Current strategies and forthcoming evidence for targeting the host response in sepsis

Immunomodulatory Treatments in Sepsis

Recently published research paper discusses the challenges and advancements in sepsis treatment, focusing on the varied immune responses of sepsis patients and the potential for precision immunotherapy to improve outcomes. It highlights the dysregulated host response to infection in sepsis and emphasizes the need to identify responders to specific immune interventions. The paper presents various immunomodulatory treatments, such as targeting tumor necrosis factor (TNF), interleukin-1 (IL-1) signaling, and IL-6, and discusses their effects on sepsis patients. It also covers the potential of targeting the complement system, glucocorticoids, antibiotics with anti-inflammatory properties, and other immunomodulatory agents in sepsis treatment. Additionally, the paper explores the role of immunostimulatory cytokines and growth factors, mesenchymal stem cells, immune checkpoint inhibitors, and extracorporeal strategies in modulating the host response to sepsis.

Precision Medicine Approaches in Sepsis

The paper emphasizes the complexity and heterogeneity of sepsis, underscoring the need for precision medicine approaches. It discusses the importance of identifying subphenotypes and endotypes in sepsis patients using biomarkers, immunophenotyping, transcriptomics, proteomics, and metabolomics, and highlights the potential for predictive enrichment to tailor targeted treatments. Furthermore, the paper addresses the role of the microbiome, host metabolism, organ dysfunction, and disease tolerance in shaping the response to infection in sepsis. It underscores the significance of understanding patients’ immunologic and metabolic status pre-sepsis to reveal risk factors and targets for immune modulation.

Future Perspectives in Precision Immunotherapy

The paper also outlines the future perspectives in the field of precision immunotherapy, the need for improved monitoring tools, and the potential for computational tools like artificial intelligence and machine learning to uncover new treatable traits. It further discusses the challenge of organizing clinical trials and emphasizes the importance of investigating organ dysfunction and finding better ways to understand host responses in sepsis patients. The overall focus is on personalizing and monitoring therapies to improve disease tolerance and modulate immunity in individual septic patients.

Refrence –

Bode, C., Weis, S., Sauer, A. et al. Targeting the host response in sepsis: current approaches and future evidence. Crit Care 27, 478 (2023). https://doi.org/10.1186/s13054-023-04762-6.

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Sun Pharma Gets CDSCO Panel Nod to Study Tildrakizumab Injection 100 mg/ ml

New Delhi: The drug major Sun Pharma has got approval from the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) to conduct the clinical trial of Tildrakizumab injection, a monoclonal antibody designed for the treatment of immunologically mediated inflammatory disorders.

This came after the drug major Sun Pharma presented phase 3 clinical study protocol no. TILD-21.01, amendment 2 dated 9th November 2023.

Tildrakizumab is a high-affinity, humanized, IgG1 κ antibody targeting interleukin 23 p19 that shows promise in the evolution of treatment strategy in chronic plaque psoriasis.

This drug selectively binds interleukin (IL)-23 p19 subunit of cytokine IL-23 and neutralizes its function IL-23 regulates Th17 cells and is a powerful activator of keratinocyte proliferation. Targeting IL-23p19 alone is a promising treatment approach in patients with moderate-to-severe chronic plaque psoriasis. Upon administration, downregulation of Th17 and Th22 cell responses occurs.

IL-23 is a naturally occurring cytokine that is involved in inflammatory and immune responses. Tildrakizumab inhibits the release of proinflammatory cytokines and chemokines.

At the recent SEC meeting for Analgesic and Rheumatology held on the 6th of February 2024, the expert panel reviewed the Phase III clinical study of the drug Tildtildrakizumab injection.

After detailed deliberation, the committee recommended a grant of permission to conduct the trial as presented by the firm.

Also Read:Indiscreet prescribing of antibiotics is key contributor to microbial resistance nationwide: MoS Health

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Making mathematical models to study fentanyl and morphine pharmacokinetics

Pain is an unpleasant feeling that includes emotional and physical aspects. It may be connected to an injury or the risk of becoming hurt. On the other hand, analgesia is the relief of pain by a variety of pharmaceutical and non-pharmacological techniques, depending on the kind and degree of the pain. Pharmacokinetics is the study of how a drug moves through the body when it is administered and ends with excretion. Pharmacokinetics often uses compartmental modelling to describe how medications travel through the body and are eliminated. Recently published research examined many mathematical model types to comprehend medication pharmacokinetics. On the drug kinetics, the impact of starting concentration and rate constants was examined. The effectiveness and long-term effects of morphine and fentanyl on the human body were investigated using models specifically designed for these drugs.

