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Need to educate people on kidney damage due to antibiotic misuse: Nephrologists

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Hyderabad, Feb 16 (IANS) The overuse of antibiotics leads to severe public health issues, including antimicrobial resistance, increased healthcare costs, reduced antibiotic effectiveness, the spread of resistant pathogens in agriculture, and the risk of untreatable infections, highlighting the need for judicious use and education on antibiotic overuse, say nephrologists.

Uncertainties about their use, overprescription, incomplete treatments, a lack of regulation, agricultural practices, public ignorance, and inadequate drug development are just a few of the factors that contribute to the misuse and overuse of antibiotics, which in turn fuels the global crisis of antibiotic resistance and public health threats, they point out.

Internal organs such as the kidney, liver, and nervous system suffer the most due to irrational antibiotic usage, warn nephrologists.

Among these, kidney damage due to inappropriate use of antibiotics is the most common, they point out.

Dr MV Rao, nephrologist, Asian Institute of Nephrology and Urology (AINU) in Hyderabad told IANS that the greatest culprit, which is widely prevalent in India, is the sale of antibiotics without a prescription, leading to their overuse and misuse.

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“The widespread overprescription of antibiotics and the common practice of not completing the full course of antibiotics significantly contribute to kidney damage and the rise of antibiotic-resistant infections,” said another nephrologist Dr. PS Vali.

“Certain antibiotics, particularly when used inappropriately or in high doses, can cause direct damage to the kidneys. This is particularly concerning in individuals with pre-existing kidney conditions or genetic predispositions. This is the case with some antibiotics, such as Amikacin or Gentamycin,” said Dr. B. Srikanth.

Due to their unique genetic makeup, some individuals are prone to unusual hypersensitivity reactions in the kidney when confronted with antibiotics from the penicillin group, such as amoxicillin.

Another concerning outcome is the development of life-threatening urinary tract infections due to multidrug-resistant microbes that can mix up with the blood in no time from urine and result in blood sepsis.

Such infections lead to a condition known as acute kidney injury, where the kidneys shut down within hours as the septic blood laden with these bugs floods the kidneys and chokes their filters.

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Nephrologists have underlined the need to take various measures to safeguard the community from the ill-effects of the irrational use of antibiotics. They say it’s essential to boost public understanding about their correct usage.

They say antimicrobial stewardship programmes are required to enhance the effective use of antimicrobials, including antibiotics. The goal is to improve patient outcomes, minimise microbial resistance, and prevent infections from drug-resistant organisms.

These programmes guide healthcare professionals in choosing the right antibiotic, dosage, duration, and administration method. The experts have also called for implementing strict regulations against selling antibiotics without a prescription.

Healthcare providers should adhere to established national and international guidelines for antibiotic prescriptions. This involves avoiding unnecessary prescriptions and ensuring the correct dosage and duration.

According to nephrologists, there is also a need to focus on research and development of new antibiotics that can reduce the overreliance on existing ones, thereby decreasing resistance risks.

These measures call for a collaborative effort from healthcare professionals, policymakers, the pharmaceutical industry, and the public.

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It’s also important that these strategies are customised to meet the specific needs and conditions of different regions and healthcare systems.

–IANS

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Developing countries in Asia-Pacific still report high TB cases: ADB

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Manila, July 6 (IANS) Many developing countries in the Asia-Pacific region, including the Philippines, still have a high tuberculosis (TB) incidence rate, according to an article published in the Asian Development Blog of the Asian Development Bank (ADB).

Citing World Health Organization (WHO) data, the recently published article said the highly infectious disease “remains rife” in the region, with Southeast Asia responsible for 46 per cent of global infections in 2022, “the highest in any region”, Xinhua news agency reported.

The article also said the pandemic devastated national TB prevention and treatment programmes, causing an estimated half a million excess deaths between 2020 and 2022.

However, the good news is that there has been a post-pandemic recovery in the number of people diagnosed with and treated for TB, helping to reduce the damage done by the pandemic, it added.

According to the WHO Global Tuberculosis Report 2023, the Philippines, along with Indonesia, Mongolia, Papua New Guinea, and Vietnam, have some of the highest levels of TB in the region — around 700,000 people out of a population of 115 million have active TB.

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Nearly 10 million people in the Philippines reside in impoverished urban areas. Poverty and overcrowding, along with poorly-resourced public health services, are major factors in the widespread incidence of TB in the country, according to The Lancet.

