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Jan 20
Brain stimulation enhances motor learning
WASHINGTON: A mild electrical stimulation of a specific brain area help people learn and perform a complex motor task better than those in control
groups, a new study has found.
Motor skills, which are used for activities from typing and driving to sports, require practice and learning over a prolonged period of time.

The findings could improve prospects of rehabilitation for people with traumatic brain injury, stroke and other conditions.

The study was conducted by researchers of the National Institute of Neurological Disorders and Stroke (NINDS) and Columbia University, New York City and Johns Hopkins University, Baltimore.

During practice, the brain encodes information about how to perform the task, but even during periods of rest, the brain is still at work strengthening the memory of doing the task. This process is known as consolidation.

Participants were presented with a novel and challenging motor task, which involved squeezing a \"joy stick\" to play a targeting game on a computer monitor, which they practised over five consecutive days.

During practice, one group received 20 minutes of transcranial direct current stimulation (tDCS) and the other group received only a 30 second \"sham\" stimulation; tDCS involves mild electrical stimulation applied through surface electrodes on the head, and works by modulating the excitability, or activity, of cells in the brain\'s outermost layers.

In this study, NINDS\' Leonardo Cohen and his team directed tDCS to the primary motor cortex, the part of the brain that controls movement.

Over the five-day training period, the skill of the tDCS group improved significantly more that that of the control (sham) group, apparently through an effect on consolidation, said a NINDS release.

During the three month follow-up period, the two groups forgot the skill at about the same rate, but the tDCS group continued to perform better because they had learned the skill better by the end of training.

Jan 16
Oral contraceptives carry risks
WASHINGTON: Although 80 percent women in the US have used oral contraceptives at one time or another since the sixties, these could carry unknown
long-term risks.More so when women\'s lifestyles change and new forms of contraceptives become available, according to specialists in women\'s heart disease at Cedars-Sinai Medical Centre(C-SMC).

\"As women use these therapies more frequently and for longer periods of time, there is an urgent need to better understand and minimise associated cardiovascular risks,\" said C. Noel Bairey Merz, director of the Women\'s Heart Center(WHC)at the C-SMC.

Women at high risk for cardiovascular problems, especially those who smoke, should consider alternative forms of contraception.Those with other cardiac risk factors, such as hypertension or elevated cholesterol, can consider using hormonal contraceptives if they are carefully monitored by their health care provider, said Bairey Merz, who is also professor of medicine at Cedars-Sinai.

Any woman considering the use of contraceptives should be evaluated for cholesterol levels, blood pressure, smoking, diabetes, kidney problems, obesity and other vascular diseases, including migraines.

Healthy, non-smoking women who are 35 or older can continue taking a low dose oral contraceptive until 50 to 55 years after reviewing the risks and benefits.
Bairey Merz co-authored the study that provides an overview of the known cardiovascular risks and benefits of hormonal contraceptives while pointing out areas that require further research.

Reproductive hormones affect the tone and function of blood vessels as well as lipid (fat) levels in the blood. Low oestrogen levels have been found to increase risk of coronary atherosclerosis (thickening and hardening of artery walls) and \"adverse cardiac events\", such as heart attacks and strokes.

But the use of supplemental oestrogen in hormone replacement therapy has been linked to an elevated risk of blood clots that can lead to heart attacks and strokes.
\"Health care providers must evaluate each woman\'s risk factors, especially those related to cardiovascular health, prior to starting any contraceptive therapy,\" she said.

\"Although pre-menopausal women have a much lower risk of cardiovascular disease, routine screening for potential problems and follow-up is important,\" said Chrisandra L. Shufelt, assistant director of the WHC and co-author of the study.

The earlier contraceptives used higher levels of oestrogen than the newer formulations, which are now available not only in pill form but in patches and vaginal rings.
Newer formulations use lower doses of oestrogen, safer in terms of lowering the risk of blood clots, and they tend to use a progestin, a synthetic version of progesterone that may slightly reduce blood pressure, said Bairey Merz, according to a Cedars-Sinai release.

