The eight-day old indefinite strike by government doctors today spread to peripheral health centres in the district affecting their emergency and other services.

Over 4,000 doctors, demanding revision in their pay packages, intensified their agitation after talks to break the deadlock failed yesterday.

"All emergency services in the peripheral institutions of the province have been brought under the purview of strike from today in protest against irresponsible and suppressive attitude of the government," spokesman of Doctors Joint Action Committee (DJAC) Dr Neeraj Sharma said here.

This was necessitated because of failure of talks with the government, he said, adding, the two-hour-long meeting between a delegation of DJAC and the Minister for Medical Education RS Chib here did not yield any positive results.

DJAC will continue their strike until their demand, including time bound promotion, is accepted by the state government, Sharma said.

He said that more doctors from Government Medical College (GMC), other associated hospitals and those serving in peripheral institutions of the province will submit their resignations. Earlier, about 300 junior doctors have already tendered their resignations, Sharma said.

However, Chib said that he assured DJAC representatives that the government is actively considering their demand and any announcement in this regard would be made at the time of bi-annual meeting in November.

The minister said that he told the representatives that their two demands regarding change of pay band and enhancement of stipend appeared to be genuine.

Now it is their choice whether to join the duties or keep on striking work, the minister said.

The DJAC among other things has been demanding change of pay band, introducing a law to make assault on health personnel a non-bailable offence, and payment of arrears from January 2006.

Meanwhile, the health services across Jammu continued to remain paralysed today, official sources said, adding, the Out Patients Department (OPD) remained shut in the city hospitals as doctors stayed away from the work.

However, emergency wards were operating in the hospitals, the sources said.

The strike has badly hit the poor patients, who could not pay fee of doctors at the private clinics.

The National Institutes of Health is preparing to launch the first government-sponsored clinical trial to determine what dose of the 2009 H1N1 influenza vaccine is needed to induce a protective immune response in people with asthma, especially those with severe disease. The study is cosponsored by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Heart, Lung, and Blood Institute (NHLBI), both part of NIH.

"People with severe asthma often take high doses of glucocorticoids that can suppress their immune system, placing them at greater risk for infection and possibly serious disease caused by 2009 H1N1 influenza virus," says NIAID Director Anthony S. Fauci, M.D. "We need to determine the optimal dose of 2009 H1N1 influenza vaccine that can be safely administered to this at-risk population and whether one or two doses are needed to produce an immune response that is predictive of protection."

The study plan has been submitted to the Food and Drug Administration for review. With FDA allowing it to proceed, the clinical trial will be conducted at seven sites across the United States that participate in NHLBI's Severe Asthma Research Program.

This program already has a well-characterized group of participants with mild, moderate or severe asthma who may be eligible for this new study. These groups are largely distinguished by the amount and frequency of glucocorticoids needed to control asthma symptoms. People with mild disease may not need glucocorticoids, or may require low doses of inhaled glucocorticoids; those with moderate asthma need low to moderate doses of inhaled glucocorticoids; and those with severe asthma need high doses of inhaled glucocorticoids and frequently use oral glucocorticoids as well.

Individuals who already have been infected with 2009 H1N1 influenza or have received a 2009 H1N1 influenza vaccination will not be eligible for the study.

"The results of this study will have immediate implications for individuals with severe asthma as well as those who have milder asthma," says NHLBI Director Elizabeth G. Nabel, M.D.

Early results from other clinical trials of 2009 H1N1 influenza vaccines in healthy adults have shown that a single 15-microgram dose of 2009 H1N1 influenza vaccine without adjuvant is well tolerated and induces a strong immune response in most participants. The same vaccine also generates an immune response that is expected to be protective in healthy children ages 10 to 17 years. Ongoing trials are comparing the immune response to one and two doses of 15- or 30-micrograms of vaccine given three weeks apart in various populations.

The Centers for Disease Control and Prevention has recommended that certain at-risk populations receive the new H1N1 vaccine as a priority before the general population. These target populations include pregnant women, health care providers and individuals with underlying chronic medical conditions, including asthma.

