Making self-testing kits for HIV widely available could help reduce the global epidemic of AIDS, according to a new study led by an Indian-origin scientist.


The research which analysed data from many countries, including India, shows HIV self-testing removes much of the fear and stigma associated with being tested for the deadly disease.

The study by Dr Nitika Pant Pai from The Research Institute of the McGill University Health Centre (RI-MUHC) is the first of its kind and could pave the way for early detection and treatment around the world, thereby reducing transmission.


"Thirty years into the HIV epidemic, there is no vaccine in sight. Treatment as a prevention strategy has been known to work, but uptake of HIV screening seems to be limited by a societal problem: HIV stigma and perceived discrimination," said Pant Pai, first author of the study.


According to UNAIDS, 50 per cent of people living with HIV worldwide are unaware of their HIV status and about 2.5 million people become infected every year.


Pant Pai believes that access to an HIV self-test linked to expedited counselling systems will help expand access to screening and reduce judgement and perceived attitudes around HIV testing.


Self-tests are performed in oral fluid samples from the gum lining of the mouth in the privacy of one`s home. They are non-invasive, convenient, ensure confidentiality and can provide results within 20 minutes.


The results are self-interpreted however, and require confirmation at a medical clinic if positive.


Several studies have been conducted to determine the best methods of making a self-test with linked counselling and referral services available in various African, North American and European settings.


Pant Pai and her colleagues decided to look at the global evidence on self-testing strategies based on acceptability, feasibility and accuracy and success with linkages to care.


They examined 21 worldwide studies and found that two distinct self-testing strategies have been tried: supervised self-testing, and unsupervised self-testing.


Most of the data came from studies carried out in high-income settings including the US, Canada, Spain and the Netherlands, as well as Kenya, Singapore, Malawi and India.


Across the various studies, researchers observed that acceptability was very high for both self-testing strategies.


They also found evidence that people preferred self-testing to facility-based testing and oral self-testing to blood-based self-testing.


"The preference was largely driven by the fact the oral self-tests are non-invasive, convenient, easy to swab and do not involve a finger stick or blood from your arm for a preliminary screen," said Pant Pai in the study published in PLoS Medicine journal.

Bowel cancer rates have increased by 29 percent among men but only by about six percent among women in the past 35 years, a report by Cancer Research UK has claimed.

The figures also showed that the raise is particularly severe among people in their 60s and 70s, who account for more than 23,000 cases every year, the Telegraph reported.

Doctors though baffled by the increase of the cancer in this particular age group, and the disparity between men and women, said that risk factors for the disease include diet, weight, physical exercise, drinking and smoking.

The report was released to mark a new awareness and fundraising campaign in the name of English footie ace Bobby Moore , the World Cup winning captain who died from the disease in 1993, aged 51.

The report further showed that bowel cancer cases have increased from 45 per 100,000 men in 1975-77 to 58 cases in 2008-10, equalling to a rise of almost 33 percent.

In contrast, the charity said that the rates among women were risen from 35 cases per 100,000 to 37 cases over the same period.

Prof Matthew Seymour, director of the National Cancer Research Network, said they know that the bowel cancer risk increases as people age and, since everyone is living longer, it is no surprise to see that the number of people getting afflicted with the disease is on the rise.
He said but when they looked at these figures and took people`s age into account, they still see that the bowel cancer risk has gone up in men in the last 35 years.

Scientists have discovered a new biological pathway of innate immunity that ramps up inflammation and then identified agents that can block it, leading to increased survival and improved lung function in animal models of pneumonia.

Pneumonia and other infections sometimes provoke an inflammatory response from the body that is more detrimental than the disease-causing bacteria, said senior author Rama Mallampalli, M.D, professor and vice chair for research, Department of Medicine, and director of the Acute Lung Injury Center of Excellence at the University of Pittsburgh School of Medicine.

"In our ongoing studies of pneumonia, we found infecting bacteria activate a previously unknown protein called Fbxo3 to form a complex that degrades another protein called Fbxl2, which is needed to suppress the inflammatory response," said Dr. Mallampalli, who is also chief of the pulmonary division of the VA Pittsburgh Healthcare System.

"The result is an exaggerated inflammatory response that can lead to further damage of the lung tissue, multi-organ failure and shock," he added.

The research team, led by Bill B. Chen, Ph.D., associate professor, Division of Pulmonary, Allergy and Critical Care Medicine, conducted experiments in which mice that lacked the ability to make Fbxo3 were infected with a strain of Pseudomonas bacteria, and found that they had better lung mechanics and longer survival than mice that still made the protein.

