New tool may help predict mortality risk in COPD patients

London, Aug 29 (ANI): Researchers have developed a new tool that would help predict a patient’s risk of dying from chronic obstructive pulmonary disease (COPD).

What’s more, it would also help determine the effective level of treatment.

Boffins have come up with an ADO index that can help physicians assess the severity of the illness.

Presently, the BODE index is used by chest physicians to estimate a patient’s risk of death from COPD. It assesses body-mass index, airflow obstruction, dyspnea and exercise capacity.

However, the BODE index is rarely used in primary care settings where most patient treatment options are managed, because exercise capacity cannot be easily measured in the typical doctor’s office.

“The burden from COPD is so enormous that we need to reach out to any doctors who care for COPD patients,” The Lancet quoted Dr Milo A. Puhan, associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and lead author of the study.

“The ADO index can be used in any setting and we hope that it will serve as a basis for more individualized treatment selection in the near future,” Puhan added.

For the study, Puhan and colleagues developed a simplified BODE index and the ADO index, which included age, dyspnea and airflow obstruction.

The research team compared the predictions of the BODE index with the 3-year risk of all-cause mortality from 232 COPD patients from Switzerland.

The updated BODE index and the new ADO index were then validated with a cohort of 342 COPD patients from Spain.

The findings showed that updated BODE and ADO indices accurately predicted 3-year mortality compared to the original BODE index, which performed poorly at predicting 3-year risk of mortality. (ANI)

‘Thick’ blood causes as well as protects from heart attack, stroke

Washington, Aug 25 (ANI): Animal studies carried out by researchers at Heidelberg University Hospital have shown that “thick” blood can not only cause heart attack and stroke, but also prevent them.

In their study report, the scientists say that mice with a greater tendency to form blood clots have larger plaques in their vessels, but they are more stable.

Thus, there is less risk that these plaques will rupture and obstruct circulation.

Usually, the more blood coagulates, the greater is the risk of vascular obstruction, and anticoagulants are used to protect against these complications.

However, clinical studies have thus far not proven that an increased clotting tendency also has a detrimental effect for plaque development.

Led by Dr. Berend Isermann, the researchers examined mice with elevated blood fat levels, and a genetic defect that leads to an increase in blood clotting.

They found that the mice developed larger plaques than those without the genetic defect, but the plaques were more stable.

In addition, no vascular obstruction was observed, as the vascular wall expanded to adapt to the new situation.

The negative effect of larger plaques on circulation was compensated by the positive effect of stability and a greater vessel diameter.

However,the long-term use of anticoagulants (in this case, low molecular weight heparin) reversed these advantages- the size of the plaques was reduced, but stability was lost, increasing the risk of complications.

“Our findings were made on mice, but they confirm the results of clinical studies on humans. In addition, in vitro studies show that human cells react similarly to mouse cells,” said Isermann.

The team assumed that the results could be transferred to humans and recommends weighing the advantages and disadvantages of anticoagulants carefully before administering them to a patient.

“Currently, there is no indication that these new observations also apply to drugs that inhibit the function of platelets,” said Isermann.

When deciding on therapy, the cause of the coagulation disorder and the degree of already existing atherosclerosis should be taken into consideration.

Additionally, the researchers recommended using anticoagulants that inhibit specific coagulation factors in order to preserve the positive effects on plaque stability.

Various new drugs that inhibit specific coagulation factors are currently being studied in clinical trials.

“It is important that plaque stability and the influence on atherogenesis are also studied in these trials,” said Isermann.

The study has been published in the journal Circulation. (ANI)

Fat people ‘more likely to die of swine flu’

London, July 16 (ANI): Here’s some bad news for fat folks: Overweight people are more likely to die of swine flu, says a new US study.

According to unpublished figures, which were reported at a recent meeting of the US Centers for Disease Control and Prevention in Atlanta, Georgia, 99 people who died in the early stages of the pandemic in the US, 45 per cent were obese.

Up till now, most of the individuals who have died from H1N1 swine flu have had an underlying health problem which weakened their ability to fend off the virus, reports New Scientist.

Among the conditions recognised as increasing the risk from flu are hypertension, diabetes, chronic lung obstruction and coronary disease. Now it may be time to add obesity to the list.

