Healthcare

PM Modi urges India Inc to invest more in Ayurveda (The Times of India:20171018)

http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=PM-Modi-urges-

India-Inc-to-invest-more-18102017015044

Inaugurates India's First All India Institute Of Ayurveda

Pitching for affordable and accessible healthcare, Prime Minister Narendra Modi on Tuesday

said the time has come for a “health revolution“ through ayurveda and the corporate sector

must invest to strengthen the traditional stream of medicine by means of more research.

“We have seen the IT revolution in last 30 years. Now, the time has come for a health

revolution under ayurveda.Let's pledge to strengthen, revive ayurveda,“ Modi said,

addressing a gathering after inaugurating the country's first All India Institute of Ayurveda

(AIIA), an apex institute under the AYUSH ministry, built on a campus area of over 10 acres

with a budget of Rs 157 crore in Delhi.

Emphasising the importance of ayurveda, Modi said the world is heading “back to nature and

wellness“ and urged private players to use part of their CSR funds to help strengthen the

field.

He also asked experts from the field to find medici nes which can, like allopathy , give

immediate relief to people but without side-effects.

The Prime Minister said that the government is working towards establishing an ayurveda

hospital in every district of the country.

DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DayWednesday 20171018

More than 65 AYUSH hospitals have already been developed in the last three years, he

added. AIIA, built on the lines of AIIMS, has an NABH-accredited hospital and an academic

block. The hospital will provide outpatient services and free medicines.

Currently, it will offer clinical services in the area of neurological & degenerative diseases,

rheumatology & musculoskeletal care , diabetes & metabolic disorders as well as yoga.

It will also house a panchakarma clinic, kriya kalpa, diabetic retinopathy clinic, kshara evum

anushastra karma and an infertility clinic. Besides, the institute also has pathology ,

biochemistry , microbiology and radiology laboratories and diagnosis facilities. The indoor

patient department has provision for 200 beds.

Marking `Ayurveda Divas' on Tuesday , Modi described the medicine system as India's

strength and urged those working in the sector to revive it.

He said there was a need to revise the ayurveda syllabus and underlined the requirement for

standard guidelines and treatment in the medicine system so that it is not overpowered by

allopathy He also said the ministries of AYUSH and agriculture can guide farmers to sow

medicinal plants in their fields.This will also help farmers boost their income in line with the

government's plan to double their income by 2022, when India attains 75 years of

independence, he said.

Child Marriage

27% children in India are married before they turn 18, says UN report (Hindustan

Times:20171018)

http://www.hindustantimes.com/india-news/27-children-in-india-are-married-before-they-

turn-18-says-un-report/story-L9GH7YDqabxsGwqge7uHcN.html

The report by the United Nations Fund for Population Activities (UNFPA) says India

continues to lag behind in protecting women from birth-related deaths.

A bride at her wedding ceremony at Bhuvaldi village on the outskirts of Ahmedabad. The

UN said 27% of India’s children get married by age 18 as compared to 28% the world over.

India is on track to population stabilisation but is still lagging behind in preventing child

marriage and protecting mothers from birth-related complications and deaths.

India’s maternal mortality rate (MMR) — mothers dying per 1,00,000 live births — of 174 is

below the global average of 216, but it is a far cry from the MMR of 12 in the more

developed countries, shows ‘State of World Population 2017’ released by United Nations

Fund for Population Activities (UNFPA) on Tuesday.

Twenty-seven percent of India’s children get married by age 18 as compared to 28% the

world over. Among its neighbours, Bangladesh is worst off, with 59% of the married couples

being under-age, followed by Nepal (37%).

The report, which analyses changes in global demographics — birth, migration, aging, death

etc — notes India’s total fertility rate (TFR) — number of children a woman has in her life —

is lower than the world average of 2.5.

India’s downward spiral

India’s maternal mortality rate (MMR) — mothers dying per 100,000 live births — of 174 is

below the global average of 216, but is a far cry from the MMR in more developed regions

Source: UNFPA’s State of World Population 2017

Updated data from India’s ministry of health puts India’s TFR at 2.2. “The latest data shows

TFR has come down to 2.2 but we need to bring it down to 2.1, which is essential for

population stabilisation,” said a senior health ministry official.

The average TFR in India’s neighbourhood of the Asia and the Pacific regions is 2.1, while

it’s 1.7 in more developed countries.

“We are focusing on select districts with TFR of more than three by introducing programmes

specifically designed for the purpose,” said the official.

The report also revealed that gaps in wealth have grown wide within most countries; with

many hundreds of millions living on less than Rs 78 a day.

Govt data shows India’s infant mortality rate has declined 8%

Most stunted under-5 kids in UP, high cases of hypertension in Kerala

The combined wealth of the world’s 2,473 billionaires exceeds $7.7 trillion, which equalled

the combined gross domestic product of four-fifths of the world’s countries in 2015.

The unmet demand for family planning in developing countries, for example, was also found

to be greatest among women in the poorest 20% of households.

Among adolescents, those in the poorest 20% of households in developing countries have

about three times as many births as adolescents in the richest 20%.

Meeting the contraception demand is a foundational element, not just of reproductive health,

but of social and economic equality. In developing countries, the poorest 20% of women are

more likely to give birth without assistance. In rural areas of least developed countries, 48%

of births happened with skilled attendants as compared to 99% in the villages of more

developed countries.

India avoided 1 million child deaths since 2005: study

India’s cities fighting twin issues: Malnourished children, obese adults

India ranks 18th in the world with 81% of its births taking place through skilled personnel,

which is better than 77% globally. Adolescent birth rate per 1,000 girls aged 15-19 years

between 2006 and 2017 is 28. The rate around the world is 44 per 1,000 girls in the same age

group.