In Indonesia, TB is the fourth-highest cause of death overall, and among those aged 15 to 49 years, it is the number one cause of death by a contagious disease.

TB, an airborne disease spawned by urban poverty, is currently the world’s second-biggest infectious killer after Covid-19. Many countries are working to eliminate TB by 2030, which aligns with the WHO’s End Tuberculosis Strategy.

The article said adapting practices such as mask-wearing and improved hygiene at home and work that proved effective against Covid-19 could play an important role in helping Asia and the Pacific rid themselves of TB permanently.

However, socioeconomic factors, including poverty, overcrowding, poor sanitation, lack of infrastructure, and inadequate public health systems, allow the disease to remain endemic, it added.

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–IANS

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Cut down smoking to avoid cognitive ageing: Study

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New Delhi, July 6 (IANS) Want to maintain sharp memory skills and cognitive function as you age? Cutting down on smoking suggests a large study that found it to be a key lifestyle factor linked to cognitive decline.

The study, published in Nature Communications, is based on a 10-year survey of 32,000 adults aged 50 or over from 14 countries in Europe.

The team led by researchers from the University College London, UK showed that cognitive decline was faster for lifestyles that included smoking. People who smoked had cognitive scores that declined up to 85 per cent more over 10 years than those who did not.

Lead author Mikaela Bloomberg (UCL Behavioural Science & Health) said the study “is observational; it cannot definitively establish cause and effect, but it suggests smoking might be a particularly important factor influencing the rate of cognitive ageing”.

As per previous studies, people who engaged in more healthy behaviours like regular exercise, and moderate alcohol intake have slower cognitive decline. However, it did not specify whether all behaviours contributed equally to cognitive decline.

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However, the new study showed that among the healthy behaviours, “not smoking may be the most important in terms of maintaining cognitive function”.

Among those unable to stop smoking, the study suggests engaging in other healthy behaviours such as regular exercise, moderate alcohol consumption, and remaining socially active “to offset adverse cognitive effects”, Mikaela said.

–IANS

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Surging dengue cases in K'taka: BJP urges Cong govt to declare medical emergency

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Bengaluru, July 6 (IANS) The BJP in Karnataka has demanded that the Congress government declare a medical emergency over the rising dengue cases in the state.

Addressing a joint press conference at the BJP headquarters in Bengaluru, BJP MP C.N. Manjunath demanded that along with declaring a medical emergency, the state government should also form a task force and take the opinion of experts in handling the situation.

“Dengue is detected more among children and it is increasing every day. Six to seven deaths have been reported so far and more than 7,000 active dengue cases are reported in the state. Every day 600 to 700 dengue cases are reported in the state.”

“More cases are reported in Bengaluru, Chikkamagaluru, Mysuru and Hassan. A doctor has succumbed to dengue fever,” Manjunath said.

“Once complications start in dengue, death is 99 per cent as there is no treatment. Controlling dengue is nothing but controlling mosquitoes. The medicines would be administered for fever and blood pressure,” he added.

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“Along with dengue, mosquitoes will also infect people with Zika virus and Chikungunya. Dengue should be declared as an endemic as it has affected people all over the state. The war-footing approach, like how things moved during Covid-19, is needed to tackle the spread of dengue, hence there is a need to declare a medical emergency,” the BJP MP said.

Manjunath also added that the growth of mosquitoes is not coming under control as the construction of flyovers, underpasses and bridges have not been completed on time.

“The land is dug and water is filled and it is becoming a breeding ground for Aedes aegypti mosquitoes known as primary transmitters of dengue fever.”

State BJP Spokesperson C.N. Ashwath Narayan said: “Dengue is spread in all districts. It is a seasonal disease and the Congress government has failed to take precautions. Health Minister Dinesh Gundu Rao is busy touring the state and engaged with party-related activities.”

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The Union government had issued a circular on precautions to be taken by the states after dengue cases were reported from Maharashtra, he added.

“Minister Gundu Rao is not at all focused on the rising number of cases of dengue fever in the state. The private hospitals and laboratories are charging exorbitant rates for blood tests from Rs 1,000 to 1,500, violating all guidelines by the government in this regard,” he said while criticising the Karnataka government.

