Chandigarh, June 20 (IANS) In a first in the world, the Department of Surgical Gastroenterology in the PGI History published a path-breaking study which has established the role of streptokinase in the management of the dreaded disease of severe acute pancreatitis.
Detailing about the study, Rajesh Gupta, Professor and Head, Department of Surgical Gastroenterology, said, "Streptokinase has been used since early 1960's for dissolution of intra-vascular thrombosis in pulmonary thromboembolism, myocardial infarction and deep vein thrombosis.
"The Department of Surgical Gastroenterology in close collaboration with the Department of Medical Gastroenterology started off-label use of streptokinase in 2013.
"The idea to use streptokinase in patients of severe acute pancreatitis was conceptualised after we observed its successful use in chest collections by pulmonologists."
Gupta further elaborated, "We first conducted experimental work in 2013 to look at the effect of streptokinase on pancreatic necrosis removed at the time of surgery and results were heartening.
"This encouraged us to use streptokinase in two patients who were critical and not fit for surgery. We observed that addition of streptokinase in irrigation fluid in abdominal drain led to gradual improvement in their clinical condition and both the patients recovered without need of surgery.
"We published this work in a top journal of pancreatic disease in 2014 namely Pancreatotology."
"After this initial success, we planned the first study in 2015 and subsequently did three more studies including two M.Ch thesis in surgical gastroenterology in collaboration with medical gastroenterology and radiology. We combined data from four studies and published results in one of the top surgical journals namely Surgery," said Gupta.
Attributing the success to the commitment and perseverance of the team comprising of Surinder Rana, Mandeep Kang, Ujjwal Gorsi,A Ritambra Nada and all other senior and junior residents involved in the study, Gupta threw light on the results as he shared, "Results by our study have clearly shown that there was significant decrease in the need of surgery with use of streptokinase and there was no increase in complications with its use which was major apprehensions.A
"Ours is the first large study involving more than 100 patients where streptokinase has been proven efficacious in management of severe pancreatitis with infected necrosis. We have observed that results of streptokinase were better with higher doses."
Gupta added, "We have recently completed another study where we have compared use of streptokinase with another agent i.e. hydrogen peroxide and found encouraging results with streptokinase.
"This study is at present under consideration of another prominent journal. Now, we are planning a bigger study involving various Surgical and Medical Gastroenterology Departments in different parts of the country. This is the first time in the world that streptokinase has been found to be a useful adjunct in management of severe acute pancreatitis".
"It is important to emphasise that the Department of Surgical Gastroenterology and Medical Gastroenterology are top departments in the country in management of severe pancreatitis with a lot of research happening to reduce the complications and deaths in this dreaded disease," said Gupta.
Along with physical and mental health, sexual health problems are also aggravated by the ongoing pandemic, a primary reason being increasing stress due to factors such as job, work life balance, financial challenges, lack of socialising and strained relationships. A recent study has revealed that Covid-19 increases the risk of developing erectile dysfunction (ED) by nearly six times.
Sexual health and wellness is defined as a state of physical, emotional, mental, social, and spiritual dimensions in relation to sexuality. Sexual intimacy is a highly stigmatised and taboo topic in India, and people are usually unwilling to talk openly about their sexuality and sexual health.
Stress directly affects our hormones and mood and can take away a person's libido, thereby affecting quality time of a couple. It can also cause one to indulge in smoking or alcohol consumption which in turn can adversely affect sexual performance. These can lead to problems such as premature ejaculation, erectile dysfunction, reduced libido, and male fertility.
Erectile dysfunction, or ED, is a common condition that can make sexual activity difficult. It may lead to a loss of intimacy in a marriage or long-term relationship, affecting the mental well-being of both partners. Some leading Indian andrologists share their thoughts on the recent study and the co-relation between the coronavirus and erectile dysfunction.
