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Jul 05
Dietary guidelines for New Age Indian
A change in socio-economic status generally brings change in food habits, which then gets reflected in the changed disease profile. "Indian consumers are increasingly taking to packaged food due to accessibility, affordability and attractive marketing," said Dr B Sesikeran, director, National Institute of Nutrition.

Addressing a conference on National Priorities in Nutrition Research here on Monday, Dr Sesikiran added, "The incidence of diabetes has nearly doubled among the rural population over the last decade which is more than that observed in the urban populace."

A book of revised Dietary Guidelines for Indians, was released on the occasion, which reveals the increase in lifestyle-related diseases among both the urban and rural population.

Dr Sesikeran said the book meant for the general public, monitors the shifting profile of nutrition-related diseases over time. "The data presented indicates that the average blood pressure has increased in Indians due to increased consumption of processed foods and snacks," said the director.

A new guideline has been specifically included about 'regular physical activity', keeping in mind the increasingly sedentary lifestyle being followed. The upper limit for Body Mass Index (BMI) which determines whether a person is considered obese has been lowered from 25 to 23, as Asians are at a higher risk of obesity and cardiac arrests at marginally high BMIs, he added.

However, the new-found affluence has failed to trickle down to those at the bottom, as the poor remain calorie-deficient and incidence of anaemia among children and pregnant women has increased.

He said the book recommends an increase in fat intake by 20 percent than what it was in 1998. "The book also recommends increase in calcium intake for children and adolescents to 600-800 mg per day considering under-nutrition and stunted growth still prevails," added Dr Sesikeran.

Jul 05
Rush for medical seats begins
The admission process for government medical colleges began on Monday at the Sir JJ Hospital campus. Around 1,92,685 students will be competing for 9,000 seats spread across a broad range of courses, including MBBS (Bachelor of Medicine and Bachelor of Surgery), Dental, Ayurveda, Homeopathy and Unani medicine.

The admission process, conducted by the Directorate of Medical Education and Research (DMER), will continue for nine days till July 12.Students who have cleared the MHT-CET 2011 are eligible for admission.

On the first day, students who figured in the state merit list between 1 to 900, were invited to take admission into their preferred course and college.

Apart from the Mumbai centre, admissions are ongoing at three other centres across the state - BJ Medical College in Pune, Government Medical College in Aurangabad and Government Medical College at Nagpur. Students from Mumbai city and the suburbs, Thane, Raigad, Ratnagiri and Sindhudurg must come to the Mumbai centre.

Dr Pravin Shingare joint director, DMER, said, "During the process, we counselled students on how to fill up the form while checking and verifying documents. After the submission of the form, we give an acknowledgement copy to the student. We have deputed more than 100 officials to conduct the admission process in our four centres and guide students at every step."

Each student takes an average of two hours to complete the formality of filling and submitting the form.

According to a senior official from JJ hospital, the admission process on Monday was relatively lighter than what's expected in days to come, since the brightest students come on the first day and get admission into medical colleges for MBBS courses.

Each student can fill 60 choices of colleges in the preference form. The DMER official asks students to take their time to file their preferences and also suggest using a dummy form before ticking the boxes on the final form.

Jul 04
Treatment Approach To Human Usher Syndrome
New treatment approach shall soon be ready for use in Usher syndrome patients / Publication in "Human Gene Therapy".

Usher syndrome is the most common form of combined congenital deaf-blindness in humans and affects 1 in 6,000 of the population. It is a recessive inherited disease that is both clinically and genetically heterogeneous. In the most severe cases, patients are born deaf and begin to suffer from a degeneration of the retina in puberty, ultimately resulting in complete blindness. These patients experience major problems in their day-to-day life. While hearing loss can be compensated for with hearing aids and cochlea implants, it has not proven possible to develop a treatment for the associated sight loss to date. Researchers at Johannes Gutenberg University Mainz (JGU) in Germany have now developed a new treatment approach to this disease.

In previously conducted research into this subject, the research team headed by Professor Uwe Wolfrum of the Institute of Zoology at Mainz University had already gained insight into of the fundamental molecular processes and mechanisms causing this debilitating syndrome. Using the results of this successful basic research, the Usher treatment team in Mainz headed by Dr Kerstin Nagel-Wolfrum has now evaluated potential ocular treatment options. Their attention was focused on a mutation identified in a specific German family known to develop the most severe form of Usher syndrome. This mutation is a so-called nonsense mutation in the USH1C gene, which leads to the generation of a stop signal in a DNA base, resulting in premature termination of protein synthesis.

