Indian Research on HPV Shows the Way
The lead article in a recent issue of the NEJM is from
India. It has been feted in the editorial and received warm applause from
round the world. This randomized clinical trial conducted by many groups
including the Tata Memorial Hospital, Mumbai may just change the way we
screen for cervical cancer globally. In 1999, more than 1,30,000 women
(age 30-59 years) in the Osmanabad district of Maharashtra were screened
for cervical cancer using 4 techniques–DNA testing for HPV from cervical
brushings, the Pap test, visual inspection of the cervix using acetic acid
(VIA) or no screening at all. Those who tested positive for HPV, Pap or
VIA received further examination and treatment including removal of
precancerous lesions, if necessary.
The three screening tests turned up similar numbers of
cervical cancer at the outset of the study. But women getting the HPV
screen were less likely to develop any advanced-stage cervical cancer over
the course of the study. And by the end of the study in 2008, 34 women who
got the HPV screening had died of cervical cancer, compared with 54 in the
Pap smear group, 56 in the visual exam group and 64 among the controls.
This study has shown that screening for HPV infection
will reduce cervical cancer mortality within 5-10 years. In contrast HPV
vaccination will show a decline in mortality after many decades because of
the long latency between infection and cancer. The only drawback is the
cost of the test. To counter it, cheaper yet as effective versions of the
test have been developed in China called the careHPV test and are likely
to become available commercially very shortly. (HPV screening for
cervical cancer in rural India. N Engl J Med 2009; 360: 1385-1394.)
Artificial Heart From IIT Kharagpur
After four years of hard labor, scientists in IIT
Kharagpur have developed a thirteen chambered artificial heart. It is
undergoing trials in small animals and results so far have been extremely
heartening. They have now applied to the ICMR for permission for trials in
humans.
This ingenious device will cost just Rs 1 lakh,
compared to the American version which costs 30 lakhs. If creativity is
thinking new things, innovation is transforming these ideas into concrete
reality –possible only with single-minded tenacity and patience. (www.indiaedunews.net,
March 19, 2009)
Treating Head Lice
Solving the small problems of life is as satisfying as
solving big problems. The FDA has recently approved 5% benzyl alcohol
lotion for the treatment of head lice (pediculosis capitis) in
children ³6 months old). Benzyl
alcohol is used as a solvent in paints and inks and has been used
medically in ointments, emulsions and lotions for treating insect bites.
The approval comes after 2 clinical trials with 628 patients comparing the
lotion with placebo. Interestingly, a 2005 study found that wet combing
for 30 minutes every third or fourth day for a 2 week period was more
effective than chemical methods. The world is full of interesting problems
waiting for a simple solution. (http://www.fda.gov/bbs/topics/NEWS/2009/NEW01993.html)