The figures surprised most flu researchers.

“In 40 years of studying flu, I have never heard anything about obesity,” says virologist John Oxford of Barts and The London School of Medicine and Dentistry, University of London. (ANI)

Naxal-hit states Chief Ministers to meet in August

New Delhi, July 7 (ANI): Home Minister P Chidambaram today said the meeting of Chief Ministers of Naxal-hit states will be held in August to discuss the menace which has increasing in some states.

Replying to supplementaries in the Lok Sabha, Chidambaram said the meeting will discuss the strategy to tackle the threat posed by the Naxals in some states.

He also asked the Chief Ministers of the affected states to renew their appeal to the Naxal leaders to lay down arms and come to the negotiation.

The appeal came at the suggestion of Samajwadi Party leader Mulayam Singh Yadav, who claimed that he had successfully resolved the problem in some districts in Uttar Pradesh through talks. (ANI)

Nepal Parliament resumes, paves way for new budget session|World[Kathmandu {Kathmandu, July 7 (ANI): After months of obstruction, Nepal Parliament has resumed on Monday.

The session was prorogued after the Unified CPN (Maoist), obstructed normal proceedings of the House for more than two months it has now allowed the resumption of the House following a four-point agreement among the three largest parties in the Constituent Assembly (CA).

Prime Minister Madhav Kumar Nepal and Maoist chairman Prachanda addressed the resumed session.

Prachanda said his party adopted maximum flexibility to allow the House work for the welfare of the country and that the obstruction of the House would resume after a month if the agreements are not fulfilled by then.

The parties have agreed to categorically define Prime Minister’s and President’s jurisdiction and forge a consensus among the parties about the same within a month.

Prime Minister Nepal vowed to address the issue of defining powers of the President and Prime Minister within a month in consultation with other parties.

Addressing the Maoist demand of maintaining civil supremacy, Nepal said nobody is in favour of military supremacy. The very idea of republican set up is to maintain civil supremacy.

In his address, Prachanda said his party has agreed to end the disruption of the House to speed up the process of concluding the peace process and drafting of the new Constitution.

Prachanda however warned that his party would launch an aggressive agitation if the government failed to reach an understanding to resolve the issue of Army Chief issue.

The resumption of the normal functioning of parliament will pave the way for the President Dr. Ram Bran Yadav to allow the presentation of the new budget before the current fiscal year ends on 15th of this month.

Meanwhile, Finance Minister Surendra Pande has said that the preparations for the next fiscal year’s budget is almost over.

The size of the next budget is likely to be about Rs 280 billion,” he said, nepalnews reported. (ANI)

Judge rules ‘serious flight risk’ Stanford must stay in jail pending trial

London, July 1 (ANI): Texas billionaire businessman and alleged fraudster, Sir Allen Stanford, is a “serious flight risk” and must stay in jail pending trial, a judge has ruled.

The cricket entrepreneur has been charged with seven counts of wire fraud, ten counts of mail fraud and conspiracy to launder money. The billionaire financier will continue to be detained in a Houston jail until his multi-billion dollar fraud case is heard.

Stanford’s access to “an international network and financial resources” and “his familiarity with global travel” persuaded Judge David Hittner to deny him temporary freedom.

He added that the severity of the punishment he faces if convicted could also see Stanford go on the run.

The mogul could receive up to 375 years in jail if found guilty of 21 charges of multi-billion-dollar fraud, money laundering and obstruction, SKY News reports.

Stanford’s lawyer Dick DeGuerin confirmed his “disappointed” client would appeal against judge’s decision

He had argued in front of the judge that Stanford would have fled by now if that had been his intention, and the possibility was void given that “he’s broke” after his assets were seized.

“They even took his underwear,” DeGuerin told the court.

But Judge Hittner replied in writing: “Stanford is a serious flight risk. There is no condition or combination of conditions of pre-trial release that will reasonably assure his appearance as required for trial.” (ANI)

Madhesi leaders ask Prachanda to stop obstructing parliament

Kathmandu, May 12 (ANI): Leaders of the Madhesi parties today asked caretaker Prime Minister and Maoist chairman Prachanda to end the obstruction created by his party in the parliament against the formation of a majority government.

