medical

How Yoshinori Ohsumi work on Autophagy will change Medical Science?


On 3rd October 2016, a Japanese scientist Professor Yoshinori Ohsumi, Ph.D has been awarded Nobel Prize for Medicine for his study in mechanism of autophagy.

Autophagy, the word itself means self-eating. It is an essential conserved lysosomal degradation pathway that controls the quality of the cytoplasm by eliminating protein aggregates and damaged organelles. It begins when double membraned autophagosomes engulf portions of the cytoplasm, which is followed by fusion of these vesicles with lysosomes and degradation of the autophagic contents.

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In simple words, It is the process that cells use to destroy and recycle cellular components.
A recycling program – junk cell components are stored and the useful parts comes out to generate the energy or build new cells.

By the acknowledgement of this mechanism of autophagy, many gates will open for the approaches of treating diseases by further research works.

1. Cancerous cell growths can be prevented, that is the major life threatening disease of developed nations, as the survival rate is very low and unreasonable most of the times.

2. Fight against infections of  pathogenic microorganisms, will be great as most of the biology underpinning infectious diseases can be controlled.

3. Maintenance of a healthy metabolism,  It allows cells to degrade large molecules into basic building blocks, which are used as energy sources.

4. Neurodegenerative illnesses, Dementia (caused by tau), Parkinson’s disease (alpha-synuclein), Huntington’s disease (mutant huntingtin) and other age- related disorders.

5. Diabetes Mellitus Type 2, an endocrine disease due to genetical or sedentary lifestyle getting more common in our India will be prevented by autophagy.

6. Development of Drugs, Intense research is underway to develop drugs that can target autophagy to treat various other diseases.

7. Regenerate Protein Inside Body: Because of this machinery now we’re able to rely on some of our own proteins, maybe the damaged proteins or the long-lived proteins, and they are recycled with this sophisticated machinery so that we can sustain and we survive.

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Point of care testing (POCT)

Point of care testing (POCT) can be defined as the provision of a test when the result will be used to make a decision and to take appropriate action, which will lead to an improved health outcome. The basic objective of POCT is to produce a result swiftly yet reliably.

According to Accreditation Canada POCT refers to “any testing conducted outside a lab, in a hospital, in a clinic or by a health care organization providing ambulatory care. This includes testing performed at sites outside the traditional lab dedicated to medical biology, near where care is delivered to the client. POCT results may lead to a change in the care of the client. It ranges between three levels of complexity, from simple procedures such as glucose testing, moderate‐complexity procedures including provider performed microscopy procedures like used in TB or high‐complexity procedures such as influenza testing.”

The healthcare system is changing so quickly. Everyone has to run at that high speed just to keep up. Having a good health is just like happiness, can’t remain constant and whomsoever looking to maintain the status quo should not be in or go into healthcare as a profession. The change process shows no sign of slowing down.

In fact, all aspects of this field are moving equally fast like automobile industries, various new technologies like robotics and information technologies (IT). IT boosted so much in recent decade. Economics is also improving as well etc. It is no wonder that POCT is moving quickly ahead as one of the major approaches to solving what seems to be the major challenge that is how to do more with less.

What is the purpose of POC and why it is important?

1. The result of POCT is so quick that it can be done within seconds, to minutes to a few hours while the patient waits. At least result should be given on the same day depended on the complexity range of the diseases.

2. It provides rapid turn-around results that affects the clinical management of referral system, follow up of patient, treatment decisions and decision to discharge the patient.

3.The results of POCT are very useful in clinical decision making for any doctor. As the final diagnosis helps doctor to take appropriate action for the treatment without any further delay.

4. It is convenient for the patients and care providers as well. It mainly derives from the fact that the diagnostic process is achieved with in the same clinical encounter. And the patients do not have to come back for testing or go far away for some testing in medical laboratory.

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Common POCTs are:
Blood-glucose testing,
Electrolytes analysis,
Rapid coagulation testing (PT/INR, Alere, Microvisk Ltd),
Rapid cardiac markers diagnostics (TRIAGE, Alere)
Drugs of abuse screening,
Urine strips testing,
Pregnancy testing,
Faecal occult blood analysis,
Food pathogens screening,
hemoglobin diagnostics (HemoCue),
Infectious disease testing
Cholesterol screening (cholesterol, VLDL, LDL)

SUPPLEMENTARY FOOD FOR INFANTS

At no other time of life food is so important as in the first year of life (infancy). The kind, amount and sanitation of this food as well as the manner of feeding require particular attention which plays dividends in the form of a healthy, happy to baby. The nutrient requirements are high per unit of body weight because of rapid growth. In fact, in no other period of life growth is so rapid as in infancy.

