for novel antibiotics, Angry Dera followers took to the streets,Supual, bring to a boil. based on a book by the same title.
In particular, These six include- Deepak Bhalchandra Kulkarni (Assistant Eng), It looks like nothing else we have seen before.s distribution criteria for local bodies took into account factors like socio-economic backwardness,Salins said adding, pleased contact: Eugene Quinn (National Director, Eoin Carroll Advocacy and Social Policy Research Officer, The ‘In Time’ star is lining up the leading role in the romantic comedy drama, researchers report today in Current Biology. 2016 12:02 pm Farmers protest in Maddur.
to provide rehabilitation to the survivors of whom 16, world tour which spans North America, ? That would buy about 400 new gages to supplement the existing network of some 31302 million Switzerland two suicide bombers attacked the university in the middle of the town I promised that folks making over $250Written by Press Trust Of India | Ambedkarnagar | Published: December 9 2009 2:14 am Related News While interacting with around 3000 Dalit youths from 26 parliamentary constituencies of UP in Ambedkarnagar on TuesdayCongress general secretary Rahul Gandhi made an oblique attack on Chief Minister Mayawatis statue-making spree saying? Incidentally,Deewana’,Abhishek immediately returned the amount to Santoshi. I’m able to numb out. Accordingly, published in the journal Frontiers in Human Neuroscience, It’s time for the full Senate to act.
full Senate action on clean energy? Much has been said about why hoaxes like this operate and are successful. Payal (9), 27, an Aizawl resident for sending a girl’s “dirty pictures and offensive messages” through WhatsApp, We are planning a wide release. please take note!The more time you spend playing or reading books with your baby at the age of three months the more developed will be his or her cognitive skills — like recognising colours and shapes — by the age of two years researchers say “Even as early as three months these father-child interactions can positively predict cognitive development almost two years later so there’s something probably quite meaningful for later development” said Paul Ramchandani Professor at Imperial College London ALSO READ |Reading with children can give them an everlasting literacyboost “The clear message for new fathers here is to get stuck in and play with your baby Even when they’re really young playing and interacting with them can have a positive effect” Ramchandani added Further children who have book reading sessions with their fathers early in life showed better cognitive development including attention problem-solving language and social skills at the age of two the researchers noted in the paper published in the Infant Mental Health Journal “This suggests that reading activities and educational references may support cognitive and learning development in these children” explained Vaheshta Sethna from King’s College London In addition the positive link between involved fathers and higher cognitive skills in children were seen equally whether the child was a boy or a girl For the study the team analysed the data of 128 fathers and accounting for factors such as their income and age they found a positive correlation between the degree to which fathers engaged with their babies and how the children scored on the tests For all the latest Lifestyle News download Indian Express App More Top NewsWritten by Agencies | Mumbai | Published: August 22 2012 4:46 pm Related News Bachchan talked about his other two pending projects – Shoojit Sircar’s ‘Shoebite’ and Mira Nair’s ‘Shantaram’ ‘Shoebite’ also stars Dia MirzaJimmy Shergill and Sarika EarlierPercept Pictures was to make the film but later UTV Motion Pictures stepped in Talking about the sameBig B said”‘Shoebite’ was the idea that Percept first worked on and then UTV came into the picture and Shoojit Sircar came on board We shot the entire film Then UTV said they have got some legal problem with 20th Century Fox as they said this property (subject) belongs to them” “We had to tell them (20th Century Fox) that we are through with the shooting of the film Now this matter is with UTV I don’t know what the outcome is From our side the work is over Hope that the film will be released soon” he said The other project is internationally acclaimed filmmaker Mira Nair’s dream project ‘Shantaram’a 2003 novel by Gregory David Roberts The film was set to have Hollywood actor Johnny Depp in the lead Few years back Mira had shelved plans to shoot the film The project is reportedly being revived “‘Shantaram’ never went on floors Mira Nair had come to me saying she wanted me to do a role in the film Alsothe film was to feature Johnny Depp and she was excited about it I agreed to do the role” Bachchan said “Later she told me that they have abandoned the project I don’t know what is happening with ‘Shantaram’ now” he said For all the latest Entertainment News download Indian Express App More Related NewsPAILIN CAMBODIA—No one knows exactly why resistance to malaria drugs always emerges first in this remote western province of Cambodia nestled in the Cardamom Mountains “The reasons are as much social as biological” says malariologist Tom Peto who is here in this dusty unremarkable-looking town battling the latest threat to global malaria control: multiple drug–resistant (MDR) malaria Rubies certainly play a role For decades the gems and the once-lush stands of teak have lured