People who brush their teeth twice a day have a significantly lower risk of heart disease compared to individuals who have poor oral hygiene, says a report published in the British Medical Journal (BMJ) today.

Over the last couple of decades there has been a growing interest in the link between heart and gum disease. While it has been agreed that inflammation in the body (including mouth and gums) plays an important role in the accumulation of clogged arteries, this is the first study to examine whether the number of times individuals brush their teeth has any impact on the risk of developing heart disease, says the researchers.

Lead author, Professor Richard Watt from University College London, and team analyzed data from over 11,000 adults who took part in the Scottish Healthy Survey.

The team looked at information regarding the adults' lifestyle behaviors, such as physical activity, oral health routines and smoking. People were asked how regularly they went to the dentist's - once every six months, two years, rarely, or never. They were also asked how often their brushed their teeth - twice, once, or fewer times per day.

On a separate visit nurses gathered information on medical and family history of heart disease, blood pressure and blood samples from consenting adults. The samples helped the researchers to determine levels of inflammation that were present in the body. The data gathered from the interviews were linked to hospital admissions and deaths in Scotland until December 2007.

The results showed that oral health behaviors were generally good, with 62% of participants saying they visit the dentist every six months, and 71% reporting that they brush their teeth twice a daily. Once the data were adjusted for established cardio risk factors such as social class, obesity, smoking and family history of heart disease, the authors found that individuals who reported less frequent toothbrushing had a 70% higher risk of heart disease compared to individuals who brushed their teeth twice a day, although the overall risk remained quite low. Participants who had poor oral hygiene also tested positive for inflammatory markers such as the C-reactive protein and fibrinogen. Professor Watt concluded:

Researchers in the US have developed a new type of treatment that could herald a new approach to fighting infectious diseases that stimulates the immune system to protect the body against a range of bacteria instead of relying on antibiotics to attack them directly, which can lead to the emergence of resistant strains of pathogens.

The team, comprising scientists from government, academia and private industry, wrote a paper about their study that was published in the May issue of the open access journal PLoS Pathogens, available online.

Dr Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health, said in a statement that:

"A therapeutic that protects against a wide array of bacterial pathogens would have enormous medical and public health implications for naturally occurring infections and potential agents of bioterrorism."

Dr Catharine Bosio, and her colleagues at NIAID's Rocky Mountain Laboratories in Hamilton, Montana, led the study.

Bosio and colleagues developed a new treatment that protected mice from infection with the bacterium Francisella tularensis that causes the highly infectious rodent disease tularemia (rabbit fever), which can also pass to humans.

In a further set of experiments with human immune cells, they showed that the treatment was also able to confer protection against bacteria that cause plague, melioidosis and brucellosis. These bacteria occur naturally, can be highly virulent, and are considered possible agents of bioterrorism.

The novel approach works by stimulating the host immune system to destroy the bacteria. In contrast, treatments based on antibiotics rely on the drugs to destroy the pathogens, which often develop resistance to the medications.

The researchers suggest their new approach has the potential to enhance the action of antibiotics as well as provide an alternative to them.

For the study, Bosio and colleagues isolated membrane protein fractions (MPFs) from a weakened strain of F. tularensis and combined them with CLDC (cationic liposome DNA complexes) and tested them in vitro (using mouse and human cell cultures) and in vivo (using live mice).

CLDC is used as an adjuvant with vaccines to activate the innate immune response by mimicking natural infection; but as in this study, more and more researchers are also investigating its potential use in immunotherapy.

In vitro, the CLDC+MPF combination stimulated the natural antibacterial reactions ROS (reactive oxygen species) and RNS (reactive nitrogen species) in mouse cells and ROS in human cells. ROS and RNS target and kill invading bacteria (macrophages) and stop them replicating and spreading to other cells.

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In vivo, 60 per cent of mice injected with CLDC+MPF three days before lethal intranasal pulmonary infection with virulent F. tularensis survived. As with the in vitro experiments, the researchers showed this was due to the presence of RNS and ROS.

No mice survived when given either CLDC or MPF alone, showing that it was the combination that conferred protection.

And finally, the researchers showed that the combination also protected human immune cells from bacteria that cause plague, melioidosis and brucellosis (Yersinia pestis, Burkholderia pseudomallei and Brucella abortus).

Mostly seen in the tropics, melioidosis spreads to humans and animals through contaminated soil and water, and while brucellosis mostly affects animals, it can also infect humans who come in contact with infected animals or animal products, such as contaminated milk.

The researchers concluded that:

"Thus, CLDC+MPF represents a novel prophylaxis to protect against multiple, highly virulent pathogens."

Bosio said giving the treatment to the mice three days before infection appeared to be crucial: it gave enough time to stimulate the immune system. When they gave the protection less than three days in advance, it failed, she said.

"We are continuing to improve the versatility of this treatment as an antibacterial therapeutic with respect to timing of delivery and efficacy," she told the press.

