Ethics Committee in Tamil Nadu

Having Major Depression Could Cause Up to 20 Unrelated Diseases, Gene Study Shows

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Having genes that put you at risk of depression could also make you susceptible to a variety of other health conditions, often seemingly unconnected. According to new research, this could include things like coronary heart disease and even bacterial infections.

The new study assessed the genetic risk factors of major depressive disorder in relation with more than 900 other diseases; the research team found that having poor mental health isn’t always a consequence of serious illness – it can be directly responsible for it.

“Data shows that people living with serious mental diseases, like depression, have much higher rates of physical illness than those in the general population,” says genetic epidemiologist Anwar Mulugeta from the Australian Centre for Precision Health at the University of South Australia.

Suffering from severe depression while dealing with another major illness is maybe not all that surprising, but researchers have long wondered whether the root causes of depression might be somehow more directly responsible.

Previous research has indicated that depression isn’t just a disease of the mind, but can have a debilitating influence over the entire body.

The team used what’s known as a Mendelian randomisation approach to a pool of genomic data taken from UK Biobank records on nearly 340,000 individuals to work out which comes first.

While many similar studies have already established links between depression and individual diseases, this kind of approach applies various controls suited to establishing a more causal relationship.

It turns out that having a high genetic risk score for major depressive disorder also makes it more likely a patient will have been admitted to hospital with – or even died from – at least one of 20 different diseases.

In the context of the analysis, these genes predisposed the individuals to a serious illness affecting just about every system in the body. These include such diverse conditions as asthma, high cholesterol, gastroenteritis, oesophagitis, urinary system disorders, and even infections from E.coli.

The study also highlighted potential sensitivities and adverse reactions to some drugs, suggesting a strong need to monitor prescriptions for individuals with a diagnosis of major depressive disorder.

“This research puts the ‘chicken and egg’ conundrum to rest, showing that depression causes disease, rather than only the other way around,” says Mulugeta.

“Importantly, this research signals that an individual diagnosed with depression should now also be screened for a defined set of possible comorbidities, enabling much better clinical management and significantly improved outcomes.”

Exactly how genes for depression might lay the groundwork for developing a range of other diseases isn’t clear. Given the number of gastrointestinal illnesses on that list, the researchers speculate that medications used to treat mental illness could be having an adverse effect on our guts.

This isn’t out of line with previous studies pointing at similar conclusions, but further research should help nail down the mechanisms behind the relationship.

“Understanding the connections between depression and other diseases is critical to ensure people with depression receive the support they require. The more we can look at the individual patient, the better their outcomes are likely to be,” says study lead Elina Hyppönen, also from the Australian Centre for Precision Health.

“Our results suggest that it is important to look beyond the obvious, and that we need to screen and effectively manage depression-related comorbidities if we want to minimise the longer-term negative implications on health.”

With more than 300 million people all over the globe experiencing depression, it ranks among one of the most common illnesses of our time.

It’s clear that finding better ways to treat and prevent the effects of depression without putting us at risk of other conditions is becoming more important than ever.

This research was published in Molecular Psychiatry.

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Indian medical consumables market holds huge growth potential

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Medical consumables market in India is at a growth stage and has significant potential to grow in the country. The country’s medical consumables market revenues are further estimated to grow in terms of revenue. The increasing manufacturing of medical consumables in country would lead to a massive growth in the volume of medical consumables which would result in the downfall of the value in the market, according to a new research report on “India Medical Consumables Market Outlook to 2023”, by Ken Research.

Aging population along with increase in number of hospitals and clinics, increase in total healthcare expenditure by the government and increase in medical tourism in the country are going to impact the demand for medical consumables in the positive manner. Additionally, setting up of research and development centres and potential medical educational universities is expected to boost demand for medical devices in the country, the report points out.

The market encompasses several products from basic cotton gauze to complex collagen-based dressings, sutures, catheters and others. The country’s medical consumables market revenues were observed to grow during the review period 2013-2018. Incline in incidences of accidents and diseases in the country coupled with rise in number of cosmetic surgeries and surgical births aided towards the growth of medical consumables market in the last few years. The market is highly dependent on the local production and the market continues to expand at a steady pace. The market is price sensitive, which explains the growing presence of local manufacturers of medical consumables. Major factors impacting demand are population growth, steady economic growth and hospital expansion and upgrading.

The Indian market is a mix of both imported and domestically manufactured medical consumables. The local production dominated the medical consumables market in India. The international companies such as Triage Meditech Pvt. Ltd, B Braun Medical Pvt. Ltd and others have established their manufacturing unit in India owing to the low medical consumables manufacturing.

