Nov 14 2014 : The Times of India (Delhi)

`Diabetes could rob India of demographic dividend'

DurgeshNandan Jha

New Delhi:





The medical community has warned against serious financial implications from diabetes if the country does not act fast to tackle the spread of the disease. At about 65 million, India has the second highest number of diabetics in the world after China.Previously considered a disease of the affluent, diabetes has spread fast among the rural poor too, thanks to unhealthy diet and reduced physical activity. On the eve of World Diabetes Day on Thursday, experts said it is important to create awareness about preventive measures and provide support for regular screening of people at risk of developing the condition.
“The government needs to revisit its health promotion strategies for non-communicable diseases to increase awareness about simple and effective lifestyle changes, such as physical activity and healthy diet. Healthy food should be made available at affordable rates to make healthy choice an easy choice,“ WHO regional director Poonam Khetrapal Singh said. She said creating easy access to early diagnosis and management of diabetes is also required.
According to Dr Sujeet Jha, who heads the Institute of Endocrinology , Diabetes and Metabolism at Max hospital Saket, most patients get to know about the disease when it has already started affecting organs like the heart and kidney . “Regular health screening, particularly among the elderly and those at high risk is essential for early diagnosis,“ he said.
The Public Health Founda tion of India (PHFI), concluded in in a recent study that non-communicable diseases, mainly diabetes and heart diseases, affect people in their productive years. “They cause reduced productivity and early retirement. Also, they put immense pressure on public health expenditure as in most cases the treatment costs are higher compared to communicable diseases,“ said a senior doctor at PHFI.
He said the increasing burden of non-communicable diseases could rob India of the `demographic dividend' it is projected to reap on account of a predominantly young population. A recent report published by IRIS Knowledge Foundation in collaboration with UN-HABITAT states that by 2020, India is set to become the world's youngest country with 64% of its population in the working age group.

Medical curriculum to be revamped

The Medical Council of India is all set to revamp the country’s 58-year-old curriculum in medical education. The process includes incorporating the latest medical technology and teaching aids in subjects such as anatomy, pathology and biochemistry at the MBBS level and introduction of new specialities and super-specialities for post-graduation and beyond. The new curriculum and new courses are in the last stage of being finalized.

Furthermore, the council is also planning to obtain a copyright for the curriculum by June 2015. The curriculum will be distributed to medical colleges, which will be required to conduct teachers’ training for the next one year, and by 2016, medical undergraduates can move away from the curriculum established in 1956.

- See more at: http://digitallearning.eletsonline.com/2014/11/medical-curriculum-to-be-revamped/#sthash.GIcyXkP4.dpuf

World’s first dengue vaccine likely by 2015: Sanofi

The company said the vaccine gives a 95.5% protection against severe dengue and an 80.3% reduction in the risk of hospitalisation.

As India deals with increasing number of dengue cases, pharma major Sanofi on Tuesday said the world’s first vaccine against the mosquito-borne viral disease may be available by the second half of 2015.

Sanofi Pasteur, the French drugmaker’s vaccine unit, will file for registration of its vaccine candidate and subject to regulatory approval the world’s first dengue vaccine could be available by the second half of 2015, the company said in a statement.

Results of the last stage of the clinical study showed that the vaccine gives a 95.5 per cent protection against severe dengue and an 80.3 per cent reduction in the risk of hospitalisation, it said.

Dengue has been a serious challenge to public health as it affects lakhs of people annually in India, Sanofi said.

The company added that its phase III efficacy clinical study programme for the dengue vaccine candidate was conducted in over 31,000 participants across 10 endemic countries in Asia and Latin America.

“We plan to submit the vaccine for licences in 2015 in endemic countries where dengue is a public health priority,” Sanofi Pasteur president and CEO Olivier Charmeil said.

Sanofi Pasteur India head Stephan Barth said dengue is a serious health concern in India, causing a significant but under-reported burden.

“Over recent months we have seen a worrying increase in cases in many parts of the country, putting a huge strain on healthcare systems. India is part of Sanofi Pasteur’s global development strategy for dengue vaccine.

“Results of CYD 15 are very encouraging and in line with the results of the phase III study results in Asia and the Phase II study results in India,” he said.

Committed to dengue vaccine research for more than 20 years, Sanofi Pasteur aims to make the tropical ailment the next vaccine-preventable disease, Mr. Barth said.

US Government confirms first case of Ebola

The first case of Ebola diagnosed in the U.S. was confirmed on Tuesday in a patient who recently travelled from Liberia to Dallas — a sign of the far-reaching impact of the out-of-control epidemic in West Africa.

The unidentified man was critically ill and has been in isolation at Texas Health Presbyterian Hospital since Sunday, federal health officials said. They would not reveal his nationality or age.

Authorities have begun tracking down family and friends who may have had close contact with him and could be at risk for becoming ill. But officials said there are no other suspected cases in Texas.

