Advisory Board: Option or Compulsion

The privilege of having access to top-notch advice can increase the odds of success for an already established business and even for a startup. To achieve this, increased attention is being paid to advisory boards (1). Advisory board is a committee or group of business executives who are appointed by the owner or the management of an organization to provide leadership, support, and constructive feedback as well as providing recommendations on specific areas (2).

Selection of members of the advisory board is based on the expertise needed or voids needed to be filled within an organization. For example, an organization can hire a lawyer for legal matters, a public relation executive for branding and marketing purposes, an industry specialist for in depth business knowledge, and/or an investor for fundraising advice (3). Unlike the traditional board of directors, members of the advisory boards have no powers and obligations (4). The President or CEO of an organization typically reports to the board of directors, whereas, the instituted advisory board serves as an advocate, supporter, and resource for the president and/or CEO (5).

Although their influence on the management cannot be sidelined but they are never really involved in the decision making process and are not entitled to impose any obligations on the management of the organization (4).

Advisory board members are appointed under the following criteria (4):

• Do not represent owners and shareholders 
• Typically appointed by the managing director of the company 
• Functions independently without any obligations 
• Provide advice and assistance to the managing director 
• Possess versatility in the composition 
• Do not represent replacement to an official statutory board
• Never takes part in decision making process 
• A reservoir of business intelligence and insight due to experience.  

Depending upon the requirements of an organization, advisory board can be categorized as (5):  

• Informal advisory board: Organizations with limited budget usually have this type of an advisory board. These boards typically involve a group of volunteers with a very ad‑hoc style of discussion. Having such advisory boards can produce positive outcomes specially for the businesses that are in their germinal stage.
• Formalized advisory board:  It is recognized by having a presence of an independent chair, a charter, minutes and annual impact measurement. Primarily, this type of advisory board consists of two internal directors, a Certified Chair, and two external advisors chosen specifically to fulfill the priorities included in the charter. Meetings are held on a quarterly basis, whereas the chair and directors meet more frequently. 
• Formal project advisory board: This type of advisory board is instituted with some specific purpose and for a fixed period of time which could range from 3 to 18 months.
• Formal corporatized advisory board: This type of advisory board is somewhat similar to the formal project advisory board, in an organization where governance board is already in place. The charter in this type of board usually expresses the reporting mechanisms and where it stands in relation to the already established governance board. Multinational operations, commercialization, and innovation typically uses this corporatized board.

Although advisory boards are flexible in their composition, it is of great importance to provide a good infrastructure to the advisory boards, so as to make them work effectively. Some of the considerations while establishing an advisory board might include (6):

• First is to determine the mandate of the board. 
• Mandate should explicitly state the roles, responsibilities, and target the areas to be advised.
• Develop policies on how deliberations of the board would take place. 
• To have minutes of the meeting in order to confirm compliance of the advisory board with the mandate. 
• Organizations should have it on their websites the relationship that exist between the involved parties.
• There should be a formal agreement between the advisory board members and the organization.  

An advisory board could prove beneficial to a business or even to a startup, especially in situations where the owners do not possess much experience or intent to expand their knowledge base surrounding the business (7). In addition to this, an advisory board could provide an organization with the following advantages (8): 

• Increased credibility: With the help of an advisory board, a business/business owner can help increase legitimacy in the marketplace.
• A bigger network: With members from varied disciplines and with vast experience, advisory boards help organizations in expanding their network. For example, suggesting a vendor or selecting a new employee. 
• Focus on the future: While the organization is dealing with day-to-day operations, advisory board remain focused on future prospects for the organization.

Despite many advantages that an advisory board has to offer, it does have some concerns associated with it. One of the most important one is that it has no legal responsibility which might result in generating an advice which may prove to be unsafe for the business (7).  Instituting an advisory board may demand personnel and organizational investment (9). The members of the advisory board are usually required to work at little or no compensation which would result in indifference and/or lack of commitment towards the organization by the members of advisory board (7). It is quite common for an individual to be on a board with a different organization at the same time which can create a conflict of interest (7). 

While an advisory board does poses potential to provide a path for a superior corporate governance (1), it is of great importance to get the purpose fulfilled by instituting an effective and productive advisory board for an organization. Realizing the needs and having a target set is what makes an organization look for members to be on the board of an advisory panel. Only if managed efficiently, advisory boards can do wonders, if not, it can hamper the growth and reputation of the organization in the market.

We at Turacoz Healthcare Solution are equipped with expert level professionals for advisory boards and conference coverage. To read more about the services we provide, click here.

If you have any queries, email us at hello@turacoz.in 

Diabetes: Types, Symptoms and Treatment

According to statistics by the WHO, “The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.” Also, “In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.”

