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India had world’s highest child mortality rate in 2015, shows Lancet study

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India had more deaths among children under five than any other country in 2015, with large disparities in the child mortality rate between richer and poorer states, a Lancet study has found.


The researchers at the Johns Hopkins Bloomberg School of Public Health in the US analysed state-level Indian data on the causes of death among children under five for the years 2000-2015.



They found that India made great progress during the period, reducing annual mortality among children under five from 2.5 million in 2000 to 1.2 million in 2015 — which was still the highest in the world.


However, among India’s states, great disparities remained: The highest mortality rate in Assam was more than seven times that in Goa. Although most under-five deaths were due to preterm complications, preventable infectious diseases featured prominently as causes of death in higher-mortality states.


“India can accelerate its reduction of under-five mortality rates by scaling up vaccine coverage and improving childbirth and neonatal care, especially in states where mortality rates remain high,” said Li Liu, PhD, assistant professor at the Bloomberg School.


Using data sources from Indian government health surveys, the team assessed total mortality, mortality rates and causes of mortality for children under five in 25 states. United Nations Millennium Development Goals (MDG) set in the year 2000 was to reduce the under-five mortality rate in 2015 to one-third of the 1990 figure.


For India that would have meant reducing the under-five mortality rate to 39 deaths per 1,000 live births.


The analysis showed, however, that despite great progress since 1990 — and even since 2000 when the under-five mortality rate was 90.5 deaths per 1,000 live births — India in 2015 was still well above the MDG target, at 47.8 deaths per 1,000 live births. Most (57.9 per cent) of deaths among Indian children under five in 2015 occurred in the first four weeks of life — the neonatal period.


Countrywide, the leading cause of death for children under five was preterm birth complications, which accounted for 27.5 per cent of the mortality total. However, second on the list for cause-of-death was pneumonia (15.9 per cent of deaths), and infectious illnesses were more often among the top causes in the poorer, high-mortality states.


“Noncommunicable diseases such as preterm birth complications and congenital abnormalities were usually the leading causes in states with low under-five mortality,” Liu said.


Although progress in reducing the under-five mortality rate has been occurring throughout India, the period from 2000 to 2015 saw widening disparities among richer and poorer states — ranging from Goa’s 9.7 under-five deaths per 1,000 live births to Assam’s 73.1. Liu used as a basic indicator of overall disparity the ratio of the highest regional mortality rate (Northeast region) vs the lowest (South region), and found that that ratio increased from 1.4 in 2000 to 2.1 in 2015.


To accelerate India’s progress against child mortality, the team recommends more extensive use of childhood vaccines, particularly against pneumonia- and meningitis-causing Streptococcus and H influenzae bacteria.


They also advocate — especially for higher-mortality regions — a scaling up of standard care strategies for newborns, including “kangaroo care” in which the baby rests against the mother’s skin, thermal care to reduce hypothermia and early initiation of breastfeeding.



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Medtronic says won’t recall pacemakers after drug regulator issues alert

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Medtronic India has said it is not recalling its pacemaker models in the country and is in discussion with relevant stakeholders following an alert issued by drug regulator Central Drugs Standard Control Organisation (CDSCO) over the performance of pacemakers.


CDSCO has alerted patients with implants of three Medtronic pacemaker models to seek immediate medical care if they feel certain symptoms that could be signs of the devices’ sudden battery depletion.


Medtronic sells in India, Astra pacemaker, Solara CRT-P and Serena CRT-P.


“We have and continue to communicate proactively with the doctors and relevant stakeholders in India and have informed them about the performance note. There have been no patient issues reported in India related to this performance note,” the statement by the company said.


Stressing that it was “not a case of product recall”, Medtronic India said, “We are in proactive discussion with CDSCO”.


Medtronic has published a performance note about a rare mode in a population of Azure and Astra pacemakers and Percepta, Serena and Solara cardiac resynchronization therapy pacemakers.


“We have received three complaints out of 266,700 devices distributed worldwide since February 2017. The projected rate of occurrence for this issue is 0.0028 per cent, with the most susceptible period being the first 12 months after a device is implanted,” the statement said.


In consultation with company’s independent physician quality panel, “We do not recommend device replacement, and advise physicians to continue normal patient follow-up in accordance with standard practice and, where possible, to continue with remote monitoring,” it added.


“While the devices continue to perform well within reliability projections, Medtronic has implemented additional process and component enhancements that have been reviewed and approved by Food and Drug Administration,” the statement said.


The CDSCO has asked patients with any of the three models to seek immediate medical care if they feel light-headed, dizzy or experience chest pain and loss of consciousness.


The alert by the regulator came after the US Food and Drug Administration raised alarm over the use of the pacemaker models Astra, Serena and Solara.