Distributor mediated sales have accounted for the largest share of revenue in India medical consumables market in 2018. The medical consumable companies including both the international and domestic choose a distributor mediated network so as to spread the business in different regions of the country. Direct sales are low owing to the lack of awareness about the medical consumables companies.

Wound care products were observed to dominate the medical consumable product category segment in 2018 owing to the increasing number of accidents and surgeries in India. Also, the wound care products are in demand both by the hospitals, other health care centres and general public for their first aid owing to which the market generates the highest revenue share in the medical consumables industry in India. The market is followed by syringes, sutures, catheters, IV cannula, IV sets, blood bags, ostomy, needles and others which include consumables such as HME filters, endotracheal tubes and tracheostomy tubes.

Urinary and PIV catheters have accounted for the highest revenue share in India medical consumables market in 2018. The rising diseases such as bladder obstruction, urinary retention, urinary incontinence, and bladder cancers in India are leading to the growth of this market. The market was followed by cardiovascular in 2018, owing to the high number of cardiac diseases in the country followed by haemodialysis catheter and other catheters.

Traditional wound care is the primary treatment approach in India. Owing to perception of high cost-low benefit for advanced wound care products, the use of traditional products has been rampant. The segment has witnessed huge demand for products such as cotton, gauge, dressings and bandages. These products are affordable by everyone and enjoy high adoption in medical institutions, clinics and end consumers. Among the traditional wound care products in India, Gauze contributed the highest revenue share whereas in the advanced wound care market dressing was the market dominator.

Advanced silver dressings were the most widely used product in the advanced wound care dressings segment. Better healing and anti-microbial properties of advanced dressings has witnessed adoption in the country and was observed to occupy massive revenue share in the market. Advanced silver dressing was followed by foam, collagen, hydrocolloid, and alginate products in the advanced wound care dressing product segment in 2018 respectively.

Negative Pressure Wound Therapy (NPWT) is the most popular device used in advanced wound management and comprised for the largest market share in 2018. Effectiveness of negative pressure wound therapy in treating acute and chronic wounds such as leg ulcers, decubitus ulcers, skin grafts, vascular surgery wounds, burns and several others has been key factor driving its adoption across hospitals, clinics, and homecare settings. NPWT was followed by pressure relief devices and hyperbaric oxygen therapy devices.

Absorbable sutures are the most commonly used sutures in India and increasing awareness about these absorbable sutures among the general public has also resulted in the growth of absorbable sutures leading to the highest revenue share in the sutures segment of medical consumables in 2018 followed by non-absorbable sutures. In the absorbable sutures category, synthetic sutures dominated the market followed by catgut suture.

Multiple blood bags were the most widely used in the blood bags segment owing to the increasing surgeries and blood donations in the country where these bags are widely used. The multiple blood bags dominated the blood bag market in terms of revenue share in 2018. Multiple blood bags were followed by Single blood bag and Inline filter blood bag. In the multiple blood bags segment, Triple blood bag has highest share followed by double blood bag and Quadruple bags.

Hospitals both public and private are the major end users of medical consumables and have witnessed the highest revenue share in India medical consumables market in 2018. The increasing number of hospitals and the adoption of the advanced facilities at these hospitals are leading to the growth of this end user segment in the country.

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Just One Head Injury Could Be Enough to Tangle Proteins in Your Brain

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A single serious knock to the skull could be all it takes to develop the nerve damage thought to be responsible for neurodegenerative conditions like Alzheimer’s disease, according to a recent study.

Most research into the neurological impact of head trauma has focussed on repeated damage, like that experienced by sports fighters or footballers; often, it’s based on post-mortem results. So researchers from across Europe and the UK teamed up to look at the potential impact a single accident could have on the brain tissue of living volunteers.

Using positron emission tomography (PET) scans, the researchers imaged the brains of 21 volunteers who’d experienced a moderate to severe head injury up to 37 years prior, due to a fall, assault, or road accident.

“Scientists increasingly realise that head injuries have a lasting legacy in the brain – and can continue to cause damage decades after the initial injury,” says neurologist Nikos Gorgoraptis from Imperial College London.

A dozen of the volunteers qualified as disabled based on an evaluation, with the rest labelled as having ‘recovered’. This traumatic brain injury group was then compared with 11 healthy individuals without any history of head trauma.

By administering a chemical that sticks exclusively to a repeating ‘tangled’ version of a protein called tau, the researchers were able to piece together individualised maps showing which brains had clumps of tangled tau and which didn’t.

They noticed a significant increase in the amount of tau collecting in the right occipital lobe – the back part of the brain – among those who’d had a traumatic brain injury, regardless of whether they were disabled or had recovered.

“This is the first time we have seen these protein tangles in patients who have sustained a single head injury,” says Gorgoraptis.

