Health Sector News : Overuse of antibiotics to be curbed

[RAM]

Time-keeping brain neurons discovered

Groups of neurons that precisely keep time have been discovered in the primate brain by a team of researchers that includes Dezhe Jin, assistant professor of physics at Penn State University and two neuroscientists from the RIKEN Brain Science Institute in Japan and the Massachusetts Institute of Technology (MIT). "This research is the first time that precise time-keeping activities have been identified in recordings of neuron activity," Jin said. The time-keeping neurons are in two interconnected brain regions, the prefrontal cortex and the striatum, both of which are known to play critical roles in learning, movement, and thought control.

The timing of individual actions, like speaking, driving a car, or throwing a football, requires very precise control. Although the lives of humans and other primates are extremely dependent on this remarkable capability, surprisingly little has been known about how brain cells keep track of time. This new discovery, published this week in the Proceedings of the National Academy of Sciences, is an important step toward answering this fundamental question.

To make the discovery, Jin analyzed thousands of neural-activity recordings made by Naotaka Fujii, from RIKEN, who then was a postdoctoral researcher in the lab of Ann Graybiels, an institute professor at MIT. Jin developed the computational tools that enabled the discovery of the novel results to emerge from the team's vast data set.

"The key finding is that neurons in the prefrontal cortex and the striatum encode the time information associated with sensory cues," Jin explained. "Visual cues, for example, elicit a variety of responses in a particular population of neurons. We found that the brain is able to tell the passage of time from the visual cues because different neurons are active at different times. Most remarkably we found that there are neurons that are active at precise times after a particular visual cue, and these neurons act like clocks that mark time."

The team of researchers trained two macaque monkeys to perform a simple eye-movement task. After receiving a "go" signal, the monkeys were free to perform the task at their own speed. The researchers found that neurons in the prefrontal cortex and the striatum consistently fired at specific times after the "go" signal -- at 100 milliseconds, 110 milliseconds, 150 milliseconds, and other intervals. Like a stopwatch, these neurons provided a fine-scale coverage over a period of several seconds. The combined activity of these neurons provided "time stamps" that could specify any given time point with a remarkable precision of less than 50 milliseconds, which is more than sufficient to account for most behaviors.

"Another key finding of our work is that the brains of the monkeys constructed neural activities to encode time even though timing was not required for the experimental task," Jin said. "We suggest that time encoding is the essential function of the brain's neural networks."

Jin said this kind of time-keeping activity long had been suggested in theories of how animals learn to recognize a stimulus that leads to delayed rewards, but his team's work is the first experimental demonstration of this Time-keeping function using recordings of neuron activity.

The discovery opens the door to many investigations, including how the brain produces this time code, and how the time code is used to control behavior and learning. In the longer term, the ability to read the brain's natural time code may facilitate the development of neural prosthetic devices for conditions such as Parkinson's disease, in which neurons in the prefrontal cortex and basal ganglia are disrupted and the ability to control the timing of movements is impaired.

courtesy
Time-keeping brain neurons discovered

 

[RAM]

New pathway may explain link between alcohol, cancer spread

Tuesday, October 27, 2009 17:59 IST
Washington: Scientists from Rush University Medical Center have identified a cellular pathway that might help explain the link between alcohol and cancer spread.
The study showed that alcohol stimulates what is called the epithelial-to-mesenchymal transition, in which run-of-the-mill cancer cells morph into a more aggressive form and begin to spread throughout the body.
"Our data are the first to show that alcohol turns on certain signals inside a cell that are involved in this critical transition," said Dr Christopher Forsyth, assistant professor of medicine and biochemistry at Rush University Medical Center and lead author of the study.
"Cancer cells become dangerous when they metastasize. Surgery can remove a tumor, but aggressive tumor cells invade tissues throughout the body and take over. If we can thwart this transition, we can limit cancer's toll," Forsyth added.
During the study, researchers treated colon and breast cancer cell lines with alcohol and then looked for the biochemical hallmarks of the epithelial-to-mesenchymal transition, including evidence of a transcription factor called Snail and of the receptor for epidermal growth factor.
Snail controls the epithelial-to-mesenchymal transition; when overexpressed in mice, it induces the formation of multiple tumors. Epidermal growth factor is required by many cancer cells.
It showed that alcohol activated both these and other biochemicals characteristic of the epithelial-to-mesenchymal transition.
The study also showed that the alcohol-treated cells had lost their tight junctions with adjacent cells, a preparation for migrating, as metastatic cells do.

courtesy
New pathway may explain link between alcohol, cancer spread - dnaindia.com

 

[ppgj]

Steady decline in Infant Mortality Rate in India

Wed, Oct 28 01:25 PM

New Delhi, Oct 28 (PTI) India has witnessed a steady decline in Infant Mortality Rate over the last three years. The Infant Mortality Rate in the country was 57 per 1,000 births in October 2007, 55 in 2008 and 53 in 2009.