At the Centers for Disease Control and Prevention, Director Tom Frieden said the man left Liberia on September 19, arrived the next day to visit relatives and started feeling ill four or five days later. He said it was not clear how the patient became infected.

There was no risk to any fellow airline passengers because the man had no symptoms when he was travelling, Mr. Frieden said. Ebola symptoms can include fever, muscle pain, vomiting and bleeding, and can appear as long as 21 days after exposure to the virus. The disease is not contagious until symptoms begin, and it takes close contact with bodily fluids to spread.

“The bottom line here is that I have no doubt we will control this importation, or this case of Ebola, so that it does not spread widely in this country,” Mr. Frieden told reporters. “It is certainly possible that someone who had contact with this individual, a family member or other individual, could develop Ebola in the coming weeks,” he added. “But there is no doubt in my mind that we will stop it here.”

In Washington, U.S. President Barack Obama was briefed about the diagnosis in a call from Mr. Frieden, the White House said.

Four American aid workers who became infected in West Africa have been flown back to the U.S. for treatment after they became sick. They were cared for in special isolation facilities at hospitals in Atlanta and Nebraska. Three have recovered.

Also, a U.S. doctor exposed to the virus in Sierra Leone is under observation in a similar facility at the National Institutes of Health. The U.S. has only four such isolation units. Asked whether the Texas patient would be moved to one of those specialty facilities, Mr. Frieden said there was no need and virtually any hospital can provide the proper care and infection control.

Dr. Edward Goodman, an epidemiologist at the hospital, said the U.S. was much better prepared to handle the disease than African hospitals, which are often short of doctors, gloves, gowns and masks. “We don’t have those problems. So we’re perfectly capable of taking care of this patient with no risk to other people,” Dr. Goodman said.

After arriving in the U.S. on September 20, the man began to develop symptoms last Wednesday and initially sought care two days later. But he was released. At the time, hospital officials did not know he had been in West Africa. He returned later as his condition worsened.

Blood tests by Texas health officials and the CDC separately confirmed an Ebola diagnosis on Tuesday.

State health officials described the patient as seriously ill. Dr. Goodman said he was able to communicate and was hungry.

The hospital is discussing if experimental treatments would be appropriate, Mr. Frieden said. Since the summer months, U.S. health officials have been preparing for the possibility that an individual traveller could unknowingly arrive with the infection. Health authorities have advised hospitals on how to prevent the virus from spreading within their facilities.

People boarding planes in the outbreak zone are checked for fever, but that does not guarantee that an infected person won’t get through. Liberia is one of the three hardest-hit countries in the epidemic, along with Sierra Leone and Guinea.

Ebola is believed to have sickened more than 6,500 people in West Africa, and more than 3,000 deaths have been linked to the disease, according to the World Health Organization. But even those tolls are probably underestimates, partially because there are not enough labs to test people for Ebola.

Two mobile Ebola labs staffed by American naval researchers arrived this weekend and will be operational this week, according to the U.S. Embassy in Monrovia. The labs will reduce the amount of time it takes to learn if a patient has Ebola from several days to a few hours. The U.S. military also delivered equipment to build a field hospital, originally designed to treat troops in combat zones. The 25-bed clinic will be staffed by American health workers and will treat doctors and nurses who have become infected.

The U.S. is planning to build 17 other clinics in Liberia and will help train more health workers to staff them. Britain has promised to help set up 700 treatment beds in Sierra Leone, and its military will build and staff a hospital in that country. France is sending a field hospital and doctors to Guinea.

Keywords: Ebola, Ebola virus, Ebola in the US, West African countries, Liberia, Sierra Leone, Guinea, Ebola outbreak

Sep 30 2014 : The Times of India (Delhi)

Heart disease is hitting Indians early: US study

Malathy Iyer

Mumbai:





In the Indian pool of heart patients, almost every second patient has high blood pressure, every fourth has diabetes and every fifth has plaque deposits in his her arteries. And Indians are getting heart problems almost a decade ahead of patients in western countries.This scientific picture of Indian heart diseases comes from the American College of Cardiology's newly setup study centres across India.
ACC is a not-for-profit medical association that works out guidelines for cardiac treatment which are in variably followed globally.
The ongoing study provided data of 85,295 patients who clocked 2.11 lakh visits to out-patient departments of 15 hospitals from Mumbai to Patna over the last 26 months. Of these patients, 60,836 were found to have heart disease. In capturing all-India data, this is one of the most scientific studies,“ said Dr Prafulla Kerkar, the head of Parel's KEM Hospital's cardiology department. He is also the chairperson of ACC's Pinnacle registry's India Quality Improvement Programme.
In the backdrop of World Heart Day on Monday , the ACC data underlines that the average age of a heart patient in India is 52 years. “If one looks at ACC's American registry, the average age is much higher in the sixties,“ said Dr Ganesh Kumar, cardiologist at Hiranandani Hospital in Powai and vice-chairperson of the study.
The ACC study for the first time shows how badly diabetes affects the Indian heart. It provides the breakup of the 13,077 patients with diabetes who visited the 15 centres a total of 35,441 times.
“Here, we found a doubling of the diseases. For instance, 32% of the diabetic patients had narrowed arteries or coronary artery disease. Almost 10% of them had heart failure and 70% had hypertension. The corresponding numbers for non-diabetic patients are half,“ said Dr Kumar. He said the actual number of diabetic patients with heart complications would run into millions.

