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Friday, 20 July 2012

Planning Commission Steering Committee recommends incentives, grants and loans for upgradation of Ayush industry

The Steering Committee of the Planning Commission has recommended giving of incentives, grants and soft loans to the Ayush industry for prompting voluntary quality assurance certification and requisite upgradation of laboratory and manufacturing infrastructure to meet the stipulated norms for standard and premium markets.
“Support a coordinated programme to establish pharma-technology development platforms in "several" institutions, viz reputed colleges, universities and research institutions to standardize selected processes and products and their pharmacodynamics and kinetics, by building upon the well documented, traditional quality standards, that were achieved traditionally, through home scale production. Research on standardization of Bhasmas should be one of the agendas of this programme,” the steering committee said, ahead of the finalization of the Plan documents.
“All the State Governments should be required to obtain NABL accreditation. Support to R&D Centres for collaborative work with industry to publish definitive technical monographs for raw materials (botanical, mineral, metal, animal biproducts and marine products), in processed and finished formulations. Support for studies, surveys and macro data to develop a firm and complete statistical identity for the Ayush sector and all its aspects including knowledge,” it said.
The panel also recommended a programme to compile a computerized national licenced drug list with unique product codes for both classical and propriety drugs. This programme should be facilitated by developing uniform national software for drug licensing, harmonized for use by all State agencies in the country, the panel said.
“Supplementing of the drugs inspection machinery suffers from paucity of resources. These are available with the State Governments. The States may be supported to utilize professional inspection bodies whose competence to inspect establishments for compliance to Ayush regulations can be established by way of their accreditation by NABCB to the applicable international standards, ISO 17020. Such accredited inspection bodies can then be formally approved by the Drug Regulator and the industry given a choice to get itself inspected by any of these bodies at a prescribed frequency.
“Following this the organizations may submit reports confirming compliance to regulators. In case of any non-compliance, the regulator can initiate suitable action against the erring unit. A system can be developed whereby the establishments are advised to go to accredited inspection bodies by rotation and the accredited inspection bodies can be made to submit reports directly to the regulator. All this while, the regulator shall retain the right to directly inspect the manufacturing unit for any valid reason,” the report said.

Natural Way to Heal the Flu Without Side Effects Using Botanical Compound

In addition to previous work with the botanical abscisic acid, researchers in the Nutritional Immunology and Molecular Medicine Laboratory (NIMML) have discovered that abscisic acid has anti-inflammatory effects in the lungs as well as in the gut. The results will be published in the Journal of Nutritional Biochemistry. "While the immune effects of abscisic acid are well understood in the gut, less was known about its effects in the respiratory tract. We've shown definitively that not only does abscisic acid ameliorate disease activity and lung inflammatory pathology, it also aids recovery and survival in influenza-infected mice," said Raquel Hontecillas, Ph.D., study leader, assistant professor of immunology at Virginia Bioinformatics Institute, and co-director of NIMML.
Influenza accounts for anywhere from 3,000 to 49,000 deaths per year in the United States alone, according to the Centers for Disease Control. It is difficult to treat if not caught immediately; antivirals usually become ineffective after the virus incubation period has passed and resistance to antiviral drugs poses a serious public health problem in the face of outbreaks. Abscisic acid, however, has been shown to be most effective at about seven to ten days into the infection, targeting the immune response rather than the virus itself, which many researchers feel is a safer way to reduce flu-associated fatalities.
"Most drugs for respiratory infections target the virus itself, rather than the inflammatory responses caused by the virus. Abscisic acid activates peroxisome proliferator-activated receptor-gamma, a receptor that aids in reducing inflammation, through a newly identified pathwaya but it does so without the side effects of other agonists like thiazolidinediones, which are known to have strong adverse side effects. The development of complementary and alternative Medicine approaches that modulate the host response has great promise in decreasing respiratory damage caused by influenza or other respiratory pathogens," said Josep Bassaganya-Riera, Ph.D., director of NIMML and professor of nutritional immunology at the Virginia Bioinformatics Institute.
From this and previous research, it's clear that abscisic acid could yield a novel new way to combat inflammatory disease, both in the gut and the respiratory tract. By using host-targeted strategies to mediate disease, alternate pathways can be established to activate immune responses without the deadly side effects of many drugs currently on the market.


Cell research opens new avenues in combating neurodegenerative diseases

Scientists at the University of Manchester have uncovered how the internal mechanisms in nerve cells wire the brain. The findings open up new avenues in the investigation of neurodegenerative diseases by analysing the cellular processes underlying these conditions.
Dr Andreas Prokop and his team at the Faculty of Life Sciences have been studying the growth of axons, the thin cable-like extensions of nerve cells that wire the brain. If axons don't develop properly this can lead to birth disorders, mental and physical impairments and the gradual decay of brain capacity during aging.
Axon growth is directed by the hand shaped growth cone which sits in the tip of the axon. It is well documented how growth cones perceive signals from the outside to follow pathways to specific targets, but very little is known about the internal machinery that dictates their behaviour.
Dr Prokop has been studying the key driver of growth cone movements, the cytoskeleton. The cytoskeleton helps to maintain a cell's shape and is made up of the protein filaments, actin and microtubules. Microtubules are the key driving force of axon growth whilst actin helps to regulate the direction the axon grows.
Dr Prokop and his team used fruit flies to analyse how actin and microtubule proteins combine in the cytoskeleton to coordinate axon growth. They focussed on the multifunctional proteins called spectraplakins which are essential for axonal growth and have known roles in neurodegeneration and wound healing of the skin.
What the team demonstrate in this recent paper is that spectraplakins link microtubules to actin to help them extend in the direction the axon is growing. If this link is missing then microtubule networks show disorganised criss-crossed arrangements instead of parallel bundles and axon growth is hampered.
By understanding the molecular detail of these interactions the team made a second important finding. Spectraplakins collect not only at the tip of microtubules but also along the shaft, which helps to stabilise them and ensure they act as a stable structure within the axon.
This additional function of spectraplakins relates them to a class of microtubule-binding proteins including Tau. Tau is an important player in neurodegenerative diseases, such as Alzheimer's, which is still little understood. In support of the author's findings, another publication has just shown that the human spectraplakin, Dystonin, causes neurodegeneration when affected in its linkage to microtubules.
Talking about his research Dr Prokop said: "Understanding cytoskeletal machinery at the cell level is a holy grail of current cell research that will have powerful clinical applications. Thus, cytoskeleton is crucially involved in virtually all aspects of a cell's life, including cell shape changes, cell division, cell movement, contacts and signalling between cells, and dynamic transport events within cells. Accordingly, the cytoskeleton lies at the root of many brain disorders. Therefore, deciphering the principles of cytoskeletal machinery during the fundamental process of axon growth will essentially help research into the causes of a broad spectrum of diseases. Spectraplakins like at the heart of this machinery and our research opens up new avenues for its investigation"
What Dr Prokop's paper in the Journal of Neuroscience also demonstrates is the successful research technique using the fruit fly Drosophila. The team was able to replicate its findings regarding axon growth in mice which in turn means the findings can be translated to humans.
Dr Prokop points out fruit flies provide ideal means to make sense of these findings and essentially help to unravel the many mysteries of neurodegeneration.
Dr Prokop continues: "Understanding how spectraplakins perform their cellular functions has important implications for basic as well as biomedical research. Thus, besides their roles during axon growth, spectraplakins of mice and humans are clinically important for a number of conditions and processes including skin blistering, neuro-degeneration, wound healing, synapse formation and neuron migration during brain development. Understanding spectraplakins in one biological process will instruct research on the other clinically relevant roles of these proteins."
The recently published paper represents six years of work by Dr Prokop and his dedicated team.
Source:University of Manchester 

