Friday, 19 July 2013

20 July, 2013

‘Need for cost-effective dialysis’

With kidney failure becoming common in Indian families, there is need for a cost-effective course of dialysis, health experts said on Thursday. Kidney failure, a chronic condition, is becoming more and more common in India. Dialysis in hospitals also entails high risk of Hepatitis C and other infections in patients, health experts gathered for a round table discussion on ‘Rational and cost-effective management of chronic renal failure: Payer and payee perspective’ said. (Read: 12 symptoms of kidney disease you shouldn’t ignore)
The condition becomes a source of great distress to patients and their families as treatment through dialysis is expensive. There is thus urgent need for a cost-effective, rational financial means of performing dialysis, the experts said. The forum offered an opportunity to recognise the need for inclusion of peritoneal dialysis (which uses the peritoneum in the abdomen as the membrane across which fluids and dissolved substances are exchanged from the blood) in health insurance cover.  Peritoneal dialysis offers better quality of life to renal patients, as the treatment can be conducted at home. It also lowers risk of infection, a release said. (Read: Organ transplant facts you must know)
Dialysis is a life-saving treatment for patients with kidney failure waiting for an organ transplant. On the panel of doctors who participated in Thursday’s discussions were Dinesh Khullar of Sir Ganga Ram Hospital and Gokulnath of St. John’s Hospital, Bangalore.


20.07.2013



Obesity linked to asthma

Researchers including an Indian have found that genes linked to chronic inflammation inasthma could be more active in obese people.
First author Paresh Dandona, MD, PhD, SUNYDistinguished Professor and Chief of Endocrinology, Diabetes and Metabolism at the University at Buffalo, said that his team findings point the way to the management of asthma in the obese through simple weight reduction.

The research involved two related studies: A comparative study between obese people and people of normal weights; and an experiment that looked at how various biological indicators - including the behavior of asthma-linked genes - changed when morbidly obese patients received gastric bypass surgery.
In the comparative study, the scientists found that four genes associated with chronic inflammation in asthma were more active in obese and morbidly obese people, by more than 100 percent in some cases. The highest activity was found in the morbidly obese.
This increased gene expression matters because it can cause white blood cells called mononuclear cells to produce far greater amounts of inflammatory factors like interleukin 4, LIGHT and lymphotoxin beta receptor which contribute to allergic inflammation and other abnormalities in the bronchial passages in asthma.
The scientists also found higher concentrations of two asthma-related compounds in the plasma of obese and morbidly obese patients: MMP-9, which is associated with inflammation, and nitric oxide metabolites (NOM), which are an indicator of oxidative stress.
Following gastric bypass surgery in morbidly obese diabetic patients, MMP-9 and NOM levels dropped, along with the expression of six asthma-related genes including the key factors, interleukin 4, LIGHT, lymphotoxin beta and interleukin 33 in parallel with weight loss and improvements in the status of their diabetes.
"Ours is the first study to provide a mechanistic link between obesity and asthma through biological/immunological mechanisms," Dandona said. "There has been, until now, no biological, mechanistic explanation other than the fact that obesity may raise the diaphragm and thus reduce lung volumes."
Importantly, the research established a connection between Type 2 diabetes, obesity and asthma based on biological mechanisms. This is important because obesity and Type 2 diabetes are associated with a more than 100 percent increase in the prevalence of asthma, Dandona said.

The research has been published online in the journal 
Obesity.
Source: www.timesofindia.com    20.07.2013






Not being able to do everything is no excuse for not doing everything you can

Ashleigh Brilliant

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