Sunday, June 28, 2009

Muscular Dystrophy: The need to fight this crippling disease

By Syed Akbar
Hyderabad: Nipun Loya was bubbling with energy and vigour till a few years ago. Today at 14, Nipun cannot stand, write or even wipe out the sweat from his face. And he could barely utter a few words.
Nipun is one of the 50 and odd muscular dystrophy patients who have gathered in the city from different parts of the country to dissolve their sorrow in a unique fun camp. Nipun no longer feels he is alone in suffering. He has found quite a few new friends from places as far away as Solan in Himachal Pradesh.
"Muscular Dystrophy patients do not generally move out of their homes. Most of them are caged in their living rooms for months together. An outing once in a while makes a big difference to them. The present fun-cum-picnic camp is programmed on the lines of "Jerry Kids" camps being held regularly by Hollywood comedian Jerry Lewis for MD patients", says Vipul Goel, himself a victim of the crippling genetic ailment. Vipul's brother Atul and sister Sanjana are also MD patients. Muscular Dystrophy is a common disease affecting mostly children progressively distroying their muscular system. Patients generally die before they attain the age of 25.
The city's fun camp is incidentally the first outdoor programme for MD patients in south India. With 52 patients in attendance, it is also the second biggest fun camp in the country after the Solan's camp held last year in which 92 patients participated. Points out Sanjana, president of Indian Association of Muscular Dystrophy, "no where in the world not even in the USA more than three dozen MD patients turn up for such programmes. Indeed it is an achievement".
The child patients participated in several fun events including infotainment competitions like word building, Antakshari, throw ball and lucky names. According to Sanjana and Vipul, chess player Venkatesh, who died from MD after his euthanasia plea was rejected by government, had inspired them to hold fun camps all over India. "We have made a beginning in Hyderabad and it will continue every year", they said.
Unmindful of what the cruel fate has in store for them, young MD patients spent time in sharing their dreams. "I want to be doctor", says 14-year-old G Srikrishna, who is good at sciences and social but not so good at mathematics. Srikrishna is now studying in 9th class and goes to school in his father's car.
Like Nipun, O Rahul and K Bharadwaja have stopped studying. "It is quite difficult to physically lift the child and put him in the classroom. He cannot maintain personal hygiene and so we have stopped sending him to school", says Nipun's father Narayan Loya. "He eats only one chapathi in the morning and one in the evening. He does not feel hungry. He even cannot change sides on the bed. We have to attend to his every need", he says.
The grown-up patients, however, want to spend the rest of their life in happiness. "We do not want to die early. We want to live and enjoy life to its fullest. We are against mercy killing. Why should one ask for it. Why the desperation" argues Vipul. Our picnic programmes are with a purpose and we want to bridge the gap between normal and disabled people, he adds.
According to Dr R Janardhan Rao, the association has an enrolment of about 3000 patients all over the country. Though the exact number of MD patients in the country is not known, it is believed that there are at least 3.5 lakh people affected by the disease.

Muscular Dystrophy – How To Tackle It?

By Syed Akbar
Muscular dystrophy is a crippling genetic disease. It continues to be an enigma to scientists and researchers all around the world. There is no cure as yet to muscular dystrophy. Clinically speaking, muscular dystrophy falls under the broad category of motor neuron disorders.
In patients affected with muscular dystrophy muscles stop synthesizing a particular type of protein called dystrophin. This protein is vital for all muscles to work perfectly. Unlike polio where disability stops soon after the attack, muscular dystrophy is a progressive disease crippling muscles throughout the life of the patient. Patients, if afflicted with the disease in early childhood, do not generally live beyond 25 years of age.
At present, there is no medicine to treat muscular dystrophy. It is advisable that those with the history of the disease in family should go for genetic counseling before the marriage. They may also prefer amniocentesis and go for abortion if the foetus carries the defective gene. This is the only way to avoid a muscular dystrophy patient from taking birth.
Muscular dystrophy may attack at any age. However, it generally attacks children at young age. The first symptoms of the disease include faulty gait and frequent falls. The calf muscles are bulged and the child cannot stand on its own.
The suffering caused by the disorder is considerable. First, it cause long-lasting disability, secondly there is no definitive treatment, and thirdly it may affect other family members because of its hereditary nature.
Untill a couple of decade ago virtually nothing was known about its pathogenesis. Now we know that it is a genetic disease.
In muscular dystrophy, the muscle fibres are gradually replaced by fatty tissue and the normal function of the muscle is impaired. The rate at which this happens, and therefore the rate at which weakness occurs, varies somewhat between children with the same condition. It is important to realize that some muscles are affected earlier than others, and this upsets the normal balance of strength between the muscle groups.
In children with muscular dystrophy the most frequently seen contractures occur at the ankles, knees and hips. These are partly caused by the child walking on his toes, with the knees at little bent and the feet apart, a position he adopts in order to balance in standing and walking as weakness of the hip. Knee and trunk muscles make it more difficult to keep his balance. The contractures are aggravated by the fact that children in latter stages of the condition spend more time sitting.
It is important to seek advice about physiotherapy and to start treatment aimed at preventing contractures as soon as possible after diagnosis, before there is any tightness. Do not wait untill there is an obvious deformity.
Increasing weakness makes tasks like walking and dressing more difficult but there are ways in which your child can be helped to make the most of his abilities and retain as much independence as possible, either causing distress or disrupting education or recreation.
Remember that worldwide search for a cure is on all the time, but when a therapy is found it will not make stiff or twisted joints move again. So this is another reason for trying to prevent deformities and keeping muscles supple and strong for as long as possible.
Exercises should be done regularly. It helps enormously if the exercises are done in an atmosphere of fun. They can be combined with singing, story telling and a general sense of enjoyment.
The child should not be stressed during exercises. Making the exercises into a game or having a chart of achievement might help towards a cooperative attitude.
It is important to keep a happy balance between encouragement and demand.
Praise and emphasise all the positives. Everything the child does successfully must be complimented and rewarded with a hug or on some other appropriate way.
Breathing exercises should be conducted for older children.
The child should be encouraged to attend school as long as possible. The teachers should be told about the problem in the child as their help is essential to provide the child greater and easier mobility in the school premises.

Sunday, June 21, 2009

Swine flu: A deadly cocktail of Human Influenza A and HIV?

Syed Akbar
Hyderabad, June 17: With swine flu gradually turning deadly in many parts of the world, health experts and scientists fear that a mix of swine flu virus with human immunodeficiency virus (HIV) may lead to a cocktail of a severely potent viral strain that could wreak havoc.

The HIV-H1N1 co-infection risk is more in Andhra Pradesh as it has a large number of people living with HIV. The State has 5.4 lakh HIV positive cases, the highest number for any State in India. Since half of the 31 swine flu cases reported in the country are from Hyderabad and other parts of the State, any lax on the part
of health and quarantine authorities may spell a doom.

Since people with HIV have suppressed immunity, it takes quite a long period for swine flu virus to subside. The virus may develop into a potent viral strain by being a co-pathogen with the human immunodeficiency virus.

"People suffering from HIV, particularly those with low CD4 cell counts in their blood, are at higher risk of contacting swine flu. While swine flu may not develop pneumonia in ordinary people, chances are higher among people living with HIV," warns senior researcher Dr MN Khaja, who formed part of the team that
sequenced Hepatitis C virus.

Moreover, the swine flu or novel influenza A (H1N1) virus may emerge into a more potent viral strain in PLWH as in the case of tuberculosis bacteria. The TB bacteria has turned more potent in people with TB and HIV co-infection, causing resistance to available drugs.

"Though we do not have sufficient research data on H1N1 and HIV co-infection and how severe the human influenza virus would behave in people with low or compromised immunity, the World Health Organisation and the Centers for Disease Control and Prevention, USA, have preliminary data that suggests the severity of the problem. The virus may turn more lethal and a new strain may emerge in HIV hosts," Dr Khaja told this correspondent.