Contraceptive coverage is another area that needs government focus, as contraceptive

prevalence rate— percentage of women who are currently using, or whose sexual partner is

currently using, at least one method of contraception — in India remains 56% among women

aged 15-49 years. Those opting for modern contraceptive methods is even less at 50 %.

“We have introduced two new contraceptives this year in a bid to increase the basket of

choice,” said the health ministry official.

Air Pollution

Delhi better equipped to control pollution (Hindustan Times:20171018)

http://paper.hindustantimes.com/epaper/viewer.aspx

EPCA says more monitoring stations in Delhi-NCR will help agencies implement local

solutions quickly

There Are 13 Air Monitoring Stations In Delhi, 5 In Ncr, 2 In Rajasthan And 23 More Will

Come Up In Ncr By Year End

From page 01 NEW DELHI: Delhi-NCR is better prepared to fight air pollution this winter

due to a wider network of monitoring stations, said Supreme Court-appointed body

Environment Pollution Control and Prevention Authority (EPCA) on Tuesday.

Protesters burst crackers outside the gate of Supreme Court in Delhi on Tuesday.

“Till now, the air quality monitoring stations in Delhi were not linked. Also there was,

practically, no air monitoring station in NCR. Now we have 32 stations in Delhi — 19 under

Delhi Pollution Control Committee, five with Central Pollution Control Board and eight

under Union ministry of earth sciences. The network is so dense that now we can take local

actions, if and when required,” said EPCA member Sunita Narain, while announcing

implementation of measures under the ‘very poor’ and ‘severe’ categories of its Graded

Response Action Plan (GRAP) to curb air pollution in Delhi and adjoining areas.

“In NCR, three stations are up at Gurgaon, Faridabad and Rohtak. Thirteen more stations will

come up by December-end in Haryana. In Uttar Pradesh, two stations are functioning in

Noida and Ghaziabad. Another 10 will come up by November-end. In Rajasthan, two stations

have come up in Alwar and Bharatpur,” she added.

The key measures, which are listed under the ‘moderate’ and ‘poor’ categories, have been in

force through the year, with state governments monitoring the progress. The measures

announced by the EPCA on Tuesday will be in force till March 15, 2018.

In November 2016, the Supreme Court directed the government to frame and implement

GRAP to control air pollution. The Union environment ministry notified the plan on January

17, 2017. “The plan is designed like a disaster alert system, which directs governments to

take tougher and tougher actions based on the level of air pollution. The objective is to ensure

that pollution levels do not spike and that emergency measures are not required,” a senior

Delhi government official said.

Apart from closing down Badarpur power plant, which will be shut down permanently in July

2018, the EPCA said the two other thermal power plants in the region, at Dadri and Jhajjar,

will also be shut down if pollution touches emergency levels.

Apart from this, brick kilns, which have not converted to a cleaner zig zag technology, have

been ordered to shut down.

However, experts warned that Delhi’s air quality is likely to worsen and turn ‘severe’ a day

after Diwali, mainly due to meteorological conditions that will trap pollutants from local

sources such as firecrackers and vehicles.

With an air quality index (AQI) of 308, the city’s air quality was recorded as ‘very poor’ by

the Central Control Pollution Board (CPCB) on Tuesday and the possibility of it turning

‘severe’ is looming large. However, if air quality deteriorates further and AQI goes beyond

500, severe plus or the emergency action plan under GRAP shall come into force, which

proposes a ban on construction activities, implementation of odd-even scheme, ban on entry

of trucks and closure of schools.

Cancer

AI system can spot breast lesions at risk of being cancerous cutting down number of

surgeries(The Hindu:20171018)

http://www.hindustantimes.com/fitness/ai-system-can-spot-breast-lesions-at-risk-of-being-

cancerous-cutting-down-number-of-surgeries/story-jP70ZS916KbaQtAExoYJ5L.html

High-risk breast lesions are biopsy-diagnosed lesions that carry an increased risk of

developing into cancer.

Many high-risk lesions do not pose an immediate threat to the patient’s life and can be safely

monitored with follow-up imaging, sparing patients the costs and complications associated

with surgery.

Many high-risk lesions do not pose an immediate threat to the patient’s life and can be safely

monitored with follow-up imaging, sparing patients the costs and complications associated

with surgery.(Shutterstock)

Scientists have developed an artificial intelligence (AI) system that can identify which breast

lesions are likely to become cancerous - potentially reducing unnecessary surgeries. High-risk

breast lesions are biopsy-diagnosed lesions that carry an increased risk of developing into

cancer.

Due to that risk, surgical removal is often the preferred treatment option. However, many

high-risk lesions do not pose an immediate threat to the patient’s life and can be safely

monitored with follow-up imaging, sparing patients the costs and complications associated

with surgery.

“Most institutions recommend surgical excision for high- risk lesions such as atypical ductal

hyperplasia, for which the risk of upgrade to cancer is about 20 per cent,” said Manisha Bahl,

from Massachusetts General Hospital (MGH) and Harvard Medical School in the US.

“For other types of high-risk lesions, the risk of upgrade varies quite a bit in the literature,

and patient management, including the decision about whether to remove or survey the

lesion, varies across practices,” Bahl said. Researchers studied the use of a machine learning

tool to identify high-risk lesions that are at low risk for upgrade to cancer.

Breast Cancer Awareness Month: Double mastectomy may negatively affect employment

Scientists offer a ray of hope for patients with rare bone cancer

“Because diagnostic tools are inexact, there is an understandable tendency for doctors to

over-screen for breast cancer,” said Regina Barzilay, professor at MIT. “When there’s this

much uncertainty in data, machine learning is exactly the tool that we need to improve

detection and prevent overtreatment,” said Barzilay.

Machine learning is a type of artificial intelligence in which a model automatically learns and

improves based on previous experiences. The model developed by researchers analysed

traditional risk factors such as patient age and lesion histology, along with several unique

features, including words that appear in the text from the biopsy pathology report.

