India’s Pharma Exports May Reach $20 bn by 2020: ASSOCHAM

Export of pharmaceutical products from India is likely to cross $14. billion (bn) mark this year and may reach about $20 bn by 2020, thereby registering a compounded annual growth rate (CAGR) of about eight per cent, according to an ASSOCHAM-TechSci Research joint study.

“However, growth in pharmaceutical products’ exports from India may decline by almost half i.e. from the level of CAGR of about 15 per cent clocked during 2010-14 to about eight per cent during 2015-2020 on account of delay in regulatory approvals in top markets of the US, Russia, Africa and others,” highlighted the study titled ‘IPR in pharmaceuticals: Balancing, innovation and access,’ jointly conducted by ASSOCHAM and TechSci Research.

“Consolidation of pharmacy players is leading to an increase in pricing pressures for generic companies existing in the US market which is expected to result in decline in year-on-year growth of pharmaceutical exports from India over next five years,” highlighted the ASSOCHAM-TechSci Research study.

Besides, a steep decline in currency in emerging markets like Africa, Russia, Ukraine and Venezuela is expected to add woes to drug manufacturing companies that supply pharmaceutical drugs to that region and are unable to generate high revenues on account of selling their drugs at a low priced currency.

India is the largest supplier of medicine to the US. Pharmaceutical exports from India to the US rose from $3.4 bn in 2013 to $3.7 bn in 2014, mainly due to increasing demand for high quality generic drugs in the market.

However, growth rate for exports of pharmaceutical products from India to the US is declining, due to increasing US Food and Drug Administration (USFDA) scrutiny on the quality of pharma products coming from drug manufacturing plants located in India.

In order to boost growth rate of exports to the US, Indian companies will need to leverage their compliance to the USFDA regulations.

The exchange rate crisis in the country is affecting pharmaceuticals market in Russia. As such, stabilization of currency is of utmost importance in generating revenues through exports.

In addition, many Indian companies are operating through the Pharmaceutical Benefits Program (PBP) and hospital tenders, for supplying vital and essential drugs, for which prices are then regulated by the Russian government.

Similarly, India's exports of pharmaceuticals to Africa are being affected due to port delays and prolonged custom valuation.

“Pharmaceuticals’ exports are a major factor contributing to growth of this industry in India with the US and few fast growing markets like Brazil, Mexico, Russia, South Africa and in South-East Asia emerging as the main export markets for generic drugs,” said D.S. Rawat, secretary general of ASSOCHAM while releasing the study.

“India’s pharmaceutical industry has transformed from being mainly a generic manufacturer to providing complex drug formulations to foreign markets thereby registering a significant growth,” said Mr Rawat.

“Pharmaceutical market in India is being driven by rapid socio-economic changes, rising sedentary lifestyle amid people and expected growth in number of people suffering from obesity, diabetes, cardiac problems and other related ailments,” he added.

Further, with a view to benefit and drive the growth of pharmaceutical research and innovation in India, the ASSOCHAM-TechSci Research study has recommended for data protection to be introduced as an Intellectual Property Right.

It has also suggested for digitisation of IPR for pharmaceuticals in India to strengthen online processing and maintenance of information database thereby making the process more systematic and convenient.

Though it would require allocation of more personnel for patent examinations and training sessions to be organised as part of resource development module, the study has emphasised that efficient management of IPR filings would help in building a stronger IPR framework in India.

India’s pharmaceutical market may reach $20 bn this year and about $55 bn by 2020 from about $18 bn as of 2014 thereby clocking a compounded annual growth rate (CAGR) of over 22 per cent.

Pharmaceutical sector in India will register higher growth during the course of next five years (22 per cent) as compared to a CAGR of about 14 per cent clocked by the sector during 2010-14.

New drug target for diabetes discovered

Washington: In a breakthrough, Indian-origin scientists have identified a potential new therapeutic target for controlling high blood sugar - a finding that could help millions suffering from type 2 diabetes worldwide.

Researchers showed that lipid molecules called phosphatidic acids enhance glucose production in the liver.     These findings suggest that inhibiting or reducing production of phosphatidic acids may do the opposite.

"This study establishes a role for phosphatidic acids in enhancing glucose production by the liver and identifies enzymes involved in the synthesis of phosphatidic acids as potential drug targets," said senior author of the study, Dr Anil Agarwal, from the University of Texas.

These observations were made while studying a mouse model of lipodystrophy, a rare metabolic disease in which the body is devoid of fat.

Lipodystrophy patients often develop diabetes and accumulate fat in the liver because of an imbalance in the body's ability to properly regulate lipids and glucose. The causal gene, AGPAT2, which is involved in the synthesis of phosphatidic acid and triglycerides, was removed in the mice, resulting in rodents with generalised lipodystrophy.

The research team then examined what impact this genetic manipulation had on phosphatidic acids and glucose production.

"We expected the levels of phosphatidic acids to go down. However, in examining the livers of these lipodystrophic mice, we unexpectedly found high levels of this lipid class," said Agarwal.

This led to the identification of new targets involved in the production of phosphatidic acids. The buildup of these lipid molecules was due to an increase in the levels of two enzymes in the liver, diacylglycerol kinase and phospholipase D. Researchers also discovered a marked increase in glucose production in the livers of the lipodystrophic mice.

The lack of normal insulin signaling in these lipodystrophic mice led to unrestricted production of phosphatidic acid, Agarwal said, contributing to development of hyperglycemia, or high blood sugar.