According to the latest data released by the Registrar General of India, Madhya Pradesh had the highest mortality rate of 70 per 1,000 live births. The state also had the dubious distinction of the highest child mortality rate in 2008 as well as 2007 data with 74 and 72 respectively.

Closely following MP was Uttar Pradesh which had 71, 69 and 67 per 100 deaths in 2007, 2008 and 2009. Madhya Pradesh along with Uttar Pradesh and Rajasthan reported above 80 infant mortality rates in the 1991 census.

Infant mortality rate is defined as the probability of a child born in a specific year or period dying before reaching the age of one, if subject to age-specific mortality rates of that period. The mortality rates also differ significantly between rural and urban areas.

While in villages of India the average Infant Mortality Rate is 62 per 1,000 live births, in urban areas it is 39.

Steady decline in Infant Mortality Rate in India - Yahoo! India News

 

[Singh]

Curry spice 'kills cancer cells'

Curry spice 'kills cancer cells'​

An extract found in the bright yellow curry spice turmeric can kill off cancer cells, scientists have shown.

The chemical - curcumin - has long been thought to have healing powers and is already being tested as a treatment for arthritis and even dementia.

Now tests by a team at the Cork Cancer Research Centre show it can destroy gullet cancer cells in the lab.

Cancer experts said the findings in the British Journal of Cancer could help doctors find new treatments.

Dr Sharon McKenna and her team found that curcumin started to kill cancer cells within 24 hours.

'Natural' remedy

The cells also began to digest themselves, after the curcumin triggered lethal cell death signals.

Dr McKenna said: "Scientists have known for a long time that natural compounds have the potential to treat faulty cells that have become cancerous and we suspected that curcumin might have therapeutic value."

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "This is interesting research which opens up the possibility that natural chemicals found in turmeric could be developed into new treatments for oesophageal cancer.

"Rates of oesophageal cancer rates have gone up by more than a half since the 70s and this is thought to be linked to rising rates of obesity, alcohol intake and reflux disease so finding ways to prevent this disease is important too."

Each year around 7,800 people are diagnosed with oesophageal cancer in the UK. It is the sixth most common cause of cancer death and accounts for around five percent of all UK cancer deaths.

BBC NEWS | Health | Curry spice 'kills cancer cells'

 

[RAM]

Scientists use world's fastest supercomputer to create the largest HIV evolutionary tree


Supporting Los Alamos National Laboratory's role in the international Center for HIV/AIDS Vaccine Immunology (CHAVI) consortium, researchers are using the Roadrunner supercomputer to analyze vast quantities of genetic sequences from HIV infected people in the hope of zeroing in on possible vaccine target areas. Physicist Tanmoy Bhattacharya and HIV researcher Bette Korber have used samples taken by CHAVI across the globe – from both chronic and acute HIV patients – and created an evolutionary genetic family tree, known as a phylogenetic tree, to look for similarities in the acute versus chronic sequences that may identify areas where vaccines would be most effective.

In this study the evolutionary history of more than 10,000 sequences from more than 400 HIV-infected individuals was compared.

The idea, according to Korber, is to identify common features of the transmitted virus, and attempt to create a vaccine that enables recognition the original transmitted virus before the body's immune response causes the virus to react and mutate.

"DNA Sequencing technology, however, is currently being revolutionized, and we are at the cusp of being able to obtain more than 100,000 viral sequences from a single person," said Korber. "For this new kind data to be useful, computational advances will have to keep pace with the experimental, and the current study begins to move us into this new era."

"The petascale supercomputer gives us the capacity to look for similarities across whole populations of acute patients," said Bhattacharya. "At this scale we can begin to figure out the relationships between chronic and acute infections using statistics to determine the interconnecting branches – and it is these interconnections where a specially-designed vaccine might be most effective.

Scientists use world's fastest supercomputer to create the largest HIV evolutionary tree

Scientists use world's fastest supercomputer to create the largest HIV evolutionary tree | Eureka! Science News

 

[Pintu]

Dengue bites Delhi, 352 infected - Delhi - City - The Times of India

Dengue bites Delhi, 352 infected
TNN 31 October 2009, 04:40am IST

NEW DELHI: After H1N1 influenza, it's dengue that is slowly firming its grip on the capital. Till Friday, 352 dengue cases, including eight from NCR region, were reported in the city. Though MCD officials claim the figures are very low as compared to last year, private hospitals say they are getting a large number of patients with dengue and malaria. Experts say a majority of these patients have high fever and low platelet count.

"At present, 60% of our OPD rush is due to dengue and malaria patients. We have close to 20 patients admitted. The numbers have drastically shot up in the last three weeks,'' said Dr SP Byotra, chairperson, internal medicine, Sir Ganga Ram Hospital.

MCD maintains that mosquito breeding is under control and the dengue figures are way less than last year. Till October 30 last year, 1,065 positive cases of dengue were reported. "This year, we didn't have a good monsoon and after rain, the temperature shot up. As a result, we didn't see much breeding. Moreover, we were well-prepared to handle dengue and our domestic breeding checkers have been taking rounds of their respective areas since May,'' said Dr NK Yadav, medical health officer, MCD. A majority of dengue cases have been reported from Shahdara North and Central Delhi.

