Twin & Tranguility

The peace and tranquility one gets from a silent place is very relaxing.It freshens the mind and soul.Gives renewed energy to work.The twin palm trees stand calm anticipating a refreshing shower for them. The clouds loom large overshadowing the sky and forecasting a soothing shower.It is very much pleasing to watch. A good warm serving of tea and some snacks are in offing.I enjoyed the moment with my family in my father-in-law's place at chandikhole in India. A small tourist attraction in India with temples in the foot hills of eastern Ghats in India. 

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HIV /AIDS Vaccine, An Update.

This was the news.HIV/AIDS vaccine may become a reality.Previously the code was not cracked effectively to produce a vaccine.This news has been forwarded to me by one of my Ranboxy friends.

Image via Wikipedia Thursday, September 3, 2009 By Maggie Fox, Health and Science Editor WASHINGTON (Reuters) - The discovery of immune system particles that attack the AIDS virus may finally open a way to make a vaccine that could protect people against the deadly and incurable infection, U.S. researchers said on Thursday. They used new technology to troll through the blood of 1,800 people infected with the AIDS virus and identified two immune system compounds called antibodies that could neutralize the virus. And they found a new part of the virus that the antibodies attack, offering a new way to design a vaccine, they reported in the journal Science. "So now we may have a better chance of designing a vaccine that will elicit such broadly neutralizing antibodies, which we think are key to successful vaccine development," said Dennis Burton of The Scripps Research Institute in La Jolla, California, who led the study. "The findings themselves are an exciting advance toward the goal of an effective AIDS vaccine because now we've got a new, potentially better target on HIV to focus our efforts for vaccine design," added Wayne Koff of the International AIDS Vaccine Initiative, or IAVI, which sponsored the study. Since the AIDS pandemic started in the early 1980s, more than 25 million people globally have died from the virus. The World Health Organization estimates that 33 million are currently infected. There is no cure, although a cocktail of drugs can help keep the virus under control. Efforts to make a vaccine have failed almost completely.

MUTABLE VIRUS Part of this is because the virus mutates so much that any one person is infected with millions of different versions, each one appearing different to the immune system. In addition, the virus infects the very immune cells that are supposed to help protect the body. And if even one virus gets past the immune defense, it appears to set up a lifelong infection. No drug has been able to eradicate it. IAVI director Dr. Seth Berkley said the findings will not lead directly to a vaccine, but show that there are new and better ways to design one. He said 10 percent of the patients whose blood was screened had a strong antibody response to the virus. "We have people with even more potent serum out there. We will probably see more," he said in a telephone interview. It may also be possible to use such antibodies as therapy themselves -- such as the gamma globulin used for hepatitis virus. But the eventual goal, Berkley said, is a vaccine that produces antibodies that could stop the virus from ever infecting a person in the first place. "We haven't been able to do that because we haven't been able to find the right kind of response," Berkley said. Most vaccines elicit an antibody response, priming the body to make antibodies that will recognize and attack an invader such as a bacteria or virus. The two antibodies, called PG9 and PG16, are the first new HIV antibodies to have been identified in more than 10 years. They target a region of the spike the virus uses to infect cells, the researchers wrote. A team at South San Francisco-based Monogram Biosciences Inc screened the blood for the ability to neutralize HIV. Theraclone Sciences used its technology to identify the antibodies involved. North Carolina-based Laboratory Corp of America Holdings acquired Monogram in July. Image Of Cycle Image via Wikipedia

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• Study Finds Potential Way to Make an AIDS Vaccine (nlm.nih.gov)
• Antibodies 'may aid HIV jab hunt' (news.bbc.co.uk)

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Search for Cancer Vaccine Showing Promise

Search for vaccines against cancer was already there .As reported the enthusiasm has gained new boost.The direction of research is to make the tumor look more foreign to the immune system of body.Now it is not effectively distinguished and that is why the immune system could not act on it.Once that is done the body defense mechanism will act on them to eliminate.Now there is reports that vaccine against HPV and Hepatitis B is showing promise in preventing cervical cancer and liver cancer respectively.Let us hope for the best.

clipped from www.oncologystat.com Search for a Cancer Vaccine Beginning to Show Promise As Reported by TIME. 2009 Sept 14 The search for an effective cancer vaccine has been elusive until now, but positive results for separate vaccines against melanoma and lymphoma were finally reported this past June. Although the theory behind a cancer vaccine seems logical—enlist the immune system to seek and destroy cancer cells—it also poses an inherent problem, specifically, that cancer cells aren’t foreign pathogens, such as bacteria or viruses, but cells from a person’s own body. Getting a vaccine to work against cancer requires a deep understanding of how the immune system works and how malignant cells evade detection. A feature article in the September 14 issue of TIME, written by Alice Park, explains the quest thus far for cancer vaccines.

