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Apr 21
Paediatricians to track infectious diseases in children
Parents can now expect planned long-term health management for their children. The Indian Academy of Paediatrics (IAP) are starting a surveillance project to track childhood diseases that can be prevented through vaccinations. The Infectious Disease Surveillance project will serve as a platform for paediatricians across India to report cases of children diagnosed with diseases such as pneumonia, chicken pox, mumps and dengue.

"It will help us to generate data on the spread of a disease and also help us to analyse the impact of existing vaccines on reducing the spread of a disease," said Dr Vijay Yewale, paediatrician and convener, IAP committee on immunisation. "For instance, there are vaccines for measles and pertussis - a highly contagious bacterial disease. Through the surveillance model, we can analyse the impact of the vaccine on reducing these diseases."

The project will target 9 diseases. The doctors can report cases either by logging onto the official website, sending an SMS or by calling up the integrated voice recognition system. It can help collect data on immunisation status of the patients. The reporting paediatrician will be sent a report on the cases reported by him on every week.

"Earlier, it was not possible to do the epidemiological analysis of these diseases," said Yewale.

The project served as an alert when it reported more than 70 measles cases in Gandhi Dham in Gujarat, a month ago.

"The data alerted the health authorities and culminated into a door-to-door survey," said Dr Naveen Thacker, a paediatrician.

Apr 20
Medical errors among top 10 killers: WHO
It is true that medicines save lives, but the same might not apply to every 300th patient being admitted to a hospital. According to the World Health Organization (WHO), one in 10 hospital admissions leads to an adverse event and one in 300 admissions in death.

Dr Nikhil Datar, a gynaecologist and health activist, was quoted as saying to a leading newspaper that "the brunt of this adverse event might range from a patient being asked to spend an extra day in the hospital or missing a dose of medicine. Unintended medical errors are a big threat to patient safety".

No Indian data is available on this topic, and the WHO has listed it among the top 10 killers in the world. While a British National Health System survey in 2009 reported that 15% of its patients were misdiagnosed, an American study published in the Journal of the American Medical Association in 2000 quantified this problem most effectively.

It said that there are 2,000 deaths every year from unnecessary surgery; 7,000 deaths from medication errors in hospitals; 20,000 from other errors in hospitals; 80,000 from infections in hospitals; and 106,000 deaths every year from non-error, adverse effects of medications. In all, 225,000 deaths occur per year in the US due to unintentional medical errors.

Further, pointing towards the medical error cases being registered in the West, Dr Datar mentioned "in the Western nations, it is believed that the incidence of unintentional medical errors is between 10% and 17% of all cases".

The Indian government after realizing this concept, set up the National Initiative on Patient Safety in the All-India Institute of Medical Sciences a couple of years back.

Dr Akhil Sangal of the Indian Confederation for Healthcare Accreditation told a newspaper that "the idea is not to apportion blame. When medical negligence occurs, the first question to be asked is who is to blame. We instead have to evolve to a system in which we ask questions about how, when and where the negligence occurred".

Apr 19
Pulitzer for US-Indian Siddhartha Mukherjee's book
Mukherjee's book, The Emperor of All Maladies, recounts the history of the disease and how the war against it is being fought by doctors.

The India-born doctor teaches medicine and is a cancer physician at Columbia University Medical Centre.

A Rhodes scholar, Mukherjee is also an award-winning science writer.

The Pulitzer award citation described The Emperor of All Maladies as "an elegant inquiry, at once clinical and personal, into the long history of an insidious disease that, despite treatment breakthroughs, still bedevils medical science".

The Pulitzer in the general non-fiction category carries an award of $10,000 (6,152 Pounds).

The critically-acclaimed book has been described as a "literary thriller with cancer as the protagonist".

Detailing the long history of the disease and the battles being fought to conquer it through case studies, the book also provides a glimpse into the future of cancer treatments.

