Victory Over Polio for India!

One of India's biggest public health success stories, which was believed to be impossible to achieve- the eradication of polio, will now be celebrated on Tuesday by Indian leaders.            

President Pranab Mukherjee, Prime Minister Manmohan Singh as well as the health minister and the head of the World Health Organisation are all due at a New Delhi stadium to celebrate "India?s victory over polio", the information ministry says.

India, long one of the biggest sources of the paralysing virus, has gone three years without a new case, which means it will soon be certified as having wiped out the scourge.

On the three-year anniversary of the last case, on January 13, Health Minister Ghulam Nabi Azad hailed the "monumental milestone" and promised a celebration in honour of the officials, volunteers, NGOs and UN agencies which made it possible.

Polio is a virus spread through faecal matter that affects the central nervous system and can leave its victims with withered limbs or paralysis.

There is no cure but it can be prevented through mass vaccination programmes.

India's poor sanitation, mass internal migration and dilapidated public health system made experts once fear it would be the last country to eradicate the disease.

There are now only three countries where polio is endemic -- Pakistan, Afghanistan and Nigeria -- and health workers say progress is being made towards global eradication.

Isolated polio outbreaks in the Horn of Africa and war-racked Syria emerged as new causes for concern in 2013, however, and polio vaccination workers in Pakistan are still being killed by the Taliban.

The wretched sight of crippled street hawkers or beggars on wheeled trolleys will also endure in India as a legacy of the country's time as an epicentre of new cases.

In the absence of official data, most experts agree there are several million survivors left with withered legs or twisted spines who face discrimination and often live on the margins of society.

India reported 150,000 cases of paralytic polio in 1985 and still accounted for half of all cases globally in 2009, with 741 infections that led to paralysis.

In 2010 the number of victims fell to double figures before the last case on January 13, 2011, when an 18-month-old girl in a Kolkata slum was found to have contracted it.

The girl, Rukshar Khatoon, is now attending school and leads a "normal life", although she still suffers pain in her right leg, doctors and her parents have told AFP.

Tuesday's celebration in New Delhi will be held in the Talkatora indoor stadium at 05:00 pm (1130 GMT).

Official certification by the World Health Organisation that India has eradicated polio is likely to come next month.
 Source:AFP
 

Virtual World Personality Affects Your Behaviour in Real Life: Study

The role played by a person in the virtual world of video games affects a person's behaviour in the real world, says a new study.    The report says that virtual environments give "a vehicle for observation, imitation, and modelling". It gives them a chance to act or behave in a certain manner that they cannot do in a real life.

"Our results indicate that just five minutes of role-play in virtual environments as either a hero or villain can easily cause people to reward or punish anonymous strangers," says lead researcher Gunwoo Yoon of the University of Illinois at Urbana-Champaign.

To understand the relationship between the behaviour in the virtual world and that in everyday life, researchers made 194 students participate in two different studies. The participants were randomly made to play a five-minute game as Superman (a hero), Voldemort (a villain) or circle (a neutral). Later, they were asked to taste and then give either chocolate or chilli sauce to a future participant. It was found that those who played Superman, poured double the amount of chocolate sauce and in fact more compared to the one who had played Voldemort, who poured more of chilli sauce.

Yoon said, "People are prone to be unaware of the influence of their virtual representations on their behavioural responses." So the good or the evil personality continues to stay with you even when you have moved out of the video game world.

The study was published in the journal Psychological Science.

 Source: journal Psychological Science
 

Fat Production is Regulated by Recycling of 'Chauffeur Protein'

Johns Hopkins researchers have discovered a biological switch that regulates a protein that causes fatty liver disease in mice. This discovery was made while studying a cycle of protein interactions needed to make fat.
Their findings, they report, may help develop drugs to decrease excessive fat production and its associated conditions in people, including fatty liver disease and diabetes.

A summary of the research appeared online on Jan. 29 in the Journal of Biological Chemistry.

"We've learned how the body finely tunes levels of a protein called SCAP that is required to turn on fat production in cells," says Peter Espenshade, Ph.D., professor of cell biology at the Johns Hopkins University School of Medicine. "We hope this new information will eventually lead to interventions that could help people suffering from obesity-induced fatty liver disease and diabetes."

Espenshade explains that fats, which include cholesterol, are essential to the life of organisms, but too much can sabotage systems that rid the body of toxins and regulate hormones, among other functions. Crucial to the right balance of fats is a family of proteins called sterol regulatory element-binding proteins (SREBPs), which turn on fat-making genes when fat levels in cells are low.

SREBPs are made and embedded in the membrane of the cellular compartment called the endoplasmic reticulum, or ER. To get to the cell's nucleus to turn on genes, the business end of SREBPs has to be clipped away from the membrane. Two different proteins, S1P and S2P, make those clips in sequence. But S1P and S2P live in a different cellular compartment, known as the Golgi.