ECGs administered by paramedics can speed treatment for severe heart attacks

New protocol reported in the Canadian Journal of Cardiology

Philadelphia, PA, July 20, 2012 – A new program that trains emergency medical service technicians (EMS) to read electrocardiograms so that they can evaluate patients with chest pain, and expedite treatment for the severe heart condition known as ST-segment elevation myocardial infarction (STEMI), a serious form of heart attack, has excellent results and should become the standard of care, according to two studies published in the current issue of the Canadian Journal of Cardiology.
"It's well established that morbidity and mortality in myocardial infarctions is directly related to the duration of ischemia, and delays in restoring the flow of blood to the heart of even 30 minutes have been associated with an increase in mortality," says lead investigator Robin A. Ducas, MD, of the University of Manitoba, Winnipeg, Canada. "By training EMS to administer and interpret ECGs at the scene, with oversight from an on-call physician, we demonstrated that we could achieve benchmark times from first medical contact to treatment."
An audit of hospitals in Manitoba in 2005 had previously revealed that only 14% of patients received thrombolysis, the administration of drugs to dissolve blood clots, within 30 minutes from first medical contact, and only 11% received primary percutaneous coronary intervention (PPCI, or angioplasty) within 90 minutes of first medical contact, the benchmark established by leading heart associations, including the Canadian Cardiovascular Society.
To address this, a system of pre-hospital ECG interpretation and triage was developed. EMS receive additional training in administering and interpreting ECGs for signs of STEMI. When EMS suspect STEMI, the ECG is transmitted to the hand-held device of the on-call physician for confirmation. When STEMI is confirmed, the physician directs EMS to begin pre-hospital thrombolysis (PHL) or to alert the PPCI laboratory at the hospital to prepare for the patient. Transmission of the ECG allows for a real-time conversation between the physician and EMS, decreases false positive test results for STEMI, and improves resource allocation by decreasing activation of the catheterization laboratory when it is not warranted. The emergency room is bypassed in positive cases, and patients are directly transported to the cardiology department or the PPCI laboratory. In cases in which the physician finds the ECG negative for STEMI (PHENST), patients are transported to the nearest emergency room.
The investigators evaluated 380 cases from July 2008 to July 2010. Of 226 patients confirmed with STEMI, 70% received PPCI, 21% received PHL, and 20% underwent coronary angiography without revascularization. The median time from first medical contact to treatment in the PHL treatment group was 32 minutes. In the PPCI group, the median time was 76 minutes. In the PHENST group, 41% were directed to a hospital capable of PPCI and 59% were sent to one of the six other hospitals in the system. They presented more often outside of normal catheterization laboratory hours. 44% were diagnosed with acute coronary syndromes, including seven cases of missed STEMI, and a higher mortality rate.
"The adoption of similar strategies in other urban areas could allow for achievement of guideline times, particularly for PPCI and regardless of the time of day," says Dr. Ducas. "Transfer of patients with suspicious but negative ECG for STEMI (PHENST) to hospitals with comprehensive cardiac care may be warranted, and deserves further consideration."
In a related study, Dr. Ducas and her team audited 703 cases evaluated by EMS. 323 cases were evaluated as negative for STEMI and therefore were not transmitted to the on-call physician. Upon arrival at the nearest emergency room, 52% received a diagnosis of "nonspecific chest pain" and were subsequently discharged; one case of STEMI was missed, and 2 other patients developed STEMI after arrival at the hospital. 25% had a cardiovascular diagnosis after physician evaluation.
The ECGs of 380 patients were evaluated as positive and transmitted. Of this group, physicians suspected 226 cases of STEMI, of which 96.9% were confirmed. The false activation of the catheterization lab occurred in only seven of the 226 cases, and the physician missed the diagnosis in seven cases.
"The high level of false positives is a concern, given the risk of treatment," notes Dr. Ducas. "We do not have a clear guide as to what are acceptable levels of false positives and negatives. However, we have found both in the literature and in our own study that EMS pre-hospital ECG interpretation is fast, reliable, and plays a pivotal role in the care for patients with STEMI."
In an editorial accompanying the articles, Robert C. Welsh, MD, FRCPC, FAHA, FACC, of the Department of Medicine, University of Alberta and the Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada, says, "Our colleagues describe a program which provides the optimal platform to advance STEMI care in Canada. Although this approach is dependent on a motivated group of physicians willing to invest additional time and energy to deliver enhanced STEMI care, it allows pre-hospital confirmation of diagnosis, individual patient risk stratification, immediate decision regarding the optimal mode of reperfusion, and expansion of optimal systems of care to rural patients."

Thursday, 19 July 2012

e-Health Access allocates Rs.48-cr for telemedicine technology focusing on preventive care

Medical care start-up company e-Health Access Pvt. Ltd, which received an angel funding of Rs.120 crore, has allocated 40 per cent of the funding for the development of telemedicine technology and the remaining for marketing and expansion.
The telemed network is a web based service via mobile and broadband connectivity. It has identified a panel of doctors and specialists to provide instant medical consultation over the phone where one can get expert advice on any health-related issue through its panel of over 350 specialists and 200 general practitioners. In the last three years, it has managed to garner a customer-base of 35,000.
“We have built a virtual telemedicine technology eco-system which connects patients and doctors through email, chat, video and phone call. We are also bringing in a medical kiosk which will be a virtual multi specialty centre wherever it is located. While we believe that every individual should have seamless access to healthcare and thus create a bridge between patient and healthcare practitioner with a major focus not to fall ill. Therefore we are not linking to hospitals but only looking at primary and preventive care to connect to a doctor anywhere in India,” S Jayadeep Reddy, MD and CEO, e-Health Access told Pharmabiz in an email interaction.
The Hyderabad-based company through its website provides healthcare services over internet and through phone. One can get opinions from top specialists in various medical specialties like gynaecology, dermatology, gastroenterology, cardiology, psychology among others right through 24/7.
With the kind of hectic schedules for India’s working population, now all that is required is a phone to dial a doctor. We are looking to provide fast and affordable healthcare for patients through a large network of physicians across the globe, he added.
The cost of service ranges from Rs.99 to Rs.999 where the user who is subscribed for the latter would get a year-long unlimited access for entire family.
The future efforts with telemedicine for the company is to be able to work on technology based devices which will enable a low cost and easily accessible solutions for India. Right now these services are for India but plans global reach.
Commenting on India’s presence in this area, Reddy stated that there was a need for a good policy framework for telemedicine operations and right regulations in place would only help to bring lot of change in the healthcare eco system.
“Telemedicine has proved to be beneficial and cost effective solution for years. To commercialize this, there needs to be considerable efforts from the policy makers as well. However, there is a challenge to bring in doctors to this platform as patients are already interested. Until a few years ago, technology gadget usage by doctors was considerably low unlike today where its adaptation is seen to be more viable which is a clear indication that telemedicine is the way forward,” stated Reddy.