The Mainz research team has now published its latest work on pharmacogenetic strategies for the treatment of Usher syndrome patients with nonsense mutations in the May edition of the journal "Human Gene Therapy". The researchers were able to show that a small molecule known as PTC124 (Ataluren) causes the stop signal in the mutated USH1C gene to be ignored, thus resulting in continuing protein synthesis and the formation of the functional genetic product in cell and organ cultures. In addition to its ability to cause readthrough of stop signals, the active agent PTC124 has also been demonstrated to be highly compatible with murine and human retina cultures. Moreover, the team managed for the first time to demonstrate readthrough of an eye mutation codon in vivo.

"PTC124 is already being tested in clinical trials for its efficacy in treating other diseases involving nonsense mutations, such as cystic fibrosis and Duchenne muscular dystrophy. We therefore hope that this treatment approach will soon be ready for use in Usher syndrome patients," explains Dr Kerstin Nagel-Wolfrum.

Currently putting the finishing touches on his doctoral thesis, Tobias Goldmann is comparing the efficiency of the readthrough rate and the biocompatibility of other molecules that induce the readthrough of nonsense mutations. The focus is particularly on modified aminoglycosides, i.e. derivatives of commercially available and clinically tested antibiotics. These are being designed and synthesized by an Israeli cooperation partner, Professor Timor Bassov of the Haifa Technicon, and have already been successfully used by researchers in Mainz for readthrough of nonsense mutations in Usher genes. In addition to conducting further preclinical studies of the ocular applications of these new substances, the Usher laboratory in Mainz is planning to use this new method of treating this specific form of Usher syndrome in hospital patients as soon as possible.

Jul 04
digg Study Sheds New Light on HIV
New research may help explain why some patients with HIV experience neurological problems. Investigators have found that HIV weakens the blood-brain barrier -- a network of blood vessels that keeps potentially harmful chemicals and toxins out of the brain.

Standard antiretroviral treatments suppress the replication of HIV and slow its progression. However, recent studies reveal that 40 to 60 percent of patients on these therapies continue to experience mild to moderate neurological deficits such as memory loss and learning challenges.

In this new study, researchers found that HIV infection in a small number of supporting brain cells -- called astrocytes -- breaks down the blood-brain barrier, despite low to undetectable viral production. Normally, astrocytes help bolster the blood vessels comprising the barrier.

"Researchers have been stymied to explain why HIV-associated neurological complications persist, despite potent combination antiviral therapies that have dramatically improved health and survival," Igor Grant, an expert who studies HIV-associated neurocognitive impairment at the University of California, San Diego, was quoted as saying.

"This study provides a possible explanation indicating that minute numbers of infected astrocytes can trigger a cascade of signals that could open the brain to various toxic influences."

The investigators say these findings open up the possibility of developing new treatment approaches that block or modify the transmission of signals from the HIV-infected astrocytes.

Jul 02
Snacking clue to obesity epidemic
Snacking and super sizing are two of the dieter's worst enemies, research suggests.

The average daily calorie intake in the US has increased by almost a third in 30 years, reaching 2,374 kilocalories.

The influence of bigger portion sizes and excessive snacking outweighs the shift towards high-calorie foods, say experts.

Focusing on reducing how much and how often people eat could help tackle obesity, they report in PLoS Medicine.

Obesity levels have risen sharply in many Western countries since the 1970s. In the US, where the study was carried out, a third of all adults - more than 72 million people - are now categorised as obese.

A team from the University of North Carolina analysed data from food surveys carried out in the seventies, eighties, nineties and the last decade. The surveys record all food and drink a person consumes over a 24-hour period. The average daily energy intake of a US citizen increased from 1,803 kcal in 1977-78 to 2,374 kcal in 2003-06. In the last decade of the study alone, the average daily calorie intake went up by 229 kcal.

Several factors are involved in energy intake - the number of calories (energy) in a specific amount of food (energy density), portion size and how many meals and snacks a day eaten. The researchers say that while all of these have gone up, increases in the number of eating occasions and portion size seem to account for most of the change.

