Research led by scientists in India suggests there is a direct link between smoking and brain damage whereby a compound in tobacco that turns into a cancer-causing chemical once it has been through the body's metabolism, triggers white blood cells in the brain's immune system to attack healthy brain cells.

The study is the work of lead investigators Debapriya Ghosh and Dr Anirban Basu from the Indian National Brain Research Center (NBRC) and was published online on 2 June in the Journal of Neurochemistry.

NNK is a procarcinogen commonly found in tobacco. A procarcinogen is a chemical that becomes cancer-causing (carcinogenic) once it has been metabolised in the body.

While alcohol and many drugs used by drug abusers damages brain cells directly, the researchers believe NNK damages brain cells indirectly, by first causing inflammation in brain cells, similar to that which leads to disorders like Multiple Sclerosis.

For the study, Ghosh, Basu and colleagues carried out two types of test: one in the test tube and the other in live mice ( in vitro and in vivo).

Using a technique called Western blot analysis they showed that treatment with NNK led to significant increases in signalling and effector proteins that promote inflammation, as well as other stress-related proteins. They also found increased levels of proinflammatory cytokines, compounds that help cells communicate with each other.

The researchers suggest the NNK caused the brain's immune cells or microglia, which normally only destroy damaged or unhealthy cells, to overreact and attack healthy cells.

"Immunohistochemical staining of the brain sections of NNK-treated mice reveals massive microglial and astrocyte activation along with distinct foci of neuronal damage," they wrote and concluded that:

"Both in vitro and in vivo results provide strong indication that NNK causes significant upheaval of the inflammatory condition of brain and inflicts subsequent neuronal damage."

Basu said these findings prove that:

"Tobacco compound NNK can activate microglia significantly which subsequently harms the nerve cells."

NNK passes into the body not just through smoking tobacco, it can also pass into the body from chewing tobacco.

Second hand smoking or so called "passive" smoking is another way that NNK can enter the body since it is present in tobacco smoke. A smoke-filled room may contain as much as 26 nanograms of NNK, which is on a par with the amount of NNK found in cigarettes which ranges from 20 to 310 nanograms, said the authors.

Ghosh said this research helps us understand one way that people who smoke or consume tobacco regularly might end up with damaged nerve or brain cells.

According to research cited by the National Cancer Institute (NCI) and the US Centers for Disease Control and Prevention (CDC), cigarette smoke contains about 4,000 chemical agents, including over 60 carcinogens, many of which are also poisonous in their own right (eg carbon monoxide, tar, arsenic, and lead).

Notch signaling helps determine the fate of a number of different cell types in a variety of organisms, including humans. In an article that appears in the current issue of Nature Cell Biology, researchers at Baylor College of Medicine report that a new finding about the Notch signaling pathway in sensory organ precursor cells in the fruit fly could explain the mystery behind an immunological disorder called Wiskott-Aldrich syndrome.

"This finding provides a model for how Wiskott Aldrich syndrome - a form of selective immunodeficiency in children - occurs," said Dr. Hugo Bellen, professor of molecular and human genetics and director of the Program in Developmental Biology at BCM. He is also a Howard Hughes Medical Institute investigator.

It all begins with the Notch pathway, which controls cell fate.

In the fly peripheral nervous system, two daughter cells arise from a single sensory organ precursor mother cell. Among the daughter cells, Notch is activated in one and not in the other. This differential activation of signaling results in two different kinds of cells which arise from the same mother cell. Thus the fruit flies sensory organ precursor cell division has been used as a model to understand how Notch signaling is activated during asymmetric cell division.

In a screen of fruit fly mutants that have disrupted peripheral nervous system development, Akhila Rajan and An-chi Tien, two graduate students in Bellen's laboratory, identified a mutant with a cluster of neurons. This occurs when there is a problem in Notch signaling.

Ordinarily, the sensory organ progenitor cell uses the Notch pathway to specify the fate of two daughter cells called pIIa and pIIb, which arise from a single mother cell. The pIIa cells go on to become the shaft and socket cells on the exterior of the fly's external sensory organ. The pIIb, through two divisions, become the neuron and sheath - internal cells of the external sensory organ. These four types of cells become the sensory cluster.