To safely make the trip to the Golgi, says Espenshade, cells give each SREBP a chauffeur — the protein SCAP — which binds to SREBP before they both make their way to the Golgi. Once there, S1P and S2P free SREBP from the membrane so that it can move to the nucleus.

"We knew lots about this first part of the cycle, but we didn't know what happened to SCAP after it 'dropped off' the SREBP," says Espenshade.

While testing a chemical inhibitor of S1P activity, Espenshade says, he and his team added the chemical to hamster cells and were surprised to find that SCAP disappeared from the cells. That meant that it was either no longer being made or was being broken down somehow, he says.

When they added both the S1P inhibitor and a chemical that prevents SCAP from leaving the ER, SCAP reappeared. This suggested that SCAP was still being made but that the S1P inhibitor was somehow encouraging the destruction of SCAP once SCAP left the safety of home base. Further testing revealed that SCAP was indeed being broken down — in another part of the cell called the lysosome.

Tweaking the components of the cycle again, they engineered cells to keep SREBP in the ER while allowing SCAP to move to the Golgi on its own. This time, even though S1P was blocked, SCAP was no longer broken down by the lysosome, suggesting that what determines the fate of SCAP is the clipping of SREBP by S1P. SCAP can only cycle back to the ER for more rounds of SREBP transport if S1P is able to do its job.

"We don't know what is responsible for freeing SCAP from SREBP, but we now understand that SCAP keeps the cycle going," says Espenshade. "Since SCAP is so central to fat production and all of its consequences, we hope this improved understanding of its activity will help others develop drugs to better regulate the process."

The other author of the report is Wei Shao, Ph.D., of the Johns Hopkins University School of Medicine.
 SourceJournal of Biological Chemistry:           

Teens who consume energy drinks more likely to use alcohol and drugs

Widespread adolescent energy drink/shot use strongly associated with substance use, says study in Journal of Addiction Medicine

Philadelphia, Pa. (February 4, 2014) – Nearly one-third of US adolescents consume high-caffeine energy drinks or "shots," and these teens report higher rates of alcohol, cigarette, or drug use, reports a study in the January/February Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
The same characteristics that attract young people to consume energy drinks—such as being "sensation-seeking or risk-oriented"—may make them more likely to use other substances as well, suggests the new research by Yvonne M. Terry-McElrath, MSA, and colleagues of the Institute for Social Research, University of Michigan, Ann Arbor.
High Use of Energy Drinks/Shots by US Teens…
The researchers analyzed nationally representative data on nearly 22,000 US secondary school students (eighth, tenth, and twelfth graders). The teens were participants in the University of Michigan's "Monitoring the Future" study, funded by the National Institute on Drug Abuse.
In response to questionnaires, about 30 percent of teens reported using caffeine-containing energy drinks or shots. More than 40 percent said they drank regular soft drinks every day, while 20 percent drank diet soft drinks daily.
Boys were more likely to use energy drinks than girls. Use was also higher for teens without two parents at home and those whose parents were less educated. Perhaps surprisingly, the youngest teens (eighth graders) were most likely to use energy drinks/shots.
Students who used energy drinks/shots were also more likely to report recent use of alcohol, cigarettes, and illicit drugs. Across age groups and with adjustment for other factors, teens who used energy drinks/shots were two or three times more likely to report other types of substance use, compared to those who didn't use energy drinks.
Soft drink consumption was also related to substance use. However, the associations were much stronger for energy drinks/shots.
…May Have Implications for Risk of Substance Use
Energy drinks and shots are products containing high doses of caffeine, marketed as aids to increasing energy, concentration, or alertness. Studies in young adults suggest that consumption of energy drinks is associated with increased use of alcohol, marijuana, and tobacco.
In young adults, energy drinks have been linked to behavioral patterns of "sensation-seeking or risk orientation." Energy drinks are often used together with alcohol, which may "mask" the intoxicating effects of alcohol. The new study is one of the first to look at consumption of energy drinks by US adolescents, and how they may be related to other types of substance use.
"The current study indicates that adolescent consumption of energy drinks/shots is widespread and that energy drink users also report heightened risk for substance use," Terry-McElrath and colleagues write. They emphasize that their study provides no cause-and-effect data showing that energy drinks lead to substance abuse in teens.
However, the researchers believe that the findings linking energy drinks to substance use in young adults are likely relevant to adolescents as well. They write, "[E]ducation for parents and prevention efforts among adolescents should include education on the masking effects of caffeine in energy drinks on alcohol- and other substance-related impairments, and recognition that some groups (such as high sensation–seeking youth) may be particularly likely to consume energy drinks and to be substance users."
Even without the possible link to substance use, Terry-McElrath and coauthors note that, with their high caffeine and sugar content, energy drinks and shots aren't a good dietary choice for teens. They cite a recent American Academy of Pediatrics report stating that "[C]affeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents."
Source: Journal of Addiction Medicine

