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السلام عليكم ورحمة الله وبركاته
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Malaria

Resistance spread 'compromising' fight against malaria
By Matt McGrath
Science reporter, BBC WorldService
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Scientists have found new evidence that resistance to the front-line
treatments for malaria is increasing.
They have confirmed that resistant strains of the malaria parasite on
the border between Thailand and Burma, 500 miles (800km) away from
previous sites.
Researchers say that the rise of resistance means the effort to
eliminate malaria is "seriously compromised".
The details have been published in The Lancet medical journal.
For many years now the most effective drugs against malaria have been
derived from the Chinese plant, Artemisia annua . It isalso known as
sweet wormwood.
In 2009 researchers found that the most deadly species of malaria
parasites, spread by mosquitoes, were becoming more resistant to these
drugs in parts of western Cambodia.
This new data confirms that these Plasmodium falciparum parasites that
are infecting patients morethan 500 miles away on the border between
Thailand and Burma are growing steadily more resistant.
The researchers from the Shoklo Malaria Research Unit measured the
time it took the artemisinin drugs to clear parasites from the
bloodstreams of more than3,000 patients. Over the nine years between
2001 and 2010, they found that drugs became less effectiveand the
number of patientsshowing resistance rose to 20%.
Prof Francois Nosten, who is part of the research teamthat has carried
out the latest work, says the development is very serious.
"It would certainly compromise the idea of eliminating malaria that's
for sure and will probably translate into a resurgence of malaria in
many places," he said.
'Untreatable malaria'
Another scientist involved with the study is Dr Standwell Nkhoma from
the Texas Biomedical Research Institute.
"Spread of drug-resistant malaria parasites within South East Asia and
overspill into sub-Saharan Africa, where most malaria deaths occur,
would be a public health disaster resulting in millions of deaths."
The drug artemisinin is derived from the Artemisia annua plant
The scientists cannot tell if the resistance has moved because
mosquitoes carrying the resistant parasites have moved to the Burmese
border or if it has arisen spontaneously among the population there.
Either way the researchers involved say it raises the spectre of
untreatable malaria.
"Either the resistance has moved and it will continue to move and will
eventually reach Africa. Or if it has emerged, now thatartemisinin is
the standard therapy worldwide then it means it could emerge
anywhere," Prof Nosten told the BBC.
"If we were to lose artemisinin then we don't have any new drugs in
the pipeline to replace them. We could be going back 15years to where
cases were very difficult to treat because of the lack of an
efficacious drug."
Artemisinin is rarely used on its own, usually being combined with
older drugsto help fight the rise of resistance. These artemisinin
based combination therapies are now recommended by the World Health
Organization as the first-line treatment and have contributed
substantially to the recent decline in malaria cases in many regions.
Prof Nosten says the current spread of resistancecould be similar to
what happened in the 1970s with chloroquine, a drug that was once a
front-line treatment against the disease.
"When chloroquine resistance reached Africa in the middle of the 1970s
it translated into a large increase in the number of cases and the
number of children who died increased dramatically."
In a separate paper published in the journal Science researchers have
identified a region of the malaria parasite genome that is linked to
resistance to artemisinin.
Dr Tim Anderson, from Texas Biomed who led this study, says that while
mapping the geographical spread of resistance can be challenging it
may be hugely beneficial.
"If we can identify the genetic determinants of artemisinin resistance
we should be able to confirm potential cases of resistance more
rapidly. This could be critically important for limiting the further
spread of resistance."
According to the World Malaria Report 2011 malaria was responsible
forkilling an estimated 655,000 people in 2010 - more than one every
minute. A majority of thesewere young children and pregnant women/

