Be cautious about OTC drugs

By Syed Akbar
Hyderabad: Suffering from headache, loose motions or common cold? Just don't rush to a chemist for an over-the-counter (OTC) medicine. Chances are that you may develop nausea, severe allergic reactions, kidney failure or even cancer.
More often than not the blame does not lie with the chemist but with the type of drug he gives you. As many as a dozen generic or basic drugs, which have been banned world-wide, are freely available in twin cities. Strangely enough, these drugs enjoy the legal status as they are yet to be banned by the Indian government.
"For a drug to be banned the Central government needs concrete evidence supported by research studies on its bad side-effects. Unfortunately, in India we do not have post-drug follow-up records. Pharmaceutical companies take advantage of this", argues R Uday Bhaskar, secretary-general of All-India Drug Control Officers' Confederation.
He, however, wants these drugs to be banned as "what is bad for people in the USA and Europe is equally bad for Indians, whether we have post-drug follow-up studies or not".
The Central government has banned 76 categories of Fixed Dose Combination or individual drugs. Ironically, the government banned these drugs only after the manufacturers voluntarily withdrew them. Rofecoxid is one such drug. It was found to be dangerous to heart patients. However, many irrational combination drugs are still sold freely.
Some of the drugs banned in the USA, European Union, Australia and developed countries but still available in India are:
Analgin (pain-killer), Cisapride (acidity, constipation), Droperidol (anti-depressant), Furazolidone (anti-diarrhoea), Nimesulide (pain-killer, fever), Nitrofurazone (anti-bacterial cream), Phenolphthalein (laxative), Phenylpropanolamine (cold and cough), Oxyphenbutazone (non-steroidal anti-inflammatory), Piperazine (anti-worms) and Quiniodochlor (anti-diarrhoeal).
Nimelsulide, a non-steroidal anti-inflammatory drug, has been banned in many countries for its reported liver toxicity. The Central government approved Nimelsulide in 1994 for treatment of painful inflammatory musculo-skeletal disorders but many doctors prescribe it for ordinary pain and fever. Nimelsulide and Cyproflaxin (100 mg) have been banned for paediatric use but doctors continue to prescribe them for children.
Dr SV Chandrasekhar, consultant surgeon of Apollo Hospitals, says drugs like analgin should not be used for children while furazolidone is equally bad for adults and children. "Combination drugs are not advisable. When a patient suffers from one problem why should he or she be given a combination of drugs? Vitamins are always sold in combination. A person does not suffer from deficiency of several vitamins or minerals at a time. Overdose may cause severe problems", he points out.


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The side-effects:
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1. Analgin (it is used in dozens of drugs including Novalgin): Causes bone marrow depression, ulcers and reflex action.
2. Cisapride (available under brand names Ciza and Syspride): Causes irregular heartbeat and palpitation.
3. Droperidol (brand name Droperol): Affects the heart and blood circulation.
4. Furazolidone (Furaxone, Lomofen): Nausea, severe headache, cancer and damage to intestines.
5. Nimesulide (Nise, Nimulid): Causes liver failure.
6. Nitrofurazone (Furacin): Causes cancer.
7. Phenolphthalein (Agarol): Found to be carcinogenic.
8. Phenylpropanolamine (D'Cold, Vicks Action-500): May lead to stroke.
9. Oxyphenbutazone (Sioril): Bone marrow depression.
10. Piperazine (Piperazine): Causes damage to nerves.
11. Quiniodochlor (Enteroquinol): Damages eyesight.

