Health

An Ontario hospital network is investigating an incident from last month in which an older Sikh patient’s beard was shaved off without his consent, a move that has been condemned by the Sikh community as a severe breach of religious rights.

As the investigation unfolds, Balpreet Singh, legal counsel and spokesperson for the World Sikh Organization of Canada (WSO), expressed hope that the patient and his family will receive an explanation and that accountability will follow.

He also emphasized the need for the hospital to reassure the Sikh community that their faith practices will be respected and understood.

“This is unspeakable. I can’t exaggerate the trauma this has really caused, not just for this family, but for the community. It’s a loss of trust,” Singh told Global News. “There need to be steps in the future to ensure this cannot happen again. And that means working with the Sikh community on ongoing training and awareness.”

In late August, Joginder Singh Kaler, a practising Sikh from the Greater Toronto Area (GTA), was transferred to Brampton Civic Hospital from Toronto’s St. Michael’s Hospital. About a month earlier, he had a major fall and was taken to the Toronto hospital to receive treatment and underwent reconstructive surgery on his fractured jaw. His beard was not shaved for that procedure.

While Kaler was unconscious at Brampton Civic Hospital and unable to provide consent, the hospital contacted his family to request permission to shave him, according to advocates for the family.

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The family refused, wishing to preserve his beard, but it was shaved nonetheless.

“He’s never shaved his beard because uncut hair is a part of the Sikh faith, it’s one of the articles of faith,” Singh said. “But to see him in that state was a shock for the family. And it’s a humiliating violation of someone’s faith.”

4:44
Celebrating Sikh Heritage Month in B.C.

In a media release regarding the incident, the WSO stated that it had written to the William Osler Health System, which oversees Brampton Civic Hospital, to express its “shock and outrage” over the matter.

William Osler Health Systems has now launched a “thorough investigation upon receiving the concern,” a spokesperson from the health network told Global News in an email on Thursday.

“Out of respect for patient privacy, Osler cannot comment on any individual experience, however, we are undertaking a comprehensive review of this case in accordance with our standard processes,” the spokesperson said.

“Osler has expressed its commitment to share updates and partner with the family throughout this investigation. As part of this review, Osler is also collaborating with external partners also involved in the patient’s care to ensure a complete understanding of the circumstances.”

The WSO said the incident has not only inflicted emotional distress upon Kaler’s family but has also caused them profound trauma during an already challenging time.

4:58
Celebrating Sikh history and culture

“No one really understood the gravity of the issue and that they violated this individual’s faith in the worst possible manner… removing it completely is a robbing of dignity,” Singh said.

He added that the family was never informed of any medical necessity to remove the beard, especially since Kaler had already undergone jaw surgery.

“He’d already had his jaw surgery and he had arrived with his beard and now he had it completely removed. It made no sense,” Singh said.

In the statement to Global News, the Osler spokesperson said the health network respects the religious rights and freedoms of all Canadians and supports a positive, inclusive and safe environment.

“Serving a diverse community, including a significant Sikh population – many of whom are represented among Osler’s staff, physicians, and volunteers – Osler remains dedicated to respecting the religious and cultural practices of all patients and their families,” the spokesperson said.

&copy 2024 Global News, a division of Corus Entertainment Inc.

In 2011, Shannon McKenney, a singer from Burnaby, B.C., suddenly fell violently ill at a dinner party.

Thinking it was food poisoning, she went to the emergency room with severe pain and nausea, only to be sent home with a diagnosis of the stomach flu.

But when her appendix ruptured days later, her condition took a life-threatening turn. Though she survived the ordeal, her health never fully returned to normal.

Doctors initially blamed the lingering symptoms on complications from her appendix. What none of them realized was that McKenney had just survived a hidden and dangerous battle with sepsis.

“I thought, ‘OK, I’m a young, healthy woman. I’m going to recover. It was just a ruptured appendix, no big deal,’” McKenney told Global News.

“But that was the beginning of 13 years of recovery from sepsis.”