When a cluster of neurons is observed, cell fate determination has gone wrong as too many cells of one kind are being made from the mother cell. Akhila and An-chi found that mutations in the Actin-related protein 3 (Arp3), a component of the seven protein Arp2/3 complex, resulted in the loss of Notch signaling.

This occurs because the ligand Delta - a protein that activates the Notch pathway - cannot travel properly within the sensory organ cells in the absence of Arp3 protein. In addition, they found that under normal conditions vesicles (tiny bubbles) containing the Notch activating protein Delta travel to the top of the daughter cell to a structure rich in actin. This specialized actin structure contains many membrane protrusions that increase the surface area of cells called microvilli. Under normal circumstances Delta containing vesicles traffic to the microvilli. In the Arp3 mutants, there are significantly fewer microvilli but, more important, the transport of Delta is compromised in Arp3 mutants, affecting the ability of Delta to activate Notch. This is an important part of their work.

"Normally, Delta is presented at the top of the actin structure," said Bellen. It is then encapsulated in the vesicles and travels to the basal, or bottom, of the structure. Delta then travels back to the top of the daughter cells.

Bellen and colleagues have found that the Arp2/3 complex and its activator WASp (Wiskott-Aldrich syndrome protein) function in these daughter cells to transport Delta vesicles to the apical region of the daughter cells. If this complicated trafficking of Delta does not occur, the ability of Delta to activate Notch is compromised.

"It is likely that whatever we have discovered here has a relationship to what is happening in the patients with Wiskott-Aldrich syndrome. The patients with Wiskott-Aldrich syndrome have mutations in a gene called WASp. WASp is an activator of the Arp2/3 complex. In our work we found that WASp is also required for the trafficking of Delta to the top of the actin structure," said Bellen.

Notch signaling is required for proper development, differentiation and activation of a class of immune cells called the T-cells. T-cell function is compromised in patients with Wiskott-Aldrich syndrome. Since the gene WASp is mutated in the patients with Wiskott-Aldrich syndrome, the work done by Bellen and his colleagues suggest that defects in the presentation of Delta could explain the loss and dysfunction of T-cells in patients with Wiskott-Aldrich syndrome.

Indian Hospitals, Wellness and Medical Tourism players join forces to make India the Global Healthcare Destination - Indian Medical Travel Association (IMTA) launched.

Leading Indian Hospitals, Healthcare providers (both Modern Medicine and Traditional Indian Medicine), Travel and Medical Tourism Industry providers have come together to form an industry association - Indian Medical Travel Association (IMTA) that aims to work together to make India the leading global healthcare destination.

The phenomenon now popularly known as Medical Tourism is often cited as the next big opportunity for India after the IT outsourcing to earn billions of dollars in forex earnings and create jobs in the healthcare sector. So far only a select group of Indian hospitals have been making valiant attempts to market their services in international arena. More than a million overseas patients already treated at top Indian corporate hospitals like Apollo, Fortis, Wockhardt, Max, Manipal and many others have already proved to the world that the clinical quality, technology and cost proposition offered by India is unmatched. The capacity in super specialty segment Indian hospitals is expanding fast and there is no waiting period for local or overseas patients.

CII Mc'Kinsey study first reported on medical tourism as the billion dollar opportunity for India way back in 2002 and the steady growth in overseas patient arrivals has validated the potential. With a large number of new private super specialty hospitals and even integrated health cities coming up in India's top ten cities, India has the potential to become the global leader in the Medical Travel/ Outsourcing industry. Indian doctors and professionals are world renowned for their skills and the country has abundance of all the inputs like talented young manpower, local high quality manufacturing base for pharmaceuticals, technology hardware and software that makes the Indian costs for high end surgical procedures so attractive. The challenge really is on the non medical side, primarily on the marketing front and also to create infrastructure and services to support the growth of medical tourism.