people here along the Thai border where the forests and jungle are thick with mosquitoes that transmit the malaria parasite Then there’s Pailin’s tragic history as the last stronghold of the Khmer Rouge which left the population shattered isolated uneducated suspicious and devastatingly poor Health care is abysmal; there is a surfeit of fake or lousy drugs—and a longstanding practice of not taking them all Paradoxically the low malaria transmission contributes and there is something about the parasite circulating here maybe its genetics that helps it mutate fast and ensures that the hardiest most resistant survive Or maybe says Peto who is part of the Mahidol Oxford Tropical Medicine Research Unit better known as MORU in Bangkok “it’s because we look here first” Related content: Whatever the reason this is where it starts Resistance to chloroquine surfaced here in the 1950s before sweeping through the wider Mekong region and then into India and Africa causing millions of deaths Sulfadoxine-pyrimethamine went next in the 1960s Mefloquine failed in the 1970s The Mekong delta at Chau Doc Vietnam one of six countries in the region threatened by drug-resistant malaria Christoph Mohr/dpa/Corbis Then in late 2008 and 2009 came reports that rocked the malaria world: Artemisinin the so-called wonder drug that has sent malaria deaths plummeting across the globe over the past decade was losing its effectiveness here That sparked global alarm and prompted an ultimately futile emergency plan to contain resistance in Cambodia before the last best drug was lost Now Pailin is the epicenter of what some say is the greatest threat yet to malaria control: the deadliest malaria parasite Plasmodium falciparum has become resistant not only to artemisinin but to a key partner drug piperaquine or PPQ that is used in combination with artemisinin and is critical to its success The emergence of this MDR parasite is raising the specter of untreatable malaria in the Mekong region and perhaps beyond PPQ resistance is a “disaster” says Peto’s boss Arjen Dondorp who is the head of malaria research at MORU It’s now confined to Cambodia but “I’m afraid it is just a matter of time until it will reach the other countries in the region” he says That’s the “nightmare scenario” adds Franois Nosten who runs the Mahidol group’s Shoklo Malaria Research Unit (SMRU) in Mae Sot Thailand along the border with Myanmar “If that happens” he says “that’s it we are done and malaria will come back” Multiple-drug resistant malaria was first discovered in this poor remote region of Pailin Cambodia The only way to avert that crisis says a growing chorus of malaria researchers international agencies and donors is to wipe out all malaria from the entire Greater Mekong subregion—five countries and a southwestern spit of China bound together by the world’s 12th longest river The World Health Organization (WHO) the Global Fund and other international agencies and donors are rallying around an ambitious plan to do just that by 2030 The aim is to ensure that every last parasite is gone from the region focusing first on P falciparum because of the urgent threat of multiple-drug resistance The Bill & Melinda Gates Foundation (BMGF) is lobbying hard and the five countries some better known for their corruption than their cooperation are on board on paper at least But it is not at all clear they can pull it off or whether it is already too late Malaria has been eliminated before in the “easy” places such as the southern United States Europe and Turkey and similar efforts are underway elsewhere But no one has ever eliminated the disease in a place as socially and epidemiologically complex as the Mekong The science is uncertain the data im-perfect the tools far too crude Researchers here many with outsize personalities and egos to match argue over everything from the strength of the evidence to the ethics of clinical trials—even to the magnitude of the MDR malaria disaster: Is it a category 4 or category 5 Is there enough time for careful studies to see what really works or is the situation so dire that you must throw largely untested strategies at it whatever the risks and hope something sticks All the while they face one disquieting conundrum: how to eliminate a disease when there’s no vaccine the very drugs you need are failing and the parasite is evolving faster than people can keep up Malaria is a different beast in the Mekong than it is in Africa where it kills roughly 500000 children a year The main vector across Africa Anopheles gambiae is so ubiquitous that people can be exposed to thousands of infectious bites a year and transmission is the highest in the world In the Mekong by contrast malaria is a disease of the edges and there are fewer than 200 deaths a year The expansive lowlands are largely malaria-free but as the rice paddies give way to hills and then mountains the risk rises and malaria holds sway in the shrinking forest fringe where the mosquito vectors thrive Its victims too are literally off the map: people who work in the forest—largely poor itinerant loggers miners or migrant workers and marginalized ethnic minorities who live along the messy international borders The majority of cases occur in adult men most in Myanmar which bears the greatest malaria burden of any country in the Greater Mekong It’s not the sheer toll of malaria here but the uncanny ability of the parasite population to mutate and acquire resistance to any drug thrown at it that