Immune System Can Be Badly Affected By Sleep Loss

According to a report published in the journal SLEEP by scientists from Netherlands and the United Kingdom, lack of sleep and physical stress are equally detrimental and can adversely affect our immune system.
The researchers from Erasmus Medical Center at Rotterdam and the Faculty of Health and Medical Sciences at the University of Surrey, United Kingdom, studied the number of white blood cells (WBC) in 15 healthy young males with normal sleep and compared them with the WBCs in healthy young males with severe sleep loss.
The circadian clocks of the 15 young men studied had to be stabilized and for this reason they were made to adhere to a strict regime of eight hours sleep every day, for a whole week. Ninety minutes after waking up, they were exposed to 15 minutes of out-door light. The subjects also had to stay away from caffeine, alcohol and some medications.
The white blood cells of the subjects were then categorized and measured. A comparison was carried out between the WBC counts taken for a week during their normal sleep/wake cycle and the WBC counts during the second part of the experiment, when the subjects had to remain sleepless for 29 hours.
It was found that in individuals experiencing sleep deprivation day-to-night time rhythmicity was lost as the number of WBCs shot up, especially during nighttime. The most affected WBCs were the granulocytes.
Katrin Ackermann, PhD, the lead author said,"The granulocytes reacted immediately to the physical stress of sleep loss and directly mirrored the body's stress response."
Granulocyte is a subset of white blood cells, which has microscopic granules that contain enzymes for digesting microorganisms. They form a part of our innate immune system and unlike the B and T cells that respond exclusively to specific antigens, the granulocytes have a broad based activity.
Earlier studies have indicated that adequate sleep is necessary for one’s well being and for the immune system to work properly.
Besides immune–impairment there are several problems associated with sleep deprivation like memory lapses, cognitive impairment, irritability, tremors aches, hallucinations, risk of heart disease, diabetes and obesity.
There are several reasons for sleep deprivations and the most common ones include stress, junk food or an underlying medical condition.
"Future research will reveal the molecular mechanisms behind this immediate stress response and elucidate its role in the development of diseases associated with chronic sleep loss”. ”If confirmed with more data, this will have implications for clinical practice and for professions associated with long-term sleep loss, such as rotating shift work", Ackermann said. 

Source:Fox News


Efficacy of Herbal Remedies for Managing Insomnia

Approximately 1 in 3 Americans suffers from chronic sleep deprivation and another 10-15% of the population has chronic insomnia. Sleep disorders can profoundly affect a person’s whole life and have been linked to a range of diseases, including obesity, depression, anxiety, and inflammatory disorders. Over-the-counter herbal remedies are often used to treat insomnia, but surprisingly, very little research has been done to study their efficacy, according to an article in Alternative and Complementary Therapies, published by Mary Ann Liebert, Inc., publishers. The article is available free on the Alternative and Complementary Therapies website.People need many hours of sound, restorative sleep every night to maintain an optimal state of physiological and psychological health, but many factors can disrupt sleep schedules and compromise the quality of sleep. In the article, “Sleep…Naturally: A Review of the Efficacy of Herbal Remedies for Managing Insomnia,” the authors conducted a search of the Internet and electronic databases to identify literature on herbal remedies that are commonly used to manage insomnia, including valerian, hops, kava-kava, chamomile, and St. John’s wort. They found that few scientific studies had been published that reported on the therapeutic potential and safety of these herbal remedies and the results were either inconclusive or contradictory.The authors concluded that, considering the benefits that a natural management strategy could offer patients with insomnia, additional research is required to assess the effectiveness and safety of herbal remedies as therapeutic agents.
Alternative and Complementary Therapies is a bimonthly journal that publishes original articles, reviews, and commentaries evaluating alternative therapies and how they can be integrated into clinical practice. Topics include botanical medicine, vitamins and supplements, nutrition and diet, mind-body medicine, acupuncture and traditional Chinese medicine, ayurveda, indigenous medicine systems, homeopathy, naturopathy, yoga and meditation, manual therapies, energy medicine, and spirituality and health. Complete tables of content and a sample issue may be viewed on the Alternative and Complementary Therapies website.

Stanford researchers first to determine entire genetic sequence of individual human sperm

The entire genomes of 91 human sperm from one man have been sequenced by Stanford University researchers. The results provide a fascinating glimpse into naturally occurring genetic variation in one individual, and are the first to report the whole-genome sequence of a human gamete — the only cells that become a child and through which parents pass on physical traits.
"This represents the culmination of nearly a decade of work in my lab," said Stephen Quake, PhD, the Lee Otterson Professor in the School of Engineering and professor of bioengineering and of applied physics. "We now have devices that will allow us to routinely amplify and sequence to a high degree of accuracy the entire genomes of single cells, which has far-ranging implications for the study of cancer, infertility and many other disorders."
Quake is the senior author of the research, which will be published July 20 in Cell. Graduate student Jianbin Wang and former graduate student H. Christina Fan, PhD, now a senior scientist at ImmuMetrix, share first authorship of the paper.
Sequencing sperm cells is particularly interesting because of a natural process called recombination that ensures that a baby is a blend of DNA from all four of his or her grandparents. Until now, scientists had to rely on genetic studies of populations to estimate how frequently recombination had occurred in individual sperm and egg cells, and how much genetic mixing that entailed.
"Single-sperm sequencing will allow us to chart and understand how recombination differs between individuals at the finest scales. This is an important proof of principle that will allow us to study both fundamental dynamics of recombination in humans and whether it is involved in issues relating to male infertility," said Gilean McVean, PhD, professor of statistical genetics at the Wellcome Trust Centre for Human Genetics. McVean was not involved in the research.
The Stanford study showed that the previous, population-based estimates were, for the most part, surprisingly accurate: on average, the sperm in the sample had each undergone about 23 recombinations, or mixing events. However, individual sperm varied greatly in the degree of genetic mixing and in the number and severity of spontaneously arising genetic mutations. Two sperm were missing entire chromosomes. The study has long-ranging implication for infertility doctors and researchers.
"For the first time, we were able to generate an individual recombination map and mutation rate for each of several sperm from one person," said study co-author Barry Behr, PhD, HCLD, professor of obstetrics and gynecology and director of Stanford's in vitro fertilization laboratory. "Now we can look at a particular individual, make some calls about what they would likely contribute genetically to an embryo and perhaps even diagnose or detect potential problems."
Most cells in the human body have two copies of each of 23 chromosomes, and are known as "diploid" cells. Recombination occurs during a process called meiosis, which partitions a single copy of each chromosome into a sperm (in a man) or egg (in a woman) cell. When a sperm and an egg join, the resulting fertilized egg again has a full complement of DNA.
To ensure an orderly distribution during recombination, pairs of chromosomes are lined up in tight formation along the midsection of the cell. During this snug embrace, portions of matching chromosomes are sometimes randomly swapped. The process generates much more genetic variation in a potential offspring than would be possible if only intact chromosomes were segregated into the reproductive cells.
"The exact sites, frequency and degree of this genetic mixing process is unique for each sperm and egg cell," said Quake, "and we've never before been able to see it with this level of detail. It's very interesting that what happens in one person's body mirrors the population average."
Major problems with the recombination process can generate sperm missing portions or even whole chromosomes, making them incapable of or unlikely to fertilize an egg. But it can be difficult for fertility researchers to identify potential problems.
"Most of the techniques we currently use to assess sperm viability are fairly crude," said Quake.
To conduct the research, Wang, Quake and Behr first isolated and sequenced nearly 100 sperm cells from the study subject, a 40-year-old man. The man has healthy offspring, and the semen sample appeared normal. His whole-genome sequence (obtained from diploid cells) has been previously sequenced to a high level of accuracy.
They then compared the sequence of the sperm with that of the study subject's diploid genome. They could see, by comparing the sequences of the chromosomes in the diploid cells with those in the haploid sperm cells, where each recombination event took place.
The researchers also identified 25 to 36 new single nucleotide mutations in each sperm cell that were not present in the subject's diploid genome. Such random mutations are another way to generate genetic variation, but if they occur at particular points in the genome they can have deleterious effects.
It's important to note that individual sperm cells are destroyed by the sequencing process, meaning that they couldn't go on to be used for fertilization. However, the single-cell sequencing described in the paper could potentially be used to diagnose male reproductive disorders and help infertile couples assess their options. It could also be used to learn more about how male fertility and sperm quality change with increasing age.
"This could serve as a new kind of early detection system for men who may have reproductive problems," said Behr, who also co-directs Stanford's reproductive endocrinology and infertility program. "It's also possible that we could one day use other, correlating features to harmlessly identify healthy sperm for use in IVF. In the end, the DNA is the raw material that ultimately defines a sperm's potential. If we can learn more about this process, we can better understand human fertility." Source:Stanford University Medical Center 