Indian Medical Travel Association (IMTA) - a non profit body and a unified voice of the Indian healthcare (modern medicine as well as traditional Indian medicine) and travel industry is aimed at preparing India for facing the challenges of global competition and actualise the tremendous opportunity for India to become a leading global healthcare destination. Modern medicine as well as India's 5000 year old traditional therapies like Ayurveda, Siddha and Yoga can offer to the world an unbeatable healing package.


"IMTA would strive to help its members reach out in a cost effective manner to millions of our potential global consumers who reside on the other side of the globe in a different time and cultural zone and make them aware of the tremendous value that Indian healthcare offers. The fact is that prior to choosing a hospital, the international patients first decide on the country or the destination. Therefore we all must join hands to aggressively promote INDIA as a preferred global healthcare destination," Says Pradeep Thukral, Executive Director, Indian Medical Travel Association (IMTA)

The Government of India and its various arms are actively supporting the growth of medical tourism to India. Two years ago the Government of India introduced a special category of Visa called M Visa for foreigners desirous of coming to India for medical treatment. India's Ministry of Tourism has achieved phenomenal success in last five years with its much acclaimed "Incredible India "campaign that has multiplied the arrival of foreign tourists to India. The current year 2009 is being promoted by Indian Ministry of Tourism as "Visit India'" year and the ministry is keen to promote Medical Tourism. It has recently notified the Market Development Assistance (MDA) Scheme to eligible Medical Tourism players which enables them to get financial support for participation in overseas promotional events.

About Indian Medical Travel Association. www.indianmedicaltravelassociation.com

A non profit body aimed at preparing India for facing the challenges of global competition in Medical Tourism space and actualise the tremendous opportunity for India to become a leading global healthcare destination. IMTA's membership has a diverse base of India's leading JCI, NABH accredited hospitals, Indian System of Medicine and Wellness service providers, travel industry, Insurance, Assistance and Medical Tourism facilitation companies.

For more details please contact :-

Mr Pradeep Thukral,

Executive Director,

Indian Medical Travel Association

Phone : 91 9810907151

Website : www.indianmedicaltravelassociation.com

Swine flu (swine influenza) is a disease of pigs. It is a highly contagious respiratory disease caused by one of many Influenza A viruses. Approximately 1% to 4% of pigs that get swine flu die from it. It is spread among pigs by direct and indirect contact, aerosols, and from pigs that are infected but do not have symptoms. In many parts of the world pigs are vaccinated against swine flu.

Most commonly, swine flu is of the H1N1 influenza subtype. However, they can sometimes come from the other types, such as H1N2, H3N1, and H3N2.

The current outbreak of swine flu that has infected humans is of the H1N1 type - this type is not as dangerous as some others.
Avian Influenza (Bird Flu) can also infect pigs
Avian flu and human seasonal flu viruses can infect pigs, as well as swine influenza. The H3N2 influenza virus subtype, a virulent one, is thought to have come from pigs - it went on to infect humans.

It is possible for pigs to be infected with more than one flu virus subtype simultaneously. When this happens the genes of the viruses have the opportunity to mingle. When different flu subtypes mix they can create a new virus which contains the genes from several sources - a reassortant virus.

Although swine influenza tends to just infect pigs, they can, and sometimes do, jump the species barrier and infect humans.
What is the risk for human health?
Outbreaks of human infection from a virus which came from pigs (swine influenza) do happen and are sometimes reported. Symptoms will generally be similar to seasonal human influenzas - this can range from mild or no symptoms at all, to severe and possibly fatal pneumonia.

As swine flu symptoms are similar to typical human seasonal flu symptoms, and other upper respiratory tract infections, detection of swine flu in humans often does not happen, and when it does it is usually purely by chance through seasonal influenza surveillance. If symptoms are mild it is extremely unlikely that any connection to swine influenza is found - even if it is there. In other words, unless the doctors and experts are specifically looking for swine flu, it is rarely detected. Because of this, we really do not know what the true human infection rate is.
Examples of known swine flu infecting humans
Since the World Health Organization's (WHO's) implementation of IHR (2005) in 2007, they have been notified of swine influenza cases from the USA and Spain.