Indian children capable of registering high growth rate

By Syed Akbar
Hyderabad: Indian children are capable of registering a high growth rate provided they get a well-balanced nutritional diet during the schooling years.
A study conducted by the city-based National Institute of Nutrition showed micronutrient-rich supplement would increase tissue growth and skeletal shell in apparently normal children. School-children who received micronutrient-rich food recorded growths up to three cm in height and four kgs in weight during the 14 months of study as compared with children fed with regular normal diet.
The NIN carried out the study among residential school-children, between six and 16 years of age, in Hyderabad. As many as 268 children were selected randomly from two classes of each grade (1 to 9) and were provided a micronutrient-enriched beverage. While 146 got the micronutrient-rich beverage, 122 children received a placebo drink.
Bone parametres and bone area at various sites and the entire body were measured with dual-energy X-ray absorptiometry at the beginning and end of the study.
After 14 months, increments for height, weight, fat-free mass, percentage of fat, whole-body bone mineral content, whole-body bone area and bone mass density at the neck of the femur were significantly greater in the supplemented group than in the placebo group.
NIN deputy director Veena Shatrugna, who conducted the research study, told this correspondent that diets in the boarding school provided 745 mg/d of calcium, including the calcium from milk used to reconstitute the respective supplements.
This is the first time that data on bone parametres in children between the ages six and 16 years is reported from India. The baseline values appear to correspond to reported values from the West. In addition, the beneficial effects of an additional calcium intake of 224 mg with other micronutrients in the supplemented group compared with the placebo group have been demonstrated, she pointed out.
The children in this study belonged to middle-income group from the semi-urban areas of Hyderabad with apparent adequate intake of energy and protein, but intakes of vitamin A, iron, folate, thiamin, and niacin were less than 60 per cent of recommended dietary allowance and calcium intakes were only 700 mg/d which is much below the Western RDAs.

Asteroid 2009 BD81: Potential hazardous asteroid makes closest approach to human planet

If the current projections of the asteroid's next visit in 2042 are to be believed, it will fly past the Earth as close as 31,800 km. It will come
even closer in 2046. Robert Holmes discovered the new asteroid while observing a known asteroid on January 31, 2009. This asteroid is potentially hazardous.

February 27, 2009
By Syed Akbar
Hyderabad, Feb 26: A celestial visitor will make a flypast of the human
planet tomorrow giving a glimpse to astrophysicists of the secrets
buried deep in the asteroidal belt that occupies the space between the
Earth and the Mars.

Asteroid 2009 BD81 will make its first-ever recorded trip to the Earth
after it was discovered accidentally 26 days ago. This is the newest
asteroid to have been discovered, but astrophysicists attach importance
to its study as it is one of the 1000 and odd asteroids that are declared
"potentially hazardous".

The asteroid, in this visit, will fly at an astronomically safe distance of
70 lakh km away from the Earth's orbit. But when it comes again in
2042, Asteroid 2009 BD81 may pose severe threat to the human planet
as astrophysicists fear a possible collision then.

"If the current projections of the asteroid's next visit in 2042 are to be
believed, it will fly past the Earth as close as 31,800 km. It will come
even closer in 2046," Planetary Society of India secretary N Sri
Raghunandan Kumar told this correspondent.

The new asteroid is quite small about 1000 ft in diametre and thus is
not visible to the naked eye. It has to be observed through high aperture
telescopes or observatories.

He said in the next nine months as many as 400 asteroids are predicted
to have a "Near Earth Flyby" or closest approach to human planet. At
least 10 per cent of them are hazardous asteroids with a potential threat
of passing too close to the Earth.

The story of "criminal" genes: Criminal activity has genetic basis, says CCMB

Several studies have reported either higher levels of testosterone among rapists or the correlation of shorter CAG repeats with criminal activities. However, to date, no study has analyzed AR gene in rapists worldwide.

February 24, 2009
By Syed Akbar
Hyderabad, Feb 23: Criminal activity has genetic basis too. Though
most of the crimes recorded in the world are influenced by
environmental factors, genes too play a crucial role in pushing people
to commit crimes.

Scientists at the city-based Centre for Cellular and Molecular Biology
have found that the androgen receptors (AR) gene containing Cytosine,
Adenosine and Guanine (CAG) repeat, plays an important role in
shaping the criminal mentality or otherwise of an individual. Those
with shorter repeat of CAG in their AR gene develop antisocial
personality disorders. On an average the CAG repeats 21 times in
normal people and 18 or less number of times in those with criminal
bent of mind.

In the first-ever study conducted on criminals from Indian
subcontinent, the CCMB team analysed the AR-CAG repeat length in
645 men, of which 241 were convicted for rape, 107 for murder, 26 for
both murder and rape, and 271 were control males.