MCD officials say a majority of dengue cases are being reported from areas around AIIMS like Kidwai Nagar, Church colony in central zone, Tughlaqabad, Shahdara North and Central zone, etc. Though the cases are relatively less than last year, breeding is found in large number of areas.

A majority of patients coming in, doctors say, have low platelet count. "In some cases, specially in children, the platelets have dropped to as low as 6,000-10,000. These patients have to be given platelets,'' said Dr Sanjeev Bagai, director and head of the department, paediatrics, Rockland Hospital. High fever with low platelet count are symptoms of dengue, but MCD accepts a case of dengue only if the serology report for Immunoglobulin (IgM) tests positive. "IgM comes positive after six-seven days and one can't wait that long. We are giving them platelets and have started the treatment,'' said Dr Virender Anand, senior consultant, internal medicine, Moolchand Medcity.

Meanwhile, a large number of people are coming very late to the hospital. "People are coming with a history of prolonged fever. As they have been on self-medication, it has resulted in complications in some cases. Certain analgesics result in the breakdown of platelets,'' said Dr Mukesh Mehra, head of the department, internal medicine, Max Healthcare. Agrees Dr Bagai, "A lot of patients have been taking Ibroprofen or nimesulide before coming to us. People should not take analgesics on their own. One should see a doctor if high-grade fever continues for more than 24 hours, specially in children.''

 

[RAM]

High sodium diet and artificially sweetened soda linked to kidney function decline


2. November 2009 00:09

Individuals who consume a diet high in sodium or artificially sweetened drinks are more likely to experience a decline in kidney function, according to two papers being presented at the American Society of Nephrology's annual meeting in San Diego, California.

Julie Lin MD, MPH, FASN and Gary Curhan, MD, ScD, FASN of Brigham and Women's Hospital studied more than 3,000 women participating in the Nurses' Health Study to identify the impact of sodium and sweetened drinks on kidney function.

"There are currently limited data on the role of diet in kidney disease," said Dr. Lin. "While more study is needed, our research suggests that higher sodium and artificially sweetened soda intake are associated with greater rate of decline in kidney function."

The first study, "Associations of Diet with Kidney Function Decline," examined the influence of individual dietary nutrients on kidney function decline over 11 years in more than 3,000 women participants of the Nurses' Health Study. The authors found that "in women with well-preserved kidney function, higher dietary sodium intake was associated with greater kidney function decline, which is consistent with experimental animal data that high sodium intake promotes progressive kidney decline."

The second study, also conducted by Dr. Lin and Dr. Curhan, "Associations of Sweetened Beverages with Kidney Function Decline," examined the influence of sugar-sweetened and artificially sweetened beverages on kidney function decline in the same group of Nurses' Health Study participants. An analysis of the nationally representative NHANES III participants had previously reported an association between sugar-sweetened soda and urinary protein, but data on kidney function change was not available. This investigation reported "a significant two-fold increased odds, between two or more servings per day of artificially sweetened soda and faster kidney function decline; no relation between sugar-sweetened beverages and kidney function decline was noted" said Dr. Lin. This association persisted even after the study authors accounted for age, caloric intake, obesity, Hypertension.aspx">high blood pressure, diabetes, cigarette smoking, physical activity, and cardiovascular disease. The mechanisms for kidney decline in the setting of high intake of artificial sweetenters have not been previously studied and deserve further investigation.


The study participants were older Caucasian women and the authors note that the findings may not be directly applicable to men or people of other ethnicities.

High sodium diet and artificially sweetened soda linked to kidney function decline

 

[RPK]

'Stealth smart bomb' to treat cancer

fullstory


Washington, Nov 5 (PTI) Scientists have inched closer to a nanotechnology therapy that targets cancer with a "stealth smart bomb" tuned to dodge the body?s immune system.

BIND 014, which targets tumour cells while evading the body?s immune system, promises to deliver larger and more effective doses of drugs to cancers, while simultaneously sparing patients many of the distressing side-effects of chemotherapy, The Times newspaper said today.

Measuring about 100 nanometres ? or one ten-millionth of a metre ? this nanoparticle?s diameter is 1,000 times smaller than that of a human hair.

The drug-filled "warhead" is covered with a "stealth coating" of polyethylene glycol, which helps the particle to hide so that it is not attacked by elements of the body?s immune system such as antibodies and macrophage cells.

Normally, nanoparticles for drug delivery risk being recognised by the immune system and destroyed.

 

[Daredevil]

New scheme for maternal and child health

Aarti Dhar

Union Health and Family Welfare Ministry has launched a new programme, Navjat Shishu Suraksha Karyakaram, to train the healthcare providers at various health centres across the country.

