All-woman planet with no men

Syed Akbar

Hyderabad: Imagine an all-woman planet where there are no men. And this is going to happen, if scientists have their say.

British scientists have already produced what they term, "female sperm", to do away with the role of man in reproduction. If the female sperm works well, women will be able to reproduce children without the help of man. But, all the offspring they produce will be girls. The female sperm will not be able to produce boys since it lack the "Y" or the male sex chromosome.

It will also help lesbian couples to have their children, again all girls. The Earth will then become a planet of women and the male species will become extinct. In case gay men too decide to benefit from the research, they can have their own "eggs" produced from their stem cells and fertilised artificially. They will then be able to produce children without the help of women. But unlike in the case of women, gay men will be able to produce both boys and girls.

City scientists, however, take the research of British scientists with a pinch of salt. "The British scientists have taken stem cells from a woman's bone marrow and then cultivated them in chemical soup to make them female sperm cells. Stem cells have the capacity to turn into any part of the body. If they use the bone marrow of a woman for sperm production, then the offspring will be girls. If the bone marrow of a man is used, the children can both be boys and girls," says senior geneticist and stem cell researcher Dr MN Khaja.

"It is wrong to say that men may not be required to create babies," points out Dr Khaja. Stem cell technology can do wonders. "Using the technology, we can argue that women may not be required to produce babies. If female sperm could be produced artificially, male eggs could also be made in laboratory. The stem cell research should be utilised to improve the health of people and not to procreate clones with unknown genetic complications."

Geneticists express serious concern over artificial production of "female sperm" from the bone marrow of woman. They say it will not only lead to an all-woman Earth upsetting the natural balance, but will also cause a plethora of genetic diseases, which are mostly incurable. There will also be no genetic lineage, since it is the male sperm or the Y chromosome that is responsible for family lineage.

As the British scientists apply for permission to carry out their work to the next stage, Indian infertility experts say it's better to take the male stem cells to generate sperm for in vitro fertilisation. "We have done pioneering research on production of sperm tissue from stem cells in test tube. The stems cells of an infertile person can be taken and processed to become sperm. The sperm can then be used for artificial fertilisation of the egg of his wife. The child can either be male or female. This way we can maintain the genetic lineage without tampering with the natural laws," argues senior in vitro expert Dr Roya Rozati.

She is also working on developing methods to inject artificially produced sperm into the testes of infertile men, so that they could conceive naturally. This will eliminate the need for in vitro or test tube fertilisation for couples with male infertility problems.

The British research on stem cells led by Prof Karim Nayernia centred around mice. According to him, "mature sperm capable of fertilising eggs may take three more years."

The research paves the way for a woman to produce her own sperm through artificial means. She then can use the artificially produced sperm to fertilise the naturally formed eggs in her womb. But city scientists warn that such children will have massive genetic complications. The children born may be abnormal and lead a miserable life.

Children, who do not skip breakfast, will perform well in school and score a high percentage of marks in examinations

By Syed Akbar

Hyderabad: Children, who do not skip breakfast, will perform well in school and score a high percentage of marks in examinations.

The city-based National Institute of Nutrition, in a study, has found that regular habit of consuming breakfast can improve attention-concentration, memory and school achievement. This is primarily because the micronutrient supplementation in breakfast improves attention concentration among schoolchildren.

The NIN team comprising deputy director Shehnaz Vazir, NS Gajre, S Fernandez and N Balakrishna selected two schools catering to middle class families in Hyderabad. As many as 379 students of classes 6, 7 and 8 were enrolled for the study. They were divided into two groups: one partaking breakfast and the other skipping it.

Comparison between the groups indicated significant differences in the letter cancellation (special test involving hand-eye movement) total scores with the regular breakfast group achieving the highest mean scores compared to the no breakfast group.

Moreover, marks scored by the regular breakfast group in science and English and total percentage were significantly higher compared to those scored by the children in the no breakfast group.

"Regular breakfast eating habit and weight for age per cent were significantly associated with immediate recall memory score explaining 4.3 per cent variation. Regular habit of eating breakfast as opposed to irregular consumption or skipping breakfast altogether had beneficial influence on attention-concentration, memory and school achievement," the NIN researchers said.

According to the team, eating breakfast provides energy for the brain and improves learning. The effect of glucose deprivation is noticeable by a fall in blood glucose level of sufficient degree, which is rapidly followed by disturbance in cerebral function. The gap of about 10 to 12 hours between dinner and breakfast causes, low blood glucose levels and habitually missing breakfast can adversely affect cognitive performance.