Mind Over Matter: Beating Pain and Painkillers

With nearly one-third of Americans suffering from chronic pain, prescription opioid painkillers have become the leading form of treatment for this debilitating condition. Unfortunately, misuse of prescription opioids can lead to serious side effects—including death by overdose. A new treatment developed by University of Utah researcher Eric Garland has shown to not only lower pain but also decrease prescription opioid misuse among chronic pain patients.
Results of a study by Garland published online Feb. 3 in the Journal of Consulting and Clinical Psychology, showed that the new treatment led to a 63 percent reduction in opioid misuse, compared to a 32 percent reduction among participants of a conventional support group. Additionally, participants in the new treatment group experienced a 22 percent reduction in pain-related impairment, which lasted for three months after the end of treatment.
The new intervention, called Mindfulness-Oriented Recovery Enhancement, or MORE, is designed to train people to respond differently to pain, stress and opioid-related cues.
MORE targets the underlying processes involved in chronic pain and opioid misuse by combining three therapeutic components: mindfulness training, reappraisal and savoring.

• Mindfulness involves training the mind to increase awareness, gain control over one’s attention and regulate automatic habits.

• Reappraisal is the process of reframing the meaning of a stressful or adverse event in such a way as to see it as purposeful or growth promoting.

• Savoring is the process of learning to focus attention on positive events to increase one’s sensitivity to naturally rewarding experiences, such as enjoying a beautiful nature scene or experiencing a sense of connection with a loved one.

“Mental interventions can address physical problems, like pain, on both psychological and biological levels because the mind and body are interconnected,” Garland said. “Anything that happens in the brain happens in the body—so by changing brain functioning, you alter the functioning of the body.”
To test the treatment, 115 chronic pain patients were randomly assigned to eight weeks of either MORE or conventional support group therapy, and outcomes were measured through questionnaires at pre- and post-treatment, and again at a three-month follow-up. Nearly three-quarters of the group misused opioid painkillers before starting the program by taking higher doses than prescribed, using opioids to alleviate stress and anxiety or another method of unauthorized self-medication with opioids.
Among the skills taught by MORE were a daily 15-minute mindfulness practice session guided by a CD and three minutes of mindful breathing prior to taking opioid medication. This practice was intended to increase awareness of opioid craving—helping participants clarify whether opioid use was driven by urges versus a legitimate need for pain relief.
“People who are in chronic pain need relief, and opioids are medically appropriate for many individuals,” Garland said. “However, a new option is needed because existing treatments may not adequately alleviate pain while avoiding the problems that stem from chronic opioid use.”
MORE is currently being tested in a pilot brain imaging trial as a smoking cessation treatment, and there are plans to test the intervention with people suffering from mental health problems who also have alcohol addiction. Further testing on active-duty soldiers with chronic pain and a larger trial among civilians is planned. If studies continue to demonstrate positive outcomes, MORE could be prescribed by doctors as an adjunct to traditional pain management services.
Garland is an associate professor of social work at the University of Utah, research fellow of the National Center for Veterans Studies and associate director of integrative medicine in the Supportive Oncology and Survivorship Program at the U’s Huntsman Cancer Institute. He conducted this early-stage trial with Eron Manusov, physician at Duke Southern Regional Area Health Education Center; Brett Froeliger, assistant professor of neuroscience at the Medical University of South Carolina; Amber Kelly, social work doctoral candidate at Smith College; Jaclyn Williams, social work doctoral student at Florida State University; and Matthew Howard, Frank Daniels Distinguished Professor of Social Work at University of North Carolina at Chapel Hill.
Source:The study was published by the American Psychological Association and was funded by the National Institute on Drug Abuse, grant R03DA032517.

Need strong regulatory framework to monitor and implement D&C Act effectively: Experts

Stressing the need to strengthen the initiatives towards better implementation of the Drugs & Cosmetics (D&C) Act and Rules across the country, experts in the pharmacy field have asked the Drugs Controller General of India (DCGI) to take immediate steps towards reducing the problem of availability of prescription drugs without a prescription. To ensure safety and health of the patients further, they wanted the Centre to urgently work on a short and long term, multi-pronged national strategy by taking all the stakeholders into confidence.

This demand comes in the wake of high incidents of improper implementation of the D&C Act and Rules, especially lack of any uniform implementation as the extent and strictness of the same varies from the competence of the state drug licensing authorities (SLAs). This they fear is leading to malpractices like medical stores and pharmacies selling prescription only medicines without any prescription or proper prescription.

