Malaria vaccine to be tested in 3 African nations

POOR COUNTRIES HAVE THE CHALLENGE OF DELIVERING THE REQUIRED 4 DOSES OF THE VACCINE FOR EACH CHILD

JOHANNESBURG : Three African countries have been chosen to test the world’s first malaria vaccine, the World Health Organization announced Monday.

Ghana, Kenya and Malawi will begin piloting the injectable vaccine next year with hundreds of thousands of young children, who have been at highest risk of death.

The vaccine, which has partial effectiveness, has the potential to save tens of thousands of lives if used with existing measures, the WHO regional director for Africa, Dr. Matshidiso Moeti, said in a statement. The challenge is whether impoverished countries can deliver the required four doses of the vaccine for each child. Malaria remains one of the world’s most stubborn health challenges, infecting more than 200 million people every year and killing about half a million, most of them children in Africa.Bed netting and insecticides are the chief protection. Sub-Saharan Africa is hardest hit by the disease, with about 90 percent of the world’s cases in 2015.

Malaria spreads when a mosquito bites someone already infected, sucks up blood and parasites, and then bites another person.

A global effort to counter malaria has led to a 62% cut in deaths between 2000 and 2015, WHO said. The vaccine will be tested on children five to 17 months old.

Source: Hindustan Times

After Much Delay, UP Gets Moving on Family Planning

MISSION PARIVAR VIKAS Govt plans free condom boxes, saas-bahu meets... Akhilesh
ignored Centre's directive on family welfare sent last November.

Free condom boxes at strategic locations in cities and villages, a kit for newly-wed couples
with packs of condoms, emergency contraceptive pills and a pregnancy testing kit, and saasbahu
sammelans are Uttar Pradesh government's latest tools to drive home the message of
family planning in its post populous districts.

The Yogi Adityanath government has decided to roll out a new central family planning
scheme, `Mission Parivar Vikas' in UP, which his predecessor Akhilesh Yadav ignored
despite the centre's directions last November.

On November 10, the union health ministry had written to seven states, seeking family
planning intervention to address maternal and infant mortalities. It said 145 high-fertility
districts in UP, Bihar, Rajasthan, Madhya Pradesh, Chhattisgarh, Jharkhand and Assam with
total fertility rate (TFR) of 3 and above account for 28% of India's population and 30% of
maternal deaths and nearly 50% of infant deaths.

The scheme targets 145 districts in the seven states which have a Total Fertility Rate (TFR)
of 3 and overimplying a woman on average bears three or more children here. UP has the
highest 57 of its 75 districts under the scheme.

UP as a whole has a 3.3 TFR and contributes most to India's high population growth.

“It is directed that the scheme, which as per the centre's direction was to be started from
November 10, 2016, will stand initiated from the date of this order,“ UP's additional chief
secretary , Arun Kumar Sinha, said in an order issued on April 24. The order has been sent to
DMs and chief medical officers of 57 districts.The scheme aims to bring down TFR in these
districts to 2.1 by 2025. In UP , 11 districts have TFR above 4 including Bahraich and
Balrampur at 4.8 and Siddharthnagar at 4.9.

Among the districts with low fertility rates, and hence out of the scheme's purview, are
Varanasi (TFR 2.3), Rahul Gandhi's Amethi, and the CM's Gorakhpur (TFR 2.7). Urban
districts like Kanpur, Noida, Ghaziabad and Lucknow also have low fertility rates. The new
scheme includes measures like a family planning kit for newly-weds in rural areas worth `220
which will include two packs of three condoms, a marriage registration form, five
contraceptive pills and two pregnancy test kits.

Free condom boxes will be put up at strategic locations like health facilities and gram
panchayat bhawans. A new contraceptive injection is being rolled out, where women opting
for it will be paid an incentive of Rs 100 per shot.

Nearly 47000 nurses and Asha workers would be trained to give these injectables. Financial
incentives for those undergoing sterilisation procedures like tubectomy and vasectomy have
been hiked under the scheme by 50% to Rs 2000 and Rs 3000.

Saas-bahu sammelans are planned for rural areas to facilitate improved communication
between mothers-in-law and daughters-in-law through interactive games and exercises to
bring about change in attitudes.

Raise Awareness, Empower Women
The UP government's focus to have a stable population and ensure improved access for
womens' healthcare is welcome. Priority should also be given to programmes that educate
women to influence their health and consequently their overall wellbeing. Raising awareness
will empower them to take critical decisions. This is superior to incentivising sterilisation.

Source: The Economic Times

New cause of high BP discovered

Researchers have discovered a new cause of high blood pressure which could lead to major

changes in managing the disease.

In a study published in the journal JCI Insight, the researchers named the new cause as

Connshing syndrome which is linked to the over production of the stress hormone cortisol.

In up to 10% of hypertensive patients, the over production of the adrenal hormone

aldosterone — a condition known as primary aldosteronism or Conn syndrome — is the

cause of disease.

Patients are left untreated for cortisol excess.

Source: The Hindu

A pinprick to detect cancer

 Drawing on genetics, Indian companies are offering blood tests to ferret out cancers

While the humble blood test has for long been the touchstone to catch diabetes, malaria and

HIV, companies are now drawing on knowledge from human genetics to make blood tests

smart enough to fish out several kinds of cancers.

Earlier this month, Strand Life Sciences, a Bengaluru-based company, began offering a test

called ‘STRAND LB’ that claims to be able to detect traces of a tumour “from a simple blood

draw”.

MedGenome, another company based in Bengaluru — also announced the launch of

“ONCOTRACK”, another ‘liquid biopsy’ test. “Management of cancer will undergo a

massive transformation in India with NGS (next-generation sequencing)-based liquid

biopsies… ONCOTRACK is one such offering,” says MedGenome chairman Sam Santhosh

in a press statement.