–IANS

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'Will affect lakhs of honest students': Centre opposes cancellation of NEET-UG exam in SC

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New Delhi, July 5 (IANS) The Centre, in a preliminary affidavit filed before the Supreme Court on Friday opposed the batch of pleas seeking cancellation of the NEET-UG examination, for admission in undergraduate medical programmes, saying it would affect “lakhs of honest candidates” who appeared in it on May 5.

The Union Ministry of Education said that scrapping the entire exam would seriously jeopardise the interests of the lakhs of honest candidates who attempted the question paper held on May 5 this year.

“In the absence of any proof of any large-scale breach of confidentiality in a pan-India examination, it would not be rational to scrap the entire examination and the results already declared. It is submitted that in any examination, there are competing rights that have been created whereby the interests of a large number of students who have taken the examination without adopting any alleged unfair means must not also be jeopardised,” the affidavit said.

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As regards the alleged instances of irregularities, including cheating, impersonation, and malpractices, the Central Bureau of Investigation (CBI) is undertaking an investigation and has taken over the cases registered in different states, it added.

The Centre said that it is committed to conducting all competitive examinations in a fair and transparent manner and if at the behest of some criminal elements, the confidentiality of competitive examinations has been breached, they must be dealt with sternly and with the full force of law to ensure that they are punished.

“The Government is committed to ensure the sanctity of examinations and protect the interest of students. To ensure transparency, fairness, and credibility in public examination, Parliament has enacted the Public Examination (Prevention of Unfair Means) Act, 2024 on 12.02.2024. The Act was brought into effect on 21.06.2024 and provides for stringent punishment for offences related to unfair means in public examinations. Public Examination (Prevention of Unfair Means) Rules, 2024 under the Act have also been notified on 23.06.2024,” it said.

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Recently, the top court had expressed reservations over the filing of a writ petition by a coaching institute alleging irregularities in the conduct of the NEET-UG exam.

“What fundamental rights of yours are violated to enable you to maintain a writ petition filed under Article 32 of the Constitution?” a vacation bench had asked the senior counsel representing Xylem Learning, a coaching institution providing assistance to NEET students.

Meanwhile, President Droupadi Murmu, in her address to a joint sitting of Parliament, asserted that the government was committed to a fair investigation and ensuring strict punishment to the guilty in the instances of paper leaks.

“Even earlier, we have witnessed many instances of paper leaks in different states. It is important that we rise above party politics and undertake concrete measures nationwide. Parliament has also enacted a strict law against unfair means in examinations,” she added.

The Supreme Court is slated to hear on July 8 the batch of petitions pertaining to the NEET-UG exam, including its cancellation.

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–IANS

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Study shows how cancer evades chemotherapy, finds mechanism to reverse

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New Delhi, July 5 (IANS) An international team of researchers from the UK and China has shown how cancer builds up resistance to chemotherapy — one of the biggest challenges in the treatment of the deadly disease.

Using a mice study, the early-stage research, led by The Institute of Cancer Research (ICR), London, and Sun Yat-sen University, China showed that Stiripentol — a drug currently used to treat epilepsy — can help reverse cancer’s resistance to chemotherapy, which will help shrink tumours and prolong survival.

In the study, the team zeroed in on lactate — the product that builds up as cancer cells convert nutrients to energy — which was found to be most abundant in chemotherapy-resistant cancer tissues.

For the study, published in the journal Nature, the researchers examined tissue from 24 patients with stomach cancer, where 15 of the cancers were resistant to chemotherapy and the tumours had continued to grow.

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Stiripentol and chemotherapy reduced the size of tumours — for four weeks after treatment — in mice with stomach cancer. These also survived for longer — for more than 70 days.

In comparison, tumours in mice treated with chemotherapy alone shrunk for one week and started to grow again. With only chemotherapy, no mice survived for longer than 40 days after treatment.

Further, lactate was also found responsible for altering the structure of a key protein involved in DNA repair, called NBS1, and affecting its efficiency.

The researchers believe that lactate may be behind chemotherapy resistance in other cancers such as “pancreatic, lung and ovarian cancers”.

“This extremely promising research has uncovered a likely mechanism for how cancer evades chemotherapy,” said Professor Axel Behrens, Professor of Stem Cell Biology at The Institute of Cancer Research.

“In our early-stage study, we’ve seen that you can prevent the build-up of lactate and make a tumour that was resistant to chemotherapy sensitive again — the treatment continues to work,” Axel added.

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–IANS

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