Since 2000, death rates have increased in women between the ages of 35 and 44, while all other age groups have seen a decline. These findings are slated for publication in the Jan 20 issue of the Journal of the American College of Cardiology.

Jan 16
New pain relief guidelines for cancer patients at AIIMS
By IANS, New Delhi, Jan 9 - With only three percent cancer patients receiving pain management care in India, the All India Institute of Medical Sciences - has launched a no-pain policy to provide immediate relief to such patients.

The institute has adopted new pain relief guidelines with interventional therapies that are likely to provide relief to cancer patients from the chronic pain.

Through interventional therapies, the medication is surgically placed under the skin of the abdomen to deliver it directly to the fluid-filled area surrounding the spinal cord that carries pain signals to the brain.

\'About 75-85 percent cancer patients with chronic pain can be treated with oral morphine. However, some 10-15 percent patients react to morphine treatment and these interventional therapies can be boon for them,\' said Sushma Bhatnagar, professor for pain and palliative care at the Cancer Hospital of AIIMS.

The World Health Organisation estimates that 25 percent of cancer patients in the world die due to unrelieved pain and new guidelines are likely to acknowledge and manage chronic pain.

According to Bhatnagar, when a patient gets excessive side effects with oral morphine it is reasonable to directly target the spinal cord that carries pain signals to brain, thus providing an immediate relief.

\'The interventional therapies provide sustained pain control, less drug-related toxicity and possibly better survival for cancer patients,\' said G.K Rath, head of Cancer Hospital.

To make the medical fraternity across country aware about cancer pain management, the AIIMS is organising a three-day seminar \'Freedom from Pain\' starting Feb 13.

\'The seminar will provide opportunities to doctors, nurses and other health care professionals to have a good overview of pain management,\' Rath added.

Jan 16
Heart valves implanted without open-heart surgery
By New York- Presbyterian Hospital/Columbia University Medical Center, NEW YORK (Jan. 7, 2009) -- An innovative approach for implanting a new aortic heart valve without open-heart surgery is being offered to patients at NewYork-Presbyterian Hospital/Columbia University Medical Center. Known as the PARTNER (Placement of AoRTic traNscathetER valves) trial, this Phase 3 multicenter study is being led by national co-principal investigators Dr. Martin Leon and Dr. Craig Smith and is focused on the treatment of patients who are at high risk or not suitable for open-heart valve replacement surgery.


The Edwards SAPIEN transcatheter heart valve, made of bovine pericardial tissue leaflets hand-sewn onto a metal frame, is implanted via one of two catheter-based methods -- either navigated to the heart from the femoral artery in the patient\'s leg, or through a small incision between the ribs and into the left ventricle. It is then positioned inside the patient\'s existing valve, using a balloon to deploy the frame, which holds the artificial valve in place. Both procedures are performed on a beating heart, without the need for cardiopulmonary bypass and its associated risks.


This breakthrough technology could save the lives of thousands of patients with heart valve disease who have no other therapeutic options, says Dr. Leon, the study\'s national co-principal investigator, associate director of the Cardiovascular Interventional Therapy (CIVT) Program at NewYork-Presbyterian Hospital and Columbia University Medical Center, and professor of medicine at Columbia University College of Physicians and Surgeons.


Annually, some 200,000 people in the U.S. need a new heart valve, but nearly half of them do not receive a new valve for a variety of reasons.


This study may show that transcatheter valve replacement is a safe and effective alternative to open surgery, which remains the \'gold standard\' for most patients, says Dr. Smith, study co-principal investigator, interim surgeon-in-chief and chief of cardiothoracic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center, and the Calvin F. Barber Professor of Surgery at Columbia University College of Physicians and Surgeons.