Popular Herbal Remedy Used by Patients to Treat Hepatitis C-Related Liver Disease Proves Ineffective, Penn Study Finds

Silymarin, an extract of milk thistle commonly used to treat chronic liver disease by millions of people around the World, does not offer significant improvements for patients, according to a new study conducted by a nationwide group of researchers including faculty at the Perelman School of Medicine at the University of Pennsylvania. Milk thistle fruit extracts have been widely used by patients in treating liver disease based on previous evidence showing that it has anti-inflammatory, anti-oxidant, and potentially anti-viral properties. However, the new study is the first rigorous trial of its kind conducted to assess true efficacy in a group of hepatitis C patients who were previously unsuccessfully treated with interferon-based therapy — the standard anti-viral method used to treat the disease. Full results of the study are published in the July 18 issue of The Journal of the American Medical Association.The Centers for Disease Control and Prevention (CDC) estimates that 3.2 million persons in the United States have chronic hepatitis C virus (HCV) infection. Of those, the study says 33 percent have reported current or past use of silymarin to treat the disease. The new study was designed to measure the potential benefit of increasing doses of silymarin in patients with chronic HCV. To determine efficacy, researchers monitored levels of serum alaninie aminotransferase (ALT) — the enzyme found in the blood stream that is most often tested to identify liver disease. Low levels of ALT are normally found in the blood, but are elevated when the liver is damaged or diseased. Secondary outcomes included quality-of-life measures.
"By all indications, silymarin is no more effective at treating hepatitis C related chronic liver disease, in those who failed standard therapy with interferon, than a placebo," said K. Rajender Reddy, MD, professor of Medicine and medical director of Liver Transplantation at Penn Medicine, and senior author of the study. "This is a landmark study as millions of people around the world are looking for supplements and other forms of alternative medicines to help reduce ALT levels every year."
The trial, which included 154 adult participants with chronic HCV, was conducted over the course of two years at four medical centers in the United States. Participants were randomly assigned to receive 420mg silymarin, 700mg silymarin or a matching placebo administered three times/week for 24 weeks, a standard duration of treatment. After 24 weeks, researchers found only two participants in each treatment group achieved lowered ALT levels. Neither the average decline in ALT activity nor quality-of-life measures at the end of treatment differed significantly across the treatment groups.
"These data show that even higher-than-normal doses of silymarin don't significantly reduce ALT levels for patients with HCV," said Reddy, noting that the doses used in the trial were three and five times higher than the customary dose. "At the end of the trial we saw no significant changes in physical or mental health assessments between the patients who received treatment, and those who did not. Quality-of-life measures were also largely unchanged."
The study was supported by grants from the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM) (UO1 AT003571, UO1 AT 003560, IO1 AT 003573, UO1 AT003566, and UO1 AT003574); with cofounding from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); and with support from the NIH Clinical & Translational Sciences Awards Division of Research Resources (UUL1 RR024134, UL1 TR000083). The trial was conducted under an investigational New Drug Application from the US Food and Drug Administration.
Source:Penn Medicine

A good night's sleep could keep you out of a nursing home

Tired? Scientists have discovered another possible benefit of a night of restful and uninterrupted sleep. According to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health fragmented or interrupted sleep could predict future placement in a nursing home or assisted living facility. The study is featured in the July 2012 issue of the Journal of the American Geriatrics Society and outlines the association between objectively measured sleep and subsequent institutionalization among older women.
"Sleep disturbances are common in older people," said Adam Spira, PhD, lead author of the study and an assistant professor with the Bloomberg School's Department of Mental Health. "Our results show that in community-dwelling older women, more fragmented sleep is associated with a greater risk of being placed in a nursing home or in a personal care home. We found that, compared to women with the least fragmented sleep, those who spent the most time awake after first falling asleep had about 3 times the odds of placement in a nursing home. Individuals with the lowest sleep efficiency—those who spent the smallest proportion of their time in bed actually sleeping—also had about 3 times the odds of nursing home placement." The authors found similar patterns of associations between disturbed sleep and placement in personal care homes, such as assisted-living facilities. Sleep duration per se did not predict placement in either of these settings.
According to the Centers for Disease Control and Prevention, insufficient sleep is associated with a number of chronic diseases and conditions—such as diabetes, cardiovascular disease, obesity and depression. In addition, insufficient sleep is associated with the onset of many diseases and is responsible for motor vehicle and machinery-related crashes. Previous studies have also linked disturbed sleep with disability in older adults and impairment in activities of daily living and mobility.
Using a prospective cohort study, researchers measured the sleep of women with a mean age of 83 years old from the Study of Osteoporotic Fractures. Participants were asked to wear actigraphs on their non-dominant wrists for at least three days. These devices record movement, and the resulting data can be used to characterize patterns of sleep and wake. Demographic information as well as place of residence at initial interview and at 5-year follow-up was also provided. Although several prior studies had investigated the link between sleep disturbance and nursing home placement, those studies asked participants questions about sleep rather than collecting objective sleep data.
"Despite the growing literature on sleep disturbance and disability, prior to our research very little was known about the association between sleep disturbance in older adults and risk of placement in long-term care facilities. Greater sleep fragmentation is associated with greater risk of placement in a nursing home or personal care home 5 years later after accounting for a number of potential confounders," said Kristine Yaffe, MD, senior author of the study, and professor of Psychiatry, Neurology, and Epidemiology and Biostatistics at the University of California, San Francisco.
Spira adds, "It's important to remember that this is an observational study, so our findings cannot demonstrate a conclusive causal link between sleep disturbance and placement in long-term care facilities. We need more research to explain how sleep disturbance might lead to this outcome, and whether interventions to improve sleep might prevent it."
Source:Johns Hopkins University Bloomberg School of Public Health 

Moderate alcohol intake is associated with a lower risk of kidney cancer

A majority of previous epidemiologic studies have shown that moderate drinking is associated with a lower risk of kidney cancer, which may affect about 1% of the general population. In published prospective cohort studies, the risk for such cancer among moderate drinkers is usually about 25% less than the risk seen among non-drinkers.
This well-done meta-analysis supports these findings: for the more-reliable prospective cohort studies (rather than case-control studies) the current study finds a 29% lower risk for subjects in the highest category of alcohol consumption in comparison with subjects in the lowest alcohol category. The findings suggest similar effects among men and women, and for all types of alcohol beverages. The effects are seen at a level of about one drink/day, with little further reduction in risk for greater alcohol consumption.