"The gradual decline of insulin and glucose level could determine a stress response, which interferes with different aspects of cognitive

function, such as attention and working memory. It is plausible that the decline in cerebral iron level likely to result from diet that is deficient in heme (iron molecule) intensifies the stress associated with overnight and morning

fast," the study pointed out explaining how breakfast would help schoolstudents improve their academic performance.

Breakfast eaters tend to have higher basal metabolism, and have less craving for the food. Children who skip breakfast but eat later on in the

day may catch up their daily nutrient requirements but are unlikely to attend and concentrate on the teacher’s lecture in the morning session because they are hungry. If the transitory metabolic changes due to skipping breakfast were to occur frequently, they would be likely to have a cumulative adverse effect that may place a child’s school progress at risk, the NIN nutritionists warn.

Doctors-pharma nexus: What's the solution?

By Syed Akbar

Health experts suggest the following remedial measures to curb the problem of cut practice:

1. The concept of general practitioner or family physician referring patients to specialists depending on the situation.

2. Doctors should prescribe only generic drugs and evidence-based
medicine system.

3. The price control order has to be reviewed adding costly anti-cancer
drugs, stents and other implant material.

4. The manufacturing price and the margin of profit shall only be 50
to 100 per cent.

5. Striking the name of the erring doctor from the rolls who are
found to be resorting to unethical practises and giving powers under AP Medical Council and Medical Council of India Acts.

6. Medical representatives shall meet only purchase committees of the
hospitals.

7. Penal action against pharma companies that lure doctors.


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MCI commandments

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1. Thou shalt not accept gifts from pharmaceutical companies.

2. Thou shalt not go on tours sponsored by drug firms.

3. Thou shalt not accept cash either as gift or as incentives.

4. Thou shalt not engage in research work without the approval of the institutional ethics committee.

Doctors-pharma nexus: Pharma industry's gifts to doctors

By Syed Akbar

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What doctors get from drug firms

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1. Personal gifts like car, air conditioner, refrigerator, flat, plot and gold coins.

2. Hospital or nursing home equipment.
3. Cash as commission.
4. Five star hotel stay.
5. Foreign trips.

6. Free medical course for the children of doctors.
7. Supply of medicines to medical shops owned by doctors.
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Unethical practices indulged in by doctors

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1. Commission for referring their patients to superspecialists or specialists.
2. Employing PROs to foster their business.

3. Paying commission to quacks/RMPs in rural areas for referring patients to their hospitals or clinics.

4. Commission from diagnostic centres.
5. Being part of clinical research organisations.
6. Being part of multi-level marketing chains.
7. Manipulating drug prices by irrational combinations, not in Drug Price Control Order.

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Games small pharma companies play

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Small and medium pharma companies sell their products to propaganda-cum-distribution dealers, who tie up with doctors. A local brand of drug made by these companies is only sold in medical shops around the select  doctor's clinic or hospital. Such drugs are not sold elsewhere. The same drug manufactured by MNCs or reputed pharma companies is available for less. Here the patient has to shed more money for the local brand as he is denied access to the drug of the company known for the quality.

This usually happens in the case of B complex, vitamin syrups, antibiotics, antacids and anti-ulcer drugs.

In rural areas, RMPs and quacks also prescribe these local drugs and get commission ranging from 50 to 60 per cent of the maximum retail
price.

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Modus operandi by big pharma units

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The modus operandi of pharma companies and distributors, in luring medical
practitioners, is quite interesting. Most of the multinational and big Indian pharma companies has specialist doctors on their payrolls and booked for the next few decades.

These firms lure doctors by offering them trips to Singapore, Bangkok, Malaysia and even Europe in case of specialists.

Manipulating things with Drug Price Control Order is another major
aberration in the industry. There are around 74 drugs in the price control order and it has not been reviewed after 1995. The government has fixed MRP for all these drugs in the Order.

Pharma companies add an ingredient to make it a combination drug and
sell it under a different brand to escape the Price Control Order. They fix their own MRP. Even the recent high-end medicines like retroviral, TB and cancer drugs, stents and implants used in cardiovascular and orthopaedic surgeries do not fall under the Price Control Order category.

Doctors-pharma nexus: Do you have to go round pharmacies to find the medicine prescribed by your doctor?