Health officials point out that adults and adolescents with HIV infection are known to be at higher risk for viral and bacterial lower respiratory tract infections and for different types of recurrent pneumonia. Evidence that influenza can be more severe for HIV-infected adults and adolescents comes from studies among HIV-infected persons who had seasonal influenza.

The novel influenza A virus has been found to be sensitive to the neuraminidase inhibitor anti viral medications zanamivir and oseltamivir. But whether it works in people living with HIV is not yet clear.

Saturday, June 20, 2009

Indian cars will soon have a "star" rating on their fuel efficiency

Syed Akbar
Hyderabad, June 19: Indian cars will soon have a "star" rating on their fuel efficiency so that those intending to buy a four-wheeler will have the option of the selecting the best one in the market.

The Bureau of Energy Efficiency of the Union Ministry of Power has decided in principle to star rate the automobile brands based on their fuel efficiency and performance on road. To begin with, the star rating system will be implemented for cars. A vehicle rated "5 star" is the best in the market. The lower the number of stars the less the fuel efficiency of the vehicle.

Presently star rating is implemented for air conditioners and refrigerators on a pilot basis. Given the tremendous response the star rating system has generated from consumers, the BEE has decided to go in for more products from January 1 next year. They include fans, distribution transformers and tubelights.

"Air conditioners, fridges, fans, tubelights and distribution transformers will invariably have to get star rating from January 1, 2010. These products without star rating will be banned for sale in the country.
Ultimately we will bring 21 products including cell phone chargers, washing machines, computers and geysers," said Sandeep Garg, energy economist from the Bureau of Energy Efficiency, New Delhi.

The Central government plans to save about 10,000 mw of power by going in for star rating for electric and electronic consumer products. Star rating for card will help save consumption of fossil fuels.

Referring to high transmission and distribution losses in the country, Sandeep Garg said the Chief Ministers' meeting in New Delhi on January 23 would discuss the issue, including the need for star rated distributing transformers. Already five States including neighbouring Karnataka have made star rated transformers
mandatory for their power distribution companies and electricity boards.

Wednesday, June 17, 2009

Meteorite Grains Divulge Earth’s Cosmic Roots

The interstellar stuff that became incorporated into the planets and life on Earth has younger cosmic roots than theories predict, according to the University of Chicago postdoctoral scholar Philipp Heck and his international team of colleagues.

Heck and his colleagues examined 22 interstellar grains from the Murchison meteorite for their analysis. Dying sun-like stars flung the Murchison grains into space more than 4.5 billion years ago, before the birth of the solar system. Scientists know the grains formed outside the solar system because of their exotic composition.

“The concentration of neon, produced during cosmic-ray irradiation, allows us to determine the time a grain has spent in interstellar space,” Heck said. His team determined that 17 of the grains spent somewhere between three million and 200 million years in interstellar space, far less than the theoretical estimates of approximately 500 million years. Only three grains met interstellar duration expectations (two grains yielded no reliable age).

“The knowledge of this lifetime is essential for an improved understanding of interstellar processes, and to better constrain the timing of formation processes of the solar system,” Heck said. A period of intense star formation that preceded the sun’s birth may have produced large quantities of dust, thus accounting for the timing discrepancy, according to the research team.

Scientists Discover Magnetic Superatoms

A team of Virginia Commonwealth University scientists has discovered a ‘magnetic superatom’ – a stable cluster of atoms that can mimic different elements of the periodic table – that one day may be used to create molecular electronic devices for the next generation of faster computers with larger memory storage.

The newly discovered cluster, consisting of one vanadium and eight cesium atoms, acts like a tiny magnet that can mimic a single manganese atom in magnetic strength while preferentially allowing electrons of specific spin orientation to flow through the surrounding shell of cesium atoms. The findings appear online in the journal Nature Chemistry.

Through an elaborate series of theoretical studies, Shiv N. Khanna, Ph.D., professor in the VCU Department of Physics, together with VCU postdoctoral associates J. Ulises Reveles, A.C. Reber, and graduate student P. Clayborne, and collaborators at the Naval Research Laboratory in D.C., and the Harish-Chandra Research Institute in Allahabad, India, examined the electronic and magnetic properties of clusters having one vanadium atom surrounded by multiple cesium atoms.

They found that when the cluster had eight cesium atoms it acquired extra stability due to a filled electronic state. An atom is in a stable configuration when its outermost shell is full. Consequently, when an atom combines with other atoms, it tends to lose or gain valence electrons to acquire a stable configuration.

According to Khanna, the new cluster had a magnetic moment of five Bohr magnetons, which is more than twice the value for an iron atom in a solid iron magnet. A magnetic moment is a measure of the internal magnetism of the cluster. A manganese atom also has a similar magnetic moment and a closed electronic shell of more tightly bound electrons, and Khanna said that the new cluster could be regarded as a mimic of a manganese atom.

“An important objective of the discovery was to find what combination of atoms will lead to a species that is stable as we put multiple units together. The combination of magnetic and conducting attributes was also desirable. Cesium is a good conductor of electricity and hence the superatom combines the benefit of magnetic character along with ease of conduction through its outer skin,” Khanna said.

“A combination such as the one we have created here can lead to significant developments in the area of “molecular electronics,” a field where researchers study electric currents through small molecules. These molecular devices are expected to help make non-volatile data storage, denser integrated devices, higher data processing and other benefits,” he said.

Khanna and his team are conducting preliminary studies on molecules composed of two such superatoms and have made some promising observations that may have applications in spintronics. Spintronics is a process using electron spin to synthesize new devices for memory and data processing.

The researchers have also proposed that by combining gold and manganese, one can make other superatoms that have magnetic moment, but will not conduct electricity. These superatoms may have potential biomedical applications such as sensing, imaging and drug delivery.

This research was supported by the U.S. Department of the Army.

EDITOR’S NOTE: A copy of the study is available for reporters in PDF format by email request from the Nature Publishing Group press office by contacting

About VCU and the VCU Medical Center: Virginia Commonwealth University is the largest university in Virginia with national and international rankings in sponsored research. Located on two downtown campuses in Richmond, VCU enrolls 32,000 students in 205 certificate and degree programs in the arts, sciences and humanities. Sixty-five of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 15 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers

Having a Higher Purpose in Life Reduces Risk of Death Among Older Adults

Possessing a greater purpose in life is associated with lower mortality rates among older adults according to a new study by researchers at Rush University Medical Center. The study, published in the June 15 issue of the journal, Psychosomatic Medicine, is available online at

Patricia A. Boyle, PhD, and her colleagues from the Rush Alzheimer’s Disease Center, studied 1,238 community-dwelling elderly participants from two ongoing research studies, the Rush Memory and Aging Project and the Minority Aging Research Study. None had dementia. Data from baseline evaluations of purpose in life and up to five years of follow-up were used to test the hypothesis that greater purpose in life is associated with a reduced risk of mortality among community-dwelling older persons.

Purpose in life reflects the tendency to derive meaning from life’s experiences and be focused and intentional, according to Boyle.

After adjusting for age, sex, education and race, a higher purpose of life was associated with a substantially reduced risk of mortality. Thus, a person with high purpose in life was about half as likely to die over the follow-up period compared to a person with low purpose. The association of purpose in life with mortality did not differ among men and women or whites and blacks, and the finding persisted even after controlling for depressive symptoms, disability, neuroticism, the number of medical conditions and income. During the study period, 151 participants died.

“The finding that purpose in life is related to longevity in older persons suggests that aspects of human flourishing—particularly the tendency to derive meaning from life’s experiences and possess a sense of intentionality and goal-directedness—contribute to successful aging,” said Boyle.

Significant associations with mortality were found with three specific items on the purpose of life questionnaire to determine the study participants’ agreement with the following statements: “I sometimes feel as if I’ve done all there is to do in life;” “I used to set goals for myself, but that now seems like a waste of time;” and “My daily activities often seem trivial and unimportant to me.”

“We are excited about these findings because they suggest that positive factors such as having a sense of purpose in life are important contributors to health,” said Boyle.