Wednesday, 18 July 2012

Am I Having a Heart Attack or is It Just the Hiccups?

According to a new study consumers who self-diagnose are more likely to believe they have a serious illness because they focus on their symptoms rather than the likelihood of a particular disease. The study was published in the Journal of Consumer Research. This has significant implications for public health professionals as well as consumers.
"In today's wired world, self-diagnosis via internet search is very common. Such symptom-matching exercises may lead consumers to overestimate the likelihood of getting a serious disease because they focus on their symptoms while ignoring the very low likelihood that their symptoms are related to any serious illness," write authors Dengfeng Yan and Jaideep Sengupta (both Hong Kong University of Science and Technology).
Consumers often fear the worst when it comes to their own health while maintaining a calm objectivity with regard to others. For example, when someone else suffers from indigestion, we tend to accurately perceive it as indigestion, but experiencing the same symptom might lead us to panic and worry that we're having a heart attack.
The authors asked consumers to imagine that they or someone else were suffering from common symptoms such as cough, fever, runny nose, and headache. They were then asked to assess the likelihood that they or the other person had contracted either H1N1 (swine flu) or regular flu. Consumers were much more accurate when assessing other people's symptoms. Since they are more likely to misdiagnose themselves, consumers may end up taking unnecessary medical action, which is bad for them, and also bad from a societal cost perspective.
"One of the easiest ways to get rid of this bias is to see a real doctor instead of Dr. Google. A real doctor possesses much more knowledge and will take the prevalence of a disease into consideration because she is viewing the patient from a distance. This will prevent symptoms from exerting a disproportionate influence on the diagnosis," the authors conclude. 


Practicing Banned Foetal 'Sex Tests' Gets Doctors Suspended in India

Conducting alleged prenatal sex tests practice, which is banned to stop the abortion of female foetuses that has widened India's gender gap, gets twelve Indian doctors suspended, reported officials.
The physicians were suspended on Monday from practising medicine following a court order, said Archana Johri, an official of the Rajasthan Medical Council watchdog.
"Five of the doctors were found guilty of sex determination practices while the remaining seven violated other provisions of the Pre-conception and Prenatal Diagnostic Techniques Act," she told AFP in Rajasthan state capital Jaipur.
In New Delhi, the Indian Medical Association condemned the alleged violations by the doctors in Rajasthan.
"It is a deplorable practice and we condemn it," Association Secretary D.R. Rai told AFP.
A study published last year in The Lancet said sex selection of foetuses in India led to 7.1 million fewer girls than boys up to age six, a gender gap that had grown by more than a million in a decade.
The 1996 law designed to prevent the use of ultrasound for prenatal sex tests is widely flouted in India, according to the study by researchers led by Prabhat Jha of the Centre for Global Health at the University of Toronto.
India's prime minister Manmohan Singh last year labelled the practice of aborting female foetuses a "national shame" and ordered policy planners to increase efforts to stamp it out.
Married women in India face huge pressure to produce male heirs, who are seen as breadwinners while girls are often viewed as a burden to the family as they require hefty dowries to be married off.
India has launched an array of schemes to change attitudes towards girls, including offering cash incentives for families not to abort them, but many have had little impact.


High Vitamin E Intake From Food or Vitamin Supplements may Lower Liver Cancer Risk

Taking a lot of vitamin E either in food or as vitamin supplements may lower the risk of liver cancer, reveals a study published July 17 in the Journal of the National Cancer Institute.
Liver cancer is the third most common cause of cancer mortality in the world, the fifth most common cancer found in men and the seventh most common in women. Approximately 85% of liver cancers occur in developing nations, with 54% in China alone. Some epidemiological studies have been done to examine the relationship between vitamin E intake and liver cancer; however, the results have been inconsistent.
To determine the relationship between vitamin E intake and liver cancer risk, Wei Zhang, MD, MPH., of the Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine and colleagues analyzed data from a total of 132,837 individuals in China who were enrolled in the Shanghai Women's Health Study (SWHS) from 1997-2000 or the Shanghai Men's Health Study (SMHS) from 2002-2006, two population-based cohort studies jointly conducted by the Shanghai Cancer Institute and Vanderbilt University. Using validated food-frequency questionnaires, the researchers conducted in-person interviews to gather data on study participants' dietary habits. They compared liver cancer risk among participants who had high intake of vitamin E with those with low intake.
The analysis included 267 liver cancer patients (118 women and 149 men) who were diagnosed between 2 years after study enrollment and an average of 10.9 (SWHS) or 5.5 (SMHS) years of follow-up. Vitamin E intake from diet and vitamin E supplement use were both associated with a lower risk of liver cancer. This association was consistent among participants with and without self-reported liver disease or a family history of liver cancer. "We found a clear, inverse dose-response relation between vitamin E intake and liver cancer risk," the authors write, noting a small difference between men and women in the risk estimate, which is likely attributable to fewer liver cancer cases having occurred among SMHS participants due to the shorter follow-up period. Overall, the take home message is that, "high intake of vitamin E either from diet or supplements was related to lower risk of liver cancer in middle-aged or older people from China."


Columbia Asia Hospital performs rare surgery to remove a tapeworm from a patient’s voice box

Columbia Asia Hospital at Hebbal in Bengaluru has treated cysticercosis which is a parasitic infestation by pork tapeworm and a leading cause of multiorgan infections. A 34-year-old patient was suffering from intermittent hoarseness of voice since two years and the hospital performed a two-hour long microlaryngeal surgery to remove the tape worm.
While the patient had no history of throat pain or voice abuse, the situation turned worse when he started having excruciating pain and could barely manage to talk. Involvement of the vocal cords or voice box by cysticercus is a rare occurrence. Only two or three cases have been reported across the globe. Confirmatory diagnosis is usually done by histological examination from affected part.
Dr Santosh S Consultant ENT, Head and Neck Surgeon, Columbia Asia Hospital, Hebbal, Bangalore who led the team said that examination and investigation indicated that there was a grayish semi transparent mass inside the voice box.
“The mass was a parasitic infestation caused by a tapeworm found in the intestines of pigs and a leading cause of multi-organ infections,” said Dr Santosh.
What made it challenging was the fact that the worm was lodged right in his voice box. In a two hour long microlaryngeal surgery, the worm was removed from his vocal cord. The patient has recovered extremely well, has recovered his normal voice and has resumed a normal life, he added.
Cysticercosis is no longer an endemic disease but is now a global issue  because of immigration from endemic areas. Tapeworm infestation is commonly seen in developing countries due to a combination of factors like crowding and poor sanitation leading to faecal contamination of food and water, close contact between humans and pigs and thus more opportunities for transmission of disease. Tapeworm infestation is common in rural areas than in urban areas, due to lack of a proper sewerage system and lesser access to health care. Infestation with the adult worm takes place by the ingestion of uncooked or poorly-cooked pork containing encysted larvae of tape worm, Taenia solium.
Columbia Asia Hospitals Pvt. Ltd. is one of the first healthcare companies to enter the country through 100 per cent foreign direct investment (FDI) route. The Group is owned by more than 150 private equity companies, fund management organizations and individual investors. It currently operates six multi-specialty community hospitals, one referral hospital and one clinic in India. The company also operates hospitals in Malaysia (10), Vietnam (three), and Indonesia (one). The Indian management operations are managed from Bengaluru.