The transcatheter valve procedures take about 90 minutes, compared with four to six hours for open-heart surgery. In open-heart surgery, the surgeon cuts through the breastbone, stops the heart, removes the valve and replaces it. Open-heart surgery can require a two- to three-month recovery period, compared to only a few days for the transcatheter approach.


The PARTNER trial is a prospective randomized study with two separate treatment arms. In the surgical arm, patients are randomized to receive either the Edwards SAPIEN transcatheter heart valve or an Edwards surgical valve via open-heart surgery. In the non-surgical, medical management arm, patients considered to be non-operative are randomized to receive either the Edwards SAPIEN transcatheter heart valve or appropriate medical therapy.

Jan 16
From outer space to the eye clinic: New cataract early detection technique
By NIH/National Eye Institute, A compact fiber-optic probe developed for the space program has now proven valuable for patients in the clinic as the first non-invasive early detection device for cataracts, the leading cause of vision loss worldwide.

Researchers from the National Eye Institute (NEI), part of the National Institutes of Health, and the National Aeronautics and Space Administration (NASA) collaborated to develop a simple, safe eye test for measuring a protein related to cataract formation. If subtle protein changes can be detected before a cataract develops, people may be able to reduce their cataract risk by making simple lifestyle changes, such as decreasing sun exposure, quitting smoking, stopping certain medications and controlling diabetes.

By the time the eye\'s lens appears cloudy from a cataract, it is too late to reverse or medically treat this process, said Manuel B. Datiles III, M.D., NEI medical officer and lead author of the clinical study. This technology can detect the earliest damage to lens proteins, triggering an early warning for cataract formation and blindness.

The new device is based on a laser light technique called dynamic light scattering (DLS). It was initially developed to analyze the growth of protein crystals in a zero-gravity space environment. NASA\'s Rafat R. Ansari, Ph.D., senior scientist at the John H. Glenn Research Center and co-author of the study, brought the technology\'s possible clinical applications to the attention of NEI vision researchers when he learned that his father\'s cataracts were caused by changes in lens proteins.

Several proteins are involved in cataract formation, but one known as alpha-crystallin serves as the eye\'s own anti-cataract molecule. Alpha-crystallin binds to other proteins when they become damaged, thus preventing them from bunching together to form a cataract. However, humans are born with a fixed amount of alpha-crystallin, so if the supply becomes depleted due to radiation exposure, smoking, diabetes or other causes, a cataract can result.

We have shown that this non-invasive technology that was developed for the space program can now be used to look at the early signs of protein damage due to oxidative stress, a key process involved in many medical conditions, including age-related cataract and diabetes, as well as neurodegenerative diseases such as Alzheimer\'s and Parkinson\'s, said NASA\'s Dr. Ansari. By understanding the role of protein changes in cataract formation, we can use the lens not just to look at eye disease, but also as a window into the whole body.

The recent NEI-NASA clinical trial, reported in the December 2008

Jan 16
For perfect chest, young Indian men go under knife
By Kavita Bajeli-Datt, New Delhi, Jan 11 - Many an Indian man who is in his 20s and lives in a metro is dying to flaunt a firm, clean chest like Bollywood\'s Shah Rukh Khan, Akshay Kumar and Aamir Khan, and doesn\'t mind being operated upon for it.

Cosmetic and aesthetic surgeons say they are seeing a surge in men who come to them for breast reduction and permanent hair removal from their chests in the hope of showing off their cleavage.

\'Ten years ago, about 10 percent of my clients used to be men. Now it is 40 percent. Most young men want to flaunt a firm, unshaven chest,\' Anup Dhir, a senior consultant in the department of cosmetic surgery at Indraprastha Apollo Hospital, told IANS.

Inspired by Bollywood actors and models who strut around shirtless, these men - mostly in their 20s - are ready to shell out money to show off cleavage.

\'Appearance has taken precedence among both men and women. Earlier it was considered a woman\'s department, now more men are going under the knife than ever before,\' he said.

