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May 25
Finally, an effective treatment for that 'ringing in your ears'
Tinnitus, a disease that is associated with ringing in the ears, is now curable by a new combination of therapies, The Lancet reported on Friday.

The multidisciplinary approach is a combination of psychological training and audio therapy that requires focussing on the sound, rather than ignoring and running way.


The study was conducted in The Netherlands on 245 adults suffering with tinnitus while 247 others were referred for standard counselling at a hearing clinic.

It was noticed that after 12 months, the first group who got the therapy had an average improvement of 33 percent in problems caused by severe tinnitus, compared to others who were referred to the hearing clinic.

Rilana Cima and Johan Vlaeyen from Maastricht University, who led the research, explained that "the results are highly relevant for clinical practice because best practice for tinnitus has not been defined, and current treatment strategies are fragmented and costly".

Till date, many treatments have been offered for tinnitus, but not much result is visible and also there is very little evidence about which ones work best.

Hope that the new treatment proves a bane and acts like a button to switch off that noise.

May 25
Why ignoring emails could be good for your heart
Many of us struggle to go more than a few minutes without checking our email inboxes.

But new research suggests ignoring messages altogether can reduce stress by having a positive effect on the heart.

Scientists who attached heart rate monitors to office workers found they remained in a state of 'high alert' throughout the day if they had constant access to email.

But those told they had their manager's permission to not check their messages for up to five days at a time had much healthier heart rates.
Now researchers who carried out the study, at the University of California Irvine, are calling for employers to consider implementing email 'holidays' to preserve workers' health.

According to some estimates, more than 200 billion e-mails are sent across the internet every day.

But while they may have improved communication speeds, there have been concerns that electronic messaging is detrimental to both physical and mental health.
To assess the effects, scientists recruited 13 men and women who used computers in the workplace, ranging from chemical engineers to psychologists.

At the same time, software was added to their computers to measure how often they switched from what they were working on to their email inbox.

The results, presented at a recent computing conference in Austin, Texas, showed those who stayed logged on to email had 'high alert' heart rates.

This is where the heart remains at a steady, relatively fast beat because of constant underlying stress.

In stress-free conditions, the heart rate is more variable, slowing down as the body becomes more relaxed.

A constantly raised heart beat is known to lead to higher levels of a potentially damaging stress hormone, called cortisol.

The study also found limiting email access might boost workers' concentration levels.

Volunteers with access to email switched screen an average of 37 times an hour - twice as much as those denied it.

Professor Gloria Mark, who led the study, said she was surprised by the results, since not having access to email could lead to a loss of control - a major factor in workplace stress.

But she said: 'Email vacations on the job may be a good idea. Participants loved being without email, especially if their manager said it was okay.

'In general, they we much happier to interact in person.

'We were surprised by the results. We didn't expect that people would become significantly less stressed.'

May 24
Breaking the myth about mental illnesses
Many who suffer from mental illness are hesitant to get help, due either to a lack of knowledge or to the stigma associated with the disease. Sometimes even families are scared to seek help from a doctor.

Dr Vishwanathan Balan, a 74 year-old retired professor of psychiatry, says this way of thinking is more prevalent among urban, educated people. "Rural people are more willing to talk about such issues. I have seen families in rural areas who are supportive of the patient."

Dr Balan says all mental illness is genetically caused. "It may or may not be triggered by some incident in the patient's life. Such illness is the same as any physical ailment that can be cured."

He says people have a misconception about psychiatric medication. "People need to get rid of their prejudice and see psychiatry as just another branch of medicine."

P K Syam Kumar is Dr Balan's patient and has no reservations about speaking of his illness schizo-affective disorder. Syam Kumar was brought to Dr Balan 16 years ago by his friend Valli Nachiar and her mother after his family abandoned him.

Over the years they worked together to make Syam Kumar better. He is now completely cured, has his own business and is married with two children; for him Dr Balan is a father figure.

"I still call him at odd hours to speak to him," he says. "Dr Balan helped me immensely. With his treatment and the support from my wife and mother-in-law I have become much better. Dr Balan has guided me all these years and I know that he is still there for me."

Dr Balan says, "I made Syam understand that he could tell me anything without fear of being criticised or ridiculed. I explained the problems he brought up, without brushing them aside as part of his illness.

After a few sessions, his confidence in me grew and he also became emotionally dependent on me. As this dependence was mutually acceptable, I became a 'father surrogate' for him."

As Syam Kumar slowly learned to function independently, he got 'weaned' from this emotional dependence. Dr Balan says, "One may be very professional and skilful. But only doctors who take personal interest in the patients can really help them."

