How not drinking enough water can lead to urinary bladder infections the winters it is common for people not to feel too thirsty, which leads to a lessened urge to drink water. But for those of you who think that this is not a big problem, here is some news for you. Drinking less water can lead to painful and sometimes serious conditions like urinary tract infection and cystitis – especially in women. Recognized by burning sensation while urinating, feeling a frequent need to urinate but passing only small amounts or no urine, pain in the lower back, dark smelly urine, sometimes blood in the urine and fever, cystitis has potential to cause major damage.

According to Dr Malvika Sabharwal, head of department of gynaecology and obstetrics, Nova Speciality Hospitals, ‘Women are prone to cystitis because they have a shorter urinary tract (tube that carries urine from the bladder to the outside) as compared to men.’ According to the statistics about 15% women suffer from cystitis every year, and the risk of suffering from the condition is almost eight times higher in women than in men. Dr Malvika adds, ‘Women of all ages can acquire such infections but it is more with women who have just been married and women approaching menopause.’ .

What is cystitis?

Cystitis is a condition where the urinary bladder gets inflamed, usually due to some kind of infection.

Are you at risk?

Dr Sabharwal stresses that women who are suffering from tuberculosis, diabetes mellitus, those who are pregnant and those who are sexually active are most prone to the condition.

Diagnosis is simple

According to Dr Amita Shah, consultant gyanecologist, Columbia Asia Hospital, Gurgaon, if you experience these symptoms the diagnosis usually involves a physical examination where the doctor will ask you about the symptoms and their severity.

In case he/she would like to know about the seriousness of the infection he/she may advice a urine culture (where the infectious organisms in the urine are detected in the lab). Also, to look for the presence of blood in your urine your doctor may advice a microscopic examination as well.

Prompt treatment of cystitis is the key

Dr Shah says, ‘The treatment for cystitis includes addressing each episode promptly with a short course of antibiotics and sometimes, a regular dose of antibiotics for the long-term. Another great way to help relieve the symptoms of cystitis is to have daily doses of cranberry juices. However, if left untreated, the infection can go from the bladder to the kidney.’ Read Tips to deal with urinary tract infections.

Prevention is better than cure

Preventing the onset of this infection is paramount, especially in pregnant women. Here are some precautions they should take:

  • Doctors stress that pregnant women should take special care not to keep their bladder empty as it can create an environment for the bacteria to multiply.
  • Avoid acidic drinks like coffee. According to Archana Dhawan Bajaj, gynaecologist and obstetrician at Nurture Clinic, ‘Pregnant women should try not to drink too much caffeine or acidic drinks such as orange juice as these can irritate the bladder.’ Read about the 10 foods that can help deal with women’s health problems.

Everyday precautions include:

  • Doctors advise drinking at least 12 glasses of water a day to help flush out infection and dilute urine.
  • Women who are more prone to the condition should get a microscopic urine examination once every three to six months.
  • Maintain adequate hygiene. Dr Shah says, ‘Self-hygiene is important and more important is that the washroom should also be cleaned and sanitised.’ Read about some effective hygiene tips.


New class of antibiotics can treat drug-resistant tuberculosis

LungsScientists have discovered a “promising” new class of antibiotics that could treat drug-resistant strains of tuberculosis (TB).

Researchers from St Jude Children’s Research Hospital in US said the drugs increased survival of mice infected with TB and were effective against drug-resistant strains of TB. The antibiotics, called spectinamides, were created by changing the chemical structure of an existing antibiotic, spectinomycin, which does not work against TB. In multiple trials of mice with both active and chronic

TB infections, researchers found that one version of the new drug – an analog known as 1599 – was as good as or better than current TB drugs at reducing levels of the bacteria in the lungs of mice.

In addition, 1599 caused no serious side effects.

“This study demonstrates how classic antibiotics derived from natural products can be redesigned to create semi-synthetic compounds to overcome drug resistance,” said corresponding author Richard Lee, a member of the St Jude Department of Chemical Biology and Therapeutics. The new class of antibiotics works against TB by disrupting the function of a part of the cell known as the ribosome, which is responsible for protein synthesis. To do that, the spectinamides bind to a particular site on ribosomes that is not shared by other TB drugs. That allows the drug to be used in combination with other medications.

For this study, researchers used an approach called structure-based design to re-engineer how spectinomycin binds to the ribosome.

