnatally?”

She also said that we also need to look at the fact that those mothers who are busy on cellphones do not have enough time for their children, shaping their behavior differently. Children become hyperactive and through tantrum to get the parents away from the cell phone and before long it becomes a habit.

The Russian National Committee on Non-Ionizing Radiation Protection advises to limit the use of phone in children too. It concludes that children who talk on the handsets are likely to suffer from "disruption of memory, decline of attention, diminishing learning and cognitive abilities, increased irritability" in the short term, and that longer-term hazards include "depressive syndrome" and "degeneration of the nervous structures of the brain".

On July 1,2015 more than one hundred medical doctors, scientists and public health experts from around the world have signed a Joint Statement advising pregnant women to take simple precautions to protect themselves and their babies from wireless radiation. The Statement is part of a national right-to-know campaign called the BabySafe Project created by two non-profit organizations to inform pregnant women about the issue.

"The wireless world may be convenient, but it's not without risks," says Patricia Wood, Executive Director of Grassroots Environmental Education and co-creator of the BabySafe Project. "When more than one hundred of the world's leading medical doctors and researchers on wireless radiation say we have enough evidence for women to take protective action, we think women should know about it."



Friday, April 21, 2017

FDA clears Bovie Medical J-Plasma generator incorporating Cool-Coag™ technology for use in various surgical procedures.

 
Courtesy: Bovie Medical
Bovie Medical recently received FDA clearance for its novel J-Plasma generator and handpiece featuring the company’s “COOL-COAG” technology.

 In Gynecological surgeries, J-­Plasma increases a surgeon’s ability to target endometriosis and chronic pelvic pain which may result in less inflammation, accelerated healing (as compared to electrocautery) reduced adhesion formation and improved outcomes in patients with chronic pelvic pain and endometriosis.

This one of a kind device performs tissue dissection with minimal thermal spread with excellent control of its plasma stream and can switch to monopolar or helium spray coagulation mode with just a push of button.

The J-Plasma® makes use of helium ionization process to produce a stable, focused beam of ionized gas that provides surgeons with greater precision, minimal invasiveness and an absence of conductive currents through the patient during surgery.

The plasma stream generated by passing inert helium gas over a blade can perform all the three functions of cutting, coagulating and vaporizing the tissues at a much lower temperature than CO2 lasers, thereby limiting damage. The surgeon also benefits using a single device and absence of any smoke, odor or eschar.


extension of the blade 
                               
The handpiece distinctive design allows the retraction or extension of the surgical blade between different mode of operation. When the plasma stream is switched off, the blade can be used as scalpel for incision and when the stream is put on it can be used for coagulation or blunt dissection.

retraction of the blade 


Robert Gershon, CEO of Bovie Medical said “The development of Bovie’s Cool-Coag technology is a direct result of feedback from surgeons who have used our J-Plasma product for procedures that require greater coagulation capability, specifically in the areas of gynecologic oncology and surgical oncology. The unique flexibility of Cool-Coag enables the surgeon to use J-Plasma to perform the most delicate procedures, where precision and low risk of injury to surrounding tissue are paramount and also have the full power of monopolar coagulation to control, pinpoint and diffuse bleeding as needed.”

Dennis Chi, MD, head of ovarian cancer surgery at Memorial Sloan Kettering Cancer Center “This new Cool-Coag technology has the potential to increase usage of the J-Plasma device in many of our most complex cancer procedures. It combines J-Plasma’s ability to be used close to vital structures with minimal collateral damage and standard full monopolar coagulation capability, all in one hand-held instrument.”

Plasma is one of the four fundamental states of matter besides solid, liquid, and gas. When a gas is ionized by passing current through it, electrons are stripped from its atoms, turning it into plasma.

The plasma energy is generated as a precise stream that dissipates rapidly as it comes in contact with the tissue, but with controlled penetration and minimal thermal effect.

Use of plasma cutter is going to open many new treatment avenues in near future specially in field of oncology. 


This video will demonstrate the extremely low thermal spread and remarkable precision of both ease and safety with J plasma helium based surgical technology.



Morning after pill now available through vending machines at UC Davis Campus. Seriously!

Vending machine 

Is UC Davis validating unsafe behavior by selling ‘morning after ‘pill through vending machine across campus? Would you be getting the pill just by pressing a button? Well Yes! 

UC Davis is one of the first college campuses in the country to have a vending machine that offers the Plan B emergency contraceptive, otherwise known as the "morning after pill."