According to the American Society of Aesthetic Plastic Surgery, surgery is becoming increasingly popular with men as a way to deal with image maintenance and change. \'BBC news has reported that breast reduction surgery is gaining popularity amongst men with gynaecomastia, generally known as man boobs or moobs,\' Dhir said.

Dhir said gynaecomastia is linked to hormonal changes and some diseases. In some cases, it is due to being overweight and thus caused by an accumulation of fat.

He said apart from breast reduction, many men also want permanent cure for their hairy chests. \'We use the laser technique for hair removal. This is a permanent way to remove hair from the chest. It means one sitting a month for four or five months,\' he said.

Breast reduction can cost anything between Rs.40,000-60,000 and laser surgery for hair removal can burn a Rs.60,000 hole in the pocket.

Charu Sharma, who runs two clinics called Gorgeous Looks in Greater Kailash and Patel Nagar and also works as a consultant in Fortis and Sri Balaji Action Medical Institute, said 50 percent of her total clientele comprises men. And the figure is on the rise.

\'Men are becoming very conscious about body flab, particularly younger ones. They want to have a body shape that they want to show off, especially a perfect chest. Trends are changing. More men come to us for male breast reduction and nose surgery,\' she said.

While most younger men come for breast reduction and a nose job, older men in their 40s want to remove flab from their abdomen and get hair transplants, she said.

Agreeing with her, Dhir said men are also becoming image conscious. \'It is common to see men wearing clothes that highlight their male cleavage.\'

He said most men come for breast reduction because they have to take off their shirts when they go swimming or to the gym.

Rahul Kumar - went to a cosmetic surgeon as he was conscious of his sagging breasts. He had no idea that many men face the same problem. It was by sheer chance that he met a cosmetic surgeon at a party. He underwent the surgery and is now more sure of himself.

\'I am more confident now. I am no longer hesitant in taking off my shirt. My friends now tease me and call me Salman Khan as he also takes off his shirt at the drop of a hat,\' said the 28-year-old executive.

M.S. Bhatia, the head of the department of psychiatry at Guru Tegh Bahadur Hospital, said media projections on good looks make youngsters vulnerable. \'It is sometimes due to sheer peer pressure that they want to follow current styles,\' he added.

But looking sure good has its advantages.

Like Dhir told IANS: \'Looking good improves your self-image and confidence and can play a part in being successful at home and at work.\'

Jan 16
A couple of glasses of red wine a day keep disabilities away!
By University of California - Los Angeles, It is well known that moderate drinking can have positive health benefits — for instance, a couple of glasses of red wine a day can be good for the heart. But if you\'re a senior in good health, light to moderate consumption of alcohol may also help prevent the development of physical disability.

That\'s the conclusion of a new UCLA study, available in the online edition of the American Journal of Epidemiology, which found that light to moderate drinking among these seniors reduced their odds of developing physical problems that would prevent them from performing common tasks such as walking, dressing and grooming.

\"If you start out in good health, alcohol consumption at light to moderate levels can be beneficial,\" said lead study author Dr. Arun Karlamangla, an associate professor of medicine in the division of geriatrics at the David Geffen School of Medicine at UCLA. \"But if you don\'t start out healthy, alcohol will not give you a benefit.\"

The researchers based their study on data from three waves of the National Health and Nutrition Examination Survey\'s Epidemiologic Follow-up Study (1982��, 1987 and 1992). The sample, which included 4,276 people split evenly between male and female, was about 92 percent white, with a mean age of 60.4 years.

Drinkers were classified as light to moderate if they consumed less than 15 drinks per week and less than five drinks per drinking day (less than four per day for women). Heavy drinkers were those who consumed 15 or more drinks per week or five or more per drinking day (four or more for women). Abstainers were those who drank fewer than 12 alcoholic beverages the previous year.

