Indian Surgeon Helping Polio Patients Take First Steps.

India is getting close to marking its third year without a new recorded polio case, setting the stage for the country to be officially declared polio-free in January. While much has been done to immunize infants against the disease, millions of people are living with polio, unable to live a normal life.

But one surgeon is working to change that.

At one of New Delhi’s oldest hospitals, in the only designated polio ward in all of India, patients like Abida Khatoon have only one goal.

“I can stand and walk,” Khatoon said. “I just need a little help, and soon I won’t need that as well. Soon, I will be able to walk on my own.”

It took two months of surgery and rehabilitation at St. Stephen’s Hospital for Khatoon to achieve her life-long dream of being able to walk.

She and other young women in this eight-bed ward credit Dr. Mathew Varghese, an orthopedic surgeon who has devoted his entire career to restoring mobility and dignity to those left crippled by the poliovirus that invades the brain and spinal cord, causing paralysis.

“All these girls have been crawling, except for this one, all the others have been crawling,” Varghese said. “The other muscles are very weak. They have never had the opportunity to stand on their two feet. For the first time in their lives – like this girl is paralyzed at six months — she has never been able to stand on her two feet.”

As India gets closer to officially being declared polio-free, the effect of the massive immunization effort can be seen in the hospital, with Varghese now mostly treating people in their early twenties as opposed to young children some two decades ago.

In 1990, New Delhi alone saw 3,000 new polio cases. Now that number is zero.The trend is reflected here at this polio ward, where at its peak it saw 600 patients annually. Now that number is down to fewer than 200.

Rotary International has been on the frontline of India’s polio eradication efforts and helps fund reconstructive surgeries at St. Stephen’s. Former Rotary President Rajendra Saboo saw the need to give polio patients a second chance at a normal life during a trip to a village in the northern Indian state of Uttar Pradesh.

“Then another child came, also crawling,” said Saboo. “And I said ‘what is happening to these children?’ They seem to have been struck by polio. And the villagers said, ‘no, no, no, just forget them, they are dust.’”

But Rotary and Varghese did not forget them. Patients hear about the ward and travel to New Delhi from across India in hopes of correcting bent legs and feet. No one is turned away.

After weeks in the hospital, 19-year-old Abida Khartoon is getting ready to go home to her village in Uttar Pradesh.

“If I had only met Dr. Varghese earlier, I wouldn’t have had as much hardship in life,” she said. “My hands wouldn’t be so calloused [from using them to get around]. Because of him, I am doing better,” she said tearfully.

But Khartoon is not the only one brought to tears. When asked what this surgeon’s dream is — the answer was simple.

“My dream,” he asked, trying to choke back his own tears. “This ward should be empty. No polio.”

read the fill story:

Indian scientists break dengue code, develop non-infectious vaccine from yeast.

Indian scientists have achieved an important breakthrough in their efforts to develop a vaccine to prevent the deadly dengue. Supported by the Department of Biotechnology under the Ministry of Science & Technology, scientists at International Centre for Genetic Engineering and Biotechnology (ICGEB) in New Delhi have developed a non-infectious dengue vaccine from yeast.

Preliminary animal trials of the vaccine have yielded good results.

“Search for a dengue vaccine has been going on across the world for past several decades. We, at our centre, started experiments seven years ago. The new technology we have used, i.e. recombinant DNA technology, to develop the dengue vaccine is a breakthrough,” said Dr Navin Khanna, group leader of Recombinant Gene Products Group, ICGEB. The initial trials done on mice gave encouraging results.

The research team explored virus-like particles which can provide “robust immunity” against the vector-borne disease that is endemic to more than a hundred countries. “There are four closely related dengue viruses (DENVs) that cause this disease. A vaccine that can protect against all four DENVs is an unmet public health need,” said Dr Khanna.

Explaining the need to explore a new technology to develop the vaccine, he said: “Efforts to develop a live attenuated vaccine (a vaccine created by reducing the virulence of a pathogen but still keeping it viable) have encountered unexpected interactions between the vaccine viruses, raising safety concerns. This underscored the need to experiment with non-replicating vaccine options.”

Among the disadvantages of the vaccine developed by live attenuated technology is that it can cause severe complications in patients with low immunity.

The ICGEB scientists used the yeast ‘Pichia pastoris‘ to develop dengue virus-like particles. “Using recombinant DNA technology, we have created non-infectious dengue virus-like particles made of only the major DENV ‘envelope protein’ important for eliciting virus-specific immunity.