Drug distribution, transition, and concentration in the bodily compartments were theoretically analysed using non-linear ordinary differential equations and numerical analytic approaches. A computer application called MATLAB, version 2023a from Math Works, Inc. was used to characterise how the drug’s kinetics were affected by beginning concentration and rate constants. Pharmacokinetic parameters were plotted to determine a specific therapeutic concentration of fentanyl and morphine in blood.

The study’s findings demonstrated how long it takes for morphine and fentanyl to accumulate to a point in the bloodstream where they may provide the desired therapeutic effects. The pharmacokinetics of fentanyl and morphine were compared mathematically, and the results indicated that fentanyl was metabolised and excreted from the body more quickly (44 minutes sooner than morphine) and reached the target therapeutic concentration 125 minutes earlier.

Several mathematical models were used in this work to describe the behaviour of drugs within the human body. The pharmacokinetics of morphine and fentanyl were plotted with the use of compartment modelling; it was discovered that fentanyl took less time to reach the goal therapeutic threshold established in the blood. Fentanyl exited the body sooner than morphine. In order to define medication interactions inside the human body, optimise dosage schedules, forecast drug effects, and plan clinical trials, pharmacokinetic models are essential. These mathematical models improve our knowledge of how medications affect various targets and pathways by predicting and quantifying drug-drug interactions caused by one drug changing the effects of another. Nevertheless, by dividing the human body into two compartments, these models are limited to the bolus administration of the medication.

Reference –

Shenoy, Prathvi; Rao, Mahadev1; Chokkadi, Shreesha2; Bhatnagar, Sushma3; Salins, Naveen4. Developing mathematical models to compare and analyse the pharmacokinetics of morphine and fentanyl. Indian Journal of Anaesthesia 68(1):p 111-117, January 2024. | DOI: 10.4103/ija.ija_1036_23

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Incorporate AETCOM in NEET, MBBS curriculum: Parliamentary Panel

New Delhi: Highlighting the role of the Attitudes, Ethics, and Communication (AETCOM) module in cultivating the right attitude, ethics and communication skills among medical students, a Parliamentary Health Committee has suggested that the module should be made part of the MBBS curriculum. Further, the panel has suggested incorporating these criteria in the National Eligibility-cum-Entrance Test (NEET) as well to assess the aptitude of aspiring medical students.

The panel opined that such aptitude tests at the entrance level not only assess the knowledge of the aspirants but also evaluate the genuine interest and passion of the candidate for the field of medicine.

“It will enable the system to identify candidates who have a sincere calling for the profession and distinguish them from those who may be under external pressure or legacy expectations. By doing so, we can ensure that medical work continues to attract individuals who are genuinely committed to delivering high-quality healthcare,” opined the Department-related Parliamentary Standing Committee on Health an d Family Welfare in its One Hundred Fifty-Seventh report.

The panel, chaired by Shri Bhubaneswar Kalita, presented its report before the Parliament on 9th February 2024. Several issues related to medical education such as infrastructure, faculty issues, and quality control of medical education were discussed in the report.

Referring to the new UG curriculum the panel observed that the new curriculum aims to help students transition from acquiring knowledge to acquiring practical skills. It further noted that achieving this shift depends on aligning and integrating various disciplines.

The committee observed in its report that the key elements of the revised curriculum include foundational courses (FC), early exposure to clinical practice (ECE), training in attitudes, ethics and communication (AETCOM), elective opportunities, and alignment and integration of different areas of study. Additionally, the curriculum promotes electives, self-directed learning, problem-based learning, structured feedback, and maintaining a logbook, the panel noted.

At this outset, the committee acknowledged the critical elements introduced in the new curriculum to help students acquire practical skills and strongly recommended implementing AETCOM module within the MBBS curriculum.

“The Committee strongly recommends the rigorous and comprehensive implementation of the AETCOM module within the MBBS curriculum. This module is paramount as it is pivotal in cultivating the right attitude, ethics, and communication skills among medical students. Patient care is not solely about clinical knowledge and technical skills; it hinges on empathy, compassion, and effective communication. By instilling these qualities in future healthcare professionals, we can significantly enhance the overall quality of patient care. Therefore, the Committee recommends the Government ensure that the AETCOM module is enforced consistently and effectively to empower medical students with the essential attributes needed to provide holistic and patient centered healthcare,” recommended the panel.

Apart from implementing AETCOM in the MBBS curriculum, the panel further advised incorporating these criteria in NEET as well to assess the aptitude of the aspiring medical students.

It mentioned in the report, “In addition to the implementation of AETCOM, the Committee recommends the incorporation of these criteria in NEET so that the aptitude of aspiring medical students can be assessed. Such aptitude tests at the entrance level go beyond mere knowledge assessment of aspirants, often obtained through rote learning and mastering MCQ-based exams, and evaluate the genuine interest and passion of the candidate for the field of medicine. It will enable the system to identify candidates who have a sincere calling for the profession and distinguish them from those who may be under external pressure or legacy expectations. By doing so, we can ensure that medical work continues to attract individuals who are genuinely committed to delivering high-quality healthcare.”