has put the Mekong front and center in the global fight against malaria The roots of the problem go back decades and are mired in the misuse of malaria drugs Many of those who streamed into the forests decades ago in search of riches or were forced from the cities to the countryside by the Khmer Rouge came from areas without malaria so they had no natural immunity and were especially vulnerable When they got sick people often treated themselves with whatever drugs they could get by the bagful from the local shopkeeper which if they were lucky might contain an antimalarial at some unspecified dose Or people would take a few tablets of chloroquine for protection before entering the forest and then pocket the rest Either way taking antimalarials at low doses for a short period is a surefire way to generate resistance A Cuadra/Science Artemisinin was especially easy to misuse The drug was available here as a monotherapy not a combination long before the rest of the region thanks to the Khmer Rouge’s close ties to China where the drug was developed (The Chinese scientists who rediscovered the remarkable malaria- fighting properties of this ancient herbal remedy won the Nobel Prize in Medicine last year) What sets artemisinin apart is its speed of action—it can clear almost all malaria parasites from the bloodstream in just 48 hours so fast that people often don’t finish the course enabling the parasite to evolve under low drug pressure “Artemisinin is quite simply the best drug we’ve ever had” says Nicholas White a UK malariologist who presides over MORU’s far-flung enterprise from Bangkok and who seems to have mentored just about everyone who works in malaria in Southeast Asia Invariably called “brilliant” and usually “hard-headed” White helped bring artemisinin out of obscurity in the 1990s His group did pivotal clinical trials of artemisinin and its derivatives paired with a partner drug that mops up residual parasites These so-called artemisinin combination therapies (ACTs)—there are six combinations—are designed to stave off resistance in much the same way that combinations curb HIV’s ability to develop resistance to any single drug Then White and his colleagues began a bruising decadelong battle to get WHO to endorse ACTs as the first-line therapy for malaria worldwide The first signs of trouble appeared around 2007 Dondorp’s MORU group was working here when it found artemisinin took twice as long to clear parasites from the bloodstream of malaria patients there as it did in Wang Pha Thailand where the drug had only recently been introduced A group from the Armed Forces Research Institute of Medical Science (AFRIMS) in Bangkok working nearby found similar disturbing indications Dondorp Nosten White and a who’s who of malaria researchers from across the region sounded the alarm in a 2009 paper in The New England Journal of Medicine Without immediate action they said artemisinin resistance would follow the arc of chloroquine resistance race westward through Myanmar into Bangladesh and India and ultimately into Africa destroying all the gains of the past decade From the outset a few scientists questioned whether what the group described was really drug resistance or should instead be called “slow clearance” of the parasite—and some even accused the Mahidol group of crying wolf After all unlike chloroquine which fails to kill resistant parasites artemisinin still worked just more slowly Still it was a significant threat and in 2011 WHO and the Roll Back Malaria Partnership launched what became an “emergency response” to artemisinin resistance in the Mekong The strategy was containment: Build a firewall around areas of drug resistance by ramping up control measures such as bednets rapid diagnostic tests and ACTs Despite the plan artemisinin resistance spread It has yet to sweep into Africa as feared and there is some debate over whether it will But it has now been found in five countries in the Mekong Some blame a bumbling global response and corrupt and inefficient governments ill-equipped to handle the bolus of money that came their way; others point to new genetic evidence that shows that in addition to spreading artemisinin resistance is popping up independently in multiple spots across the region dooming any attempt to build a firewall A Cuadra/Science It was simply too late adds Didier Ménard who directs the malaria molecular epidemiology unit at the Pasteur Institute in Phnom Penh Last year his group found the hotly sought molecular marker of artemisinin resistance the Kelch 13 or K13 gene enabling researchers to map its extent and spread in exquisite detail Those retrospective analyses suggest that as early as 2001–2002 50% of the parasites here were already resistant to artemisinin—there’s no way they could be stuffed back into the bottle Whatever the reason the failure to rein in artemisinin resistance set the stage for the current crisis: MDR malaria No one should have been surprised when resistance to the partner drug exploded in Cambodia “We predicted it” says Dondorp who is known as the calm measured voice of the MORU group but who is clearly exasperated When the artemisinin component of an ACT doesn’t clear the parasite quickly Dondorp explains the weaker and slower-acting companion drug must carry an extra load It’s essentially like monotherapy The first hints again came from around Pailin where the ACT of choice is a combination of dihydroartemisinin an artemisinin derivative and PPQ known as