Though Syam Kumar is still on pharmacotherapy (medicines) and psychotherapy, he can now function like a normal person. He says he channels his energy into things he likes to do. "I like reading the newspaper and keeping myself updated. I write to newspapers about relevant social issues."

Syam Kumar says that he wants people to be aware that there are ways to get better. "It is possible to be cured. I want to give mentally ill patients the assurance that they can get better."

May 24
Herbal cure centre to come up at Araku soon
A common facilitation and wellness centre for cultivation of medicinal herbs with in-house ayurveda medicine practitioners and tribal healers will be set up in six months' time at the Araku valley by the Tribal Cooperative Marketing Development Federation (TRIFED) of India Limited. TRIFED managing director Jiji Thomson said procurement of 20 acres for setting up the facility had begun and the estimated cost for completion is Rs 10-20 crore.

The centre will house greenhouse for sustainable cultivation of medicinal plants and processing facilities for manufacturing finished medicines. "We will test the efficacy of the medicines in collaboration with research and development facilities of Indian Council of Medical Research and other national institutes," said Thomson at a two-day national dissemination workshop on findings of National Nutrition Monitoring Bureau's (NNMB) tribal surveys.

The second repeat survey conducted in ITDA areas in 2007-09 was released by the Department of Biotechnology (DBT) secretary Dr. M.K Bhan at the workshop held on the premises of National Institute of Nutrition.

The survey revealed prevalence of Marasmus, a protein-energy malnutrition disease in infants, was the highest in tribal areas in Andhra Pradesh at 0.8 percent while the general prevalence in the country was recorded at 0.2 percent.

NIN director Dr. B Sesikeran, director general of ICMR, Dr. V.M Katoch, tribal welfare officials were present.

May 23
Folic acid food fortification may lower risk of rare cancers
Between 1968 and 2008, there were 3,790 cancer cases in children during the years before folic acid fortification, and 3,299 cases after fortification.
The rates of three rare childhood cancers have dropped since the U.S. began to fortify some foods with folic acid, a new study says.

The rate of Wilms' tumors, which develop in the kidneys, dropped from 18.4 yearly cases per 1 million children to 14.8 yearly cases per 1 million children, the study showed, after folic acid fortification of grain foods began in 1996.

The rate of tumors called primitive neuroectodermal tumors (PNETs) dropped from 4.2 yearly cases per 1 million children to 2.3 yearly cases per 1 million children. There was also a slight drop in the rate of tumors called ependymomas; both PNETs and ependymomas usually develop in the brain or spinal column.

All three cancers are believed to typically begin while a fetus is developing in utero, according to the study.

"Folate is critical for embryonic development," the researchers wrote in their study. Studies have shown that babies born to women who get enough folic acid during pregnancy have reduced risks of neural tube defects and some congenital abnormalities. After folic acid fortification began in foods, the rate of neural tube defects dropped by 31 percent, the study said.

Some previous evidence had also suggested a link between folic acid and a lower rate of childhood cancers.

In the new study, researchers at the University of Minnesota and Washington University in St. Louis used data from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program. They looked at cancer rates in children under age 5 between 1986 and 2008, but excluded children born between 1996 and 1998, because the fortification mandate was being implemented during the years these children were in utero.

In all, there were 3,790 cancer cases in children during the years before fortification, and 3,299 cases after fortification.

The researchers found that the drops in the rates of the rare tumors was greatest for children under age 1, though there was no drop in the overall rate of childhood cancers, they noted.

The study showed an association, not a cause-and-effect link between folic acid fortification and the drops in the cancer rates, the researchers noted. It's possible that the cancer rate reductions are due to other factors. However, there are reasons to think that folic acid did lower the cancer rate; for example, the sharpest decline was seen immediately following the beginning of fortification, they said.

Adults should consume 400 micrograms of folate daily, according to the 2010 U.S. Department of Agriculture dietary guidelines. A typical multivitamin contains 400 micrograms of folic acid, and a typical slice of enriched whole wheat bread contains 16 micrograms.

Folic acid is also called vitamin B9.

The study is published online on May 21 in the journal Pediatrics. The research was funded by the National Institutes of Health.

May 23
Moderate weight loss may halve hormone levels behind breast cancer risk
Even a moderate amount of weight loss can considerably reduce levels of circulating estrogens, which are linked to an increased risk of breast cancer, according to a new study.

Research showed that overweight women who shed 5 per cent of their body weight are up to 50 per cent less likely to have the disease

Anne McTiernan, M.D., Ph.D., and colleagues at Fred Hutchinson Cancer Research Center conducted the first randomized, controlled clinical trial to test the effects of weight loss on sex hormones in overweight and obese postmenopausal women, a group at elevated risk for breast cancer

"Based on previous research, our results suggest that losing just 5 percent or more of one's weight could cut by a quarter to a half the risk for the most common, estrogen-sensitive breast cancers," said McTiernan, director of the Hutchinson Center's Prevention Center and a member of its Public Health Sciences Division.