These virus-like particles elicit high levels of virus-neutralising antibodies which protected the mice significantly against lethal DENV challenge,” said Dr Khanna. “The encouraging data obtained for virus-like particles specific to one of the four DENVs warrant the development of virus-like particles specific to the remaining three DENV strains,” he added.

Spironolactone/metformin superior to either treatment alone for PCOS.

Low-dose spironolactone and metformin combination therapy compared with either drug alone appeared to be an effective treatment for the management of polycystic ovary syndrome, according to results from an open-label, randomized study conducted in India.

“The key findings suggest superior efficacy (menstrual cyclicity, Ferriman–Gallwey [FG] score, serum total testosterone, insulin sensitivity and compliance) of low-dose spironolactone and metformin over either drug alone in the management of PCOS, without increasing the adverse event rate,”Mohd Ashraf Ganie, MD, of the department of endocrinology and metabolism at All India Institute of Medical Sciences in Ansari Nagar, New Delhi, India, and colleagues wrote.

Women who fell under the Androgen Excess-PCOS (AE-PCOS) 2006 criteria for PCOS were randomly assigned to one of three groups: metformin 1,000 mg per day (n=56), low-dose spironolactone 50 mg per day (n=51) or a combination of both drugs (n=62) for 6 months.

Before randomization, women were given dietary counseling (30 kcal/kg to 35 kcal/kg composed of 50% to 55% carbohydrates, 20% to 25% protein and 15% to 20% fat with high fiber content) besides lifestyle advice (ie, 25 to 35 minutes of brisk walking per day).

Menstrual cycle patterns, FG score, BMI, waist-hip ratio, blood pressure, luteinizing hormone, follicle-stimulating hormone, total testosterone, glucose and insulin sensitivity indices were measured at baseline, 3 and 6 months after the intervention. Data indicate all groups had comparable mean age and BMI at baseline.

At 6 months, menstrual cycles per year increased, whereas FG scores, serum total testosterone, AUC-glucose and AUC-insulin decreased significantly (P<.05) in the combination group compared with either therapy alone, according to data.

The adverse events associated with combination therapy were not significantly high. However, some of the clinical benefits could be the result of lifestyle modifications due to the lack of a placebo arm, researchers wrote. Yet, the efficacy and compliance were apparent without an increase in adverse events.



  • This study confirms what we have suspected for some time: that combination therapy is better for women with PCOS than single-agent treatment. In this case, combination therapy included an insulin sensitizer (metformin) and an androgen blocker (spironolactone). It is important to understand that combination therapy works best if the medications being used have differing mechanisms of action. For example, there are a number of drugs that decrease the production of androgens (i.e., metformin or oral contraceptives) while other drugs will block the action of androgens (i.e., spironolactone, finasteride, etc.). Medications may also improve metabolic function (e.g. metformin) if needed. In a disorder as complex and multifactorial as PCOS, optimum therapy will be one that combines currently available therapies to affect maximum benefit while minimizing side-effects. This study suggests that the combination of metformin 1000 mg and spironolactone 50 mg daily is one of these therapies.
  • Ricardo Azziz, MD
  • Professor of obstetrics and gynecology, medicine, and medical humanities
    President of Georgia Regents University
    CEO of Georgia Regents Health System

Source: Endocrine Today


Getting Better All The Time.



New Delhi, India

Halfway through the first day of my India trip, TV personality Prannoy Roy told a story I think really highlights the progress of India’s long journey to better health.

We were filming a question-and-answer segment in front of a studio audience for his show on New Delhi Television, one of India’s largest news networks. Prannoy was asking me and Bollywood star Aamir Khan about philanthropy, health, and India’s development when he recounted a discussion he had about 20 years ago. A former prime minister asked him and a group of other people what India could do to be a better country.  Prannoy said his answer – provide better toilets for women – was met with nothing but laughter.

Things have really changed. Just before seeing Prannoy, I had spent several hours in meetings with Indian parliamentarians and ministers. Our wide-ranging conversations about health and vaccines almost always returned to how to stop the spread of diseases through better sanitation and, specifically, toilets.

I was glad: the toilet is one of my favorite topics. At each meeting I got to talk about how flush toilets (ones that use water to clear the waste away through plumbing) won’t make it anytime soon to much of the world, including rural India where infrastructure is poor and water is scarce. Instead, we need to invent a better toilet, one that doesn’t use water yet eliminates harmful microbes and gets rid of any smell. Last year our foundation sponsored a “re-invent the toilet” fair where 14 universities submitted innovative answers to that problem. None were perfect but they all were a step in the right direction.