Besides revealing a new potential therapy to test for treatment of diabetes, the study's findings may have implications in understanding how cancer develops.

Increased phosphatidic acid levels may play an important role in a metabolic pathway that supplies energy to cancer cells.

Lead author Dr Shireesha Sankella plans to test the inhibitors of diaclyglycerol kinase and phospholipase D in cultured cells and in animals to understand the molecular mechanisms for increased glucose production by phosphatidic acids in liver and cancer cells.

The study was published in The Journal of Biological Chemistry.

Solar fridge for vaccines could play key role in aid efforts

London: Delivering life-saving vaccines in remote areas of developing countries could soon be possible with UK scientists developing new solar-powered fridges.
 

Engineers have developed a prototype system that could keep vaccines cool until treatment, a PTI report said quoting a release by the Edinburgh University .
 

Dr Giulio Santori of the University of Edinburgh School of Engineering, who is leading the project, said, "We are very pleased by the encouraging results obtained so far on the proof-of-concept prototype."
 

"We are now seeking to develop a first generation commercial version which combines the solar thermal and adsorption based technologies," Santori said. Tests show that the proposed system, designed at the University of Edinburgh and tested in collaboration the Italian National Research Council's ITAE research institute, can produce up to 5 kilogramme of ice each day.
 

The solar fridges can store vaccines between 2 and 8 degree Celsius for as long as three days, the target set by World Health Organisation, it said.
 

Under normal operation ice is stored for the following day, when a new cycle starts. Scientists believe this shows that the technology could be employed in remote areas.
 

Solar refrigeration could benefit the majority of third world countries, owing to high levels of sunlight available.     The technology is also compliant with the requirements of the main humanitarian organisations in supporting aid operations in areas affected by catastrophic events, the
university said. Thousands of children in third world countries die every day from diseases that are preventable by vaccination.
 

Researchers believe the technology could have a huge impact in countries where delivering humanitarian aid is compromised by fuel shortages and high  temperatures.

New eye layer may help treat blindness

London: An Indian-origin scientist in the UK has discovered an ultra-thin layer hidden deep in the eye that may help cure blindness caused by glaucoma.

The new layer in the human cornea, discovered by Professor Harminder Dua, of Nottingham University, plays a vital role in the structure of the tissue that controls the flow of fluid from the eye, research has shown.

The findings could shed new light on glaucoma, a devastating disease caused by defective drainage of fluid from the eye and the world's second leading cause of blindness, researchers said.

The latest research shows that the new layer, dubbed Dua's Layer, makes an important contribution to the sieve-like meshwork, the trabecular meshwork (TM), in the periphery of the cornea.The TM is a wedge-shaped band of tissue that extends along the circumference of the angle of the anterior chamber of the eye.

It is made of beams of collagen wrapped in a basement membrane to which trabecular cells and endothelial cells attach. The beams branch out randomly to form a 'meshwork'. Pressure within the eye is maintained by the balance of aqueous fluid production by eye tissue called the ciliary body
and drainage principally through the TM to the canal of Schlemm, a circular channel in the angle of the eye.

Defective drainage through the TM is an important cause of glaucoma, a condition that leads to raised pressure in the eye that can permanently affect sight, researchers said. Around 1 to 2 per cent of the world's population yearly have chronic glaucoma and globally around 45 million people have open angle glaucoma which can permanently damage the optic nerve - 10 per cent of whom are blind, researchers said.

The latest research sheds new light on the basic anatomy of Dua's Layer, which is just 15 microns thick but incredibly tough. Comprised of thin plates of collagen, it sits at the back of the cornea between the corneal stroma and Descemet's membrane.

By examining human donor eyes using electron microscopy, the researchers were able to look at Dua's Layer beyond the central part of the cornea to shed more light on its features at the extreme periphery of the cornea.

It is hoped the discovery will offer new clues on why the drainage system malfunctions in the eyes of some people, leading to high pressure.

The research was published in the British Journal of Ophthalmology.

Dogs too suffer from obsessive compulsive disorder!

Washington: Man's best friend can also suffer from obsessive compulsive disorder, say scientists who have identified four genes that are connected to OCD in dogs.   

Researchers said few breeds of dogs exhibit particularly high rates of OCD. These include Doberman Pinschers, bull terriers, Shetland sheepdogs and German shepherds, according to a report.

OCD is an anxiety disorder characterised by intrusive thoughts that produce uneasiness, apprehension, fear, or worry; by repetitive behaviours aimed at reducing the associated anxiety; or by a combination of such obsessions and compulsions, PTI reported.

Dogs with OCD may display behaviours such as incessant tail chasing, repetitive shadow stalking and relentless paw chewing.
Since dogs are genetically simpler than people, researchers turned to these canines in their search for OCD-related genes, 'Discovery News' reported. Elinor Karlsson, a computational biologist at the Broad Institute at Harvard University, and colleagues began by sequencing and comparing a large section of the genomes of 90 Dobermans that had OCD with 60 that didn't. They also searched for genes that looked the same in all of the Dobermans but that differed between that breed and
others.
When they had zeroed in on several suspicious areas of the genome, the researchers compared the suspect Doberman genes with genes from a sample of the three other breeds that also suffer higher-than-usual rates of OCD. Those analyses pinpointed four genes that have unusually high rates of mutations in dogs with obsessive and compulsive behaviours.
The genes implicated in the new study play roles in pathways that have also been connected to human OCD, Karlsson said, suggesting that dogs could provide a helpful model system for developing better treatments for people. The study was published in the journal Genome Biology.