Diabetes is a chronic, metabolic disease in which the body does not properly process glucose in blood for use as energy. This causes increased sugar level in the blood, eventually resulting in heart disease, blindness, kidney failure, and lower-extremity amputations. In 2019, Approximately 463 million adults (20-79 years) are presently living with diabetes and is expected to touch 700 million by 2045. In India, about 73 million people suffer from diabetes, and this figure is likely to go up to 80 million by 2025, making it the 'Diabetes Capital' of the world. Presently, diabetes is the seventh leading cause of death worldwide.

Diabetes can be classified into: type 1 diabetes caused due to autoimmune β-cell destruction of insulin producing pancreas, leading to absolute insulin deficiency), type 2 diabetes manifested by insulin resistance followed by relative deficiency in insulin secretion, Gestational diabetes mellitus diagnosed in the second or third trimester of pregnancy, specific types of such as neonatal diabetes and maturity-onset diabetes of the young [MODY]), disease of pancreas such as cystic fibrosis and pancreatitis, and drug- or chemical-induced diabetes. In addition, over secretion insulin antagonistic hormones (cortisol, glucagon, etc.) and certain viral infection (rubella, coxsackievirus B, cytomegalovirus, adenovirus, and mumps) also causes diabetes.

Diagnostic criteria for Diabetes

• Fasting blood glucose (FPG, no calorific intake for 8 hours) ≥126 mg/dL/7.0 mmol/L) or,
• Plasma glucose ≥200 mg/dL/11.1 mmol/L) after 2h of oral glucose load containing the equivalent of 75-g anhydrous glucose dissolved in water or,
• Glycated hemoglobin (HbA1C) ≥6.5%/48 mmol/mol or,
• A random plasma glucose ≥200 mg/Dl/11.1 mmol/L).

Symptoms of diabetes:

• Urinating often
• The feeling of constant thirsty
• Extreme fatigue
• Blurry vision 
• Cuts/bruises that heal slowly 
• Weight loss—even though you are eating constantly (type 1) 
• Tingling, pain, or numbness in the hands/feet (type 2)

Risk of diabetes 

Prediabetics are usually referred to individuals whose glucose levels are towards upper limit of the normal range. Prediabetes is usually associated with obesity, dyslipidemia, cardiovascular diseases and hypertension. The ranges for the prediabetes are: 

• HbA1C level: ≥5.7% but <6.4%/39–47 mmol/mol 
• Fasting Plasma Glucose: 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L) 
• 2-h plasma glucose (OGTT): 140 mg/dL (7.8 mmol/L) to 199 mg/Dl

At least annual monitoring for the development of type 2 diabetes in those with prediabetes is suggested

Metformin therapy for prevention of type 2 diabetes should be considered in those with prediabetes, especially for those with BMI ≥35 kg/m2, those aged <60 years, and women with prior gestational diabetes mellitus

Treatment

People with type 1 diabetes should be treated with:  

• Multiple daily injections of prandial and basal insulin, or continuous subcutaneous insulin infusion (CSII).
• Knowledge of patients on matching prandial insulin doses to carbohydrate intake, premeal blood glucose levels, and anticipated physical activity. 

Pharmacologic Therapy for Type 2 Diabetes: 

• Metformin is the preferred initial pharmacologic agent for the treatment of type 2 diabetes and continued unless it shows any intolerable side effect. Other agents, including insulin can be added if needed.
• Periodic measurement of vitamin B12 levels should be considered in metformin-treated patients, especially in those with anemia or peripheral neuropathy. 
• A choice of pharmacologic agents should be based associated comorbidities (atherosclerotic cardiovascular disease, heart failure, chronic kidney disease), hypoglycemia risk, impact on weight, cost, etc.
• Glucagon-like peptide 1 receptor are preferable to patients over insulin, requiring a greater glucose-lowering effect.
• The medication regimen should be reevaluated at regular intervals (every 3–6 months).

Recent challenges and developments

About 65 million people with type 2 diabetes need insulin, but only half of them can afford it. Insulin is required to all type 1 diabetics. Data from 24 countries showed that access to human insulin and analogue insulin at health center is only 61% and 5% respectively. In high income countries people often ration insulin which can be deadly for people who do not get the right quantity of the medicine 

The World Health Organization (WHO) on 13 November 2019,  announced the start of a pilot program to prequalify human insulin to increase treatment for diabetes in low- and middle-income countries.

FDA on September 20, 2019, approved Rybelsus (semaglutide) oral tablets to improve control of blood sugar in adult patients with type 2 diabetes, along with diet and exercise.