The researchers note that knowledge of the relationship of purpose of life with other demographic characteristics is limited and future studies are needed to examine whether the association of purpose of life with mortality might be modified by other variables not measured in this study, such as how religious a participant may be. In addition, researchers suggest that future studies should examine whether purpose in life can be enhanced in older persons with interventions.
“Although we think that having a sense of purpose in life is important across the lifespan, measurement of purpose in life in older persons in particular may reveal an enduring sense of meaningfulness and intentionality in life that somehow provides a buffer against negative health outcomes,” said Boyle.

The Rush Memory and Aging Project, which began in 1997, is a longitudinal clinical-pathological study of common chronic conditions of aging. Participants are older persons recruited from about 40 continuous care retirement communities and senior subsidized housing facilities in and around the Chicago Metropolitan area. More than 1,200 older persons are enrolled in the study.

The Minority Aging Research Study began in 2004 and is a study of risk factors for cognitive decline in older Blacks. Participants are recruited from community-based organizations, churches, and senior subsidized housing facilities in and around the Chicago Metropolitan Area. More than 350 older persons are enrolled in the study.

This study was funded by the National Institutes on Aging. The authors thank the NIA for supporting this work and are indebted to the participants of the Rush Memory and Aging Project and the Minority Aging Research Study for their invaluable contributions to aging research.

Boyle is a neuropsychologist in the Rush Alzheimer’s Disease Center.

The Rush Alzheimer’s Disease Center is one of 29 Alzheimer’s disease research centers across the country designated and funded by the National Institute on Aging. In addition to community-based research, the center offers patient care services through its outpatient clinic; it conducts numerous clinical trials, and provides educational programs, resources and early onset programs for patients, family caregivers, and healthcare professionals.

Good News for Some Hard-To-Treat Hepatitis C Patients

In a multi-center trial led by a Saint Louis University researcher, investigators found that a new combination therapy of daily consensus interferon and ribavirin helps some hepatitis C patients who have not responded to previous treatment. The findings, published in the June issue of Hepatology, offer a new option for hepatitis C patients, and may be effective even for those patients with factors that make their condition difficult to treat.

“This represents an important advance for difficult to treat hepatitis C patients who have failed to respond to traditional therapy,” said Bruce Bacon, M.D., director of the division of gastroenterology and hepatology at Saint Louis University School of Medicine and co-director of the Saint Louis University Liver Center .

About 4 million people in the U.S. have been infected with hepatitis C; an estimated 10,000 to 12,000 people die from complications each year in this country. Hepatitis C is caused by a virus, transmitted by contact with blood, and may initially be asymptomatic. For patients who develop chronic hepatitis C infection, inflammation of the liver may develop, leading to fibrosis and cirrhosis (scarring of the liver), as well as other complications including liver cancer and death.

For patients with chronic hepatitis C, the prognosis varies. About half fully recover after an initial course of pegylated interferon and ribavirin anti-viral therapy that may last from six months to a year.

The remaining patients, known as non-responders, may improve but the virus is not eliminated. These patients are at greatest risk for worsening, and subsequent treatments have shown limited effectiveness for this group. In addition, those with genotype 1 (a particular genetic variation of the virus), those with high baseline virus levels, those with advanced liver disease and African American patients are all less likely to respond well to treatment.

The study looked at 515 patients at 44 different sites. Patients were given either one of two doses of daily consensus interferon and ribavirin, or no treatment.

For patients with less severe liver damage who had shown some response to initial treatment, the success rate was above 30 percent. The overall results showed that, for patients who had been unresponsive to initial treatment, consensus interferon and ribavirin worked for about 7 percent of patients given the lower dose and about 11 percent of patients given the higher dose of consensus interferon and ribavirin.

“This study shows that select patients who have failed to respond to prior therapy are candidates for retreatment with consensus interferon and ribavirin,” Bacon said.

The study, Daily-Dose Consensus Interferon and Ribavirin: Efficacy of Combined Therapy (DIRECT) was funded by Valeant Pharmaceuticals and 3 Rivers Pharmaceuticals.

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.

Depression May Increase Risk of Alzheimer’s Disease in People with Memory Problems

People with memory problems who are depressed are more likely to develop Alzheimer’s disease compared to people who are not depressed, according to a study published in the June 16, 2009, print issue of Neurology ®, the medical journal of the American Academy of Neurology. However, the research also shows that the popular Alzheimer’s drug donepezil may delay the progression to Alzheimer’s disease for depressed people with mild cognitive impairment (MCI) or memory problems.

MCI is described as the period in-between normal aging and Alzheimer’s disease. A person with MCI experiences memory problems that are greater than expected with normal aging but does not show other symptoms of Alzheimer’s disease, such as difficulties in completing everyday activities.

For the study, researchers followed 756 people with MCI who were between the ages of 55 and 91 for three years. Of those, 208 were diagnosed with depression using a test that measures the severity and intensity of a person’s depressive symptoms. For every one point increase on the test, a participant’s risk of developing Alzheimer’s disease went up by three percent.

“Our longer term findings add to the body of evidence that suggests depression is a major risk factor for Alzheimer’s disease,” said study author Po H. Lu, PsyD, assistant professor of neurology with the David Geffen School of Medicine at UCLA in Los Angeles. “Since the drug donepezil has been shown to improve the behavioral symptoms of Alzheimer’s disease, our study also tested whether the drug would delay the progression to Alzheimer’s disease in people with memory problems.”

Participants were given either vitamin E, donepezil or a placebo pill. The study found that at 1.7 years, among depressed people with mild cognitive impairment, 11 percent of those taking donepezil developed Alzheimer’s disease compared to 25 percent of those who took vitamin E or placebo. At 2.2 years, 14 percent of those taking donepezil developed Alzheimer’s compared to 29 percent of those who took vitamin E or placebo. Donepezil had little effect in the group of people who were not depressed.

“If we can delay the progression of this disease for even two years, it could significantly improve the quality of life for many people dealing with memory loss,” said Lu.

Donepezil is not approved for use in mild cognitive impairment by the FDA. It is indicated for mild to moderate and severe Alzheimer’s disease.

The study was supported by the National Institute on Aging, the Alzheimer’s Association, the Alzheimer’s Disease Cooperative Study grant, the Alzheimer’s Disease Research Center, Jim Easton and the Sidell Kagan Foundation.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, and multiple sclerosis.

Molecular Marker of Aging in Humans

In 2004, researchers at the University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center announced a crucial discovery in the understanding of cellular aging. They found that as cells and tissues age, the expression of a key protein, called p16INK4a, dramatically increases in most mammalian organs. Because p16INK4a is a tumor suppressor protein, cancer researchers are interested in its role in cellular aging and cancer prevention.

Now the team has proven that the same biomarker is present in human blood and is strongly correlated both with chronological age and with certain behaviors such as tobacco use and physical inactivity, which are known to accelerate the aging process.

In a paper published online ahead of print in the journal Aging Cell, the researchers reported that they have solved technical hurdles to develop a simple blood test to detect p16INK4a expression, which is present in cells called T-lymphocytes, also known as T-cells.

"This is a major step toward a practical tool to clinically determine a person’s actual molecular, as opposed to just their chronological age," said UNC Lineberger member Norman Sharpless, M.D., the senior author of the study and associate professor of medicine and genetics at UNC’s School of Medicine.

They validated the test by obtaining blood from two groups of healthy human volunteers, totaling 170 subjects, who also filled out a questionnaire about current and past health status and health behaviors.

They found that expression of the biomarker was strongly correlated with the donor’s chronological age and, in fact, increased exponentially with age. In addition, increased levels were independently associated with tobacco use and physical inactivity as well as with biomarkers of human frailty.

Sharpless said that the researchers were surprised by some of their findings, “We found a very weak correlation between the biomarker and obesity – as measured by body mass index (BMI) – despite other data suggesting that caloric restriction slows aging. The data suggest the possibility that reduced exercise may actually be worse with regard to molecular age than a higher BMI.”

