Friday, 30 October 2009

Endometriosis: Polychlorinated biphenyls found to trigger mutation in GSTM1 gene

2009
By Syed Akbar
Hyderabad, Oct 29: City health researchers have found an environmental and genetic link to endometriosis,
one of the most commonly encountered problems in gynaecology.
Endometriosis is associated with chronic pelvic pain and irregular monthly cycles. It is also one of the
major causes of infertility in women. It is a debilitating gynaecological disorder affecting about 15 per cent
of women of child bearing age.

The city team has noticed that polychlorinated biphenyls, the liquid used in coolants, transformers and capacitors, interferes with the genetic set up of women exposed to the compound, thereby causing endometriosis. The PCBs cause mutations in the GSTM1 gene (glutathione S-transferase).
This is the first attempt to resolve the conundrum of conjugation of both PCBs and GSTM1 gene deletion frequency in the pathogenesis of endometriosis.
The team comprised Dr Rozati Roya, Dr Giragalla Simha Baludu and Dr B Satyanarayana Reddy of the department of obstetrics & gynaecology, Owaisi Hospital & Research Centre and the department of
reproductive medicine, Maternal Health & Research Trust, Hyderabad. Their study established the link between PCBs and GSTM1 mutation as women suffering from endometriosis showed high concentration of the environmental pollutant.
-------------------
Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body. Endometriosis lesions can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall. Other common sites include the uterosacral ligaments, the cul-de-sac, the Pouch of Douglas, and in the rectal-vaginal septum.In addition, it can be found in caecarian-section scars, laparoscopy or laparotomy scars, and on the bladder, bowel, intestines, colon, appendix, and rectum. But these locations are not so common.
------------------
"Women with endometriosis showed significantly higher concentrations of PCBs compared with control
group. Twenty six per cent of women with endometriosis had the GSTM1 null genotype, which showed
significant association with endometriosis," Dr Roya said.

As part of the study, the team selected 97 unrelated women, who were diagnosed to have endometriosis. It
also took 102 women with other gynaecological problems like fibroids, tubal defects and polycystic ovaries,
as the control group.
The research group is of the view that the compromised detoxification, determined genetically, might be a risk factor for the development of endometriosis. Significant increase in the concentrations PCBs was observed in plasma of women as the severity of endometriosis increased.

Nosocomial infection caused Nellore blindness: All about the hospital bane called pseudomonas

2009
By Syed Akbar
Hyderabad, Oct 27: It was not a wrong incision that caused infection leading to blindness at a mass surgical camp in Nellore. Health experts feel that there could have been inadequate sterilisation of the equipment used and indequate care exercised against infections during the operation.
According to Dr CR Sundaresan from Singapore, "perhaps since it was a camp setting, asepsis would not have been adequate". The improper follow up could also have contributed.
======
About two dozen people, who underwent surgeries for cataract at a free camp organised by Bollineni Foundation in Nellore, were infected. Half a dozen of them turned blind. Improper disinfection is said to be the cause.
======

Pseudomonas, which is blamed as the causative agent of infection in 16 of the people who underwent cataract surgery, is a highly dangerous organism that is capable of living even in antiseptic lotions. The doctors should have exercised utmost caution on the asepsis aspect, instead of just depending on the brand of the aseptic material used during the surgeries.
==============
Being Gram-negative bacteria, most Pseudomonas spp. are naturally resistant to penicillin and the majority of related beta-lactam antibiotics, but a number are sensitive to piperacillin, imipenem, tobramycin, or ciprofloxacin.This ability to thrive in harsh conditions is a result of their hardy cell wall that contains porins. Their resistance to most antibiotics is attributed to efflux pumps which pump out some antibiotics before they are able to act.
=============
Dr Sundaresan pointed out that Pseudomonas is the bane of hospital or medical procedure acquired infection (nosocomial infection). This notorious organism is hard to eliminate except with the most diligent measures, as it can even thrive in antiseptic lotions.
"Also a 'work up' before surgery is mandatory, which means that certain conditions such as diabetes mellitus, which could potentially cause this turn of events, must be excluded. Except for a single measurement of blood sugar, which in and of itself may not be an adequate measure to identify diabetes, a few investigations would have been performed," he argues.