Under this programme, health care providers are imparted training in resuscitation, prevention of infections, hypothermia, and , Union Health and Family Welfare Minister Ghulam Nabi Azad announced this here at the Parliamentary consultative committee meeting . The programme aims to reduce the infant and maternal mortality rate. The Minister said another priority area would be strengthening the government’s resolve to population stabilisation. So far, 11 States and Union Territories have already reached the replacement level of total fertility. The Ministry would focus on Bihar, Uttar Pradesh, Jharkhand, Assam, Madhya Pradesh, Rajasthan and Chhattisgarh in the coming months. These States have high total fertility rates.

“Though achievement of a TFR of 2.1 by 2010 seems impossible, as we were at 2.7 in 2007, we will make all efforts to ensure that we are able to move closer towards replacement levels by 2015,” Mr. Azad said.

This exercise, the Minister said, helped to identify 288 districts that account for 80 per cent of maternal and infant deaths; and Primary Health Centres and Community Health Centres that are geographically remote and difficult to access within these villages and blocks that have a high percentage of the Scheduled Castes and Scheduled Tribes. “For these areas, we are now formulating a comprehensive package of additional incentives to health workers and doctors. We intend to give special focus to new born care, as nearly 23 per cent of the neonatal deaths occur in the first two days of birth,” he said. Asphyxia, hypothermia, sepsis are major causes of such deaths.

“We still have a long way to achieving our goals related to maternal mortality, infant mortality and total fertility ratio, the burden of disease on account of malaria and TB and other infectious diseases, universal immunisation,” he said, adding that heasked the officers to focus on most difficult and inaccessible areas.

 

[Daredevil]

Diabetes centre gets global recognition

CHENNAI: With the notion that education is the key to prevent diabetes, the International Diabetes Federation (IDF) has declared the Dr Mohan’s Diabetes Specialties Centre (DMDSC) and Madras Diabetes Research Foundation (MDRF) as an IDF Centre of education on diabetes.

It is a matter of pride for the country as only six institutions have been selected of the 40 applications worldwide and India is one among the prestigious few. “The aim of this initiative is to internationally collaborate to ensure high-quality education for healthcare professionals in diabetes,” explained Prof. Jean Claude Mbanya, who was conferred the 16th Dr Mohan’s DSC Gold Medal Oration Award. “Though Diabetes is prevalent today, the estimate by World Health Organisation that every 20 person per 1000 will turn diabetic every year suggests that at least the future generation can be prevented by basic education,” he added.

He also said that education can prevent other complications caused by diabetes such as heart attack, stroke and obesity to name a few

 

[Pintu]

Dengue spurt: 45 new cases in capital - Delhi - City - The Times of India

Dengue spurt: 45 new cases in capital
TNN 12 November 2009, 04:17am IST

NEW DELHI: The number of dengue cases being reported in the city seems to be on the rise. A total of 45 cases were reported on Wednesday as against 42 cases reported on Tuesday which was said to be the highest number of cases reported in a day.

Meanwhile, the expenditure on taking preventive measures against the viral disease is much more this year than what was spent in 2008 when a larger number of dengue cases were reported due to the heavy rainfall. As per MCD's official records, the budget allocated for providing manpower, medicines etc this year is Rs 12 crore, which has already been spent and the civic body still requires more. Last year, the budget allocation was Rs 17 crore out of which Rs 10.67 crore was spent.

MCD health officer N K Yadav said: "The overall health budget allocation that we get from the government this year has been lesser. We used to get Rs 30 crore till last year but have got only around Rs 20 crore this year. We are expecting that more funds will be released by the government.''

Meanwhile, the rising cases of dengue being reported in the city continued to hold centrestage at the meeting of MCD's standing committee held on Wednesday. While BJP-led MCD stated that several number of cases were from the peripheries of Delhi and that the civic agency had no power to check the import of dengue patients from neighbouring cities, leader of opposition J K Sharma alleged that MCD was giving misleading information about the number of dengue deaths.

BJP demanded that the Centre should ensure formation of a coordination committee with representatives from MCD and neighbourhood areas to prevent spread of dengue.

Sharma said: "At a meeting of MCD House on Monday, the official document given to members said there was no death due to dengue this year while in documents provided by MCD on Wednesday's standing committee meeting two deaths have been mentioned. No arrangement is being done by MCD to tackle the situation. The civic body does not have adequate fogging machines nor here is required manpower in hospitals and people are forced to share beds.''

According to Yadav, MCD has 450 hand-held fogging machines, apart from the vehicle-mounted machines. MCD challaned 6,501 people and 46,503 legal notices have been issued so far. The total number of dengue cases has reached 661.

 

[RAM]

How the Brain Encodes Memories at a Cellular Level

How the Brain Encodes Memories at a Cellular Level

ScienceDaily (Dec. 25, 2009) — Scientists at UC Santa Barbara have made a major discovery in how the brain encodes memories. The finding, published in the December 24 issue of the journal Neuron, could eventually lead to the development of new drugs to aid memory.The team of scientists is the first to uncover a central process in encoding memories that occurs at the level of the synapse, where neurons connect with each other.