To guide their design efforts, scientists used a 3-D model that provided an atomic-level view of spectinomycin bound to the tuberculosis ribosome.

The research reported on the first 20 of the more than 120 spectinomycin derivatives that have resulted from the effort. The list includes 1599 and two other analogs tested

against TB in mice, researchers said.

The three analogs not only bound the ribosome tightly, but they were more successful at avoiding a TB resistance mechanism called efflux.

The TB bacteria use efflux pumps as a strategy to remove drugs and other threats from the cell before they can work against the bacteria. Efflux pumps, however, did not protect TB against spectinamides, researchers said.

The drugs were also effective against multi-drug-resistant strains of TB growing in the laboratory. The strains had been isolated from patients with the disease.

The study is published in the journal Nature Medicine.

Scientists urge caution on antibiotic alternatives

The new treatments are intended to enable the patient to tolerate disease, and buy the immune system valuable time to get rid of the infection naturally

New types of drugs intended for use in place of antibiotics have been given a cautious welcome by scientists at the Universities of Liverpool and Edinburgh.

Researchers have been probing the long-term effectiveness of drugs being developed by the pharmaceutical industry. These work by limiting the symptoms caused by a bug or virus in the body, rather than killing it outright.

Becoming resistant

These treatments are designed to avoid the problem of infections becoming resistant to treatment, which has become widespread with antibiotics.

This approach is intended to enable the patient to tolerate disease, and buy the immune system valuable time to get rid of the infection naturally.

“Antibiotic resistance is a serious issue and these alternatives offer hope in solving the problem”

Researchers at the Universities of Liverpool and Edinburgh created a mathematical model to discover how drugs that limit the damage caused by disease could affect how infections spread and evolve.

They found that for infections where the symptoms are not linked to the spread of disease, these drugs may prevent disease from evolving too quickly. They will be useful over longer periods of time.

However, parasitologist, Dr Andy Fenton, from Liverpool’s Institute of Integrative Biology cautions that people given damage limitation treatments may appear healthy, but carry high levels of infection and so may be more likely to pass on disease. In addition, people with lesser symptoms could remain undiagnosed and add to the spread of disease.


“Antibiotic resistance is a serious issue and these alternatives offer hope in solving the problem,” he said.

“However we should be cautious as it’s possible that in some cases these drugs may cause disease to spread.”

The study, ‘Limiting Damage during Infection: Lessons from Infection Tolerance for Novel Therapeutics’, was published in PLoS Biology. Read it here

Paracetamol can slow brain development in kids

ChildA new study has found that paracetamol can interfere with the brain development of children, and can even be dangerous for unborn kids.

Researchers at Uppsala University examined paracetamol, one of the most commonly used drugs for pain and fever in children, by giving small doses of it to ten-day-old mice. They later carried out tests on the behavioral habits of the mice in adulthood.

They found that the mice could be hyperactive in adulthood, could display behavioural disturbances, and could have lower memory capability compared to the mice that weren’t given the dose, the Local reported.

Researchers said that the exposure to and presence of paracetamol during a critical period of brain development can induce long-lasting effects on cognitive function and alter the adult response to paracetamol in mice.

They added that parents should be careful in administering the drug.

Researcher Henrik Viberg told the Upsala Nya Tidning newspaper that this shows that there are reasons to restrict the use of paracetamol at the end of pregnancy and to hold back from giving the medicine to infants.

The study was published in the online Toxicological Sciences journal.

Astrocal Update: Sunshine reduces BP and cuts risk of heart attack and stroke

A new study has revealed that exposing skin to sunlight may help to reduce blood pressure and thus cut the risk of heart attack and stroke.

Research carried out at the Universities of Southampton and Edinburgh showed that sunlight alters levels of the small messenger molecule, nitric oxide (NO) in the skin and blood, reducing blood pressure.

Martin Feelisch, Professor of Experimental Medicine and Integrative Biology at the University of Southampton, said: “NO along with its breakdown products, known to be abundant in skin, is involved in the regulation of blood pressure. When exposed to sunlight, small amounts of NO are transferred from the skin to the circulation, lowering blood vessel tone; as blood pressure drops, so does the risk of heart attack and stroke.

While limiting sunlight exposure is important to prevent skin cancer, the authors of the study, including Dr Richard Weller of the University of Edinburgh, suggested that minimising exposure may be disadvantageous by increasing the risk of prevalent conditions related to cardiovascular disease.