Syed Akbar 

A middle-aged man visits a doctor with a complaint of mild food poisoning. The doctor examines him and prescribes certain medicine. The man goes to at least a dozen medical stores with the prescription, only to be told that the medicine is not available. He then approaches the doctor to inform him about the non-availability of the drug. The doctor then directs him to a particular pharmacy, and presto! the patient finds the prescribed medicine.

Many patients silently make rounds to a number of medical stores before they finally get the drug prescribed. It is not that the drug is exclusive, restrictive  or of high curative value. It is because the doctor does want the pharmaceutical company to stock the drug only with a limited number of chemists. And what does the doctor get in return by restricting the sale of the drug?

Restricting the sale of drug to a medical store or a group of pharmacies is part of the larger game plan, what insiders in the medical field prefer to call, "cut practice". By restricting the sale of the particular drug, the pharma firm jacks up the MRP by almost 100 per cent. A commission ranging between 20 and 40 per cent of the MRP is then passed on to the doctor concerned. The loser, as always, is the patient. He pays, for instance, Rs 10 for a tablet or capsule that normally costs Rs 5 or Rs 6.

"Cut practice" is a term that encompasses everything unethical that a person or firm in the medical or pharma industry indulges it. It ranges from simply restricting the sale of drugs to certain medical stores, to garnering costly gifts by doctors from pharmaceutical companies for prescribing their drugs, and from sponsored luxury foreign visits to commission in diagnostic tests.

According to insiders, an ordinary doctor gets anything upward of Rs 2 lakh a year from pharmaceutical companies and diagnostic centres. In the case of specialist doctors/superspeciality hospitals, the commission and gifts touch even Rs 50 lakh a year. The price, patients pay in India thanks to the system of cut practice, is estimated at a whopping Rs 2,000 crore a year. This is patients' money, which otherwise they would have saved.

The recent guidelines, issued by the Medical Council of India prohibiting doctors from taking commissions from diagnostic centres and gifts from pharmaceutical companies, have kicked off a debate in the pharmaco-medical industry in the country on this nasty cut practice. All doctors, though openly support the new medical ethics, they do not want to come out of the cut practice, as it cuts their income drastically.

"Doctors get more than what you pay as consultation fee every time you visit them. They get commission from pharmaceutical companies for prescribing their products, including those which are classified as irrational medicines,"
says cancer specialist Dr P Raghuram.

According to a study by the Indian National Commission on Macroeconomics and Health, doctors prescribe drugs that are "irrational or non-essential or (even) hazardous." After a study of 25 top-selling medicines in the country, the Commission came out with a report saying that 10 of the 25 fell in the irrational or non-essential drugs  category.

"The drug industry, immensely powerful and profitable, spends more than 11 billion US dollars each year in promotion and marketing. It has succeeded in tightening its grip over the medical community over the last two decades. It tempts doctors by such offers as expensive gifts and foreign junkets, which often leads to the unscientific, costly and irrational use of drugs," points out Dr SP Kalantri, associate editor of the Indian Journal of Medical Ethics.

Dr Raghu Ram, who is also the director of KIMS-Ushalakshmi Centre for Breast Diseases, argues "cut practice is common in every segment of medical
and health care industry across the country. Taking money from the manufacturers and distributors for prescribing medicines, for obtaining diagnostic tests some of which may be unnecessary, doctors employing people with the sole purpose of luring patients is now a part and parcel of Indian practice. Faith, which is the principal link between the doctor
and patient, is fast losing its relevance and the practice of medicine is no longer considered to be noble".

The modus operandi of pharma companies and distributors to lure medical
practitioners is quite interesting. Most of the multinational and big
Indian pharma companies has specialist doctors on their payrolls.

Says Dr MN Khaja "the quality of drug is often compromised and patients have to shed more from their pockets as the drug was insisted by the doctor.
For instance, medical oncologist can only prescribe medicines for
cancer patients. However, the common practice is that the surgical
oncologists prescribe chemotherapy medicines."

Another vicious web involving doctors and diagnostic centres is that
the patients are forced to take the tests which are unnecessary. Even some doctors prescribe the tests on the letterhead of the diagnostic centres.
Inquiries revealed that the software of the diagnostic centres has a
names of the doctors who are on their pay list and when each and every patient comes them it is noted down in the database.

At the end of the month the doctors get the pay pack from the
diagnostic centre The propaganda-cum-distribution system in pharma sales is a big business where the branded drugs of promoted companies are prescribed for the patients by doctors.

A senior official in the drug control department said manipulating things with the Drug Price Control Order is another major aberration in the
industry. There are 74 drugs in the price control order and it has not been reviewed after 1995. The government fixed MRP for all these drugs in the order.

