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Health Bulletin


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  1. #811
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    Re: Health Bulletin

    Being lazy could be genetic, scientists say

    A mutation in a gene with a critical role in the brain could explain why some people are "couch potatoes" according to researchers.

    Scientists in China and Scotland have made what is being called a "key discovery", which centres on the system that regulates physical activity levels.

    The teams are hopeful that the study could help "millions of patients".

    Based on the findings published in the journal 'PLOS Genetics', pills could be developed in the future which would motivate those who are less inclined to exercise.

    While the experiments were conducted on mice, 400 overweight Chinese patients were also screened for metabolic syndrome, with scientists finding that two of them had mutations in the gene.

    To make their discovery, scientists compared normal mice with those that had a mutation in a gene called SLC35D3, and found that it produces a protein which plays a key signalling role in the brain's dopamine system, affecting the regulation of physical activity.

    Mice with this gene had far fewer of this type of dopamine receptor on the surfaces of their brain cells. It was instead stuck within in the cell, leaving the signal process unable to function.

    But when the affected mice were treated with a drug that activates dopamine receptors, the problem was reversed and the mice became more active and lost weight.

    Study leader Professor Wei Li, of the Institute of Genetics and Developmental Biology (IGDB) in Beijing, said he was excited about the findings.

    "We discovered that mice with this gene mutation were typical couch potatoes," he said.

    "They walked only about a third as much as a normal mouse, and when they did move they walked more slowly.

    "The mice became fat and they also developed other symptoms similar to a condition in people called metabolic syndrome - a medical term for those with a combination of risk factors related to diabetes, high blood pressure and obesity," he explained.

    He added that the discovery could signal a change in attitudes towards obesity.

    "A long-standing prescription in combating obesity is to mind your mouth and move your legs. However, genetics contributes to the reluctance to move in some obese people. Medical treatments will in the future be tailored to fit a person's individual genetic make-up."

    Co-author of the research paper Professor John Speakman, who works between the University of Aberdeen and the IGDB, said: "Although only about one in 200 people may have these "rare" mutations, there are a very large number of people worldwide that have metabolic syndrome. Consequently, the population of sufferers that may benefit from being treated with dopamine receptor drugs runs into many millions of patients."


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  2. #812
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    Re: Health Bulletin

    Surgeons do jugaad in the operation theatre

    The common paper clip is certainly a versatile piece of twisted steel. On occasion, it can open locks or even double up as a tooth pick. But Dr Pushkar Waknis, a Pune-based maxillofacial surgeon, found an altogether unexpected use for it - to keep the skin flap in place while operating. Not only is it effective, but also more easily accessible than the textbook prescribed Raney clips, which are hard to find in India and, at Rs 40,000 a box, quite expensive.

    "The paper clip can bring down the cost of the surgery by around Rs 3,000. This can be a big amount for a poor patient," says Dr Waknis who works at Dr D Y Patil College of Dentistry and Nursing in Pune. He co-wrote a paper on this innovation, which was published in the Journal of Maxillofacial and Oral Surgery last year.

    The Indian habit of 'jugaad' -roughly, making do with what you have - is now coming in handy in surgeries and clinics, reducing healthcare costs considerably. Enterprising surgeons are replacing costly, disposable imported surgical devices with cheaper, more common and locally-sourced tools. Being frugal, say doctors, doesn't mean they compromise on quality and safety.

    Such low-cost alternate techniques are usually developed in Third World countries where the state has not been able to take quality health care to the masses. "We come up with 'jugaads' because we have to cater to all patients, whether poor or rich," says Dr Suresh Vasistha, joint secretary, Association of Surgeons (ASI) of India and consultant general and laparoscopic surgeon.

    Take the example of Dr Shibu Vasudevan Pillai, a neurosurgeon at Narayana Health City (formerly Narayana Hrudalaya) in Bangalore, who uses a locally-manufactured ventriculo-peritoneal (VP) shunt to drain out fluid from the brain. "Traditional shunts made abroad are 10 times costlier - the ones we use cost Rs 3,000 per unit," says Pillai.