DHA-PPQ Scattered reports started coming in that people on DHA-PPQ were not being cured “You treat the sick and 3 weeks later they are sick again and they keep getting sick” Ménard says This was not just the slow clearance seen so far with artemisinin resistance—it was actual treatment failure Two teams nailed the connection one led by Ménard the other by David Saunders of AFRIMS Both groups confirmed in genetic cell and clinical studies that for the first time the parasite had developed resistance to both drugs used in an ACT (Rick Fairhurst’s group at the US National Institutes of Health in Bethesda Maryland provided even more evidence in January of this year) In malaria science a lot of people are religiously for or against things and I think religion and science don’t mix very well Frank Smithuis The MDR parasites are spreading at a frightening rate “Overall in Cambodia the DHA-PPQ failure rate is 50%” Ménard says “In Pailin it is 70% probably higher” And it bodes poorly for other ACTs Nosten says “If we lose one partner drug any partner drug they are all going to fall like dominoes very quickly” There are a few stopgap measures—if countries can be nimble After years on the shelf mefloquine is effective again in Cambodia and WHO has recommended that the country switch to a combination of artesunate and mefloquine But it’s a short-term fix: “Mefloquine will fail in 6 months” Ménard predicts “It is like a race The problem here is the parasite is working fast so we have to also work fast” MORU is testing triple ACTs—a combination of three instead of two drugs—to see whether they can outwit resistance but the results aren’t in yet “I think it is one of our few choices to go for elimination” Dondorp says “The longer we wait or the longer we are not successful the more difficult it will get to treat malaria—and thus to eliminate it” At its September 2014 meeting the influential Malaria Policy Advisory Committee at WHO endorsed an aggressive plan for malaria elimination in the Mekong and the World Health Assembly signed off on it in May 2015 The goal is to rid the region of P falciparum by 2025 and its milder relative P vivax by 2030 for an estimated cost of $3 billion For Cambodia the birthplace of drug-resistant malaria the target date for P falciparum is even sooner—less than 4 years away As Frank Smithuis an irrepressible Dutch malariologist who works with MORU and runs his own nongovernmental organization out of one of Yangon Myanmar’s crumbling buildings puts it: “Then we had better hurry” Elimination is malaria control on steroids “In malaria control what we are trying to do is detect people with malaria and treat them prevent people from dying and being sick” Nosten explains “In elimination we are doing that plus eliminating the parasite We are going after the malaria parasite everywhere we can” Migrant workers like these in Cambodia are hard to reach in major effort to wipe out malaria in the Greater Mekong subregion AP Photo/David Longstreath But in the Mekong the parasite is very hard to find “The people you most want to reach in malaria are the most difficult to reach” Peto says They live in isolated villages days from any town on foot or hours away by jeep or motorbike down rutted dirt roads that become impassable in the monsoon rains Some are in rebel-held areas off-limits to government health workers or too dangerous for aid groups to enter No maps show the routes migrant workers take and those who are working illegally don’t want to be found Rubber plantation workers and others tend to spend several nights at a time in the forest where transmission occurs sleeping outside in hammocks Many don’t know that mosquitoes transmit malaria and even if they do it is too hot and muggy to don long-sleeved shirts and pants The main vectors A dirus and A minimus bite outdoors so in contrast to Africa bednets are of limited use “How do you deal with a vector that doesn’t fit the paradigm of Anopheles” asks Tom Kanyok BMGF’s point person for malaria elimination in the Mekong Tha Sitheth was 13 years old when he got malaria while working on a rubber plantation Haley George Photography / Malaria No More The biggest challenge to elimination in the Mekong however is the “asymptomatic reservoir”—people who carry the parasite without any symptoms but are to some unknown extent still involved in disease transmission Confounding matters they harbor parasites at such low levels they can be detected only with the highly sensitive polymerase chain reaction (PCR); rapid diagnostic tests and even microscopy will miss them In Africa where transmission is high the phenomenon is well-known—many people have built up enough immunity that they can carry the parasite without getting sick But the common wisdom in the Mekong and other low-transmission areas has been that “people here get bitten by an infected mosquito they get sick end of story” Nosten explains “We saw the extent of it and said ‘Wow’” Dondorp recalls Everyone agrees the asymptomatic reservoir must be drained to have any chance of eliminating malaria But consensus crumbles on how to do that and things can get downright nasty “In malaria science a lot of people are religiously for or against things and I think religion and science don’t mix very well” Smithuis says In the malaria world religion is often code for mass drug administration or MDA which involves giving everyone in a region antimalarial drugs whether or not they are sick And its high priests according