Sepsis is a severe condition that occurs when the body’s response to an infection damages its own tissues and organs.

It is also known as septicemia or “blood poisoning,” and is most commonly caused by bacterial infections but can also stem from viruses or fungal infections, according to the World Health Organization and the U.S. Centers for Disease Control and Prevention.

It can develop rapidly, often within hours if left untreated. It may lead to shock, multi-organ failure and death — especially if not recognized early and treated promptly.

With nearly 50 million cases and 11 million deaths globally each year, sepsis is a significant health crisis; but despite its prevalence, it remains difficult to diagnose quickly and accurately.

In Canada, one in 18 deaths involves sepsis, making it the 12th leading cause of death nationally, according to the Canadian Sepsis Foundation.

And anyone can get sepsis, no matter the age.

Many patients diagnosed with the illness require care in the ICU, placing a considerable burden on the health-care system. The cost of treating sepsis in Canada amounts to $325 million annually. And although diagnosis and treatment of sepsis is improving, the foundation said rates are still on the rise.

Early symptoms of sepsis often resemble those of other common illnesses. Patients might experience flu-like signs such as fever, rapid breathing and a fast heart rate. These symptoms, however, are easily mistaken for other illnesses and make it hard to diagnose, according to Johns Hopkins Medicine.

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Treating sepsis requires urgent medical care, including antimicrobials, intravenous fluids and other supportive measures. Even when patients survive, sepsis can have long-lasting effects, leading to ongoing health issues that may persist for years.

McKenney’s first sign that something was wrong came when she didn’t recover as expected.

She was constantly in pain and couldn’t eat. Over the next two years, she was in and out of the hospital with various issues causing her severe discomfort. In 2013, she was hospitalized again — this time for intense pain caused by her gallbladder. She developed another infection, once again leading to sepsis.

Yet, even then, doctors couldn’t pinpoint why she was so sick.

“My hair fell out. My toenails fell off. It was pretty bad,” McKenney said. “However, they didn’t call it sepsis that time,” she said, adding that she was weak and barely able to stand, and she spent 18 days over Christmas and the new year in the hospital.

After her hospital stay, she continued to struggle with her recovery, leaving doctors still baffled by her condition.

Then, in July 2019, sepsis returned for a third time — this time triggered by the flu and possibly something she believed she contracted from a plane. Finally, doctors diagnosed her with sepsis and
confirmed the previous two times she was in hospital she had also suffered from sepsis.

“That’s when all the dots started connecting,” she said.

McKenney believes she was misdiagnosed for over a decade due to the challenges of diagnosing sepsis.

McKenney continues to struggle with the long-term effects of sepsis. She lives with anxiety, depression, insomnia and fatigue, and worries that she may never be able to return to work.

“I’ve had a migraine for six years — it’s unrelenting. Now, I struggle with memory recall and have ongoing gastric issues from the trauma to my abdomen,” she said.

Once a singer, she added that she has also struggled with her singing since her battle with sepsis.

While there is no cure for sepsis, Dr. Claudia dos Santos, a critical care clinician-scientist at St. Michael’s Hospital in Toronto, is developing life-saving treatments for the condition.

“Sepsis is treated in two ways. The first way is with antimicrobials. So these include antibiotics, antivirus or antifungal medications that treat the invading organism. The other way that we treat sepsis is we provide support, organ support for example, like fluid resuscitation, sometimes mechanical ventilation, and dialysis,” she said.

“But those two types of treatments don’t treat the reason why sepsis happens, which is this immune dysregulation.”

Dos Santos is developing a new treatment for sepsis that aims to block inflammation, boost white blood cells’ ability to fight bacteria and prevent heart and lung failure. She now hopes to test her groundbreaking approach in preclinical trials to move quickly toward saving lives.