They suggest efforts to prevent obesity should focus on reducing the number of snacks and meals a day as well as portion size.

"These findings suggest a new focus for efforts to reduce energy imbalances in US adults," write Kiyah Duffey and Barry Popkin of the University of North Carolina in the journal PloS Medicine.

Commenting on the paper, Dr Aine O'Connor, a scientist at the British Nutrition Foundation said: "Many factors influence total energy intake that can lead to [being] overweight and obesity but it is possible that having more eating occasions through the day, for example by frequent snacking, would increase calorie consumption and so lead to weight gain.

"This study also looked at portion size and studies have shown that having larger portions of food leads to an increased intake.

"The researchers were based in the US, but many of the factors causing the obesity epidemic there are mirrored in the UK and, for those trying to control their weight, it is important to manage both how much and how often they eat."

Jul 01
11-kg tumour removed from teen's abdomen
In a rare and complex surgery, an 11-kg tumour was removed from the abdomen of a teenage Kenyan girl at the Asian institute of Gastroenterology.

Interestingly, using the new cell-saver technology, most of the blood that was lost during the surgery, was sucked back in. The blood cells were cleansed, warmed, processed and transfused back into the girl while the AIG staff and donors donated their blood products to compensate for 13 litres of blood lost.

The 17-year-old orphan girl, Ms Vincencia Awuor, from Embakasi Garrison Secondary School, in Nairobi, Kenya, had a huge liver tumor. This had bloated her abdomen and she had been stigmatized since 2008 as her classmates thought she was pregnant. The increasing size of her abdomen even restricted her movement.

Ms Awuor was treated at various medical centres in Kenya and there was an attempt to remove the tumour surgically. However, due to massive bleeding, the surgery was abandoned.

Ms Awuor's uncle, Mr Martin Awuor, came to AIG about three weeks ago after hearing about the institute from other Kenyans. On June 16, the girl underwent the complex surgery to get rid of the tumour.

"It was a non-cancerous benign hamartoma tumour. Two large incisions had to be made for the surgery," said Dr D. Nageshwar Reddy, the chairman and chief of gastroenterology at AIG.

"I was confident of a successful surgery," said Ms Awuor, who aspires to become a doctor and serve at AIG someday.

Jun 30
Laughter lights up our faces, brains
Our brains as well as our faces virtually 'light up', especially when we laugh on hearing or seeing something funny.

The more hilarious a joke is, the greater the activity seen in 'reward centres', specific neurons (nerve and brain cells) which create feelings of pleasure.

And learning how humour affects the brain could help determine whether patients in a vegetative state experience positive emotions, the Journal of Neuroscience reports.

A team of Medical Research Council (MRC) scientists scanned the brains of volunteers to compare what happened when they heard ordinary sentences and jokes. This showed that the reward centres 'lit up' much more in response to humour, according to the Daily Mail.

Researcher Matt Davis, from the MRC Cognition and Brain Sciences Unit in Cambridge, said: "We found a characteristic pattern of brain activity when the jokes used were puns."

"For example, jokes like "Why don't cannibals eat clowns? Because they taste funny!" involved brain areas for language processing more than jokes that didn't involve wordplay.

"This response differed again from non-humorous sentences that also contained words with more than one meaning," said Davis.

"Mapping how the brain processes jokes and sentences shows how language contributes to the pleasure of getting a joke."

"We can use this as a benchmark for understanding how people who cannot communicate normally react to jokes," added Davis.

Jun 29
Swine flu strikes back
The dreaded H1N1 virus that has claimed many lives over the past two years, has reared its ugly head once again in Mumbai

Yesterday, two Mumbaikars tested positive for the virus. After throat swabs were sent to Haffkine institute, pathological tests conducted on the samples diagnosed that the swine flu virus had infected a 37-year-old woman from Chandivli and a three-year-old girl.

The two diagnoses follow close on the heels of similar cases in Pune and Nashik. Alarmed by the re-emergence of the disease, the state health department had a closed-door meeting with experts last morning at the Mantralaya to think of measures that can safeguard the city from another pandemic.

Once may recollect at that the state health department had issued detailed precautionary guidelines to be adopted when the outbreak of the disease assumed the pandemic proportions two years back.