Tau proteins can be thought of as scaffolds that help stabilise cellular structures, particularly neurons.

In individuals diagnosed with Alzheimer’s disease and other neurodegenerative conditions such as chronic traumatic encephalopathy, these scaffolds appear rather kinked and knotted.

Along with the clumping of another protein called beta-amyloid, tangles of tau are thought to play a key role in the pathology of dementia-like diseases.

The exact mechanisms behind the interplay of these two misshapen proteins, and how they develop in the first place, is still a matter of ongoing study.

Research into treatments based on clearing beta-amyloid plaques and knotted tau proteins has also been rather hit-and-miss over the years, suggesting we still have much to learn on how they’re involved in the steady degeneration of neural tissues.

The fact there appears to be some kind of relationship, though, makes them important markers for the progress of such debilitating conditions.

This particular study is an early stage investigation, based on a relatively small number of individuals, so we’ll need more research for sure.It also doesn’t mean a single head injury necessarily causes long lasting damage, let along dementia.

“It’s well established that a major blow to head, for example from a road traffic incident or an assault, can increase your risk of developing dementia, but of course, this does not mean everyone with a head injury will get dementia,” says James Pickett, Head of Research at Alzheimer’s Society.

There was also no indication that this tangles themselves had any noticeable impact on the memory or behaviour of those affected.

But the researchers believe the most promising outcome of their research is the scanning method: combining PET with a chemical flag for tau clumps to keep a close eye on signs of trouble.

“What is exciting about this study is this is the first step towards a scan that can give a clear indication of how much tau is in the brain, and where it is located,” says Gorgoraptis.

“As treatments develop over the coming years that might target tau tangles, these scans will help doctors select the patients who may benefit and monitor the effectiveness of these treatments.”

Medical professionals are already calling for increased vigilance when it comes to activities that carry a risk of repeated blows to the head.

Knowing even just a single injury can leave traces of damage deep inside our brains makes it more important than ever that we develop the tools to better diagnose dementia as early as possible.

This research was published in Science Translational Medicine.

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Union govt sees its SUGAM National Drugs Licensing System to bolster e-governance initiatives

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Union government sees its SUGAM National Drugs Licensing System to further strengthen the e-governance initiatives. The National Database of Manufacturers & Formulators along with the generation of unique ID for production sites will enable a smooth transition to the e-system. It will allow both operations agility and efficiency.

The data captured from the manufacturers provides a hands-on information of the pharmaceutical production and marketing activity in the country, said Shivani Nangia, project manager, e governance, Centre for Development of Advanced Computing (CDAC).

From details of user registration, manufacturing site, formulations, production and production capacity of site will now empower the government with an effective real time platform, she added.

In a presentation titled SUGAM and National Drug Licensing System, at a workshop for providing training to pharma manufacturers on drug approval under the recent amendments to the Drugs & Cosmetics Rules in Bengaluru, she said that registration on SUGAM portal for adding manufacturing unit and formulation details allows ease of application submission for licensing, tracking its status, grant of permission and related approvals. Further, it creates live statistics of the registered pharma companies, number of submitted applications, processed applications and inspections conducted.

With the Digital India, the country is on the surge of change and revolution. The drug control officials in general see the need to create simple, automated and efficient processes for the pharma industry. Moreover, the convergence of cloud computing, mobile technology, social media and big data analytics is reshaping the future of e-governance. States like Karnataka, Gujarat among others are already way ahead in these initiatives which have facilitated transparency and efficiency in operations. The e-system of licensing and drug approvals has seen to enable maximising the network-level effectiveness. The streamlined structure leads to faster turnaround and better performance. For the long run, the e-system is seen as a cost-effective approach. Its implementation helps to achieve lower operational cost, improved access, reduced processing and dispatch of applications pending for approval of drugs and issue of licenses.

Scope of work for national drug licensing system covers grant and renewal of licenses for manufacturing and sales of medicines, vaccines and blood products. Online system also issues certificates and no objection certificates (NOC). Further enforcement activities can be carried out by state drug controller officers. This is all enabled with the Management Information System(MIS) and Analytical platform.

The portal will also provide details of facility with regard to dosage, site, lab information and production capacity. There is also scope for queries to be posted on doubts about submission and cancellation of licenses.

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Taking The Pill as a Teen Seems to Have a Long-Lasting Effect on Your Depression Risk

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The pill is one of the great success stories of modern medicine. When it became widely available in the 1960s, it helped to revolutionize the role of women in society by giving them unprecedented control over their fertility.

Today, more than 100 million women around the world take hormonal birth control pills and they are particularly popular among teenagers.