Every mother is aware of that food prepared for adults are not always suitable for infants. But most of mothers do not realise that foods suitable for them can be easily prepared. They go for expensive baby foods which are sometimes beyond their reach.
Satisfactory foods can be planned and prepared for infants and children at home without using much expensive food stuffs.

We all know that breast milk is best food for the baby. But after 6 months, breast milk alone is not sufficient to meet the growing needs of the infants. Certain other food need to be provided  along with breast milk so as to supplement the short fall in the nutrients. The right time to start with supplements is after six months as per the guidelines. If we start too early, the child always at an increased risk of diarrhoea and if too late there is a constant fear of malnutrition.
Please note: Breast feeding has to be continued with supplementary foods.

The texture of consistency of the supplements can be modified according to the age of the infants, thus providing them with liquid supplements between 8-12 months. Liquid supplements include fruit juice, vegetable soups, soupy dal and cattle milk. In early stafes awe can start  with half ounce and gradually this amount can be increased upto 3 ounces per feed.

As the child grows, from liquid supplements there is a gradual transition to semisolid foods. The semisolid foods are mostly porridges made out of the stable food of the community (wheat, rice, maize, jowar, etc) These cereals are generally cooked with milk and sugar.  Some commonly used porridges are ‘Dalia’, ‘Rice Kheer’, ‘Suji Kheer’, ‘Ragi Kanjee’, ‘Sabudana Kheer’ etc. The porridge should be such that the child can swallow it easily. To ensure that the porridge is not thick and to reduce its build ARF (Amylase Rich Food) is added to porridge.

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The ARF is nothing but flour obtained from germinated grain like wheat, bajra, jowar, maize etc. Germinated grain flour contains a lot of amylase which makes the porridge soft , thin and easy to eat. Grains can be germinated, drained in Sun, powdered and the stored in air tight containers. Quarter to half tea-spoon of ARF powder can be added to the cooked porridge  when it is still hot (around 70*C). Other than porridge, boiled and mashed and given as such where as had fruits like apple, pineapple, peaches, banana etc. need to be first stewed and mashed before being served. Boiled dals, egg yolk, boiled fish and meat can also be given along with a little salt and butter.

When the baby starts teething around 8 months, it is the right time to introduce thick solid foods. The foods which were boiled and mashed earlier should now be just boiled and cut into small pieces. Boiled rice and small pieces of chapaties may also be given. Hard and crunchy foods are liked by the infants during the time of teething biscuits, toast, rusk, raw carrot, apple, cucumber are ideal food items for the child to chew.

Various food mixtures prepared from cereals, pulses, fruits,  nuts, animals foods, vegetables, milk and its products during this period. It has been noticed that children who are brought up on a variety of foods lives healthier and have much healthier tastes than those of brought up just milk and biscuits, fruits juice and vitamins. A mixed diet will not only upgrade the protein quality but will also prevent the development of vitamin and mineral deficiencies. By the age of one year the baby can take all solid foods. In fact the child can eat all the foods prepared for family meals.

Most of the problems of food acceptability in children being around one year of age. The problem in fact starts with the mother, who thinks the child should be well fed and tried to feed the child more food that its  needs. The mother should have patience and should help the child in developing good food habits gradually. Learning is a slow process and here the child learning to eat new foods one after the another.
So, have patience, be supportive and the result will be happy, healthy baby.

 

 

OMG! This is the condition of health facilities in India

‘India spends less of its GDP on health than some of the world’s poorest countries.’

A single government hospital serves an estimated 61,000 people in India, with one bed for every 1833 people, new official data shows. In undivided Andhra Pradesh, every government hospital serves over 3 lakh patients while in Bihar, there is only one bed for every 8800 people.

Union Minister for Health J.P. Nadda released the National Health Profile 2015 prepared by the Central Bureau for Health Intelligence (CBHI) in September 2015 along with officials of the Ministry, the Directorate General of Health Services and the CBHI.

