Re:Congenital Zika syndrome with arthrogryposis: retrospective case series study. Aleem M A.BMJ 2016;354:i3899

Research

Congenital Zika syndrome with arthrogryposis: retrospective case series study

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i3899 (Published 09 August 2016)

Cite this as: BMJ 2016;354:i3899

Rapid response

Re: Congenital Zika syndrome with arthrogryposis: retrospective case series study

Zika virus is a severely pathogenic virus causing many brain malformations, several birth defects and many neurological problems, including microcephaly in neonates. Two mechanisms hav been postulated for the development of central nervous malformations due to zika virus.

Zika virus activates the TLR3 (Toll Like Receptor 3) molecule normally used to defend against invading viruses in human cells.Then this hyper-activated TLR3 turns off genes that stem cells need to specialise into brain cells and turns on genes that trigger cell cell death, leading to various brain malformations. If this mechanism is proved, it will help to develop new therapies like TLR3 inhibitors against zika virus infection associated brain malformations.

The second possible mechanism by which zika viral infection causes brain malformations in the fetuses of zika virus infected women is interference with retinoic acid signaling by introducing its genome sequence repeats (called Retinoic Acid Response Elements or simply RARE consensus repeats) into the developing brain cells of the fetus. Retinoic acid (a metabolite of vitamin A) is one of the earliest factors for regulating the anteroposterior axis of neural tube and positioning of structures in the developing brain through RARE consensus sequence in promoter regions of retinoic acid-dependent genes.

Based on this, it may be helpful to design vaccines and other newer and effective treatments against zika viral infection and its complications in the near future.

Competing interests: No competing interests

11 August 2016

M A Aleem

Neurologist

ABC Hospital.Apollo Hospitsl and Dhanalakhmi Srinivasan Medical college and Hospital

Annamaalainagar Trichy 620018.Apollo Hospital Trichy 620010.Apollo clinic 620018. Dhanalakhmi Srinivasan Medical College and Hospital Siruvachure Perambalur 631113.Tamiknadu India

@drmaaleem

 

EXCLUSIVE HELPLINE - In Reader's Mail The Hindu Tiruchi 9.8.2016

Reader’s Mail 

THE HINDU TIRUCHI TAMIL NADUAugust 9, 2016

EXCLUSIVE HELPLINE

Dowry is one of the important aspects of modern matrimony and it is perpetuated by one and all with all its attendant societal ills. To do away with the age old menace may be a daunting task, but it can be regulated to a large extent by making the marriageable women aware of their rights. The government can step in by establishing an exclusive helpline in all districts in order to attend to the dowry-related problems that crop up in the run-up to the solemnisation of marriage.
A separate helpline exclusively to prevent the giving and accepting the dowry would be very much useful.

M.A. Aleem,
Tiruchi.

Air horns deafening in city . The Hindu Tirichi 7.8.2016

Air horns deafening in city

SPECIAL CORRESPONDENT

The HINDU TAMIL NADU TIRUCHI, August 7, 2016

Indiscriminate use of air horns by private and State-owned transport corporation buses has raised concern among residents of the city.
Though there are regulations in place to restrict use of high-decibel air horns, residents allege that there are no concerned efforts to check the noise pollution.
Incessant honking of air horns on roads, which deafens the ears, is not limited to private buses alone. Tamil Nadu State Transport Corporation buses, lorries and school buses also use high decibel horns.

This violation of traffic rule is clearly noticeable by road users across the city.

It is common to see pedestrians and two-wheeler riders getting agitated and showing signs of displeasure at drivers of buses and other vehicles whenever they use ear-piercing air horns.

It is observed that noise pollution caused by indiscriminate use of air horns is on the higher side during the peak hours — from 8.30 a.m. to 10.30 a.m. and 4 p.m. to 7 p.m., when the office-goers and students use cars and motorcycles to reach their respective work places or educational institutions.

The violation is acute at Central Bus Stand and Chathiram Bus Stand, the hubs of city and mofussil buses.
There were incidents of accidents owing to blowing of air horns leading to panic reactions from other motorists.

Residents allege that buses, mainly the private ones, have been extensively using air horns so as to compete others in collecting more passengers waiting at various bus stops.

No action

Road transport, Tamil Nadu Pollution Control Board and police officials, who are empowered to take action against those causing noise pollution, have not taken any action to curb the menace.