"When we learn new things, when we store memories, there are a number of things that have to happen," said senior author Kenneth S. Kosik, co-director and Harriman Chair in Neuroscience Research, at UCSB's Neuroscience Research Institute. Kosik is a leading researcher in the area of Alzheimer's disease.

"One of the most important processes is that the synapses -- which cement those memories into place -- have to be strengthened," said Kosik. "In strengthening a synapse you build a connection, and certain synapses are encoding a memory. Those synapses have to be strengthened so that memory is in place and stays there. Strengthening synapses is a very important part of learning. What we have found appears to be one part of how that happens."

Part of strengthening a synapse involves making new proteins. Those proteins build the synapse and make it stronger. Just like with exercise, when new proteins must build up muscle mass, synapses must also make more protein when recording memories. In this research, the regulation and control of that process was uncovered.The production of new proteins can only occur when the RNA that will make the required proteins is turned on. Until then, the RNA is "locked up" by a silencing molecule, which is a micro RNA. The RNA and micro RNA are part of a package that includes several other proteins.

"When something comes into your brain -- a thought, some sort of stimulus, you see something interesting, you hear some music -- synapses get activated," said Kosik. "What happens next is really interesting, but to follow the pathway our experiments moved to cultured neurons. When synapses got activated, one of the proteins wrapped around that silencing complex gets degraded."When the signal comes in, the wrapping protein degrades or gets fragmented. Then the RNA is suddenly free to synthesize a new protein.


"One reason why this is interesting is that scientists have been perplexed for some time as to why, when synapses are strengthened, you need to have proteins degrade and also make new proteins," said Kosik. "You have the degradation of proteins going on side by side with the synthesis of new proteins. So we have now resolved this paradox. We show that protein degradation and synthesis go hand in hand. The degradation permits the synthesis to occur. That's the elegant scientific finding that comes out of this."

The scientists were able to see some of the specific proteins that are involved in synthesis. Two of these -- CaM Kinase and Lypla -- are identified in the paper.One of the approaches used by the scientists in the experiment was to take live neuron cells from rats and look at them under a high-resolution microscope. The team was able to see the synapses and the places where proteins are being made.

The first author on the paper is Sourav Banerjee, a postdoctoral fellow with the Neuroscience Research Institute and the Department of Cellular, Molecular, and Developmental Biology. The other author is Pierre Neveu, who is affiliated with the Neuroscience Research Institute and the Kavli Institute of Theoretical Physics.

How the brain encodes memories at a cellular level

 

[Pintu]

http://www.ptinews.com/news/443061_Pop-a-chilli-pill-to-stay-slim-

Pop a chilli pill to stay slim!

STAFF WRITER 14:13 HRS IST

London, Dec 28 (PTI) Here's some good news for those looking for a readymade remedy to shed flab -- you can now burn your calories by just popping a chilli pepper pill, say scientists.

Several studies have found that hot peppers and their extracts are a safe option for nutritional supplements aimed at regulating diet.

Now, a team, led by the University of Oklahoma, has developed the slimming pill, which is made from chilli peppers and capsicum, and can burn as many calories as some 80 minutes of walking or a 25-minute jog, the 'Daily Mail' reported.

Trials at the university showed that adults taking the pill, called Capsiplex, burned off 278 more calories before, during and after a bout of exercise than those on placebos.

 

[ppgj]

Financing healthcare in India

Financing healthcare in India

N. J. Kurian, January 15, 2010

\
A woman labourer in a tea estate in Assam holds a severely undernourished child. India's population pays the bulk of its healthcare expenses out-of-pocket, as governmental spending is low. Photo: Ritu Raj Konwar.

The government needs to allocate more funds for public health. The mismatch between the declared objective of universal healthcare through the public health system and the actual level of expenditure remains serious.

One of the three most important planks on which Barack Obama won the U.S. presidential election was the country’s healthcare system, which he promised to fix. Indeed, the most important legislative measure initiated by Mr. Obama so far is the health reform legislation, titled the Patient Protection and Affordable Care Act. It was reported that the U.S. pharmaceutical lobby has spent an average of $600,000 a day over the last six months lobbying against the Bill, mostly seeking to curry favour with Congressmen and Senators. The main reason for healthcare in the U.S. receiving so much attention is its political and economic costs. The new U.S. legislation involves nearly $1 trillion over a 10-year period.

In India, meanwhile, problems related to the financing of healthcare continue to be politically insignificant and publicly invisible. Healthcare has not been an important election campaign issue except in 2004 when the United Progressive Alliance promised to raise expenditure on healthcare to 2 to 3 per cent of the Gross Domestic Product. According to recently released National Health Accounts (NHA) statistics, public health expenditure as a share of GDP increased from 0.96 per cent in 2004-05 to just 1.01 per cent in 2008-09.