Meanwhile, the Andhra Pradesh Opthalmological Society on Tuesday argued that the complication is not related to surgery "but to factors outside the control of the surgeon". According to Dr K Sivarama Krishna, association president, clustering or grouping of cases specially means some material or fulid used during surgery, such as irrigating fluid bottle, intraocular lens, viscoelastics, gloves etc were contaminated with bacteria.
"A surgeon uses these items of the brands he trusts, and it is not possible to check the sterility of each item before use. He has to trust the brand," he points out adding that this complication cannot be eliminated despite all efforts and "this risk has to be accepted as long as surgery happens. Otherwise surgery cannot happen".
The association said doctors had obtained consent of the patients for possible infection following eye surgery.

Neem Extracts - NeemAzal T/S: Azadirachta indica as larvicide of harmful, disease-causing mosquitoes

2009
By Syed Akbar
Hyderabad, Oct 27: Indian vector control experts have now found that extracts from the common neem can
fight the spread of dangerous diseases like malaria, dengue and chikungunya, by killing the mosquitoes that
harbour the causative organisms.

Mosquito species like Aedes, Anopheles and Culex carry harmful organisms that cause chikungunya,
dengue, malaria and elephantiasis. The spread of mosquitoes is controlled world-wide by spraying synthetic pyrethroids like permethrin, deltamethrin and alpha-cypermethrin.These chemical insecticides kill mosquitoes but cause untold damage to environment and human health. Moreover, many species of mosquitoes have developed resistance to chemical pesticides.
A team of researchers from the Vector Control Research Centre has found that Azadirachta indica (Indian neem) to be a potential resource for the development of new insecticides for arresting the spread of mosquitoes. The neem extracts can also be used for the treatment of netting or housing.
Though neem products have been used world over in agriculture and gardening to control pests, they have
never been tested on human pathogens and mosquitoes or disease vectors. According to the researchers, Dr
K Gunasekaran and Dr T Vijaykumar, the neem extracts effectively control adult mosquitoes as well as
their larvae.

"Antiviral activity of neem leaf extracts has been evidenced against dengue virus, HIV and several important parasitic protozoa, including Trypanosoma, Leishmania and Plasmodium. The neem product, NeemAzal T/S 1.2 per cent EC, has successfully controlled mosquitoes like Anopheles stephensi, Culex quinquefasciatus and Aedes aegypti," the study pointed out.
The produce, when used even in minute quantities (less than 1 ppm), kills 50 per cent of larvae before they become adult mosquitoes. NeemAzal T/S 1.2 per cent EC is a promising insecticide to complement currently used biological larvae control agents including larvivourous fish, the researchers said.

Tuesday, 27 October 2009

Blinding at an eye camp: Inadequate sterilisation of equipment caused infection

2009
Syed Akbar
Hyderabad, Oct 27: It was not a wrong incision that caused infection leading to blindness at a mass surgical camp in Nellore. Health experts feel that there could have been inadequate sterilisation of the equipment used and indequate care exercised against infections during the operation.

According to Dr CR Sundaresan from Singapore, "perhaps since it was a camp setting, asepsis would not have been adequate". The improper follow up could also have contributed.

Pseudomonas, which is blamed as the causative agent of infection in 16 of the people who underwent cataract surgery, is a highly dangerous organism that is capable of living even in antiseptic lotions. The doctors should have exercised utmost caution on the asepsis aspect, instead of just depending on the brand of the aseptic material used during the surgeries.

Dr Sundaresan pointed out that Pseudonomas is the bane of hospital or medical procedure acquired infection (nosocomial infection). This notorious organism is hard to eliminate except with the most diligent measures, as it can even thrive in antiseptic lotions.

"Also a 'work up' before surgery is mandatory, which means that certain conditions such as diabetes mellitus, which could potentially cause this turn of events, must be excluded. Except for a single measurement of blood sugar, which in and of itself may not be an adequate measure to identify diabetes, a few investigations would have been performed," he argues.

Meanwhile, the Andhra Pradesh Opthalmological Society on Tuesday argued that the complication is not related to surgery "but to factors outside the control of the surgeon". According to Dr K Sivarama Krishna, association president, clustering or grouping of cases specially means some material or fulid used during surgery, such as irrigating fluid bottle, intraocular lens, viscoelastics, gloves etc were contaminated with bacteria.

