Indian-origin doctor in US implants first leadless pacemaker inside patient's heart

February 9, 2014

Pacemaker_inside_patients_heartNew York, Feb 9: An Indian-origin doctor in the US has implanted the first miniature-sized, leadless cardiac pacemaker directly inside a patient's heart without surgery.

The leads-free pacemaker is implanted directly inside the heart during a catheter-guided procedure through the groin via the femoral artery.

The device implanted by Vivek Reddy from The Mount Sinai Hospital, resembles a small metal silver tube, and is only a few centimetres in length, making it less than ten per cent the size of a traditional pacemaker.

The Nanostim device, made by St Jude Medical, is being tested for safety and efficacy in an international, multicentre clinical trial called LEADLESS II, which is planning to enroll 670 patients at 50 centres across the US, Canada, and Europe.

"This clinical research trial will be testing the latest innovative, non-surgical pacemaker option for patients experiencing a slowed heart beat," said Reddy, the study's co-investigator.

"This new-age, tiny pacemaker may ultimately be safer for patients because it doesn't have leads or have to be inserted under the skin of a patient's chest, like a traditional cardiac pacemaker," Reddy said.

Similar to other cardiac pacemakers, the Nanostim device treats a heart rate that is too slow called bradycardia.

It works by closely monitoring the heart's electrical rhythms and if the heart beat is too slow it provides electrical stimulation therapy to regulate it.

More than 4 million patients globally have a pacemaker, and 700,000 new patients receive one each year, researchers said.

The possible advantages of the leadless pacemaker include the elimination of a surgical pocket and no visible pacemaker device under a patient's chest skin, no incision scar on the chest, no connector wires or leads, and no restrictions on a patient's activities.

The device's benefits may also allow for less patient discomfort, infections, and device complications and dysfunction.

In addition, the free-standing, battery-operated pacemaker device is designed to be fully retrievable from the heart.

"The same cardiac pacing results for patients may be available with this smaller leads-free device with the added benefits of a non-surgical procedure and less complication risks," said Srinivas Dukkipati, who is the study's principal investigator.

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Agencies
March 3,2020

Taking multiple courses of antibiotics within a short span of time may do people more harm than good, suggests new research which discovered an association between the number of prescriptions for antibiotics and a higher risk of hospital admissions.

Patients who have had 9 or more antibiotic prescriptions for common infections in the previous three years are 2.26 times more likely to go to hospital with another infection in three or more months, said the researchers.

Patients who had two antibiotic prescriptions were 1.23 times more likely, patients who had three to four prescriptions 1.33 times more likely and patients who had five to eight 1.77 times more likely to go to hospital with another infection.

"We don't know why this is, but overuse of antibiotics might kill the good bacteria in the gut (microbiota) and make us more susceptible to infections, for example," said Professor Tjeerd van Staa from the University of Manchester in Britain.

The study, published in the journal BMC Medicine, is based on the data of two million patients in England and Wales.

The patient records, from 2000 to 2016, covered common infections such as upper respiratory tract, urinary tract, ear and chest infections and excluded long term conditions such as cystic fibrosis and chronic lung disease.

The risks of going to hospital with another infection were related to the number of the antibiotic prescriptions in the previous three years.

A course is defined by the team as being given over a period of one or two weeks.

"GPs (general physicians) care about their patients, and over recent years have worked hard to reduce the prescribing of antibiotics,""Staa said.

"But it is clear GPs do not have the tools to prescribe antibiotics effectively for common infections, especially when patients already have previously used antibiotics.

"They may prescribe numerous courses of antibiotics over several years, which according to our study increases the risk of a more serious infection. That in turn, we show, is linked to hospital admissions," Staa added.

It not clear why hospital admissions are linked to higher prescriptions and research is needed to show what or if any biological factors exist, said the research team.

"Our hope is that, however, a tool we are working for GPs, based on patient history, will be able to calculate the risks associated with taking multiple courses of antibiotics," said Francine Jury from the University of Manchester.

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Agencies
May 9,2020

17-year-old Pratyusha Jha, wakes up scrambling for newspapers these days to look for any news about her pending board exams and is anxious about what the future has in store for her.