The researchers trained the model on a group of patients with biopsy-proven high-risk lesions

who had surgery or at least two-year imaging follow-up. Of the 1,006 high-risk lesions

identified, 115, or 11% were upgraded to cancer.

After training the machine learning model on two-thirds of the high-risk lesions, the

researchers tested it on the remaining 335 lesions. The model correctly predicted 37 of the 38

lesions, or 97 per cent, that were upgraded to cancer. The researchers also found that use of

the model would have helped avoid almost one-third of benign surgeries.

Diseases

Plethora of diseases threaten to mar festivities (The Hindu:20171018)

http://www.thehindu.com/news/cities/Delhi/plethora-of-diseases-threaten-to-mar-

festivities/article19880477.ece

Doctors ask people to stay away from Diwali pollution, urge them to take precautionary

measures

With a spike in cases of viral fever, swine flu, dengue, chikungunya, respiratory infections

among residents, the Capital seems to be entering Diwali festivities with a plethora of

diseases.

Dr. Vikas Maurya, senior consultant and Head of the Department, pulmonology and sleep

disorders department, Fortis Hospital, Shalimar Bagh, said: “Last year, we had several

patients who came in with health complications triggered by the festival celebrations.”

“It is advisable that we observe safety and security measures for a safe Diwali. We are sure to

see more children coming in this year too with a compromised respiratory capacity which

could be because of multiple flu, changing seasons and rise in pollution levels. Spiked

pollution levels during Diwali could prove difficult for those already affected,” he added.

‘Avoid injuries’

But it isn’t just seasonal flu that the city doctors are warning people about, Dr. Rohit Batra,

dermatologist, Sir Ganga Ram Hospital said.

“Diwali is all about firecrackers and we have to avoid injuries. Make sure your kids are

wearing cotton clothes. Avoid synthetic clothes as they catch fire quickly.”

Dr. Bornali Datta, associate director, respiratory and sleep medicine, Medanta - The

Medicity, said: “Control pollution as much as you can. The farmers should be given an

alternative option to dispose of the stubble as their burning adds to particulate matter

pollution in the atmosphere.”

“Since, winter is about to begin, you need to understand that early mornings and evenings are

the time you should avoid going out. At that particular time, the air is denser with particulate

matter that settles down as the temperature is lower. Go for walks during daytime and wear

masks. You should use air purifiers at home. If you are a person with respiratory problems,

you should use medication and inhalers. One should stay indoors as much as possible. The

patients should actively get themselves vaccinated and follow a healthy lifestyle. However, if

the problem still persists, seek medical attention and visit the nearest hospital,” Dr. Datta

said.

Eat healthy

Adulteration is another concern. Dr. Sushila Kataria, director, internal medicine, Medanta -

The Medicity, said: “We should be careful while buying sweets and eatables during Diwali as

there are many cases of adulteration that come up every year. We are already receiving twice

the number of cases for gastroenteritis and acidity.”

The festival also takes its toll on expecting mothers and children. “Smoke and pollution from

the firecrackers can be harmful for women, particularly if they are pregnant,” said Dr. Shobha

Gupta, medical director and IVF specialist from Mother’s Lap IVF Centre.

Severe cases of skin allergies are also noticed during and after Diwali. Due to the increase in

pollutant levels, complains of eye burns, skin allergy and skin rashes are often heard.

Stress

Stress may harm gut health as much as junk food (Medical News Today:20171018)

https://www.medicalnewstoday.com/articles/319780.php

Research suggests that stress has the same effect on gut microbiota as a high-fat diet.

Be it financial worries, work pressures, or relationship problems, we all get stressed from

time to time. To what extent does stress harm us, though? According to a new study, stress

may be just as detrimental to our health as junk food — for women, at least.

Researchers found that stressed female mice experienced changes to their gut microbiota —

that is, the community of microorganisms that reside in the intestine — comparable with

what is seen in response to a high-fat diet. In male mice, however, stress appeared to have no

effect on gut microbiota.

Study co-author Laura Bridgewater, of the Department of Microbiology and Molecular

Biology at Brigham Young University in Provo, UT, and colleagues say that their findings

indicate that the gut microbiota may play a role in gender-specific health outcomes in

response to stress.

The researchers recently reported the results of their study in the journal Scientific Reports.

According to the American Psychological Association, around 80 percent of people in the

United States report experiencing at least one symptom of stress in the past month.

It is common knowledge that stress can have negative implications for both emotional and

physical health, including an increased risk of anxiety, depression, and obesity. The new

study suggests that some of these implications may be down to how our gut microorganisms

respond to stress.

Diet, stress, and gut microbiota

Bridgewater and her colleagues came to their findings by testing a large group of male and

female mice. Half of the female mice and half of the male mice were fed a high-fat diet for 16

weeks, while the remaining mice were fed a standard chow diet.

After 16 weeks, the entire group of mice was subjected to mild stress once or twice per day

for a total of 18 days. Stressors included a forced swim in cold water, damp bedding, and

predator sounds and smells.

How broccoli protects your gut

Researchers reveal the mechanisms behind broccoli's benefits for gut health.

The researchers analyzed fecal samples taken from the mice before and after stress exposure,

in order to determine how their gut microbiota had been affected by diet and stress.

Additionally, the team measured the rodents' anxiety levels, as determined by how far they

were willing to roam in an open maze.

Stress 'causes distinct physical changes'

Both male and female mice demonstrated significant changes to gut microbiota in response to

a high-fat diet.

Compared with female mice fed a high-fat diet, the team found that male mice fed a high-fat

diet showed greater anxiety. In response to stress, the male mice fed a high-fat diet also

showed reduced physical activity, compared with female mice fed a high-fat diet.