“Although we don’t know whether this test is a good reflection of cellular age in all types of human tissues, we believe it is a first step toward a better understanding of issues like the suitability of organs for transplantation, how well patients are likely to recover after surgery or the future toxicity of chemotherapy for cancer patients,” he added.

Along with Sharpless, study co-authors from UNC Lineberger are laboratory technician Chad Torrice, postdoctoral researchers Yan Liu, Hyunsoon Cho and Christin Burd, and UNC Lineberger members Dr. Hanna Sanoff, assistant professor of medicine, Dr. Nancy Thomas, associate professor of dermatology, and Dr. Joseph Ibrahim, alumni distinguished professor of biostatistics at UNC’s Gillings School of Global Public Health. (Newswise)

Tuesday, June 16, 2009

New guidelines issued: Registration must for human clinical trials in India

Syed Akbar
Hyderabad, June 15: The Central government's new guidelines on compulsory registration of clinical trials involving human beings came into force on Monday.

From now onwards all clinical trials involving human subjects will have to be invariably registered with the Central drug control authorities. The move comes in the wake of reports of gross misuse of clinical trials. Hyderabad, which has of late emerged as the pharma hub of India, virtually leads the country in terms of drug research. There have been instances of deaths of human subjects involved in
laboratory trials of new drugs.

Registration of clinical trial has to be made in ICMR Clinical Trial Registry at

However, the new guidelines will be applicable to all new clinical trials that will be taken up after June 15. Pharma and research institutions, who want to involve research on human subjects, will have to register themselves with the Clinical Trial Registry controlled by the Indian Council of Medical Research. Those failing to register will be prosecuted, according to a Government of India Gazette notification.

Meanwhile, the State Human Rights Commission has posted for hearing on June 22 the human trial death case involving GVK Bio. The SHRC has issued notices to the State Drug Control Administration. Now that the new guidelines have come into effect, the State Drug department wants to wash its hands off the responsibility in the GVK Bio case.

According to sources, the State Drug department will plead with the SHRC that the Central government be made a party to the GVK Bio clinical trial death case.

State Drug Control Administration director-general RP Meena welcomed the new guidelines and demanded that the State body too be given powers under the new legislation. "We do not have the power of licencing and thus no power of regulation. We will request the Central government to give us equal powers on par with the Central drug authority," he said.

Several multinational pharma companies have been outsourcing clinical research trials to India and the Central government has put the market at around Rs 1500 crore. The new regulations will rein in the erring pharma firms which do not follow the established ethical guidelines where human subjects are involved.

R Uday Bhaskar, general secretary of All India Drug Controllers' Federation, said the government should come out with stringent punishment for those misusing the trials. "Unless we have severe penal provisions, we cannot curb malpractice," he warned.

All About the Clinical Trial Registry

Clinical trials hold enormous potential for benefiting patients, improving therapeutic regimens and ensuring advancement in medical practice that is evidence based. However, the data and reports of various trials are often difficult to find and in some cases do not even exist as many trials abandoned or are not published due to "negative" or equivocal results.

However, this tendency for availability of only selective information from the myriad clinical trials conducted is not commensurate with the practice of "evidence-based medicine". Today, world over, a need has been felt on the imperative for transparency, accountability and accessibility in order to re-establish public trust in clinical trial data. And this would be feasible only if all clinical trials conducted are registered in a centralized clinical trials registry.

Hence, a registry for clinical trials has been set up by the ICMR's National Institute of Medical Statistics (NIMS) and anybody who wishes to conduct a clinical trial in the country would have to declare not only the twenty items of the Trial Registration Data Set as required by the WHO's ICTRP, but also a few more items relevant to the Indian scenario such as Ethics committee Approval Status, Regulatory Clearance by the DCGI, etc, before the enrolment of the first patient.

Thus, the Registry will collect information on all prospective clinical trials to be undertaken in India and make this information available to the public. The Indian Registry is planned to be a freely available and searchable Primary register. To register a study, trialists will submit information including the basic data required by the ICTRP and will receive a WHO assigned unique identification number. In addition, CTRI will encourage trialists to include subsequent protocol amendments and give regular updates on the status of trial.

Thus, setting up a Clinical Trials Registry would ensure that all clinical trials conducted in India are publicly declared and identifiable and a minimum set of information of all clinical trials is freely available to physicians, health researchers, academicians, pharmaceutical industries as well as the common man.


The mission of the Clinical Trials Registry-India (CTRI) is to encourage all clinical trials conducted in India to be prospectively registered before the enrolment of the first participant and to disclose details of the 20 mandatory items of the WHO International Clinical Trials Registry Platform (ICTRP) dataset. In this manner the CTRI hopes to become a WHO ICTRP ICMJE compliant Primary Register for India.

While registration is voluntary, only trials that disclose details of the 20 mandatory items of the WHO/ ICMJE dataset will receive a full registration number that satisfies WHO/ICMJE requirements. While 20 item dataset comprise the majority of the items required for a full registration number, a few additional items are required for registration in the ICTRP, particularly items describing clearance from ethics committees and regulatory agencies.

The vision of the CTRI is to ensure that every clinical trial conducted in the region is prospectively registered with full disclosure of the 20-item WHO ICTRP dataset, as well all items of the CTRI dataset. While this register is meant primarily for trials conducted in India, the CTRI will also accept registration of trials conducted in other countries in the region.

Trials registered in CTRI will be monitored to ensure increasing voluntary disclosure of all items in the register. These items have been selected in order to:

Improve transparency and accountability: By disclosing all required details of the protocol of trials, public confidence in clinical trials is likely to be enhanced.
Improve the internal validity of trials:

Empirical research has shown that some aspect of the methods of the trial are particularly important to produce reliable results by minimizing biases, confounders and the effects of chance or coincidence. These include the method of random sequence generation, adequate concealment of allocation of participants to interventions, adequate blinding of participants, investigators and outcome assessors, and inclusion of all participants' results.

The CTRI hopes that these items, though not mandatory at present, will be disclosed by all registrants, as incorporating such elements at the protocol stage is likely to increase the internal validity of the trial and also increase the chances of publication in a high impact journal that endorses the ICMJE requirement of reporting trials in accordance with the CONSORT statement.

Conform to accepted ethical standards: The Indian Council of Medical Research through its Bio-ethics initiative has developed ethical guidelines for the conduct of trials and for ethics committees.

Clearance by local ethics committees is mandatory for all clinical trials and the CTRI hopes that making disclosure of ethical clearance a mandatory field for registration, it will lead to better links with the ICMR's bio-ethics initiative.
Lead to reporting of all relevant results of all clinical trials in India and the region: The WHO ICTRP is also working towards full reporting of all relevant results from clinical trials and the CTRI will work with the WHO ICTRP to ensure reporting of results of all trials registered with the CTRI.

Gold nanoparticles to help better delivery of drugs, reduce drug resistance

Syed Akbar
Hyderabad, June 15: Gold does not just glitter, it also delivers
medicines effectively and solves the problem of drug resistance for
various diseases.

Using gold nanoparticles, a group of scientists has devised an
innovative method of delivering antibiotics, overcoming the problem of
drug side-effects. The new technology will also solve the problem of
multi-drug resistant micro-organism, which have developed immunity
against certain drugs because of their prolonged and excessive use.

Dr Pankaj Poddar, who led the team of scientists at the Pune-based
National Chemical Laboratory, told this correspondent that the idea of
"dressing up or capping nanoparticles with antibiotics had worked

The team used cephalexin, a broad-spectrum betalactam antibiotic, for
the in situ reduction and capping of gold nanoparticles. According to
Dr Pankaj, gold nanoparticles also helped in effective delivery of the

"Many diseases have become resistant to certain drugs. This makes
things complicated for health planners and doctors. We have to
overcome the problem of drug resistance to make the medicine work
effectively. Gold nanoparticles have been successful on certain drugs.
We are continuing with the research on some more medicines," he said.