Top leaders of the Madhesi Janadhikar Forum (MJF), the Terai Madhes Loktantrik Party (TMLP) and the Sadbhawana Party (SP) met Prachanda and discussed issues related to formation of new government, which has hit an obstacle with the parties failing to reach a consensus.

Talking to reporters after the meeting, the Madhesi leaders said that they asked Prachanda to end the obstruction in the parliament as this would cause more uncertainly over the formation of new a government.

The meeting could not arrive at any concrete conclusion regarding Prachanda’s proposal to the Madhesi parties for support to Maoist-led government.

The three Madhesi parties have revived their alliance called Unified Democratic Madhesi Front and they want the would-be ruling alliance to give clear commitment to implement the past agreements with the Front.

Earlier, leaders of the Maoist party have said that a government with civilian supremacy cannot be formed unless President Ram Baran Yadav’s decision to reinstate Army Chief, General Rookmangud Katawal, who was sacked by the government, is retracted.

Maoist Politburo had reiterated its claim that the government formed without establishing civilian supremacy would be purposeless.

Talking to reporters party spokesperson Dinanath Sharma said, “There is the possibility of forming the new government with civilian supremacy once the president’s intervention into the Constitution and the civilian government’s decision are rectified and the procedure to take action against General Katawal is rectified.”

“Otherwise, it is pointless to form the government that cannot maintain civilian supremacy,” Nepalnews quoted him as saying. (ANI)

Maoist protesters, police clash outside Nepal presidential palace

Kathmandu, May 11 (ANI): Maoist protesters and riot police clashed in front of Nepal’s presidential palace on Monday.

The demonstrators were seeking information on the country’s missing people and why President Ram Baran Yadav had no sacked the country’s army chief, General Rookmangud Katawal.

Over 1,200 people have been reported as missing between 1996 and 2006.

The protests came hours after diplomatic envoys from 16 countries, representatives of multinational donors and chief of the United Nations Mission in Nepal (UNMIN), Karen Landgren, jointly called on acting Prime Minister Pushpa Kamal Dahal.

Envoys from United States, Germany, France, UK, Norway, China and India and representatives from World Bank and Asian Development Bank were among those who participated in the meeting.

The discussion dwelled mainly on postponement of NDF meeting and delay in formation of the new government due to continued obstruction of parliament proceedings by the Maoists.

Finance Minister Dr. Baburam Bhattarai informed the envoys that the new government would organise the NDF meet in September or October.

The delegations of UNMIN, foreign envoys and representatives of donor agencies also met Nepali Congress President Girija Prasad Koirala at his residence in Maharajgunj.

During the meeting, the delegation expressed concern over political changes that would have negative impact on the ongoing peace process.

Koirala assured that he would personally consult with Maoist chairman Dahal and UML chairman Jhala Nath Khanal to resolve the stalemate. (ANI)

Exercise may benefit patients with mild to moderate OSA

Washington, May 7 (ANI): People suffering from mild to moderate form of obstructive sleep apnea (OSA) may benefit from certain tongue and pharyngeal exercises, according to a study.

“It was commonly thought among doctors that strengthening and toning oropharyngeal muscles would have no benefit to the patient during sleep, but a recent study showed that didgeridoo playing helped decrease snoring and OSA. This was a change of paradigm, and indicated that not everything you do during the day is lost during sleep,” said Dr. Geraldo Lorenzi-Filho.

During the study, the researchers investigated the effects of exercises on the symptoms of OSA in the first randomised, controlled study to do so. Thirty-one recently-diagnosed patients were evaluated for OSA severity using polysomnography.

Snoring frequency and intensity, daytime sleepiness and sleep quality were assessed using self-reports and validated questionnaires.

The subjects were the randomized to two groups-the exercise group and the control group. Each of the 16 individuals in the exercise group underwent a daily and weekly regimen of tongue and pharyngeal exercises.

There was also a control group of 15 individuals, who underwent a sham treatment regimen involving deep breathing and nasal lavage with a saline solution.