WHO’s Heart Day advice: reduce salt intake

Sets target of 30% reduction by 2025

Cutting down on salt can lower the risk of developing heart disease and stroke, the World Health Organisation said on the eve of World Heart Day, targeting a 30 per cent reduction in salt intake in all supporting nations by 2025.

In a communiqué to all countries, the WHO asked stakeholders to take action against the overuse of salt by implementing its sodium reduction recommendations.

Pointing out that non-communicable diseases such as heart disease and stroke were the leading causes of premature deaths, the WHO wanted the governments to implement the “global action plan to reduce non-communicable diseases” that set nine targets, one being to reduce salt intake by a relative 30 per cent across the globe by 2025.

“If the target to reduce salt by 30 per cent globally by 2025 is achieved, millions of lives can be saved from heart disease, stroke and related conditions,” Oleg Chestnov, WHO Assistant Director-General for Non-communicable Diseases and Mental Health, said in a statement.

The WHO cautioned that consuming too much salt could lead to, or contribute to, hypertension, or high blood pressure, and greatly increase the risk of heart disease and stroke.

“On average, people consume around 10 grams of salt per day. This is around double the WHO-recommended level from all sources, including processed foods, readymade meals and food prepared at home. The WHO recommends that children aged two to 15 consume even less salt than this, adjusted to their energy requirements for growth,” the statement said.

Population health

Dr. Chestnov said reducing the salt intake was one of the most effective ways for countries to improve population health, and urged the food industry to work closely with the WHO and national governments to reduce the level of salt in food products incrementally.

Recommending strategies for individuals and families to reduce salt intake, the WHO suggested reading food labels when buying processed food to check salt levels; asking for products with less salt when buying prepared food; removing salt dispensers and bottled sauces from dining tables; limiting the amount of salt added in cooking to a total maximum amount a fifth of a teaspoon over the course of a day; and limiting frequent consumption of high salt products.

Keywords: World Heart Day, reduced salt intake

How corn plants defend against pathogen attack

Researchers from the North Carolina State University have identified crucial genes and cellular processes that appear to control the so-called hyper-sensitive defence response (HR) in corn.

The findings could help researchers build better defence responses in corn and other plants.

“It is similar to a human having an auto-immune response that never stops,” said Peter Balint-Kurti, a professor from the department of plant pathology and crop science at the North Carolina State University.

When corn plants come under attack from a pathogen, they sometimes respond by killing their own cells near the site of the attack, committing “cell suicide” to thwart further damage from the attacker.

It has so far been difficult to understand how the plant regulates this defence mechanism because the response is so quick and localised.

During the study, researchers examined over 3,300 maize plants that contained a similar mutation.

They found that 44 candidate genes appear to be involved in defence response and a few other responses linked to resisting attack.

“This mutation causes a corn plant to inappropriately trigger this hyper-sensitive defence response, causing spots on the corn plant as well as stunted growth,” added Balint-Kurti.

The researchers examined the entire corn gene blueprint to find the genes most closely associated with HR.

“Hopefully this work provides an opening to really characterise this important defence response and learn more about it in other plants,” Balint-Kurti concluded.

The study appeared in the journal PLoS Genetics.

Keywords: corn plants, PLoS Genetics, North Carolina State University, hyper-sensitive defence response, plant defence mechanism, cell suicide

Sep 04 2014 : The Times of India (Delhi)

HEALTH THREAT - Diabetes triggering India's TB burden, says WHO study

Kounteya Sinha

London





Diabetes has now been found to be fuelling India’s tuberculosis burden.India has the world’s highest diabetes patients and is also referred to as the world’s TB capital. Now, a study to be announced by the British medical journal Lancet on Thursday, reveal that India tops the list of countries with the highest estimated number of adult TB cases associated with diabetes.
New estimates produced reveal that the top 10 countries with the highest estimated number of adult TB cases associated with diabetes are India (302000), China (156000), South Africa (70 000), Indonesia (48000), Pakistan (43000), Bangladesh (36000), Philippines (29000), Russia (23000), Myanmar (21000) and Congo (19000). “These findings highlight the growing impact of diabetes on TB control in regions of the world where both diseases are prevalent,“ says author Dr Knut Lönnroth from the Global TB Programme at WHO in Geneva.
“TB control is being undermined by the growing number diabetes patients, which is expected to reach an astounding 592 million worldwide by 2035”.
The study indicates that 15% of adult TB cases worldwide are already attributable to diabetes. These diabetes-associated cases correspond to over 1 million cases a year, with more than 40% occurring in India and China alone. If diabetes continue to rise out of control, the downward trajectory in global TB cases could be offset by 8% or more by 2035, warn the authors.