However, McTiernan insists that these findings only apply to overweight or obese women who are not taking hormone-replacement therapy

Epidemiologists have long noted an association between obesity and increased risk of postmenopausal breast cancer.

A relationship between body fat and estrogen formation is thought to contribute to this risk

The study was based on data from 439 overweight-to-obese, sedentary, Seattle-area women, aging botween 50 to 75, who were randomly assigned to one of four groups

These groups were, exercise only (mainly brisk walking), diet only, exercise plus diet and no intervention.

By the end of the study, participants on the diet-only and diet-plus-exercise regimen lost an average of 10 percent of their starting weight, which was the goal of the intervention

The study measured the effects of diet- and exercise-related weight loss on blood levels of several types of sex hormones, including three forms of estrogen (estrone, estradiol and free estradiol); two types of testosterone (total testosterone and free testosterone); a steroid necessary for the production of sex hormones (androstenedione) and sex hormone binding globulin, or SHBG, a protein that binds to sex hormones and therefore makes them biologically less active

High levels of SHBG are associated with reduced breast cancer risk. Free estradiol and free testosterone are forms of the hormones that are not bound to SHBG and therefore are more biologically active

At the end of the study, the researchers discovered significant reductions in hormone levels among the women who received the dietary weight loss intervention, with the most striking results among those who both dieted and exercised

The study found that Estrone levels decreased 9.6 percent with diet and 11.1 percent with diet plus exercise

Estradiol levels reduced 16.2 percent with diet and 20.3 percent with diet plus exercise

Besides this, free-estradiol levels decreased 21.4 percent with diet and 26 percent with diet plus exercise

SHBG levels increased 22.4 percent with diet and 25.8 percent with diet plus exercise

While free-testosterone levels decreased 10 percent with diet and 15.6 percent with diet plus exercise

The researchers found that losing as little as 5 percent of one's total body weight had a advantageous impact on hormone levels, and the effect increased with the amount of weight lost

"The amount of weight lost was key to changes in hormone levels," McTiernan said.

"The biggest effect was through diet plus exercise; exercise by itself didn't produce much of a change in weight or estrogen," she said

She also revealed that exercise has many important profits for those on a weight-loss program. Exercise prevents loss of muscle and bone, and it helps keep off the weight long term.

"I recommend women both diet and exercise, because in the long run that should help keep weight down and therefore keep estrogens down," she said

McTiernan claimed that this is the first study to show that losing weight through a healthy diet that included reducing calories, reducing fat and increasing vegetables, fruits and fiber significantly lowers blood estrogen levels in postemenopausal women.

"This shows that it's never too late to make lifestyle changes to reduce your risk for breast cancer," she added

The results of the research could also be relevant to overweight women, who take breast cancer prevention drugs such as tamoxifen, raloxifene and exemestane, which either block the action of estrogen or stop its production.

May 22
Now, a robotic way to hassle-free surgeries
Four finger-tip sized incisions, four robotic arms, including a camera eye snaking inside, the magnified image of the visceral organs being watched on a screen outside as the surgical instrument arm moves deftly to remove the tumour or blockage. Minimal blood loss, no long hospital stay - welcome to the revolutionary world of robotic surgery that is gaining in popularity in India

Some of the major hospitals in the capital, including the All India Institute of Medical Sciences (AIIMS), are performing complex surgeries the robotic way.

Major procedures such as removal of tumours, heart surgery and gynaecological surgery that would traditionally require the scalpel to make large and deep cuts in the body and consequent blood loss are now being done with robotic arms

"Robotic surgery allows us to do many complex operations that would require large incisions," Sudhir Srivastava, chairman, CEO and managing director, Fortis Healthcare International Centre for Robotic Surgery in New Delhi, told IANS.

Srivastava said conventional cardiac surgery requires splitting of the sternum, but in robotic surgery, using a robotic surgical system called Da Vinc, just four-five finger-tip sized incisions are all it requires

"The tips of the robotic arms behave like human wrists and allows us to do complex surgeries through tiny holes," he said

The camera arm of the robot allows surgeons to see inside the body in 3D. The image of the internal organs - magnified up to 10 times in high definition - shows up on a screen at the surgeon's console. Using hand and foot controls, the surgeon directs the robotic arms with the surgical tools to perform the required procedure.

"The camera acts as the eyes, while the instruments act as the arms of the surgeon," said Srivastava, adding that the surgery is "very precise, the incisions are tiny, there is little trauma and the patient can return home in a day or two. There are less complications, less blood transfusion and it is cosmetically preferable".

