September « 2009 « ThePclinic

Polyheme As Blood Substitute In Accidents.

Now-a-days accident is the major cause of death world wide. Again majority are due to road accidents. On time resuscitative measures play a larger role in the survival of the victim. Many passerby do not respond fearing a legal hassle. But that is not the fact now but many are not aware of it. In “ABCD” of resuscitation of a victim, A stands for air way, B for breathing, C for circulation and D for death when ABC fail. These are looked into on the priority basis in that order. Air way cleaning is the first step as patient can not take respiration oxygen and can not withstand oxygen lack for more than three minutes. Next in the hierarchy comes circulation which is to be maintained for adequate perfusion of brain and other vital organs. If all these are not looked into promptly D for death will be inevitable. Though mentioned in a order, all those can be followed simultaneously.
Circulation, the third in the hierarchy is often not adequately taken care of. This is because non availability of blood when there is severe blood loss. Many ambulances neither carry blood nor have trained persons to administer it. In India the situation is still worse in a sense that arranging blood even in a hospital setting is difficult,that to many hospitals do not have the facility to collect and store blood.

In this setting researchers are in search of a blood substitute which could maintain the the circulation, carry oxygen as well as be non reactive to the human. Typically the haemoglobin in the red blood cells are responsible for caring oxygen to the target cells. So, many polymers were developed and tested to resuscitate a patient from haemorrhagic shock due to severe blood loss requiring six to eight units in first twelve hours. Many polymers failed to fulfill the target. Recently a haemoglobin based polymer has been synthesized and available for use in developed countries. Though some reactions have been observed in its use, the benefits clearly outweigh the risks. I do not know if it is available in India. I think we will have to wait for some more time to get it at least in national highway side areas. Also, I think nanotechnology may be the future hope for development of more efficient oxygen carrying fluid. if it is blocked and the foreign material may choke the air way. The next is to establish respiration as brain is very much sensitive to lack of

Artificial Blood: Coming Soon to An Artery Near You (singularityhub.com)

Filed under: Accidents, injury and health — Tags: Bleeding, Blood, blood substitute, Cardiopulmonary resuscitation, PolyHeme, Red blood cell — Dr.Prahallad @ September 30, 2009 9:32 pm

Swelling on the Wrist.

: Image by Fr Antunes via Flickr

The man was very much worried.” A bone was growing over the wrist since a few months” was his complain. The swelling was nearly circular, painless, almost defined boarders, does not move in any direction, hard to feel, almost fixed in the depth and was very slowly growing in size. So, he thought it to be a bony growth and must be dangerous.

I examined the swelling. It sits over the wrist with the characteristics as described above. Frequently I encounter this sort of complain. Mostly ladies are affected. This is also a beauty concern for them. Though most commonly seen near the wrist, it is also seen over the back of hand, forearm and near the tendons. That was diagnosed to be a ganglion.

A ganglion forms because of degenerative changes in the tissue covering of a tendon or that of a joint called synovial capsule. This may be termed as pseudoganglion or ganglion. When originates from the tendon sheath it is called pseudoganglion and when comes from the joint capsule is called a ganglion. A thick gelatinous material is found enclosed in a capsule. Many times the capsule is thin and sometimes it is thick. Diagnosed is based on clinical findings. Sometimes an x-rays examination is ordered to eliminate a bony growth.

The ganglion or the pseudoganglion is pressed hard so that it bursts and that gives a dramatic cure evidenced by sudden disappearance of the swelling. If thick walled it may not burst under pressure. In that case a wide bore needle is inserted into it and the gelatinous material is aspirated. Sometimes about 1 ml. of steroid is injected to the cavity. These procedures cure majority of patients. Sometimes larger ones require surgery by removing as much of capsule as possible. Ganglion is notorious for its recurrence. But it is an innocent disease.

Filed under: swellings — Tags: Articular capsule, Surgery, Tendon — Dr.Prahallad @ September 29, 2009 7:03 am

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Filed under: General — Dr.Prahallad @ September 27, 2009 6:25 pm

HIV/AIDS Vaccine In Indian Perspective

: Phylogenetic Tree Of the SIV and HIV Viruses

This message was sent to me by one of my Ranbaxy friends has been posted for the knowledge of all.The researchers are very much enthusiastic about the breakthrough.We hope it will be available soon in Indian perspective.