Aug 06 2014 : Mirror (Pune)

Ants show the way to new antifungal drugs

Pune Mirror Bureau punemirror.feedback@gm TWEET @ThePuneMirror





Researchers are collecting samples of antifungal bacteria found on various species of Brazilian ants that could fight off everything ­ fungal and viral infections to cancer and Chagas disease

In the Atlantic Forest of Brazil, leaf-cutter ants carry fresh foliage back to their home colony. There, the partially digested leaves nourish a “garden“ of white fungus that the ants cultivate to feed their larvae, their queen and other ants that never leave the nest.Like human gardeners, the fungus-farming ants must protect their crop from invaders. The parasitic fungus Escovopsis poses a constant threat. Fortunately, the ants have an ally: Pseudonocardia bacteria. During more than 45 million years of symbiosis with the ants, the bacteria have evolved to produce specific antifungal compounds that kill invading Escovopsis while sparing the good fungus. The ants, meanwhile, have evolved special pockets and glands in their bodies to house and feed their bacterial partners.
A team of scientists from the US and Brazil hopes that studying the compounds these bacteria produce will lead to new drugs that combat invasive fungal infections in people, as well as new treatments for cancer and parasitic diseases.
The idea is rooted in history. Pseudonocardia belongs to a group of actinobacteria that has already provided most of the world's antibiotics as well as antifungals, antivirals, anti-clotting drugs and more. And the fungus they fight for the ants is related to fungi that cause life-threatening human disease. To date, no one has gone hunting for natural compounds in the fungusfarming ant ecosystems.
“I'm very excited. I think this project has a good chance of success, and I think it aligns ecology and drug discovery in a way that we haven't tried before,“ said Jon Clardy from the Harvard Medical School, who will co-lead the team with Monica Pupo of the University of Sao Paulo.
INCREDIBLE OPPORTUNITY
More than 200 kinds of fungus-farming ants live in South and Central America. Many of them make their homes in the diverse biomes of Brazil. Each colony may host a slightly different strain of bacteria that makes slightly different compounds to fight a slightly different invader. “We have an incredible opportunity to rigorously evaluate biodiversity in the context of therapeutic discovery and ecology,“ said Clardy.
The team's main focus will be discovering antifungal agents. The world is in desperate need of new antifungal medicines. Invasive fungal infections ­ those that spread inside the body, as opposed to superficial infections of the skin and nails ­ are on the rise, new strains are emerging and infections are getting resistant to drugs.
“Worldwide, more people die of invasive fungal diseases than die of malaria or tuberculosis,“ said Clardy. “What's scary is it's not widely appreciated how dangerous these diseases are because the incidence is quite low, but the mortality is typically very high.“
Aspergillosis, for example, may only affect about 2,00,000 people worldwide, but it has a mortality rate between 30 to 95 per cent. Fungal infections are a top cause of infection-related death in cancer and transplant patients.
In addition to antifungals, the team will look for natural products that could become anticancer drugs. Many chemotherapeutics act in a similar way to antifungals: They spare slowergrowing cells (like those of ants, beneficial fungi and humans) while killing faster-growing cells (like those of invading fungi and tumours). In fact, many chemotherapy drugs were originally developed as antifungals, including the immune suppressor rapamycin, which was found in soil-dwelling actinobacteria on Easter Island.
The team's third goal involves searching for antiparasitics to help treat Chagas disease, also known as the New World version of African sleeping sickness, and leishmaniasis, both of which the World Health Organisation has named neglected tropical diseases. Chagas disease is a particular burden in Brazil, where it kills as many each year as tuberculosis.

Jul 31 2014 : The Times of India (Delhi)