People who have severe asthma may be particularly at risk for infection with the 2009 H1N1 influenza virus. A report published in 2004 suggested that some people who took high doses of glucocorticoids to treat their asthma may receive less protection from influenza vaccines against some strains of influenza. Early in the 2009 H1N1 flu outbreak a CDC review of hospital records found that people with asthma have a four-fold increased risk of being hospitalized with infection compared to the general population.

The study will enroll approximately 350 people with mild, moderate and severe asthma. Participants will be organized into two groups: those with mild or moderate asthma and those with severe asthma. Half of the participants in each group will receive a 15-microgram dose of vaccine, and the other half a 30-microgram dose. Three weeks later, each participant will receive a second dose of the same amount. The strength of the immune response induced by the vaccine will be determined in blood samples by measuring the level of antibodies against 2009 H1N1 flu virus.

Safety data will be collected and examined throughout the course of the study by trial investigators and by an independent safety monitoring committee. Participants will be monitored for any side effects they may experience because of the vaccine, as well as asthma attacks that occur during the study period.

While ultraviolet exposure and the environmental effect had long been linked to skin cancer, recent studies suggest the condition runs in families.

According to a study published in Journal of Investigative Dermatology, genes account for about half of the risks that an individual faces in developing the skin malignancy.

Individuals with a sibling or parent affected with a type of non-melanoma skin cancer are more vulnerable to developing skin cancers of various types, not just the ones their relatives had.

The familial influence is believed to be stronger among those with tumors located at body parts more exposed to the sun such as the face.

Compared to having a non-identical twin with melanoma, giving birth to an identical twin with the disease also increases an individual's risk of developing the skin disease by nearly 10-fold.

Scientists said family history can be used to assess an individual's possible risks of developing skin cancer.

It has come to the knowledge from a new study, the breast cancer tumors that till now have not spread do contain cells, those are having tendencies to migrate to new tissue. This, on the other hand, reveals that just because a cancer has not yet spread doesn\'t mean its cells lack the ability or inclination to do so, to the decision of the researchers at the Salk Institute for Biological Studies in La Jolla, Calif.

To them, in addition, there is no such evidence regarding the display of relationship of these cells with a positive or negative health outcome for women with breast cancer. In this respect it should be accepted, that the availability of the processes of self-screening for breast cancer, regular doctor\'s visits and mammograms have all made it possible to identify breast cancer tumors in their early stages. With the detection at the early stage, the cancer cells are found to remain confined within the milk duct, the most common origin of breast cancer tumors. Exclusion of the small tumor and surrounding tissue, is known as lumpectomy, and happens to be the usual treatment for this early stage of breast cancer.

Now there has always been a debate on whether women should also have radiation treatment to address any stray cancer cells, since a steady return of cancer among16 percent of these patients within five years is confirmed.

The study was conducted by the eminent team of researchers in the lab by the process of letting the breast tissue to grow under observation. The next approach was by depending on series of chemical signals, called the ERK1/2 MAP kinase pathway, that remains often active during tumor growth. The aggressive tendency and subsequent growth of the cells was witnessed afterwards. To the researchers, the next step would be to identify biological markers for the diagnosis of patients who are at higher risk of metastasis.

jammu Health services in the state were hit for the third consecutive day on Wednesday as the doctors, demanding revision in their pay packages, continued their indefinite strike.

Work was badly affected in Government Medical College and several hospitals in Jammu district due to the strike, officials said, adding the emergency services were, however, being run by senior doctors in the district.

The strike has affected the health care services in Primary Health Centres hospitals at Samba, Rajouri, Ramban, Poonch, Udhampur, Kathua, Billawar, Basholi, Bhaderwah, Doda, Kishtwar and Batote of Jammu region.

The strike has been called by Doctors Joint Action Committee (DJAC) in protest against the government for not fulfilling their demands.

The strike would continue till the government does not accept our demands, a spokesman of DJAC said.

"During the agitation the routine work in hospitals remains close in entire Jammu division as about 4,000 junior doctors are taking part in the indefinite strike," Spokesman of DJAC Satyainder Singh told reporters here.

The demands of DJAC included one grade pay higher than 10+2 lecturers, BUMS and BAMS as recommended by S L Bhat committee and payment of arrears from January 2006, and time bound promotions for its members.