Also Read: Multiple registrations of doctors with various State Medical Councils makes tracking difficult, Parliamentary Panel gives recommendations

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Navi Mumbai doctor, associate cheat farmer of Rs 25000 with job promise

Thane: The Navi Mumbai doctor and his associate have been booked for allegedly a 32-year-old farmer of Rs 25,000 by making a false promise to get him a job in the Indian Railways.

The victim, hailing from Jalgaon in Maharashtra, allegedly paid Rs 25,000 to the doctor at his clinic in the Belapur area of Navi Mumbai on November 28, 2023, the official from CBD police station said on Thursday.

Also Read:Lucknow doctor alleges dowry harassment by husband, in-laws; FIR lodged

The farmer claimed he was promised the job of an announcer in the Railways and a fake appointment letter was provided to him after he paid the money.

He filed a complaint with the Government Railway Police at Igatpuri station.

The complaint was transferred to the CBD police station, where a case was registered against the doctor and his associate on Wednesday under Indian Penal Code sections 420 (cheating), 465 (forgery) and 34 (common intention), the official said.

Also Read:Navi Mumbai doctor allegedly demands 20 lakh dowry, FIR lodged

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PM Modi lays down foundation stone for AIIMS in Rewari

PM Modi to inaugurate six new All India Institutes of Medical Sciences (AIIMS) next week, complementing the initiation of AIIMS in Rewari, Haryana. Prime Minister Narendra Modi laid down the foundation stone for AIIMS Rewari today marking a significant development in healthcare infrastructure. The project, with an estimated cost of Rs 1650 crore, will feature a comprehensive hospital complex offering 720 beds, a medical college with 100 seats, a nursing college with 60 seats, and an AYUSH Block with 30 beds.

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NEET not to be conducted outside country this year

The registration process for NEET 2024 is currently underway. Along with the application form, the National Testing Agency (NTA) released the information bulletin, listing down the exam cities along with city codes where the NEET 2024 will be conducted.

This year’s NEET will not be conducted outside the country, and natiowide the exam cities have been increased from 499 from last year to 554 this year. Last year, the NTA conducted NEET 2023 in 14 exam centres abroad for admission to MBBS, BDS and other UG courses in Indian medical colleges.

For the full story, check out the link given below:

NEET 2024: 554 Exam Cities In India, MBBS Entrance Test Not To Be Held Abroad This Year

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Exploring Diabetes: More Than Just Sugar Control – Dr Somnath Mitra

Diabetes, characterized by high blood sugar levels, demands concern due to its potential complications. It can lead to serious issues like heart disease and kidney problems. Proactive management through a healthy lifestyle, regular monitoring, and medical guidance is essential to prevent complications, ensuring a better quality of life for individuals dealing with diabetes.

Contrary to the popular myth that diabetes is solely a sugar control issue, it’s important to recognize its multifaceted nature. While managing blood sugar levels is pivotal, diabetes also affects various organs and systems, leading to potential complications like heart disease and kidney issues. It involves intricate factors such as insulin resistance, genetic predisposition, and lifestyle choices. Comprehensive diabetes management encompasses more than sugar control, addressing overall health through balanced nutrition, regular exercise, and medical supervision.

In this video, Dr Somnath Mitra from Manipal Hospital, Bengaluru, Karnataka discusses Diabetes and its complications while dispelling the myth that Diabetes is only a sugar control issue.

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Myths related to Diabetes and eating chocolates – Dr Nancy Purwar

The HbA1c test is vital for assessing how well a patient’s blood sugar has been managed over time. Maintaining a target HbA1c level is essential in preventing diabetes-related complications such as nerve damage, kidney problems, and heart disease. Regular HbA1c tests empower individuals with diabetes to track their progress, make necessary adjustments to their treatment plan, and adopt a proactive approach to managing the condition effectively for better overall health

Contrary to the myth that having diabetes means abstaining from desserts or chocolate, the HbA1c test encourages a balanced approach to diet. While moderation is key, occasional indulgences can be accommodated within a well-managed diabetes care plan. This emphasizes that people with diabetes can enjoy a varied diet, including treats while maintaining overall health and effectively managing their condition.

In this video, Dr Naincy Purwar, an Endocrinologist and Diabetologist from Jaipur, Rajasthan, discusses the HbA1C test for diabetes and its importance while debunking the myth that people with diabetes cannot eat chocolate or desserts.

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Using cannabis can ease cravings for street-level drugs, new research suggests

New findings from researchers at the University of British Columbia suggest that cannabis could play a role in addressing the ongoing opioid overdose crisis.

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