After several meetings it was clear there was strong interest in holding a similar “re-inventing the toilet” event in India early next year. We set some follow-up meetings to start figuring out how to make it happen. We agreed that applying India’s many creative minds to the sanitation problem could speed the path to a breakthrough.

In my post, “Why I’m Going to India,” I wrote that the country is an ideal place for understanding both the problems and the solutions in areas that our foundation focuses on. In my meetings yesterday, the sanitation discussions were just one example of the great optimism I felt from government leaders and health experts for overcoming the problems. I also heard about several new solutions.

A group of polio experts updated me on how India’s focus on ridding itself of that disease is paying dividends to broader health efforts. After a lot of hard work, India has been polio free since January 2011. India will be certified polio-free if there isn’t another case by next January. I’m confident we can get there. Yesterday the experts walked me through how they are using satellite mapping to not only see where they need to provide the polio vaccine but also to expand the country’s system of routine vaccinations (the vaccines children get in their early years). With satellites and cellphones we are getting far more detailed health data on hard-to-reach places. I’m convinced those tools, pioneered with polio, will be a game changer for expanding routine vaccination.

I also sat down with some of India’s top scientists, public health experts and pediatricians. This group was celebrating amazing progress of the phase 3 trial of Rotavac, India’s first home-grown vaccine for rotavirus, the world’s main cause of diarrheal disease—which, after pneumonia, is the second leading killer of children under age five. I touched on rotavirus in yesterday’s post but it’s worth emphasizing again. The work the group did to create the vaccine, and run a very high quality trial is nothing short of phenomenal. Rotavac is a rare global collaboration among the Indian government, vaccine manufacturer Bharat Biotech, and others including PATH, the U.S. Centers for Disease Control and Prevention and the National Institutes of Health. Our foundation provided grants to support the work.The next milestone is to get the vaccine licensed by Indian authorities.

Dr. M.K. “Raj” Bhan, former secretary of India’s Department of Biotechnology and a pediatrician who shepherded the vaccine’s creation, told me that he expects the vaccine to clear India’s regulators by the end of the year, an estimate the country’s minister of health echoed later in the day. That means that India could start introducing the vaccine next year and start saving tens of thousands of kids’ lives a year.

In answering the prime minister two decades ago, Prannoy, our TV interviewer, pointed to a health problem that India still hasn’t fixed. Yet things are absolutely getting better. Since that time, India’s child mortality has dropped 45%, better than 35% for the world as a whole. With every visit to the country I see how India will drop that further as it gradually solves its health issues. An official I met at India’s Planning Commission yesterday described how India is “slow and deliberate” and ultimately successful in working through challenges. “That’s what this country is all about: finding a way,” she told me.

Today I’ll see another example of how India is finding a way when I visit a research center using old and new technologies to help boost agriculture productivity and fight malnutrition.


To Stop Malaria, Infect the Mosquitoes.


For thousands of years, mosquitoes have made people sick. But now humanity may have found a way to turn the tables. In a new study, researchers report that giving mosquitoes an infection of their own—with a strange bacterium that tinkers with the insects’ sex lives—may prevent mosquitoes from transmitting malaria.

The advance is being hailed by some as a milestone in medical entomology. “I’m quite jealous,” says entomologist Scott O’Neill of Monash University in Australia, who was not involved in the work. “We have all tried this for years and years and years.” The mosquito species in question, Anopheles stephensi, is a key malaria vector in South Asia and the Middle East, and the study offers the tantalizing possibility of ridding entire cities such as New Delhi and Calcutta of malaria, says Willem Takken of Wageningen University in the Netherlands, who was also not involved in the work. In the future, the same technique might also work for other malaria-carrying mosquitoes, such as A. gambiae, which predominates in Africa, Takken says.

Scientists have long dreamed of replacing disease-carrying mosquito populations with new ones that pose no threat to humans because they cannot transmit disease. In the past decade, a bacterium called Wolbachia has emerged as a promising ally in their work. These intracellular bacteria spread from insect mothers to their offspring and play some bizarre tricks on their hosts’ sex lives. For instance, by ensuring that infected males can’t reproduce with uninfected females—a phenomenon called cytoplasmic incompatibility—the bacteria can maximize the number of infected offspring in the next generation and sweep through populations in very little time.

Scientists’ initial idea was to introduce genes conferring resistance to human pathogens into mosquitoes, and then enlist Wolbachia to help these traits race through the population. The difficult part was infecting mosquitoes with Wolbachia in the first place; for some reason, they seemed not amenable to a long-term, stable infection. A landmark came in a 2005 Science paper, in which Xi Zhiyong, then at Johns Hopkins University in Baltimore, Maryland, and colleagues infected a mosquito species called Aedes aegypti, which is the main carrier for dengue fever, a debilitating viral disease that causes intense muscle and joint pains.