Common HIV drug can kill HPV causing cervical cancer

London: In a world-first clinical trial, scientists have found that a commonly-used HIV drug can kill off the human papilloma virus (HPV) that leads to cervical cancer.

The trial was led by The University of Manchester in UK with Kenyatta National Hospital (KNH) in Nairobi. Researchers examined Kenyan women diagnosed with HPV positive early stage cervical cancer who were treated with the antiviral HIV drug lopinavir in Kenya.

The study looked at 40 women with both high and low-grade pre-cancerous disease of the cervix and the antiviral drug, normally used orally to treat HIV, was self-applied directly to the cervix as a pessary.

The results showed a high proportion of women diagnosed with HPV positive high-grade disease returned to normal following a short course of the new treatment, a report said.

The women were treated with one capsule of the antiviral drug twice a day for 2 weeks.

Repeat cervical smears showed a marked improvement within one month of the treatment although after three months, there was a definite response.

Out of 23 women initially diagnosed with high-grade disease, 19 (82.6 per cent) had returned to normal and two now had low-grade disease giving an overall positive response in 91.2 per cent of those treated. Furthermore, the 17 women initially diagnosed with borderline or low-grade disease also showed similar improvement.

Photographic images of the cervix before and after treatment showed clear regression of the cervical lesions and no adverse reactions were reported.

"For an early stage clinical trial the results have exceeded our expectations. We have seen women with high-grade disease revert to a normal healthy cervix within a comparatively short period of time," said Dr Ian Hampson from the Manchester University's Institute of Cancer Sciences, according to a PTI report.

"We are convinced that further optimisation of the dose and treatment period will improve the efficacy still further," Hampson said.

"Current HPV Vaccines are prophylactics aimed at preventing the disease rather than curing or treating symptoms. Other than surgery, as yet there is no effective treatment for either HPV infection or the pre-cancerous lesion it causes which is why these results are so exciting," added
Dr Lynne Hampson from Manchester University.

"Further work is needed but it looks as though this might be a potential treatment to stop early stage cervical cancer caused by HPV," Lynne said.

Spit-test can predict risk of depression in teens

London: Cambridge scientists have identified the first biomarker for clinical depression after they found that high levels of stress hormone in spit can indicate a serious risk of developing psychiatric disorders in teen boys.
 

Teenage boys with symptoms of depression and raised levels of the stress hormone cortisol are up to 14 times more likely to develop major depression than those without these traits, researchers found.
Clinical depression affects one in six people at some point in their lives. Until now, doctors have lacked a biomarker for clinical depression, partly because its causes and symptoms are so varied.
 

"Through our research, we now have a very real way of identifying those teenage boys most likely to develop clinical depression," said Professor Ian Goodyer of the University's Department of Psychiatry who led the study.
 

"This will help us strategically target preventions and interventions at these individuals and hopefully help reduce their risk of serious episodes of depression and their consequences in adult life," Goodyer said. The researchers collected spit samples from hundreds of teenagers and measured levels of cortisol in the saliva, as well as self-reported information on symptoms of depression.
 

This they used to divide the teenagers into one of four groups depending on their cortisol levels and symptoms of depression.
 

After following the group for 12 to 36 months, they were then able to work out which group was most likely to develop clinical depression and other psychiatric disorders. They found boys with high levels of cortisol and depressive symptoms were 14 times more likely to develop clinical depression than those with neither. In girls, however, this difference was less marked.
 

Girls with high cortisol and depressive symptoms were four times more likely to develop clinical depression than those with neither, suggesting gender differences in how depression develops.
 

The researchers hope that having an easily measurable biomarker - in this case, raised cortisol plus depressive symptoms - will allow primary care services to identify boys at high risk and consider new public mental health strategies for this part of the population.
 

"This new biomarker suggests that we may be able to offer a more personalised approach to tackling boys at risk for depression," said co-author Dr Matthew Owens.
 

The study was published in Proceedings of the National Academies of Science.

Scientists closer to find vaccine for dengue

Washington: Scientists have unveiled the mechanism behind how dengue enters cells of our immune system, a finding that could help develop vaccine for the deadly virus.

Dengue fever, an infectious tropical disease caused by a mosquito-borne virus, afflicts millions of people each year, causing fever, headache, muscle and joint pains and a characteristic skin rash, a PTI report quoting researchers, said.

In some people the disease progresses to a severe, often fatal, form known as dengue hemorrhagic fever. Despite its heavy toll, the prevention and clinical treatment of dengue infection has been a "dramatic failure in public health compared to other infectious diseases like HIV," said Ping Liu of the University of North Carolina at Chapel Hill.

Now, new research by Liu and her colleagues could offer vital insight into the mechanism of dengue virus entry into cells - and aid vaccine and clinical drug development.

Liu along with dengue fever expert Aravinda de Silva, used high-resolution microscopes to examine the expression of a particular protein, known as DC-SIGN, on the surface of immune system cells called dendritic cells.

The normal role of DC-SIGN (dendritic cell-specific intercellular adhesion molecule-grabbing nonintegrin) is to capture pathogens so that fragments of those pathogens can be presented as antigens on the surface of the dendritic cells.

Such antigens then are recognised by T cells - the workhorse cells of the immune system - "which is one of the first steps in the normal immune response," Liu said. While it has been known for some time that dengue used DC-SIGN to attach to cells, Liu and her colleagues used high-resolution microscopy to study exactly how the viruses used the protein to gain entry into cells.