"Meanwhile, CLDC plus membrane protein fractions is proving to be an excellent tool to determine how to safely and successfully stimulate the body's own antibacterial army to protect itself against highly infectious invaders," she added.

Bosio and colleagues are now moving on to study exactly how MPFs work with CLDC to produce RNS and ROS in mouse and human cells.

Production and sale of counterfeit drugs is on the rise in rich and poor countries, with more unwary consumers buying them over the Internet, said experts from World Health Organization (WHO).

Fake or substandard versions of medicines are often hidden in cargos taking circuitous routes to mask their country of origin as part of criminal activity worth billions.

In wealthy countries, counterfeiting often involves expensive hormones, steroids and anti-cancer medicines and pharmaceuticals related to lifestyle. But in developing countries, especially Africa, counterfeit medicines are commonly available to treat life-threatening conditions such as malaria, tuberculosis and HIV/AIDS.

Margaret Chan, WHO director-general, said that illicit products had also increased the problem of drug resistance, which is emerging as a big problem reducing the efficacy of vital anti-malarials and HIV/AIDS drugs.

Major generic drug makers India and Brazil, backed by health activists, charge that concerns about counterfeit drugs are being led by pharmaceutical companies keen to protect their patents against legitimate generic competitors.

A rare feat in the world of transplantation sciences in the country was accomplished by Dr Pranjal Modi and his team from the GR Doshi and KM Mehta Institute of Kidney Diseases & Research Centre and Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS). Modi and his team successfully transplanted the liver from a deceased 'heart-dead' donor. In most transplantation surgery, body parts are taken from 'brain dead' people whose heart is still beating.

IKDRC has performed about 17 liver transplants till now, in which all the organs have been obtained from cadavers. For this liver transplant, the organ was obtained from Kantaben Shah, 76, wife of a businessman from Ahmedabad, and patient of IKDRC alumni Dr Apoorva Parekh. Diabetes had damaged her kidney for the last 20 years, Shah became unconscious on May 3 and was admitted to Sterling Hospital where a CT scan revealed irreversible brain haemorrhage.

Dr Sudhir Shah, neurologist, diagnosed that her brain was severely damaged and chances of her recovery were nil. However, she was not brain dead by medico-legal definition, that is, her brain had not permanently stopped functioning and so her body could not be used for organ donation at that time.

However, the Shah family was inclined towards social service and, on the suggestion from the patient's daughter-in-law Pragnya, author of a book written in Gujarati, 'Cancer- maara sakha', the family decided to donate the patient's organs. "The liver was found to be good. Her liver was given to Dilip Patel, a 55-year-old farmer from Thaltej, Ahmedabad, who had lost his liver to alcoholic cirrhosis and was on our waiting list for the past few months," said Modi.

Dr Modi, chief surgeon during the operation, said: "Our team clearly explained to the Shah family that if Kantaben remained in hypotension, with BP less than 50 mm mercury, vital organs like kidney and liver could suffer and hence become unusable. The entire family was more than co-operative."

Eventually when the patient's heartbeats stopped at 4:30 pm on May 5, an emergency operation to remove her liver was conducted by Dr Modi and his team.

With the Met Department forecasting a fall in temperature and likelihood of more rain in the coming days, doctors have warned of possible Swine Flu (H1N1) outbreak in the twin cities as the virus spreads faster during monsoon and winter seasons.

"The virus has been mild so far, but it is a well-known fact that it could change its behavior. And if that happens, then the virus could become dangerous. Swine flu can spread rapidly during monsoon and winter months. Therefore, we could see more infections in the coming days due to cool weather conditions," SV Prasad, superintendent of Andhra Pradesh Government Chest Hospital, told expresso.

"Surveillance and screening has to be given high priority and special medical staff and testing centres are being made available at various parts of the twin cities," he said. He, however, pointed out that there was no need for panic. People need to be more vigilant and take precautionary measures. "It is likely that the virus could spread in a community or in clusters like schools or localities," he opined.

If people living in a community or a cluster exhibit similar illness symptoms, they should be screened for the virus so that in case of any positive signs they could be administered the anti-virus, Tamiflu medicine, in time.

"Every season 10 percent of the population is affected with common flu, and if the number in the coming season rises to 25-30 percent then it is a cause of concern. We should have a database of the swine flu patients in the State and also the twin cities to check against any unusual outbreak," Prasad added.

Dr BSV Manjula, superintendent of Fever Hospital, said sufficient staff and stocks of medicines are available to cope up with diseases which commonly erupt during advance rains. "We maintain proper stock of medicines for diarrhoea, normal fever and other communicable diseases," she added.

Over 787 cases were detected in the State and nearly 55 persons died of swine flu H1N1 influenza since its outbreak last year. At least 80,000 doses of vaccination have been released and the entire medical staff of the Chest hospital were vaccinated recently. All government hospitals, including those in the districts, have been given sufficient doses of the vaccine for immunisation of health workers.