Intensify diplomacy to ease Indo-Pak tensions: Obama to admin

In a secret directive, President Barack Obama has asked his administration to intensify efforts to make India resolve its tensions with Pakistan, a priority for progress of the “US goals in the region”.

He has also asked his officials to intensify American diplomacy aimed at easing tensions between India and Pakistan, asserting that without detente between the two rivals, the administration’s efforts to win Pakistani cooperation in Afghanistan would suffer, the Wall Street Journal reported.

The directive, issued in December, concluded that “India must make resolving its tensions with Pakistan a priority for progress to be made on US goals in the region,” the US daily said quoting ‘people familiar with its contents’.

According to officials, the Pentagon, in particular, has sought more pressure on New Delhi, it said.

The only specific US request to New Delhi has been to “discourage India from getting more involved in training the Afghan military, to ease Pakistani concerns about getting squeezed by India on two borders”, the journal said quoting US and Indian officials.

The move comes amid continued requests by Pakistan for an intercession by the US in Indo-Pak disputes, despite a longstanding resistance from India to any mediation by a foreign country.

Pakistan has long regarded Afghanistan as providing “strategic depth” or a buffer zone in a potential conflict with India, and does not want India to have a larger influence in the country.

“Current and former US officials said the discussion in Washington over how to approach India has intensified as Pakistan ratchets up requests that the US intercede in a series of continuing disputes,” it said, adding the White House declined to comment on Obama’s directive or on the debate within the administration over India policy.

The directive to top foreign-policy and national-security officials was summarised in a memo written by National Security Adviser James Jones at the end of the White House’s three-month review of Afghan war policy in December, the journal said.

US military officials were circumspect about what specific moves they would like to see from New Delhi, the Journal said.

But according to people who have discussed India policy with Pentagon officials, the ideas discussed in internal debates include reducing the number of Indian troops in Kashmir or pulling back forces along the border, it said.

A 56-page dossier presented by the Pakistani government to the Obama administration ahead of Strategic Dialogue in Washington last month “contained a litany of accusations against the Indian government, and suggestions the US intercede on Pakistan’s behalf”, the journal reported quoting officials as saying.

re-diabetes, an epidemic that Indians need to be concerned about (ANI-Medical Service – Diabetes)

New Delhi, Jan.13 (ANI): Pre-diabetes is a condition where blood glucose levels are higher than normal, but not high enough to be called diabetes. re-diabetes has been shown to have harmful effects on the body in the long run, and is a disease that Indians need to be concerned and informed about.

A pandemic of obesity and diabetes is occurring. Diabetes now affects an estimated 24.1 million people in the United States, an increase of over three million people in approximately two years.

Another 57 million people in that country have pre- diabetes, some of whom in fact already have micro-vascular changes (such as blindness, amputations and kidney failure) consistent with diabetes.

In India, over 30 million have been diagnosed with diabetes. The CPR (Crude Prevalence Rate) in the country’s urban areas is thought to be about nine per cent. In rural areas, the CPR is approximately three per cent of the total population. Another estimate says that the actual number of diabetics in India is around 40 million. As far as the pre-diabetic population is concerned, only China surpasses India, and by 2025,every fifth diabetic in the world will be an Indian.

IGT (Impaired Glucose Tolerance) is also a mounting problem in India. The prevalence of IGT is thought to be around 8.7 per cent in urban areas and 7.9 per cent in rural areas, although this estimate may be too high. It is thought that around 35 per cent of IGT sufferers go on to develop Type 2 diabetes. So, India is genuinely facing a healthcare crisis and the type of diabetes that its people suffer from differs considerably from what patients in the West suffer from.

Pre-diabetes currently refers to people who have impaired fasting glucose (IFG) i.e. fasting glucose levels between 100- 125mg/dl or impaired glucose tolerance (IGT), i.e. two hours post glucose load between 140-199mg/dl or both. Pre-diabetes raises short-term absolute risk of Type 2 diabetes five to six fold, and in some populations this maybe even higher.

As the prevalence of and progression to diabetes continues to increase, diabetes-related morbidity and mortality have emerged as major public health care issues.