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The Risks of Early Hormone Replacement Therapy In Menopausal Ladies.

Female hormones influence growth and initiation of a few cancers.One amongst them is breast cancer.The linked article below narrates about it.The hormone replacement therapy should be weighed against it's possible adverse effects.

http://www.oncologystat.com/journals/journal_scans/Breast_Cancer_After_Use_of_Estrogen_Plus_Progestin_in_Postmenopausal_Women.html

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Aspirin in Prevention of Cancer

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 Aspirin prevents colon carcinoma has been suggested.It's effect on other cancers needs more research. That has been published in the article below I would like to share.


http://www.oncologystat.com/journals/journal_scans/Aspirin_and_Non_Steroidal_Anti_inflammatory_Drugs_for_Cancer_Prevention_An_International_Consensus_Statement.html

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Breastfeeding May Prevent Cancer Breast.

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 I have found this article in The Oncologystat and like to share it with others.It is an established fact that breast feeding prevents cancer of breast.The exact cause is not known.

http://www.oncologystat.com/news-and-viewpoints/news/Breastfeeding_May_Protect_Women_With_Family_History_of_Breast_Cancer_US.html

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H1N1 an Overview.

I found link to this site from a goolge advertisement and wanted to share with my friends across the globe.That is all.

clipped from www.america.gov Learn more about how international organizations are working together to respond to outbreaks of a new strain of a H1N1 virus initially referred to as swine flu. Single-Dose Vaccines for Pandemic H1N1 Will Protect Most Adults As H1N1 Flu Cases Increase Worldwide, Health Ministers to Meet Scientists Learn More About H1N1 Flu; Critical Questions Remain Learn more about how international organizations are working together to respond to outbreaks of a new strain of a H1N1 virus initially referred to as swine flu. Single-Dose Vaccines for Pandemic H1N1 Will Protect Most Adults As H1N1 Flu Cases Increase Worldwide, Health Ministers to Meet Scientists Learn More About H1N1 Flu; Critical Questions Remain Preparation for Avian Flu Helps Nations Fight H1N1 Outbreak World Health Organization Declares Global Pandemic for H1N1 Flu World Health Organization: Director-General Statement 7:17 WHO Centre for Strategic Health Operations 1:06

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Difficulty in deglutition

Viral Pharyngitis

Difficulty in deglutition (shallowing) is a complain whose cause range from the simplest one to dangerous ones.It may be as simple as a pharyngitis and at the other end a cancer.This symptom in medical language is called Dysphagia. We will see two most important causes of dysphagia.It may occur in response to intake of solids or liquids.The causes vary for the two.Dysphagia to solid should be investigated for an obstructing lesion in the esophagus such as a cancer of esophagus.There are a host of other diseases which give rise to dysphagia to solids.Dysphagia to liquid more commonly occur in a disease called achalasia of cardia i.e.where there is congenital narrowng of lower esophagus.


A cancer of esophagus more commonly affects the middle third of esophagus.It may cause dysphagia,blood vomiting,vomiting of food unmixed with gastric content or a pain in the chest.Diagnosis is very easy through an endoscopic biopsy but treatment is a bit difficult.However now-a-days laparoscopic method is being applied successfully.
Achalasia of cardia causes dysphagia to liquids because solids pass through the lower end of esophagus by it's weight whereas liquids can not.This is a paradox situation to cancer esophagus where liquids tickle down but solids get struck .It also can be diagnosed through endoscopy and/or by a barium shallow and a myotomy relieves the symptoms. 

Endoscopic View of Achalasia of Cardia.     Barium Shallow of same Condition

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Foreignbody in Respiratory Tract & Accidental Entry.

Image by jemsweb via Flickr

It is very difficult for the foreign body to go down to the respiratory tract but not impossible as the news reports it.Sometimes while dinning and sucking food such as the marrow from the bone it may accidentally enter to the respiratory tract and may choke it.Human can sustain life without air for about 3 minutes.So,the first three minutes is important.Accidental entry of foreign body body generally evokes violent cough to expel it but sometimes fails to expel it out.In that case the friends should come to rescue.There is a particular procedure for it.One should go to the back side of the person,clasp him/her near the lower chest and forcibly squeeze the chest wall  keeping his chest to the back of victim while the victim keeps opening his/her mouth.The fragment should come out.If this fails one should not hesitate to do a tracheotomy.With help of any sharp instrument the throat is to be cut about 3 cms above the upper end of sternum.Or,else a wide bore needle may be thrust to the trachea.One or other procedure will definitely save the life of a person in this emergency situation.