WATCH IT - Antibiotics used to boost growth in chicken: CSE





Each time you eat chicken, you could also be consuming a cocktail of antibiotics. A lab study released by Centre for Science and Environment (CSE) found antibiotic residues in 40% of chicken samples collected from Delhi and NCR outlets.While the amount of antibiotics found in each sample was not very high, experts said regular consumers of such meat could be in danger of developing antibiotic resistance. In other words, eating chicken with drug traces over a period of time could make you immune to impor tant antibiotics prescribed to treat common illnesses.
The study said it had evidence of large-scale and reckless use of antibiotics by poultry owners, which can also lead to antibiotic-resistant bacterial strains in the chicken itself.
CSE said it conducted the study after being alerted by doctors, including Bangalore-based cardiac surgeon Devi Shetty , about a rising trend of antibiotic resistance among patients.
CSE said 22.9% of the 70samples collected contained residues of one antibiotic while 17.1% had more than one.
chicken sample purchased from Gurgaon was found to have a cocktail of as many as three antibiotics.The CSE report, released on Wednesday, said poultry owners routinely pumped antibiotics into chicken during their short life of about 35 to 42 days, to promote growth so that they look bigger and also to treat or prevent infections. India has no law to regulate antibiotic use in the poultry sector.
CSE’s research team tested chicken samples at its Pollution Monitoring Laboratory. Three tissues in each sample were tested — muscle, kidney and liver.
Residues of five of the six antibiotics were found in all three tissues of the samples in the range of 3.37 to 131.75 micrograms per kg.
According to Dr Shetty, after a researcher conducted a study on antibiotic resistance at his hospital, they found about 10% of the patients to be resistant to common antibiotics.
“These are people who probably haven’t taken antibiotics before. They are villagers. We started thinking it could be caused from the food they are eating. That is why I approached CSE to do a study and now the data says it all,” he said on a live video chat from Bangalore during the presentation of the findings.
Dr Shetty also said that the likelihood of becoming antibiotic resistant after eating chicken depends on how often we eat chicken. “If you are eating poultry chicken on a daily
basis then you could be at a higher risk. That is why I asked my family to get only village reared chicken not the poultry ones,” he said.Dr Randeep Guleria, head pulmonary medicine at AIIMS said he wasn’t surprised that antibiotics were entering the food chain through poultry.
“The findings aren’t surprising. It’s a big concern and in the last few years after the NDM 1 superbug scare, the medical community has been raising concern about indiscriminate use of antibiotics in poultry and agriculture,” Dr Guleria said.
Said Chandra Bhushan, CSE’s deputy director general, “Our study is only the tip of the
iceberg. There are many more antibiotics that are rampantly used that the lab has not tested,” Bhushan said.When contacted by TOI, Union health minister Harsh Vardhan said he would react to the findings only after reading the entire lab report.
CSE also conducted a review of 13 research studies on antibiotic resistance (ABR) in India since 2002 and found that ABR levels were very high for ciprofloxacin and doxycycline, both used for illnesses such as diarrhoea, pneumonia, urinary tract infections and others.
High level residues of the same antibiotics were found in chicken samples tested by CSE. The problem according to CSE is compounded by the fact that antibiotics that are essential for humans are now being used in the poultry industry.

Jul 30 2014 : The Times of India (Delhi)

7-min run daily could add 3 years to your lifespan

Kounteya.Sinha @timesgroup.com

London:





A simple 7-minute run everyday can significantly cut the risk of a heart attack or death due to stroke.DC Lee, lead author of the study and an assistant professor in the Iowa State University said they found that runners who ran less than 51 minutes per week have the same mortality benefits compared to runners who ran more than three hours per week. The benefits were the same no matter how long, far, frequently or fast participants reported running.
Researchers studied 55,137 adults between the ages of 18 and 100 over a 15-year period to determine whether there is a relationship between running and longevity. Those who did run had a 30% lower risk of death from all causes and a 45% lower risk of death from heart disease or stroke. Runners on average lived three years longer compared to non-runners. The authors have therefore concluded that promoting running is as important as preventing smoking, obesity or hypertension.
Benefits were also the same regardless of sex, age, body mass index, health conditions, smoking status or alcohol use. The study showed that participants who ran less than 51 minutes, fewer than 6 miles, slower than 6
miles per hour, or only one to two times per week had a lower risk of dying compared to those who did not run.Thus, it is possible that the more may not be the better in relation to running and longevity.
“Since time is one of the strongest barriers to participate in physical activity, the study may motivate more people to start running and continue to run as an attainable health goal for mortality benefits,” Lee said. The optimum running speed was between 7.1mph and 7.6mph which cut the risk of dying from a heart attack or stroke by 60%, the study found.
For the full report, log on to http://www.timesofindia.com

Jul 26 2014 : The Economic Times (Delhi)