1:16
What is sepsis? Girl catches infection trying on shoes without socks

“We have found that very small molecules can be used to treat the immune dysregulation,” she said. “And we’re encapsulating these very small molecules into something called a nanoparticle. And what these molecules do is they bind to cells and allow us to deliver inside the cell … thereby helping the immune system fight the infection without getting so much of the damage associated with sepsis to the other cells.”

The research is now entering safety studies, but dos Santos noted that it has already been 15 years in the making.

“And we’re now moving to the final stages of making sure that they are safe so that we can go ahead and move towards trying them in patients with sepsis,” she said.

“Our plan is to work over the next year, complete our safety studies and submit the entire all of the data that we’ve garnered to Health Canada … at which point Health Canada will let us know if we have approval to begin our first human trials over the next year,” dos Santos said.

London: Zenas BioPharma, which develops immunology-based therapies, said on Thursday that it has raised $225 million in its U.S. initial public offering (IPO).

The clinical-stage company, backed by drugmaker Bristol-Myers Squibb, priced its offering of 13.2 million shares at $17 apiece, the midpoint of its targeted range of $16 to $18 per share.

Despite 2024 being touted as a comeback year by several analysts, the U.S. IPO market has struggled to gain traction. Weak market conditions have resulted in several firms abandoning their plans to go public.

Zenas, which does not have any products approved for commercial sale, is developing its lead candidate obexelimab for the treatment of various immunology and inflammation diseases.

These include multiple sclerosis, a chronic neurological disorder, and systemic lupus erythematosus (SLE), a chronic disease where the body’s immune system attacks its own tissues.

The Waltham, Massachusetts-based company, which was incorporated in 2019, plans to use the IPO proceeds to advance the clinical development of obexelimab and prepare for its potential launch in the United States and Europe, pending approval.

Zenas will list on the Nasdaq Global Select Market on Friday under the ticker symbol “ZBIO”.

Biotechnology company MBX Biosciences and biopharmaceutical firm Bicara Therapeutics are also set to go public on Friday alongside Zenas.

Morgan Stanley, Jefferies, Citigroup Global Markets and Guggenheim Securities are underwriting Zenas’ offering.

(Reporting by Rishabh Jaiswal and Pritam Biswas in Bengaluru; Editing by Tasim Zahid and Sonia Cheema)

London: Fulcrum Therapeutics said on Thursday its experimental drug to treat a type of muscle disorder failed to meet the main goal in a late-stage study, sending the company’s shares down nearly 70 per cent before the bell.

The company was testing its drug, losmapimod, in 260 patients with facioscapulohumeral muscular dystrophy (FSHD) who received either the therapy or a placebo for 48 weeks.

At the end of treatment period, patients who received the drug did not show improvement on a measure of shoulder and proximal arm mobility – the main goal of the study. The study also failed to achieve statistical significance on any of its secondary goals.

In light of the results, the company said it plans to suspend testing of losmapimod in FSHD patients.

FSHD is a genetic disorder that causes muscle weakness and wasting in the face, shoulder blades and upper arms. The estimated prevalence of the disease is about 4 cases per 100,000 individuals, according to the Muscle Dystrophy Association. (Reporting by Bhanvi Satija in Bengaluru; Editing by Vijay Kishore)

Washington: Shares of Moderna tumbled early Thursday after the vaccine developer said it was cutting research and development spending and pushed back its time frame for breaking even. The company also forecast a 2025 revenue range that fell below Wall Street expectations.

Moderna said it planned an approximately 20 per cent reduction in expected research and development expenses for 2025 to 2028 from $20 billion to $16 billion. It expects a reduction of about $1.1 billion in annual spending starting in 2027 through cost cuts and by prioritising its portfolio.

Moderna developed the Spikevax COVID-19 vaccine, and regulators approved this year its vaccine for RSV or respiratory syncytial virus. The company also has a combination flu/COVID vaccine and an RSV vaccine for high-risk younger adults that it expects to submit to regulators in 2024.

The company also said Thursday that it now expects to break even in 2028. It predicted last November that this would happen in 2026.

