Tuesday, 22 October 2013

23 October, 2013

Indian doctors devise score to assess patients’ bleeding risk

A score has been derived by doctors here to assess the bleeding risk in Indian patients who are on drugs that prevent clotting of blood.
The research by geneticists at the Sir Ganga Ram Hospital here focused on deriving and validating a Genetic Bleeding Risk (GBR) score based on genetic and non-genetic factors associated with bleeding in patients on long-term anti-coagulation (blood clotting) therapy, a release said on Monday.
There are already a few bleeding risk prediction scores available in the world, but most are derived from the white population and more importantly, none have evaluated the predictive significance of genetic risk factors so far, it said.
A substance that prevents clotting of blood, anti-coagulants are being used all over the world since early 1940s for treatment and prevention of thrombosis – clot formation in a blood vessel that obstructs flow and affects various body parts and organs like legs, heart, kidneys, brain and lungs etc.  
Despite its common usage, oral anti-coagulant (OAC) therapy is associated with significant bleeding complications.
The study was conducted on 310 patients from departments of vascular surgery, cardiac surgery and neurology from August 2009 to August 2012 at Sir Ganga Ram Hospital here. It took approval from the hospital’s ethics board committee and was in accordance with the ethical standards of World Medical Association.
‘The report shows that the number of bleeding episodes can be effectively reduced, thus sparing the patients from adverse outcomes and reducing hospital admissions,’ said Risha Nahar, scientist at the hospital’s Centre of Medical Genetics.
‘The present study is the first to devise and validate a genetic scoring scheme for predicting bleeding among first time users of oral anti-coagulants,’ he added.
Both genetic and non-genetic factors (drug-drug interactions, additional medical conditions, age, history of bleeding) are known to contribute towards bleeding or haemorrhage in patients on anti-coagulant therapy.  
23.10.2013



Supreme Court stands firm on clinical trial ban

The clinical trials of 162 new chemical entities will continue to be on the hold as Supreme Court on Monday said that the technical committee and the apex committee will examine the benefits of these trials for the country. A bench of Justice R.M.Lodha and Justice Shiva Kirti Singh said that 157 new chemical entities which were cleared for clinical trials till December 31, 2012, would be reviewed by the two apex committees.
‘It is not possible to pass any order in respect of the clinical trials of 157 new chemical entities. We are not passing any order. You will tell us the findings of the apex committee and the technical committee,’ the bench told Additional Solicitor General Siddarth Luthra who had appeared for the government.
Reviewing the clearance for clinical trials of 157 new chemical entities by the National Drugs Advisory Committee and the Drug Controller General of India, the court said the technical and apex committees would look into the assessment of risk vs benefits to the patients, innovation vis-a-vis existing therapeutic options and the unmet medical needs of the country.
The court said the apex committee will examine whether the new chemical entities that are being put to clinical trials are actually required in the country.
In respect of five other new chemical entities for which approval has been granted for the clinical trials in 2013, the court accepted the statement of Luthra which said that appropriate directions will be issued with regard to audio visual recording of the consent of the subject participating in such trials.
The court directed that such documents in the wake of the video recording shall be preserved and the principle of confidentiality and transparency would be observed. In the course of the arguments, senior counsel Colin Gonsales informed the court of the Aug 30 report of the Parliamentary Standing Committee which had made damning findings about the working of the office of the Drug Controller General.
He said that the Standing Committee has said that it were the invisible hands that were writing the report and were being approved by the office of the DCGI. At this, Justice Lodha said: ‘We should have a balanced approach. These are the issues where you can’t have one sides approach. We should allay their (of the petitioner) apprehensions reasonably. The clinical trials should help us.’ Gonsalves said that the ministry of health and family welfare was using a committee headed by Ranjir Roy Chaudhury to derail the regime set up by the Standing Committee. He sought the disclosure of the 162 new chemical entities.
Assailing the position of Chaudhury, Gonsalves said that he wanted to make India a hub of clinical trials even in the phase I and Phase II in which healthy people are subjected to the testing of the new chemical entities.
The next hearing of the matter will take place Dec 16.
23.10.2013






You must have long range goals to keep you from being frustrated by short range failures
Charles C. Noble


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