Stating that high level of noise pollution might cause hearing disorders, A. Aleem, former vice-principal, K.A.P. Viswanatham Medical College Hospital, Tiruchi, said that there had been a sharp increase in patients visiting hospitals with hearing disabilities.

A section of them was affected with continuous exposure to the high decibel of sound caused by buses and trucks.

“If the people are exposed to high level of noise, they will have to experience many health effects. It may cause hearing loss, severe headache, stress, fatigue and others,” Dr. Aleem said.
He warned that continuous exposure to noise pollution would precipitate the patients affected migraine. Moreover, the sudden honking would lead to accidents owing to the chances of loosing balance by the two wheeler riders.
V. Sathiyanarayanna, Regional Transport Officer, Tiruchi West, said that officials had been continuously taking action against those using high decibel air horns.
A drive against the menace was conducted a few months ago.
Such drives would be conducted shortly against violators, he said.

Olympic and Zika viral Infection prevention. Aleem M A, A M Hakkim. BMJ 2016;354:i4133

News

Sixty seconds on . . . Zika and the Olympics

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4133 (Published 27 July 2016)

Cite this as: BMJ 2016;354:i4133

Rapid response

Re: Sixty seconds on . . . Zika and the Olympics

Olympic 2016 and zika viral infection prevention.

The 2016 Summer Olympics will take place in Rio de Janeiro, Brazil, from August 5 to August 21, 2016. The Paralympic Games are scheduled for September 7 to September 18, 2016. If any one plans to travel to Brazil for the Olympics or Paralympics, follow the recommendations of WHO and CDC below to help you stay safe and healthy during and after the trip.

Women who are pregnant-

They should not go to the Olympics 2016.
If you must go, talk to your doctor or other health care provider first; strictly follow steps to prevent mosquito bites and use condoms or do not have sex during your trip.
If you have a male partner who goes to the Olympics, either use condoms or do not have sex (vaginal, anal, or oral) during your pregnancy.

Women who are trying to become pregnant-

Before you or your male partner travel, talk to your doctor or other health care provider about your plans to become pregnant and the risk of Zika virus infection.
See the WHO and CDC guidance for how long you should wait to try to get pregnant after travel to areas with Zika viral infected region.
You and your male partner should strictly follow steps to prevent mosquito bites.
Men who go to the Olympics and have a pregnant partner should use condoms or not have sex (vaginal, anal, or oral) during the pregnancy.

After Olympic 2016 trip:

If you are not feeling well after your trip, you may need to see a doctor. Be sure to tell your doctor about your travel, including where you went and what you did on your trip.
If you are pregnant, talk to your doctor about your recent travel. Pregnant travelers returning from the Olympics can be tested for Zika virus infection.
To protect sex partners from Zika, men who have been to the Olympics should consider using condoms or not having sex for 8 weeks if they do not get symptoms of Zika. Men who have Zika symptoms or are diagnosed with Zika should use condoms for 6 months. If the man’s partner is pregnant, the couple should either use condoms or not have sex during the pregnancy.

Women who have traveled to an area with Zika should wait at least 8 weeks after travel before trying to get pregnant if they do not get symptoms of Zika. Women who have Zika symptoms should wait at least 8 weeks after symptoms start; men with Zika symptoms should wait at least 6 months after symptoms start before attempting conception.

At present all the travelers should continue to take steps to prevent mosquito bites for 3 weeks after they leave Brazil to avoid spreading Zika, even if they do not feel sick.

Competing interests: No competing interests

04 August 2016

M A Aleem

Neurologist

A M Hakkim

ABC Hospital .Apollo Hospital. Dhanalakhmy Srinivasan Medical college and Hospital

No 1 Annamalainagar Trichy 620018.Apollo Hospital chennai bypass Road Trichy 620018. Apollo clinic Thillainagar Ttichy 620018. Dhanalakhmy Srinivasan Medical college and Hospital Siruvschure Petsmbakur Tamilnadu India

@drmaaleem

  

Passing Flatus Is Good For Health.

Passing Flatus (Gas) is Good For Health

There are few topics that people find more uncomfortable to talk about than farting.