"DC-SIGN has a unique carbohydrate recognition domain on its extracellular portion, which binds to all sorts of carbohydrates on pathogens," she said.

"An effective medication or vaccine should stop the process of dengue virus entry into cells," Liu said.
She said, de Silva and his colleagues have identified strong neutralisation antibodies that block dengue infection. By identifying the mechanism of antibody neutralisation, Liu and colleagues hope to advance the development of vaccines for dengue virus infections.

Scientists find safe way to kill cancer cells

Washington: Indian-origin scientists have successfully developed a radical new technique that may kill
brain tumours by hijacking them into toxic pits or areas of the body that are safer to operate on.

One factor that makes glioblastoma cancers so difficult to treat is that malignant cells from the tumours spread throughout the brain by following nerve fibres and blood vessels to invade new locations.     Now, researchers have learned to hijack this migratory mechanism, turning it against the cancer by using a film of nanofibres thinner than human hair to lure tumour cells away, a media report quoting PTI, said.

Instead of invading new areas, the migrating cells latch onto the specially-designed nanofibres and follow them to a location - potentially outside the brain - where they can be
captured and killed.

Using this technique, researchers can partially move tumours from inoperable locations to more accessible ones. Though it would not eliminate the cancer, the new technique reduced the size of brain tumours in animal models, suggesting that this form of brain cancer might one day be treated more like a chronic disease, researchers said.

"We have designed a polymer thin film nanofibre that mimics the structure of nerves and blood vessels that brain tumour cells normally use to invade other parts of the brain," said Ravi Bellamkonda, lead investigator and chair of the Wallace H Coulter Department of Biomedical Engineering at Georgia Tech and Emory University.

"The cancer cells normally latch onto these natural structures and ride them like a monorail to other parts of the brain. By providing an attractive alternative fibre, we can efficiently move the tumours along a different path to a destination that we choose," said Bellamkonda.

Treating the Glioblastoma multiforme cancer, also known as GBM, is difficult because the aggressive and invasive cancer often develops in parts of the brain where surgeons are
reluctant to operate.

Even if the primary tumour can be removed, however, it has often spread to other locations before being diagnosed. "The signalling pathways we were trying to activate to repair the spinal cord were the same pathways researchers would like to inactivate for glioblastomas," said first author
of the study, Anjana Jain, an assistant professor in the Department of Biomedical Engineering at Worcester Polytechnic Institute in Massachusetts.

Tumour cells typically invade healthy tissue by secreting enzymes that allow the invasion to take place, Jain said. That activity requires a significant amount of energy from the cancer cells.
"Our idea was to give the tumour cells a path of least resistance, one that resembles the natural structures in the brain, but is attractive because it does not require the cancer cells to expend any more energy," she said.

Details of the technique were reported in the journal Nature Materials.

Stay healthy with a glass of wine a day

Washington: Moderate alcohol consumption can boost your immune system and potentially improve your ability to fight infections, a new study has claimed.
 

A research team led by an immunologist at the University of California, Riverside found that moderate consumption of alcohol can improve immune response to vaccination.
 

The finding could pave the way for potentially new interventions to improve our ability to respond to vaccines and infections, benefiting vulnerable populations, such as the elderly for whom the flu vaccine, for example, has been found to be largely ineffective.
 

"It has been known for a long time that moderate alcohol consumption is associated with lower mortality," said Ilhem Messaoudi, an associate professor of biomedical sciences in the School of Medicine and lead author of the study published in the journal Vaccine.
 

"Our study, conducted on non-human  primates, shows for the first time that voluntary moderate alcohol consumption boosts immune responses to vaccination," Messaoudi said.
 

To study the impact of alcohol consumption on the immune system, the researchers trained 12 rhesus macaques to self-administer/consume alcohol on their own accord. The team first vaccinated the animals (against small pox) and then allowed them to access either 4 per cent ethanol (the experimental group) or calorically matched sugar water (the control group).
 

All the animals also had open access to water as an alternative fluid, as well as food. The researchers monitored the animals' daily ethanol consumption for 14 months. The animals were vaccinated one more time, seven months after the experiment began.
 

The research team found that over nine months of the animals' ethanol self-administration, mean daily ethanol intake varied markedly among them. "Like humans, rhesus macaques showed highly variable drinking behaviour. Some animals drank large volumes of ethanol, while others drank in moderation," Messaoudi said.
 

The animals' voluntary ethanol consumption segregated them into two groups: animals in the first group were those that consumed more alcohol, averaged a blood ethanol concentration (BEC) greater than the legal limit of 0.08 per cent and were therefore designated 'heavy drinkers'; animals in the second group consumed less alcohol, averaged a BEC of 0.02-0.04 per cent and were designated 'moderate drinkers.'
 

"Prior to consuming alcohol, all the animals showed comparable responses to vaccination. Following exposure to ethanol, however, the animals showed markedly different responses after receiving the booster vaccine," Messaoudi said. The researchers found that those animals that drank the
largest amounts of alcohol showed greatly diminished vaccine responses compared to the control group.

Soybean compound may prevent HIV spread

A compound found in soybeans can be used in new treatments to inhibit the deadly HIV infection, scientists claim. Researchers from George Mason University in the US found that genistein, derived from soybeans and other plants, may become an effective HIV treatment without the drug resistance issues faced by current therapies.

Genistein is a "tyrosine kinase inhibitor" that works by blocking the communication from a cell's surface sensors to its interior.