Broadly, there are three patterns of healthcare financing across the world. The National Health Service (NHS) of the U.K. is a stark example of a state-run and publicly-funded system. As in the case of the Scandinavian countries, the U.K. uses tax finances to pay for 80 per cent of its healthcare spending. Elsewhere in Europe, social insurance schemes bear most of the financial burden. The U.S. relies on private insurance, paid for mostly by employers: almost half of the supersized health spending (16 per cent of GDP) is financed by tax money for the care of the old and the very poor.

The NHS is relatively inexpensive, accounting for 8 per cent of GDP, even below the OECD (Organisation for Economic Co-operation and Development) average of 9 per cent. The U.K. and other OECD countries have better health indicators than the U.S., although they spend less on it. The contrast between the health indicators of Cuba vis-À-vis the U.S. health expenditure is even more striking. Cuba, with a per capita income that is less than a fifth of that of the U.S., has a publicly funded system that yields better health outcomes than the U.S.

The William Beveridge Committee report (1944) formed the basis of the NHS. Beveridge designed the NHS when Winston Churchill was in power, and there was little hope in hell of his government ever implementing a National Health Service fully funded by tax money. But after the War, the Labour Party headed by Clement Attlee came to power, and one of the first major welfare schemes his government took up was the NHS. In the 1980s, the Conservative government of Margaret Thatcher stripped the NHS of much of the funds and manpower. The ‘New Labour’ government of Tony Blair, however, restored the finances and infused new life into it. The NHS today remains one of the world’s best healthcare models.

Parallel to the developments in the U.K., India had the Joseph Bhore Committee report which came up with somewhat similar recommendations. The Government of India’s acceptance of its major recommendations resulted in a nationwide healthcare machinery with reasonable norms in terms of coverage, availability of personnel and institutional linkages. The Indian public health system never reached NHS standards in terms of universality and access. But following the Alma Ata Declaration and the first National Health Policy in the 1980s, an attempt was made to strengthen it. This enthusiasm, however, was short-lived. Since the start of the economic reforms in the early-1990s, systematic efforts have been made to weaken India’s public healthcare system.

The share of health expenditure in total public expenditure peaked in the Indian States in 1987, but it has been more or less secularly declining thereafter. According to the constitutional division of expenditure responsibilities, the principal burden of health expenditure has to be borne by the States. In recent years, the Centre has stepped up healthcare expenditure through various schemes. Nevertheless, the States’ share in health expenditure remains above 70 per cent.

The Central theme of the Eleventh Five-Year Plan is to deepen the role of the market in healthcare. The principal instrument suggested is Public-Private Partnership (PPP). Though the professed objective of the National Rural Health Mission (NRHM) is to strengthen primary healthcare infrastructure, in practice it has been pandering to the private sector. Reviews of the NRHM indicate that its intended objectives are not being achieved.

An admired aspect of the U.K.’s NHS and European healthcare models is the presence of the General Practitioner (GP), who acts as a gatekeeper for more expensive hospital treatment. Though one of the main recommendations of Bhore Committee was the creation of a ‘Basic Doctor’, Indian policy-planners did not carry it forward. The basic weakness of the Indian system is the absence of an accessible basic doctor. Even today, 70 per cent of primary healthcare is provided by unqualified practitioners.

Over 80 per cent of the health expenditure in India is in the private sector, while in most developed societies more than 80 per cent of health expenditure is borne by the exchequer. Our public sector share is around one per cent of GDP: in this respect India’s peers are Burundi, Myanmar and Sudan. Among the countries of the South Asian Association for Regional Cooperation (SAARC), all except Pakistan have a higher proportion of health expenditure in the public domain. India does not shine among its neighbours in terms of health outcomes. India’s infant mortality rate at 56 per 1,000 live births in 2005 is better than that of only Pakistan. It is a far cry from 12 in Sri Lanka. Similarly, life expectancy at birth of 64 years in India compares favourably only with that of 63 in Nepal. Again, it is a far cry from Sri Lanka’s 75.

One of the reasons for cost escalation in the U.S. system is the nexus between private health insurance companies and healthcare providers. The performance incentives in the private sector boosts the expenditure in a commercialised context. Invariably expensive drugs and procedures are prescribed. Insurance companies provide health cover to the young, the employed and the rich, and avoid those who are elderly, unemployed and poor. There is a cozy relationship between the insured, the insurance company and the healthcare provider.

In India, the share of healthcare expenditure borne by insurance companies is now less than 3 per cent. But there is a build-up for a significant expansion of the health insurance business. Those think-tanks and economists who support this, forget certain facts. Most important, insurance covers only the cost of hospitalisation and not expenditure on outpatient care. NHA statistics show that close to 70 per cent of the out-of-pocket expenditure of the household is for outpatient care, which will not be covered by insurance. Secondly, even in the U.S. about 50 million persons (over 15 per cent of the population) do not have any health insurance cover as they do not have employers to pay their premium. In the Indian situation where a majority of the people are self-employed, universal coverage will remain a mirage. Thirdly, many villages in India do not have a hospital worth the name within accessible distance. What use would insurance cover be for people living there?