Lifestyle Interventions

Diabetes Prevention Program (DPP) recommends patients to achieve and maintain 7% loss of initial body weight and increase moderate-intensity physical activity (such as brisk walking) to at least 150 min/week. IDF recommends physical activity at least between three to five days a week, for a minimum of 30-45 minutes. 

• Choosing water, coffee or tea instead of fruit juice, soda, or other sugar sweetened beverages.
• Eating at least three servings of vegetable every day, including green leafy vegetables.
• Eating up to three servings of fresh fruit every day.
• Choosing nuts, a piece of fresh fruit, or unsweetened yoghurt for a snack.
• Limiting alcohol intake to a maximum of two standard drinks per day.
• Choosing lean cuts of white meat, poultry or seafood instead of red or processed meat.
• Choosing peanut butter instead of chocolate spread or jam.
• Choosing whole-grain bread, rice, or pasta instead of white bread, rice, or pasta.
• Choosing unsaturated fats (olive oil, canola oil, corn oil, or sunflower oil) instead of saturated fats (butter, ghee, animal fat, coconut oil or palm oil.

Diabetes in smart phone applications

Few popular mobile applications available in android and iPhone, that support diabetes management are:

Fooducate, My Net Diary Calorie Counter PRO, MySugr, BG Monitor Diabetes, Health2Sync, Glucose Buddy, DiabetesConnect, Diabetes:M, Sugar Sense, One Drop, Diabetes and Blood Glucose Tracker (Apple); Diabetes and Diet Tracker (Android).

Figure 1: Natural remedies that can make some difference 

The herbs and plant derivatives listed below are used by native people in the treatment of diabetes, in the regions in which they grow: 

• Allium 
• Bauhinia forficata and Myrcia uniflora found in south America 
• Coccinia Indica found in Indian subcontinent 
• Ficus carica found in Spain and south-western Europe
• American GINSENG
• Gymnema sylvestre found in southern and central India, used in Ayurveda
• Momordica charantia, some areas of Asia, India, Africa and South America
• Ocimum sanctum is used in Ayurveda
• Opuntia streptacantha used by people of Mexican desert
• Silibum marianum

However, all these herbs and home remedies have limited evidence for diabetes control. It should be used as a complementary along with the mainstream treatment and under licensed medical practitioner.

Future hope on diabetes treatment 

Type 1 diabetes: 

Replacing missing cells with cell therapy 

Diabetes Research Institute in the US is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. In 2016, the institute announced that the first patient in Europe treated with this approach in an ongoing phase I/II trial no longer requires insulin therapy. A similar device is made by US based company Viacyte and this is also under clinical trial.

The Belgian company, Orgenesis and UK based Islexa is working on transforming patient’s liver/pancreas respectively into insulin-producing cells to avoid the issues of sourcing cells from donors.

Sanofi, also a big name in diabetes, is working with the German Evotec in a beta cell replacement therapy for diabetics.

Attacking the origin with immunotherapy

Imcyse, a Belgian company is running a clinical trial with an immunotherapy designed to stop type 1 diabetes by specifically killing the immune cells that destroy the pancreas.

ActoBio Therapeutics is now running a phase I/II trial with to stop the progression of type 1 diabetes by cheese-producing bacteria to deliver two drugs that stimulate regulatory T cells to instruct the immune system not to attack insulin-producing cells.

Type 2 diabetes:

• Stimulating insulin production 
• Development of glucagon-like peptide (GLP)-1 receptor agonists to stop glucagon production
• Targeting the microbiome 

An unbalanced and less microbiome composition has been found in patients with diabetes. Fecal transplants, used to transfer the microbiome of a healthy person to the gut of one with diabetes, can result in a short-term improvement of insulin resistance in obese patients with type 2 diabetes.

The needle-free revolution

Devices like GlucoTrack, GlucoSense, MediWise can measure glucose using electromagnetic waves, laser like and radio wave respectively

Researchers are already anticipating about microchips that can diagnose diabetes type 1 before the symptoms appear or nanorobots traveling in the bloodstream while they measure glucose and deliver insulin.

Turacoz Healthcare Solution is committed to raise awareness about diabetes management, prevention and educating people so as to make them aware of this chronic disease. We urge the people to eat healthy and exercise daily. #FightDiabetes

If you have any queries, email us at hello@turacoz.in

 

 

Sudden Infant Death Syndrome (SIDS): Awareness for new mothers

Sudden Infant Death Syndrome (SIDS) is the primary cause of death among infants of one month and one year of age. In 2017, the infant mortality rate was 5.79 infant deaths per 1,000 live births, and SIDS was the fourth leading cause of mortality. Approximately 1360 infants died of SIDS in the year 2017 [1, 2].