This was made possible by 2 years’ efforts by Parteek Singh, a 21-year-old senior, was running for the student government senator position. "Here at Davis we only have one pharmacy that is open 24/7, and a couple of my friends shared incidents when the pharmacy has ran out of emergency contraceptives on a Friday night and they weren't getting a new shipment until Monday," Singh said.

The vending machine is called ‘Wellness to go’ and also dispenses pregnancy tests, tampons, Advil and condoms.

Federal law makes the levonorgestrel pill available without a prescription to anyone 17 or older and it is freely available at pharmacies across US.

The other pill containing ulipristal acetate is a prescription medicine.

Debate is rife on social medias, news agencies and health forums about the easy availability of the pill on college campuses. The critics are saying that it’s like taking personalized medicine too far! College students will be able to buy the pill, without any medical knowledge or discussing the side effects and risk factors with a health care provider.

Also, it may lead to less frequent use of condoms, that besides preventing pregnancy protects from Sexually Transmitted Infections(STI). Critics also are debating the issue because it is like encouraging more sex on college campus with easy access to contraceptives.

People who favor it say that it will help prevent unwanted pregnancies. Many students support it easy access while others are not comfortable to talk about it.

Meanwhile, A proposed California bill that would require the abortion pill to be provided on all University of California and California State University campuses passed its first committee.

It requires that campuses that have student health services to offer medical abortion pill and scientifically accurate information to be provided to the students.  

  

Thursday, April 20, 2017

FDA grants Emergency Use Authorization for Nanobiosym Gene-RADAR Zika diagnostic Test.

Courtesy: Nanobiosym


The US Food and Drug Administration has granted Emergency Use Authorization (EUA) to Nanobiosym's Gene-Radar Zika virus test. Emergency Use Authorization is only granted by FDA for Serious or life-threatening disease or condition to humans.

The WHO reports that Zika virus infection is prevalent and active in more than 60 countries including 40,000 people in the U.S. and its territories, that also includes at least 4,750 pregnant women. The greatest threat of Zika infection during pregnancy is the neurological deficit and damage to the unborn child in the form of microcephaly, decreased brain tissue and brain damage.
About one in 10 pregnant women with confirmed Zika infection had a fetus or baby with birth defects during 2016, said CDC during a press conference.

The Gene-RADAR®Zika Virus Test is a real-time reverse transcription polymerase chain reaction (rRT-PCR) assay for the qualitative detection of RNA from Zika virus in human serum and other authorized specimen types.

Gene-Radar technology by Nanobiosym Inc was the winner of the Nokia Sensing XCHALLENGE in 2013. Gene radar is a mobile diagnostic device that allows you to diagnose any disease with a genetic fingerprint in real-time with gold standard accuracy at a price a hundred times cheaper than anything else on the market today.

Zika testing is currently done by either a serological test or nucleic acid based tests, looking for DNA/RNA sequences. Serological testing yield high false-positive rates because of cross-reactivity with Zika-like viruses such as Dengue or Chikungunya. Gene-RADAR Zika test look precisely at the RNA sequence of the virus hence eliminating cross reactivity.

Essentially it is a point of care platform with nanochip test cassettes that can potentially run using a drop of sample, such as serum, blood, or saliva. The machine is the size of our palm, just like an iPad and weighs 3.5 pounds. The consumer can get the results back in an hour, instead of waiting for 1-2 days for other tests.  

The Gene-RADAR® Zika Virus Test is authorized for the qualitative detection of RNA from Zika virus in human serum from individuals in accordance to the CDC’s algorithm for Zika testing.
This test has not been FDA cleared, and is only authorized for use till such time that emergency circumstances exist justifying the authorization of emergency use of in vitro diagnostic tests for detection of Zika virus and/or diagnosis of Zika virus infection, unless the authorization is terminated or revoked sooner.

"This FDA EUA represents a major milestone towards realizing our deeper vision: to decentralize, personalize, and mobilize the next generation of healthcare, much like cell phones transformed the telecommunications industry," said Dr. Anita Goel, M.D., Ph.D., Chairman and CEO of Nanobiosym and a Harvard-MIT trained physicist and physician. "The FDA's prompt feedback has accelerated our journey from winning the first XPRIZE for healthcare to bringing this new technology to patients and providers battling Zika on the front lines."

Clinical trials are already underway in Rwanda for detecting HIV viral load at point of care. Other application of Gene Radar technology is in fields of personalized medicine and cancer therapeutics.

The full text of FDA authorization could be accessed here.

             Nanobiosym’s XPRIZE winning-video about the Gene-Radar technology.