People with diabetes are vulnerable to multiple and complex medical complications. These complications involve both cardiovascular disease (heart disease, stroke) and peripheral vascular disease) and microvascular disease.

Epidemiologic evidence suggests that these complications of diabetes begin early in the progression from normal glucose tolerance to frank diabetes.

Early identification and treatment of persons with pre-diabetic conditions has the potential to reduce both the incidence of diabetes and related cardiovascular and microvascular disease. Therefore, the following steps need to be considered:

Management of pre-diabetes:

The management of pre- diabetes involves a set of global treatment measures designed to address its abnormalities. The preferred treatment approach for all the abnormalities of persons in this group is intensive lifestyle management, given its safety and the strong evidence of efficacy of this approach in improving glycemia and reducing cardiovascular risk factors such as hypertension and Dyslipidemia.

Persons with pre- diabetes should reduce weight by 5-10 percent with long-term maintenance at this level. Even modest weight loss (seven to ten percent of body weight) results in decreased fat mass, blood pressure, glucose, low density lipoprotein, and triglyceride levels. These benefits can also translate into improved long-term outcome, especially if weight loss and lifestyle alterations are maintained.

A program of regular moderate-intensity physical activity for 30-60 minutes daily, at least five days a week is recommended.

The diet should be low in total, saturated fat and trans-fatty acids and with adequate dietary fiber. Specifically for blood pressure, lifestyle recommendations would include lower sodium intake and avoidance of excess alcohol.

Blood Pressure in pre-diabetes:

Pre-diabetic patients should achieve the same target blood pressure currently recommended for persons with diabetes, systolic – 130 and diastolic – 80mmHg.

Lipid goals in pre-diabetes:

Persons with pre- diabetes should achieve the same lipid goals as those with established diabetes i.e. cholestrol, non – HDL cholestrol, or apoB treatment goals of 100mg/dl, 130mg/dl, and 90mg/dl respectively.

Monitoring in pre-diabetes:

Monitoring of patients with pre diabetes to assess for worsening of glycemic status should include regular blood sugar test and testing for micro-albuminuria. Those patients at highest risk should be more carefully monitored. Fasting blood sugars, Glycosylated haemoglobin (index of sugar control in last three months) and lipid profile should be followed at least twice a year. If the results of monitoring reveal worsening hyperglycemia, intensified lifestyle and treatment with anti – diabetic medicines must be considered. (ANI)
Dr. Vikas Ahluwalia is a Senior Consultant in Diabetes and Metabolism and President, Diabetes Care Foundation Of India. He can be contacted on diabetesinstitute@gmail.com.(ANI)

Tom Cruise gets emotional about Jett Travolta”s death

Melbourne, Jan 9 (ANI): Tom Cruise struggled to maintain his composure in a TV interview as he talked about John Travolta”s son Jett’s tragic death.

News.com.au reports that while on The View, the ‘Valkyrie’ star was forthright as he addressed suggestions that the actors” Scientology beliefs could have impacted on the care given to Jett, who was known to suffer seizures.

He said the church did not discourage conventional medical care.

“Actually, the exact opposite. They say, ”Get your physical, get your medication, get your physical illnesses handled”,” he said.

Jett, 16, died last weekend at his family”s holiday home in the Bahamas.

“John just adored him, both of his children,” Cruise said.

“It”s something that I don”t have the words for,” the hunk added.

He described Travolta and his wife, Kelly Preston, as “doting parents, just wonderful people”. (ANI)

Kids who misbehave at school may suffer health and social problems as adults

London, January 9 (ANI): A 40-year study of British citizens suggests that adolescents who misbehave at school are more likely to suffer health and social problems throughout their adult lives.

Appearing online in bmj.com, the study report suggests that these difficulties cover all areas of life, from mental health to domestic and personal relationships to economic deprivation.

Ian Colman, an Alberta Heritage Foundation for Medical Research Population Health Investigator, and Assistant Professor at the University of Alberta”s School of Public Health, has revealed that his findings are based on more than 3,500 individuals taking part in the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort), over a 40-year period.

According to him, all of the subjects were aged between 13 and 15 at the start of the study, and about a quarter of the participants had mild behavioural problems.

The researcher revealed that the participants were rated by their teachers as having severe, mild or no conduct problems.