Raj Vaidya, an expert in this field, pointed out that in many instances it has been found that while medical stores or pharmacy shops do not dispense psychotropic medicines without a prescription, they dispense all other drugs without a prescription. At the same time, some do not dispense psychotropic medicines, antibiotics, and some other medicines having a misuse potential without a prescription, but dispense all other Rx drugs without a prescription. To make matters worse, some chemists do give at times the above, to clients they know without any prescription, at their discretion.

In his representation to the DCGI, Vaidya stressed that it has come into notice that some pharmacists and medical shops sell prescription medicines against telephonic orders and also conduct door delivery, while many have been found to be practically selling medicines without a prescriptions or without the presence of a pharmacist. Experts feel that while some state FDAs do make efforts to ensure strict control on sale of psychotropic medicines, many other crucial prescription medicines remain out of proper control.

It is understood that the difficulty in controlling may be due to socio-economic reasons, but at the same time, misuse of medicines taking place because of sale without a prescription can also lead to health hazards even with medicines which are not for misuse or abuse. Ironically, people rampantly self-medicate anti-depressants, anti-hypertensives, anti-diabetics, NSAIDs, anti-ulcer medicines all of which are prescription medicines, because it was once previously prescribed to them or their family members. Vaidya pointed out that such actions are major cause of concern as it can lead to medication errors and ADRs.

He said, “Overnight change will not happen, and a sudden, knee-jerk implementation will only lead to boomerang and failure. Therefore, a gradual strategy will have to adopted, first tackling the drugs with more misuse potential, and step wise tackling of the others. There is an urgent need for massive awareness and education campaign amongst all the stakeholders and the public in particular, across the country to bring about the change. I sincerely hope that the Centre will take up the problem on a war footing, in the best interest of public health and safety.”

He further stressed that while ill effects of wrong use of medicines is an alarming public health issue, it is also puts India in poor light at the global stage for having a not so effective drug regulatory system in the country.
Source:Pharmabiz

India to press for simplification of laws on generics during meeting with US FDA commissioner

India is expected to press for simplifying the guidelines and clauses for generic exports to the United States during the talks with US Food and Drug Administration (US FDA) Commissioner Margaret A Hamburg, who is slated to visit India from February 10 to 18.

The matter of simplification of laws for generics would be taken up in the wake of the recent instances of increased scrutiny by the US authorities on Indian companies putting pressure on the generic export. The issue is expected to come up in her meeting with her counterpart and also the industry captains from India.

However, Drug Controller General of India (DCGI) Dr G N Singh told Pharmabiz that as it was the meeting between the regulators of two countries, issues similar to the warnings to some particular companies like Ranbaxy would not figure in the talks. “We will be discussing the broader issues around the statutory guidelines and how to improve the systems by sharing the knowledge,” he said.

Dr Singh and US FDA commissioner will hold meeting here on Monday. This is her first visit to India and she would also hold discussions with several Ministers including the Union Health Minister Ghulam Nabi Azad. She would also visit Mumbai and Cochin during her week-long trip.

“US has a very strong system and we will have many things to learn. Likewise, they will also look to pick up lessons from Indian regulatory system. No formal agreement with US is planned at my level, but will be touching a number of regulatory issues including the clinical trials,” he said, indicating that he would take up the issue of simplifying the guidelines for generics in the US.

The industry, it is learnt, would be taking up with the US regulator the recent developments of increased regulatory enforcements on generic drug manufacturing facilities. She will meet them separately. While Ranbaxy's active pharmaceutical ingredient-manufacturing factory in Toansa (Punjab) is the latest to come under the US FDA scanner, other major drug makers such as Wockhardt, RPG Life Sciences and Agila Specialities have faced enforcements from the US regulator in the past year.

Reports also claimed that Indian officials would be discussing the issue of clinical trials, especially the suggestion to give equal consideration and protection to Indian subjects by the multinational companies, as they extend the same to those in the US.

Confirming the visit, the US FDA has issued a statement which said the trip by the Commissioner is aimed at further strengthening cooperation between the FDA and its Indian regulatory counterparts. “Indian regulators are important strategic partners to the FDA and regular engagement is essential. Currently, India is the second largest provider of finished drug products and the eighth largest exporter of food products to the United States,” the statement said.

“The FDA’s ongoing engagement with our regulatory counterparts in India is critical to our ability to effectively promote the health and safety of American and Indian consumers,” said Commissioner Hamburg. “I look forward to enhancing our existing relationship and identifying additional opportunities for collaboration,” she said.

“The cooperation of United States and Indian food and drug officials is wide ranging, from sharing information on the conduct of clinical trials to jointly addressing product safety issues that may have an impact on both American and Indian consumers. Commissioner Hamburg will also meet with industry leaders in India to discuss the importance of maintaining high-quality standards in producing goods to ensure consumers have access to safe products,” the statement said.
Source:Pharmabiz