The NCL study will serve as an excellent model system to relook at the
growth of nanocrystals in solution phase. The antibiotics
capped gold nanoparticles can be further used in biomedical
applications and cellular biology, where the desired target molecule can
be tagged on the surface of the drug.

Monday, June 15, 2009

Children with kidney problems increasing in India

By Syed Akbar
Hyderabad: Ten-year-old Obaid Ahmed shudders to drink water. For, the more he drinks water the more he has to go to toilet. Suffering from a congenital urological defect, he cannot fully empty his urinary bladder. He has to undergo the trauma of inserting a plastic catheter to clear the urine accumulated in the bladder.
Obaid is one of the 48 lakh children in the State suffering from one or other renal or kidney-related health problem, needing immediate medical attention. Like Obaid, a majority of these children hail from the lower strata of society and their parents are too poor to bear the cost of treatment.
According to Dr Ramesh Ramayya, director of Dr Ramayya's Urology Nephrology Services, more children are born with defects in kidneys, ureters and bladder than that of the heart or any other organ. "These children, if not treated early and followed up regularly until adolescence, may end up with permanent kidney damage", he warns.
Dr Ramesh recently set up the Image Hospitals - Dr GP Ramayya Medical and Research Foundation to take care of poor children with kidney problems. The Foundation has applied for IT exemption and is in the process of enrolling children with kidney defects.
It has also reimbursed the cost of treatment to three children including Obaid. "We have just started the foundation. Our project is to save children with kidney problems", he said.
He said several studies in India have suggested the acuteness of the problem and financial constraints to treat these children. "Based on demographic data, there are 48 lakh children in Andhra Pradesh alone with renal problems requiring treatment. Unfortunately, the number is going up", he adds.
Obaid was born with posterior urethral valves. His incomplete emptying of bladder led to weakening of his bladder and back-pressure changes in the kidneys resulting in damage to his kidneys. The problem was first diagnosed when Obaid was two years old. He has since been visiting Dr Ramayya's hospital with persistent urinary tract infection every three-four months proven microbilogically for which he is on a long-term antibiotic prophylaxis. His present condition is stable chronic renal failure.
Says Dr Ramayya, "if we have to prevent further damage to Obaid's kidneys, the boy needs monthly blood tests and urine culture, ultrasonic scan of the kidneys and bladder every three months and renogram every six months. Our aim is to keep close surveillance to prevent further damage to the kidneys called end-stage renal disease. Presently, the boy needs Rs 1500 to Rs 2000 every month and his father with a meagre salary is not in a position to afford treatment".
The child may need a kidney transplant which involves an expenditure of about Rs three lakh.

People who sit for long hours in office and those who travel long distances quite frequently are more susceptible to impotency

By Syed Akbar
Hyderabad: Sedentary employees and frequent travellers beware! According to a research study by a team of city doctors, people who sit for long hours in office and those who travel long distances quite frequently are more susceptible to impotency or loss of sexual vigour than the people on the move.
The study conducted by the Assisted Conception Services Unit of Mahavir Hospital and Research Centre and the Institute of Genetics and Hospital for Genetic Diseases revealed that the sperm count had come down by about 45 per cent in sedentary employees (47.9 mill/ml) as compared with the control group (80.75 mill/ml). In case of frequent travellers the count recorded was 66.23 mill/ml.
The doctors took three groups of men for the study - a controlled group with just 0.5 hrs of mean seated hours in travel per day, people who travel for 4.25 hrs a day and sedentary employees with sit in offices for 7.9 hrs a day on an average. The normal morphology of semen was 57.25 per cent in the control group, 39.75 in long distance travellers and 38.67 in sedentary workers. The hypo-osmotic swelling test showed a percentage of 56, 54 and 50 in these groups respectively.
"Thermo-regulation in testis is important for normal development and maturation of spermatozoa. Semen is produced at a temperature lower than that of the normal body temperature. Even slight elevations in testicular temperature may have a profound impact on sperm quantity, quality and its fertilising potential. Those who remain seated for long hours have increased scrotal temperature and hence defect in semen quality", says fertility expert Roya Roazati who conducted the research study along with eminent geneticist PP Reddy and Rubina Mujtaba.
Frequent long distance travellers and sedentary workers showed significant impairment in spermatogenesis, percentage sperm motility and normal morphology, particularly sperm head morphology. The sperm quality of sedentary employees is worse than that of the long distance travellers as the former spend more hours in chairs. However, the impact of environmental pollution is more on travellers than on sedentary employees.
According to her, the increased testicular temperatures, a result of prolonged seating, may be a factor directly responsible for the deterioration of semen quality and consequently infertility.
Testis is more vulnerable to heat than any other part of the body. The importance of precise thermo-regulation of the testis is evidenced by the fact that even slight elevations in scrotal temperature are associatied with infertility.
"Long distance sedentary travellers, travelling for more than 200 km or more than three hours a day and sedentary workers spending more than six hours a day seated at work could be victims of impotency", the study pointed out.
The doctors took a detailed history of couples attending the Assisted Conception Services Unit and those couples with a male factor problem but normal female profile. Normospermic men with no evidence of male factor infertility, a non sedentary occupation and time lesser than one hour in travel were taken as controls. All men underwent a thorough clinical evaluation by an urologist to rule out any associated clinical pathology. In all 45 cases were studies and semen samples were analysed after a prescribed three day period of abstinence, for sperm count, motility, morphology, vitality, hypo-osmotic swelling test and the presence of immature germ cells as part of the investigation into their infertility.

Men exposed to industrial fumes are at risk of losing their reproductive strength

By Syed Akbar
Hyderabad: Men exposed to industrial fumes are at risk of losing their reproductive strength with the quality and count of their sperm being significantly affected.
According to a joint research study by city-based Institute of Genetics, Mahavir Hospital, Indian Institute of Chemical Technology and Owaisi Hospital and Research Centre, men exposed to industrial fumes containing nickel and chromium, showed decreased vitality and significantly higher percentage of defects in sperm.
The study, however, found that smoking did not show any effect on semen parameters in industrial workers and welders as also in the control group. Though there was no significant difference in the volume of ejaculated semen of men exposed to fumes and those in the control group, the former had a lower sperm count (almost half), rapid linear progressive motility, and slow progressive motility when compared to control men.
The percentage of normal sperm was also low in the exposed group. They also showed higher percentage of defects in the head and mid-piece of sperm.
Research team member Dr Roya Rozati points out that men exposed to nickel and chromium had a large number of morphologically abnormal spermatozoa in their ejaculates. The levels of these metals in blood was also higher than that of the control group.
"There was a significant positive correlation between the percentage of tail defects and blood nickel and chromium concentration in male welders. Sperm vitality decreased with increasing chromium concentration", Dr Roya told this correspondent.
The study covered 57 employees of an industrial welding plant. The workers have been exposed to two to 21 years to welding fumes. The control group also consisted of 57 subjects, not exposed to known harmful chemicals. Forty-five per cent of the men in the study were smokers and 32 were alcohol consumers. Sperm samples were obtained after a three-day period of sexual abstinence.
Heavy metals nickel and chromium are widely distributed in the work place. Nickel is extensively used in the plating industry, sometimes in combination with other metals. It is also used in electroplating, welding, flame cutting, flame spraying, and mould making. Nickel is also used in the manufacture of jewellery, coinage, cutlery, cooking utensils and dental or surgical prostheses. Chromium is used in metallurgy, chrome plating, welding, chemical industry, textile manufacture, wood preservation, photography and photoengraving, refractory industry and cooling system.
Nickel crosses the placental barrier, directly affecting the developing embryo or foetus in experimental animals. Spermatotoxic effects of nickel in mice have also been observed.

Sunday, June 14, 2009

Epidemic Act: Medical arrests if people do not cooperate

Syed Akbar
Hyderabad, June 13: The fall in temperatures with the onset of rainy season may create a conducive atmosphere for the human influenza virus or swine flu to spread fast through human-to-human contact in the State, even as the State government declared that the Epidemic Act is in force.