For 2025, Moderna said it expects revenue ranging from $2.5 billion to $3.5 billion.

Analysts forecast $3.87 billion, according to FactSet.

Shares of Cambridge, Massachusetts-based Moderna Inc. were down 12 per cent to $69.61 before markets opened Thursday.

That price has already dropped 20 per cent so far this year after starting 2024 around $100. (AP) ZH ZH

New Delhi: Panacea Biotec on Thursday said the US International Development Finance Corporation (DFC), has agreed to provide a long-term loan of up to $20 million to the company for capacity-expansion of its hexavalent vaccine.

DFC’s financing will enable Panacea to expedite completion of the ongoing expansion and supply the hexavalent vaccine to United Nations (UN) agencies for childhood immunisation globally.

Panacea Biotec is expanding manufacturing capacity for drug substance antigens used in its hexavalent vaccine EasySix to meet future demand from U.N. agencies and public health organisations.

The World Health Organisation and Strategic Advisory Group of Experts on Immunisation approved adoption of this hexavalent vaccine in the global immunisation program. Following this, Gavi and the Pan American Health Organisation also adopted the hexavalent vaccine. UNICEF forecasts the demand for a wP-IPV-based hexavalent vaccine for Gavi countries to be 19 million doses in 2025 and over 100 million doses by 2030.

Panacea developed the world’s first whole-cell pertussis(wP) and inactivated polio vaccine (IPV)-based, fully liquid hexavalent (six-in-one) vaccine called EasySix. The vaccine was launched in India in March 2017. The vaccine protects children from diphtheria, pertussis (whooping cough), tetanus, hepatitis B, Haemophilus influensae type B (Hib) which causes pneumonia and meningitis and polio.

Currently, the routine immunisation involves taking pentavalent (5-in-1) and inactivated polio vaccine (IPV) separately, the hexavalent which includes IPV leads to less vaccination sessions and higher coverage.

New Delhi: Alkem Laboratories Ltd, India’s fifth-largest branded pharmaceutical company, has joined the race for JB Chemicals and Pharmaceuticals as KKR and Co looks to cash out of the 48-year-old company on the back of a significant rise in market value, said people with knowledge of the matter.

This coincides with Torrent Pharmaceuticals, India’s fifth-largest drugmaker, pulling out of negotiations over valuation differences, said the people cited above. Torrent had been seen as the frontrunner for the likely $3 billion buyout of the Mumbai-based company. Other suitors such as EQT are also said to have baulked at the target’s rising share price. Torrent may resume discussions if the valuation declines.

Ahmedabad-based Torrent had been in active negotiations with global banks to finance a potential deal after missing out on Cipla and Biogaran, France’s largest generics company. However, earlier this week, Torrent’s management told lenders that it’s pausing negotiations with KKR.

JB Chemicals ended Thursday with a market capitalisation of Rs 29,192.24 crore, its share having shot up 16 per cent since the beginning of the year. Alkem’s market capitalisation is Rs 75,880.73 crore while that of Torrent Pharma is Rs 1.17 lakh crore.

Alkem’s Largest M&A
Alkem, KKR and Torrent declined to comment. Alkem MD Sandeep Singh didn’t respond to queries.

If successful, this will be Alkem’s largest M&A ever and will potentially move it to fourth place, replacing Mankind, in the domestic formulations market. It will further strengthen Alkem’s presence in the chronic segment, which accounts for 18 per cent of revenue, whereas for JB Chem, it’s nearly half.

The 52-year professionally run Alkem is overseen by the third generation of the Singh family, Sandeep and Anirudh. The promoters own 56.38 per cent of the company between various factions of the family.

For more than 15 years, Alkem has defended the number 1 position in anti-infectives by successfully tapping into the largest sub-therapy area, i.e. anti-bacterial. At the same time, same time, GI and VMN have injected growth in the company. The company has slowly diversified its revenue base in chronic/semi-chronic therapies such as Neuro/CNS, derma, cardiac and anti-diabetic while maintaining its core strength in its major therapy areas—anti-infectives, gastro-intestinal (GI), vitamins and minerals (VMN), and pain; which account for 75 per cent of its branded sales.