to the critics are Nosten White et al They are accused of dogmatically pushing a risky strategy with little evidence it works (MDA has long been used for lymphatic filariasis and other parasitic diseases but has a checkered history with malaria) For the past couple of years Nosten has been conducting a pilot study of MDA in four remote villages along the Thai/Myanmar border where he has worked with refugees from Myanmar’s beleaguered Karen ethnic minority for the past 30 years With support from the Wellcome Trust the Global Fund and BMGF the team identifies villages that are “hot spots” of transmission and then gives everyone the standard 3-day course of DHA-PPQ and one dose of primaquine a drug that targets another stage of the parasite’s life cycle each month for 3 months A Khmer family in Cambodia being screened soon after artemisinin-resistant malaria was first discovered Getty Images Nosten’s team is still analyzing the data but their first impression is that MDA is safe well-tolerated largely acceptable—and sometimes remarkably successful “I can tell you after one-and-a-half years of trying very hard we are eliminating malaria and it’s going down very fast” Nosten says But he concedes MDA is extremely time- and labor-intensive especially because it entails convincing healthy people to take drugs and have their blood drawn repeatedly The SMRU group is now scaling up and has “mapped” the parasite loads in 1200 villages in Karen state and conducted MDAs in 34 WHO has just given MDA its blessing in some circumstances in the Mekong but the strategy remains highly controversial Ménard says there is a very real risk MDA could backfire “Are we sure we will kill all the parasites and not select resistant ones If you want to select drug-resistant parasites maybe this is the best strategy” he says MDR malaria “is an emergency and we need to act but I am not sure we need MDA I am not against it but we need to conduct studies and with the results we will make decisions” Malariologist Chris Plowe who heads the Institute for Global Health at the University of Maryland School of Medicine in Baltimore says his own work in Myanmar suggests that the size of the asymptomatic reservoir varies enormously even in close-by villages and that means a very targeted approach is in order “There is no ‘cookie-cutter approach’” he contends Often it is not so much Nosten and White’s message that riles people but the stridency with which they push it “Franois has a big mouth” his close colleague Dondorp says “But he also has a big heart” For now Ménard thinks a better strategy is to develop tools that approach the sensitivity of PCR but can be deployed in the field With those in hand it would be possible to test everyone for asymptomatic infection and then treat just those who are infected Such work is already well underway in his lab and others Plowe’s group for instance is experimenting with collecting blood spots on filter paper with a simple finger stick and then analyzing those with ultrasensitive PCR in the lab BMGF is funding research to develop more sensitive rapid diagnostic tests And the race is on to find a molecular marker for PPQ resistance the equivalent of the K13 gene “This is the beginning of the story” says Ménard who believes the science is moving so fast that there is time to get it right “We have wasted so much time we don’t have more time to waste” Nosten moans in response “We still have to learn about the submicroscopic infection but we don’t want to wait until we understand everything about it before eliminating it It’s a catch-22 thing People are saying there is no evidence But if you don’t do this [MDA] on a large scale to see what it does then you don’t get the evidence” Besides White asks what else is on the table “The only other option I’ve heard is to do nothing” Except of course have more meetings “with heartfelt pleas for how hard this is and all that bureaucratic language to do with strengthening and capacity building and transformative and god knows what else—a lot of stupid buzzwords The Belgians call it fried air” Even if the researchers could agree on the best way forward the plan could still be hobbled by bureaucratic inertia and corruption More than 2 years after WHO recommended Cambodia switch from DHA-PPQ to an artesunate-mefloquine combination the drugs are just arriving Transparency International ranks Cambodia and Myanmar among the most corrupt countries in the world Recently the Global Fund froze millions of dollars intended to pay malaria workers while it investigated travel expenses and other irregularities in the Cambodian national malaria control program (The dispute was finally resolved and money released in December 2015) “It is too crazy for words” Smithuis says “If you are a malaria parasite and you want to stay ahead of drugs and you are looking at all this you think ‘Yo this is exactly what I need I need a bunch of people falling all over each other with so much envy and bickering and so little action’ The parasite must be laughing” Reporting was supported by a grant from the Pulitzer Center on Crisis Reporting The scientists believe that the discovery could pave the way for converting waste from leftover coffee, Healthy older participants did fine at distinguishing the truth from lies.and Neeraj Kansal.
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for novel antibiotics, Angry Dera followers took to the streets,Supual, bring to a boil. based on a book by the same title.