However, among mice fed the standard chow diet, the researchers found that female mice

displayed gut microbiota changes in response to stress that were similar to those seen in

response to the high-fat diet. No such response was seen in male mice fed standard chow.

According to the researchers, their findings indicate that stress may have different effects in

men and women due to its impact on gut microbiota.

"Stress can be harmful in a lot of ways," says Bridgewater, "but this research is novel in that

it ties stress to female-specific changes in the gut microbiota. We sometimes think of stress as

a purely psychological phenomenon, but it causes distinct physical changes."

The team cautions that their study was conducted in mice, but they do believe that the results

may apply to humans.

"In society, women tend to have higher rates of depression and anxiety, which are linked to

stress. This study suggests that a possible source of the gender discrepancy may be the

different ways gut microbiota responds to stress in males vs. females."

Schizophrenia

Schizophrenia affects whole-brain connectivity, major study finds (Medical News

Today:20171018)

https://www.medicalnewstoday.com/articles/319776.php

A new study shows that the brain's entire white matter (shown here) is disrupted in

schizophrenia.

In the largest study of its kind to date, 160 scientists from 27 institutions worldwide set out to

examine how schizophrenia affects the brain's white matter, which is the fatty substance

found in the deep tissues of the brain.

To this end, the researchers examined the data available on almost 2,000 people with

schizophrenia, comparing them with data on more than 2,300 healthy controls.

Researchers looked at the brain's white matter, which can be found in the subcortical areas of

the brain. White matter contains nerve fibers, which it protects by keeping them in a myelin

sheath.

White matter is also responsible for improving the communication between neurons, making

it speedier and more efficient.

The data for the new study were collected from 29 existing studies conducted by the

Enhancing Neuro Imaging Genetics through Meta Analysis (ENIGMA) global consortium.

ENIGMA is led by Paul Thompson, of the Imaging Genetics Center at the Institute for

Neuroimaging and Informatics in the Keck School of Medicine, which is part of the

University of Southern California (USC), Los Angeles.

Neda Jahanshad, who is an assistant professor of neurology at the Imaging Genetics Center

within the USC's Neuroimaging and Informatics Institute, co-led the study together with

Sinead Kelly, who is a researcher at the USC's Neuroimaging and Informatics Institute in the

Keck School of Medicine.

Kelly is also the first author of the paper, which was published in the journal Molecular

Psychology.

'A disorder of global brain connectivity'

Kelly and her colleagues used data obtained using diffusion tensor imaging, which is a type

of magnetic resonance neuroimaging that enables researchers to estimate the location and

orientation of the brain's white matter fibers.

Diffusion tensor imaging works by tracking the movement of water molecules in the brain's

white matter.

The study found that the brain's entire communication system — and not just isolated areas

— seems to be disrupted in schizophrenia.

In the authors' words, schizophrenia may be "a disorder of global brain structural

connectivity."

Schizophrenia 'voices' quietened by magnetic stimulation

Transcranial magnetic stimulation may reduce auditory hallucinations in people with

schizophrenia.

"We can definitively say for the first time that schizophrenia is a disorder where white matter

wiring is frayed throughout the brain."

Sinead Kelly

However, two brain areas were found to be affected more than others. One is a brain region

known as the corpus callosum, which enables the two hemispheres to communicate with one

another, and the other is the frontal part of the so-called corona radiata, which is a brain

region key for processing information.

To the authors' knowledge, this is the largest ever study of schizophrenia and the brain's

white matter.

Significance of the study

The research challenges the existing consensus, which posited that schizophrenia occurs

because of disruptions that arise exclusively in the prefrontal and temporal lobes. These are

brain regions known to regulate personality, decision-making, and auditory perception.

"Without this study, future research could have been misdirected [...] Rather than looking for

genes that affect a certain 'stretch of wiring,' scientists will now look for genes that affect the

brain's entire communication infrastructure."

Prof. Neda Jahanshad

"We're showing that just studying a single brain region to try to find out what causes

schizophrenia is not a good approach," she continues.

"The effect is global. Focusing on a certain part of the brain where you think that effect will

be is not going to give you the whole story."

"Our study," says Kelly, "will help improve the understanding of the mechanisms behind

schizophrenia, a mental illness that — left untreated — often leads to unemployment,

homelessness, substance abuse, and even suicide."

In fact, the United States Department of Housing and Urban Development estimate that 26

percent of all the homeless people staying in a shelter live with a "serious mental illness such

as schizophrenia."

Also, the National Institute of Mental Health say that 1.1 percent of U.S. adults have

schizophrenia. Current treatment options are limited, as the causes of schizophrenia are

unknown.

"These findings," adds Kelly, "could lead to the identification of biomarkers that enable

researchers to test patients' response[s] to schizophrenia treatment."

Next steps stemming from this research include examining the causes for the observations

noted in this study. Kelly notes the hereditary aspect of the disease, suggesting that specific

genes could alter the entire brain's wiring.

Medical News Today, in fact, have recently reported on a large-scale study that confirmed

that 80 percent of schizophrenia's risk is genetic.

Diabetes

Type 2 diabetes: Blood sugar pill shows promise (Medical News Today:20171018)

https://www.medicalnewstoday.com/articles/319772.php

Semaglutide in the form of a pill may help type 2 diabetes patients to achieve better glycemic

control.

The pill form of the drug semaglutide is worth pursuing as a way to control blood sugar in

patients with type 2 diabetes, say researchers.

So concluded a phase II clinical trial that found that the pill was better at glycemic control

than a placebo over a 26-week period.

A report on the trial — by lead author Dr. Melanie Davies, of the Diabetes Research Centre

at the University of Leicester in the United Kingdom, and colleagues — has been published

in JAMA.

The results justify phase III trials to assess the longer-term effects and safety of semaglutide

in pill form to help patients with type 2 diabetes to control blood sugar, note the authors.

