1-Feb-2018: Artificial vertebral disc using silk polymer.
Degenerative disc disease is a major cause of low back pain affecting mobility of people. A group of Indian scientists have developed a silk-based bioartificial disc that may find use in disc replacement therapy in future.
At present, therapeutic treatment for degenerative disc disease can only provide symptomatic relief of pain without restoring the functions of discs, while disc replacement surgery is very costly. The use of a silk biopolymer to fabricate a biocompatible disc can reduce the cost of artificial discs in future, claim researchers from the Department of Biomaterial and Tissue Engineering at Indian Institute of Technology, Guwahati, who have developed the new technology.
The group has developed a fabrication procedure for a silk-based bioartificial disc adopting a “directional freezing technique”. The disc mimics internal intricacy of human disc and its mechanical properties too are similar to those of the native ones.
The fabricated discs supported primary annulus fibrosus or human mesenchymal stem cell proliferation, differentiation, and matrix deposition of a sufficient amount. The annulus fibrosus is a specialized tissue having a complex, multilamellar, hierarchical structure consisting of collagen, proteoglycans and elastic fibers.
Major challenges toward successful intervertebral disc tissue engineering remain elusive, mainly because of tremendous complexity of annulus fibrosus tissues. Scientists have successfully recapitulated its internal intricacy - angle-ply construct, which is critical for the proper biomechanical functioning of the disc.
Degenerative disc disease affects intervertebral discs, which are soft pillow-like cushions between interlocking bones that structure human spine. These discs act as shock absorbers for the spine and support weight and complex motions of the spine. With growing age, these discs change from a flexible state that allows the smooth fluid motion to a stiff and rigid state restricting movement and resulting in discomfort or pain.
22-Nov-2018: Faster diagnostic tests developed for tuberculosis
Tuberculosis claims two million lives each year globally. Early detection and treatment are crucial to prevent spread, outbreaks, and development of resistance. Scientists at the Translational Health Science and Technology Institute (THSTI) and All India Institute of Medical Sciences (AIIMS), New Delhi have jointly developed highly sensitive and rapid tests for detection of tuberculosis infection in lungs and surrounding membranes.
TB spreads from one person to another through inhalation of infected air. When the bacteria attack the lungs, the disease manifests itself as pulmonary form. It is the most common form of TB. But about 15% of new patients in 2016 were found infected with extrapulmonary TB where organs other than lungs may be affected. Till now, detection of all forms of TB is mostly based on sputum smear microscopy and culture tests. While smear microscopy is simple and rapid, it has low sensitivity. Culture test is highly sensitive, but takes two to eight weeks to get results.
Conventional diagnostic tests use antibodies for detection of bacterial proteins in sputum samples. However, such tests suffer with limitations including batch-to-batch variability, limited shelf-life, and cost.
To address these problems, the researchers have now developed two DNA aptamer-based tests — Aptamer Linked Immobilized Sorbent Assay (ALISA) and Electrochemical Sensor (ECS) for detection of a bacterial protein in the sputum.
Aptamers are DNA, RNA or peptide molecules that bind to specific molecular targets. They are known to bind the right target (which defines sensitivity) and at the same time rule out any non-specific binding to other targets (specificity). The performance of the newly developed tests was compared with antibody-based tests in 314 sputum samples. ALISA showed 92% sensitivity while the antibody-based method was 68% sensitive.
The research team used ALISA to detect a bacterial protein, HspX. This method, however, took five hours to yield results because it requires sputum immobilization which is time-consuming step. So the team made efforts to develop a simplified ECS test. In this, aptamer was immobilized with an electrode and upon binding to HspX in the sputum sample, a drop in the electrical signal was recorded.
The ECS test can be used for screening of samples in the field as it takes as less as 30 minutes to deliver results. It is highly sensitive and could detect HspX protein in 91% of the samples tested in this study. In addition, there is no need for sputum sample preparation which is a complex and time-consuming process.
The aptamer-based screening tests for pulmonary TB, pleural TB, and TB meningitis hold immense promise for a country like India, where the disease burden in high and primary health care is only a dream for many. The ECS platform could be used in a mobile screening van at the point-of-care.
The group used aptamer-based test also for detection of pleural TB, the second most prevalent form of extrapulmonary TB. Early diagnosis of pleural TB is limited by availability of a sensitive and rapid test. The performance of existing DNA-based tests varies widely due to low bacterial load in pleural fluid sample.
There is no test for making a confirmed diagnosis of pleural TB. Even WHO-endorsed Gene Xpert has a poor sensitivity of 22%. On the contrary, aptamer-based test for pleural TB has showed 93% sensitivity and is cost-effective.
6-Jul-2018: Comments Invited for Creation of National Health Stack
India is currently witnessing significant trends in health: increasing prevalence of non-communicable diseases for instance, as well as marked demographic shifts. Climbing out-of-pocket costs is becoming difficult for most households.
The National Health Stack (NHS) envisages a centralized health record for all citizens of the country in order to streamline the health information and facilitate effective management of the same. The proposed NHS is an approach to address the challenge and seeks to employ latest technology including Big Data Analytics and Machine Learning Artificial Intelligence, a state of the art Policy Mark-up Language and create a unified health identity of citizens - as they navigate across services across levels of care, i.e. Primary, Secondary and Tertiary and also across Public and Private.
To address the health needs of citizens, the Government of India had announced comprehensive policy response – the Ayushman Bharat Yojana. This flagship health programme is designed with a powerful yet simple objective in mind: to develop a wellness focused strategy, ensuring cost effective healthcare for all. The program leverages a two-pronged approach:
- On the supply side, substantial investments will be made to build 1.5 lakh health and wellness centers offering preventive and primary care; and
- On the demand side, the Pradhan Mantri-Rashtriya Swasthya Suraksha Mission (PM-RSSM) will create a national insurance cover of up to 5 lakhs per year per family for over 10 crores households, towards secondary and tertiary care.
- Achieving such scale requires a rethink the core technology backbone of our system and leverage cutting edge digital solutions to tackle the challenge.
The innovativeness of the proposed National Health Stack design lies in its ability to leverage a shared public good – a strong digital spine built with a deep understanding of the incentive structures of the system. Once implemented, the National Health Stack will significantly bring down the costs of health protection, converge disparate systems to ensure a cashless and seamlessly integrated experience for the poorest beneficiaries, and promote wellness across the population.