Health experts warn that the low temperatures may also aid secondary infection through bacteria, which will make things further complicated. The H1N1 virus does not survive in high temperatures (above 40 degrees C) but the virus may take advantage of the Southwest monsoon to express its potent virulence.

"So far all the cases that have been reported in India are of viral infection, which is not generally life threatening. But the cool weather may aid bacterial infection in swine flu patients. And if this happens, both the virus and the bacteria will create severe health complications, including death," said senior chest physician Dr OA Sarma.

Dr Sarma, who worked as the superintendent of AP Chest Hospital, Hyderabad, told this correspondent that there might be pneumococcal, streptococcal and staphylococcal bacterial infection in swine flu patients. "We have to ensure that there's no secondary infection in these patients," he said.

Meanwhile, the State government has declared that the Epidemic Act of 1897 is already in force in the State and those refusing to cooperate with the authorities may face "medical arrests". The Delhi State government has already announced promulgation of the Act while the Tamil Nadu government had threatened to implement the British Era legislation.

"We have been regularly enforcing the Epidemic Act to act against traders, hoteliers etc who refuse to comply with hygienic conditions. So far there have been no cases of resistance from swine flu patients or suspects. If anyone refuses medical treatment or quarantine we will act under the Epidemic Act," said Principal Secretary (health) Dr LV Subrahmanyam.

The Union Civil Aviation Ministry has agreed in principal to install thermal scanners at international airports to separate out swine flu patients. The scanners detect the body temperature and those with abnormal body temperature (above 98.4 degrees F) will be medically examined for swine flu symptoms.

The country's first thermal scanners will be operational in Mumbai in a day or two. With half of the swine flu cases reported in the country being from Hyderabad, the city airport will also get thermal scanners. "There's
a proposal with the Union Civil Aviation Ministry," an official of GMR airport said.

Saturday, June 13, 2009

Crida warns of severe climate change impact on agriculture in India

Syed Akbar
Hyderabad, June 12: Climate change will severely affect agricultural production in Andhra Pradesh with a fall in yield ranging from eight to 30 per cent, according to city-based Central Research Institute for Dryland Agriculture.

Crida has conducted studies on the effect of climate change on sorghum production. Says B Venkateswarlu, Crida director, "rainfed sorghum yields in Rayalaseema may reduce eight to 10 per cent by 2020 and 18 to 30 per cent by 2050 and 2080
respectively. In Telangana region the productivity of sorghum will reduce by three, five and 10 per cent by 2020, 2050 and 2080".

Referring to the estimation of water surplus amounts in different regions of the State during 2020 and 2050 compared with the present levels, Crida warns that water surplus availability may reduce by five to nine per cent and 10 and 15 per cent in north Telangana regions during the period. In north coastal regions the availability may reduce by 14 to 49 per cent and 41 to 100 per cent in 2020 and 2050 respectively. This means reduction in runoff into river flows.

"Largescale shifts in cropping patterns may take place in future. We need to use water more judiciously and several new agricultural technologies need to be developed to cope with climate change. Weather insurance has to be adopted on a massive scale in the country," Dr Venkateswarlu said.

Crop simulation models indicate that an increase of two degree Celsius in temperature during the rabi season may decrease the wheat yields by 15 to 17 per cent in wheat crop in Punjab region. Similarly for Gujarat region, two degree Celsius may decrease the wheat yield by 19 per cent under optimum irrigated conditions. In Chhattisgarh region, the increase in temperature by one to two
degree Celsius during the reproductive stage will reduce the yield by three to four quintals per hectare.

In Tamil Nadu during kharif season about 10 to 15 per cent decrease in rice yields is expected by 2020 due to increase in thermal regime, further reduction in yields up to 30 to 38 per cent is expected by 2050. In Orissa the rice crop yields are expected to fall by 10 per cent by 2020 compared to the yield levels of 2006, he

Swine flu: Human Influenza virus may mutate further, turn lethal in India

Syed Akbar
Hyderabad, June 12: The swine flu virus has the potential to mutate further
and become a lethal virus, warn the Union Ministry of Health and Family
Welfare. "It is also not known how this virus or a further mutated strain
would behave in Indian population," it said.

In its draft action plan, following the WHO updation of swine flu pandemic
level from phase 5 to phase 6 on a scale of six, the Union Health Ministry is
of the view that containment may not be possible at this stage. "Only
mitigation measures are needed now," the ministry noted.

Fourteen of the 15 swine flu cases registered thus far in India have been
"import" cases and only one case was of secondary spread. "The behaviour of
this mutant virus among the Asian population cannot be predicted. The virus
has the potential to mutate further and become a lethal virus," the Health
Ministry warned on Friday.

In view of the latest WHO guidelines, the government has decided to
increase surveillance mechanism at community level, ports and airports and
border crossings to detect early clusters of influenza like illness or severe
acute respiratory illness. It has also taken up a virological surveillance to
detect the circulating strains and any new strain that enters the country or that
gets established within the country.

As of now, India has a stock of 10 million capsules of oseltamivir. Some
stocks are also committed by pharmaceutical companies for exclusive use by
the Government. This drug is only available through the public health system
and its retail sale is banned as indiscriminate use may lead to development of

The contacts of the positive cases in Delhi, Goa and Hyderabad are on
chemoprophylaxis and they are being monitored. As of now, no family or
social contacts has reported symptoms.

Wednesday, June 10, 2009

Nuclear submarine: India joins the elite club of nations with advanced technology vessels

By Syed Akbar
Hyderabad, June 10: India will join the elite club of four nuclear advanced nations when the country's first indigenously built nuclear-powered submarine will formally become operational on July 26.

Code-named "advanced technology vessel", the nuclear submarine has been on the Indian Defence agenda for more than four decades. Thevessel was first proposed after the Indo-Pak war in 1971. But thingsstarted moving fast in the last five years culminating in the country's first nuclear submarine. It will give an advantage to India over its nuclear rival Pakistan. The other nuclear neighbour China already
possesses such submarine vessels.

Prime Minister Dr Manmohan Singh will inspect the submarine on July 26. The submarine has underwater ballistic missile launch capability.

The ballistic missile was tested last year. With the induction of this vessel, India would join the elite group of Britain, China, France, Russia and the United States which have nuclear-powered submarines.

Navy neither denied nor confirmed the test trial of nuclear submarine but admitted some activity and preparations were going on for the prime Minister's visit. This was the first of planned fleet of five each having a size of 6,000 tonnes. It will have a single-shaft nuclear power plant, build indigenously. It is said to have 9,400 tons displacement when submerged. The submarine is 124 meters long.

After the designs prepared by BARC failed to click, India secured reactor designs from Russia. The reactor, nicknamed "baby boomer" was first tested five years ago.

A long-running secret project, India's nuclear-powered submarine is a 6,000-tonne modified version of the Russian Charlie-II class vessel sources said.

Started in the 1970s, the project was to have a miniaturised nuclear reactor, for which Russia agreed to offer technical help. The 100MW electrical reactor is said to use highly enriched uranium.