"A surgeon uses these items of the brands he trusts, and it is not possible to check the sterility of each item before use. He has to trust the brand," he points out adding that this complication cannot be eliminated despite all efforts and "this risk has to be accepted as long as surgery happens. Othersise surgery cannot happen".

The association said doctors had obtained consent of the patients for possible infection following eye surgery.

Monday, 26 October 2009

Oral cholera vaccine has been found to be safe in India

2009
By Syed Akbar
Hyderabad, Oct 25: Oral cholera vaccine has been found to be safe in India and is likely to be introduced for inoculation in cholera endemic areas in the country including Hyderabad.

Though oral cholera vaccine consisting of killed whole cells has been present in the market for many years,
it is never prescribed by health authorities fearing its safety.


Vietnam is the only country where it is prescribed, though in a limited way. With India and several other countries showing bouts of cholera epidemic at regular intervals, the Seoul-based International Vaccine Institute took up its safety and efficacy studies on Indian populations.

The IVI modified the vaccine to suit World Health Organisation standards and inoculated over a lakh people in Kolkata. A leading pharmaceutical research company from Hyderabad collaborated the project and prepared the vaccine. It is inexpensive and has been found to be highly useful in preventing cholera.

IVI advocacy officer Tae Kyung Byun told this correspondent that the vaccine protected individuals in age-groups one to 4.9 years, 5·0 to 14·9 years, and 15 years and older, and protective efficacy did not differ significantly between age-groups.

This modified killed-whole-cell oral vaccine, compliant with WHO standards, is safe, provides protection
against clinically significant cholera in an endemic setting, and can be used in children aged one to 4·9
years, who are at the highest risk of developing cholera in endemic settings like Hyderabad.

According to WHO statistics, cholera accounts for an estimated 1,20,000 deaths every year world-wide.
"WHO has recommended the use of oral cholera vaccine for control of the disease since 2001, and one such
vaccine, containing recombinant cholera toxin B subunit and killed whole cells is internationally licensed,"
he said.


The Kolkata trial has revealed that the vaccine is safe and confers 66 per cent protection in all individuals older than one year of age, eight to 10 months after vaccination, and 50 per cent protection, three to five
years after vaccination. The vaccine has been found to be safe and immunogenic in India.

Over all, the vaccine provides about 70 per cent protection against clinically significant cholera for at least two years after vaccination, equally in children and older people.

Sunday, 25 October 2009

Oscar winner AR Rahman says he dreams of Indian symphony: The success mantra lies in the fusion of Indian classical music, Western music and technology

2009
By Syed Akbar
Hyderabad, Oct 24: Oscar winner AR Rahman dreams about developing a unique Indian music stream, the Indian Symphony, fusing classical and Western music with the latest advances in technology.


"Fusion music is the buzz word now and we have to adapt to the latest trends by incorporating the best of what we have and the Western music with a technological touch, to remain as top-notchers," he says.

In a tête-à-tête with this correspondent over lunch, Rahman, who gave a new meaning to modern Indian music, points out that he has been implementing this novel concept in his music school, which he started
in Chennai last year. "Indian music, western music and technology, this should be our mantra."

His busy schedule notwithstanding (he arrived late, on Friday after he missed his afternoon flight), Rahman spent about 70 minutes with a select group of guests, relishing Hyderabadi Nawabi dishes including nalli gosht, koftas, kababs, gosht biryani, dhall fry and plain naan, besides mixed fruit juice. He politely refused when a chef offered him fried prawns.


The guests included GMR Airports chairman Kiran Kumar Grandhi, GMR urban infra and highways chief Srinivas Bommidala, Jet Airways area manager Ashok Kumar and representatives from a couple of media
houses. Rahman exchanged views on a variety of subjects including cricket, music, family values, environment, philanthrophy, floods, tsunami, security, his concerts in India and abroad and corporate
responsibility. Clad in a light aqua blue tunic, Rahman answered questions with ease.