For the same reason, even the publicly funded Rashtriya Swasthya Bima Yojana (RSBY) meant for the poor is unlikely to serve its purpose. Further, the present level of funding is sufficient to provide insurance to only a small proportion of those who need it.

After 60 years of planned development, there is a serious mismatch in India between the declared objective of universal healthcare through the public health system on the one hand, and the actual level of public health expenditure on the other. This mismatch between objectives and resources is at the heart of the inadequacies and inequities of the health system.

(Dr. Kurian is Visiting Professor at Council for Social Development, New Delhi and the Institute of Public Enterprise, Hyderabad. He is at [email protected])

The Hindu : Opinion / Lead : Financing healthcare in India

 

[Pintu]

BirdFlu Returns to haunt

Fresh outbreak of birdflu in Murshidabad, Central team sent - India - The Times of India

Fresh outbreak of birdflu in Murshidabad, Central team sent
PTI, 15 January 2010, 06:46pm IST

NEW DELHI: A fresh outbreak of bird flu was reported from Murshidabad district of West Bengal, prompting the authorities to launch a culling operation, as the Union Health Ministry rushed a central team to the state.

Culling of poultry began at Khargram and Nabagram areas of the district, one of the worst-affected when the avian flu hit the state last year. Over 1000 chicken and ducks have died in the two blocks in the past few days, officials said.

The Health Ministry has sent a three-member team to the state, comprising a member from the capital's Ram Manohar Lohia hospital and two researchers from the All India Institute of Hygiene and Public Health, Kolkata, ministry sources said.

Murshidabad District Magistrate Parvez A Siddiqui said samples of dead fowl have been sent to a laboratory in Bhopal which has confirmed that those were affected by bird flu.

Chief Medical Officer of the district, Subhas Mondol, said extra beds had been set up at hospitals in Khargram and Kandi in case the disease spreads among humans.

Among the other affected areas are Indrani, Kirtipur, Parulia, Jaipur and Margram.

Culling operations started from Thursday night and will be intensified.

 

[Pintu]

The Telegraph - Calcutta (Kolkata) | Bengal | Bird flu outbreak

Bird flu outbreak

Behrampore, Jan. 14: A fresh outbreak of bird flu was reported in Murshidabad district today, prompting the authorities to announce a culling drive in the area from tomorrow.

Four gram panchayats in Murshidabad are said to be affected.

Officials said the Kirtipur gram panchayat was the worst hit. The other areas are Khargram, Margram and Parulia all in the Khargram block of Murshidabad.

“So far, 4,000 birds have died. We had sent samples to Bhopal and we have received the report that confirms bird flu. We will start culling from tomorrow,” said Utpal Bhadra, sub-divisional officer, Kandi.

Last year’s bird flu outbreak in Bengal had started from the Khargram block.

 

[Pintu]

Govt plans mandatory diabetes check for those over 30 in rural areas - India - The Times of India

Govt plans mandatory diabetes check for those over 30 in rural areas
TNN, 16 January 2010, 04:01am IST

NEW DELHI: All 30-40 year olds, living in India's rural areas, will soon undergo mandatory check for diabetes.

The health ministry is also developing a system for tracking pregnant mothers and children to ascertain the status of ante-natal and post-natal care. The ministry is putting in place a method to get a first-hand idea of how many institution deliveries are actually taking place in India and how many children actually get immunised.

Addressing health secretaries on Friday, health minister Ghulam Nabi Azad said the fight against diabetes was essential. He said while rural areas would require the option of glucometer, in urban areas, state governments could use laboratories to check diabetes.

Azad has also ordered his ministry to convert vaccination data into a name based exercise. This means that against the present norm where states report only the number of children vaccinated in an area, the ministry will make it mandatory for vaccinators to write down the name of the child they vaccinate, his/her father's name, the village and mohalla they come from, which city they belong to and phone numbers of family or neighbors.

The ministry is developing a special software to pull off this mammoth exercise.

India aims to vaccinate 25 million children every year under the country's RI programme. In addition, 30 million pregnant women are administered the tetanus vaccine under RI every year.

Azad also called upon states to expedite reforms in medical education sector. The ministry and the Medical Council of India have requested all states to instruct Government Medical Colleges to send the information with regard to availability of teaching faculty.

"I would request all state governments to send the details of teaching faculty in Government Medical Colleges in their respective states at the earliest, so that the same can be considered for increase of postgraduate seats in the light of amended PG regulations," Azad said.

He added that the basic formalities of introducing a three-and-a-half year course in bachelor degree in medicine and surgery was in place. These doctors would work in rural areas and district hospitals.

 

[Pintu]

http://economictimes.indiatimes.com...-145000-rural-doctors/articleshow/5536042.cms

India to turn out over 145,000 rural doctors
4 Feb 2010, 2022 hrs IST, IANS

NEW DELHI: With people-doctor ratio six times lower in rural India in comparison to cities, the central government on Thursday said it will produce 145,000 rural doctors through a truncated medical course designed after the Chinese "barefoot doctors".