Monday, June 8, 2009

The story of false Jews in Kothareddypalem

By Syed Akbar
Hyderabad: Genetic studies carried out by the Indian Statistical Institute in collaboration with the Centre for Cellular and Molecular Biology have nailed the claim of some people in Kothareddypalem in Guntur district that they are one of the lost tribes of Israel.
The biological anthropology unit of the Indian Statistical Institute has analysed DNA of 45 caste ad tribal populations of the State with the active collaboration of the CCMB. The samples include two independent samples of Madiga community from Guntur and other areas.
"Examination of molecular genetic data (mtDNA, Y and autosomal) of Madiga population of the village vis-à-vis the genetic data available on the Jewish populations showed that they did not have any genetic affinity with the Jews," Prof B Mohan Reddy of ISI told this correspondent.
He said each of the three sets of data available with the Institute suggested that there was really nothing in the genetic data that drew Madigas closer to Jewish groups than to other AP groups, both castes and tribes.
There is one common genetic feature specific to Y-chromosome (Haplogroup J2) between the Jews and the Madigas but this genetic feature is ubiquitous to most AP Populations and in fact even in the frequency of this haplogroup Madigas are closer to neighbouring AP groups than to Jews.
"There are of course other genetic features that are frequent in AP groups including Madigas but absent in Jews. Our earlier studies based on autosomal genetic markers on 27 populations of Andhra Pradesh showed that the people of the State are genetically homogeneous, suggesting relative closeness of Madigas to other caste and tribal groups from the region," he said.
Given the genetic data with the Institute on Madigas there is very little that can substantiate the claims of this community. However, he said the institute would not contest the claim of the community on cultural affinity to the Jews.
The Madiga community in Kothareddypalem in the outskirts of Guntur numbering 50 families has been claiming that it belonged to the Ephraim tribe. It has been contesting that it was one of the 12 ancient Jewish tribes who were in search of the Promised Land with Prophet Moses.

ICRISAT develops climate change ready varieties

By Syed Akbar
Hyderabad, June 6: When the world gets warmer with climate change, the dryland tracts will become even drier making it more difficult for the farmers to grow crops in this region.

The improved crops developed by the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), and its partners, are able to withstand severe droughts, tolerate higher temperatures and mature early, enabling the farmers to be ready to meet the challenges of climate change.

According to Dr William Dar, Director General of ICRISAT, the current research strategy at the Institute is to improve the heat-tolerance and drought-resistance qualities of ICRISAT’s mandate crops.

“As the world celebrates the Environment Day, we at ICRISAT, along with our NARS partners, strengthen our efforts to develop crop varieties that will overcome the adversities of climate change, and thereby reinforce the food and income security for the poor in the developing countries,” said Dr Dar.

ICRISAT’s research is focused on crops that are important for the livelihoods of the people in the dryland areas. They are pearl millet, sorghum, chickpea, pigeonpea and groundnut. These crops have several natural evolutionary advantages for the global warming scenarios.

Both pearl millet and sorghum have high levels of salinity tolerance, and hence are better adapted to areas that are becoming saline due to global warming. Some of the pearl millet varieties and hybrids, developed from ICRISAT’s germplasm, are able to flower and set seeds at temperatures more than 42 degrees centigrade, in areas such as Western Rajasthan and Gujarat in India. Improved sorghum lines have also been developed that are capable of producing good yields in temperatures of 42 degrees C, and have stay-green traits that can enhance terminal drought tolerance.

Short-duration groundnut varieties such as ICGV 91114 have good levels of drought tolerance, and are already replacing more susceptible older varieties. For chickpea, ICRISAT has developed extra-early (85 to 90 days to maturity) and super-early (75 to 80 days) varieties that can escape terminal drought. More recently, ICRISAT researchers have identified chickpea lines that have high levels of heat tolerance, which will enable them to be grown in areas with higher temperatures during heat-sensitive pod filling stage.

Sunday, June 7, 2009

Human Influenza A: Hyderabad emerges swine flu capital in India

By Syed Akbar
Hyderabad, June 6: Hyderabad has emerged as the hub of human influenza A virus or swine flu with five of the seven cases reported so far in the country and yet health authorities here have not found it necessary to improve quarantine facilities at the lone nodal centre, the AP Chest Hospital.

A fresh swine flu case was confirmed on Saturday in a four-and-a-half year old girl. She contacted the disease while she was flying down to India from the US from a 20-year-old co-passenger. Her mother is now under surveillance for any swine flu symptoms.

The youth, who passed on the disease to the child, has also transmitted the virus to his brother, who incidentally did not travel outside the country. Both the brothers are now under treatment. This is the first "native" case of swine flu in the country in the sense that the disease has spread locally.

Even as more swine flu cases are adding up in Hyderabad, health authorities continue to make do with the existing facilities, which are not enough to treat severe cases. Luckily, all the cases reported so far in the country are mild and do not require advanced treatment. But the authorities have no answer to the question, what if a severe case of swine flu is admitted to the chest hospital.

Given the severity of the situation and lack of adequate facilities in city hospitals, the National Institute of Communicable Diseases is rushing a team of experts to Hyderabad. It includes a multi-disciplinary rapid response squad.

The World Health Organisation has issued a set of guidelines on treatment of swine flu cases, which include provision of oxygen therapy. The chest hospital does not have such a facility and a senior official admitted that it would acquire one if the need arose. The WHO has also suggested that swabs be taken from more than one source, but health authorities here continue to depend on throat swabs alone.

"All the patients admitted with swine flu are doing well and responding to the treatment. They do not require oxygen therapy. If an emergency arises we will shift the patients to intensive care unit where we have oxygen facility," said Dr K Subhash, coordinator for the State nodal centre for human influenza A. He, however, has no answer when asked if shifting of swine flu patients to intensive care unit will not spread the disease. Those suffering from swine flu have to be in isolation or quarantined.

The WHO guidelines stipulate that samples for laboratory tests should be taken from the deep nasal passages (nasal swab), nasopharynx (naso-pharyngeal swab), throat or, if available, bronchial aspirate. Upper respiratory tract sampling using a combination of a nasal or nasopharyngeal and a throat swab is advised and may
facilitate virus detection. It is not yet known which clinical specimen gives the best diagnostic yield for this specific infection. But for reasons best known to officials, all the samples collected so far are those of throat.

Swine flu is a new influenza virus detected quite recently. This virus spreads from person-to-person, probably in much the same way that regular seasonal influenza (common cold) viruses spread. Human-to-human transmission happens when infected people cough or sneeze. The infected droplets get on their hands, drop onto surfaces, or are dispersed into the air. Another person can breathe in contaminated air, or touch infected hands or surfaces, and be exposed.

To prevent spread, people should cover their mouth and nose with a tissue when coughing, and wash their hands regularly. The early signs of influenza A are flu-like, including fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting or diarrhoea.

Swine flu has assumed pandemic proportions since thousands of cases have been reported from a vast geographical area. A disease is said to be endemic if it is restricted to a particular area and pandemic when it spreads worldwide.

"At presentation or triage and routinely during subsequent care in hospitalised patients, oxygen saturation should be monitored by pulse oximetry whenever possible. Supplemental oxygen should be provided to correct hypoxaemia (low oxygen content in blood). It is advisable to have an oxygen therapy to maintain oxygen saturation above 90 per cent. Several patients in Mexico have developed ventilator-associated pneumonia or hospital-acquired pneumonia caused by typical nosocomial (hospital) pathogens," a WHO report warns.

According to Dr SV Prasad, superintendent of AP Chest Hospital, the latest swine flu patient, the plus four years girl has been doing well and responding to the treatment. "The girl is playing and her condition is normal," he said.

Climate change will have a serious impact on the agricultural scenario in Andhra Pradesh

By Syed Akbar
Hyderabad, June 5: Climate change will have a serious impact on the agricultural scenario in Andhra Pradesh, affecting the incomes of farmers by as much as 20 per cent.

According to the latest World Bank report on the impact of climate change on India, dryland farmers in Andhra Pradesh may see their incomes plunge by 20 per cent. The WB report, one of the first of its kind in South Asia, finds that climate change will have a serious impact on India where about one-third of the land is already drought or flood prone.

N Harshadeep, World Bank senior environmental specialist for South Asia, said, "If climate projections are indicative of future trends, the risks associated with water-related climate variability are likely to intensify and worsen."

Besides farmers in Andhra Pradesh, agriculturists in neighbouring Maharashtra and Orissa will also be hit badly. "In Andhra Pradesh, dryland farmers may see their incomes plunge by 20 per cent. In Maharashtra, sugarcane yields may fall dramatically by 25-30 per cent. In Orissa, flooding will rise dramatically leading to a drop in rice yields by as much as 12 per cent in some districts," the WB report warned.