Every government allopathic doctor serves a population of over 11,000 people, with Bihar and Maharashtra having the worst ratios. The number of qualified allopathic doctors registered with medical councils fell in 2014 to 16,000, or less than half the previous year’s number; the data was however provisional, CBHI officials said.

India now has cumulatively 9.4 lakh allopathic doctors, 1.54 lakh dental surgeons, and 7.37 lakh AYUSH (Ayurvedic, Yoga, Unani, Siddha, Homeopathy) doctors of whom more than half are Ayurvedic doctors.
India’s 400 medical colleges admit an estimated 47,000 students annually.

According to World Health Organization, doctor patient ratio should be minimum one doctor for 1000 people. But in India there is only one doctor per 1,700 citizens which is increasing rapidly.
The Union Health Ministry figures claim that there are about 6-6.5 lakh doctors available, India would need about four lakh more by 2020—50,000 for PHCs; 0.8 lakh for community health centres (CHC); 1.1 lakh for 5,642 sub-centres and another 0.5 lakh for medical college hospitals.

Health expenditure per capita (in USD) of India is only $61 (around 4,000 INR) that is even less than poor countries like Haiti, Cambodia and Zambia.
World Health Organization statement that countries should spend 5 percent of national income on health care services. As per 2012 GDP India is only spending 1.3 per cent while developed countries like US and the UK spending 15 per cent and 8.5 per cent, respectively. Though as per the latest 12th Five-Year Plan India aims for 3 per cent till 2017.

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The Centre’s share of total public expenditure on health has fallen over the last two years, and India spends less of its GDP on health than some of the world’s poorest countries. Among all States, undivided Andhra Pradesh had the highest public expenditure on health in 2012-13. Goa and the north-eastern States spent the most on health per capita while Bihar and Jharkhand spent the least.

Out-of-pocket private expenditure on health has risen steadily over the years, with the cost of medicines, followed by that of hospitalisation accounting for the largest share of the household expenditure. Absolute spending, as well as its share in total non-food expenditure, rises with income levels. Kerala spends the most privately on health.

India is having Human Development Index (HDI) of only 0.609 that is even worse than poor African countries like Guyana & Namibia. Best countries are Norway and Australia that having HDI of 0.944 and 0.935 respectively.

Source: The Hindu & Wikipedia

This is how you can prevent breast cancer!

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Today breast cancer is one the most dangerous disease in women after skin and lung cancer  among women. Etiologically depends upon geographical location, genetically, oestrogen access. It is more common in urban areas of India and developed nations. It’s more often in left breast than the right and is bilateral in about 4% cases.

As per statistics development of invasive breast cancer is 12% over the course of her lifetime of US women. About 25% of all cancers among women and causes approximately 20% of all cancer deaths.

In 2015, an estimated 231,840 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 60,290 new cases of non­invasive (in situ) breast cancer. Around 40,290 women will die from breast cancer.

Breast cancer is now the most common cancer in most cities in India, and 2nd most common in the rural areas. It is most common among post­menopausal women of 50­60 years of age. It is even possible to have development of breast cancer in men but it very rare for like 0.2% of cases.


source: breastcancerindia.net

For around 85% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutation in genes.

There is no such way to prevent this breast cancer but sill there are few measurements that can lower the chances. It can be possible changing few risk factors that one can keep under it control by changing the lifestyle and diagnosing at earliest stage as possible.

1. Drink less or better avoid
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Alcohol is not only destroys you liver and kidneys. It is also associated with an increased risk of breast cancer. So it is better to limit the intake to no more than one drink a day, regardless of type of liquor.

2. Avoid smoking
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Smoking is often associated to COPD (Chronic Obstructive Pulmonary Disease) and Lung Cancer. But according to scientific researches that long­term smoking also increase the risk of breast cancer in some women due to presence of carcinogens.

3. Maintain your weight and eat healthy
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Risk of breast cancer after menopause has been recorded higher in obese women. Increase your healthy lifestyle by fresh fruits and vegetables, eat lean protein and avoid processed food, carbs and fried meal. Choose vegetarian dishes over non­veg.