A few years later, O’Neill and others made a startling discovery: They didn’t even need to couple Wolbachia to infection resistance genes. The bacterium alone made Ae. aegypti unable to transmit the virus. Others have shown that the same was true for several other viruses and parasites.

It’s not clear exactly why this is; one hypothesis is that Wolbachia competes for resources with other intruders, such as the dengue virus. But that hasn’t stopped scientists from trying to make use of the phenomenon. In 2011, O’Neill’s group released Wolbachia-infected Ae. aegypti mosquitoes in Australia, where they found that the infection took hold and spread. Currently, experiments are also underway in Vietnam, where dengue is an important disease.

But dengue isn’t the biggest mosquito-borne killer; that’s malaria, which is responsible for the deaths of more than half a million people annually and is transmitted by Anopheles mosquitoes, a very different genus. They have proven even more difficult to infect with Wolbachia. The frustrating quest — and the fact that not a singleAnopheles species is known to be naturally infected with the bacteria — had led some researchers to question whether it was possible at all, O’Neill says.

But Xi, who now leads his own group at Michigan State University in East Lansing, has done it again. In a new study reported online today inScience, the researchers showed that they can infect A. stephensi withWolbachia, that the infection is passed down through at least 34 generations, and that it can take over entire populations in cages.

The secret? Part of it is luck, Takken says. The team worked with a strain called Wolbachia wAlbB that happened to catch on in this mosquito. Technical skill is another factor, says entomologist Jason Rasgon of Pennsylvania State University, University Park, who wasn’t involved in the work. Injecting mosquito eggs is “very much an art,” he says, and Xi “is probably the best person in the world to do it.”

The team had to inject thousands of embryos before they had success. Xi says part of the trick is to suck a minuscule amount of cytoplasm out of egg cells first to make room for the injected bacteria and prevent cells from bursting. Despite their horrendous death toll, Anopheles mosquitoes are delicate critters, he says.

Xi’s group also fed infected mosquitoes malaria parasites to test whether Wolbachia could block their life cycle inside the mosquito’s body. They showed that Wolbachia-infected mosquitoes didn’t become totally resistant to malaria, as hoped. Instead, the number of parasites in their saliva 14 days after their exposure went down only by about a factor of 3.4, which means the mosquitoes could still transmit the disease, although perhaps not as efficiently.

Another key issue is whether Wolbachia-infected mosquitoes can produce the same number of offspring as uninfected ones, Takken says. If they can’t, they won’t be able to outcompete wild populations, and the insects wouldn’t fly as a malaria control scheme. Xi says he plans to publish another paper on that issue. Studies are also needed to determine how many infected mosquitoes need to be released in the field to get results fast enough. There might be other Wolbachia strains that do the job better, Rasgon says. For now, what’s most important is that the researchers have succeeded in the first place, he says. He is inspired because his own group is trying to infect A. gambiae, the main malaria vector in Africa and an even more difficult target to infect. “It’s very good for me to see that it can actually be done,” he says. “We will keep pushing ahead.”


Jamia Professor’s Paper included in the Nobel Prize Committee Document, 2011

                                                     Dynamics of dark energy

ln this paper we review in detail a number of approaches that have been adopted to try and explain
the remarkable observation of our accelerating Universe. ln particular we discuss the arguments for
and recent progress made towards understanding the nature of dark energy. We review the observa-
tional evidence for the current accelerated expansion of the universe and present a number of dark
energy models in addition to the conventional cosmological constant, paying particular attention to
scalar field models such as quintessence, K-essence, tachyon, phantom and dilatonic models. The
importance of cosmological scaling solutions is emphasized when studying the dynamical system of
scalar fields including coupled dark energy. We study the evolution of cosmological perturbations
allowing us to confront them with the observation of the Cosmic Microwave Background and Large
Scale Structure and demonstrate how it is possible in principle to reconstruct the equation of state
of dark energy by also using Supernovae la observational data. We also discuss in detail the nature
of tracking solutions in cosmology, particle physics and braneworld models of dark energy, the na-
ture of possible future singularities, the effect of higher order curvature terms to avoid a Big Rip
singularity, and approaches to modifying gravity which leads to a late-time accelerated expansion
without recourse to a new form of dark energy.

by Edmund J. Copeland, M. Sami, and Shinji Tsujikawa.

Prof M Sami,Department of theoretical physics,Jamai milla islamia, New Delhi,India.