 If a foreign body however passes down without choking the upper respiratory tract it is bound to cause collapse of lung in varying proportions called Mandelson's Syndrome.Frequently vomits of an unconscious patient may go in and cause death due to choking of respiratory tract or cause mandelson's syndrome.Vomits can also cause of sudden death of babies and patients under anaesthesia.    

clipped from edition.cnn.com (CNN) -- "I know I didn't chow down on a spoon!" declared John Manley, who recently discovered that an eating utensil was the source of his two years of ill health, coughing, vomiting and pain. The Wilmington, North Carolina, resident had surgery last week to remove part of a plastic spoon from his lung. And it wasn't just any old plastic spoon; it came from the fast-food chain Wendy's, with the restaurant logo clearly visible on the handle. "It must have been in the food or drink," Manley told CNN affiliate WECT. His doctor found the spoon after looking into his lungs with an endoscope, a medical instrument with a long, thin tube containing a light and a video camera. "He explained that there was an object down there, and it had writing on it," Manley said. "It spelled out 'Wendy's' on one side and 'hamburgers' on the other, and I was a little floored." So were his relatives, who, when they were telephoned with the news, were eating ... Wendy's.

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This clip is from BBC.Development of vaccine is not easy as the virus changes it's antigenicity frequently.That is why vaccine developed to-day becomes ineffective tomorrow.Treatment is mainly symptomatic.Antiviral treatment shorten the course of disease.Secondary infection by bacteria or fungus need to be treated.
The full article can be viewed in the portal of BBC.

clipped from news.bbc.co.uk Flu Flu and complications linked to it kill hundreds of people in the UK each year. But despite massive investment in research into the virus, there is no cure. However, there are vaccines which have some protective effect. These are normally administered to the elderly and the vulnerable each year. But every few years a new strain of flu appears which spreads so rapidly that precautions cannot be developed in time. This can lead to pandemics which threaten millions of lives. The worst flu pandemic this century was the Spanish flu pandemic of 1918 which killed an estimated 40 million people - more than World War One.

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A Birds Eye View On Proteins

Common Structure of Amino Acid

     To-day a medical representative started a discussion on a protein preparation launched by his company.I saw that he is singing like a parrot.Some clarifications sought from him was not provided.So I thought it will be appropriate to have a birds eye view on proteins.
       We know that proteins are the the main constituent of building blocks of body.These are the compound of nitrogen,carbon,oxygen,hydrogen and sulpher in varying amounts.These build and repair cells,build enzymes and provide energy and many more.These consist of amino acids.There are about 22 amino acids present in human.Eight of them are called essential as are not synthesized in the body.They are to be supplemented from out side source.These are Leucine,isoleucine,valine,threonine,phenylalanine tryptophan,tyrosine and histidine to name a few.

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  There are two sources of protein, namely animal and vegetable.Animal sources are superior to plant sources as because those resemble the protein of human.Best protein is that which are easily digestible,easily assimilated to body,contain essential amino acids  and match to the protein present in human.Out of animal sources egg is by far the best and threfore called first class protein.Meat,fish and milk come after that.Plant source proteins do not contain all amino acids and may not assimilate fully.These are present in pulses,cereals,nuts and oil seeds.Groundnut is a good and cheap source of protein.So,it is named as poor man's protein.
    Protein energy malnutrition is a common problem in the developing countries.It need to be addressed more aggressively.   

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Scabies and Nephritis

Scabies

         Scabies is a problem in the developing countries specially in rural areas of India.It is contagious disease and spreads rapidly in the school going children. I hope that everybody has seen this disease and diagnosed.It appears as tiny itchy blisters and spreads rapidly to the surrounding skin and to far off skin.It commonly affects the web spaces of fingers,groin,extremities and trunk.It is caused by a itch mite called sarcoptus scabi.This organism burrows into the pores near hair root and matures there to lay eggs.As the victim scratches the affected area the eggs come to nail and spread to other areas.Scabies if gets infected by bacteria specially streptococci it enlarges in size with pus formation.These bacteria liberates a toxin which may cause nephritis.Nephritis is a bad disease which tortures the patient.

Close Up Of a scabies burrow.

            So,it goes without saying that scabies should be treated adequately. 

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Computer and Neck Pain

Neck Pain

                   Computer professionals more often complain of neck pain.They sought for drug treatment.Treatment with drugs are a short term solution. These persons never understand that the problem lies elsewhere.And if they are entitled for free treatment then they think that the doctor is avoiding to prescribe medication.I often advise them to check for microsoft health first given in their web site. Postural  defect plays a major role in neck pain and also in backache.Most working places are not equiped with optimal settings for comfortale working on computer.It has been told time and again to adhere to some of the standards.So there is nothing new in to-day's discission.Still it is better to repeat.
                            The sitting chair should be of medical grade i.e. the chair has a support at waist region with a convexity.The chair should be of such a height that while sitting the legs of the worker can comfortably go beneath the table.It should have hands to support the forearms of the worker in such a manner that the the key board remains at a comfortable level.Table should be of good height so that the monitor of PC remains at the level of eyes.If using a speck should be of correct power to see the monitor at a particular distance where he is comfortable.It may not be possible to use the same speck which he or she uses at all other times.