Research team members Bryan J. McVerry, M.D., and Yingze Zhang, Ph.D., both of the Acute Lung Injury Center of Excellence, found that blood samples from 16 people who had sepsis, a condition of systemic inflammation, revealed higher levels of Fbxo3 and other inflammatory proteins and lower levels of Fbxl2 than samples from seven patients who did not have sepsis or lung infection.

Based on the structure of Fbxo3, the researchers developed a family of small molecules with the aim of inhibiting its activity. Administration of one of them, called BC-1215, led to reduced inflammatory markers and improved lung mechanics in mouse models of pneumonia and sepsis.

"The key is to find ways to help the body temper its inflammatory response so that it's able to kill the infectious agent without causing injury to healthy tissue," Dr. Mallampalli said.

"The F-box protein Fbxo3, and other related proteins, represent ideal targets for treatment of acute lung injury, because it controls the innate immune response, is upstream of important inflammatory signaling pathways, and is more selective than traditional drugs that regulate protein turnover," noted Mark T. Gladwin, M.D., chief of the Division of Pulmonary, Allergy and Critical Care Medicine, Pitt School of Medicine.
The team is beginning to study the effects of BC-125 on other conditions of systemic inflammation, such as colitis and arthritis.

They reported their findings today in Nature Immunology.

Shruti Jain was a busy working mother juggling children, work and household chores with aplomb, until she suddenly collapsed in office one day. Diagnosed with a stroke, she had to undergo a six-month recuperation and paid a hefty fee at a private hospital.

Little did the 35-year-old marketing executive know that she had been suffering from hypertension, which had gone undetected for a long time, ultimately leading to the stroke she suffered.

Going by the lifestyles most of us lead, doctors say hypertension or high blood pressure (BP) can affect any of us and should be taken seriously as it is a silent killer.

"A lot of Indians fall into the pre-hypertension category where they think they are absolutely fine and don`t pay attention to their rising blood pressure," Ravi Kasliwal, chairman of the division of clinical and prevention cardio diseases at Medanta - The Medicity Hospital in Gurgaon, adjoining Delhi, told IANS.

According to the World Health Organisation (WHO), high BP affects every third person above the age of 18 years.

Given the seriousness of the problem, WHO has selected hypertension as its theme for 2013, with special focus on it on World Health Day on April 7.

Blaming Indian food habits and a sedantary lifestyle, Kasliwal said: "Most of us grab snacks like namkeens and samosas when hungry between meals. Not only do these have a high salt content but they are also sources of trans-fats."

Experts estimate that the number of patients in India with high BP is likely to rise from about 140 million in 2008 to nearly 215 million by 2030 along with an increase in the risk of complications such as heart attacks, strokes, kidney problems and other serious illnesses.

The problem is further compounded as high BP is a silent killer because it can remain undetected and manifest years later as a serious heart problem, say doctors.

In India, experts say a large number of people are in the pre-hypertension category - BP of 130/90 against the normal range of 120/90. People with BP of above 140/90 are considered to be in the hypertension category.

High BP, as of today, remains inadequately controlled in India as a large number of cases go undetected.

"The incidence of high blood pressure ranges from 20 to 39 percent in urban areas and 12 to 17 percent in rural areas," says Sailesh Mohan, senior research scientist and associate professor in the Public Health Foundation of India (PHFI).

PHFI is a public-private initiative that works on promoting health issues.
High BP is, however, both preventable and treatable.

For many people, lifestyle changes such as cutting down on salt; eating a balanced diet; avoiding harmful use of alcohol; getting regular exercise; and avoiding tobacco use are sufficient to control blood pressure.

For others, medication is required, which is effective when taken as prescribed.

Rohit Sobti, a physician with regional medical services in the WHO, said it is easy to prevent the problem if people just control their diet and change their lifestyle.

"Merely controlling dietary and lifestyle regime can easily avert any complications arising out of high blood pressure. It is important to get BP checked on a regular basis and avoid self-medication," Sobti told IANS.

Kasliwal said a simple measure like restricting the salt intake per person to less than five grams per day and half an hour of exercise can help control hypertension that is assuming epic proportions in the country.

He also said that coronary as well as cerebral strokes and also dementia in old age can be a direct result of high blood pressure.

One of the voluntary targets proposed by WHO and likely to be approved by the World Health Assembly in May this year is to achieve a 30 per cent reduction in average salt consumption by 2025 from the consumption level in the year 2010.

There were nine global targets, which may be adopted. These included reducing deaths due to hypertension by 25 percent by 2025, encouraging physical activity and avoiding tobacco, Sobti said.

"Unhealthy lifestyles are killing people," said Renu Garg, regional advisor in non-communicable disease, WHO regional office for South-East Asia.

"Most of us lead a sedantary lifestyle, eat unhealthy food and don`t exercise. Indians urgently need to take measures like reducing salt intake, exercising and avoiding tobacco and excessive alcohol," Garg added.