Liquid biopsies

NGS refers to techniques to scan genes and look for mutations that may cause cancer.

Traditionally, ferreting out cancer requires scooping out tissue from a suspected organ and

testing them for the disease. Depending on the location of the cancer, this frequently involves

invasive surgery.

Moreover, even after surgery or chemotherapy, several more biopsies are continually

required to check if the cancer has disappeared or worse, relapsed. Biopsies are also required

to check if the cancer is caused due to specific kinds of mutations that would render certain

kinds of treatment ineffective.

Liquid biopsies, as these tests are called, involve being able to catch free-floating pieces of a

tumour or particular pieces of tumour DNA in the blood. These are then analysed to see if the

DNA contains mutations that are known to be linked to particular kinds of cancer.

The trouble usually is that they are present in amounts too minuscule to be detected. To have

a shot at capture, any test has to be sharp enough to fish out about one molecule in 1,000.

“STRAND LB can detect tumour DNA traces in as many as 35% of patients with early-stage

cancer, going up to 70-90% in patients with locally advanced or metastatic cancer. These

figures are on a par with the best in the world,” says Dr. Vijay Chandru, chairman and

managing director, Strand Life Sciences. These numbers spanned a wide variety of cancer

types, including lung, colorectal, breast, and bladder cancer.

According to Dr. Chandru, liquid biopsy tests couldn’t yet be a replacement for traditional

biopsies but there were a variety of situations that made them useful — for instance, lung

cancer patients who couldn’t afford to part with enough tissue. These are important to

determine if their tumours carry mutations in genes such as EGFR, making them eligible for

specific treatments. It can also be used to monitor the very same patients for the emergence of

resistance to these treatments.

The cost barrier

Liquid biopsy tests approximately cost ₹ 15,000-₹ 20,000, making them roughly three-four

times as costly as solid biopsies. However, proponents say the world over, liquid biopsies are

considered an emerging technology and it was quite likely that in the next five years there

would be blood tests powerful enough to find out if a seemingly healthy person has been

struck by cancer. “At least in the case of breast cancer, research shows that liquid biopsies are

extremely effective,” says Shantanu Chowdhury, a cancer researcher at the CSIR-Institute of

Genomic and Integrative Biology in Delhi.

India is likely to have over 1.73 million new cases of cancer and over 8,80,000 deaths due to

the disease by 2020. Around 70% of all cancer patients approach the doctor when the disease

has advanced and chances of a cure are very low.

Source: The Hindu

Robotic surgery

Phase I clinical trial of Zika vaccine to begin next month

Tests, which involve 48 adults, will be randomised and placebo-controlled

Bharat Biotech International Ltd in Hyderabad will start the Phase I clinical trial of Zika virus

vaccine (MR 766) in two centres in India next month.

“We have already got the approval from DCGI [Drug Controller General of India] in March

to carry out the Phase I clinical trial,” says Dr. Krishna Ella, Chairman and Managing

Director of Bharat Biotech.

Dose ranges

It will be a randomised, placebo-controlled, double-blind trial involving 48 adults, both men

and women (who are not pregnant). Each volunteer will receive two vaccine doses on days 0

[the starting day] and 30 and will be followed-up for a year for both safety and immune

response. Three different dose ranges will be tested.

There will be three arms in the trial, and each one will recieve one of the three different dose

ranges.

The Phase I is being initiated based on the promising results in animals trials. In the animal

trials, two doses of the vaccine made using an African Zika virus strain conferred 100%

protection against mortality and disease in mice. The protection was the same when the mice

were infected with an Asian and an African Zika strains.

While the viral load was “undetectable” in the case of vaccinated mice, the amount of virus in

unvaccinated mice shot up four days after being infected.

Source : The Hindu

Banning online pre-natal sex determination content dangerous: SC

The Supreme Court on Tuesday observed that a general ban on all online content about

prenatal sex determination will curtail the fundamental right to know of a genuine

information-seeker who is driven by curiousity.

“Prenatal sex determination ads is an offence. But a general prohibitory order against all

online information pertaining to sex determination is dangerous. We will be curtailing the

right to know under Article 19 (1) (a) of the Constitution,” a three-judge Bench led by Justice

Dipak Misra observed orally.

Attorney General Mukul Rohatgi said there was a distinction between the right to know of an

information seeker and the purely commercial objectives of those who post online sex

determnation ads to make money.

"The search of the information seeker is protected by the right to know," Mr. Rohatgi

submitted.

"Yes. Curiousity is fundamental to the right to know and you cannot curtail it with a direct

order," Justice Misra observed orally.

"Yes, there should be a restriction on sex determination ads. But can we smother choice of a

person to gain information? Right to know is a fundamental right. If we pass a general type

order, that is likely to offend Article 19(1) (a)," Justice Misra asked.

The court asked for Mr. Rohatgi's assistance and allowed advocate Sanjay Parekh, counsel

for petitioner Sabu Mathew George, to effectively address the court on the question as to

whether the ban on sex determination advertisements under Section 22 of the Prenatal and

Pre-Conception Sex Diagnostic Techniques Act is restricted only to paid advertisements.

The court will hear them on April 13.

Senior advocates Harish Salve and Abhishek Manu Singhvi, appearing for search engines

Yahoo and Google, said intermediaries are not directly responsible for people uploading

content online.

Mr. Singhvi submitted that banning these ads should not restrain the "innocent searcher."

In February, the court ordered Google, Microsoft and Yahoo to immediately set up their own

in-house expert bodies to keep tabs and delete prohibited online prenatal sex determination

ads.

The court said the intent of the order was to make these search engines “responsive to Indian

law.”

Source: The Hindu