In its alert on May 7, the USFDA cited a case in which a Medtronic implantable pacemaker or CRT-P battery had fully drained because of a crack in the device’s capacitor, without any warning to the patient or health care provider.


Medtronic’s implantable pacemakers or cardiac resynchronization therapy pacemaker (CRT-Ps) are devices that provide pacing for slow heart rhythms and heart failure pacemakers and CRT-Ps are both implanted under the skin in the upper chest area with connecting insulated wires called leads that go into the heart.


As per the alert by CDSCO, doctors have been recommended to be alert and consider whether elective device replacement is warranted for a pacemaker patient.


“Be aware of sudden battery level drops during follow-up visits and remote transmissions. Watch for decrease in battery level out of proportion to the life of the device from the time of implant even if the level remains within the normal range,” the alert stated.



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India’s drug regulator warns patients against faulty Medtronic pacemakers

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The Indian drug regulator has alerted patients with implants of three Medtronic pacemaker models to seek immediate medical care if they feel light-headed, dizzy or experience chest pain and loss of consciousness, saying these could be signs of the devices’ sudden battery depletion.


The alert by Central Drug Standards Control Organisation (CDSCO) came after the US Food and Drug Administration (USFDA) raised alarm over the use of the pacemaker models Astra, Serena and Solara.


In its alert on May 7, the USFDA cited a case in which a Medtronic implantable pacemaker or CRT-P battery had fully drained because of a crack in the device’s capacitor, without any warning to the patient or health care provider.


If a capacitor in a CRT-P is cracked, it can create an electric short, which can cause the battery to drain earlier than expected.


Medtronic’s implantable pacemakers or cardiac resynchronization therapy pacemakers (CRT-Ps) are devices that provide pacing for slow heart rhythms and heart failure pacemakers and CRT-Ps are both implanted under the skin in the upper chest area with connecting insulated wires called leads that go into the heart.


India’s CDSCO has advised patients to seek immediate medical assistance if they feel dizzy, light-headed, severe short breath or loss of consciousness.


“These may be signs that your device’s battery has had a sudden drop or has drained,” it said.


Doctors have been recommended to be alert and consider whether elective device replacement is warranted for a pacemaker patient.


“Be aware of sudden battery level drops during follow-up visits and remote transmissions. Watch for decrease in battery level out of proportion to the life of the device from the time of implant even if the level remains within the normal range,” the alert stated.


Medtronic reported that healthcare providers were unable to communicate with the device due to battery depletion resulting in loss of pacemaker function. It also reported these events occurred in the US within one year after the patient was implanted with the pacemaker or CRT-P.


One of the reported events resulted in the death of a pacemaker-dependent patient.


In another reported incident, the patient experienced dizziness during follow-up and the healthcare provider was unable to communicate with the device, which resulted in the patient getting their device replaced.


In the third event, there was no harm to the patient because the device was not implanted when the healthcare provider became aware that a connection with the device could not be established.



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Specialised microscope can diagnose skin cancer, perform surgeries: Study

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Scientists have developed a specialised microscope that has the potential to diagnose diseases like skin cancer as well as perform precise surgery without making any incisions in the skin.


According to the study published in the journal Science Advances, the microscope allows medical professionals to pinpoint the exact location of an abnormality, diagnose it and treat it instantly.



“Our technology allows us to scan tissue quickly, and when we see a suspicious or abnormal cell structure, we can perform ultra-precise surgery and selectively treat the unwanted or diseased structure within the tissue — without cutting into the skin,” said Yimei Huang from the University of British Columbia in Canada.


It could be used to treat any structure of the body that can be reached by light and requires extremely precise treatment, including nerves or blood vessels in the skin, eye, brain or other vital structures, researchers said.


“For diagnosing and scanning diseases like skin cancer, this could be revolutionary,” said Harvey Lui, professor at the University of British Columbia.


The study shows that the device allows imaging of living tissue up to about one millimetre in depth using an ultrafast infrared laser beam.


Researchers said that this microscope, however, is different from previous technology due to its capability to not only digitally scan living tissue, but also treat the tissue by intensifying the heat produced by the laser.


“We can alter the pathway of blood vessels without impacting any of the surrounding vessels or tissues,” said Lui.


The researchers also said that their aim is to make multiphoton microscope technology more versatile while also increasing its precision.


“We wanted to be able to identify what was happening under the skin from many different angles and to have the capability of imaging different body sites,” said Haishan Zeng from the University of British Columbia.


Developments of a miniature version of the telescope that could be used to perform microscopic examinations and treatment during endoscopy are also underway, researchers said.


“We are not only the first to achieve fast video-rate imaging that enables clinical applications, but also the first to develop this technology for therapeutic uses,” said Zeng.

(Only the headline and picture of this report may have been reworked by the Business Standard staff; the rest of the content is auto-generated from a syndicated feed.)



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