More than 90 percent of the 30 million people living with diabetes in the United States have

type 2 diabetes, which is a condition that develops when the body cannot use insulin properly

to help cells turn blood sugar, or glucose, into energy.

Many patients can manage their type 2 diabetes by eating a healthful diet, partaking in

exercise, and taking medications to help control blood sugar, or achieve glycemic control.

Need for pill form of semaglutide

To select the right medication, doctors need to consider the complexity of the treatment and

the risk of side effects, such as low blood sugar, or hypoglycemia, and weight gain.

One option is the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide, which is

currently administered as an injection.

However, the authors suggest that a pill version of semaglutide might be more acceptable for

some patients and thus increase the number of people who follow the recommended regimen

to reduce their risk of complications.

Before a new version of a drug can be approved, it must undergo a series of clinical trials. In

a phase II trial, different doses of the drug are compared with a "dummy," or placebo. Then,

if the results are favorable, the drug progresses to a larger, phase III trial to test its

effectiveness and safety.

For their phase II trial of the pill version of semaglutide, Dr. Davies and her colleagues

enrolled 632 type 2 diabetes patients whose current treatment was not achieving sufficient

glycemic control, for instance through diet and exercise, or through use of metformin.

'Significantly' better than placebo

The researchers randomly assigned the patients to several groups, all of which underwent

treatment for 26 weeks. Some groups received a daily pill version of semaglutide or a

placebo, while others received a weekly injection of semaglutide. Those who received the pill

version were in groups that received different fixed daily doses, or gradually escalating daily

doses.

The main measure used by the team to evaluate the effectiveness of the drug was the effect

on patients' hemoglobin Alc (HbA1c) levels. The HbA1c test checks the amount of glucose

that is attached to hemoglobin, which is the oxygen-carrying protein in red blood cells.

Omega-6 could lower type 2 diabetes risk by 35 percent

The results showed that the average change in HbA1c over the 26 weeks of the trial fell in all

the groups, with the biggest fall being in the group that received semaglutide by injection.

However, all dosages of the pill form of semaglutide reduced average HbA1c "significantly

more than placebo by week 26," note the authors.

The reduction in average HbA1c in the oral semaglutide groups ranged from -0.7 percent to -

1.9 percent, depending on dosage, while reductions in the placebo group were -0.3 percent. In

the group that received semaglutide by injection, the average reduction was -1.9 percent.

Of the patients who received the pill form of semaglutide, between 44 and 90 percent

(depending on dosage) achieved the target level of HbA1c of under 7 percent, having started

at an average of 7.9 percent at baseline.

'Clinically relevant' weight loss

The results also show that 71 percent of patients on the pill form of semaglutide achieved a

"clinically relevant" weight loss of 5 percent or more. Overweight and obesity are significant

contributors to type 2 diabetes.

The side effects of taking the oral version were similar to those that occur with the injectable

form of semaglutide.

The authors conclude that, in the type 2 diabetes patients on whom they tested it, the pill form

of semaglutide achieved better glycemic control than placebo over 26 weeks. They say:

"These findings support phase III studies to assess longer-term and clinical outcomes, as well

as safety."

They note that the study has several limitations, with the main one being that it only lasted for

26 weeks. The team suggests that future studies should also test the effect of oral semaglutide

in participants with higher levels of HbA1c "to explore its potential in patients who are less

well controlled, and in combination with other glucose-lowering agents."

Oncology

Cancer recurrence may be stopped with immunotherapy (Medical News

Today:20171018)

https://www.medicalnewstoday.com/articles/319765.php

T cells are normally able to attack cancer cells (shown here), but new research finds that

residual malignant cells can subvert T cells' vigilance.

It is common for cancer to unexpectedly recur after a patient is cleared of the disease. New

research sheds light on why this happens, zooming in on the body's immune system.

The new research was a collaborative effort among scientists at the Institute of Cancer

Research in London, the Leeds Institute of Cancer and Pathology, and the University of

Surrey in Guildford — all of which are in the United Kingdom — and researchers from the

Mayo Clinic in Rochester, MN.

The Mayo Clinic's Tim Kottke is the first author of the study, and the findings have been

published in the journal Cancer Immunology Research.

Kottke and his colleagues set out to investigate why cancer recurs after many years of tumor

latency. As the authors explain, understanding and preventing this phenomenon is highly

important because usually, when the cancer recurs, it does so unpredictably and more

aggressively than the first time.

This happens because the cancer becomes resistant to treatment. As the authors note,

knowing how the recurrent tumors differ from the initial ones, as well as what triggers them,

would enable clinicians to intervene in a more timely and effective manner.

How cancer cells subvert the immune cells

To gain a better understanding of these aspects, Kottke and colleagues designed a mouse

model of cancer dormancy.

After treating mice that had cancer with chemotherapy, the rodents seemed cured for between

40 and 150 days. However, after a longer follow-up period, some of them "developed late,

aggressive local recurrences, mimicking the clinical situation in multiple tumor types."

After performing several experiments in vivo and in cell cultures, the researchers put this

relapse down to the "subversion" of two main elements of the immune system: the so-called

TNF-alpha chemical, and natural killer (NK) cells.

New cancer-causing syndrome uncovered

First and foremost, they showed that after treatment, the residual cancer cells subverted the

TNF-alpha chemical signal by turning it from an anti-tumor, immune-supporting agent into a

growth factor for the disease.

Secondly, they unraveled the mechanism that weakens the surveillance abilities of both T

cells and NK immune cells.

The scientists found that resistant malignant cells are covered with a large amount of a

molecule called PD-L1, which, in turn, interacts with another molecule called PD-1 on

immune cells, "instructing" the T cells not to attack.

So, Kottke and his team gave the mice a PD-1 or TNF-alpha inhibitor intravenously and

found that "long-term treatment [...] effectively slowed, or prevented, recurrence."