AP Medical Council member Dr K Ramesh Reddy makes it clear that the code of medical ethics prevent doctors from accepting gifts or favours from any company. "This kind of practice is more rampant in the medical disposable. These are the synthetic products used in human body for implantation and replacement," said Dr Ramesh Reddy.

The pharma companies add an ingredient and make it a combination and
sell it under different brand which will not be under price control order and they fix the MRP of their own. Even the recent high end drugs like retroviral, TB and Cancer drugs, stents and implants used in cardiovascular and orthopaedic surgeries do not fall under the price control order category.

All India Drug Control Officers Federation General Secretary Mr R Uday
Bhaskar says "the proposal to see that the MRP shall not cross more than 50 to 100 per cent of the manufacturing cost of the drugs has to be worked out."

For instance, Streptokinase costs only Rs 800 but the MRP is
around Rs 2400. "This shows that Rs 1600 on injection is shared by the doctor, distributor and the pharma company. There is no margin to this level in general products," said the official.

In many Western countries generic drugs are prescribed rather
than the brands. The Andhra Pradesh State government earlier issued GOs in 2002 and 2007 asking the government doctors to prescribe the generic drugs and the same are not implemented.

Federation of Drug Traders of Andhra Pradesh president Mr Peddi
Jagadeeswar says that there are around 45,000 retailers and wholesalers in drug trade in the State and they do ethical promotion. He puts the blame on the MNCs and Big companies. He says the presence of substandard drugs have come down in the State and there can only be three percent in circulation.

March 11, 2011 Japan earthquake gives insight into "greater earthquakes"

Syed Akbar
Hyderabad:  The recent earthquake and subsequent tsunami in Japan may have left a trail of death and destruction, but scientists here feel that it has given them enough information on the mechanism of "greater
earthquakes" and the stability of buildings including nuclear power plants falling under high seismic zones.
"Normally buildings collapse when the acceleration caused by an earthquake is substantial. The acceleration of an earthquake is measured against Gravity i.e 1.0 g. The acceleration is said to be of 1 g if a boulder is lifted off the earth under the impact of an earthquake.  In the Bhuj earthquake the gravity was just 0.35 g and hundreds of buildings had collapsed. But in the case of the earthquake in Japan the gravity was as high as 2.7 g. Such a high gravity was never recorded and yet the buildings were in tact. The structure of nuclear power plants too were in tact and they did not cave in," observes senior seismologist from NGRI-CSIR Dr RK Chadda.
Stating that the Japan earthquake has left lessons, both positive and negative, for seismologists around the world, Dr Chadda said the positive factor was that if buildings were constructed in accordance with the seismic norms, they will not collapse however high the gravity may be. "The negative side is that since most of the nuclear power plants are located near sea, the backup system should be erected on a high platform. The earthquake as such did not damage the nuclear power plants in Japan, but the tsunami had submerged the
backup systems as they were not erected on a high pedestal," he pointed out.
He said nuclear power plants in India will be not be affected even if a tsunami strikes the Indian coasts, Dr Chadda pointed out that the Kalpakkam power plant had its backup system erected 30 mts high. India faces tsunami threat only from two points - Karachi and Sumatra - and only when an earthquake of high magnitude strikes at these places, there may be a tsunami to the East or West Indian coasts. "But the golden lining is that we will have one to two hours lead time to switch off the nuclear plants and take up other
evacuation works," he added.
Dr K Rajendran of Indian Institute of Science sees an "element of surprise" at the magnitude and the underestimated fallouts of this calamity, as all this was happening in one of the most seismically active and best-studied regions of the world, with a high level of preparedness.
"Part of the problem was that the earthquake expected to occur in the concerned source area was one of smaller magnitude (7.4 to 8.2), following a 30-40 year seismic cycle," Dr Rajendran, who has published a research paper on the Japan quake, pointed out.
Earthquakes of greater magnitude occur once in a cycle of 1000 years, and the Japan earthquake is listed one among them. Most subduction zones feature two types of cycles - one of shorter duration characterised by quakes of magnitude 7.5, and another of longer duration leading to great tsunamigenic events. The quake measuring 9.0 seems to be part of the super cycle, with its predecessor occurring way back in 869 CE.
According to Dr Rajendran's study, "the 9.2 quake that occurred in 2004 at  Sumatra had ruptured 1300 km length of the plate boundary between Indian and Eurasian plates. It is considered to have marked the end of a super cycle, with an estimated duration of 500 -1000 years".