"We found significantly shorter CAG repeats in the rapists (18.44
repeats) and murderers (17.59 repeats) compared to the control men
(21.19 repeats). The criminals who committed murder after rape had a
far shorter mean repeat length (17.31 repeats) in comparison to the
controls or those convicted of rape or murder alone. Our study
suggests that the reduced CAG repeats in the AR gene are associated
with criminal behaviour. This, along with other studies, would help in
understanding the biological factors associated with the antisocial or
criminal activities," CCMB senior scientist Dr K Thangaraj told this
correspondent.

AR gene has strong effect on the function of the central as well as
peripheral nervous system and plays a crucial role in maintaining
masculine reproductive behaviour. Shorter CAG repeats are related to
personality scales characterised by dominance, high verbal aggression,
high monotony avoidance, and low lack of assertiveness in
normal populations.

"Antisocial activities like aggression and tendency to rape or murder,
once thought to be personality specific and influenced by environment
rather than by genes, are gaining more attention among geneticists. Our
present study on AR-CAG repeat length in individuals convicted for
rape or murder revealed a significant difference in the mean length and
distribution of the AR alleles between criminals and the control men.
The association of increased androgens levels or the shorter CAG
repeat length with antisocial activities may indicate additional factors
associated with the criminal activities," Dr Thangaraj said.

A genetic study on criminals may help in understanding if there is some
biological factor, which may affect psychological state of an individual,
and also in proper management and reducing the social burden due to
these offences, if the biological basis of such offenses is established, he
added.

Langerhan's cells histiocytosis: Phase IV trials begin in India

2009
By Syed Akbar
Hyderabad: Hundreds of medical experts and researchers from across the country will collaborate with their counterparts in the USA to finalise a safe drug for a strange and rare disease that afflicts mainly children below two years of age.

Called the Langerhan's cells histiocytosis or simply LCH, the disease
mimics cancer but it is not carcinogenic in nature. It affects several
parts of the body and is a complicated disease, which for decades was
thought to be a form of cancer.

The Histiocyte Society of the United States has sought the help of
medical colleges, hospitals and experts for a network to carryout the
LCH trial in the Indian sub-continent. The trials will begin later this
month. The reference centre will be Vienna, Austria. Drugs that have
been developed to fight this rare disease have already undergone three
phases and the participation of Indians in the fourth phase trials
assumes significance since there are several LCH patients in the sub-
continent.

According to Dr T Vasantha, who is coordinating the trials in the
country, histiocytosis is a very difficult disease to explain and
understand. The disease affects bones, pituitary gland, eyes, liver,
spleen, bone marrow and skin.

This is a randomised trial and randomisation takes place at Indian
Council of Medical Research. The All-India Institute of Medical
Sciences is coordinating the study. Treatment for this rare disease has
been approved and is being marketed. The present study is to evaluate
side effects that were not apparent in the phase III trial. Thousands of
people will be involved in the present phase.

"Medical colleges and hospitals will send samples to AIIMS which in
turn will forward them to the Histiocyte Society," Dr Vasantha said.

HIV-HCV coinfection highest in South India

2009
By Syed Akbar
Hyderabad, Feb 3: HIV patients from South India are two times more
prone to Hepatitis C virus coinfection than their counterparts living in
the North.

Researchers at the city-based Centre for Liver Research and
Diagnostics and the department of biotechnology, Jawaharlal Nehru
Technology University, found that the incidence of HIV and hepatitis C
virus coinfection is 3.02 per cent among HIV patients living down the
Vindhyas. The average coinfection rate for all-India is about 1.5 per
cent.

This in other words means South Indians are more susceptible to
coinfection of HIV and HCV as compared to North Indians. The study
was conducted among others by Dr CM Habibullah, Dr MN Khaja and
Dr M Chandra.

A greater proportion of HIV/HCV coinfected people may progress to
cirrhosis (serious liver scarring) and liver disease than those with HCV
alone. HIV-infected individuals have a high probability of getting
coinfected with HCV.