Immunotherapy could 'block' relapse

Study co-author Alan Melcher, a professor of translational immunotherapy at the Institute of

Cancer Research, comments on the findings, saying, "Our study finds the body's own

immune system seems to play a crucial role when cancer relapses."

"The immune system goes from keeping cancer cells in check to awakening and feeding

residual cells, while turning a blind eye to their growth."

Prof. Alan Melcher

"Excitingly," he continues, "many of the methods employed by treatment-resistant tumors to

regrow and hide from the immune system can be blocked using existing immunotherapies."

"This idea is, in fact, supported by emerging data from clinical trials, showing that

immunotherapies can reduce the risk of cancers coming back," explains Prof. Melcher.

Study co-author Kevin Harrington, who is a professor of biological cancer therapies at the

same institute, also weighs in. "It is becoming [increasingly] clear that the immune system is

at the core of the puzzle of how we can treat cancer more effectively," he says.

"This fascinating new study," adds Prof. Harrington, "helps explain why sometimes a

patient's immune system can be effective against cancer cells while at other times it is not."

"Changes must occur in these [cancer] cells that make them better able to manipulate the

immune system — and understanding this could open up new treatment options to prevent

relapse," Prof. Harrington concludes.

Rabies Vaccine (Dainik Jagran:20171018)

http://epaper.jagran.com/ePaperArticle/18-oct-2017-edition-National-page_14-4700-21218-

262.html

ȡɮ ȡ [

× Ȫ¡ ȡका जायका और ] ȧसेहत (Hindustan:20171018)

http://epaper.livehindustan.com/story.aspx?id=2294976&boxid=65406724&ed_date=2017-

10-18&ed_code=1&ed_page=15

इनसे Ʌपरहेज

’चीज और È से बने ȡɮ ȡ [

’मैदे से बने Ǘã  , ȡè ȡया ͪ Ï

’सफेद चावल (Ħȡ̀ राइस का ^è ȯ ȡ Ʌ, ǔ   ȧ ȡğ \ ȡɮ ȡ¡ ȣपरत हटाई गई हो)

’तला भोजन (उबला, भुना या देर तक पकाया गया भोजन खाएं)

’ ȡǐ का दधू और Èȯके आटा से तैयार सूप

’कोला, Ȱ ȧ ͧ ȡपेय ȡ [और पैकेटबंद जूस

ǐƬ ȡकौल और ǕĮ Ȣघोषह हम सबको पता था ͩ × Ȫ¡ ȡɉका मौसम आ रहा है। इस मौसम ȧ

Ǖǽ] हो Ǖ ȧ है, और यह नए साल ȧ Ǖǽ] तक ȡȣरहेगा। ¡ ȣवह È होता है, जब हम

एक-दसूरे से ͧ ȯ¡ ɇ, ȡǑ[ ȡȲकरते ¡ ɇ, अपने घर-ǐȡ के Ȫ ɉके साथ अपनी Ǖͧ ȡȲबांटते ¡ ɇ

और गुलाबी ठंडक के बीच तरह-तरह के लजीज ȡ ɉका मजा उठाते ¡ ɇ@सवाल यह है ͩ इस साल

आप इन सबसे तालमेल कैसे ǒȡf Ȳ ȯ?आहार ͪ ȯ£ ɉको यह पता है ͩ लोभ ͩ Ȣमायावी होता

है? वे \ Í Ȥतरह जानते ¡ ɇͩ सामने Ƚका ͫÞȡदेखते हुए `   Ʌसे एक Ƚउठाने से खदु को

रोकना ͩ ȡ Ǖǔæ होता है या × Ȫ¡ ȡȣदावत Ʌमनपसंद å Ȳ को दोबारा मांगने से बचना

ͩ ȡकचोटता है? परेशान मत होइए। इस मौसम Ʌअपने खान-पान को è ȡ[ ȣȯसे Ǔ Ȳǒğ

करने का È अब आ गया ¡ Ȱ@ͪ ȯ£ ɉ ȧ ȡɅ, तो Ǒ आप बाहर ͩ   ȢȯèȪɅ Ʌखाने ȧसोच

रहे ¡ ɉ, तो जापानी भोजन ȡ ȧबेहतर ͪ ã है। जापान को  ͧ [ Í Ȣ ȣऔर सुशी (चावल व

Í Ȣ ȣको ͧ ȡ तैयार होने वाला एक जापानी भोजन, िजसे   Ǖġȣशैवाल Ʌलपेटकर

परोसा जाता है) का देश समझने ȧभूल न Ʌ@जापानी å Ȳ Ï ȡȡ ¡ ãȯहोते ¡ ɇ, ` Ʌकम

तेल का ^è ȯ ȡ होता है और ` Û¡ Ʌबनाने ȧ ͪ ͬ सेहत के ͧ ¡ ȡ से बेहतर है। ȰÈ  ¡ ȯã ȯ Ʌ