After three months, there were no significant changes to OSA symptoms in the control group, but the treatment group showed significant improvements in lowest oxygen saturation levels in blood, subjective sleepiness, snoring symptoms and quality of sleep scores.

The researchers said while there were no changes in abdominal circumference in either group, neck circumference decreased significantly in the treatment group with no concomitant changes in body mass index.

“These data suggest that the exercises were able to promote remodeling of the upper airways,” said Dr. Lorenzi-Filho.

Overall, the treatment groups showed a 40 percent decrease in OSA severity, with 10 the 16 patients who had originally been classified as having moderate OSA being reclassified as having either mild (eight) or no OSA (two).

“This was nearly two thirds of the treatment group, whereas none of the control group were reclassified with a milder disease. This indicates to us that these exercises have significant potential to improve symptoms in sufferers of OSA,” said Dr. Lorenzi-Filho.

“The muscles of the upper airways are extremely complex and the mechanisms leading to OSA are far from being well understood. A strong muscle may be working on the wrong direction and not necessarily helping to open the airways. The overall set of exercises we tested target the correct physiology of the upper airway and should promote remodeling of the upper airways,” said Dr. Lorenzi-Filho.

The researchers say that the evidence supports that certain exercises do, in fact, aid in remodelling the upper airways in such a way as to reduce OSA symptoms.

Dr. Lorenzi-Filho acknowledges that work is just beginning in this exciting area of research.

“How exactly these exercises work? Do we need all of them or just a few? Do different patients need different set of exercises? What are the exact mechanisms leading to upper airway obstruction?” he asked.

“The answer is we don’t know, but these are some of the possible future areas of research,” he said.

The study has been published in the American Journal of Respiratory and Critical Care Medicine. (ANI)

Endoscopic surgery can effectively relieve sinusitis symptoms

Washington, May 1 (ANI): A new study claims that endoscopic sinus surgery can significantly relieve symptoms of chronic rhinosinusitis – inflammation of the sinus cavities.

The research team, led by a Georgetown physician, conducted the first large-scale analysis of surgical outcomes from the procedure.

In the May issue of Otolaryngology Head Neck Surgery, researchers found that symptoms usually associated with the chronic condition, including nasal obstruction, facial pain, postnasal discharge, headaches, and impaired smell, all substantially improved after endoscopic sinus surgery.

“This kind of surgery is indeed beneficial to patients when standard medical treatment doesn’t resolve the condition,” says the study’s lead investigator, Alexander C. Chester, MD, a physician and clinical professor at Georgetown University Medical Center. Two other physicians from St. Louis University School of Medicine collaborated in the study.

Endoscopic sinus surgery is an extremely common procedure – about 200,000 procedures are performed each year – yet this is the first meta-analysis of symptom relief following the surgery, Chester says. It was conducted by examining 21 different published studies, which included 2,070 patients, analyzing improvement for each symptom.

“Reports of relative symptom relief vary across studies, so it was important to pool the study results. We wanted to know not only if symptoms improve overall, but if they improve to a similar degree, and if these benefits last,” says Chester.

“Our findings offer reassurance that, with minor exceptions, individual symptoms usually improve substantially and similarly following surgery,” Chester, an internist, said.

The researchers assessed symptom relief using two different measures. The most precise is called “effect size” where any effect greater than .8 is considered a large effect. The researchers found that with a 1.73effect size, nasal obstruction improved the most, followed by postnasal discharge (1.19), facial pain (1.13), headache relief (.98) and improvement in smell (.97). A second way of measuring symptoms, which is less accurate but more commonly used, compares the percent of improvement after surgery compared to before surgery. They found the following percentage improvements: 61 percent in facial pain, 59 percent in nasal obstruction, 53 percent in headache, 49 percent in smell, and 47 percent in postnasal discharge.