    In dealing with severe head injuries and disease of the nervous system, it is crucial that the pressure inside the brain be measured accurately. An intra-cranial catheter is inserted and the reading taken on a monitor. The catheter usually costs Rs 30,000 and the meter is worth about Rs 10 lakh. Pillai instead inserts a simple sterilized rubber tube, filled with water, inside the brain and then connects it to any pressure monitor in the OT. "The tube costs just a few rupees. Whenever there is an effective local option, which has been documented and proven to be safe, we try to use it," adds Dr Pillai.

    In 2012, surgeons at AIIMS published a paper in the Indian Journal of Surgery, which showed that using honey (procured from beehives on neem trees) healed wounds better and faster than povidone-iodine (betadine), standard ointment used in such cases. Dr Anurag Srivastava, head of surgery at AIIMS, says that there was significant decrease in the surface area of the wound and pain in the group, where honey was used as wound dressing.

    "As long as you follow basic principles of sterilization and operative technique, and provide good post-op clinical care, it is safe to use low-cost substitutes," says Dr Satish Shukla, an onco-surgeon based in Indore and president of ASI. He further points out that although the US FDA doesn't allow the reuse of catheters in cardiac and renal surgeries, surgeons in India safely recycle them for cost-effectiveness.

    In 2003, the Indian Journal of Surgery published a paper by Dr Ravindranath Tongaonkar on the use of the mosquito net in treating adult groin hernia. Traditionally, a polypropylene mesh is used to fix the ruptured tissue but it is an expensive material. So Dr Tongaonkar replaced it with mosquito net cloth. At the time, a meter of mosquito net cloth cost Rs 40 while the imported surgical mesh cost Rs 9,430 for a 30 cm x 30 cm patch. Dr Tongaonkar has used the mosquito net mesh in more than 500 hernia operations.

    Similarly, instruments used in a range of expensive cosmetic procedures can be replaced with common household items once sterilized properly. Dr Mohan Thomas, a senior cosmetic surgeon who runs the Inceptor cosmetic surgery and skin institute in Mumbai, uses 24-inch household electric ties (used to hold wires together) as a substitute for surgical tourniquet to put compression at the base of the breast during breast reduction surgery. While surgical tourniquets are imported from the US and cost Rs 3,000 to Rs 6,000, a pack of electric ties comes for Rs 500. He also uses a stainless steel kitchen strainer (Rs 350) to filter fat harvested for grafting instead. The medical version of the strainer can cost up to Rs 12,000.

    "Most conventional surgical devices, in keeping with the US standards, are disposable. Given the cost of these devices they simply do not fit the Indian business model," says Dr Thomas. However, he also cautions that such 'jugaad' should never be used as implants because that could lead to serious complications.


  3. #813
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    Re: Health Bulletin

    Honey heals wounds faster than betadine’

    Dr Pillai uses a locally-manufactured ventriculo-peritoneal (VP) shunt to drain out fluid from the brain. "Traditional shunts made abroad are 10 times costlier — the ones we use cost Rs 3,000 per unit," says Pillai.

    In dealing with severe head injuries and disease of the nervous system, it is crucial that the pressure inside the brain be measured accurately. An intra-cranial catheter is inserted and the reading taken on a monitor. The catheter usually costs Rs 30,000 and the meter is worth about Rs 10 lakh.

    Pillai instead inserts a simple sterilized rubber tube, filled with water, inside the brain and then connects it to any pressure monitor in the OT. "The tube costs just a few rupees. Whenever there is an effective local option, which has been documented and proven to be safe, we try to use it," adds Dr Pillai.

    In 2012, surgeons at AIIMS published a paper in the Indian Journal of Surgery, which showed that using honey (procured from beehives on neem trees) healed wounds better and faster than povidone-iodine (betadine), standard ointment used in such cases. Dr Anurag Srivastava, head of surgery at AIIMS, says that there was significant decrease in the surface area of the wound and pain in the group, where honey was used as wound dressing.

    "As long as you follow basic principles of sterilization and operative technique, and provide good post-op clinical care, it is safe to use low-cost substitutes," says Dr Satish Shukla, an onco-surgeon based in Indore and president of ASI. He further points out that although the US FDA doesn't allow the reuse of catheters in cardiac and renal surgeries, surgeons in India safely recycle them for cost-effectiveness.