The team took the samples of 1487 confirmed HIV-positive patients
and tested them for anti-HCV antibodies. Of this, 1443 (97.04 per cent)
were negative and 45 (3.02 per cent) were coinfected. HIV-HCV
coinfection was predominant in the age group 41-50 years (51.1 per
cent).

"The results showed that HIV and HCV seroprevalence is higher in
South India, and the most prevalent genotype in coinfection was
genotype 1b," Dr Khaja told this correspondent.

"Prolonged survival of HIV-infected patients coinfected with HCV
may become an important clinical problem. HIV and HCV show some
common biological features like both are RNA viruses and both show a
large heterogenicity of their viral genomes producing various
genotypes," Dr Khaja said.

Globally, a total of 39.5 million are living with HIV, of whom 5.7
million are from India. Acquired immunodeficiency syndrome has
grown more rapidly than the scientific progress of understanding how
to control the main causative agent.

Globally, hepatitis C virus has infected more than 170 million people
and thus represents a viral pandemic seven times more widespread than
infection with the HIV.
It is estimated that in India about 1.8-2.5 per cent of the population is
presently infected by HCV and about 20 million people are already
having HCV infection.

"The objective is determine the prevalence of HCV antibodies in the
HIV-infected Indian population. This is aimed at providing the baseline
data on HIV/HCV coinfection and gaining better understanding of the
public health issues," he pointed out.

The male predominance was more with 61.5 per cent compared to
females by 38.4 per cent and the median age was 37 years, ranging
from 20 to 55 years. Of them 1183 (79.5 per cent) were heterosexual,
69 (4.64 per cent) were intravenous drug users (IVDs), 45 (3.02 per
cent) were blood transfusion recipients, 115 (7.73 per cent) were
haemophiliacs and 75 (5.04 per cent) were unnoticed.

Tuberculosis Breakthrough: New molecule developed to fight Mycobacterium

2009
By Syed Akbar
Hyderabad, Feb 2: Indian scientists have developed a novel compound that would hit the killer tuberculosis bacteria and cure the disease, which claims about 1000 people everyday in the country.

The novel compound has been successfully tested in laboratory and if it works on human beings, a single drug will be sufficient to deal with the menace of tuberculosis. At present, those suffering from TB are made to take a daily
dose of four drugs. The new development will help in fighting the disease through a single drug. This will save money on medication and prevent side-effects related to multi-drug therapy.

Scientists at the city-based Centre for Cellular and Molecular Biology and the Delhi-based National Institute of Immunology have jointly created the compound. Multi-drug therapy is administered in TB cases as different drugs target different metabolic pathways in Mycobacterium, the causative pathogen, killing it. But the new compound has multiple functions and hits the select metabolic pathways in the bacteria to destroy it.

CCMB scientist Dr Rajan Shankarnarayanan, one of the team members, told this correspondent that the compound stops tuberculosis by hitting four of
the bacterium's crucial metabolic pathways at the same time. "The compound weakens the pathogen before finally destroying it. We have demonstrated it in laboratory tests. However, it takes time before it becomes practical in human beings," he said.

According to Dr Rajan, if everything goes on well, a single drug will help tackle the disease. "A single drug that targets multiple pathways could save time and money by eliminating the need to take so many drugs over a period of say six to nine months," he added.

Mycobacterium tuberculosis, the organism that causes tuberculosis, contains a layer of complex lipids on its outer membrane. The CCMB-NII team found out how the bacterium builds up this complex layer that acts as drug resistant. Once they have solved the mystery, they developed a compound that would hit the metabolic pathways of the causative agent.

Although TB bacteria has been known for centuries, tuberculosis still accounts for more than two million deaths every year. The causative agent has a complex arsenal of virulence factors and has evolved elaborate strategies to escape host surveillance. The cell envelope of the bacteria is endowed with complex lipids, many of which play an important role in its pathogenesis.

"The complex lipids displayed by Mycobacterium tuberculosis are a big factor in its pathogenicity and virulence. Since this single molecule could potentially grind the assembly line to a halt at different stages of infection, this approach provides tremendous opportunity to develop unique antituberculosis drugs," he said.