He further revealed that the subjects were followed up between the ages of 36 and 53, when they were asked about their mental health, and social and economic status.

Colman said that the findings revealed disturbing new information about the societal impact of milder behavioural problems, showing that the participants with severe or mild conduct problems in adolescence were more likely to leave school with no qualifications.

He said that such children were also more likely to go on to suffer a number of problems throughout their adult lives, including depression and anxiety, divorce, teenage pregnancy, and financial problems.

The findings remained similar even after the researchers took into account predictors of outcomes in adulthood such as sex, father”s social class, adolescent depression and anxiety and cognitive ability.

However, unlike previous studies in the field, the current study showed that most of the participants who were badly behaved at school did not have alcohol problems as they got older.

“Given the long-term costs to society, and the distressing impact on the adolescents themselves, our results might have considerable implications for public health policy,” Colman and his team concluded. (ANI)

Bangkok motorists caught in the act

 Bangkok motorists caught in the act Bangkok – Bangkok drivers who love to run red lights are now being captured by new traffic cameras, a report said Friday.

The almost 30,000 motorists who have been snapped jumping lights during the first week of the cameras’ operation can expect postal fines of 500 baht (14.31 dollars), said deputy city police chief police Major-General Pharnu Kerdlarpphon.

In a city where frustrated drivers frequently run red lights rather than suffer yet another lengthy wait, people may take time to alter their behaviour, he said.

Every offender will have points knocked off his or her driver’s licence, with repeat offenders temporarily losing their licence.

Some drivers already seem to be hitting the brakes rather than risk being snapped running a red light, according to the police. “I think that the number of road accidents will go down as a result,” Pharnu told the Nation newspaper.

Cameras snap details of a car’s speed and location, sending the information automatically to the Central Control Centre’s computer system along with the time and date.

Police are ready to stamp down hard on any motorists who alter their number plates rather than give up their light-jumping habits. (dpa)

Jamie Lynn Spears’ look-alike sues LAPD for being used as a decoy

London, January 8 (ANI): A Jamie Lynn Spears lookalike is taking LAPD to court, claiming damages worth 1.3 million pounds, after she was used as a decoy for Britney’s younger sister– without being informed.

Adessa Eskeridge is considering her legal options against the department after she was put on the same flight as Jamie last September.

In order to prevent paparazzi from mobbing the young actress, the officials had used Adessa to sidetrack attention, reports the Sun.

Her lawyer R. J Molligan said: “Adessa was not given any details as to the nature of the task or of the potential danger involved. She simply followed the instructions of the police as most good citizens would do.”

The team also claimed that: “The LAX police did not want to subject Ms. Spears to the pushing, shoving, humiliation and possible physical injury that come with the paparazzi, but instead decided that Ms Eskeridge was not important enough to give the same protections to.”

Molligan further alleged that Adessa was “never informed that upon deplaning, she would be mobbed by the paparazzi, that she would be in fear of her well-being, that her picture would be taken, (and) that video of her would be all over the Internet”.

She added her client was “deceived and manipulated” by the offcials and claimed she has “suffered and continues to suffer great humiliation” post the incident.

LAPD are yet to comment on the case. (ANI)

How sleep apnea increases the risk of stroke-related death

Washington, January 7 (ANI): Scientists at the Yale University School of Medicine in New Haven, Connecticut, say that obstructive sleep apnea decreases blood flow to the brain, elevates blood pressure within the brain, and eventually harms the brain’s ability to modulate such changes and prevent damage to itself.

Reporting their observations in the Journal of Applied Physiology, they said that their findings might prove helpful in understanding why people with sleep apnea are more likely to suffer strokes and to die in their sleep.

Sleep apnea is the most commonly diagnosed condition amongst sleep-related breathing disorders, which can lead to debilitating, and sometimes fatal, consequences.

Researchers Fred Urbano, Francoise Roux, Joseph Schindler, and Vahid Mohsenin say that their current study identifies a mechanism behind stroke in patients diagnosed with sleep apnea.

During sleep apnea episodes, the upper airway becomes blocked, hindering or stopping breathing and causing blood oxygen levels to drop and blood pressure to rise.

People suffering this eventually awaken, and begin breathing so as to restore normal blood oxygen and blood flow to their brains.