ȡ ȯǑÈ  ȧȣ हेड (¢ ȯğȢ Ĥ Ǖ ) ȣǓ समदार कहती ¡ ɇ, ‘जापान और Ȫǐ ȡजैसे ȯ ɉके

खान-पान Ʌशैवाल और कम-Ȱ Ȫȣȡ ȣ  ǔÞ ɉका Ï ȡȡ^è ȯ ȡ ͩ ȡजाता है। यह खाना

उनके ͧ f ȡ ȧफायदेमंद है, जो ȡ ǒȣ से Ȣͫ° ¡ ɇया ǔ Û¡ ɅǑ या जीवन Ȱ ȣसे जुड़ी कोई

Ȣ ȡȣहै।’ Ǘ Ú   ȡ के आसपास के Ǒ¡ è  ɉ Ʌिजस तरह का खान-पान है, वह भी आहार ͪ ȯ£ ɉ

को खबू लुभाता है। इस तरह के å Ȳ ɉ Ʌh ͧ ऑयल (जैतून के तेल) और लहसुन का ^è ȯ ȡ

तो होता ¡ ȣहै,   Ǖġȣभोजन व ¡ ȣ× ȯȡ   ǔÞ ȡȲभी बड़ी ȡğ Ʌहोती ¡ ɇ@Ǒã ȣ ȧएक पोषण

ͪ ȯ£ नेहा अरोड़ा कहती ¡ ɇ, ‘h ͧ ऑयल, बादाम व ȣवसा के èè è ȯ माने जाते ¡ ɇ@

Ǘ Ú   ȡ ȣ भोजन Ʌलाल मांस (गाय या भेड़ का मांस) और चीनी ȧ ȡğ भी ȡ ȧकम होती है,

िजसके कारण यह ȡ ȧसेहतमंद बन जाता है।’अगर आप ^Ȱͧ भोजन लेने ȧसोच रहे ¡ ɇ, तो

ȡè ȡसे बचने ȧ Ȫͧ Ʌ, È ɉͩ इसे \ × ͬ सफेद सॉस या È के साथ पकाया जाता

है। हां, Ǒ टमाटर Ʌबना गेहंू ȡè ȡहो, तो वह कम Ȱ Ȫȣवाला होगा। ^Ȱͧ खाने Ʌसलाद भी

ȡ ȧÏ ȡȡहोता है, जो भले ¡ ȣआपके भोजन ȧ ȡğ बढ़ा दे, ȯͩ उसका सेहत पर नुकसान ¡ ȣȲ

के बराबर होता है। Ǒ आपका खाने-पीने पर कोई Ǔ Ȳğ ¡ ȣȲऔर भोजन सामने देखकर आप उस

पर टूट पड़ते ¡ ɉ, तो ȯèȪɅ Ʌकम से कम ऐसे å Ȳ ɉका चनुाव Ʌ, जो सेहत के ͧ ¡ ȡ से

फायदेमंद हो। नेहा अरोड़ा ȧ ȡɅ, तो भारतीय ȯè ȡȲ Ʌपनीर ǑÈ ȡया ȲǗȣ ȡ ȣ ȣजा सकती

है, ͩ ¢ͯ भारतीय å Ȳ ɉ Ʌतले हुए °ɉ ȧबजाय भाप से ȧ^ ȣका h [ देना बेहतर

होगा। गहरे तले हुए भोजन ȧबजाय × Ȫ¡ ȡȣमौसम Ʌभुने हुए, ¡ ãȯतले, उबले या भाप Ʌपके

å Ȳ ɉका चनुाव आपके खान-पान को   Ȳ Ǖͧ रख सकता है। इसी तरह, मैदा से बने å Ȳ ɉ ȧ

बजाय Ȫ ǕÈ गेहंू से बने पकवान ] ȧȰ Ȫȣको ȡ ȧकम कर सकते ¡ ɇ@̂  समय कभी न

कभी आपको चाइनीज खाने ȧसलाह भी ȣजाएगी। मगर चीनी å Ȳ ɉ Ʌभी मैदा से बने Ǘã  से

परहेज Ʌऔर `   ȧजगह गेहंू से बने Ǘã  का h [ Ʌ@कई चाइनीज ȯè ȡȲके ȰÛ Ǘ Ʌयह

ͪ ã आपको आसानी से Ǒ भी जाएगा। इसी तरह, ĥ ȡ राइस ȧबजाय भाप से पके या Ħȡ̀

चावल का चनुाव Į ȯ è रहेगा। और ȣ(Ē ȯȢ) ȡ ȣ  Þ Ȣलेने ȧबजाय सूखे å Ȳ ɉका èȡ

Ʌ@̂ Ʌवसा ȧ ȡğ कम होती है। और हां, इन × Ȫ¡ ȡɉ Ʌकोला और पैकेटबंद जूस से Ǿ परहेज

Ʌ@̂ ȧबजाय नींबू का ताजा जूस, ȡǐ पानी या ताजा ɉका जूस Ʌ, इससे आपके वजन

पर Ï ȡȡअसर ¡ ȣȲपड़गेा।खाना ¡ ȣ ¡ ȣȲ, इन Ǒ ɉअपने ȣ को पढ़ना भी आपके ͧ f ȡ ȧ

Ǿ ȣ है। ͪ ȯ£ ɉका कहना है ͩ आप महज èè ȣȯअपनाकर छह ¡ Ý ȯ Ʌतीन से पांच

ͩ Ȫतक अपना वजन कम कर सकते ¡ ɇऔर अपनी कमर एक या दो इंच तक घटा सकते ¡ ɇ@बस

इसके ͧ f आपको अपने खान-पान पर ͪ ȯ Ú ȡ देना होगा और रोजाना 40 ͧ तक å ȡ ȡ

करना पड़गेा। ऐसा करने के साथ-साथआप इस बात पर भी गौर Ʌͩ आपको मसालेदार या चटपटे

भोजन ȧ Ǿ È ɉपड़ती है? यह पता करने ȧ Ȫͧ Ʌͩ ¡ ȣȲअपनी Ȫǐ को दरू करने