Found on a cell's surface, these sensors tell the cell about its environment and also communicate with other cells. HIV uses some of these surface sensors to trick the cell to send signals inside. These signals change cell structure so that the virus can get inside and spread infection.

But genistein blocks the signal and stops HIV from finding a way inside the cell. It takes a different approach than the standard antiretroviral drug used to inhibit HIV.

"Instead of directly acting on the virus, genistein interferes with the cellular processes that are necessary for the virus to infect cells," said Yuntao Wu, a professor with the George Mason-based National Center for Biodefense and Infectious Diseases and the Department of Molecular and Microbiology.

"Thus, it makes the virus more difficult to become resistant to the drug. Our study is currently in its early stage. If clinically proven effective, genistein may be used as a complement treatment for HIV infection," Wu said.
Researchers caution that this doesn't mean people should start eating large amounts of soy products.
"Although genistein is rich in several plants such as soybeans, it is still uncertain whether the amount of genistein we consume from eating soy is sufficient to inhibit HIV," Wu said.

Wu sees possibilities in this plant-based approach, which may address drug toxicity issues as well. Because genistein is plant-derived, it may be able to sidestep drug toxicity, a common byproduct of the daily and lifelong pharmaceutical regimen faced by patients with HIV to keep the disease at bay,
Wu said.

Typically, patients take a combination of multiple drugs to inhibit the virus. The frequency can lead to drug toxicity. Plus, HIV mutates and becomes drug-resistant. Wu and his team are working at finding out how much genistein is needed to inhibit HIV. It's possible that plants may not have high enough levels, so drugs would need to be developed, Wu said.

Urine may help regrow lost teeth

Stem cells obtained from urine could one day allow humans to regrow lost teeth, scientists claim. Chinese scientists used stem cells from urine to create tiny 'tooth buds' that when transplanted into mice grew into tooth-like structures.

Stem cells - cells which can grow into any type of tissue - are popular among researchers looking for ways to grow new teeth to replace those lost with age and poor dental hygiene.

The group at the Guangzhou Institutes of Biomedicine and Health used urine as the starting point, 'BBC News' reported. Cells which are normally passed from the body, such as those from the lining of the body's waterworks, are harvested in the laboratory. These collected cells are then coaxed into
becoming stem cells.
In the study, a mix of these cells and other material from a mouse was implanted into the animals. The researchers said that after three weeks the bundle of cells started to resemble a tooth: "The tooth-like structure contained dental pulp, dentin, enamel space and enamel organ."

However, the "teeth" were not as hard as natural teeth.  The research is not immediately going to lead to new options for the dentist, but researchers said it could lead to further studies towards "the final dream of total regeneration of human teeth for clinical therapy".

However, experts caution the goal faces many challenges. Professor Chris Mason, a stem cell scientist at University College London, said urine was a poor starting point. "It is probably one of the worst sources, there are very few cells in the first place and the efficiency of turning them into stem cells is very low. You just wouldn't do it in this way," he said.

He also warned that the risk of contamination, such as through bacteria, was much higher than with other sources of cells. The study was published in Cell Regeneration Journal.

Vitamin C proves new way to combat tuberculosis

In an "unexpected" discovery, vitamin C has been found to kill drug-resistant forms of tuberculosis, which could mean existing drugs can be redesigned to combat the disease.

Researchers at Albert Einstein College of Medicine of Yeshiva University, New York have determined that vitamin C kills drug-resistant tuberculosis (TB) bacteria in laboratory culture.

The finding suggests that vitamin C added to existing TB drugs could shorten TB therapy, and it highlights a new area for drug design. TB is caused by infection with the bacterium M tuberculosis. According to the World Health Organisation (WHO), TB sickened some 8.7 million people and took some 1.4 million lives in 2011, researchers said.

Infections that fail to respond to TB drugs are a growing problem: About 650,000 people worldwide now have multi-drug-resistant TB (MDR-TB), 9 per cent of whom have extensively drug-resistant TB (XDR-TB). The discovery arose during research into how TB bacteria become resistant to isoniazid, a potent first-line TB drug.

William Jacobs, lead investigator and senior author of the study and his colleagues observed that isoniazid-resistant TB bacteria were deficient in a molecule called mycothiol. "We hypothesised that TB bacteria that can't make mycothiol might contain more cysteine, an amino acid," said Jacobs.
 

"So, we predicted that if we added isoniazid and cysteine to isoniazid-sensitive M tuberculosis in culture, the bacteria would develop resistance. Instead, we ended up killing off the culture - something totally unexpected," he said.
 

Researchers suspected that cysteine was helping to kill TB bacteria by acting as a "reducing agent" that triggers the production of reactive oxygen species, which can damage DNA. "The combination of isoniazid and vitamin C sterilised the  M tuberculosis culture. We were then amazed to discover that vitamin C by itself not only sterilised the drug-susceptible TB, but also sterilised MDR-TB and XDR-TB strains," he said.

Vitamin C induced what is known as a Fenton reaction, causing iron to react with other molecules to create reactive oxygen species that kill the TB bacteria. "We don't know whether vitamin C will work in humans, but we now have a rational basis for doing a clinical trial," said Jacobs.

Obesity and High Genetic Vulnerability cause Diabetes in India

IMARC Group, one of the world’s leading research and advisory firms, finds that the total number of diabetes patients in India grew at CAGR of nearly 3% during 2004 - 2012. Estimates from their latest report entitled “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics”, suggests that the total number of diabetes patients in India is expected to reach 107 million by 2032.