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Health

Sanjana Praveen Shivanka is 20 months old and has severe combined
immunodeficiency (SCID). The Sri Lankan 'bubble baby', suffered from a
condition which forced himto live in a sterile environment as his
immune system was seriously compromised. Like 16 other boys in his
mother's family including his two older siblings, he inherited the
condition. He is the first one to survive.
Praveen came a year ago to Chennai with funds raised by well-wishers
in Sri Lanka for treatment.
The first bone marrow transplant came from his father, but as it was
only a half match, it left him weakwithin a few months. He was
frequently hospitalised and soon he weighed less than what heweighed
at birth.
Praveen returned to India and the second time, he received an
umbilical cord blood stem cell transplant from a Taiwanese donor. A
third transplant, done four months ago, has cured himof the genetic
disease. Praveen is weak and though he will survive, he must be
protected from infection for several years to help him grow strong.
Finding a match for Praveen was a humungoustask that involved a lot of
money. The boy's father makes mattresses in Ratnapura, a town three
hours drive from Colombo. The entire treatment cost his family Rs. 80
lakh (around Rs. 1.50 crore in SriLankan currency).
"The first transplant was only a half match. It was necessary to have
a 100 per cent Human Leukocyte Antigen match to build his immune
system.
The perfect match for Praveen came from a Taiwanese cord blood donor
and we had to pay$8,000 for it. If we were to import it from a
US-based cord blood bank we would have paid $45,000. It is because we
went through the Indian branch of the US-based cord blood bank that
the cost was reduced,"said Revathi Raj, consultantpaediatric
haematologist, Apollo Specialty Hospital, who has been treating the
toddler for the past year.
Only 30 per cent of the time are cord blood stem cell transplants from
familymembers. The rest of the time, the transplants are from
unrelated donors. "The advantage of using cord blood stem cells is
that the child needs to be protected from infection for a shorter time
as withinthree weeks the body produces new cells," Dr. Revathi
explained.
Although cord blood stem cell transplantation is donein some centres
in India it is mostly unaffordable. Families have taken huge loans
hoping to save their children's lives. Stem cells are retrieved from
cord blood that is discarded as biological waste after childbirth. The
blood can be stored for 25 years and the stem cells recovered from it
can be used to treata variety of blood disorders.
There are a few cord blood banks even in India but given the large
number of childbirths in the country, ifwe set up a public cord blood
bank by investing a few lakh rupees we will be able to treat
conditions such as bone marrow failure, thalassemia and sickle cell
anaemia, Dr. Revathi says.
Stem cell transplantation isnow a common treatment option for
leukaemia. But, families often have to take huge loans for treatment
as cord blood is difficult to access.
For instance, Vikram (namechanged) took a loan of Rs.45 lakh for his
son, who had ALL and AML leukaemia. During the course of his child's
treatment for leukaemia atApollo Hospital, which lasted six years (the
child was diagnosed with the disease when he was a year old) he moved
severaljobs in search of money to cover treatment costs.
In one company, the healthinsurance was large enough to cover hospital
expenses but the two cord blood stem cell transfusions that his child
required cost him Rs. 12 lakh. He took several bank loans besides an
advance from his workplace.
Keywords: evere combined immunodeficiency , public blood bank/

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High Blood Pressure

High Blood Pressure
High blood pressure, also known as hypertension, can be a tricky
medical issue because it typically goes unnoticed. According to the
Mayo Clinic, the majority of individuals whosuffer from hypertension
have no signs until their blood pressure reaches dangerous levels.
When high blood pressure symptoms do occur, they include headaches,
nosebleeds and dizzy spells.
The Mayo Clinic recommends seeing a doctor before high blood pressure
symptoms occur. The best way to monitor your blood pressure is to have
your doctor track your readings on an annualbasis. Individuals who
havebeen diagnosed with high blood pressure may requirefrequent
screenings. Ideal blood pressure ratings depend on the person's age
and health history. However, a healthy adult typically has a reading
somewhere around 140/90.
There are several options to treat high blood pressure. First and
foremost, taking a look at your lifestyle and adjustingyour habits can
help ward off or control hypertension.Additionally, you doctor may
prescribe a combination of the following medications: thiazide
diluretics (water pills), beta blockers, angiotensin-converting enzyme
(ACE) inhibitors, angiotensin II receptor blockers, rennin inhibitors,
and calcium blockers. In extreme cases, it may also be appropriate to
prescribevasodilators, central-acting agents, alpha-beta blockersor
alpha-blockers to combat hypertension. Lastly, once your hypertension
is under control, your physician mayinstruct you to take an aspirin a
day to reduce your overall risk of cardiovascular disease. Please
note, only your doctor can properly diagnose and treat your high blood
pressure symptoms/

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