poke me - Not Death Before Life

Harmala Gupta





Euthanasia is premature when most people have no access to end-of-life care

It surprises those of us who look after people with life-limiting conditions that we are not asked more often to end lives.We do, occasionally , receive requests but have found that they quickly dissipate once the precipitating crisis is dealt with: unaddressed physical pain, a feeling of guilt or loss of meaning. Why is this so?
By and large in India, it is families and not individuals who take decisions about their lives, including medical ones. Nowhere is this more evident than when the diagnosis is a lifelimiting one like cancer. The patient's diagnosis and prognosis, the details of the treatment to be followed, etc, are generally kept away from the patient and discussed by doctors with those who are perceived as the main decision-makers in the family .
Patients, too, seem to be happy to play along as not only do they believe that the family and the doctor will do what is in their best interest, but also because they feel that since the brunt of expenses and the burden of care will have to be borne by the family , it would be churlish for them to insist on their individual right to know.
In these circumstances, where the individual affected is not the decision-maker and is not in full control of information regarding his or her illness, legalising euthanasia is out of the question. It cannot be a decision taken by someone else on your behalf when you are up and able. Not all families are happy families and not all doctors are wedded to the Hippocratic oath.
The second reason why our patients, who are often at the end-of-life and of their tether, do not ask for euthanasia is because our teams of doctors, nurses and counsellors are skilled professionals who have the medicines and competence to bring immediate relief and alleviate unnecessary suffering. They are trained in a sub-speciality known as palliative care that is not confined to symptom control alone but includes hands-on nursing and training of caregivers in simple nursing tasks.
When Care is Aspirational
The counsellor on the team seeks to prioritise the most pressing psychosocial and economic concerns to help patients and their families feel less helpless and regain a sense of control over their lives. This care and support continues till the end-of-life for the patient and post-bereavement for the family . Unfortunately , however, our patients are the lucky few, for the vast majority , palliative care is a bridge too far.
Once again, the call for euthanasia is premature in a country where people with chronic, debilitating and life-limiting illnesses have no access to end-of-life care that is appropriate, affordable and can be delivered at their place of choice, usually the home. Instead, the reality is that if they live in a city , they are likely to be shunted into a critical care unit and at some stage, put on life support, which further compounds their misery as well as that of their families. For those who cannot afford such care, it is back to the village to die without any kind of supportive care to ease their pain and suffering.
Surely , the answer lies in increasing access to palliative care by train ing more personnel and providing them with the necessary wherewith al and backup? This is not expensive care as it does not require prolonged hospitalisation or sophisticated int erventions. All it needs is good symp tom-control and compassionate care that respects the dying process and the right of the patient to continue to live with dignity .
Life Cycle
For this to happen, society , including doctors, medical bodies and lawmak ers, must first accept that death is na tural and that there is something cal led the dying process. Efforts should focus on facilitating it in a manner that does not make it grotesque, dis tasteful and something to be feared.
Doctors must have the latitude to take decisions, such as removing life support, or refusing to initiate intru sive measures that they consider fu tile without fear of legal censure.
This is not physician-assisted eu thanasia as the intention is not to kill the patient but to do what doctors are sworn to do: to cause the least harm and do what will benefit the patient the most under the circumstances.
Missing Critical Care For this to happen seamlessly , a palliative care team trained in end-of-life care needs to be at hand to support the treating team and to counsel and prepare families. The Indian Critical Care Society and the Indian Association of Palliative Care have already jointly initiated this process and it is to be hoped that their recommendations will be considered seriously by the government.
The euthanasia debate is both premature and inappropriate for India.
A vast majority of our population does not, at present, has access to humane end-of-life care. Moreover, as long as families and doctors follow a “do-not-tell-the-patient“ policy , offering euthanasia as an option is simply a non-starter.
The writer is founder-president, CanSupport

Jul 21 2014 : The Times of India (Delhi)

Camel milk: Can’t get over the hump

Anindo.Dey @timesgroup.com





Globally, camel milk is getting superfood status. But back home, its sale is still illegal. Lifting the ban may be the only way to save the ship of the desert

During a malaria outbreak, members of Rajasthan’s Rebari community have a unique remedy: camel milk.“Ten to twelve days of camel milk cures the person,” says Anand Singh Bhati, a member of Rajasthan’s camelrearing community of Rebaris who owns about 200 of the ungainly animals.
Even as the world gets pumped up about its health benefits – Time magazine recently reported that packaged camel milk is now available at Whole Foods supermarket in the US, while Dubai has been marketing everything from camel lattes to camel chocolates – the Rajasthan government has only now woken up to its potential. After giving the camel the status of state animal, it is now trying to get the sale of its milk in India legalized. The Bikaner-based National Research Centre on Camel (NRCC) has approached the Food Safety and Standards Authority of India (FSSAI) to authorize its sale. Abhay Kumar, principal secretary, state animal husbandry department, says, “We have decided to extend our support to NRCC so that camel milk is recognized by the law. It is surprising that
Rebaris have been consuming it for decades but it still hasn’t been legitimized,” he adds.Hanwant Singh Rathore of Lokhit Pashu Palak Santhan, a Rajasthan-based NGO that promotes the camel and
its produce, is confident that demand for milk will go up with the certification. “People are aware of the therapeutic value of camel's milk and want to buy it but we are bound by the law not to sell,“ says Rathore. “Currently, 3,000 to 4,000 litres of camel milk end up with roadside tea stalls or milk producers in Udaipur, Chittorgarh and Bhilwara regions who mix it with cow and buffalo milk as it's cheaper.“While camel milk was once popular for its therapeutic qualities, things soured in the late 90s, when the Rajasthan High Court ruled it wasn't fit for human consumption. In 2000, the Supreme Court overturned the ruling but despite efforts by various milk co-operatives and self-help groups to promote it, the FSSAI refused to legitimize its sale.
But the Rebari community has continued to consume the milk, which it claims has kept them free of diabetes. While they earn a living out of camel hide and handicraft items made of camel bone, they have never sold the milk because of an ancient superstition which says the camel will die if they do. However NRCC, which has its own camels, not only sells milk from the premises of the institute in Bikaner, but also items like flavoured milk, tea, coffee, kulfi, milk powder, soft cheese, peda, barfi, paneer, butter, ghee and gulab jamun made from it.
Legalizing sale of milk may also boost the declining camel population which experts say has fallen from 500,000 to 200,000 in the state.
With demand for camel transportation dwindling, herders no longer find it economically viable to raise these animals except for meat, says Rathore. “The Rajasthan government has taken the first step by giving camel state animal status but that may not be enough. It is imperative that the milk is recognized by the law so that it can be sold. Only then will the animal survive.”

