New Delhi, March 16 - Possibly hinting at the cases of medical negligence that have come to light at the All India Institute of Medical Sciences -, Health Minister Anbumani Ramadoss wants the premier referral institute to focus more on patient care and safety.

Ramadoss also believes AIIMS should give high importance to research.

\'Patient safety should be given first priority. Also, the institute should ensure that the medical staff, including nurses, are polite to them. They should behave well with them. They should offer a holistic environment,\' Ramadoss, who is also AIIMS president, told IANS.

He said the World Health Organisation - lays a lot of importance on patient safety.

On Jan 1 this year, a senior doctor was accused of leaving artery forceps in the stomach of a 30-year-old woman who had undergone operation. The forceps were removed in a subsequent operation. She was discharged later.

In October last year, a cardiac surgeon left a screw inside the chest of a heart patient. The patient died a few days after the operation. In another case, a doctor, while taking out stones from a patient\'s stomach, left a towel inside the patient.

Ramadoss said focus on research should also be high on the agenda of AIIMS.

Expressing concern that for the past few years the institute has not been able to come out with any major research breakthroughs, he stressed that research is the key area.

Research is the only way we can reduce the disease burden on the country, he added.

The health ministry last year allotted to the institute Rs.2.8 billion , out of which only Rs.2 billion was spent. \'We also gave them an additional amount of Rs.300 million to Rs.500 million,\' said Ramadoss.

\'If they ask for more money we will give them more. It is our own premier institute,\' he said.

The health minister also said that in another three months the institute would be able to shortlist the name of its new director. \'The process has begun to look for a new director,\' he said.

Ramadoss was in the spotlight last year for his bitter turf war with renowned cardiac surgeon P. Venugopal who was subsequently removed as AIIMS director.

Currently T.D. Dogra is functioning as the acting director. The minister appointed Dogra as he was next in seniority to Venugopal, who was ousted after parliament passed a legislation fixing the retirement age at 65 for the director.

Soon after his removal, Venugopal, 66, approached the Supreme Court challenging his removal as director of AIIMS. The apex court March 12 reserved its verdict on his petition.

New York, March 16 - In a new study, scientists have identified genetic markers that allow the selection of eggs with the best chance of successful pregnancy after in vitro fertilisation -.


The study, by researchers at the Universite Laval in Canada, holds the potential of both improving the success rate of single embryo transfer as well as cutting the instances of multiple pregnancies, Sciencedaily reported.


Findings of the study, for which an international patent has been filed, have been published on the website of the journal Human Reproduction.


Eggs recovered in the course of the IVF process are surrounded by follicular cells, which are removed before the actual fertilisation procedure begins.


\'While in the ovaries, these cells and the eggs are in very close interaction,\' explained Marc-Andre Sirard, who led the study.


\'A first experiment we conducted on bovine follicular cells led us to believe that these cells might possess specific markers that would be able to give us information about the quality of an egg.\'


With the help of 40 women recruited in a fertility clinic, researchers compared follicular cells surrounding eggs that ultimately led to successful pregnancies - in other words \'good\' eggs -- to cells surrounding ovules that did not result in pregnancy.


This comparison led to the identification of five genes expressed more abundantly in follicular cells surrounding good eggs.


Currently, the way to assess which embryos are to be transferred into a woman\'s uterus is based on visible criteria such as appearance and division rate.


\'At least 30 percent of embryos that look normal through visual examination nonetheless show chromosome abnormalities,\' explained Sirard, illustrating the limits of this type of assessment.


The method developed by Sirard\'s team makes it possible to objectively select ovules that have the best chance of success without altering the integrity of the embryos.


This new genomic tool could also solve an ethical problem confronting both fertility clinic doctors and the people who consult them: In order to increase the chances of pregnancy, many embryos are implanted simultaneously into the woman in the hope that at least one will survive.


This procedure along with improved IVF techniques has led to an increase in multiple pregnancies.


Even if doctors now tend to transfer fewer embryos, multiple pregnancies still occur in 30 percent of couples who resort to IVF in North America and 23 percent in European couples.


\'By selecting the embryo with the best potential, it would be possible to limit the number of embryos transferred, and thus the number of multiple pregnancies, while maintaining good success rates,\' said Sirard.

A small group of patients with a common heart defect who were treated for varicose veins with an injectable microfoam experienced no neurological, visual or cardiac changes as a result of the treatment, according to preliminary results from a phase II trial. The results are being presented today (March 17) in Washington, D.C., at the annual scientific meeting of the Society of Interventional Radiology (SIR).