    In 2003, the Indian Journal of Surgery published a paper by Dr Ravindranath Tongaonkar on the use of the mosquito net in treating adult groin hernia. Traditionally, a polypropylene mesh is used to fix the ruptured tissue but it is an expensive material. So Dr Tongaonkar replaced it with mosquito net cloth. At the time, a meter of mosquito net cloth cost Rs 40 while the imported surgical mesh cost Rs 9,430 for a 30 cm x 30 cm patch. Dr Tongaonkar has used the mosquito net mesh in more than 500 hernia operations.

    Similarly, instruments used in a range of expensive cosmetic procedures can be replaced with common household items once sterilized properly. Dr Shibu Thomas, a senior cosmetic surgeon who runs the Inceptor cosmetic surgery and skin institute in Mumbai, uses 24-inch household electric ties (used to hold wires together) as a substitute for surgical tourniquet to put compression at the base of the breast during breast reduction surgery.

    While surgical tourniquets are imported from the US and cost Rs 3,000 to Rs 6,000, a pack of electric ties comes for Rs 500. He also uses a stainless steel kitchen strainer(Rs 350) to filter fat harvested for grafting instead. The medical version of the strainer can cost up to Rs 12,000.

    "Most conventional surgical devices, in keeping with the US standards, are disposable. Given the cost of these devices they simply do not fit the Indian business model," says Dr Thomas. However, he also cautions that such 'jugaad' should never be used as implants because that could lead to serious complications.


  4. #814
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    Re: Health Bulletin

    How stem cells decide liver, pancreas formation

    How do stem cells decide whether to become liver cells or pancreatic cells during development?

    A cell's fate is determined by the nearby presence of 'prostaglandin E2' - a messenger molecule best known for its role in inflammation and pain.

    Stem cell scientists Wolfram Goessling and Trista Northat the Harvard Stem Cell Institute (HSCI) identified a gradient of prostaglandin E2 in the region of zebrafish embryos where stem cells differentiate into the internal organs.

    The finding could potentially make liver and pancreas cells easier to generate both in the lab and for future cell therapies.

    "Cells that see more prostaglandin become liver and the cells that see less prostaglandin become pancreas," said Goessling, assistant professor of medicine.

    This is the first time that prostaglandin is being reported as a factor that can lead this 'fate switch' and essentially instruct what kind of identity a cell is going to be, the researchers added.

    Other experiments showed that prostaglandin E2 could also enhance liver growth and regeneration of liver cells.

    "Prostaglandin might be a master regulator of cell growth in different organs," Goessling said.

    It's used in cord blood, as we have shown, it works in the liver, and who knows what other organs might be affected by it, revealed the findings published in the journal Developmental C


  5. #815
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    Re: Health Bulletin

    Sudden cardiac deaths on the rise in Kerala

    P Antony, a government employee from central Kerala, remembers fainting for the first time at a Christmas party. Over the next 20 days, he had many other similar "black-out" episodes. After sustaining a minor head injury following a fall, he consulted a physician who noted no abnormalities in the tests performed and suggested consulting a cardiac electrophysiologist - a doctor who specializes in treating conditions related to the electrical system of the heart.

    That's when Antony realized that though his ECG was normal, he had a heart problem which had something to do with his heart rhythm. During the seven-day monitoring, he fainted again and stopped breathing. The examination revealed very fast heart beats and an MRI proved that that he needed an implantable cardioverter defibrillator (ICD) - a type of specialized pacemaker - besides a few medicines. Fainting episodes never recurred, and has started living normal life.

    Antony is just one of those lucky persons who survived what is called a sudden cardiac arrest (SCA) which often leads to death. "Of the total number of people dying due to heart disease in the state, 100 are dying due to SCA and in 90% of the victims, death occurs abruptly and without warning," said Dr K K N Namboodiri, associate professor, cardiology, Sree Chitra Institute for medical sciences and technology (SCIMCT), Thiruvananthapuram.