Jun 27 2014 : The Times of India (Delhi)

Brain implant helps paralysed man move his hand using thoughts

Washington PTI





Ian Burkhart in the US is the first patient to use Neurobridge, an electronic neural bypass for spinal cord injuries that reconnects the brain directly to muscles, allowing voluntary and functional control of a paralysed limb

For the first time, a 23year-old paralysed man from US has been able to move his hand using his thoughts, thanks to an innovative device that bypasses the injured site.
Ian Burkhart, from Dublin, Ohio, is the first patient to use Neurobridge, an electronic neural bypass for spinal cord injuries that reconnects the brain directly to muscles, allowing voluntary and functional control of a paralysed limb.Burkhart is the first of a potential five participants in a clinical study by the Ohio State University Wexner Medical Centre and Battelle. “It's much like a heart bypass, but instead of bypassing blood, we are actually bypassing electrical signals,“ said Chad Bouton, research leader at Battelle. “We're tak ing those signals from the brain, going around the injury , and actually going directly to the muscles,“ said Bouton. The Neurobridge technology combines algorithms that learn and decode the user's brain activity and a high-definition muscle stimulation sleeve that translates neural impulses from the brain and transmits new signals to the paralysed limb. Ian's brain signals bypass his injured spinal cord and move his hand, hence the name Neurobridge.
Burkhart was paralysed four years ago during a diving accident.
During a three-hour surgery on April 22, Ohio State neuroscience researcher Dr Ali Rezai implanted a chip smaller than a pea onto the motor cortex of Burkhart's brain.
The tiny chip interprets brain signals and sends them to a computer, which recodes and sends them to the high-definition electrode stimulation sleeve that stimulates the proper muscles to execute his desired movements. Within a tenth of a second, Burkhart's thoughts are translated into action.





Jun 24 2014 : Mirror (Pune)

Scientists explain stress-heart attack link

PARIS AFP





Scientists may have unravelled how chronic stress leads to heart attack and stroke: triggering overproduction of disease-fighting white blood cells which can be harmful in excess. Surplus cells clump together on the inner walls of arteries, restricting blood flow and forming clots that block circulation or break off and travel to other parts of the body.White blood cells “are important to fight infection and healing, but if you have too many of them, or they are in the wrong place, they can be harmful,” said study co-author
Matthias Nahrendorf of the Harvard Medical School in Boston. Doctors have long known that chronic stress leads to cardiovascular disease, but have not understood the mechanism.To find the link, Nahrendorf and a team studied 29 medical residents working in an intensive care unit. Their work environment is considered a model for chronic stress exposure given the fast pace and heavy responsibility they carry for life-and-death decisions.
Comparing blood samples taken during
work hours and off duty, as well as the results of stress perception questionnaires, the researchers found a link between stress and the immune system. Particularly, they noticed stress activate bone marrow stem cells, which in turn triggered overproduction of white blood cells, also called leukocytes. White blood cells, crucial in wound healing and fighting off infection, can turn against their host, with devastating consequences for people with diseases like atherosclerosis ­ a thickening of artery walls caused by a plaque buildup.

Jun 19 2014 : Mirror (Pune)

Snakebite-inundated rural PHCs find new saviour in Ayurveda

Nozia.Sayyed





As govt struggles with anti-venom supply, Ayurvedic tablet miraculously saves woman in Satara PHC, prompting Health Director to make it available across rural Maharashtra