Also, Read► Plasma therapy boosts survival in Covid patients with blood cancers
Pramod Krishnappa, Consultant Andrologist, NU Hospitals, Bangalore tells IANSlife: "The Covid-19 pandemic has wreaked havoc on humans causing both physical and mental illness. Although the lung is the most prominent organ affected, a recent research paper from Miami has revealed the presence of Covid-19 viral particles in the most sensitive organ, penis. The authors have also hypothesised that this widespread endothelial dysfunction could lead to erectile dysfunction. An Italian survey led by Sansone also revealed that the erectile dysfunction was common among those who had Covid-19 infection in the past and very aptly commented that "Mask up to keep IT up"."
Raman Tanwar, MBBS, MS, FMAS, MCh (Urology) Gold Medallist, Department of Urology and Andrology at Uro centre, Jyoti Hospital, Gurugram adds, "Covid-19 infection leads to widespread endothelial dysfunction which means that the linings of blood vessels do not function properly once infected. For erection the optimal function of blood vessel lining is needed and many studies across the world are finding an increased incidence of erectile dysfunction in patients who are positive. Studies have also pointed that those who have ED are more likely to have Covid-19 infection."
If an individual is diagnosed with ED, the first step is to reach out to a doctor as it can be a sign of underlying health problem. Heart diseases, clogged blood vessels, high blood pressure, cholesterol, diabetes, obesity, anxiety, stress, depression and lifestyle habits like smoking and alcohol consumption are a few of the main causes of erectile dysfunction.
Vineet Malhotra, Clinical Director, Diyos Men's Health Centre shares: "The recent study conducted at the Miller School of medicine, Miami, USA notes the presence of Covid-19 in the penis even 7 months post infection. The increased risk of endothelial dysfunction can lead to a risk of erectile dysfunction in affected men."
Sanjay Pandey, Head of Uro-Andrology at Kokilaben Dhirubhai Ambani Hospital, Mumbai tells IANSlife: "Covid-19 affects different men in different ways. There is a possibility that some men might develop ED after suffering from Covid-19. So particularly for young and healthy people who abruptly develop erectile dysfunction, and especially after having Covid-19, this can be a sign of something more serious going on. This could last for long term or short term. ED is usually a symptom of another medical condition. If your health isn't great to begin with, you're more likely to have severe or unwanted symptoms from Covid-19, such as ED."
Doctors suggest that with the number of cases increasing every day and multiple studies indicating that men are more prone to Covid-19, this study makes it more imperative that men must be extra cautious in their everyday life ignoring which could affect various aspects of their lives.
Read More► Covid: Common diabetes drug may help treat lung inflammation
New York, June 18 (IANS) Administering convalescent plasma from recovered Covid-19 patients can dramatically improve likelihood of survival among blood cancer patients hospitalised with the deadly virus, according to a study.
The study led by researchers from the Washington University in the US indicates a 48 per cent reduced risk of death for Covid patients who had blood cancer and had received convalescent plasma compared to similar patients who did not receive this treatment.
The survival benefit with convalescent plasma was even greater in patients who were admitted to the intensive care unit (60 per cent reduced risk of death) and those who needed mechanical ventilation (68 per cent reduced mortality).
"These results suggest that convalescent plasma may not only help Covid-19 patients with blood cancers whose immune systems are compromised, it may also help patients with other illnesses who have weakened antibody responses to this virus or to the vaccines," said Jeffrey P. Henderson, Associate Professor of medicine and of molecular microbiology at the University's School of Medicine in St. Louis.
"The study also emphasises the value of an antibody therapy such as convalescent plasma as a virus-directed treatment option for hospitalised Covid-19 patients," Henderson added. The findings are published in the journal JAMA Oncology.
The therapy involves transfusing plasma -- the pale yellow liquid in blood that is rich in antibodies -- from people who have recovered from Covid-19 into patients who have leukemia, lymphoma or other blood cancers and are hospitalised with the viral infection. The goal is to accelerate their disease-fighting response. Cancer patients may be at a higher risk of death related to Covid-19 because of their weakened immune systems.
The team studied 143 patients who received convalescent plasma, and 823 who did not. Of the 338 patients admitted to ICUs because of severe Covid-19 symptoms, such as difficulty breathing or cardiac distress, those who received the treatment were more than twice as likely to survive.