The state had even roped in private hospitals, which had prepared special quarantine wards for those afflicted with the disease.

Dr Abhay Chaudhary, director of Haffkine institute, said, "We have received samples from two city hospitals.

Tests were conducted in our Bio Safety level (BSL) 2 + labs, and the samples tested positive for the H1N1 virus. There is no use panicking, as the virus is here to stay.

It is an air-borne disease, and the weather is conducive to the multiplication and spread of the virus. There are bound to be more cases."

Dr Chaudhary added that the Haffkine Institute had started screening patients with severe acute respiratory illnesses in all outpatient departments (OPDs) of city hospitals in order to study the virus strains circulating in the city

Jun 28
Diastolic Dysfunction Of The Heart Associated With Increased Mortality Risk
A new report published in the June 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals, suggests that diastolic dysfunction maybe an independent risk factor for increased risk of death. Diastolic dysfunction leads to an impaired relaxation of the ventricles, the pumping chambers of the heart, after contraction. This increased risk is independent of whether the patient has normal or abnormal systolic function. Systolic function is the ability of the heart to contract and push blood to the body. This risk seems to be also independent of whether the patient has any other cardiovascular abnormalities.

Each heartbeat has a systolic component and a diastolic component. The heart first contracts and pumps blood out of the ventricular chambers (Systolic phase) and then goes through a phase of relaxation which allows blood to refill the ventricles (Diastolic Phase). According to this report, even when the systolic function is normal, diastolic dysfunction (DD) has been associated with an increased risk of death from cardiovascular and other reasons. The researchers in this study attempted to determine if the mortality risk associated with DD was an independent risk factor for increased risk for death in the presence of a normal systolic function. They also set out to determine whether this held true for milder cases of DD as well. The researchers began to understand the clinical relevance of the presence of diastolic dysfunction and degree of DD in patients who had normal ejection fraction who underwent outpatient echocardiography. They used echocardiography since it is one of the most common cardiac non-invasive imaging tests in the United States.

Researchers from the Cleveland Clinic that included Dr. Carmel M. Halley, MD and his colleagues studied clinical records and electrocardiograms of 36,261 patients who had attended the Cleveland Clinic between 1996 and 2005 and had demonstrated a normal systolic function. The researchers then started collecting information on diastolic function in these patients, if any. If DD was found, it was graded as mild, moderate or severe.

The researchers determined rates of cardiovascular disease in the study population. This included congestive heart failure (3.5 percent), coronary artery disease (0.6 percent) and peripheral vascular disease (1.1 percent). DD was found in most of the patients that were studied. A total of 65.2 percent of patients had some degree of DD. When graded, it was revealed that 60.0 percent had mild DD, 4.8 percent had moderate DD, and 0.6 percent had severe DD. These patients were followed for an average of 6.2 years. During the follow up phase, 5,789 deaths occurred. It was found that the adjusted mortality rate was higher in patients with worsening DD. There were 4,469 deaths [21 percent] in the mild DD cohort, 429 deaths [24 percent] in the moderate DD cohort, and 49 deaths [39 percent] in the severe DD cohort. Nonetheless, when propensity matching techniques were applied during statistical analysis of the data, it was revealed that only moderate and severe DD were related to an increased mortality risk.

The authors note that since the prevalence of DD was so high in their study population, most patients who presented to the outpatient electrocardiographic testing had, by definition, preclinical DD. This is of great clinical relevance since DD can provide the physician with prognostic clues. Since in most cases, the electrocardiograms are ordered by non-cardiologists, this information is of particular importance. The researchers have pressed the need for more research to understand how DD increases the risk of mortality as an independent factor. They also added that the results of this study indicate that increased awareness about the clinical significance of moderate and severe DD may help in triaging patients who may be at a higher risk of dying from DD even if systolic function is preserved. This could be of particular importance when DD is at a preclinical stage.

Jun 27
Eating for two risks harm to the baby
Mothers who eat too much during pregnancy increase the risk of low IQ, eating disorders and psychosis in their children.

Every pregnant woman worries about eating properly to nurture her unborn child.