The results suggested that UVA exposure dilates blood vessels, significantly lowers blood pressure, and alters NO metabolite levels in the circulation, without changing vitamin D levels.

Further experiments indicated that pre-formed stores of NO in the upper skin layers are involved in mediating these effects.

The study was published in the Journal of Investigative Dermatology.

Romosozumab ‘Potential Breakthrough’ in Osteoporosis investigational humanized monoclonal antibody romosozumab (Amgen and UCB Pharma) increases bone mineral density (BMD) and bone formation and reduces bone resorption in postmenopausal women with low bone mineral density, a phase 2, multicenter, randomized, placebo-controlled study suggests.

The findings were published online January 1, 2014, in the New England Journal of Medicine by Michael R. McClung, MD, from the Oregon Osteoporosis Center, Portland, and colleagues.

“Romosozumab, administered subcutaneously at intervals of 1 month or 3 months over a period of 12 months, was associated with prompt, transitory increases in markers of bone formation; moderate, sustained decreases in markers of bone resorption; and rapid, large increases in bone mineral density in the spine and hip regions,” Dr. McClung and colleagues write.

Romosozumab increases bone formation by binding to sclerostin, an osteocyte-derived inhibitor of osteoblast activity. Sclerostin inhibition is an attractive drug mechanism of action because the gene that encodes sclerostin is expressed only in skeletal tissue and, therefore, off-target effects would be limited, the authors explain.

Indeed, in an editorial accompanying the report, Carolyn B. Becker, MD, an endocrinologist at Brigham and Women’s Hospital, Boston, Massachusetts, calls the new study results “a potential breakthrough in osteoporosis therapeutics,” as current antiresorptive drugs do not restore bone architecture, and the anabolic agent teriparatide is limited by inconvenient dosing, high cost, and a black box warning about osteosarcoma.

In contrast, she cautions that questions remain about romosozumab, including whether its effect on BMD will translate into antifracture efficacy and whether it will be safe for long-term use. In addition, Dr. Becker suggests, there may be a way to replicate the bone-remodeling effects of romosozumab by combining currently available osteoporosis therapies.

“Impressive” Results

The 12-month study randomly assigned a total of 419 postmenopausal women aged 55 to 85 years from 28 centers worldwide, including 367 who received 1 of 5 dosing regimens of subcutaneous romosozumab injections (70, 140, or 210 mg once a month or 140 or 210 mg every 3 months) or to 1 of 2 open-label comparators (70 mg oral alendronate weekly or 20 μg daily subcutaneous teriparatide). The other 52 participants received placebo injections either monthly or every 3 weeks.

The women all had low BMD that was not severe enough to be diagnosed as osteoporosis (T score of −2.0 or less at the lumbar spine, total hip, or femoral neck and −3.5 or more at every one of the 3 sites).

The primary endpoint was the percentage change from baseline in BMD at the lumbar spine at month 12. Of the total of 383 women who completed the 12-month visit, those receiving romosozumab had significant increases in BMD at the lumbar spine compared with placebo, regardless of dose frequency and dose level (P < .001).

Increases in BMD from baseline at the lumbar spine at month 12 were significant at all dosing levels, ranging from 5.4% with 140 mg every 3 months and 70 mg monthly to 11.3% for 210 mg monthly. The placebo group saw no increase in BMD, whereas BMD increased by 4.1% in the alendronate group and 7.1% with teriparatide.

There were similarly significant increases in BMD at the total hip and femoral neck, Dr. McClung and colleagues report.

The increases in BMD seen at 12 months with the 210-mg monthly romosozumab dose (11.3% in the lumber spine, 4.1% in total hip, and 3.7% in femoral neck) were all significantly greater than those seen with alendronate and teriparatide (P < .001) for all 3 comparisons.

“The results were impressive,” Dr. Becker comments.

In contrast, no differences in BMD at 12 months were seen among the groups at the distal third of the radius, the authors note.

Increases in bone formation markers occurred at 1 week after the initial dose in all romosozumab groups, peaked at month 1, and then returned to baseline levels or fell below between months 2 and 9, despite continued administration of the drug.

In all romosozumab groups, the level of the bone-resorption marker serum β-CTX decreased initially from baseline, primarily in the first week. In the patients receiving monthly 210-mg romosozumab doses, β-CTX remained below baseline at month 12.