    'We have no data to support it. The cause for concern is that it is seen among the younger people. The patient needs immediate attention by way of shock treatment using an automatic external defibrillator (AED)," said Dr Rony Mathew, head of cardiology, Lisie heart institute, Kochi.

    Doctors said that sudden cardiac death (SCD) might be the first sign that the victim has had of a heart problem. "Cases referred to our institute have shown that the primary electrical disturbances are not uncommon in Kerala, especially in middle and north Kerala," said Dr Namboodiri.

    Dr Rony said that one way to control the rising number of deaths is to make the service of an automatic external defibrillator (AED) in places like malls where people gather in large numbers. "Anybody who has learnt cardiopulmonary resuscitation (CPR) knows how to use it," said Dr Rony. An AED costs around Rs 2.5 lakhs and the battery of the device lasts nearly 10 years.


  6. #816
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    Re: Health Bulletin

    Obesity affects memory, emotions, appetite

    A new study has found that being overweight appears to be related to reduced levels of a molecule that reflects brain cell health in the hippocampus, a part of the brain involved in memory, learning, and emotions, and likely also involved in appetite control.

    Jeremy D. Coplan, MD, professor of psychiatry at SUNY Downstate Medical Center, led a multicenter team that visualized the molecule, N-acetyl-aspartate (NAA), using magnetic resonance spectroscopy, a non-invasive magnetic resonance imaging (MRI) application. NAA is associated with brain cell health. Overweight study participants exhibited lower levels of NAA in the hippocampus than normal weight subjects. The effect was independent of age, sex, and psychiatric diagnoses. The importance of the hippocampus - a seahorse-shaped organ deep within the brain - to the formation and preservation of memory and to emotional control is well known, Dr. Coplan said, but its role in appetite control is less established.

    "The relevance of the finding is that being overweight is associated with specific changes in a part of the brain that is crucial to memory formation and emotions, and probably to appetite," Dr. Coplan said. The study is believed to be the first human research documenting the association of NAA with body weight. "Whether low NAA is a consequence of being overweight, causes being overweight, or a combination of both remains to be determined," he added.

    The findings are published in the journal Neuroimage: Clinical


  7. #817
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    Re: Health Bulletin

    Scientists 'grow' human lungs in lab for first time

    For the first time, US scientists have grown human lungs in a lab, an advance in regenerative medicine that aims to address the problem of organ donor shortage.

    Growing organs may seem like science fiction, but it is the goal of medical researchers because so many people need organ transplants and many die waiting for one, scientists said.

    "The most exciting part is to shorten the time people have to wait for an organ transplant," said Dr Joaquin Cortiella from the University of Texas Medical Branch (UTMB).

    Researchers at UTMB used a damaged lung and removed the cells and materials until only the skeleton or scaffold of the organ was left.

    Then they added back cells from another lung that couldn't be used for transplant but still had some viable cells in it.

    They immersed the structure in a large chamber filled with a liquid that provided nutrients for the cells to grow. After about four weeks, an engineered human lung emerged, 'CNN' reported.

    The lab-made lungs look very much like the real thing, just pinker, softer and less dense, said Joan Nichols, a researcher at UTMB.

    Nichols said she thinks it will be another 12 years or so until they will be ready to try using these lungs for transplants.

    Before researchers experiment on humans, they'll try out lab-made lungs on pigs, she said.

    Nichols told KTRK-TV that her team created their first artificially created lungs in the lab about a year ago, but they decided to wait to make the announcement


  8. #818
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    Re: Health Bulletin

    Diabesity epidemic on rise in India

    Diabesity, a newly emerged term of medical science has taken more than one billion populations into its grip in past decade. Rising at an astounding level, diabesity has reached at an epidemic proportion. India is bracing for massive surge in diabesity with estimating number of sufferers in next 20 years at more than 100 million.

    Obesity is linked with diabetes, higher than normal body weight greatly increases the risk of Diabetes. An estimated 80% of Diabetes is related to Obesity. Obesity with increased diabetes is called diabesity.