Injectable foams are usually made by mixing a sclerosant, an irritant that causes damage to the vein wall and subsequent scarring, with room air. Sclerosant foams have been a standard treatment since 1997 for spider veins and small varicose veins. Varisolve®, a foam made with carbon dioxide, is relatively painless compared to other sclerosants, which can cause burning, said John D. Regan, M.D., clinical director of the Interventional Section in the Department of Radiology at Wake Forest University Baptist Medical Center.

Veins in the leg have valves that are designed to prevent blood from flowing backward as it returns to the heart. Varicose veins are caused by weakened valves (commonly in the great saphenous vein, the large vein running up the inner side of the leg) which allow blood to flow backward and pool in the veins in the leg. The resulting high pressure causes veins to expand like balloons and become tortuous or twisted. The latest treatments involve blocking the great saphenous vein (GSV) to prevent the backflow, called reflux. The Varisolve foam injection procedure is a less invasive alternative to surgical techniques and intravenous techniques that close the vein with radiofrequency ablation or laser energy.

Although any air-based foam carries a theoretical risk to the patient because of the insolubility of air in the blood, the risk is small, said Regan, the presenting author of the phase II trial’s preliminary results. “We believe that the carbon-dioxide-based foam used in Varisolve will be totally safe due to the small size of the bubbles, the consistency of the foam and the solubility of carbon dioxide.”

However, patients with a right-to-left shunt in their hearts – a common, usually asymptomatic heart defect in about one-fourth of the population – are at increased risk of foam bubbles crossing the shunt and going to the brain or heart without being filtered in the lungs, according to Regan. These patients, the subjects of the study, are continuously monitored by transcranial Doppler ultrasound of the brain before, during and after the procedure. They also undergo magnetic resonance imaging (MRI) of the brain, visual testing, neurological examinations and examinations for changes in cardiac markers in the blood.

During the procedure, a small catheter is placed in the malfunctioning GSV, and the Varisolve foam is injected into the vein. The GSV is compressed in the groin to trap the foam in the leg and additional foam is injected. The patient’s leg is then put in a compression dressing and stocking, and the patient is able to get up and walk immediately.

In more than 90 percent of the 28 patients studied so far (13 at Wake Forest Baptist) at six research sites across the country, tiny bubbles have been detected in the blood during the procedure. However, no neurological, visual or cardiac changes were observed in the monitoring. The study will continue until a total of 50 patients have been treated and monitored

A commonly used medication that prevents blood clots from forming may also prevent existing clots from damaging delicate vein walls — and may accelerate healing in a clot-damaged area of vein wall, according to new research from the University of Michigan Cardiovascular Center.

The findings, made in laboratory mice, add more evidence to support the aggressive anti-clot efforts now under way at American hospitals and nursing homes. Those efforts are aimed at preventing many of the 300,000 deaths that occur each year when clots break free of vein walls and travel to the lungs.

The new study, published in the March issue of the Journal of Vascular Surgery, looked at the impact of low-molecular weight heparin, or LMWH, a form of anti-clotting medication that is often given to hospitalized patients. It’s different from the unfractionated form of heparin that has recently been the subject of safety concerns.

Researchers from the U-M Section of Vascular Surgery created venous clots in laboratory mice, and studied how the size of the clot, the damage inflicted on the vein wall, and the natural repair process in the cells of the vein wall changed over time. Some of the mice received LMWH before the clot was formed, while others received it afterward. Another group of mice received no heparin.

“Mice that received LMWH before their clot formed went on to experience a much faster and more complete healing process, compared with those that received LMWH only after the clot was formed and those that didn’t receive the drug,” says senior author Peter Henke, M.D., an associate professor of vascular surgery. “And among those that received LMWH only after the clot was formed, the mice that got treated the soonest after clot formation healed the fastest and the most completely.”

The experiments, performed in U-M’s Conrad Jobst Vascular Surgery Research Laboratory, simulated a human condition called deep-vein thrombosis, or DVT. That’s the term for blood clots that form in the veins of the lower limbs, clinging to and damaging the vein wall. When such clots break free and travel to the lungs, they’re called pulmonary embolisms or PEs.

A million Americans each year suffer DVTs, many of them during a hospital stay – and many of them without symptoms. About half go on to develop a PE, which causes sudden symptoms and must be treated immediately. Still, more than half of PE patients will die – making the condition one of the most preventable causes of death among hospitalized patients.

LMWH is increasingly prescribed to hospitalized patients who might be at risk of developing DVTs and PEs, especially older people, surgical patients, and people with a personal or family history of clotting problems. DVTs are especially likely to form in legs that are immobile for long periods of time, that have been injured, or that have poor circulation. Cancer patients, pregnant women, and overweight people are also at higher risk of developing one.

