Archive for month: January, 2024

In a pioneering study conducted by Renalis University Hospitals in Cleveland, Ohio, a novel approach to treating overactive bladder (OAB) has emerged with the use of a digital conversational agent named CeCe. They found that CeCe’s role as a digital conversational agent emerged as a promising solution, effectively alleviating the severity of OAB symptoms and enhancing the overall quality of life for patients.

The study results were published in the journal UroGynecology. 

Also Read: No additional benefit of pelvic floor muscle training over bladder training among women with overactive bladder

Overactive bladder (OAB) syndrome stands as a persistent medical condition significantly impacting the quality of life for a considerable portion of the population. It disrupts the activities of daily living and many individuals refrain from seeking medical assistance. As conservative therapy is effective in the management of overactive bladder, researchers conducted a prospective observational trial to evaluate the efficacy of digital conversational agents for the treatment of Overactive bladder.

In this prospective observational trial, a digital conversational agent developed by Renalis University Hospitals in Cleveland, Ohio, was employed for OAB treatment. Patients accessed CeCe over 8 weeks, receiving guidance on bladder training, pelvic floor exercises, and comprehensive information on bladder health. The primary objective was to assess a reduction in the International Consultation on Incontinence—Overactive Bladder Quality-of-Life Questionnaire (ICIQ-OAB-QoL) score from week 1 to week 8. Additionally, patients completed the 36-item Short-Form Health Survey and Generalized Anxiety Disorder Questionnaire at the same intervals, along with voiding diaries at weeks 1, 4, and 8. A power analysis indicated that a total of 30 patients were necessary to demonstrate a significant difference in symptom scores post-CeCe use, with 80% power and an α error of 5%.

Findings:

• All data collection was completed by 29 patients. There was a significant difference in ICIQ-OAB-QoL scores between weeks 1 and 8 (62 [IQR], 49–75) compared to 32 [IQR, 24–43]; P < 0.001).
• Patients also noted a decrease in frequency before and after treatment (7 [IQR, 6–10] vs. 5 [IQR, 4–7]; P = −0.04), diminished nocturia (2 [IQR, 1–3] vs. 1 [IQR, 1–2]; P = 0.03), and a substantial reduction in urge urinary incontinence (2 [IQR, 1–5] vs. 0 [IQR, 0–3]; P = 0.04).
• Additionally, a noteworthy decline in alcohol consumption from 24 oz [IQR, 12–36 oz) in week 1 to 14 oz (IQR, 9–22 oz]; P = 0.02) in week 8 was noted.

Also Read: Anticholinergic medications improve overactive bladder syndrome

Published in the latest December issue of JAPI, the survey included 1007 health care professionals (HCPs) from across India. Based on consensus results, panelists recommended five commandments.

1. Perform a thorough clinical evaluation before prescribing PPIs (level 1)

2. Prescribe PPIs for a short-term duration (≤8 weeks). If long-term therapy is prescribed, reassess the need for continuation periodically and attempt to taper or discontinue if possible (level 2)

3. Educate patients about potential side effects associated with long-term PPI use, especially abnormal bowel habits, bloating, micronutrient deficiencies, flatulence, and abdominal pain (level 2)

4. Co-prescribe pre- and probiotics with PPIs when managing patients with Antibiotic-associated diarrhoea, and those experiencing abnormal bowel habits, bloating (level 1), micronutrient deficiencies, flatulence, and abdominal pain (level 2)

5. Consider co-prescribing pre- and probiotics for >3 months to achieve favorable outcomes and improve overall quality of life (level 1), while monitoring and assessing their effectiveness regularly.

PPI: proton-pump inhibitor

Level 1: >50% agreed; level 2: 30-50% HCPs agreed

Adapted from:

Kalra S et al. The Scope of Pre- and Probiotics as an Add-on to Proton-pump Inhibitors in Various Clinical Indications. J Assoc Physicians India 2023;https://doi.org/10.59556/ japi.71.0409

Mumbai: Cipla (EU) Limited, UK a wholly owned subsidiary of Cipla
Limited, hereinafter referred to as Cipla has announced a
strategic collaboration with Kemwell Biopharma Private Limited (through its subsidiary
Kemwell Biopharma UK Limited) and Manipal Education & Medical Group (through its
subsidiary MNI Ventures, Mauritius) to incorporate a joint venture in the United States.

The
primary goal of this joint venture is to develop and commercialise novel Cell therapy
products for major unmet medical needs in the United States, Japan, and EU regions.
Cipla (EU) Limited will secure a 35.2% stake in the joint venture company.