But between strange cravings and old-fashioned advice to start "eating for two" many find themselves tipping the scales far too heavily - with one in six women classed as obese within just three months of becoming pregnant, and many more putting on too much weight in later months - suggesting babies are being put at risk on a massive scale.

Now, a study has warned of new risks to their children, who are more likely than others to suffer from a range of problems including low IQs, eating disorders and psychosis.

The research found that the risks were increased not just in the early years - when children had a higher chance of suffering from attention deficit disorder, and a lower than average IQ - but also in adolescence, when eating disorders were more likely, and in adulthood, when the risk of disorders such as schizophrenia was increased.

Experts warned that even women who began their pregnancies at healthy weight, or slightly overweight, could put their child at risk if they used pregnancy as a time to ditch sensible eating habits.

The research, published in international journal Obesity Reviews, examined findings from across across the world on the impact of maternal weight on child development.

One study found that every increased unit in the pregnant woman's Body Mass Index (BMI) - calculated as her weight in kilograms divided by the square of her height in metres - was associated with a "significantly" reduced IQ in the child.

Overall, the average IQ of children of obese mothers was five points lower than those born to mothers of healthy weight, according to the study, one of 12 examined by researchers in psychiatry and behavioural neuroscience from McMaster University, in Ontario Canada.

Research from Sweden found children born of overweight mothers were more likely to suffer from attention deficit problems, while findings from Japan found every extra BMI point added in early pregnancy increased the offspring's chance of developing schizophrenia in adulthood by 24 per cent.

A study of Australian teenagers suggested their chance of having an eating disorder increased by 11 per cent for every extra BMI point gained by their mothers during the pregnancy.

Researchers said the reasons for the extra risks were not clear, but might be linked to changes in the hormonal, cardiovascular and immune systems during pregnancy as a result of excess weight.

While the studies attempted to "control" for some factors - such as the socio-economic background of obese parents, which could affect child development - the research could not pinpoint the extent to which risks were created in pregnancy, or might explained by genetic patterns or the way parents brought up their families.

Research has found that one in six women in this country are obese by the time they are three months into pregnancy - a proportion which has more than doubled in two decades, amid an obesity epidemic.

Earlier this year, scientists said more than 100,000 babies a year were at risk of dying or suffering serious problems because of the risks from obesity, which puts a woman's body under extra strain, when it is working to nurture new life.

Obesity in pregnancy increases the risk of diabetes, high blood pressure, blood clots, miscarriages and still-births, while layers of fat can mean serious defects can be missed in scans.

The study, led by Teeside University, found massive variations in levels of obesity among expectant mothers cross the country.

In London, 13 per cent of mothers-to-be were obese, while in the West Midlands, the figure was 22 per cent.

Tam Fry from the National Obesity Forum said too many women were not getting the message that they needed to "shape up" before planning a family.

Others who were a healthy weight, or slightly overweight when they conceived could easily fall into the category of obese if they used pregnancy as an excuse to ditch sensible eating habits.

He said: "There is still a lot of folklore about pregnancy, and a lot of women who still believe that 'eating for two' is the way to nurture their child.

"Those kinds of myths are really dangerous - in fact, pregnant women only need about an extra 200 calories a day in the last trimester."

"There are a lot of serious risks from obesity that we already know about, but this study shows others are still emerging, and the picture is incredibly worrying," he added.

Earlier this year, a study found that rates of foetal and infant death are twice as high among those born to obese mothers.

The study found that 16 in 1,000 babies suffered fetal or infant death if their mothers had a BMI greater than 30 in early pregnancy, compared with 9 deaths per 1,000 babies among those with a healthy BMI.

Big babies - those weighing more than 10 lbs - are around twice as likely as other babies to end up obese as adults.

Separate studies have found increased dangers of developmental problems like spina bifida and neural tube defects in infants of obese mothers.

Jane Munro, from the Royal College of Midwives, said more research was needed to establish whether the apparent risks highlighted in the latest study were a direct result of maternal obesity.

Mrs Munro said: "There are some clear risks from obesity that we already know about- hypertension, pre-eclampsia, larger babies, an increased risk of having a baby born by Caesarean section, and that the child is more likely to become obese.

"We encourage women to get to a healthy weight before conception, and eat healthily in pregnancy, but we do not encourage dieting in pregnancy, and we don't want women getting too frightened about all this."

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