"The proposal envisages training persons from rural areas on the basis of merit to equip him or her to primarily, I underline, primarily to work in 145,000 sub centres," Health Minister Ghulam Nabi Azad said here.

Azad said the proposed Bachelor of Rural Medicine and Surgery (BRMS) course, nicknamed as rural MBBS, will be a community based solution to the public health challenges in rural areas.

This course will be of three-and-half-years as against the conventional of five years of training.

The 145,000 health sub-centres, the first medical treatment point for villagers, are now being manned by Auxiliary Nurse Midwives (ANM). Through rural MBBS course, the central government will deploy at least one doctor at these centres. They will also be appointed in some primary healthcare centres (PHCs) to assist the regular MBBS doctors.

He said not recognizing the need for trained medical human resources in rural areas and unwillingness to consider new ideas for addressing it will not help the situation.

There is a visible urban-rural dichotomy in healthcare delivery in India. While urban India has 200 doctors for every 100,000 population, the ratio is one sixth in rural areas.

"Barefoot doctors" in China are trained farmers who help healthcare reach villages where well qualified doctors will not like to settle down.

Though the rural MBBS is a much better system, the idea of rural healthcare through a special cadre was influenced by the Chinese model.

The minister told doctors associations and medical college authorities from all over the country that the course will not compromise the quality of rural health care. "We are not replacing MBBS or specialist doctors."

Emphasizing the importance of quality in medical education and value of trained medical doctors, Azad said huge vacancies in lower level medical delivery points and a surge in emerging diseases was forcing rural folks to visit cities and thus spend a lot of money. This can be stabilized at local level through rural doctors.

Due to physical, social and cultural distance from medical facilities, people tend to depend on unqualified quacks who often provide "irrational treatment". Azad said past neglect cannot be reason for not thinking of innovative solutions today.

"It is not our case to shirk away from responsibility of having trained doctors but idealism needs to be tempered with reality... the existing situation prevailing in rural areas is compelling us to look beyond current solutions," Azad asserted.

The minister also asked the Medical Council of India to put safeguards in place so there is no compromise in quality.

 

[Pintu]

http://timesofindia.indiatimes.com/...ibodies-cause-stroke-/articleshow/5568784.cms

Low levels of natural antibodies 'cause stroke'
PTI, 13 February 2010, 02:24pm IST

LONDON: Low levels of a certain type of antibody in the immune system may be one of the main reasons behind strokes, says a new study.

Researchers at the Karolinska Institute in Sweden have claimed that the findings would pave the way for the development of a new vaccine that can mobilise the body's own defence against arteriosclerosis and stroke.

In the study, the researchers focused exclusively on stroke -- a blood clot in the brain -- and compared 227 individuals who had suffered stroke over a 13-year period with 445 sex and age-matched controls.

After controlling for other risk factors (age, sex, smoking habits, cholesterol levels, diabetes, BMI and blood pressure), they were able to show that low levels (below 30 per cent of average) of PC antibodies correlated with a higher risk of stroke, which in women meant a three-fold increase.

The researchers have now advanced the hypothesis that low levels of natural PC antibodies contribute to development of arteriosclerosis and its consequences which include stroke.

 

[Pintu]

http://www.google.com/hostednews/afp/article/ALeqM5gvHRQQe7f88acRRnKc4IHjIIR8mA

Australian scientists in TB drug breakthrough

(AFP) – 2 days ago

SYDNEY — Australian scientists said Wednesday they had discovered a drug which could cure tuberculosis at its non-infectious stage and could be the first major breakthrough on the disease in 50 years.

Bacteriologist Nick West said researchers at Sydney's Centenary Institute had developed a drug which could essentially combat the disease before it takes hold, potentially saving millions of lives around the world.

"We have investigated a protein that is essential for TB to survive and we have had some success in developing a drug that will inhibit this protein," said West.

"Our goal over the coming months is to find out the full extent of this drug's potential."

West said it would be the first time in history that dormant or asymptomatic, non-infectious TB would be able to be treated, potentially stemming a deadly tide of infection which claimed two million lives every year.

"Unfortunately, the antibiotics we use to fight TB aren't effective against latent TB and can only be used when the disease becomes active," he explained.

"This is a major problem as one out of 10 people who have latent TB will develop the active disease, becoming sick and contagious."

"If we can figure out a way to treat TB when it's in a latent stage, then we could save millions of lives throughout the world," West added.

If successful the drug would be the the first new treatment for TB since 1962, according to the institute which is affiliated with the University of Sydney.

One third of the world's population, or two billion people, are estimated to be infected with TB, with the disease growing fastest in South East Asia.

Lethal multidrug-resistant strains of the disease were becoming a serious threat to global health, infecting almost half a million people in 2008, of whom one-third died, the World Health Organisation warned last week.

Almost half the drug resistant cases were estimated to have occurred in India and China, the WHO said, with an extensively drug-resistant form, found in 58 countries, "virtually untreatable".