Rahman, who is in the city for a fund-raising concert to help flood victims, said he instantly fell in love with Hyderabadi biryani. "Your food is a bit spicy but I like it. I used to take lot of prawns and crabs and of late I have stopped them to keep myself fit."

Asked whether he has turned a veggie, Rahman smilingly said he tried it sometime ago for three months, but he gave it up when he became weak. "I need lot of stamina and I get it from non-veg supplements".

Attributing his success to his quick adaptation to the changing trends, he said the present-day music buffs like combo-music, combining all streams of vocal and instrumental music, says this techno-savvy musician, sporting a Black Berry in his hand. "This has been gifted to me by a friend," he answers a call.

"My dream is to develop the Indian symphony and I focus on teaching this concept to my students. A dozen leading foreign and Indian music faculty is involved in teaching 130 students at the music school," Rahman says.



An epitome of humility and continuous learner, Rahman attributes his success to God's grace, simplicity, and support from people. He recalled how he was stopped by security guards at his own concerts in Pune and Dallas. "Yes, the security system should be tight. After all it is for our own safety," he agrees.

This music maestro, who has a penchant for environment, plans to shift his music school to a sprawling 40-acre premises at Red Hills in Chennai, where he will implement the "green building" concept, with everything eco-friendly right from drawing underground water to electrification. "I am planning to some concerts on climate change."

He goes to bed at 5 in the morning and wakes up at 1.00 pm to start a fresh day. "I got used to these freak timings," he said with a smile in his face. Soon after the lunch, Rahman rushed to the GMR arena, where he

A globe-trotter Rahman covered half a dozen countries since he last visited Hyderabad on October 12. "I do not get jet lag, but I need a day's rest after a long commute. But my spouse obviously tired said she can't globe-trot any more."
performed a music show later in the evening.

The police made strict security arrangements and the roads leading to the airport were jam-packed with his fans and music lovers.

Genetic history of Muslims in India: Islam spread through cultural conversion, and not through human invasion

2009
By Syed Akbar
Hyderabad, Oct 23: The spread of Islam in India was predominantly a cultural conversion associated with minor but detectable levels of gene flow primarily from Iran and Central Asia, and not directly from the
Arabian peninsula, according to a new research study collaborated by the city-based Centre for Cellular and Molecular Biology.

The study also found that most of the Indian Muslim populations received their major genetic input from geographically close non-Muslim populations. "However, we have also observed low levels of likely sub-Saharan African, Arabian and West Asian admixture among Indian Muslims. We rule out significant gene flow from Arabia," CCMB senior scientist Dr K Thangaraj told this correspondent.

==========================
According to historical evidence, the Indian Subcontinent has been exposed to several waves of human migrations from the Arabian Peninsula and Iran, the homelands of Indian Muslim rulers Arabian Peninsula (where Islam was propagated) served as a hub for human migrations, hence the merged genetic signatures of Eurasian and African origin, which has been detected in both maternal and paternal lineages from the region. Besides Arabia, Iran is a second plausible genetic source for Indian Muslims. It is positioned in the tricontinental nexus and its populations genetically show close proximity to those from the Near East, lthough with a lesser genetic input from Africa than from the populations of the Arabian Peninsula.Besides mtDNA and the Y chromosome, which show relatively low levels of differentiation between these two potential sources, recentstudies of lactose tolerance have revealed that Iranian and Arabian populations differ significantly in genetic patterns at this locus.
=====================
The CCMB took up the study in collaboration with the National DNA Analysis Centre of the Central Forensic Science Laboratory, Kolkata, State Forensic Laboratory, Lucknow, Leverhulme Centre for Human
Evolutionary Studies of University of Cambridge, UK, Department of Evolutionary Biology of Estonian Biocentre and Tartu University, Estonia, and the Wellcome Trust Sanger Institute, UK.

To estimate the contribution of West Asian and Arabian admixture to Indian Muslims, the team assessed genetic variation in mitochondrial DNA (mother's lineage), Y-chromosomal (father's lineage) and genetic
markers representing six Muslim communities from different geographical regions of the country.

"Most Indian Muslims are closely related to their neighbouring non-Muslim populations and this suggests that they descend primarily from local Hindu converts. The exception to this are some northern and north-western Indian Muslims, who differ from indigenous Hindu populations, likely because of a higher proportion of genetic lineages of external origin," the study pointed out.