Findings from the report suggest that a major driver of the diabetes epidemic in India is the increasing levels of obesity. The Indian population that had faced under nutrition for a long time is now exposed to high fat diets and sedentary lifestyles. As a result of increasing disposable incomes and flourishing fast food chains, there were around 157 million overweight and 24 million obese people living in India in 2010. The report expects these levels to increase significantly by 2015.

Apart from the increasing obesity levels, the report also found that Indians are genetically more vulnerable to diabetes compared to other population groups. According to an analyst at IMARC Group “As a result of a higher percentage of body fat to muscle, Indians are more vulnerable to type-2 diabetes compared to other population groups. This fat increases the sugar levels as it gets deposited around the abdomen and interferes with insulin. As a result, Indians get diabetes at a much younger age compared to other population groups”.

IMARC’s new report “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics” provides an analytical and statistical insight into the Indian diabetes market. The report provides both current and future trends in the prevalence, demographical breakup, diagnosis and treatment of diabetes in India. The report has segmented the Indian diabetes market into three segments - Oral Anti-diabetics, Insulin and Diabetes Diagnostics. For each of the aforementioned categories, the report provides historical and future market sales, performance of key classes and the performance of top players.

The research study serves as an exceptional tool to understand the epidemiology, market trends, therapeutic structure, competitive structure and the outlook of the Indian diabetes market. This report can serve as an excellent guide for investors, researchers, consultants, marketing strategists and all those who are planning to foray into the Indian diabetes market in some form or the other.

Economic Survey 2013: Plan Outlay for Health up by 13.9 Per Cent

New Delhi: The economic survey tabled today in Parliament  by the Finance Ministry has increased the plan outlay for health up by 13.9 per cent for the year 2013-14. 


The Survey noted that the government had increased its plan outlay for health by 13.9% to Rs.30,4777 crores in 2012-13. Under the NHRM, over 1.4 lakhs Health Human Resources have been added (upto September, 2012) and under infrastructure strengthening 10,473 sub centres, 714 primary Health Centres and 245 community Health centres have been newly constructed. A sum of Rs.520 crore have been released to open 132 ANM schools and 137 general nursing and mid wifery schools in districts where there are no such schools. Opening of six Nursing colleges at the sites of AIIMS like institution at a total cost of Rs 120 crore is also under consideration. 

The survey also noted that due to Janini Suraksha Yojana, the number of institutional delivery have increased from 1.08 crores during 2005-06 to 1.75 crores during 2011-12. 

In 2012-13 under Indira Gandhi Matritva Sahyog Yogna (IGMSY), a budgetary outlay of Rs.520 crores was allocated to target over12.5 lakhs pregnant and lactating women, the survay said, adding, that the allocation of gender budgeting as a percentage of total budget have gone up from 2.8 % in 2005-06 to 5.96 in 2012-13. 

A proposal for strengthening and restructuring of the ICDS scheme within an overall budget allocation of Rs.1,23,580 crores during the XIIth Plan has been approved. Under Sabla Programme against an allocation of Rs.750 crores for 2012-13, Rs.496 crores has been released. In 2012-13 under Indira Gandhi Matritva Sahyog Yogna (IGMSY), a budgetary outlay of Rs.520 crores is outlayed to cover 12.5 lakhs pregnant and lactating women . 

The Survey points out that Janini Suraksha Yojana (JSY), Janini Shishu Suraksha Yojana (JSSK) and Indira Gandhi Matritva Sahyog Yojana (IGMSY) have many overlapping features and the same beneficiaries. This calls for a careful exercise in identifying overlapping schemes and weeding out or converging them, the survey further said. 

Highlights of Economic survey 2013:

• Economic growth pegged at 6.1-6.7% in 2013-14
• March 2013 inflation estimated at 6.2-6.6%
• Priority will be to rein in high inflation
• FDI in retail to pave the way for investment in new technology and marketing of agriculture produce
• Survey calls for widening of tax base and prioritising expenditure to bridge fiscal deficit
• Calls for curbing gold imports to contain current account deficit
• Aadhaar-based direct cash transfer scheme can help plug leakages in subsidies
• With subsidies bill increasing, danger of missing fiscal targets is real in FY13
• Survey pitches for hike in prices of diesel and LPG to cut subsidy burden.
• Foreign Exchange reserves remains steady at $295.6 billion at December, 2012-end
• At present, overall energy deficit is about 8.6 pc and peak shortage of power is about 9 pc. 
• Infrastructure bottlenecks affecting industrial sector performance
• Prospects for world trade as well as of India are still uncertain.
• Pitches for further opening of sectors for FDI

Omega-6 cooking oil increases heart ailment

 

In a recent study conducted by Dr. Christopher Ramsden, a clinical investigator with the U.S. National Institutes of Health in Washington, researchers offered a fresh analysis of data from the Sydney Diet Heart Study, which studied 458 Australian men aged 30 to 59 with a history of cardiovascular disease for more than three years."The group that was fed Omega-6 from Safflower oil, they had increased risk of death from all causes as well as death due to coronary heart disease and death due to cardiovascular disease" said study author Dr. Christopher Ramsden.

New Delhi: Since long the health monitoring bodies have allowed companies to put health messages on their labels saying that replacing saturated fats with poly-unsaturated fat Omega-6 rich vegetable oils help lower cholesterol. But in a story carried widely on CBC-TV's The National, this theory has been trashed.


Dr. Ramsden speculated that having more omega-6 in the diet could promote oxidation and inflammation in the arteries.