The pill is, of course, a highly efficient method for preventing unintended pregnancies. Even some women who are not sexually active use it for other reasons, including to reduce menstrual pain or treat acne.

However, it was originally developed as a medication for adults, and much remains unknown about the potential side effects for younger users.

A sensitive period

Puberty is a critical life stage that is marked by rapid growth and changes in the body and brain. In animals, sex hormones such as estrogen and progesterone are known to affect how the brain develops during puberty.

If the same is true for humans, taking synthetic estrogen and/or progesterone – core ingredients found in most formulations of the pill – during this sensitive period could affect development in ways that have long-lasting consequences on mental health.

Overall, research has yielded mixed findings about the relationship between hormonal contraceptive use and depression. Some studies have found no relationship, and others have found a lower risk of depression in adult pill users compared to non-users.

Recently, however, the largest study to date on this topic – which included over one million women living in Denmark – concluded that women who are using the pill or other hormonal contraceptives are at an increased risk for depression. The study also showed that this relationship was strongest in teenaged women.

Increasing risk of depression

Our latest study, published in the Journal of Child Psychology and Psychiatry, goes beyond prior research by examining whether contraceptive pill use might not only predict depression risk in the short term but also in the long term.

We examined data on 1,236 women between the ages of 20 and 39 enrolled in the National Health and Nutrition Examination Survey who had provided information about their history of contraceptive pill use.

Almost half of the women in the sample had first used contraceptive pills as teenagers; these women were at a higher risk for being clinically depressed (16 percent) years later, compared to women who had never used contraceptive pills (six percent), and also compared to women who had only started taking contraceptive pills as adults (nine percent).

These group differences in depression risk remained stable – or increased – when we statistically controlled for a large number of other differences between the three groups, including age at first period, age at first sexual encounter, current relationship status, socioeconomic status, ethnicity and current contraceptive pill use.

Our findings suggest that the use of oral contraceptives during the teenage years can have an enduring effect on a woman’s risk for depression, even years after she ceases using them.

Women’s prior contraceptive use

Why, then, have there been conflicting findings on the relationship between contraceptive pill use and depression in the past? We think that these contradictions could be explained by how researchers grouped the women they studied.

Because most researchers were primarily interested in short-term effects of contraceptive pills, they grouped women based on whether they were currently using oral contraceptives.

Those researchers did not take women’s previous oral contraceptive use into account and may have unintentionally underestimated the effects of contraceptive pill use on depression risk.

Smoking, for example, has long-term effects on lung cancer risk. If researchers were only to compare current smokers versus current non-smokers without taking into consideration whether someone is a former smoker, they might conclude that there is no relationship between smoking and lung cancer risk.

Combining ex-smokers and lifelong non-smokers into a single “current non-smokers” category can result in misleading conclusions, because those two groups of people may have different lung health due to the long-term effects of smoking.

For the same reason, we believe that future research should look at ex-users and lifelong non-users of the pill separately.

Choosing the pill

The decision to take hormonal contraceptives is a very personal one, and we emphatically support the United Nations’ declaration that access to contraceptive information and services is a universal human right.

There are clear benefits to using the pill and many women do not experience adverse side effects.

We do believe that there is an urgent need for more research on this topic. We do not believe that all women are likely to experience the same side effects when they take contraceptive pills.

Thus, any blanket statement suggesting that teenagers should or should not follow a specific course of action regarding the use of hormonal contraceptives is, in our opinion, premature.

We do, however, hope that our research might prompt teens and their parents to talk to their doctors about the risks and benefits associated with different options that are available to them, especially if they have a family history of depression or other reason to think that they might be particularly vulnerable to certain side effects of these medications.

Future directions

Importantly, because our study was correlational, we can’t conclude that using the pill actually causes increased depression.

Although we statistically controlled for every available variable in the data set that we felt might provide a plausible alternative explanation for the relationship we were examining, we can’t entirely rule out the possibility that another variable that we failed to look at accounts for the relationship between pill use and depression risk.

Ultimately, our study is just one piece of a much larger puzzle that will need to be filled in with a combination of correlational and experimental research designs. Each of these designs has its own strengths and limitations.

Converging evidence is needed from animal as well as human studies, epidemiological data sets and randomized controlled trials and cross-sectional and longitudinal designs.

Towards this end, we recently launched a prospective study at the University of British Columbia to look at this question in a broader context. We will be tracking several hundred teenagers’ hormone levels, hormonal contraceptive use, social and emotional functioning and stress reactivity over the next three to five years.

We hope our research will promote more informed dialogue and decision-making about the prescription of different methods of birth control for teenage women.The Conversation

Christine Anderl, Postdoctoral Fellow, University of British Columbia and Frances Chen, Associate professor, University of British Columbia.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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