Under its new CEO, Vikas Gupta, a former Cipla executive, the company ha sidentified a few core areas for growth – consolidating market share in chronic therapies with focus on anti-diabetic, neurology, dermatology, CNS, and respiratory; improving coverage among specialist doctors as well as targeting tier II to IV cities and improving digitisation of operations.

“We are looking at opportunities that comes up on table,” said Gupta at company’s last month earnings call. “We are actually looking forward to any acquisition that we can do that can add value to our overall scheme of things and which are more strategic in nature.”

According to Bansi Desai of JP Morgan, Alkem’s margin improvement will be primarily driven by improvement in product mix, operational efficiencies and higher medical representative productivity. “The company has identified med-tech as an strategic adjacency,” he said. It has already tied up with US medical devices company Exactech following an in-licensing agreement for hip and knee replacement implants to leverage on its leadership position in orthopaedics segment.

Even then, analysts believe, Alkem may need to partner with a PE fund to finance such a large transaction. Alkem Labs has a net cash of Rs 3845 crore as of June 30, 2024. It has a total debt of Rs 1418 crore as on March 31, 2024.

But with some members of the promoters group monetising part of their holdings in the company through block trades between June-August of this year, there has been speculation of a promoter sale. What added to the chatter was sections of the family expressing their desire to relocate overseas. Those plans have not materialised and they are back in the country.

“The new management plans to pursue profitable growth in India, emerging markets and CDMO business,” said Alok Dalal of Jefferies. Biologics is another growth area identified by the management that sees growth in emerging markets and in India.

KKR’s investment arm, TAU Investment, currently owns 53.78 per cent of JB Chemicals. The acquisition will trigger an open offer for another 26 per cent as it will lead to a change of control, which means a new owner could end up paying as much as Rs 26,202 crore ($3.11 billion). KKR had acquired the stake for about Rs 3,100 crore, or Rs 745 per share, from the founding Mody family in July 2020. JB Chemicals closed at Rs 1,875/ share on the BSE on Thursday.

JB Chem offers a healthy cocktail of a robust domestic franchise as well as a niche contract manufacturing organisation (CMO) play aside from exports. The company has a few star brands such as Nicardia, Metrogyl, Cilacar and Rantac and has also scooped up Novartis’ heart failure drug brand Azmarda.

After the acquisition, KKR appointed Cipla veteran Nikhil Chopra in October 2020 as JB’s chief executive. He put the Mumbai-based drugmaker on an accelerated growth path, making four acquisitions and investing $200 million in the last four years along with a fresh go to-market strategy involving therapy diversification, raising the productivity of medical representatives, optimising costs, making big brands even larger, and chronic therapies.

London: Neurocrine Biosciences said on Thursday it will halt the development of its experimental drug, aimed at improving cognitive function in patients with schizophrenia, after it did not achieve the primary goal in a mid-stage trial.

The company said the drug, luvadaxistat, did not replicate the results from a previous mid-stage trial that showed improved cognitive performance, due to a large variability in the cognitive measures across the patients and a potential imbalance in their baseline characteristics.

In the previous study, luvadaxistat failed to meet the main goal of change from baseline in negative symptoms of schizophrenia, however, it met the secondary goal of improving cognitive performance.

Neurocrine said it will focus its resources on late-stage development of its other schizophrenia and depression drug candidates.

Shares of the company were down 2.5 per cent in extended trading.

Last month, the company said its other schizophrenia drug, NBI-1117568, helped reduce the severity of symptoms in a mid-stage trial, but there were concerns whether the benefit could be replicated in larger trials.

(Reporting by Puyaan Singh; Editing by Mohammed Safi Shamsi and Shinjini Ganguli)

Copenhagen: Bavarian Nordic said on Thursday it could supply 13 million doses of its mpox vaccine by the end of 2025, up from a previous forecast of 10 million doses, and is exploring options to significantly expand its capacity.