The researchers used as many as 472 Indian Muslim mitochondrial DNAs, 431 Indian Muslim Y chromosomes and 747 Indian Muslim and non-Muslim gene (MCM6) profiles for the study. "There is a notable variation between different Indian Muslim populations, some being highly similar to local Indian populations and others having similarities with external populations, so that when they are all grouped
together as ‘Indian Muslims’, the group difference is statistically insignificant from that of non-Muslims," Dr Thangaraj said.
Shia, Sunni, Dawoodi Bohras from Gujarat and Mappla from Kerala are found to cluster together with Indian non-Muslim populations, whereas Dawoodi Bohras from Tamil Nadu seem to be an outlier. In the Y-chromosomal plot too, Shia, Sunni, Dawoodi Bohras from Gujarat and Mappla form a group with their neighbouring Indian non-Muslim populations and Europeans, whereas the Dawoodi Bohras from Tamil Nadu, again found as an outlier.


Thursday, 8 October 2009

Scientists baffled at sudden swine flu deaths in India

2009
Syed Akbar
Hyderabad, Aug 10: Scientists and health experts are baffled over the sudden swine flu deaths in the country, even as the National Institute of Virology has clarified that the novel H1N1 virus that causes human influenza has not mutated in India to become more aggressive.

Swine flu has been in existence in the country for the past five months without any fatalities. But in the last one week there have been six deaths, forcing scientists and health experts to think whether the virus had mutated in the country to take a virulent form. Some believe that the novel H1N1 virus is now in the second phase of manifestation as the human influenza viruses normally do. The Spanish flu virus did the same in early 19th century killing millions of people worldwide.

"We have been monitoring the virus from different human samples. But so far we have not found any mutation or change in the virus. The virus currently present in the country is the same as found in Mexico, USA and other parts of the world," Dr Akhilesh C Mishra, director of NIV, Pune, told this correspondent.

Asked about the sudden swine flu deaths in the last one week, Dr Mishra attributed it to the "wide profiling system" now adopted by health authorities. "Earlier, we used to screen only those coming from other countries. Now we are screening the local public too. This has led to a sudden spurt in the number of cases. And this explains the deaths too," he clarified.

But senior geneticist Dr M Khaja emphasises the need for a relook at the virus. "All through the history the influenza virus has been mutating. Even the present novel H1N1 virus is a mutant one. There are chances of it mutating further in a country like India with vast population. Swine flu virus is capable of leading to secondary infection, both viral and bacterial," he said.

Even as local scientists differ on whether the virus has mutated or turned aggressive since temperatures have gone down because of monsoon, American researchers have unravelled the mechanism the human influenza virus adopts to kill its host.

Swine flu virus is capable of binding deeper into the cells of lungs and stomach, unlike other influenza viruses. "There are slight differences in the way different flu proteins bind to receptors in lungs. Since the swine flu virus binds deeper in the lung's trachea, bronchi and bronchioles, it causes breathing problems, which ultimately lead to death. The virus is also capable of replicating faster and causing more damage than other influenza viruses. Different patients react differently to the virus. This explains the death of some swine flu patients and survival by others," said US-based senior researcher Dr G R Reddy.

While other influenza virus do not touch the stomach, the novel human influenza virus binds with the stomach lining and intestines. This causes diarrhoea, vomiting and nausea in some patients suffering from swine flu.

Wednesday, 7 October 2009

Acupuncture regaining popularity


---------------------------------------------
The doctor can be contacted on mobile No. +91-9949699469 and his address is flat No. 11, Manohar Enclave, Krishnapuri Colony, West Marredpally, Secunderabad - 500026 Hyderabad India
---------------------------------------------

By Syed Akbar

Middle-aged T Amarnath had a slip disc. Doctors suggested that he undergo
surgery. After being on bed for 29 days, he felt that surgery only would solve his
problem. But before he joined a hospital, one of his friends suggested that he
consult an acupuncture expert. Within a week, he was back to work with no signs
of slip disc.