SIDS is defined as the sudden, unexplained death of a healthy infant under one year of age that remains unexplained even after a complete investigation that includes an autopsy, review of medical history, the examination of a death scene. It is commonly known as “crib death” or “cot death” because it is associated with the time when an infant is sleeping [1].

What causes SIDS?

The fact that even doctors are not sure about the causes of SIDS makes it the leading cause of death in infants. However, a combination of factors that can make a baby more vulnerable to SIDS are demonstrated in Figure 1 [3].

Figure 1: Factors causing SIDS

How can the risk be reduced? [4]

Although there is no clear-cut way to prevent SIDS, researchers believe that there are various ways to minimize the risk of SIDS and other sleep related causes of infant death.

Always place the baby on its back

Making the infants sleep on their backs is the safest position for newborns until they are 12 months old. A baby made to sleep on the side or stomach is at a higher risk of SIDS than the one sleeping on its back. However, once the baby is almost six months old and learns to roll over both ways, let them sleep in their desired position.

Use a firm and flat surface

The soft surfaces such as a couch, sofa, waterbed, quilt, or a blanket can be dangerous for the newborns as it might lead to suffocation, entrapment, or strangulation. Always use firm and flat surfaces such as a mattress in safety approved crib covered by a fitted sheet that should not include any other bedding or soft items in the sleep area. Avoid putting soft toys, sheepskin, or crib bumpers in the baby’s sleep area.

Keep your baby away from overheating

Dress your infants appropriately for the sleep environment in sleep clothing such as wearable blankets to keep them warm without the need for loose sheets. Parents and caregivers should watch over the baby and take care of any signs of overheating, for instance, sweating or baby’s chest feeling hot to touch. Always keep the baby’s face and head uncovered during sleep.

Give your baby plenty of tummy time

Tummy time under the supervision of an adult is proven healthy for the infant as it strengthens the baby’s neck, shoulders, and muscles of the arms. Also, it prevents the flat spots on the back of the baby’s head.

A few measures every mother should take care of to minimize the risk of SIDS are depicted in Figure 2.

Figure 2: Measures to lower the risk during pregnancy and after childbirth

Keep your sleeping baby close, but not in your bed

Studies have proven that when an infant sleep in the same room as its mother, the risk of SIDS is reduced. However, it is dangerous for a baby to sleep with an adult or another child in the same bed. Always make sure to put the baby back in its sleep area after feeding or comforting and avoid any soft item near you while feeding. If the mother is tired or on some medications that make her feel dizzy, never bring the baby to feed on the bed.

Breastfeed the baby if you can

Breastfeeding can help lower the risk of SIDS for infants and is beneficial for mothers. Some experts believe that breast milk protects babies from the risk of infections that raise their SIDS risk. Avoid alcohol consumption when breastfeeding.

Consider using a pacifier for baby during sleep time

If the mother is breastfeeding, waiting for one month before introducing the pacifier is ideal. Introducing it too early might lead to nipple confusion, which may lead to the baby's preference for the pacifiers’ nipple. Keep the pacifier clean and buy a new one if the nipple is damaged. Never force a pacifier in the baby’s mouth if he doesn’t want it. Put it in the baby’s mouth when you put him down to sleep but never put it back once it falls asleep.

Note: The healthcare provider of your baby is always available to answer any questions you have about SIDS and its prevention.

Turacoz Healthcare Solutions aims to provide information on the latest trends, updates, and advances in the field of clinical research, trials, and regulatory affairs. Turacoz healthcare offers end-to-end support for scientific communications, clinical trial documents and disclosures, regulatory documents writing and submissions, and medico-marketing writing along with e-modules and e-books on healthcare and research.

If you wish to contact us, click here.

Reference:

1.            NIH. Fast Facts About SIDS [Available from: [https://safetosleep.nichd.nih.gov/safesleepbasics/SIDS/fastfacts#f1] [Accessed on November 04, 2019].

2.            Kochanek KD, Murphy, S.L., Xu, J.Q., & Arias, E.  . Deaths: Final data for 2017. National Vital Statistics Reports. 2019; 68.

3.            Clinic M. Sudden infant death syndrome (SIDS) 2018 [Available from: [https://www.mayoclinic.org/diseases-conditions/sudden-infant-death-syndrome/symptoms-causes/syc-20352800] [Accessed on: November 04, 2019].

4.            NIH. How can I reduce the risk of SIDS? 2019 [Available from: [https://www.nichd.nih.gov/health/topics/sids/conditioninfo/reduce] [Accessed on: November 04, 2019.