In March 2020, the US Food and Drug Administration approved convalescent plasma therapy to Covid patients if requested by their physicians.
Last month the Indian Council of Medical Research dropped the plasma therapy as Covid-19 treatment, citing no significant benefit.
New Delhi, June 14 (IANS) The Union Ministry of Science & Technology said on Monday that a study conducted by Indian scientists have recently found that cancer-causing Epstein-Barr Virus (EBV) affects the glial cells or the non-neural cells in the central nervous system (CNS) and alters molecules like phospho-inositols (PIP) when the virus infects the brain cells.
The findings could pave the way towards understanding the probable role of the virus in neurodegenerative pathologies, especially given the fact that the virus has been detected in the brain tissue of the patients suffering from neurological disorders such as Alzheimer's, Parkinson's disease and multiple Sclerosis.
The EBV can cause cancers like nasopharyngeal carcinoma (a type of head and neck cancer), B-cell (a type of white blood cells) cancer, stomach cancer, Burkett's lymphoma, Hodgkin's lymphoma, post-transplant lymphoid disorders, and so on.
However, the infection is mostly asymptomatic, and very little is known about the factors which trigger the development of such a disease. It was the detection of the virus in patients with neurodegenerative diseases that triggered the search for the mechanism of propagation of the virus.
Scientists' teams from the Departments of Physics nd Biosciences and Biomedical Engineering at IIT Indore along with their collaborator, Fouzia Siraj, at the National Institute of Pathology (ICMR), New Delhi, used the Raman Spectroscopy System supported by the Fund for Improvement of S&T Infrastructure (FIST), a scheme of the Department of Science and Technology, to trace the propagation mechanism of the virus.
The study, based on spatial and temporal changes in the Raman signal, was helpful in advancing the application of Raman Scattering as a technique for rapid and non-invasive detection of virus infection in clinical settings.
Over the last 3 to 4 decades, average sperm count in men as well as sperm quality, have declined alarmingly on a global scale. 1 out of 20 men, at present, are facing different fertility challenges. The growing numbers can be accredited to the exposure to environmental chemicals that disrupt ones endocrine balance.
Dr. Shweta Goswami, Associate Director- Fertility, Cloudnine Group of Hospitals, Noida says: "Ever-increasing cases of obesity and the trend of delaying parenthood, be it due to work or any other personal reason, have also been great contributing factors. It is pertinent to understand that the reasons behind male infertility can vary greatly, though these are usually linked to congenital, acquired and idiopathic factors that directly or indirectly affect the sperm."
What do the numbers say?
Dr Goswami tells: "One out of six couples who are trying to conceive are not able to achieve pregnancy naturally and are diagnosed with infertility. In fact, an article on Male Infertility, published in The Lancet on December 10, 2020, clearly suggests that 12 percent of couples globally, with a malefactor being a primary or contributing cause in approximately 50 percent of couples'."
Also, Read► How excess sugar consumption causes fatty liver
Impact of the current pandemic on male fertility
Ever since the first case of the pandemic was reported in 2019, experts all across the globe have been thriving seamlessly to explicate the unknowns of the deadly virus, Covid-19. While many new facts have come to light, studies are still going on to find out more about the virus and its side effects. Mounting evidence has pointed towards the negative impact of the virus on male infertility, she says.
"A study, COVID-19 and male reproductive function: a prospective, longitudinal cohort study', published in the journal Reproduction in January 2021, suggests that the human reproductive system may be potentially vulnerable to COVID-19 infection and the same can lead to significant impairments in semen volume, progressive motility, sperm morphology, sperm concentration and the number of spermatozoa.
"It is not uncommon for a virus to attack the male reproductive tract as previously documented evidence has shown that there are a variety of viruses that can severely impact male fertility. In light of the global decline in sperm quality, the virus has led to further concerns," says the expert.