The Danish biotech company said it had also identified measures that could boost supply by a further 50 million doses within the next 12-18 months, subject to regulatory approvals and market demand.

“It depends first and foremost on demand. If the demand is there and the other conditions are in place, we have the opportunity to increase by another 50 million doses,” Bavarian’s head of investor relations Rolf Sass Sorensen said.

The World Health Organisation declared mpox a global health emergency last month but efforts to curb the spread of the disease have been hampered by a lack of vaccines.

Sorensen said supply also hinges on ongoing discussions about collaborations with partners in Africa and elsewhere regarding the transfer of manufacturing, alongside the adoption of other methods and technologies with a higher yield.

“It could perhaps be that you get help to make fill-and-finish,” Sorensen said.

Bavarian said certain existing orders for mpox vaccines based on contracts with the U.S. government would be pushed back to 2025 from 2024 in order to meet other market needs.

The Democratic Republic of Congo, the epicentre of the latest mpox outbreak, received its first batch of mpox vaccines last week.

(Reporting by Louise Breusch Rasmussen and Stine Jacobsen, editing by Essi Lehto, Terje Solsvik and Christina Fincher)

A new program at the University of Calgary is aiming to reduce the strain on Alberta’s medical system.

The Master of Physician Assistant Studies program is the first of its kind in Alberta and will train new physician assistants to bolster the number of health-care workers across the province.

Physician assistants, or PAs, are medical professionals who have been part of Canada’s military medic system since the 1960s, but they are relatively new and unknown to provincial and territorial health systems.

They perform physical exams, takes medical histories, develop treatment plans and discharge patients.

Their training enables them to work in a wide array of health care settings, and they can perform many duties normally performed by a full-fledged doctor for routine or straightforward cases.

This frees up time and availability of physicians and surgeons to treat more complicated cases and creates opportunities for both PAs and physicians to spend more time with their patients.

As of 2022, there were fewer than 1,000 certified physician assistants in Canada.

1:56
Mayors and reeves consider role of physician assistants in southern Alberta

In order to qualify for the competitive two-year program at the U of C, applicants must already have a four-year undergraduate degree and a history of working in health care.

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Funded through grants by the Government of Alberta, admissions were limited to just 20 seats, with around 200 people applying to get in.

Mozac Samson, one of 20 students enrolled this fall, said even with his background as an paramedic, the program keeps him on his toes.

“As a paramedic, it helps a little bit when you’re coming into a program like this,” Samson said. “I also find myself at a little bit of a deterrent, ‘cause I have to try and unlearn the things that we’re dealing with, and then re-learn it.”

The fact that the program requires applicants to have a history in health care is positive according to Samson, who believes the diversity of applicants’ experience will makes them better in the field.

“Leaning on their expertise to give us a little bit of that nuance will help us from a practical perspective,” explained Samson. “So 100 per cent, at this point in time, I would say it’s helping us.”

2:14
Are physician assistants the key to solving Canada’s health care crunch?

Dr. Rahim Kachra, the medical director for the program, notes how the program intentionally fosters that kind of thinking.

“It’s heavily rooted in principles of self-directed learning,” Dr. Kachra said.

“Recognizing that once they’ve graduated and are working as physician assistants, they’re going to come across knowledge they may not have learnt before, and it will be on them to learn and acquire that knowledge in order to provide optimal and excellent patient care.”

Dr. Kachra notes that the tasks physician assistants can undertake is much like that of a resident physician, only these assistants will be working full-time under a licensed physician.

“Physician assistants will always work within the supervision of a physician,” said Dr. Kachra.

“We know that in order to provide optimal patient care, we need to provide care in team settings.”

This year’s intake is expected to graduate in the spring of 2026.

1:51
Demand for more physician assistants in health care

&copy 2024 Global News, a division of Corus Entertainment Inc.