In the first ever breakthrough in 26 years, an experimental vaccine reduced the risk of HIV, the virus that causes AIDS, in a third of the people vaccinated. The breakthrough The biggest-ever Phase III trials done to test the safety and efficacy of an AIDS vaccine showed no effect and some even suggested an increased risk of HIV infection,” said Dr Charles Gilks, India Country Coordinator, Joint United Nations Programme on HIV/AIDS (UNAIDS). “With this vaccine, we hope to understand the mechanism that offers protection and enhance it to offer 60-70 per cent protection,” said Dr Gilks. The vaccines against measles and tetanus, for example, offer over 90 per cent protection. The Thai AIDS vaccine is a combination of Sanofi-Aventis‘ ALVAC canary pox vaccine and AIDSVAX, made by VaxGen and now owned by the non-profit Global Solutions for Infectious Diseases. Apart from Sanofi and Global Solutions, Global HIV Vaccine Enterprise stakeholders included the US Military HIV Research Program, the US National Institute of Allergy and Infectious Diseases and Thailand Ministry of Public Health. “All the people involved are meeting in New York next week to discuss and try to answer some of the questions, such as how does it confer protection, why isn’t the immune response 100 per cent, will it work against other subtypes. We hope we will have the answers soon,” said Dr Bernstein. How they did it The vaccine: A combination of Sanofi-Aventis’ ALVAC canary pox vaccine and AIDSVAX, made by VaxGen and now owned by the non-profit Global Solutions for Infectious Diseases. The volunteers: 16,000 healthy men and women at no additional risk of HIV infection. The dose: Six vaccinations over six months – four with ALVAC and two with AIDSVAX. The duration: The volunteers were followed for six years. How did the vaccines work? A two-vaccine combo was used in a “prime-boost” approach. The first vaccine primed the immune system to attack HIV and the second one strengthened the immune response to it. What next? Need to boost immune response to at least 70 per cent for the vaccine to be effective When will it be marketed? If the immune response is successfully heightened, the vaccine will take another 3-5 years to hit the market. Can it be used in India? The Thailand vaccine protects against HIV-1 subtypes E and B, predominant in the US and Thailand, and not against subtype C predominant in India. Human trials in India will be needed to test its effectiveness. People who made it happen: Global HIV Vaccine Enterprise stakeholders included the Thailand Ministry of Public Health, US Military HIV Research Program, the US National Institute of Allergy and Infectious Diseases, Sanofi Pasteur and Global Solutions for Infectious Diseases. on humans showed lowered risk of HIV infection by 31.2 per cent among 16,000 healthy men and women in Thailand, trial-sponsors Global HIV Vaccine Enterprise announced on Thursday. “For the first time in 26 years, we have a vaccine that confers protection in some people. It is not the vaccine that will go into production – that will take at least another three to five years – but the Thailand trial results offer hope that a vaccine against AIDS can work,” said Dr Alan Bernstein, executive director, Global HIV Vaccine Enterprise, speaking to HT from New York. The vaccine may not work in Africa and India, where different subtypes of HIV-1 drive the infection. HIV-1 subtype B is predominant in the US and Europe, subtype E in Thailand and South East Asia, and subtype C in Africa and India. “The Thailand vaccine was formulated specifically to protect against HIV-1 subtypes E and B, so it’s premature to say whether it will work in India, where subtype C is predominant. We need trials in India before we know,” said Sujatha Rao, director general, National AIDS Control Organization. In India, 23.1 lakh (2.31 million) people have HIV, but there is no data on new infections. Worldwide, an estimated 6,800 people get infected with HIV every day, with young people under 25 years accounting for half of all new infections. “Even though the immune response is moderate, the results offer hope because they follow big setbacks. In the past, most

HIV Vaccine: AIDS Breakthrough Announced (blippitt.com)
Search for Cancer Vaccine Showing Promise (drppanda.wordpress.com)

Filed under: Vaccine — Tags: AIDS, AIDSVAX, HIV, HIV vaccine — Dr.Prahallad @ 5:39 pm

Vitamin D & Anti-Interleukin Treatment For Respiratory Disease,A promise.

: Vitamin D

Respiratory diseases particularly Asthma poses a constant problem to the clinicians as well as to the patients.Vitamin D, in addition to it’s effect on bone found to be effective in treating the respiratory diseases.It has effect on Asthma treatment.The effect of anti-interleukin-5 on the treatment of Asthma is also a novel step.I have quoted summary of two articles below with the name of the authors for the knowledge of all.

Vitamin D and respiratory healthcei_4001 20..25
D. A. Hughes* and R. Norton†
*Institute of Food Research, Norwich Research
Park, and †School of Pharmacy, University of East
Anglia, Norwich, UK
Summary
Vitamin D is now known to be of physiological importance outside of bone
health and calcium homeostasis, and there is mounting evidence that it plays
a beneficial role in the prevention and/or treatment of a wide range of
diseases. In this brief review the known effects of vitamin D on immune
function are described in relation to respiratory health. Vitamin D appears
capable of inhibiting pulmonary inflammatory responses while enhancing
innate defence mechanisms against respiratory pathogens. Population-based
studies showing an association between circulating vitamin D levels and lung
function provide strong justification for randomized controlled clinical trials
of vitamin D supplementation in patients with respiratory diseases to assess
both efficacy and optimal dosage.

………………………………………………………………………………………………………………………

Cytokine and anti-cytokine therapy in asthma: ready for the clinic?cei_3998 10..19
D. Desai and C. Brightling
Institute for Lung Health, Department of
Infection, Inflammation and Immunity,
University of Leicester, Leicester, UK
Summary
Asthma is a common disease with an increasing prevalence worldwide. Up to
10% of these patients have asthma that is refractory to current therapy. This
group have a disproportionate use of health care resources attributed to
asthma, have significant morbidity and mortality and therefore represent an
unmet clinical need. Asthma is a complex heterogeneous condition that is
characterized by typical symptoms and disordered airway physiology set
against a background of airway inflammation and remodelling. The inflammatory
process underlying asthma is co-ordinated by a cytokine network.
Modulating this network with biological therapy presents a new paradigmfor
asthma treatment. Clinical trials undertaken to date have underscored the
complexity of the inflammatory profile and its relationship to the clinical
features of the disease and have raised the importance of safety considerations
related to these novel therapies. T helper type 2 cytokine blockade remains
the most promising strategy, with anti-interleukin-5 reducing asthma
exacerbations. Although anti-cytokine therapy is not yet ready for the clinic,
the long-awaited possibility of new treatments for severe asthma is moving
ever closer.