When a 40-year-old female farmhand from rural Malharpeth in Satara was rushed to the area’s Primary Healthcare Centre (PHC) around one month ago, her chances of survival had already almost completely diminished — having suffered the bite of an extremely venomous Krait while working in a farm, she had been found unconscious and rushed to medical care, but was given only 20 minutes to live by local medical experts. In a last ditch attempt to save her life, an oral ayurvedic tablet — ‘Pinak’ — was administered.Miraculously, the woman began responding within no time, and her life was saved.
The exemplary incident sparked the interest of State Health Director Dr Satish Pawar, who is now involved in a bid to make the life-saving tablet available in the around 1,900 PHCs across Maharashtra. On Wednesday, Pawar confirmed, “We are planning to make this tablet available in all state PHCs in a month or two. After several meetings with Ayurveda experts, we realised that unlike Anti Snake Venom (ASV), which is compulsorily administered by experts or doctors, this tablet can be administered by anybody, like an Auxiliary Nurse Midwife (ANM) — this reduces the usage of and dependency on ASVs, as the tablet is handy and will be soon ubiquitous.” Elaborating on the incident, Malharpeth PHC medical officer Dr Rashmi Kulkarni, told Mirror, “The middle-aged patient was brought to us in an unconscious state and had just about 20 minutes left to live, as the poison had already spread through her system.
Moreover, since ASV injections were unavailable at that time, we were helpless. We had no choice but to call up Ayurveda expert Dr Geeta Pawar who had worked with Sassoon hospital and co-invented Pinak, which we had at the PHC.” She continued, “On her instructions, we immediately kept two tablets under the tongue of the patient — to our absolute surprise, the patient started responding 12 minutes later! We later sent a detailed report to the State Health Director, so that in cases where ASVs — which are often in short supply — are not available, this oral Ayurveda tablet with no side effects can be administered.” Kulkarni added that this is the first time an Ayurveda tablet had been known to replace an ASV.
State Deputy Director of Health Services, Dr Pandurang Pawar, said, “There are several remote areas — including the like of Ambegaon, Khed, Junnar,
Velha, Nandurbar, Gadchiroli, etc. -where snakebites are still frequently reported, and deaths due to delays in reaching hospital are common. ASVs are also often not available, and quite costly too, with each injection priced at around Rs 4-8,000. On the other hand, an Ayurveda tablet costs around Rs 400, and is much more easily available.“Dr Ashok Nandapurkar, a civil surgeon at Aundh Civil Hospital who also heads 21 rural hospitals in the state, told Mirror, “Shortages of ASVs are rampant -annually, we need almost 10,000 vials of ASVs per annum, and since only one pharma company, Haffkine, manufactures them in association with the State, we regularly experience shortages. In cases of snakebite -specially from a snake like the Krait -a neuroparalytic attack is imminent, and death is an almost 100 per cent guarantee; but for an Ayurveda tablet that is easy to administer. Treatment modules for snakebites are also something that are often missing -I myself have administered almost 60 ASV injections to one patient who suffered from a snakebite; in contrast, just giving two oral tablets seems very effective. This will not only save time, but also government expenditure.“
Pinak co-inventor Dr Geeta Pawar said, “Pinak was invented when I was heading the Ayurveda department at Sassoon General Hospital in 2005. It is a curative not only in cases of snakebite victims, but also works on scorpion and honeybee stings. Since it is purely herbal, there are no recorded adverse effects caused by this tablet. The clinical trial of this tablet took place at Sassoon in 20072008, when 30 snakebite victims reacted positively to it, and were literally saved by its administration.“
She added, “The tablet came about when we noticed a severe adverse reaction and worsening of a paralytic attack caused by ASV administration in a patient at a Karad PHC. Thereafter, it was our effort to create a drug that would not only save patients instantly, but would also have no side effects at all.“

New tech can trace back DNA 1,000 yrs

Kounteya Sinha TNN

London: A new ground breaking technique has been developed which can locate the village your ancestors lived 1,000 years ago and hence trace back DNA formation. Previously, scientists had been able to link DNA formation to within a 700 km area which in a continent like Europe is very unreliable.
    The Geographic Population Structure (GPS) tool created by Eran Elhaik from the University of Sheffield and Tatiana Tatarinova from the University of Southern California works similarly to a satellite navigation system. The new technique has been 98% successful in locating worldwide populations to their right geographic regions down to their village and/or island of origin.
    The breakthrough has massive implications for life-saving personalized medicine, advancing forensic science and for the study of populations whose ancestral origins are under debate such as African Americans, Roma gypsies and European Jews. Genetic admixture occurs when individuals from two or more previously separated populations interbreed. This results in the creation of a new gene pool representing a mixture of the founder gene pools.
    Elhaik said, “What we have discovered here is a way to find not where you were born but where your DNA was formed up to 1,000 years ago by modelling these admixture processes. What is remarkable is that we can do this so accurately that we can locate the village where your ancestors lived hundreds and hundreds of years ago — until now this has never been possible.”
    Such processes were extremely common in history during migrations and invasions.
    Discovery of a certain genotype might indicate the potential for a genetic disease and suggest that diagnostic testing be done. Also as scientists learn more about personalized medicine there is evidence that specific genotypes respond differently to medications — making this information potentially useful when selecting the most effective therapy and appropriate dosage.

RETRACING ANCESTORS 

Source:  http://epaper.timesofindia.com/Default/Scripting/ArticleWin.asp?From=Archive&Source=Page&Skin=TOINEW&BaseHref=CAP/2014/05/02&PageLabel=23&EntityId=Ar02301&ViewMode=HTML