Device to Fight Anaemia in India about to go on Sale

Healthcare in rural India is often basic, meaning people die unnecessarily.

Take anaemia for instance, more than half the cases can easily be cured with a course of free iron pills, but if left untreated it is potentially fatal, especially for pregnant women.

Massachusetts Institute of Technology graduate Myshkin Ingawale first heard about the problem from friends who worked as young doctors in remote areas of India.

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“One in five deaths among pregnant women was traced back to this. I was not aware of this problem but my friends were seeing it on an ongoing basis in the field,” he told the BBC.

Mr Ingawale decided to put his technology background to the test and come up with a solution that would be easy for healthcare workers – often untrained – to use in the field.

Lunch box

“I knew a little about technology and how to put things in a box,” he said.

He took his inspiration from an unlikely source – Hollywood.

“I had seen this machine in Hollywood movies – when someone was lying in a hospital bed they were hooked up to it,” he told the BBC.

The device he is talking about is a pulse oximeter, a non-invasive method of monitoring the oxygenation of haemoglobin using light. The patient is attached to the machine via a finger clip.

A similarly non-invasive device was perfect for his needs because healthcare workers in India are often not trained to conduct blood tests using needles and lack the equipment to assess the results of such tests.

“I found that there was no commercial availability of a device to measure haemoglobin in the same way,” said Mr Ingawale. So he set about designing one. When we first saw it is was just circuitry housed in a lunch box,” said Noah Perin, commercialisation officer at the Program for the Appropriate Technology in Health (Path).

Path follows the development of new medical technologies and has been looking for devices that can help detect anaemia for the past 20 years.

Device to Fight Anaemia in India about to go on Sale

No needle

The finished product was a little more sophisticated, a hand-held, battery-operated device that can measure haemoglobin levels without the prick of a needle.

Known as TouchHb, it comes with a probe into which the finger is inserted. When light-emitting diodes in the probe shine light through the nail, a photodiode on the other end interprets the absorption patterns to produce an instant reading of the volume of haemoglobin in the patient’s blood.

It can diagnose anaemia in less than a minute and is currently being piloted in clinics in South India as part of the vital data collection exercise that could see the device go commercial later this year.

The batteries can be recharged and are expected to last for more than 100 tests. The probe will also require yearly maintenance.

Mr Ingawale’s firm, Biosense Technologies, aims to sell the machines for between $200 and $300 (£125-£188) and the cost of individual tests will be just 5 rupees (10 cents; 6p).

The costs are outweighed by the benefits, he thinks.

He said “Pregnant women are recommended to get a haemoglobin test at least once in every trimester of their pregnancy but it is inconvenient for a women to walk to the nearest primary healthcare centre that could more than 5km away. They do not feel sick enough to justify that trip that could even come against losing a day’s wages, so a large number of women skip the screening and monitoring.”

With this simple test, available in their own community, there is much greater likelihood of spotting and subsequently treating anaemia, he suggested.

Local need

“We are quite excited about it because it is targeted at and developed for front-line health workers,” said Mr Perin. This device won’t cure anaemia but it can have a dramatic impact in alerting people to the fact that they have a problem,” he added.

Mr Ingawale wants to see more devices developed at grassroots level, based on the needs of patients in the field.

“There needs to be a rethink in the way healthcare is delivered to people. It needs to be far more decentralised. It can become a consumerist movement in the same way that Wikipedia has been for information,” he said.

Mr Perin agrees.

“We have seen devices like this before but they have been huge sophisticated machines made for the developed world and adapted. There is a real advantage in inventing devices based on local needs,” he said.

Source: BBC News UK

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Cheap Device Reduces Premature Births

A cheap medical device can dramatically reduce the number of premature births in some at-risk women, according to a team of doctors in Spain.

Being born before 34 weeks of pregnancy is linked to a host of health problems.

The study, published in the Lancet, showed that using a “cervical pessary” reduced the rate in the at-risk group. Doctors said more studies were needed before the technique was used routinely.

Cheap Device Reduces Premature Births

The authors said 13 million babies were born prematurely every year.

In the trial, doctors were looking at women who had a cervix – part of the lower section of the uterus – which was shorter than 25mm. These pregnant women are thought to be at a higher risk of an early delivery.