The expert burst male infertility myths
If we are talking about male infertility how can we forget the myths that surround it? Here are a few myths and misconceptions related to male infertility that need to be busted:
Myth 1- Infertility is a female problem and males have nothing to do with it
This common myth prevailed in our society for a very long time. In fact, there are still people out there who believe that infertility is only related to females. It is important to understand that infertility is not a gender-specific problem and can affect both females as well as males. Male infertility predominantly depends upon the quality and quantity of the sperm. Studies suggest that two-thirds of the males with fertility issues have found to have low sperm count or impaired sperm quality. Rest can be contributed to problems in the male reproductive tract, genetic conditions, hormonal imbalance and other factors.
Myth 2- Only women need to take care of their health when it comes to planning for pregnancy.
This is completely false as the quality of the sperm is as important as the quality of the egg. There are various factors that can affect the quality of the sperm which include excessive smoking, drinking, substance abuse, exposure to harmful chemicals, wearing tight fitted underwear's and sexually transmitted diseases. As most of the problems concerning male infertility are related to sperm, it is extremely important to incorporate healthy habits into your daily routine.
Myth 3- Men can have children as long as they live
No doubt males do not have a fertility window like females but this does not mean that they can impregnate their partner anytime they want. Although it is possible for some males to have children in their 70s, the time taken for or achieving the pregnancy is considerably longer than males who are below 45 years of age. This happens because sperm quality is likely to decrease after a certain age. It is also important to note that the chances of miscarriage and premature birth are higher when the man is older. Not only this, if you are planning a pregnancy after crossing 70 years of age, the child is quite likely to have genetic, chromosomal and developmental defects.
Read More► How age affects a women's fertility as compared to men?
Mandi, June 14 (IANS) A team of researchers from IIT Mandi has identified the underlying biochemical relationship between the consumption of excessive sugar and the development of afatty liver', medically known as Non-Alcoholic Fatty Liver Disease (NAFLD).
NAFLD is a condition in which excess fat deposits in the liver. The disease starts silently, with no overt symptoms for as much as two decades. If left untreated, the excess fat can irritate the liver cells, resulting in scarring of the liver (cirrhosis), and in advanced cases, can even lead to liver cancer. The treatment of advanced stages of NAFLD is difficult.
One of the causes for NAFLD is the overconsumption of sugar -- both table sugar (sucrose) and other forms of carbohydrates. The consumption of excess sugar and carbohydrates causes the liver to convert them into fat in a process called hepatic De Novo Lipogenesis or DNL, which leads to fat accumulation in the liver.
The molecular mechanisms that increase hepatic DNL due to overconsumption of sugar, which is is key to developing therapeutics for the NAFLD, have not been clear yet, said lead scientist Prosenjit Mondal, Associate Professor, School of Basic Sciences, IIT Mandi.
The team used a complementary experimental approach involving mice models, and identified the unknown link between the carbohydrate-induced activation of a protein complex called NF-KB and increased DNL.
"Our data indicates that the sugar-mediated shuttling of hepatic NF-KB p65 reduces the levels of another protein, sorcin, which in turn activates liver DNL through a cascading biochemical pathway," explained Mondal. The findings are published in the Journal of Biological Chemistry.
The team showed that drugs that can inhibit NF-KB can prevent sugar-induced hepatic fat accumulation. They have also shown that the knockdown of sorcin reduces the lipid-lowering ability of the NF-KB inhibitor.
The finding that NF-KB plays a key role in lipid accumulation in the liver opens up a new avenue of therapeutics for NAFLD. NF-KB also plays a role in other diseases that involve inflammation, such as cancer, Alzheimer's disease, atherosclerosis, IBS, stroke, muscle wasting and infections.
The research comes at a time when India has included NAFLD in the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).
India is the first country in the world to identify the need for action on NAFLD and with good reason. The prevalence of NAFLD in India is about 9 per cent to 32 per cent of the population, with the state of Kerala alone having a prevalence of 49 per cent and a staggering 60 per cent prevalence among obese school-going children.
The study has conclusively shown that excessive sugar intake leads to a fatty liver. This should offer incentive to the public to reduce sugar intake to stop NAFLD in its early stages, the team said.