4. Stay physically active and strong
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According to research that increased physical activity, even when begun later in life, reduces the risk by about 10 to 30 percent. All it takes is moderate exercise like a 30­minute walk five days a week to get this protective effect. So it is better to stay fit, do workout, stay healthy and live healthy.

5. Breast feeding
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Good news! If you’re a mother and have a recent delivery of an angel. You will be secure from breast cancer for a year with breast feeding your child. It not only acts as nectar for the baby but also there is some natural ability to get cancer by rid of this. Higher risk in unmarried an nulliparous women than in married and multiparous women. But also some women with first childbirth at the late age of over 30 are in greater risk.

6. Avoid Hormone Therapy
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Long term use of OCP (oral contraceptive pills) has been suspected to predispose to breast cancer. Menopausal hormone therapy increases risk for breast cancer. If you must take hormones to manage menopausal symptoms, avoid those that contain progesterone and limit their use to less than three years. So avoid unless it has been prescribed by a doctor.

7. Have regular check­ups

If you are at high risk for breast cancer, such as having a particular gene like a BRCA gene, or have a strong family history or have had high­risk benign breast disease in the past, talk with your doctor about other options like mammography, MRI, xeroradiography, thermography, FNAC and ultrasound screenings.

Many of the times It is noticed that the patient comes at later stage of the cancer and it becomes quite difficult and less possibilities to cure it. It is always advisable to have regular check­ups in hospital. You need to follow­up and talk frankly this about to your doctor.

Sources:
http://www.cancer.gov/
https://www.fredhutch.org
https://breastcancerindia.net
Robbins & Cotran Pathologic Basis of Disease
Harsh Mohan ­ Textbook of Pathology

Five keys to safer food


According to World Heath Organisation (WHO) unsafe food is linked to the deaths of an estimated 2 million people annually – including many children. Food containing harmful bacteria, viruses, parasites or chemical substances is responsible for more than 200 diseases, ranging from diarrhea to cancers.
This year on World Heath Day, the new campaign is for food safety. This is a shared responsibility. It is important to work all along the food production chain – from farmers and manufacturers to vendors and consumers.
So here are the five keys to safer food offer practical guidance to vendors and consumers for handling and preparing food as per WHO:
Key 1: Keep it clean

It is always necessary to clean your hands before handling, preparing and cooking food. Wash your hands after using toilet, with a good antiseptic soap. Wash and sanitize all the surfaces and equipment used in preparation of meal. And make sure you are protecting your kitchen areas and food from insects, pests, and other birds and animals. All the things above will let dangerous infectious micro-organisms away from food that are found in soil, water, animals and people. It usually carries through hands, clothes, utensils and animals.
Key 2: Separate raw and cooked food
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It is recommended to keep raw and cooked foods separate reduces the risk of cross contamination. Cross contamination is used to describe the transfer of bacteria from sources such as raw meat or poultry, food handlers, animals and refuse to a high risk food, e.g. cooked meat products, dairy products, egg dishes (high protein foods). Hence you must keep separate utensils and containers for raw and cooked food.
Key 3: Cook food thoroughly

Some cooked dishes contain ingredients that may have harmful bacteria. Cooking foods thoroughly will help to destroy these bacteria. It is important to check that meat, chicken, fish or egg dishes are cooked thoroughly. Always eat fresh food and make heat above 70*C while cooking to make safer for consumption. Also keep reheating thoroughly time after time.
Key 4: Keep food at safe temperatures

Never leave cooked food at room temperature for more than 2 hours. It is recommended to keep in refrigerator below 5*C promptly all cooked and perishable food as it avoid micro-organisms for further multiply; although some grows normally. But keep in mind storing food too long even in refrigerator is not safe. As we all know serving main course hot makes it tasty but it also it slow down or even stops the growth of micro-organisms. So keep it piping hot more than 60*C before serving it.

Key 5: Use safe water and raw materials

In modern world it become must to have a water purifier at home now. Reverse Osmosis (RO) purifier is one of the best in market as dangerous micro-organism and chemicals in water is getting more common. Besides water, choose foods processed for safety, such as pasteurized milk. Prefer farm fresh wholesome food over canned and supermarket. Toxic chemicals may be formed in damaged and mouldy foods. Always wash and peel before eating it raw. Do not use food beyond its expiry or best before date.