What about the cost
The cost varies between Rs60,000 and Rs1.5 lakh (approx $1,000-$2,700), depending on the procedure, he says.

"It works out more expensive than the conventional surgery, but the benefits are huge because of all the advantages," Srivastava said.

He says the cost is due to the technology, as each machine costs about Rs8-10 crore (approx $1.4-1.8 million), depending on the model.

He says that robotic surgeries abroad are "10 times more expensive".

Fortis has two robotic systems and the hospital performs cardiac, thoracic, urology, gynaecology, general, head and neck and orthopaedics procedures.

At AIIMS, robotic surgery is done in the field of urology, ENT cardiac, thoracic and in general surgery, says PN Dogra, professor and head of the Department of Urology, adding that the urology section gets around 130-140 patients every month.

But AIIMS does not charge anything from general patients. "During the hospital stay, even the meal charge is not taken from some patients," Dogra said.

One major advantage of the robotic system, he says, is the "tremor filtration" in which the "unintentional movement of the doctor is not carried over to the patients during the operation as the doctors are behind the operation table monitoring the robot".

Arvind Kumar, a former professor of surgery at AIIMS, who is now heading the Institute of Robotic Surgery at Sir Gangaram Hospital, says the hospital performed "Asia' first vascular surgery" using the robotic system.

Explaining the high costs, Kumar says the robotic technology is in evolution. "As its uses become more, the prices will crash, like in the case of mobiles," Kumar told IANS

May 22
Fake malaria drugs litter Southeast Asia, Africa
A study says more than a third of malaria-fighting drugs tested over the past decade in Southeast Asia and sub-Saharan Africa were either fake or bad quality.

The study published Tuesday says bogus and badly made drugs are threatening to upend a decade of progress fighting the mosquito-transmitted disease.

Fake drugs can lead to deaths because they contain no malaria-fighting agents. Pills without enough of the active ingredient to kill all malaria parasites are problematic because they increase drug resistance. That means malaria eventually will outsmart medicines and render them useless.

May 21
Timing of meals is tied to obesity
Gaining weight is not just the result of the number of calories eaten but also may have to do with the time of day those calories are consumed, at least in mice.

The researchers, from the Salk Institute in California and elsewhere, fed the mice a high-fat diet or a standard diet. Some of the mice were allowed to eat only within an eight-hour period each day and the others were given an unrestricted amount of time to eat.

When mice on the high-fat diet were restricted to eating within eight hours, they consumed just as much as those on the same diet who were permitted to eat around the clock. However, the mice with unrestricted eating times were more likely to become obese or have other metabolic disorders.

The findings suggest that food may be better processed by the body when eating is restricted to confined hours of the day, the researchers said.

May 21
Cheap amoebic dysentery drug 'promising'
A cheap drug, which is already prescribed for arthritis, could fight amoebic dysentery, according to researchers in the US.

They were testing old drugs to see if any killed the dysentery bug.

Tests on animals, published in Nature Medicine, showed that auranofin was 10 times more effective than the best drug currently available.

Further studies will be needed in humans, but researchers say it holds great promise.

Amoebic dysentery is caused by Entamoeba histolytica, which infects the bowels. It results in severe diarrhoea including bloody stools. More than 70,000 people are thought to die from the disease each year - most are in developing countries.

US researchers tested 910 drugs, some of which had already been shown to be safe for human use, on amoebas in the laboratory.

It showed that auranofin was much better than the current treatment, metronidazole, at killing Entamoeba histolytica.

Follow-up experiments showed that it was also more effective at treating mice and hamsters which had been infected with the ameoba.
In use

It has been prescribed to patients with rheumatoid arthritis since 1985.

One of the researchers, Prof James McKerrow, from the Sandler Center for Drug Discovery at the University of California, San Francisco, said: "When we're looking for new treatments for the developing world, we start with drugs that have already been approved.

"If we can find an approved drug that happens to kill these organisms, we've leapfrogged the development process that goes into assessing whether they are safe, which also makes them affordable throughout the world."

Prof Sharon Reed, from the University of California, San Diego, said: "Because auranofin has already been approved for use in humans, we can save years of expensive development.

"This new use of an old drug represents a promising therapy for a major health threat."

Dr Graham Clark, a reader in molecular parasitology at the London School of Hygiene & Tropical Medicine, said metronidazole was very effective, but it did have side effects and was not always successful.

He said: "The work presented in this paper is particularly useful as it identifies an existing drug, auranofin, that has already been tested and approved for use in humans, which seems to be at least as effective as metronidazole.

"Although auranofin has to date only been tested in animal models of amoebic disease, this means that there is now a potential alternative treatment for individual cases where metronidazole fails to cure the infection or in the event resistance to metronidazole emerge as a clinical problem in the future."

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