“The effects of romosozumab on bone turnover reflect a rapid, marked, and transitory increase in bone formation and a moderate but more sustained decrease in bone resorption,” Dr. McClung and colleagues write, adding that “[t]he reason for the transitory nature of the effect on bone formation is unclear.”

Indeed, Dr. Becker says this finding is unexpected and should be explored further. “If the changes in BMD for a presumed anabolic agent were predictable, the changes in bone-turnover markers were not.”

Reductions in serum calcium of 1.30% to 2.68% from baseline, in a dose–response pattern, were seen at month 1 but returned to baseline thereafter.


Serious event rates were 7% for the pooled romosozumab group and 10% among those receiving the 210-mg monthly dose. These rates did not differ from the rates seen among the patients taking placebo (14%), alendronate (8%), or teriparatide (9%). None were considered treatment-related.

Mild injection site reactions were more common with romosozumab than placebo, but there was no dose–response relationship, Dr. McClung and colleagues say.

Binding antibodies were seen in 20% of the romosozumab group, and antibodies with in vitro neutralizing activity in 3%. In contrast, no binding antibodies were seen in any of the other treatment groups. However, the development of antibodies appeared to have no effect on adverse events, pharmacokinetics, or pharmacodynamics, the investigators note.

New Approach

According to the editorial, romosozumab’s “pattern of brief anabolic stimulation coupled with chronic suppression of bone resorption…is unprecedented among current therapies for osteoporosis.”

However, Dr. Becker also points out that small studies suggest it may be possible to reproduce the same effect on bone remodeling by combining teriparatide, which increases bone formation markers but also stimulates bone resorption markers with antiresorptive agents such as zoledronic acid or denosumab.

Remaining questions about romosozumab may be forthcoming from a phase 3 clinical trial of romosozumab currently underway in postmenopausal women with osteoporosis, Dr. Becker notes.

The study was supported by Amgen and UCB Pharma. Dr. McClung reports receiving research grants from Amgen and Regeneron, and serving on speakers bureaus for Amgen and Vivus. Dr. Becker has no relevant disclosures.

N Engl J Med. Published online January 1, 2014.

Hit the sack to protect your brain good night’s sleep may be critical for maintaining brain health, says a new study.

“One night of sleep deprivation increases morning blood concentrations of two molecules – a neuronal enzyme (NSE) and calcium-binding protein S-100B – in healthy young men. These molecules are typically found in the brain. Thus, their rise in blood after sleep loss may indicate that a lack of snoozing might be conducive to a loss of brain tissue,” said Christian Benedict, Department of Neuroscience, Uppsala University, Sweden.

To reach the conclusion, the researchers selected 15 normal-weight men. In one condition, they were sleep-deprived for one night, while in the other condition, they slept for approximately eight hours.

“Increased blood concentrations of these two brain molecules in sleep-deprived participants mean brain damage. Thus, our results indicate that a lack of sleep may promote neuro-degenerative processes,” added the study, published in the journal SLEEP.

It’s important to note, however, that levels of NSE and S-100B previously found after acute brain damage (including as a result of a concussion), have been distinctly higher than those found in the Swedish study. “There is no suggestion that a single night of sleep loss is equally harmful to your brain as a head injury,” said Benedict.

Still, the researchers said their findings suggest “a good night’s sleep may possess neuroprotective function in humans, as has also been suggested by others”.

Five secrets for quitting smoking in 2014

Most smokers say they want to quit and many will make a New Year’s Resolution to quit in 2014. If this is your year to quit, the American Lung Association (ALA) offers five tips to help you along the way:

  1. Learn from past experiences. Most smokers have tried to quit in the past and sometimes people get discouraged thinking about previous attempts. Those experiences were necessary steps on the road to future success. Think about what helped you during those tries and what you’ll do differently in your next quit attempt.
  2. You don’t have to quit alone. Telling friends that you’re trying to quit and enlisting their support will help ease the process. Expert help is available from the American Lung Association and other groups. Friends who also smoke may even join you in trying to quit!
  3. Medication can help, if you know what to do. The seven FDA-approved medications (like nicotine patches or gum) really do help smokers quit.  Most folks don’t use them correctly so be sure to follow the directions!
  4. It’s never too late to quit. While it’s best to quit smoking as early as possible, quitting smoking at any age will enhance the length and quality of your life. You’ll also save money and avoid the hassle of going outside in the cold to smoke.
  5. Every smoker can quit. The ALA said each person needs to find the right combination of techniques that will for them, and above all, they need to keep trying.