Fighting obesity with thermal imaging

Scientists at The University of Nottingham believe they’ve found a way of fighting obesity — with a pioneering technique which uses thermal imaging. This heat-seeking technology is being used to trace our reserves of brown fat — the body’s ‘good fat’ — which plays a key role in how quickly our body can burn calories as energy.
This special tissue known as Brown Adipose Tissue, or brown fat, produces 300 times more heat than any other tissue in the body. Potentially the more brown fat we have the less likely we are to lay down excess energy or food as white fat.
Michael Symonds, Professor of Developmental Physiology in the School of Clinical Sciences, led a team of scientists and doctors at The University of Nottingham who have pioneered the thermal imaging process so we can assess how much brown fat we’ve got and how much heat it is producing. Their research has just been published in the Journal of Pediatrics.

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A stronger doctor-patient relationship for the costliest patients

$6.1 million 'innovation grant' awarded to test comprehensive care physician model

Patients who are frequently hospitalized account for a disproportionate amount of health care spending in the United States. Working with a $6.1 million grant, a new University of Chicago Medicine program will test whether an updated version of the traditional general practitioner can reduce spending while also improving care for these patients.
Under the new model, funded by a Health Care Innovation Award from the Center for Medicare & Medicaid Innovation, multidisciplinary teams led by a comprehensive care physician (CCP) will care for patients in both outpatient and inpatient settings. By improving the continuity of an individual's care after a hospital stay and strengthening the bond between doctor and patient, the model hopes to provide better care at lower cost.
"Our goal will be to really understand patients' needs so that we can give them the care that they need," said lead investigator David Meltzer, MD, PhD, associate professor and chief of the Section of Hospital Medicine at the University of Chicago Medicine. "That should be better for them, and should ultimately be less costly for the health care system and produce better outcomes."
The model is built upon 15 years of research by Meltzer and colleagues on the changing medical work force in the United States. Health care providers increasingly rely on specialized physicians known as hospitalists to care for inpatients, while primary care doctors are less likely to see their patients while they are hospitalized. Though Meltzer found that this rearrangement has produced modest benefits in terms of health outcomes and reduced spending, it also has created unintended rifts in a patient's care.
"A whole series of trends have emerged over time that has made the traditional continuity in the doctor-patient relationship between the outpatient and inpatient setting more difficult," Meltzer said. "It's not that doctors don't understand this continuity is important or don't want to provide it; they face real barriers in caring for patients in both the inpatient setting and the outpatient setting. By focusing on frequently hospitalized patients, our CCPs will be able to have a real presence in the hospital and clinic on an almost daily basis."
Previous research supports that a strong doctor-patient relationship can lower the nation's health care tab. A 1984 Veterans Administration study compared patients who saw the same primary care doctor at every clinic visit against patients who saw a different physician each visit. It found reduced hospitalizations, hospital stays, and intensive care unit (ICU) usage in the group with higher continuity of care. Another study found that advanced lung cancer patients with integrated outpatient and inpatient care were 25 percent less likely to enter the ICU before death.
"There's a huge literature suggesting that elements of the doctor-patient relationship, including trust, interpersonal relations, communication, and knowledge of the patient, are all associated with lower costs and better outcomes," Meltzer said.
While the "Marcus Welby" style of doctor who manages all facets of care in and out of the hospital is no longer economically feasible – or necessary – for all individuals, Meltzer proposes that comprehensive care could be useful for patients at the highest risk of repeated hospitalization. Such patients, dubbed "hot spotters" by surgeon/writer Atul Gawande, account for a significant portion of health care spending in the United States, with one estimate concluding that 5 percent of Medicare beneficiaries account for 40 percent of Medicare spending.
In Meltzer's model, a comprehensive care physician will lead a team of nurse practitioners, social workers, care coordinators and other specialists best suited to address the needs of such high-risk patients. CCPs will carry a panel of approximately 200 patients at a time, serving as their primary care physician during clinic visits and supervising their care while hospitalized.
The trial will enroll patients from the South Side of Chicago who are predicted to spend an average of 10 days a year in the hospital. Many of these patients are expected to be general medicine patients with chronic diseases, geriatric patients living in residence homes or patients with renal disease receiving regular dialysis treatment. Five CCPs will be recruited to serve as team leaders for the demonstration project, which is expected to begin in fall 2012. A total of 11 new jobs will be created by the project.
"One of the highest priorities in our efforts to lower health care costs is to reduce the rate of expensive hospitalizations," said Kenneth S. Polonsky, MD, dean of the Biological Sciences Division and the Pritzker School of Medicine and executive vice president of medical affairs at the University of Chicago Medicine. "Dr. Meltzer's innovative approach to this problem offers real hope that we will be able to deliver more health care in the community even to the sickest patients."
The Health Care Innovation Award for the comprehensive care program is one of two received by the University of Chicago Medicine – the only academic medical center in Illinois to receive multiple awards from the $900 million initiative. Previously, a $5.9 million grant was awarded to the institution in May to create the CommunityRx system, which will connect patients with community resources and services.
"For our institution to have two of these grants awarded is a real testimony to the forward thinking and innovative ideas that are here on our campus to deal with some of these very vexing public health and care coordination issues," said Sharon O'Keefe, president of the University of Chicago Medical Center.
Source:University of Chicago Medical Center 

Green plants reduce city street pollution up to 8 times more than previously believed

Trees, bushes and other greenery growing in the concrete-and-glass canyons of cities can reduce levels of two of the most worrisome air pollutants by eight times more than previously believed, a new study has found. A report on the research appears in the ACS journal Environmental Science & Technology.
Thomas Pugh and colleagues explain that concentrations of nitrogen dioxide (NO2) and microscopic particulate matter (PM) — both of which can be harmful to human health — exceed safe levels on the streets of many cities. Past research suggested that trees and other green plants can improve urban air quality by removing those pollutants from the air. However, the improvement seemed to be small, a reduction of less than 5 percent. The new study sought a better understanding of the effects of green plants in the sometimes stagnant air of city streets, which the authors term "urban street canyons."
The study concluded that judicious placement of grass, climbing ivy and other plants in urban canyons can reduce the concentration at street level of NO2 by as much as 40 percent and PM by 60 percent, much more than previously believed. The authors even suggest building plant-covered "green billboards" in these urban canyons to increase the amount of foliage. Trees were also shown to be effective, but only if care is taken to avoid trapping pollutants beneath their crowns.