"From the Persian Queen Atossa, whose Greek slave cut off her malignant breast, to the 19th-century recipients of primitive radiation and chemotherapy to Mukherjee's own leukaemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through fiercely demanding regimens in order to survive and to increase our understanding of this iconic disease," according to information about the book on the Pulitzer website.

The book, the site says, is a "magnificent, profoundly humane biography of cancer".

Apr 19
More effective schizophrenia cure promised
Schizophrenia, a serious mental disorder that affects tens of millions of people worldwide, can be tackled through the amino acid L-lysine, a study suggests.

Preliminary research shows that patients who received L-lysine alongside their normal medication found some reduction in the severity of their symptoms.

These include poor concentration and memory, apathy, or a reduced ability to cope with social situations, the journal BMC Medicine reports.

Study leader Caroline Wass, pharmacologist at the University of Gothenburg, Sweden, said: "This study suggests that L-lysine may be of benefit to patients in alleviating some of the negative and cognitive effects of schizophrenia."

In the study, a group of schizophrenic patients were given either six grams of L-Lysine or a placebo every day for four weeks, according to a Gothenburg statement.

Each of the patients had been on a stable dose of medication for the past three months and had been free from psychotic episodes for the two months before the study began.

They were tested for blood levels of lysine as well as the severity of their symptoms and functional ability at the start, after four, and after eight weeks.

The bulk of the patients responded to L-lysine treatment, as shown by an increase in blood lysine levels. Some of the patients reported that they felt an improvement.

Apr 18
Perception Of Intimacy Could Lie In Brain Chemical
Perception of intimacy could depend on the activity of serotonin, a brain chemical.

Understanding the powerful influence of such chemicals is important as supportive close relationships are known to protect against the development of mental illnesses and to promote recovery in those affected by psychiatric conditions. The opposite is also true: dysfunctional relationships can be triggers for those at risk of these conditions.

In the Oxford University research, two groups of volunteers were given amino acid drinks in order to manipulate blood concentrations of the amino acid tryptophan, a vital ingredient in the synthesis of serotonin. One group received drinks that contained tryptophan. The other group received drinks that did not contain tryptophan. They were then asked to make judgments about sets of photographs of couples. Differences in the judgments made by the two groups reflected changes in their serotonin activity.

"Serotonin is important in social behavior, and also plays a significant role in psychological disorders such as depression," explained Professor Robert Rogers who led the research. "We wanted to see whether serotonin activity influences the judgments we make about peoples' close personal relationships."

The volunteers who received the drink without tryptophan consistently rated the couples in the photos as being less 'intimate' and 'romantic' than the participants who received the control drink.

It is already known that serotonin function drops in episodes of depression, where the capacity for intimacy is often compromised.

Apr 18
Failure to Detect Sarcasm or Lies: A Sign of a Rare Dementia
It could be argued that a life free of lies and sarcasm would be a happier one. But the inability to recognize others' insincerity can also be hazardous - and a warning sign of a form of dementia.

Researchers have known for years that people with frontotemporal dementia - a type of dementia that affects the frontal and temporal lobes of the brain - often lose the ability to detect sarcasm and lies, while people who age normally don't experience this. (More on Photos: My Aging Father's Decline: A Son's Photo Journal)

Because frontotemporal dementia affects regions of the brain involved in complex, higher-order processes like personality and behavior, patients may show certain striking symptoms like behaving in compulsive, socially inappropriate ways or suddenly changing religions. They also become gullible, as evidenced by the many patients who lose money to hucksters and scammers online.

What a team of researchers from the University of California, San Francisco, wanted to find out was the strength of the association between frontotemporal dementia and the failure to identify insincerity or deception. Would these deficits show up in patients whose brains scans suggested the mental disorder? And would the link be strong enough to identify those at risk?