Having a physical disability means having trouble performing, or being unable to perform, routine tasks such as dressing and grooming, personal hygiene, arising, eating, walking, gripping, reaching, and doing daily errands and chores. Participants were asked if they experienced no difficulty, some difficulty, much difficulty or were unable to do these activities at all when alone and without the use of aids.

At the start of the survey, 32 percent of men and 51 percent of women abstained from drinking, 51 percent of men and 45 percent of women were light to moderate drinkers, and 17 percent of men and 4 percent women were heavy drinkers.

No one had any disabilities at the outset, but 7 percent died and 15 percent became disabled over five years.

The researchers found that light to moderate drinkers in good health had a lower risk for developing new disabilities, compared with both abstainers and heavy drinkers.

In unadjusted analyses, light to moderate drinkers had a 17.7 percent chance of becoming disabled or dying in five years, compared with 26.7 percent for abstainers and 21.4 percent for heavy drinkers. Among survivors, the risk for new disability was 12.5 percent for light to moderate drinkers, compared with 20 percent for abstainers and 15.6 percent for heavy drinkers.

However, after controlling for confounding variables such as age, smoking, exercise, heart attacks and strokes, the benefits of alcohol consumption were seen only in seniors who rated their health as good or better: There was a 3 to 8 percent reduction in the odds of developing disability with each additional drink per week in older men and women in good or better health who were not heavy drinkers, but there was no such benefit seen in those who rated their health as fair or poor.

\"Light to moderate alcohol consumption appears to have disability prevention benefits only in men and women in relatively good health,\" the researchers wrote. \"It is possible that those who report poor health have progressed too far on the pathway to disability to accrue benefits from alcohol consumption and that alcohol consumption may even be deleterious for them.\"

Jan 16
Social stigma to dementia percieved greater in UK
By Indiana University, A new study has found that in spite of their universal health care system which facilitates access to free dementia care, older adults in the United Kingdom are less willing to undergo dementia screening than their counterparts in the U.S. because the Britons perceive greater societal stigma from diagnosis of the disease than do Americans.

Researchers surveyed 125 older adults in Indianapolis and 120 older adults in Kent, England, on their opinions on the perceived harms and benefits of dementia screening. None of those surveyed had been diagnosed with dementia, however significantly more of the U.K. participants (48 percent) had close friends or relatives who have or had Alzheimer\'s disease compared to U.S. participants (27 percent).

The study of public attitudes toward early detection of dementia across different health-care systems was conducted by researchers from Indiana University in the United States and the universities of Kent and London in the United Kingdom. The research was funded in part by the U.S. National Institute on Aging, and appears in an advance online publication of the International Journal of Geriatric Psychiatry.

\"From my prospective, it was a genuine surprise that having a universal health care system, which provides services and support to all those who need it, didn\'t protect from perceived stigma and negativity,\" said the study\'s corresponding author, Malaz Boustani, M.D., assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute research scientist.

Even when taking into account education and race differences, Britons indicated greater concern with the stigma of diagnosis, with potential loss of independence, and with emotional suffering than their American counterparts.

\"This study, which investigates the acceptance and societal stigma associated with dementia – something very difficult to track – provides us with a unique insight as Americans debate the pros and cons of universal health care,\" said study first author, Michael Justiss, Ph.D., assistant professor of occupational therapy, School of Health and Rehabilitation Sciences, Indiana University-Purdue University Indianapolis.

Dementia is a growing global public health problem in both countries leading to a high burden of suffering for society with an annual cost of $100 billion in the U.S. and $10 billion in the U.K.

\"In spite of the fact that new strategies for both treatment and prevention of dementia are currently being developed, this study gives us an initial awareness so that we can develop improved care pathways for dementia. We hope the United Kingdom\'s Dementia Strategy published in the next few months will consider some of this study\'s findings,\" said Chris Fox, MB, BS of the University of Kent, who led the British researchers.