Tuesday, 17 July 2012

The deadly world of fake medicine: Roger Bate

Everyone knows about the risks that narcotics pose and the lethal war waged against them. But there are probably far more deaths caused by dangerous therapeutic medicines.
Lazy, cost-cutting manufacturers and criminal counterfeiters make billions of dollars a year peddling products that may kill you, which you might find online or even at your neighborhood pharmacy.I first came across dangerous drugs while evaluating HIV and malaria projects in Southern Africa eight years ago.
Patients were dying because the pills did not provide the needed medicine. Fakes contained chalk, talcum powder, road paint and occasionally dangerous heavy metals, instead of the expensive, hard-to-make medicine.
FDA commissioner talks counterfeit drugs
Terrorist organizations such as Hezbollah have profited from this trade, but no group has so far used it as a weapon. Most producers of bad products are not trying to kill patients.
They are out to make money and simply do not care who gets hurt, or even dies, in the process.
It is impossible to know the exact size of the trade or its lethal impact -- some guesses are as high as 700,000 deaths globally each year. I estimate that bad medicines cause at least 100,000 deaths annually.
Some markets are barely affected, while others are replete with substandard products.
Playing Russian roulette with fake drugs
"Pharmaceutical counterfeiting is a low-risk, high-profit criminal enterprise that attracts entrepreneurs and organized criminals," says John P. Clark, vice president and chief security officer for the drug company Pfizer. "What was once seen as a problem limited to lifestyle medicines is now recognized as a threat from which no therapeutic area is immune."
Up to a third of the market for anti-malarials are suspect in some way, and around 10% of all essential drugs in emerging markets fail basic quality tests.
While the United States is much better served -- far less than 1% of all drugs are faulty -- even if only 0.001% of the 4 billion prescriptions filled in this country every year were compromised, 40,000 prescriptions could be deadly.
More worryingly, lethal drug incidents are on the rise in the United States. Fakes of heparin, a blood-thinning drug, killed 149 Americans in 2007 and 2008, and many more deaths likely go undetected every year.
FDA: Beware of 'fake' potassium iodide
In most cases, no crime is suspected as the consumers are often quite sick and the evidence is swallowed. If a relative with a heart problem dies from a heart attack, who would think to investigate the medicine? But fake Plavix, Medicare's most-often reimbursed heart medication, has been found in numerous countries.
Before the civil war in Syria, its capital, Damascus, was home to a major counterfeit drug operation that made tens of millions of dollars between 2003 and 2009.
The ring manufactured more than 80 brands -- including Plavix -- of fake medicine very convincingly, only distinguishable from real drugs by experts. Yet none of them contained the correct ingredients. Fake antibiotics, cancer and heart medications penetrated every major market of the Middle East, including the one funded by U.S. tax dollars in Iraq.
While part of the operation was shut down in 2009, some gang members fled and reassembled in Iraq and Iran. My sources in the Middle East believe that this gang may have begun operations again in Damascus, bribing officials with their vast wealth to turn a blind eye.
Most worrying for Americans, they may have been the source of thefake cancer-drug Avastin that surfaced in California, Illinois and Texas in March and April.
Fighting the growing menace of fake drugs
U.S. authorities are limited in combating illegal trades outside the United States. International law is currently inadequate to combat international fake drug rings, and there is a need for a global treaty against such products. I am optimistic that this will change within the next decade; international laws will be strengthened, and global efforts against counterfeiters will constrain their activities.
But I am less certain that governments will effectively tackle legal producers who make bad products. These companies pay their taxes, provide jobs and have political clout across numerous emerging markets.
Cutthroat competition among chemical and drug manufacturers keeps prices low, but it also encourages corner-cutting. In some emerging markets, there are more than 300 brands of the same class of medicine. Local regulators do not have enough competent staff to conduct either thorough inspections of all production plants or survey products in the market.
Consequently, companies routinely get away with substandard production.
Most tragically, these producers undercut better producers on price and sometimes force more responsible players to exit the market.
Chinese and Indian producers dominate many drug categories in emerging markets, notably anti-infectives. While many of these companies make good medicines, a substantial subset routinely target poor markets with substandard versions.
Until regulators and customers in emerging markets demand better products, tens of thousands will be killed by substandard drugs, and unfortunately some of these products will make their way to U.S. markets, too.
By: Roger Bate

German actress lured by the healing power of ayurveda

 It is said that after a visit to Kerala one is never the same.Ingeborg Schoener, the German television and film actress stands testimony to that. 
The actress was recognized by a fellow guest at Coconut Bay resort, located at Mulloor where she has checked in for an intense ayurveda treatment. The word quickly got around and eyes follow her everywhere. She is touching 77, but her grace and charm holds one captive. 
Schoener, who has been resort-hoping in Kerala for the past eight years, said she has been cured of intense knee pain by ayurveda treatments. 
"A friend of mine, a stewardess with a foreign airline, mentioned about the place to me and I was intrigued. I've stayed at Somatheeram and Manaltheeram along the Vizhinjam coast and there is nothing like it in the world. I hear that there are plans afoot to develop this area into a port. It gives me goosebumps just thinking about it. The last time I felt so strongly about something was when the Berlin Wall was demolished. I was on a bus touring with a theatre company but I broke down when I heard the news," said the actress who has given lectures on ayurveda to other Germans at trade marts at the behest of her travel company. She said her hope resides on the fact that everything happens slowly in India. 
"Maybe it will take many more years to build a port. But who knows how many more years I can visit this beautiful coast." 
Schoener, who seldom leaves the resort premises because she believes that could hamper the effects of the treatment, steps out only to buy a pant-suit material from a local shop at Powerhouse Road and gets them stitched at Duron, one among the leading tailors in Kerala. "I used to pay 150 EU three years ago now I pay almost double, but that is still cheap compared to bespoke shops in Germany." 
About the bit that changed Schoener after her tryst with Kerala, she said she lives a life as prescribed by ayurveda doctors. 
"I make ghee at home and I have stopped using oil to fry food. I do my yoga, drink a glass of hot water first thing in the morning and buy one-year worth of ayurvedic medicines. I have stopped allopathic treatments. I have travelled the world but I am now at a time when my voyages are inward. Thanks to ayurveda, I feel fantastic." 


Edible Birds’ Nests Slowly Finding Base in Mainstream Health Products

Traditional Chinese medicine is slowly entering the mainstream after researchers revealed that edible birds’ nests, which are thought to have high nutritional and medicinal value, are being converted into food and drink additives.
At as much as 4,500 dollars per pound, edible birds' nests are among the most expensive foods on the planet.
Made from the saliva of cave-dwelling birds called swiftlets, the nests are dangerous to harvest, laborious to prepare and have, according to traditional Chinese medicine, a long list of health benefits.
For possibly 1,200 years, the Chinese have prepared and eaten the nests as a soup, according to two Chinese researchers who have assessed just what is known about the nutritional and medicinal properties of this expensive, and to Westerners, strange-sounding health food.
Science cannot yet explain the healing powers attributed to the soup, they noted.
Birds' nests "bioactivities and medicinal value are still open to question as there (is) not much scientific research on the medicinal properties," Live Science quoted Fucui Ma and Daicheng Liu of Shandong Normal University in China wrote in a review article to be published in the October issue of the journal Food Research International.
Swiftlets live in limestone caves around the Indian Ocean, in South and South East Asia, North Australia and the Pacific Islands. Males primarily build the nests, attaching them to the vertical walls of the caves. Removing them can be dangerous and painstaking work, and, depending on the type of nest, it can take one person eight hours to clean 10 nests, the researchers wrote.
The nests are considered to have a high nutritional and medicinal value, believed to have everything from anti-aging and anti-cancer properties to the ability to improve concentration and raise libido.
Protein is the most abundant constituent of the nests, which contain all of the essential amino acids, the building blocks out of which proteins are made. They also contain six hormones, including testosterone and estradiol, the researchers wrote.
The nests also contain carbohydrates, ash and a small quantity of lipids (naturally occurring molecules that include fats). Previous research has indicated that the nests contain substances that can stimulate cell division and growth, enhance tissue growth and regeneration, and that it can inhibit influenza infections.
But not everyone reacts well to them. Birds' nests are known to cause anaphylaxis, a life-threatening allergic reaction.
Little research has been carried out on their biological function so far, and more is needed to better understand the qualities attributed to them, they concluded.