Surendra Paul Singh (51) had been diagnosed with a kidney problem with urea
and serum creatinine levels of 140 and 7.8 respectively. A fortnight after he
underwent acupuncture therapy, the kidneys had started returning to normalcy.
The present readings are 80 (urea) and 5.2 (creatinine).

Scores of patients like Amarnath and Surendra Paul, who have benefited from
acupuncture after allopathic treatment failed, stand testimony that this ancient
Chinese medical system is gaining popularity in Andhra Pradesh. With the cost of
acupuncture treatment being affordable, more and more patients are turning
towards it. The success rate too is quite high, claim patients, who benefited from
acupuncture.

And popularising acupuncture in Hyderabad is Dr N Arun Kumar, who treats his
patients employing a sort of holistic approach, combining acupuncture with Yoga
postures, Pranayama and Ayurveda. He underwent specialised training in
acupuncture in Sri Lanka.

That acupuncture is becoming popular even among doctors practising modern
medicine is also evident from the medical history records maintained at the clinics
run by Dr Arun. Some of his clients include senior surgeons, physicians and
specialist doctors. And they all vouchsafe that acupuncture is not only safe, but
also effective.
Says housewife Aruna, who has been suffering from severe back pain, "a doctor
gave me an imported injection which costs Rs 20,000. And when it failed to
provide relief, he suggested surgery. I have been undergoing acupuncture sessions
for the past 28 days and I am much relieved now. A week more of acupuncture
sessions will, I am sure, solve this nagging problem".

According to Dr Arun, acupuncture had its birth in India but developed in China.
"It's a 5000 year old system and the cost involved in this method of treatment is
hardly five per cent of the money one has to spend if one follows allopathy. I also
prescribe simple Yoga exercises and Pranayama. In some cases a few Ayurvedic
medicines are also prescribed. There's no diet restriction except like avoiding
tamarind. I also teach them a few mudras," he points out, explaining how
acupuncture works.

"It's virtually painless. I just feel the ##### of a needle. It gives immediate relief
from pain," says one of the patients Abkari Meena. A few days ago she could not
walk because of the back pain. "It's OK now. I can stand and walk without
support. I am able to climb stairs."

As Dr Arun says acupuncture gives effective results in problems related to
orthopaedics and neurology, particularly in cases like rheumatic pains,
spondylosis, back pain, leg pain and slip disc. Also beneficial in knee pain,
cervical spondylosis, shoulder pain, frozen shoulder, tennis elbow, foot drop,
sciatica, arthritis (rheumatoid), osteo arthritis of the cervical spine, migraine,
insomnia, paralysis, bell's palsy, trigeminal neuralgia, peripheral neuropathy,
asthma, skin diseases and vertigo. The gastric and urinary systems responds well
to this form of treatment. It effectively controls diabetes.

Dr Arun, a student of noted acupuncturist Dr Lohia, uses specialised needles with
automated vibrating system to treat patients. "In early days doctors used to move
the needles manually. It was quite painful. Now it is automated and the level of
vibration can be adjusted according to the patient's requirement".

Acupuncture works on the Chinese medical principle of good and bad energy. It
removes imbalances and creates a striking balance between these two energies,
thus improving the immune system.

--------------------
Doctors testify
---------------------


I had severe back pain and I was treated by Arun Kumar (acupuncturist). Now I
am totally pain free and thankful to him for his technique and skill.
Dr. D Ramchandra Reddy, consultant anaesthetist and intensive care specialist

-------

I had severe pain in my legs even after I underwent a total knee replacement four
years ago. I sought the help of Arun to treat me. Now, I am able to wait, without
pain, comfortably.
Dr. Mangutha Narsing Rao

--------

It gives me great pleasure to state that Arun has treated my wife Dr SG Mudaliar
(retd. chief medical superintendent), South Central Railway, for back pain, which
she had been suffering for the past one year. Now she is relieved of that pain.
Dr ASG Mudaliar (retd. prof of surgery and civil surgeon, superintendent of
Gandhi Hospital)

-------

I was suffering from serious back pain. Then I got acupuncture treatment from
Arun and now I'm relieved of the pain.
Dr MV Mukteshwar (consultant anaesthetist (retd) Gandhi Hospital)

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Mother's Care

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Syed Akbar at the 11th Conference of Parties to the United Nations Convention on Biological Diversity