\"This pilot study is the beginning, not the end. We need to do further exploration with a bigger sample, with different types of individuals. But this study which found deep concern about dementia screening despite access to health care services in U.K., clearly tells us that there are many issues we must explore as we attempt to retool the American health care system. We have to be careful not to put the horse before the cart as we debate national health care in the U.S.,\" said Dr. Boustani, who is also an IU Center for Aging Research center scientist. Dr. Boustani has written extensively on the dementia screening.

Jan 16
Culling continues in bird flu-hit Assam, West Bengal
By IANS, New Delhi, Jan 13 - Over 480,000 poultry birds have been culled in the bird flu-hit areas of West Bengal and Assam as officials further intensified their awareness campaign to prevent recurrence of the disease in new areas.

A total of 483,726 birds have been culled in West Bengal and Assam, said the animal husbandry department Tuesday. Avian influenza was reported in Assam Nov 27.

There has been no human case of avian influenza, said health ministry officials.

They also said the disease has not spread to newer areas after it was reported Jan 3 in West Bengal\'s Darjeeling district where culling is on.

\'The containment operations are on in the epicentres reported in Darjeeling district. About 290 health workers are conducting active house-to-house surveillance,\' a statement issued by the health ministry said.

About 772 health workers are deployed for surveillance in the affected areas, they said.

The officials said they have intensified measures to spread awareness about the disease on local television and radio.

Officials are also spreading awareness by interacting with the villagers and through public announcements in the affected areas.

\'This is one way of ensuring that bird flu does not spread to new areas,\' the official said.

Jan 16
78,000 Indian women die in pregnancy, childbirth annually: Unicef
By IANS, New Delhi, Jan 15 - As many as 78,000 women die each year in India from causes related to pregnancy and childbirth, according to a Unicef report released here Thursday.

This implies that on an average every seven minutes, one woman dies from complications related to pregnancy and childbirth, reports the Unicef State of the World\'s Children 2009.

The report also highlights that in India, more than two-thirds of all maternal deaths occur in a few states - Uttar Pradesh, Uttarakhand, Bihar, Jharkand, Orissa, Madhya Pradesh, Chhattisgarh, Rajasthan and Assam.

\'We know what needs to be done to save the lives of the 78,000 women who die in India each year. In addition, about one million neonatal deaths occur here annually,\' Unicef India representative Karin Hulshof said while releasing the report at the India Habitat Centre.

According to the report, India has managed to cut under-five mortality rate from 117 per 1,000 live births in 1990 to 72 in 2007. But there has been little change in the 2001-03 maternal mortality rate of 301 for every 100,000 live births, and the Unicef says there is little chance of reaching the goal of cutting this ratio to 109 by 2015.

There is regional disparity here as well. In Uttar Pradesh, a woman has a one in 42 lifetime risk of maternal death compared with a probability of one in 500 for women in Kerala.

\'The health and survival of mothers and their newborns is intrinsically linked. Many of the same interventions that save maternal lives also benefit their infants. Primary healthcare must be made available to all of India\'s vulnerable women and children so that they can survive and thrive,\' Hulshof averred.

The report finds that health services are most effective in an environment supportive of women\'s empowerment, protection and education.

Both mothers and infants are vulnerable in the days and weeks after birth - this is a critical time for life-saving interventions like post-natal visits, proper hygiene and counselling about danger signs of maternal and newborn health, the report points out.

The report raps the state of healthcare services in developing countries saying that 99 percent of global deaths arising from pregnancy and complications occur in the developing world.

\'It is a well-known fact that Indian women work endlessly but end up going to sleep on an empty stomach, that is their condition,\' said Syeda Hameed, a member of the Indian government\'s Planning Commission, who was also present on the occasion.

\'Economic gains cannot be sustained if the well being of women and children, that is two-thirds our population, is not secured,\' Hameed added.

Also present at the launch was Bollywood actress Raveena Tandon, who has widely endorsed the cause of maternal care in the country.

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