The researchers asked 175 older adults, more than half of whom had some form of dementia, to watch a video of two people speaking. One of the speakers occasionally lied or used sarcasm - made clear by verbal and non-verbal cues. Viewers were then asked a series of yes or no questions about what they saw. Researchers also took MRI scans of the participants' brains. (More on Brain Exercises Delay, But Can't Prevent, Dementia)

Mentally healthy older participants had no problem identifying the speaker's lies and sarcasm. But those whose brain scans showed signs of frontotemporal dementia were blind to the deception. People with other types of dementia, including Alzheimer's, performed somewhat better on the lie-detecting task.

The study's authors concluded that the inability to perceive lies or sarcasm may help doctors identify patients with dementia, especially since other early behavioral warning signs tend to be overlooked, misdiagnosed as symptoms of depression, mid-life crisis or Alzheimer's. (More on Alzheimer's: Largely a Woman's Issue)

"We have to find these people early," said senior author and UCSF neuropsychologist Katherine Rankin in a press release, noting that early detection offers the best chance for intervention and treatment.

Frontotemporal dementia is rare, making up perhaps 5% of patients with dementia; by comparison, Alzheimer's disease accounts for nearly 80% of such patients. Frontotemporal dementia tends to occur at a younger age than Alzheimer's, typically between the ages of 40 and 70. (More on Cover Story: Alzheimer's Unlocked)

"If somebody has strange behavior and they stop understanding things like sarcasm and lies, they should see a specialist who can make sure this is not the start of one of these diseases," said Rankin.

The findings were presented at the annual meeting of the American Academy of Neurology in Hawaii.

Apr 16
Genes that hold key to a long, healthy life identified
Scientists have identified eight genes, which could slow down the ageing process - and help people live longer, healthier lives.

The key to stop the distressing signs of ageing may lie in a steroid found in blood.

If scientists could alter how this steroid, known as DHEAS, works, then the ageing process could be slowed down, reports the Daily Express.

Until now, there has been no way of knowing what role the steroid plays in ageing.

Guangju Zhai, from King's College London, whose research team identified the eight vital genes, said the discovery will help scientists gauge how much the steroid is to blame.

"It has been a mystery how DHEAS functions," he said.

"This new research offers a new insight into how the body controls levels of DHEAS and why it dwindles with age."

Previous studies have shown that the steroid reaches a peak at around 25 or 30.

But as we get older, levels plummet. By the time we reach 85 years old it has diminished by 95%.

The steroid has been linked to diseases that occur as we age, such as diabetes and certain cancers. But it is not clear if it causes us to age, or is a by-product of ageing itself.

Two of the genes have already been linked to ageing and two others to age-related diseases.

Now the King's College team says it now needs to carry out more detailed studies on the other four genes.

The research team analysed DHEAS levels and 2.5million genetic variants in 14,846 people across Europe and the USA.

They found eight common genes that control the blood concentration of DHEAS and, importantly, some of these genes are associated with ageing and common age-related diseases such as Type 2 diabetes and lymphoma.

"For 50 years we have observed the most abundant circulating steroid in the body with no clue as to its role. Now its genes have shown us its importance in many parts of the ageing process," said professor Tim Spector, senior co-author from King's College.

The study is published in the journal PLoS Genetics.

Apr 15
Life stories, written in blood
Although it has been around for a long time, diagnosis of haemophilia still defeats doctors at times, with the result that some die with the condition undetected. It's not without reason that the medical fraternity is now beginning to feel that more awareness needs to be created about the rare disease, which strangely affects only men, while women remain carriers.

A bleeding disorder that doesn't allow the blood to clot normally, it means trouble for haemophiliacs, who need to extremely careful if they are injured as they may bleed for a longer time than others.

They could also suffer internal bleeding especially in the knees, ankles, and elbows , which may damage the organs, tissues and become life threatening.

Blood transfusion is usually a solution, but the cost is proving a deterrent. And so now the Haemophilia Society is requesting the state government to make blood factors 8 and 9 freely available to haemophiliacs as is being being done in Tamil Nadu and Delhi.

Its general secretary, Ranjana Ramachander says transfusion of blood clod factors costs anywhere between Rs.20,000 to Rs.1 lakh a month, and as of now only BPL card-holders are given the treatment free of cost in Karnataka.