Migraine Could Give Rise to Other Neurological Symptoms

While a migraine is generally assumed to be a severe form of headache, American researchers reveal that it could be more than a headache in some people who also have to deal with other neurological symptoms that could affect their quality of life.
According to Dr. Rebecca Poetschke, who treats patients at the new migraine clinic at the Women's Health Center on the campus of ProMedica Herrick Hospital, migraines are actually a group of neurological symptoms that vary widely among sufferers.
The American Migraine Foundation, an American nonprofit organization that supports migraine research, states on its website that migraine symptoms generally include severe, recurring intense pain on one side of the head (although both sides can be affected) accompanied by one or more of the following: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sensorial stimulation and tingling or numbness in the extremities or face.
The fact that migraine syndrome involves multiple symptoms that differ from person to person and often change with each migraine episode can make diagnosing the condition challenging.
"Migraine syndrome affects different people in different ways and to different degrees," noted Dr. Steven Sherman, a neurologist who also treats patients in the migraine clinic at the Women's Health Center.
"For mild cases, some people are able to control their symptoms with lifestyle changes. Medications and other treatments may help more severe cases," he stated.
Although migraine does affect men, almost three times as many women suffer from the syndrome. Migraine can be a genetic disorder, making it common for children whose parents experience migraines to do the same. The American Headache Society estimates that up to 10 percent of children in the United States suffer from migraine.
Despite the widespread occurrence of the condition, many migraine sufferers go undiagnosed. While there is no immediate health risk to delaying treatment other than discomfort and lack of productivity, over the long term, research has shown that migraine sufferers are more susceptible to other health problems including depression, anxiety, sleep disorders, other pain conditions and fatigue.
"The key to treating migraine effectively is identifying the patterns of onset and any lifestyle factors that may trigger episodes," Poetschke said.
"Many people can learn to manage migraine effectively and reduce their frequency simply by being aware of things that may bring them on and making changes to avoid their triggers," he noted.
Poetschke suggested that patients keep a diary of their migraine patterns and lifestyle habits for several weeks as a tool for determining the frequency and severity of their attacks and what triggers them.
For people who suffer from chronic migraine episodes, additional therapies may be necessary.
"If you are experiencing migraines on a regular basis that are debilitating and impacting your quality of life, you should seek medical attention," recommended Sherman.
"While avoiding triggers is important, for some people medication or other clinical treatments are the only way to get their migraines under control, he added.
According to Sherman, there are many treatment options for migraine, including oral medications, injections to relax the tight muscles and block nerve pain, and alternative treatments such as acupuncture and massage.


Study may explain how exercise improves heart function in diabetics

Research on diabetic mice reveals heart benefits of increased fatty acids released during exercise

A detailed study of heart muscle function in mice has uncovered evidence to explain why exercise is beneficial for heart function in type 2 diabetes. The research team, led by scientists at the Johns Hopkins University School of Medicine, found that greater amounts of fatty acids used by the heart during stressful conditions like exercise can counteract the detrimental effects of excess glucose and improve the diabetic heart's pumping ability in several ways. The findings also shed light on the complex chain of events that lead to diabetic cardiomyopathy, a form of heart failure that is a life-threatening complication of type 2 diabetes.
The study, described in an article published online on July 17, 2012 in the journal Diabetes, was conducted in a mouse model of type 2 diabetes, and focused on the exchange of energy within heart muscle cells. The researchers looked at the impact of glucose and fatty acids, which are different types of "fuel" that provide energy to the cells—and how those affect heart muscle function.
"Our work offers a new view of the role of fatty acids in diabetic hearts under stress, and suggests potential new therapies to improve heart function," says Miguel Aon, Ph.D., assistant professor of medicine at the Johns Hopkins University School of Medicine and a senior author of the study article. "It has been commonly assumed that fatty acids were detrimental to heart muscle function, but our study showed the opposite to be true in the diabetic heart."
The researchers studied models of intact mouse hearts from both normal and diabetic mice, and also were able to isolate the mitochondria—the tiny energy drivers within cells—from the mouse hearts. The heart relies on energy from mitochondria to produce beats.
Specially bred diabetic mice have long been used successfully to study human diabetes because the disease in the tiny mammals mimics the disorder in humans. For example, both mice and people with diabetes have an excess amount of glucose circulating in their blood because of impaired insulin function, and they are generally overweight or obese.
In their experiments, the researchers "fed" the normal and diabetic hearts excess glucose and stimulated the hearts to beat faster by bathing them in a hormone-like substance, isoproterenol, which acts like the body's natural catecholamine, activated when a person is under stress or participating in high levels of physical activity. While the normal hearts were able to handle the increased glucose load and pump normally, the diabetic hearts could not contract or relax enough to keep up with the load and pump normally.
Next, the scientists repeated the experiments by feeding twice the usual amount of fatty acids to the normal and the diabetic hearts. "We found that the function of the normal heart did not change, but to our surprise, the diabetic hearts improved to the level of the normal hearts," says Nazareno Paolocci, M.D., Ph.D., assistant professor of medicine at the Johns Hopkins University School of Medicine and co-author of the study.
Aon says fatty acids appear to improve the exchange of energy within cells and also help the heart to resist the negative effects of reactive oxygen species (ROS). These molecules have a positive role in signaling within cells, but too much ROS can cause oxidative stress, damaging or even killing cells.
The researchers found that the fatty acids also counteracted impairments in the function of diabetic hearts caused by too much glucose.
When we overeat, the excess energy is stored as fat, leading to being overweight or obese, which increases the risk of type 2 diabetes. When people chronically put on weight, the fat accumulates inside cells and becomes toxic, crowding out the other functions of the cells. Aerobic exercise, such as brisk walking, jogging, biking and swimming, has long been known to modify the negative impact of diabetes on heart muscle.
Aerobic exercise breaks up stored fatty acids to provide more fuel to the heart, and this study demonstrates that additional fatty acids can be good for the diabetic heart when it needs to beat faster, Aon says.
Another key finding of the study relates to understanding why people with type 2 diabetes develop cardiomyopathy—a form of heart failure. "Over time, if the heart muscle is not receiving enough energy, the mechanical and electrical functions required to produce a normal heartbeat become impaired, which leads to cardiomyopathy," says Aon. "In our study, we were able to show a cause-and-effect relationship between dysfunction of the mitochondria—the energy-producing components of cells—and the heart's mechanical and electrical functions, which helps to explain why people with type 2 diabetes develop cardiomyopathy," he says.
To counteract the damaging chain of events, the researchers added glutathione, an important antioxidant, to the diabetic mouse heart cells, and that greatly improved their mechanical function. Researchers also found that increasing the exposure of the heart muscle cells to fatty acids raised the amount of naturally occurring glutathione. So, the scientists conclude that glutathione or similar compounds could be a new avenue of treatment for people with type 2 diabetes.
"Now that we have shed light on why exercise can improve heart function in people with type 2 diabetes," says Aon, "the next step is figuring out how to harness that knowledge to prevent heart damage from diabetes, especially among those people who cannot bring their blood sugar levels under good control."
Source:Johns Hopkins Medical Institutions 

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