                           Apart from these the person should stand for a while after working for one hour and stretch. He should move neck in different directions to relax the muscles.He should sit straight on the chair and may have a cushion.He should use firm bed.A pillow of low height is suitable for use while sleeping on sides.May not use pillow in a supine position.
                       

  The monitor of the computer should preferably be covered with an ultraviolet rays filtering screen.Surrounding lighting should be optimal i.e. no excess or no dim.
                            I hope following these tips will keep neck and and back bone pain away at least in a majority profesionals.    

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Swelling of Both the Legs

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Diabetes mellitus if uncontrolled or poorly controlled can cause a lot of problem.Even the employees of public sector undertakings in India those who get a free treatment facility from their employer do not bother to get it optimally controlled.I think diabetes mellitus carries a stigma.People hesitate to confess that they are suffering from it.Some think that taking drugs for it is not good as one has to continue it for good.Some other think that taking insulin is not good as has to take it all time to come.
To-day, I saw somebody coming with uncontrolled diabetes mellitus and swelling of both the legs down from the knees.The person it so orthodox that he has burnt his thighs above the knees by hot iron in order to get cured from the swelling down.Consequently has got non healing ulcer to the existing uncontrolled diabetes.
Diabetes affects kidneys and damage it to cause a chronic renal failure.Here the legs are swollen alon with all other features due to accumulation of toxic products generated from the body metabolic processes.In the long run one may need a dialysis and a kidney transplant.

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Right Lower Abdomonal Pain-10

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Sometimes gastroenteritis simulates an attack of acute appendicitis.There is vomiting,abdominal pain and also fever.Here the history of loose motion is important and the sequence of pain abdomen,vomiting and fever lacks.There is no particular point of pain on pressure over the abdomen.Rather there is a diffuse pain all over the abdomen and an urge for defection called tensismus .Sometimes some type of appendicitis simulates gastroenteritis. But in appendicitis usually patient goes for defaection after each feed i.e. a sort of intestinal irritation.However is has to be differentiated carefully.The stool examination holds the key .An ultrasonogram may be helpful.   

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Right lower Abdominal Pain-9

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In tropical counties where safe drinking water is still a day dream for all, get pain in abdomen due to amoebic colitis.It affects left side of colon commonly.If affects the right side and caecum (the beginning part of colon) patient get pain in the right side simulating an acute appendicitis.
 Here a history of loose or mucous motion usually precedes.The differentiating point is that here patient gets pain in the left side of lower abdomen as well.In the left side the site of pain is identical to the spot in the right called an amoebic point.Also patient may complain of pain in the upper abdomen as well.Routine stool examination will reveal the presence of amoeba.To exclude co-existing or isolated appendicitis an ultrasonogram may aid the clinical examination.Treatment is medicinal and conservative.Prevention is a good strategy.Taking raw vegetable cleaned in a hygienic way as wall as treated drinking water will prevent it to a great extent.

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Right lower Abdominal Pain-8

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     I opened the abdomen in right lower quadrant for an appendicectomy some 12 years back in a 50 bedded hospital.I found the appendix which was a little congested but the appearance did not convince me that the patient was suffering from appendicitis.I looked in side the abdomen a little upwards and swept my hand.There was pus coming from up.I thought it be be a perforated stomach or duodenum.The wound was extended and a perforated duodenum from acid peptic disease was discovered and adequate surgery was carried out.The patient recovered nicely.I thanked God because if I would have become satisfied with an appendicectomy only , could have landed in trouble as well as the patient.


    The patient presented with the features of acute abdomen then.He had pain in the right lower abdomen .The available test for perforation of stomach and duodenum was only a plain X-rays.That should show free gas under the diaphragm in about 80 to 90 percent of patients.That did not show gas .An ultrasonogram was not available there.Also features suggested the case to be a perforated appendix.Mostly we depend on clinical findings to diagnose a case of appendicitis.That is why I went for the appendicectomy.

A Removed Appendix

So till date I remember the case .An ultrasonogram at that stage would have helped.Of course ,no harm was done to the patient.Removing an appendix along with any other surgery is done if feasible.Some times pus and other exudates from a perforated stomach or duodenum gravitate down to the right lower abdomen to simulate a case of appendicitis.     

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