The high cost of treatment clearly adds to the stress that patients and their families undergo, which by itself is quite distressing. "Once the father of a haemophilic child carried him straight out of the hospital with all the tubes attached to his body, to bring him to us and demand that we poison him using the same tubes as he couldn't see his son suffering," recalls Ms Ramachander.

The society is also concerned about the problems with diagnosis of the disease. "We still see cases of people dying of bleeding because doctors were not able to recognise that they were haemophilic and did not give them the right kind of treatment," says Dr Cecil Ross, haematologist, St. John's Hospital, admitting that there is still low awareness about the disorder even in the medical fraternity.

The Haemophilia Society ,which currently has around 700 registered members in the city and around 2,000 in the state, feels there could be many more out there who are not using its services to receive financial assistance and psycho social counselling, so essential in dealing with the disease. It would like to reach out to such people and tell them they are not alone.

Apr 15
1 million stillbirths preventable globally: report
Stillbirth losses affect at least 2.6 million families a year worldwide, but there are solutions, researchers say.

In Thursday's online issue of The Lancet, researchers from 50 organizations in 18 countries examine the unseen reality of stillbirth after 28 weeks or during the third trimester - "death just when a parent expects to welcome a new life," as the summary called it.

A map in the journal shows how most stillbirths -1.8 million or 66 per cent - happen in developing countries such as India, Pakistan, Nigeria, China, Bangladesh, Congo, Ethiopia, Indonesia, Afghanistan and Tanzania.

"It's a scandal there are so many stillbirths that can be prevented," said Joy Lawn, director of global evidence and policy at Save the Children in South Africa, who led the Lancet series.

She said the politics of public health has meant the stillbirths problem has been sidelined by maternal and child health programs, even though there are more stillbirths than children killed by AIDS and malaria combined.

Major causes of stillbirth include childbirth complications, maternal infections in pregnancy and disorders such as high blood pressure and diabetes in pregnancy, and fetal growth restriction, in which babies fail to grow at the proper rate.

In developing countries, better obstetric care, treatment of conditions such as syphilis and high blood pressure in women, and other strategies could save more than one million infants a year, the researchers concluded.

In developed countries such as Canada and Australia, an indigenous woman is about twice as likely as a non-indigenous woman to experience a stillbirth.

"The paper has pointed out significant risk factors, and a lot of these risk factors - smoking and obesity and dietary issues - all these would disproportionately affect Aboriginal women," said Dr. Malcolm King, scientific director of the Canadian Institutes of Health Research's Institute of Aboriginal People's Health in Edmonton.

"These would collectively account for a lot of the stillbirths reported," he added in a statement.

The vision is to offer culturally appropriate care and locally delivered services. Canada faces challenges of transporting women from the Arctic to southern centres when needed, which is disruptive and expensive, King noted.

Apr 14
Toddler First in World Diagnosed With Extra DNA Strand
A toddler from the U.K. is believed to be the only person in the world to be diagnosed with an extra strand of DNA - a condition so rare, doctors don't even have a name for it.

Alfie Clamp, from Warwickshire in northern England, has an "extra arm on his seventh chromosome.

Doctor discovered the extremely rare condition when Alfie, who was born blind and with severe disabilities, was just 6 weeks old.

A series of tests revealed the extra strand of DNA, which has left the medical world baffled. Doctors have no idea what his life expectancy will be or whether his condition will even improve.

The 2-year-old has digestive problems, needs drugs to help his body absorb nutrients and suffers spasms brought on by high temperatures and metabolic problems.

But his parents said despite his ordeal, their son means the world to them, and they are now concentrating on the simple things, the Daily Mail reported.

"When the doctors told us I was absolutely devastated," Alfie's mom, Gemma, said. "As a pregnant woman, you spend nine months thinking about what it will be like when your baby takes their first step or claps their hands. Having a boy like Alfie makes you appreciate the little things. He did't roll over until he was 18 months old, but we were so excited when he did."

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