Damage caused to the lungs by smoking and vaping

One major cause of millions of deaths across the globe is smoking. Each year, more than 8 million people are killed due to tobacco use. Out of which approximately 1.2 million individuals are non-smokers being exposed to second-hand smoke (aka passive smokers).

 

The five-minute pleasure and “hit” causes major health issues down the line. Tobacco smoking is responsible for about 90% of all lung cancer deaths. It is also responsible for about 80% of all deaths caused due to chronic obstructive pulmonary disease (COPD). 

Reading these facts, the question at hand is; Is smoking worth it? 

The answer will always be no!

Damage due to smoking:

Starting with the mouth and throat, bad breath and stained teeth are the byproducts of smoking. It also causes major gum diseases and gives the lips and gums a faint blackish tint. Smoking is responsible for major damage to your mouth and throat, it increases the risk of cancer in your lips, throat, voice box, gullet and even tongue. 

If these facts make you to quit smoking, then we have some good news. Once you quit smoking, you greatly reduce your chance of developing neck and head cancer. If you think that only certain areas of your body will be affected by smoking, then you are in for a shock:

 

As for your lungs, those two are affected the most. Regular smokers are prone to colds, coughs, bad throats and asthma, and these are just the start to a long path of pain and suffering. Pneumonia, emphysema and lung cancer are just some of the return gifts smoking gives you. Studies have proven that smoking damages your airways and alveoli in your lungs, which in-turn causes severe lung diseases. 

One lung disease that smoking causes is Chronic Obstructive Pulmonary Disease (COPD). This disease includes emphysema and chronic bronchitis. Cigarette’s take credit for causing most cases of lung cancer. Individuals who already have asthma are at a severe risk of an attack if they passively, or directly inhale tobacco smoke. 

If you choose to continue to smoke tobacco, it will greatly impact your health and quality of life. Even though the temptations grow by the passing minute, high determination and a strong will can save you from both physical and mental agony.

Vaping 

E-cigarettes – also known as vapes, vape pens, mods and e-hookahs are considered a better alternative to the typical tobacco cigarettes. These vape pens work by heating a liquid, which produces an aerosol that users inhale. These liquids contain; THC (tetrahydrocannabinol), nicotine, CBD (cannabinoid) oils, and other addictive substances. The applications and flavors available is all together a different story. 

As of today, the specific chemical exposures in these vapes, causing lungs diseases and injuries remains unidentified and unknown. The Centers for Disease Control and Prevention (CDC) has reported nearly 800 lung injuries associated with e-cigarettes. According to one of WebMD’s articles, “Lung injuries from vaping probably result from tissue damage caused by noxious chemical fumes, rather than from organic compounds in the lungs, data suggest.”

According to Dr. Brandon Larsen, a surgical pathologist at Mayo Clinic Arizona, and a national expert in lung pathology, "While we can't discount the potential role of lipids, we have not seen anything to suggest this is a problem caused by lipid accumulation in the lungs. Instead, it seems to be direct chemical injury, similar to what one might see with exposures to toxic chemical fumes, poisonous gases and toxic agents.” Out of 17 documented cases, 11 met the criteria for a “confirmed” diagnosis of vaping-related lung injury; the remaining six met the criteria for a “probable” designation. 

According to his team’s research, “In all cases, histopathological findings showed patterns of acute lung injury, including acute fibrinous pneumonitis, diffuse alveolar damage, or organizing pneumonia, usually bronchiolocentric and accompanied by bronchiolitis.” Also,” Macrophages and pneumocyte vacuolization were seen in all cases and may be useful diagnostic clues in an appropriate clinical context.”

Even though there isn’t any definitive answer as to how and why “vaping” causes these lung injuries, when it is a way to reducing the number of normal cigarettes. It is safe to say that vaping will do you no good and that it has no possible health benefits.

Conclusion 

Smoking poses a great treat to not only your respiratory system but the entirety of your body. It is responsible for many variations of cancer and causes millions of deaths annually. On a same note, e-cigarettes are no alternative to smoking. It causes the lungs to swell up due to all the excess vapor one inhales via specialized vape pens. 

Turacoz Healthcare Solution, a medical communication company believes that with a bit of determination and a strong will power you can quit smoking. We believe that you don’t require an alternative for smoking, such as vaping. Turacoz urges people to quit smoking and vaping, and to be more physically active and vigilant and should take care of their body.

Even though the “hit” can sometimes help reduce stress, it is not a proper way to relief tension and stress. We strongly advise you to talk to someone, preferably to your friends and families, in times of need and desperation. 

Quit Smoking Today to save your Tomorrow!

Author: Duaranne Everett