Nutrition professor Richard Bazinet, who studies fatty acids at the University of Toronto said this week's study in the British Medical Journal suggesting that omega-6s may borderline increase heart attack risk, needs to be publicized for public safety.

Dr. Artemis Simopoulos, President of the Centre for Genetics, Nutrition and Health in Washington advised "The goal should be to consume a balanced amount of omega-6 and omega-3 fatty acids". She added "We should lower the intake of omega-6 rich oils such as corn oil, sunflower, safflower, cottonseed oil, including soybean," Dr. Simopoulos said. "Increase the amount of omega-3 fatty acids in our diet, which can be obtained from oils that are rich in omega-3s such as flaxseed oil, Canola oil."

For consumers, the subtle and shifting messages can be confusing. Dr. Bazinet advises reading labels carefully". Like Simopoulos, he said "flax and canola are the safer options and people might want to stay away from the straight safflower, corn and sunflower oils that typically make up five per cent of purchases".
In India, the most widely sold cooking oils like Safflower (Saffola), Soyabean, Sunflower, Cottonseed contain very high Omega-6 fats. It would be in the interest of the consumers to look at better options like Canola Oil that has high Omega-3 and the right ratio of Omega-3:6 ratio (1:2).

When we spoke to Dr. Anoop Mishra, HoD of Diabetes and Metabolic Diseases, Fortis Hospital, he added "I would rate Canola Oil as no. 1 amongst all available cooking oils in India". In a teleconversation with Jivo Wellness who are the largest sellers of Canola Oil in India we learnt that lakhs of consumers have been shifting to Canola Oil primarily due to the health benefits offered like lowest bad saturated fats, high Omega-3, best ratio of Omega-3:6. With rising medical costs, it is felt that Good health comes at a low cost if we use our choices carefully.

Promote alternative medicines to spread healthcare services: Experts

Healthcare experts today called for promoting complimentary and alternative medicines which they said can open new vistas in science and cater to a large segment of population by focusing on good nutrition and preventive practices.

However, jurisdictions where alternative practices are sufficiently widespread should be licensed and regulated, they said at a conference organised by The Associated Chambers of Commerce and Industry of India (ASSOCHAM).

Alternative medicines are frequently grouped with complimentary or integrative medicines which refer to the same interventions when used in conjunction with mainstream techniques. More focus is required on validation of their process technologies and scientific evaluation, said Dr H.K. Chopra, co-chairman of ASSOCHAM Hospitals and Healthcare Committee.

“Research and development programmes in newly-emerging and challenging areas of science in Ayurveda need to be encouraged so that they can be marketed worldwide,” he said. A recent systematic review of studies in 13 countries concludes that about 31 per cent of cancer patients use some form of complimentary and alternative medicines.

Dr J.D. Sarangi, special secretary at the Delhi government’s department of health and family welfare, said the growing interest in alternative medicines is a positive symbol for the medical community which has started moving from a narrow approach to more holistic remedies.
However, the scientific community has to debate that in the era of evidence-based medicine, should official endorsement be given to remedies that cannot be scientifically proven.

Among those present during the inaugural session were Dr C.K. Katiyar, vice-president and head of ayurveda department at Dabur, Dr R.K. Khandal, director at Shriram Institute for Industrial Research, Dr Shikha Sharma, managing director of Nutri-Health Systems, Dr Lalit Verma, secretary at the Central Council of Homeopathy, and Arun Kumar, deputy secretary general of ASSOCHAM.

India invests only one per cent of GDP in primary healthcare centres. The country has an average of 0.6 doctors per 1,000 people against the global average of 1.23. The country’s healthcare sector currently estimated at Rs 3.75 lakh crore is likely to double in volume over the next five years.

Now, girls attain puberty at 10 years!

Now, girls are reaching puberty, two years earlier. The age of attaining sexual maturity among a girl, when she changes physically, hormonally and sexually has dipped, especially in urban India, to 10 years from 12-13 earlier, not just in India but globally, according to a Times of India report. 

A study published in the Lancet on Wednesday says the age of 18 years clearly no longer signifies adulthood.

According to it, the earlier onset of puberty has increased the window of risk associated with adolescence. It said previous generations of parents viewed the physical changes of puberty as being of greatest significance with raging hormones being blamed for much of adolescent bad behaviour.

Professor Susan Sawyer and George Patton (Murdoch Children's Research Institute, Melbourne and University of Melbourne) say, "Puberty is increasingly recognized as a significant physiological event that catapults adolescents into higher risk for a range of health-related behaviours like mental disorders and substance use," said the study.

Dr Rajiv Chhabra, chief of pediatrics at the Artemis Health Institute, agrees with the findings. He said the phenomenon is leaving girls with well-developed bodies, which they're not emotionally equipped to handle. "Premature puberty is becoming common among girls in India. Lifestyle and dietary changes could be fuelling this trend. Vegetables and eggs containing hormones like oxytocin can hasten puberty. Earlier, we would tell parents to teach a girl the concept of menstrual cycle when she turns 13. Now, we ask parents to talk about it to their 10-year-old daughters," said Dr Chhabra.

Promote alternative medicines to spread healthcare services: experts

Healthcare experts today called for promoting complimentary and alternative medicines which they said can open new vistas in science and cater to a large segment of population by focusing on good nutrition and preventive practices.

However, jurisdictions where alternative practices are sufficiently widespread should be licensed and regulated, they said at a conference organised by The Associated Chambers of Commerce and Industry of India (ASSOCHAM).