It said other climate hotspots in India like the fragile Himalayas, the biodiverse Western Ghats, the vast coastal areas, and the prolific agricultural lands of the Gangetic plains will need to be looked at in subsequent studies. Harshadeep said "monsoonal rainfall over India has decreased by approximately five to eight per cent since the 1950s, and combined with impending climate change, this might contribute to more intense, longer, or more widespread droughts across the region."

Emphasising the ill-impact of climate change on agricultural productivity in Andhra Pradesh, the WB report pointed out that in the arid regions of Andhra Pradesh, the yields of all the major crops like rice, groundnut, and jowar are expected to decline, although groundnut is expected to fare better than others.
Under a modest to harsh climate change scenario - a substantial rise in temperatures (2.3 C - 3.4 C) and a modest but erratic increase in rainfall (four per cent to eight per cent) - small farmer incomes could decline by as much as 20 per cent.

"Agriculture as it is practised today will no longer be able to sustain large
populations on small rain-fed farms," the report predicted.

To arrest the problem the World Bank suggested that unrestrained competition for ground water should be regulated and there should be aggressive pursuit of water conservation. "While much research is being conducted for rice, horticulture, and other crops, farmers will need greater support with knowledge and policy assistance to make the transition to sustainable dryland farming on a large scale. They could also diversify into agro-forestry which is more resilient, as well as livestock production," it said.

Monday, June 1, 2009

Indians are not genetically similar

By Syed Akbar
Hyderabad: Contrary to popular belief that Indian are genetically similar despite their caste, religion and regional affiliations, a major study conducted across the nation by Indian Genome Variation Consortium has revealed that Indians are genetically different and the similarity in Indian populations is limited to certain clusters.
The IGVC carried out the largest-ever exercise in the country to arrive at the genetic affinity of various Indian people based on castes, tribes, religions, regions and customs. As many as 55 diverse endogamous Indian populations were covered under the study.
The groups included 32 large (more than one crore people) and 23 isolated populations representing a large fraction of people in the country.
"We observe high levels of genetic divergence between groups of populations that cluster largely on the basis of ethnicity and language. Indian populations not only overlap with the diversity of HapMap populations, but also contain population groups that are genetically
distinct. These data and results are useful for addressing stratification and study design issues in complex traits especially for heterogeneous populations," Dr Saman Habib, scientist in the Division of Molecular and Structural Biology, Central Drug Research Institute, Lucknow, told this correspondent.
The present study contradicts earlier reports that Indians are genetically similar despite their physical and geographical differences.
A number of research institutes across the country including Lucknow's CDRI participated in the study. Genetically isolated populations are considered to be important in dissecting complex diseases and mapping underlying genes. However, the validation of results across populations has met with limited success. Population stratification, a consequence of differences in allele frequencies across populations arising mainly due to natural selection and genetic drift, is a major problem in association studies.
It is, therefore, important to assess the nature and extent of population stratification in contemporary endogamous populations especially in the context of established or candidate disease genes, she said adding that Indians, comprising about one-sixth of the world population, with large family sizes and high levels of endogamy, provide a unique resource for dissecting complex disease aetiology and pathogenesis. According to scientists who participated in the study, India provides a large patient pool with the majority being drug naive. Historically, the Indian population is a conglomeration of multiple culture and evolutionary histories.
"Anatomically modern man is estimated to have reached the north-western periphery of the Indian subcontinent around 70,000 years before present and moved southward into Sri Lanka in the next 20,000 years. Modern human communities may also have migrated into eastern India from Myanmar around 4500 to 11,000 ybp. The evolutionary antiquity of Indian ethnic groups and subsequent migration from central Asia, west Asia and southern China has resulted in a rich tapestry of socio-cultural, linguistic and biological diversity," the study pointed out.
Broadly, Indians belong to Austro–Asiatic, Tibeto–Burman, Indo–European and Dravidian language families. Distinct religious communities, hierarchical castes and subcastes, and isolated tribal groups that comprise the people of India remain largely endogamous. Most of these groups have strict social rules governing mating patterns.
Earlier studies using mitochondrial, Y-chromosomal and limited autosomal markers, that primarily addressed issues of origin and migrations, have demonstrated extensive genetic diversity in India
In contrast, a recent study based on autosomal microsatellite markers has inferred that Indian populations show low levels of genetic differentiation. This inference was possibly due to biased recruitment of study participants and insufficient classification based on
language and ethnicity.
The representative set of genes included drug-response genes, genes involved in cancer and ageing, eye diseases, allergy and asthma, neuro-psychiatric, metabolic and cardiovascular disorders as well as genes involved in susceptibility to infections.
It is contented that the Dravidian speakers, now geographically
confined to southern India, were more widespread throughout
India prior to the arrival of the Indo–European speakers. They, possibly after a period of social and genetic admixture with the Indo–Europeans, retreated to southern India, a hypothesis that has been supported by
mitochondrial DNA analyses.
"Our results showing genetic heterogeneity among the Dravidian
speakers further supports the above hypothesis. The Indo–
European speakers also exhibit a similar or higher degree of
genetic heterogeneity possibly because of different extents
of admixture with the indigenous populations over different
time periods after their entry into India. It is surprising that
in spite of such a high levels of admixtures, the contemporary
ethnic groups of India still exhibit high levels of genetic
differentiation and substructuring," the study revealed.
It further said, "we note that the people of India are referred as ‘Indian’ in many population genetic studies. The implication of such usage is that the Indian population is genetically homogeneous, which, as the
results of our study indicate, is evidently not true. However,
we have also shown that it is possible to identify large clusters
of ethnic groups that have substantial genetic homogeneity".

South Indian men are increasingly turning infertile

By Syed Akbar
Hyderabad: South Indian men are increasingly turning infertile as compared with their counterparts in north India if the decline in sperm count, quality and motility is any indication.
In the first-ever evidence on quality of sperm in southern part of India, scientists and researchers at the Division of Reproductive Medicine, Kasturba Medical College, Manipal University, Manipal, have found that the quality of human semen evaluated for infertility is deteriorating in the South over the years. This, they attributed to environmental, nutritional, lifestyle or socio-economic causes.
The Manipal group comprising Dr Adiga Satish Kumar, Dr V Jayaraman, Dr G Kalthur, Dr P Kumar and Dr D Upadhya studied a cohort of infertile individuals at a regional level, in terms of the sperm concentration, total sperm motility, sperm morphology and incidence of azoospermia over a period of 13 years. They evaluated as many as 7,770 subjects, who presented for semen analysis since 1993.
The study revealed that the average sperm density among infertile men has come down to 26.61 ± 0.71 millions/millilitre which was significantly lower than the average sperm density observed a decade ago (38.18 ± 1.46 millions/mL).
Similar trend was also observed for sperm motility (47.14 per cent motile sperms vs 61.16 per cent) and normal sperm morphology (19.75 per cent vs 40.51 per cent).
"In particular, the decline in sperm count was 30.31 per cent whereas sperm motility and morphology was reduced by 22.92 per cent and 51.25 per cent, respectively in the last 13 years. Furthermore, the regression analysis also confirmed a true decline in the semen quality over this period," the scientists pointed out in their study.
The baseline sperm concentration and motility for Indian men was reported as 68.22 ± 15.14 millions/mL and 40.95 ± 9.15 per cent respectively and a previous study failed to demonstrate any change in the semen quality among infertile men in the northern part of the India for a period of 11 years.
In contrast, the mean sperm count observed by the Manipal team was 26.61 millions/mL which was much lower than the baseline value of 68.22 millions/mL for Indian men.
"However, there was no significant difference in the motility between two studies, suggesting a definite decline in the sperm concentration in the southern part of the India," they said.
The decline in the semen quality coincides with an increasing incidence of abnormalities of the male genital tract including testicular cancer and cryptorchidism (undescended testis) in various countries. More importantly, the increase in the incidence of sperm morphological abnormalities in addition to low-sperm count observed in this study indicates qualitative impairment of spermatogenesis and perhaps of the Sertoli cells.