The cervix was measured between 18 and 22 weeks into the pregnancy by an ultrasound scan. Of the 11,875 women who took part in the trial, 726 had a cervical length less than 25mm. Half of these women had a pessary, a small ring of silicone, inserted into their cervix.

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Pretty Amazing

In the group of women without the pessary, 27% of babies were born prematurely. The rate was six per cent among those fitted with a pessary.

Maria Goya, one of the researchers at the Vall d’Hebron Hospital, said: “Placement of a pessary is an affordable procedure, non-invasive, and easy to insert and remove as required.”

The study concluded the pessary was a “reliable alternative for prevention of preterm birth” in a group of at-risk women.

Prof Steve Thornton of the University of Exeter, a spokesman for the Royal College of Obstetricians and Gynaecologists, said: “The difference in the two groups is pretty amazing.”

He said more research was needed to prove that it worked, and to find out if it could help other women at risk of a premature birth. “If this is borne out it could make a big difference,” he added.

Drs Steve Caritis and Hyagriv Simhan, of the Magee Women’s Hospital in Pittsburgh, said the findings had “renewed enthusiasm for the cervix as a therapeutic target” in preventing premature births.

However, they warned that few women had a short cervical length, which made “this screening approach fairly inefficient”. They added: “Additional well-designed studies are needed before pessary use can be validated as an effective treatment.”

Source: BBC News UK

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Unlimited Human Eggs ‘Potential’ for Fertility Treatment

It may be possible to one day create an “unlimited” supply of human eggs to aid fertility treatment, US doctors say.

Researchers have shown it is possible to find stem cells in adult women which spontaneously produced new eggs in the laboratory.

Further experiments on mice showed such eggs could be fertilised, according to a study in the journal Nature Medicine.

One British expert said the study re-wrote the rule book with “exciting possibilities” for improving fertility.

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The long-established theory is that women are born with all the eggs they will ever have. Lead researcher Dr Jonathan Tilly, from Massachusetts General Hospital, said this study, a follow up to one on mice in 2004, disproves that.

His team has reported finding and isolating the stem cells which go on to produce eggs in the ovaries of reproductive age women. It was done by searching for a protein, DDX4, which was unique to the surface of the stem cells. This allowed researchers to fish out the right cells.

When grown in the laboratory, the cells “spontaneously generated” immature eggs – or oocytes, which looked and acted like oocytes in the body.

The cells were “matured” when surrounded by living human ovarian tissue, which had been grafted inside mice.

There are tight legal and ethical restrictions on research on human eggs. The same experiments repeated using stem cells taken from mice showed the eggs could be fertilised with sperm and produced embryos.

Unprecedented

Dr Tilly said: “The primary objective of the current study was to prove that oocyte-producing stem cells do in fact exist in the ovaries of women during reproductive life, which we feel this study demonstrates very clearly.

“The discovery of oocyte precursor cells in adult human ovaries, coupled with the fact that these cells share the same characteristic features of their mouse counterparts that produce fully functional eggs, opens the door for development of unprecedented technologies to overcome infertility in women and perhaps even delay the timing of ovarian failure.”

He told Nature: “These cells, when maintained outside of the body, are more than happy to make cells on their own and if we can guide that process I think it opens up the chance that sometime in the future we might get to the point of having an unlimited source of human eggs.”

Dr Allan Pacey, a fertility expert at the University of Sheffield, said: “This is a nice study which shows quite convincingly that women’s ovaries contain stem cells that can divide and make eggs.  Not only does this re-write the rule book, it opens up a number of exciting possibilities for preserving the fertility of women undergoing treatment for cancer, or just maybe for women who are suffering infertility by extracting these cells and making her new eggs in the lab.”

Potential landmark

Stuart Lavery, a consultant gynaecologist and director of IVF at Hammersmith Hospital, said the findings were “extremely significant” and “a potentially landmark piece of research”.

He told the BBC: “If this research is confirmed it may overturn one of the great asymmetries of reproductive biology – that a woman’s reproductive pool of gametes may be renewable, just like a man’s.”

While cautioning that the cells were “some way” from any clinical use, Mr Lavery said they had potential, “particularly in young women facing sterilising treatment such as chemotherapy”.

Source: BBC News UK

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