As the body’s own repair mechanisms break down the clot, they often leave behind a small patch of damaged vein wall that is never fully repaired, and interferes with the vein’s ability to push blood back up to the heart – a situation called chronic venous insufficiency. The damaged area may also be more hospitable for future clot formation.

LMWH helps encourage the breaking up of clots, and prevents new ones from forming. So, the U-M researchers, led by Henke and former U-M medical student Daria Moaveni, M.D., set out to see how the cells of the vein wall, or endothelium, react to a DVT when the drug is present.

First, they studied the “natural history” of DVTs by performing detailed molecular analyses of the vein wall tissue in the area of a clot after one, four and 14 days.

They found that the clots grew over the first four days, then began to shrink as the body’s repair mechanisms kicked in. Using a special stain, the researchers could see endothelial cells and vascular smooth muscle cells dying off immediately after clot formation, and then saw new ones growing in the vein lining in the clot-damaged area.

Then, the researchers induced DVTs in the three groups of mice in the heparin experiment. The mice that received LMWH before the DVT formed had the fastest endothelial repair, followed by those that received LMWH soon after the DVT was induced. The biggest difference was seen at four days after the DVT formed, but by day 14 the two heparin-treated groups of mice had about the same extent of repair. The pre-treated mice had the greatest recovery of the vein wall lining.

Using real-time polymerase chain reaction tests, the researchers were also able to look at patterns of gene expression in harvested veins in culture. As with the cell staining, they saw signs that the pre-treated mice reacted in a way that suggested fastest recovery.

While the new results can’t immediately be translated into human patients, they do help illuminate the process by which LMWH works – including the advantages of pre-treatment in at-risk patients, or early treatment of patients in whom a DVT has formed.

“Hospitalized patients who are on prophylactic heparin can still develop clots, but these results suggest that having heparin ‘on board’ can lessen the long-term impact of a DVT,” says Henke. “At the same time, our findings also suggest that rapid heparin treatment after a DVT forms is important for long-term healing.” This conclusion is supported by a previous U-M study, published in Thrombosis and Haemostasis in 2007, showing that the longer a clot is in contact with a vein, the worse the damage.

Now, the team is studying the proteins in the vein wall that are involved in promoting endothelial health and regeneration after an injury or other insult. They’re also working on the clinical level to increase the appropriate use of preventive measures among patients hospitalized at U-M. A new standardized risk-factor assessment tool is now in use among all surgical patients, and will soon be used in all U-M hospital patients, to determine which patients need prophylaxis the most.

An international science team from Penn State University in the United States and the University of Southampton in the United Kingdom has developed a process for growing a single-crystal semiconductor inside the tunnel of a hollow optical fiber. The device adds new electronic capabilities to optical fibers, whose performance in electronic devices such as computers typically is degraded by the interface between the fiber and the device. The research is important because optical fibers -- which are used in a wide range of technologies that employ light, including telecommunications, medicine, computing, and remote-sensing devices -- are ideal media for transmitting many types of signals.

The development of the single-crystal device, which will be described in a paper to be published later this month in the journal Advanced Materials, builds on research reported in 2006, in which the team first combined optical fibers with polycrystalline and amorphous semiconductor materials in order to create an optical fiber that also has electronic characteristics. The group\'s latest finding -- that a single-crystal semiconductor also can be integrated into an optical fiber -- is expected to lead to even further improvements in the characteristics of optical fibers used in many areas of science and technology.

For most applications, single-crystal semiconductor materials have better performance than polycrystalline and amorphous materials, said John Badding, associate professor of chemistry at Penn State. We have now shown that our technique of encasing a single-crystal semiconductor within an optical fiber results in greater functionality of the optical fiber, as well.

The team used a high-pressure fluid-liquid-solid approach to build the crystal inside the fiber. First, the scientists deposited a tiny plug of gold inside the fiber by exposing a gold compound to laser light. Next, they introduced silane, a compound of silicon and hydrogen, in a stream of high-pressure helium. When the fiber was heated, the gold acted as a catalyst, decomposing the silane and thus allowing silicon to deposit as a single crystal behind the moving gold catalyst particle, forming a single-crystal wire inside the fiber.

The key to joining two technologies lies not only in the materials, but also in how the functions are built in, said Pier Sazio, senior research fellow in the Optoelectronics Research Centre at the University of Southampton. We were able to embed a nanostructured crystal into the hollow tube of an optical fiber to create a completely new type of composite device.

The research team sees potential to carry the application to the next level. At present, we still have electrical switches at both ends of the optical fiber, said Badding. If we can get to the point where the electrical signal never leaves the fiber, it will be faster and more efficient.