    Medically it is defined as metabolic dysfunction that ranges from mild blood sugar imbalances to full-fledged type 2 diabetes. Obesity is considered a major risk factor for diabetes, as it makes cells less able to use insulin to bring sugar in from the bloodstream. When you are already insulin resistant (diabetic or pre-diabetic) then it can be even harder to lose weight.

    "Uncontrolled diabetes leads to serious complications such as high BP, heart attacks, brain strokes, blindness, kidney failures and nerve damages with amputations. People with family history of diabetes, heart disease and obesity are predisposed to have diabesity. If a woman's waist is greater than 35 inches and man have more than 40 inches and they often have craving for sugar and refined carbohydrate then they should have their check up done for diabeisty," said Dr Deep Goel, director, bariatric & GI cancer surgery, BL Kapur Hospital, New Delhi.

    Infertility is also very commonly associated with Diabesity. 70% of infertility cases are reported to have diabesity problem. Patient with diabesity also have low sex drive or sexual dysfunction problems.

    Diabesity is the major cause of heart disease, stroke, dementia, cancer, kidney failure and blindness therefore it has become the leading cause of death. Obesity is second most common preventable cause of cancer after tobacco.


  9. #819
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    Re: Health Bulletin

    Pill to cure ‘couch potatoes’ ?

    A gene mutation may explain why some people are more likely than others to be couch potatoes , according to a study which offers hope of a personalized pill to counter the problem.

    Scientists found that a mutation in a gene may explain why some people are less inclined to exercise and are more likely to put on weight and develop health problems. Researchers from the Chinese Academy of Sciences, Institute of Genetics and Developmental Biology (IGDB) in Beijing and the University of Aberdeen compared 'normal' mice with mice that had a mutation in a gene called SLC35D3.

    The researchers found that SLC35D3 produces a protein which plays a key signalling role in the brain's dopamine system This system is involved in regulation of physical activity levels.

    They found that SLC35D3 seems to be key to transporting a type of dopamine receptor, from where they are made inside the cell, to the cell surface, where they can bind with dopamine. Mice with this gene mutation had far fewer of this type of dopamine receptor on their brain cell surfaces. Instead, the dopamine receptors were stuck within the cell. This meant that their signalling process was not functioning properly.

    "Mice with this mutation were typical couch potatoes. They walked about a third as much as a normal mouse, and when they did move they walked more slowly," said Wei Li of the IGDB.


  10. #820
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    Re: Health Bulletin

    Lack of dedicated team, retrieval centres hampers heart transplants

    Even though Kerala is the most affordable state to have a heart transplant, it has not gained momentum here. The reasons, according to Dr Jose Chacko Periyappuram, the man who performed the first heart transplant in the state way back in 2003, are shortage of dedicated team of doctors, not enough organ retrieval centres and lack of infrastructural facilities.

    "At present we have only three institutions offering heart transplant in the state," said Dr Jose Chacko .

    However, he added that there were some positive signs in this super specialty streams as he could perform six transplants in the last six months in Kerala. "The awareness level of organ donation has started picking up and the government is now giving full support for this programme. The launching of Mrithasanjeevani- Kerala Network for Organ Sharing, has helped in a major way in getting the heart transplants done," said Dr Jose Chacko, who is in the city to attend the annual conference of cardiovascular and thoracic surgeons.

    "It is not that we cannot do transplants. But there should be motivation among doctors to make it a passion. It needs complete dedication and commitment such that we have to entirely devote our time for this. We are in the process of building such a team of doctors in Kerala," he said.

    "The doctors performing the surgery will have to go through tremendous difficulties. Most of our doctors do not consider transplantation to be a viable option in end stage," said Chacko.

    The only concern for him was the fact that the donation rate was very low in the state till recently. However, this has gained momentum. Now what the state require are hospitals offering transplants and organ retrieving centres.

    "Soon the state will get two more transplantation centres in the government sector, which would mean that the transplantation cost could be brought further down," he added.

    "A heart transplant costs Rs 5 lakh in Kerala when it is Rs 25 lakh in Tamil Nadu. If we can spend Rs 2 to Rs 3 lakh for bypass, then the people can certainly prefer heart transplants too," said Dr Jose Chacko, who did a presentation on agonies and ecstasies in heart transplantation at the conference.


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