Similar concerns are shared by Bipin Kumar, a class 12 student, who says the announcement of board exams from July 1 to 15 brought limited clarity as the larger questions remain unanswered.

The COVID-19 lockdown, came with a different set of concerns for class 12 students, whose board exams were postponed midway following the outbreak of coronavirus, putting on hold their future plans as well.

"Everyday I have been looking for news about the exams and about entrance exam dates. I feel unfortunate that this happened during the year I was supposed to take the big college leap. I don't want my future decisions to be shaped by this very year as what I opt to study now will remain with me lifelong," Pratyusha told PTI.

Ending some uncertainty for students, HRD Minister Ramesh Pokhriyal 'Nishank' on Friday announced that the pending class 10 and 12 board exams will be held from July 1 to 15. While class 12 exams will be conducted across the country, the class 10 exams are only pending in North East Delhi where they were affected due to the law and order situation.

"The anxiety doesn't end here, there is no date sheet yet. What will be the modalities of exams, how will we reach centres, what protocols have to be followed, there is no clarity on that. My friends and I keep calling our school teachers and also the CBSE helpline to seek some clarity," Bipin Kumar said.

Vaibhav Sharma, a class 12 student in Gurgaon said, "There is no clarity yet. I wanted to apply for DU, but now that the exams are taking place in July when will the results be declared, when will cut offs be announced. If I don't get a good college here, will I be able to travel to different cities for admission, nothing is known yet."

Similarly, for the students in northeast Delhi, the wait for the exams has become a "test of patience" as they were postponed first in the area due to law and order situation, and later due to the coronavirus outbreak, resulting in a four-month-long wait for the exams.

"It has become an endless wait and now I don't feel like studying too. Right from childhood, we are taught that board exams are too crucial and have to be focussed at least two years in advance. But now, it is a different picture altogether," Rani Kumari, a resident of Chandbagh said.

Universities and schools across the country have been closed and exams postponed since March 16 when the Centre announced a countrywide classroom shutdown as one of the measures to contain the COVID-19 outbreak.

Later, a nationwide lockdown was announced on March 24, which has now been extended till May 17.

The board was not able to conduct class 10 and 12 exams on eight examination days due to the coronavirus outbreak. Further, due to the law and order situation in North East Delhi, the board was not able to conduct exams on four examination days, while a very small number of students from and around this district were not able to appear in exams on six days.

The board had last month announced that it will only conduct pending exams in 29 subjects which are crucial for promotion and admission to higher educational institutions. The modalities of assessment for the subjects for which exams are not being conducted will be announced soon by the board.

The schedule has been decided in order to ensure that the board exams are completed before competitive examinations such as engineering entrance JEE-Mains, which is scheduled from July 18-23, and medical entrance exam NEET, which is scheduled on July 26.

The University Grants Commission (UGC) has issued guidelines to universities that new academic session for freshers will begin from September while for the existing students from August.

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Agencies
May 25,2020

Singapore, May 25: COVID-19 patients are no longer infectious after 11 days of getting sick even though some may still test positive, according to a new study by infectious disease experts in Singapore.

A positive test "does not equate to infectiousness or viable virus," a joint research paper by Singapore's National Centre for Infectious Diseases and the Academy of Medicine, Singapore said. The virus "could not be isolated or cultured after day 11 of illness."

The paper was based on a study of 73 patents in the city-state.

The latest findings may have implications on the country's patient discharge policy. The discharge criteria is currently based on negative test results rather than infectiousness.

Singapore's strategy on managing COVID-19 patients is guided by the latest local and international clinical scientific evidence, and the Ministry of Health will evaluate if the latest evidence can be incorporated into its patient clinical management plan, according to a report by the Straits Times.

So far, 13,882, or about 45% of the total 31,068 Covid-19 patients in Singapore have been discharged from hospitals and community facilities. Singapore reported 642 new Covid-19 cases as of noon on Saturday.

The government has been actively screening pre-school staff as it prepares to reopen pre-schools from June 2. On Friday, two pre-school employees tested positive for the novel coronavirus, bringing the total number of confirmed cases among pre-school staff to seven, according to the Ministry of Health.

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