Stop ‘abuse’ of antibiotics: Nobel laureate

HYDERABAD: “Antibiotics are not like the latest and the most powerful cars that you want to buy over the counter. Antibiotics should not be sold over the counter in India and should be sold only on the prescription of a doctor,” said Nobel laureaute Prof Venkatraman Ramakrishnan of the MRC Laboratory of Molecular Biology, Cambridge, England.

While delivering a lecture on “Antibiotics and the cell’s protein factory,” the first in the distinguished lecture series at the Centre for Cellular and Molecular Biology (CCMB-CSIR) at the IICT auditorium here on Friday, Prof Ramakrishnan held the jam-packed auditorium literally to ransom. Prof Ramakrishnan had won the Nobel prize for chemistry along with Thomas Steitz and Ada Yonath in 2009 for ‘studies of the structure and function of the ribosome’.

Prof Ramakrishnan said the ‘perfect magic bullet’ for fighting bacteria was yet to be developed as they become resistant to antibiotics over a period of time. While scientists the world over are working to find a way out to make antibiotics without side-effects, the Nobel laureate said that governments, social organisations and individuals should ensure that there is no abuse of antibiotics.

“If you need antibiotics, it means it is a sign of desperation. Antibiotics kill the protein synthesis,” he said. However, he exuded confidence that with the available technology, scientists can come out with new compounds as a solution to the problem of antibiotics causing side-effects. “Ideally, it should be the responsibility of the government and NGOs to fund programmes and not leave it to private companies to do the research and come up with drugs. Obviously, private companies have profit motive in mind,” he said.

Prof Ramakrishnan said the overuse of antibiotics has become a social problem. He said there should be enough surveillance to detect infections and treatment should be started immediately.

“In India, it is easy to buy a third generation antibiotic from a chemist without a prescription. This should stop,” he said.

In an interaction with the media, Prof Ramakrishnan said funds alone won’t suffice for India to produce better scientists. “Funds are important even to bring the best brains back to the country. What is even more important is providing the right kind of atmosphere, liberty and guidance. There should be no hierarchy, cronyism,” he said.

Asked if there was a possibility that he could collaborate with CCMB or any Indian institution, he replied in the negative explaining that his work keeps himself busy in the UK and for the kind of work he does, he can only collaborate with one who can contribute his part to the research.

“But there are scientists who are willing to collaborate with Indian scientists on problems relating to Indian conditions,” he said.

How humans take difficult decisions: decoded

WASHINGTON: Heads or tails? Random fluctuations in the brain determine how we make decisions when faced with two equally appealing options, scientists say.

An emerging field of study known as neuroeconomics is combining the economists’ insights with scientific study of the brain to learn more about decision-making processes and how they can go awry.

“Neuroeconomics is not only helpful for the development of better economic theory, it is also relevant from a clinical point of view,” said author Camillo Padoa-Schioppa, from Washington University School of Medicine in St Louis.

“There are a number of conditions that involve impaired economic decision-making, including drug addiction, brain injury, some forms of dementia, schizophrenia and obsessive-compulsive disorder,” said Padoa-Schioppa.

“There are a number of conditions that involve impaired economic decision-making, including drug addiction, brain injury, some forms of dementia, schizophrenia and obsessive-compulsive disorder,” said Padoa-Schioppa.

To study the roles brain cells play in decision-making, Padoa-Schioppa developed a system for presenting primates a choice between two drinks, such as grape juice or apple juice.

The type and amount of the drink varies, and researchers record the activity of individual brain neurons as the primates choose.

Based on the decisions of a single animal over multiple trials, scientists infer the subjective value the animal assigns to each drink and then look for ways this value is encoded in brain cells.

Analysing data from the original experiment, Padoa-Schioppa showed that different groups of cells in the orbitofrontal cortex reflect different stages of the decision-making process.

“Some neurons encode the value of individual drinks; other neurons encode the choice outcome in a binary way – these cells are either firing or silent depending on the chosen drink,” he said.

“Yet other neurons encode the value of the chosen option,” said Padoa-Schioppa.

Padoa-Schioppa then examined how different groups of cells determine decisions between options of equal value. He showed that toss-up decisions seemed to depend on changes in the initial state of the network of neurons in the orbitofrontal cortex.

“The fluctuations in the network took place before the primates were even offered a choice of juices, but they seem to somehow bias the decision,” Padoa-Schioppa said.

The study was published in the journal Neuron.

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