Most people feel really embarrassed when it happens, warning those around them that it will soon smell rather unpleasant. But it's obviously a completely normal bodily function that we all do, and if you look a little deeper, you'll find out that it's actually really healthy for you. Passing gas is nothing to be embarrassed about; in fact, it can tell you some important information about what's happening in your body:

1. An early warning signal

No matter what you do, there is no way to completely rid yourself of gas. But that's a good thing, because your farts can tell you a lot about your health. Even if you sometimes find it annoying, you should be grateful for them because they are early warning signals for several health problems. Strong smells, high frequency, and/or unusual pain while tooting can all be signs of serious illness. If you are regularly experiencing these symptoms, you might want to mention them to your doctor.

2. They reduce bloating

We've all been there: You just downed a gigantic, delicious meal and now you're sitting fat and happy in the corner. But not only do you feel five times your size, you actually are. When a large amount of food has to be digested all at once, your body stores excess water and your intestines produce excess gas. When you let that loose, your stomach will feel much better and your jeans will be easier to button.

3. The stench is good for you

That's right: It is healthy to smell your own farts! Studies have shown that there are ingredients in your gas that shield you from harmful disease. This is due to hydrogen sulfide, the chemical that gives some gas that rotten egg smell. In high doses the chemical is poisonous, but in small amounts it can protect your cells and help prevent heart attack and stroke.

4. It can help sort out your nutritional needs

Everyone knows how important nutrition is, but did you know that your gas can tell you what's missing from your diet? Different types of food produce different types of gas, which can indicate whether you are eating too much or too little of something. If you rarely have gas, your diet is probably lacking in fiber. Good sources of fiber are whole grains, green vegetables, and lentils. Too much red meat can cause a bad smell and may be an indicator that you should cut back on those steaks and burgers.

5. Farts are a sign of healthy bacteria

Are you ready for a scary truth? Thinner people toot more often and are happier! That's because people who eat healthy often have higher intakes of fiber and eat more fruits and vegetables that stimulate digestion. Those things all give your gut bacteria more to work with, giving your digestive tract more practice, which can lead to more gas production.

6. It's healthy for your intestines

Did your parents ever tell you to "hold it in?" It's not very healthy to always hold your gas in. Every once and a while won't do any harm, but if you are constantly holding back, your intestinal activity can be affected, which can cause painful cramping. It's much better to just relax and let it all out.

7. It just feels good

Let's be honest: There are few things that feel as good as just letting it loose. There's a reason why it's funny (in the right circumstances) when someone just lets one go. Sure, you might blush, but if you're constantly holding everything in, you'll probably feel pretty terrible. So, now you have no reason to hold on - just let it out!

   

NEED PRICE CONTROL. Aleem M A . BMJ 2016;354:i4136

Editorials

High cost of new drugs

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4136 (Published 27 July 2016)

Cite this as: BMJ 2016;354:i4136

Rapid responses

Re: High cost of new drugs

NEED PRICE CONTROL

Life saving and disease specific newer agents like drugs for hepatitis C viral infection must be brought under price control and the Government should also give subsidies to cut down the cost of the newer drugs.

Every one's life is precious. So the drug companies with patents for the newer molecules must also cooperate in this matter to give these drugs at an affordable price.

This type of policy decision may also help patients in both developing and under developed countries, as well as patients in well developed Nations.

Competing interests: No competing interests

28 July 2016

M A Aleem

Neurologist

A M Hakkim

ABC Hospital and Apollo Hospital

Annamalainagar Trichy 620018 Tamilnadu India. Apollo Hospital chennai Bypass Trichy 620010 and Apollo clinic 6th cross Thillainagar Trichy 620018 Tamilnadu India

@drmaaleem

 

For The Need Of You My Son

For The Need Of You My Son

I need you to touch,
I need you to see,
I need you so much,
I need you with me.

My life feels so empty,
My heart feels so cold.
I need you beside me,
I need you to hold.

Why were you taken?
I ask that each day,
But no one will answer,
I therefore now pray.

I pray that you're happy,
I pray that you're safe,
I pray that I'll hear you,
And that I have faith.

That's all I have now
I have to believe
In life beyond this one,
We all must achieve.

Come to me, haki, 
And whisper my name.
Tell me you're happy, 
and I'll be the same.

My life at the moment
Is empty and dark.
The light that once shone
Has gone out in my heart.