In March/April 2009 human cases of influenza A swine fever (H1N1) were first reported in California and Texas. Later other states also reported cases. A significant number of human cases during the same period have also been reported in Mexico - starting just in Mexico City, but now throughout various parts of the country. More cases are being reported in Canada, Europe, and New Zealand - mainly from people who have been in Mexico.
How does a human catch swine influenza?

* From contact with infected pigs (most common way)
* From contact with infected humans (much less common way)

In cases when humans have infected other humans close contact was necessary with the infected person, and they nearly always occurred in closed groups of people.
Can I eat pork meat and pork products?
If the pork meat and pork food products have been handled properly transmission of swine influenza to humans is not possible. Cooking pork meats to a temperature of 70C (160F) kills the virus. So the answer is YES, pork meat and pork food products are safe to eat.
Where have pigs been infected?
As swine influenza infection among pigs is not an internationally notifiable disease we cannot be completely sure. Swine influenza infection among pigs is known to be endemic in the USA. Outbreaks have also occurred in other parts of North America, South American, Europe, Africa, China, Japan, and other parts of Asia.
Is there a pandemic risk?
People who are not in close contact with pigs generally have no immunity to the swine influenza viruses - they are less likely to be able to prevent a virus infection. If the virus infects enough people in a given area, the risk of an influenza pandemic is significantly greater. Experts say it is very hard to predict what impact a flu pandemic caused by a swine influenza virus would have on the global human population. This would depend on how virulent the virus is, what existing immunity among humans there already is, plus several other factors.
Do we have a specific swine flu vaccine?
No - not for humans.
Will current human flu vaccines help protect people from swine influenza infection?
We really don't know. Influenza viruses are adapting and changing all the time. If a vaccine was made, it would have to be specifically for a current strain that is circulating for it to be effective. The WHO says it needs access to as many viruses as possible so that it can isolate the most appropriate candidate vaccine.
What are the signs and symptoms of swine influenza in humans?
They are similar to those of regular flu, and include:

* Body aches
* Chills
* Cough
* Diarrhea (less common)
* Headache
* Sore throat
* Temperature (fever)
* Tiredness (fatigue)
* Vomiting (less common)

What medications are there?
There are some drugs around that can effectively treat swine flu infection in humans - and many types of flu infections in humans. There are two main types:

* adamantanes (amantadine and remantadine)
* inhibitors of influenza neuraminidase (oseltamivir and zanamivir)

Most previous swine influenza human cases recovered completely without the need for medical attention.
What can I do to protect myself?

* Wash your hands regularly with soap
* Try to stay healthy
* Get plenty of sleep
* Do plenty of exercise
* Try to manage your stress
* Drink plenty of liquids
* Eat a well balanced diet
* Refrain from touching surfaces which may have the virus
* Do not get close to people who are sick
* Stay away from crowded areas if there is a swine flu outbreak in your area

If I am infected, how can I stop others from becoming infected?

* Limit your contact with other people
* Do not go to work or school
* When you cough or sneeze cover your mouth with a tissue. If you do not have a tissue, cover your mouth and nose.
* Put your used tissues in a waste basket
* Wash your hands and face regularly
* Keep all surfaces you have touched clean
* Follow your doctor's instructions

Physician representatives will gather in Copenhagen in September to discuss the health consequences of climate change to ensure that the medical profession's voice is heard when a new global climate treaty to replace the Kyoto accord is considered two months later.

The seminar will be held by the World Medical Association on September 1, when physician leaders and climate change experts will highlight the health impact of climate change and suggest the role physicians can play in alerting the world to the increased risks of disease.

Dr. Otmar Kloiber, Secretary General of the WMA, said: 'It is vital that health is fully considered in current global debates and that physicians are provided with accurate information and awareness raising tools to advocate action at a national level.

'The WMA is preparing major new policy for physicians in areas such as advocacy, capacity building and collaboration. We hope to adopt this at our annual General Assembly in New Delhi in October so that it can be fed into the United Nations climate change conference being held in Copenhagen in December'.