के ͧ f तो आप ȡæ ȡया Ǿ से \ ͬ खाना ¡ ȣȲखा रहे ¡ ɇ? È ȡहर कोई भोजन कर रहा है,

^  ͧ f आप भी खाने पर टूट रहे ¡ ɇ? È ȡ ͩ   Ȣकाम से Ú ȡ हटाने के ͧ f आपको खाने ȧ Ǿ

महसूस हो ¡ ȣहै? या आप तनाव Ʌ¡ ɇ, ^  ͧ f खाने ȧतलब जगी है? ȡǑ¡ है ͩ भूख जगने के

मूल ȡ ɉको गंभीरता से Ȫ Ʌऔर ` Û¡ Ʌदरू करने का Ĥ ȡ  Ʌ; वरना सेहत के ͧ ¡ ȡ से

फायदेमंद å Ȳ ɉ ȧतलाश Ʌऔर उनको अपने आस-पास Ʌ, ȡͩ Ǿ के समय उसे खाया

जा सके।वजन घटाने के È Ʌभोजन छोड़ने से भी ¡ Ʌबचना ȡǑ¡ f , खासतौर से ȡæ ȡसे,

È ɉͩ यह आपके पूरे Ǒ का सबसे सेहतमंद खाना हो सकता है। ȡæ ȯ Ʌउन å Ȳ ɉको Ǿ

ȡͧ Ʌ, ǔ Ʌ ȡȯ¡ ȡ̂ Ĝȯ और ĤȪȣ हो। इसी तरह, Ǒ के खाने ɅȪȣ,   Þ Ȣ, दाल और

¡ ȣ Ʌ@ ȡȲ  ȡ¡ ȡȣलोग Ǖ ȡ[या ȣका सेवन भी कर सकते ¡ ɇ@पूरे Ǒ का सबसे ¡ ×Ǘ [समय

शाम के पांच और सात बजे के बीच का È होता है, È ɉͩ तब तक लंच (Ǒ का खाना) ͧ f ȡ ȧ

È बीत चकुा होता है और ͫ (रात का खाना) Ʌ ȡ ȧसमय होता है। इस समय ȡæ ȯ ȧतलब

जगती है। ͧ ¡ ȡ ȡĒ Ȣ ȣके साथ ǒèǕ या भुना हुआ चना खाया जा सकता है। नेहा अरोड़ा कहती

¡ ɇ, ‘इस समय ऐसे ȡɮ ȡ Ⱦसे Ʌ, ǔ ɅȰ Ȫȣ ȡ ȧÏ ȡȡ ȡğ Ʌहोती है। जैसे, ͪ Ï ,

[ या अडंे ȧ ȹ] Ǒ से भरे   ɇ ͪ@’ जहां तक रात के खाने का सवाल है, तो शाम नौ बजे के

बाद ͫ करने से Ʌऔर देर रात è Ȱ वगैरह न खाएं। ‘अगर देर रात आपको भूख लगती है, तो

एक कप गरम दधू, कैमोमाइल ȣया फल वगैरह Ʌ@अगर Ǔ ȡ Ǖ  ȡ इन तमाम ] ɉको अपने

जीवन Ʌहम उतार Ʌ, तो ȧ ȡǓ f अपना वजन कम करने के ͧ f ¡ Ʌͩ   Ȣतरह के आहार को

तुरंत बंद करने या ȡ̂ ǑȲ ȧ Ǿ ¡ ȣȲपड़गेी।’ ऐसा नेहा अरोड़ा का मानना है।कई लोग इस

È Ʌउन å Ȳ ɉसे भी परहेज करते ¡ ɇ, ǔ Ʌ ȡȯ¡ ȡ̂ Ĝȯ होता है। वे  ͧ [ फल व   ǔÞ ȡȲ

लेना पसंद करते ¡ ɇ@यह ĤǙǔ× गलत है। ȡȯ¡ ȡ̂ Ĝȯ हमारे ȣ ȧa ȡ[के ͧ f बेहद Ǿȣ है।

ǔÈ Ǔ ȡ̂ Ǒ ͧ और ȡ ǒȣ एजुकेटर ^Ȳġȡ Ȣपवार कहती ¡ ɇ, ‘अपने भोजन Ʌसाबूत

अनाज और Ï ȡ, बाजरा, रागी, जा◌ै जैसे अनाज को Ǿ ȡͧ Ʌ@ये आपका पेट \ ͬ समय

तक भरा Ʌ ȯ@’× Ȫ¡ ȡȣमौसम Ʌͧ ȡ̂ ɉसे परहेज रखना भी लगभग असंभव होता है, ^  Ȣͧ f

पोषण ͪ ȯ£ जुबैदा तुंबी कहती ¡ ɇ, ‘ऐसी सूरत Ʌबादाम, मेवा या ͧ Èè ͧ ȡ_ को ǕɅ@गुलाम

जामुन या ȡ Ǖ ȡ¡ ȣ ȧ\ ȯ¢ ȡ  Ǖã ȡऔर रसमलाई खाना ¡ ȣȲÏ ȡȡबेहतर है। इसी तरह,   Ʌȯ

या भुने हुए ͬ °ȯसे बेहतर ͬ Ü  , Ǒ ȡया Ȩ [लेना फायदेमंद होगा, È ɉͩ ^ Ʌकम Ȱ Ȫȣ

होती है।’ कुल ͧ ȡ , इस मौसम Ʌ Ǿ से \ ͬ कतई न खाएं। वैसे ȨÈɉ ȧ ȡɅ, तो

\ Í ȡ ¡ ȣहोगा ͩ कम खाने ȧआदत को हमेशा के ͧ f अपने जीवन Ʌउतार ͧ ȡजाए। Ǒã ȣ

ȧ ¡ ȯã कोच è ȡ ǕȲġȡभी ¡ ȣराय देती ¡ ɇͩ ‘कम अतंराल पर कुछ न कुछ खाना ¡ ȣ ] [

ǔè Ǔ है। बेहतर है ͩ हर तीन-चार घंटे Ʌकुछ खा ͧ ȡजाए। यह ¡ ȡȣसेहत के ͧ ¡ ȡ से एक

\ Í Ȥआदत है।’

èğȪ : ¡ ͩ Ȳ Ȫè

आंकड़े : Ȱ ȪȣĤǓ इकाई Ʌ

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