Alternative medicines are frequently grouped with complimentary or integrative medicines which refer to the same interventions when used in conjunction with mainstream techniques. More focus is required on validation of their process technologies and scientific evaluation, said Dr H.K. Chopra, co-chairman of ASSOCHAM Hospitals and Healthcare Committee.

“Research and development programmes in newly-emerging and challenging areas of science in Ayurveda need to be encouraged so that they can be marketed worldwide,” he said. A recent systematic review of studies in 13 countries concludes that about 31 per cent of cancer patients use some form of complimentary and alternative medicines.

Dr J.D. Sarangi, special secretary at the Delhi government’s department of health and family welfare, said the growing interest in alternative medicines is a positive symbol for the medical community which has started moving from a narrow approach to more holistic remedies.
However, the scientific community has to debate that in the era of evidence-based medicine, should official endorsement be given to remedies that cannot be scientifically proven.

Among those present during the inaugural session were Dr C.K. Katiyar, vice-president and head of ayurveda department at Dabur, Dr R.K. Khandal, director at Shriram Institute for Industrial Research, Dr Shikha Sharma, managing director of Nutri-Health Systems, Dr Lalit Verma, secretary at the Central Council of Homeopathy, and Arun Kumar, deputy secretary general of ASSOCHAM.

India invests only one per cent of GDP in primary healthcare centres. The country has an average of 0.6 doctors per 1,000 people against the global average of 1.23. The country’s healthcare sector currently estimated at Rs 3.75 lakh crore is likely to double in volume over the next five years.
 

US-based Indian creates first artificial kidney

New Delhi: US-based Indian origin researcher Shuvo Roy has created the world’s first implantable artificial kidney. What’s sensational about Roy’s creation is that the organ, no larger than a coffee cup, will be able to mimic the kidney’s most vital functions like filtering toxins out of the bloodstream, regulate blood pressure and produce the all important vitamin D. The artificial kidney has been tested successfully on a small number of animals. Large-scale trials on animals and humans are expected over the next five years.

Once available, and if affordable, this creation by the Roy-led team at University of California will do away with the need for kidney dialysis. This will be a boon for all patients with chronic kidney disease (CKD). At present in India, of the 1.5 lakh new patients who suffer from endstage renal failure annually, only 3,500 get kidney transplants and 6,000-10,000 undergo dialysis. The rest perish due to an acute shortage of dialysis centres and nephrologists to man them. CKD is rising at a rapid pace in India and the majority of those who perish are either unable to find a suitable organ for transplantation or are unable to pay for the high dialysis costs.

According to Roy, the device has a filtration section to remove toxins from the blood, alongside a compartment with renal cells to conduct other functions of a kidney. He believes the artificial kidney could last for decades and require no pumps or batteries. Patients wouldn’t require anti-rejection drugs (as is required after transplants) either because there would be no exposed natural tissues for the immune system to attack. The University of California team is awaiting approval to conduct larger scale animal and human trials. Already, it has successfully tested the implant in a few rats and pigs. “The payoff to the patient community is tremendous,” said Roy.

“It could have a transformative impact on their lives...With the right financial support, I think we could reach clinical trials in five years. But it’s hard to say how long after that it becomes commercially available due to the uncertainties of the FDA and commercialization prospects.’’

THE ULTIMATE RELIEVER?
The artificial, implantable kidney developed by Dr Shuvo Roy is the size of a coffee cup and is ready for test on humans. If successful, it could replace the need for dialysis and transplants for lakhs of people suffering from chronic kidney diseases

The patient’s blood passes through two stages after entering the device
1- Filter Side: Silicon membranes filter the blood and remove toxins
2 - Cellular Side: A bed of kidney cells (grown with help of tissue engineering) regulates chemical balance of the blood

SHUVO ROY
Roy’s father is from India while his mother is a Bangladeshi. Born in Bangladesh, young Roy spent some time in India as well. Studied in Uganda, where his father was a doctor. Went to US for higher studies

KIDNEY DISEASE IN INDIA
Every year, 1.5 lakh new patients end up suffering from end-stage renal failure. Only 3,500 get transplants and 6,000 undergo dialysis. The rest die due to shortage of dialysis centres and nephrologists Patient undergoing dialysis  spends 10,000 a month, with the  process taking up to 72 hours ‘

Artificial kidney will be boon for India’
So what would this artificial kidney mean for India? ‘‘It will be a real boon,’’ said Dr S C Tiwari, director of nephrology and renal transplantion medicine at Fortis health care. He added: ‘‘The biggest problem with CKD patients in India is that majority of them are diagnosed in the final stages where they would either require constant dialysis or a transplant. They would require dialysis three times week. However, of the two lakh CKD patients requiring dialysis, only 10,000 get it, mainly because they can’t afford it. Maybe only 1,000 such patients get it for free or at a subsidized rate in government hospitals. The artificial kidney, when available and if affordable, will be a miracle.’’ Dr Madan Bahadur, nephrologist with Mumbai’s Jaslok Hospital added, ‘‘Work on creating tubular cells (that perform the biochemical work of the kidney) began a decade back. But bio-chemical engineering has so far not managed to replicate the kidney.’’ According to Dr Jitendra Kumar, head of nephrology at Asian Institute of Medical Sciences, the main reason why this artificial kidney will be a real breakthrough is because it will be able to mimic the vital functions of a kidney like regulate BP and produce vitamin D — things a dialysis can’t do.