They also found that improvements do not decrease over time, as some smaller studies had suggested. (ANI)

Kids who consume melamine ‘more likely to develop kidney stones’

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Washington, April 27 (ANI): Two new studies have shown that kids with a history of consuming melamine-contaminated milk powder are at a higher risk of developing kidney stones and other urological complications. /pp
The study found that melamine calculus occurred mostly in infants at six months to 18 months after consuming melamine-contaminated milk powder after birth but that the stones could be effectively managed with noninvasive treatment./pp
In the first study, researchers analyzed the clinical data of 50 young children with double kidney stones who had a history of consuming melamine-contaminated milk powder. /pp
Researchers studied ultrasound images from each child, measuring kidney stone size, number, shape and location. Eighty-five percent of these cases occurred in children ages six to 18 months. Of these 50 children, 42 formed kidney stones in both kidneys; multiple stones were found in 18 children; and single stones were found in nine of them. /pp
Eleven kids experienced kidney failure, in which the stone diameters of bilateral kidneys were significantly larger than those who did not experience kidney failure. In 21 cases, the stone was passed after non-operative hospital treatment in an average of eight days./pp
In the second study, researchers analyzed the clinical data of 165 infants, aged 50 days to three years, with urinary stones who had a history of consuming melamine-contaminated milk powder. /pp
The kids were divided into mild (25 cases), moderate (122 cases) and severe (18 cases) groups. Researchers found that the peak incidence of urolithiasis (urinary stones) was found in children aged six months to 12 months. /pp
Of these patients, 50.3 percent were asymptomatic, 16.9 percent experienced dysuria (painful urination), 14.6 percent had infantile colic, 10.9 percent experienced oliguria or anuria (decreased urine and absence of urine, respectively) and 7.3 percent had hematuria (blood in the urine). /pp
Acute urinary retention (the sudden inability to urinate) caused by urethral stones was found in five cases. The stone diameter ranged from 22mm to 16mm, and 63.5 percent of cases had 4-10 mm stones. All cases accepted non-operative treatment, except those cases with a bilateral stone and obstruction. After hospital treatment, the stone expulsion rate was 43 percent. /pp
This study presents us with the long-term complications for children who had been fed with melamine contaminated products. Both parents and physicians should be vigilant of these signs and symptoms in children who may have consumed the contaminated milk powder, said Anthony Atala, MD, an AUA spokesman./pp
The two studies were presented at the 104th Annual Scientific Meeting of the American Urological Association (AUA). (ANI)/p

Fuel supplies still short as Deora promises price cut

New Delhi/Mumbai, Jan.10 (ANI): India’s fuel crisis blew over on Friday, but commuters in New Delhi continued to grapple with short fuel supply even on Saturday.

Commuters ran from one petrol pump to the other in search of fuel as many of the pumps had run dry after the three-day strike.

“The strike has ended but we are not able to get petrol or diesel anywhere. I’ve checked two three petrol pumps but have not been able to get any fuel,” said Kapil, a commuter.

A few filling stations were found functioning normally, meeting the commuters’ demand for fuel.

“First two days we faced many problems, but now things are okay. Except for some petrol pumps, there is fuel in petrol pumps, all the HP outlets are functioning normally,” said Ravinder Arora, another commuter.

The government has already declared the strike as illegal. The strike was called off after the government called in troops to load tankers and threatened to imprison union leaders.

The government had invoked laws forbidding the obstruction of essential commodities.

In Mumbai, Petroleum and Natural Gas Minister Murli Deora said today that the Centre is considering a proposal to reduce petrol prices by a further five rupees, while the price of diesel could go down by rupees three. He also said that the price of an LPG cylinder could go down by rupees 25.

“We have talked to Prime Minister, in coming days we are trying to reduce the prices of petrol, diesel and LPG…give us 10-15 days,” Deora told reporters.

“According to me the advisable reduction would be Rs 5 per litre for petrol, Rs 3 per litre for diesel and Rs 25 on LPG cylinder,” he said when asked about the extent of reduction in prices.

Oil companies have minimized the losses on petrol and diesel, as crude oil prices have lowered to 40 dollars per barrel from its peak of 147 dollars a barrel in July last year.

“From this quarter onwards, we expect the oil marketing companies to start making profits. But, if the crude oil price rises beyond 40 dollar per barrel, then it (profit) will not happen,” Deora added.

When asked about a reduction in kerosene prices, he said it is already available at the cheapest rate in India of Rs 9 per litre.

On December 6, the Government had reduced prices of petrol and diesel by Rs five and Rs two per litre, respectively, as global crude prices hovered around a four year low. (ANI)