Generally, the brain regulates its blood flow to meet its own metabolic needs, even in the face of changes in blood pressure — a process known as cerebral autoregulation.

The researchers say that their study has shown that the repeated surges and drops in blood pressure and blood flow during numerous apnea episodes each night reduces the brain’s ability to regulate such functions.

Dr. Mohsenin and his colleagues have already shown in a previous study that sleep apnea patients are three times more likely to suffer a stroke or die, compared to people in a similar state of health but without this condition.

“After we found that sleep apnea is a risk factor for stroke and death, independent of other risk factors, we hypothesized that there must be something wrong with the regulation of blood flow to the brain,” he said.

His team has now found that repeated surges and drops in blood pressure and low oxygen levels eventually impair the body’s ability to regulate blood flow to the brain.

Dr. Mohsenin also warns that sleep apnea may occur over a long period of time before the person becomes aware of it and seeks medical treatment. Here are the symptoms Dr. Mohsenin says to watch out for:

He suggests that those being treated for sleep apnea remain compliant with treatments. (ANI)

Ranbaxy May Suffer Lose Of Rs 300-cr Due To ‘Imitrex’ Delay

Ranbaxy May Suffer Lose Of Rs 300-cr Due To ‘Imitrex’ DelayThe US Food and Drug Administration (FDA) can take more time to approve Ranbaxy’s generic version of GSK’s anti-migraine medicine, Imitrex. The delay may cause potential loss of Rs 300 crore to the drug major. Research Analyst Ranjit Kapadia said, “Since, Ranbaxy has not been able to launch the drug in the US and patent for the drug is also going to expire in February 2009, the company may have to suffer a potential revenue loss of Rs 240-250 crore in the current year.”

The company holds considerable share of the US market and it has been selling various generic and anti-infection drugs in the US. The company had planned to launch Imitrex in December 2008 in the 25 mg, 50 mg and 100 mg strengths in the US, after getting approval from USFDA but sources said that its launch would take some time.

It is recalled that the USFDA had imposed an import ban in September on 30 drugs after noting defects at Ranbaxy’s plants located at Dewas, Madhya Pradesh and Poanta Sahib in Himachal Pradesh. But Imitrex is not manufactured at these plants and does not come under the ban by the US authorities as per the company sources.

Angel Broking Pharm’s Sarvajeet Kaur said, “Ranbaxy is likely to suffer a potential revenue loss of up to Rs 300 crore as it has not been able to meet the deadline of the fourth quarter for launching Imitrex in the US market.” the spokesperson of company said that it is waiting for approval from the US health authorities.

India’s second largest drug maker, Dr Reddy’s Laboratories also has some market share in US generic market. It sells the drugs by GSK in the US and its margin is lower than Ranbaxy.

Parents should monitor their teens’ mood swings

Parents should monitor their teens' mood swingsCologne, Germany – Teenagers commonly experience mood swings and are not always approachable, and this behaviour can make it hard for parents to differentiate such emotional fluctuations from genuine depression.

Experts say it’s important for parents to monitor their teenager’s moods and seek treatment when warranted.

“Parents should make an appointment with a paediatrician, if their teenager falls into a deep depression or if there is a distinct change in the teenager’s behaviour that lasts more than two weeks,” said Ulrich Fegeler of Germany’s association of paediatricians in Cologne.

A medical examination can rule out other diseases such as under active thyroid and help with the search for a psychiatric counsellor. As in adults, some teenagers who are depressed are also more prone to suicide.

A depressed teenager can experience restlessness, anxiety, difficulty concentrating and a defiant attitude, changing from one to the other. They commonly have problems achieving, withdraw into themselves, suffer a lack of drive, fear the future and have problems with self esteem.

“Irritability, a low tolerance for frustrations and a quick temper also can indicate depression in puberty,” said Fegeler.

Statistically, the incidence of psychological diseases increases greatly from age 12. Painful experiences such as a break-up and loss, as well as certain parenting styles and hereditary factors, can trigger depression.

An estimated one in 10 teenagers suffers a depressive phase at least once before reaching adulthood. As in the adult population, females are two to three times more likely than males to be affected. (dpa)