“By capitalizing
on Cipla’s leadership in product development and commercialisation and aligning with
Kemwell’s expertise in biologics and Manipal’s expertise in healthcare delivery, this
strategic collaboration is aimed at expediting development, manufacturing, licensing,
import and export of cutting-edge Cell therapy products to cater to patients globally,” the release stated.

Commenting on this development, Umang Vohra, Managing Director & Global Chief
Executive Officer, Cipla, said, “This joint venture reinforces our concerted efforts to move
up the innovation curve and pioneer transformative treatments in the areas of stem cell
and CAR T-cell therapies, enabled by advances in biotech, mRNA and cell-engineering
research, that can make a difference to patient lives globally. As we steer Cipla into the
future and lead with purpose, our partnership with Kemwell and Manipal Group will be
integral in realising these advancements.”

Commenting on the tie up, Dr Ranjan Pai, Chairman, Manipal Education & Medical
Group, said, “We are very happy to partner with Cipla and Kemwell in bringing the next
generation of biological therapies to address unmet medical needs globally. Physicians
will have accessible, safe, and clinically effective Cell therapies in their hand to fight
against many serious indications. We believe that Cell therapy products will be a gamechanger in offering an advanced therapeutic treatment for millions of patients suffering
with painful diseases.”

Anurag Bagaria, Chairman and CEO, Kemwell added “We believe that Cell therapies will
become a major branch of medical treatment and will become a standard of care for
challenging diseases. Kemwell has built a world-class cGMP facility in Bangalore and
made India an emerging hub for cell therapy development and manufacturing. The
synergistic combinations of Cipla, Manipal and Kemwell will accelerate the
development of novel cell-based products for patients and transform the new JV into a
global player in cell therapeutics.”

In a groundbreaking exploration at the intersection of platelet volume and patient outcomes, a recent study has illuminated the potential role of mean platelet volume (MPV) as a significant indicator of mortality risks in individuals undergoing peritoneal dialysis (PD). While MPV has previously been associated with severity and mortality in sepsis patients, this study expands its relevance to the realm of renal care. The study found that MPV is independently associated with both all-cause mortality and cardiovascular mortality in patients undergoing peritoneal dialysis.

The study results were published in the journal BMC Cardiovascular Diseases. 

Also Read: Adults receiving hemodialysis at higher risk of developing AF versus peritoneal dialysis

In the realm of medical research, the mean platelet volume (MPV) has emerged as a valuable indicator, demonstrating associations with severity and all-cause mortality in patients with sepsis. However, a recent study has delved into uncharted territory, exploring the relationship between MPV and all-cause mortality, as well as cardiovascular mortality, in patients undergoing peritoneal dialysis (PD). The primary objectives of this retrospective study were to uncover the potential links between MPV and both all-cause mortality and cardiovascular mortality among patients treated with PD.

Researchers retrospectively gathered data from 1,322 patients undergoing PD between November 1, 2005, and August 31, 2019. The study’s primary outcomes were identified as all-cause mortality and cardiovascular mortality. To classify MPV, the researchers employed the X-tile software. The correlation between MPV and mortality was assessed using Cox models, and survival curves were generated using the Kaplan-Meier method.

Key Findings:

• The median follow-up period for the study participants was 50 months (ranging from 30 to 80 months), during which a total of 360 deaths were recorded.
• For all-cause mortality, patients with MPV ≥ 10.2 fL exhibited a significantly higher risk across three different models.
• Furthermore, PD patients with MPV ≥ 10.2 fL demonstrated a notably elevated risk of cardiovascular mortality in all three models.

This groundbreaking study concludes that MPV is independently associated with both all-cause mortality and cardiovascular mortality in patients undergoing peritoneal dialysis. These findings offer valuable insights into the potential role of MPV as a prognostic marker for mortality risks in the context of PD. 

Also Read: Abbreviated DAPT regimen more beneficial to women compared to men: JAMA

The implications of this research extend beyond the specific patient population studied, prompting further exploration of MPV as a potential biomarker in other medical contexts. As the scientific community continues to uncover the intricate relationships between platelet volume and health outcomes, these findings open new avenues for understanding and managing mortality risks in diverse patient groups.

Further reading: Mean platelet volume and the association with all-cause mortality and cardiovascular mortality among incident peritoneal dialysis patients. https://doi.org/10.1186/s12872-023-03551-x

Totally magnetic technique effective option for sentinel lymph node detection and breast cancer localization suggests a new study published in the JAMA Surgery