Saturday, February 28, 2015

2015 - February: Interesting Articles & Links

* Nirupama Rao's recco -- Canteloube - "Bailero" sung by Patricia Rozario --

* Bill Gates on the Future of Diseases --
- River Blindness -

* WSJ Insiders guide to Delhi --

* (2015, Feb26 - Guardian) -- Black rats wre not the primary caus of the Great Plague of 1347

* (2015 Feb24 - Hindu) - From the first human genome, to a "great library of life" --
- Lecture at AIIMS by Eric  Lander, leader of the Human Genome Project
- Cost of sequencing - mapping a single genome (as part of HGP 1990-2003) cost $3billion, today it costs $3000
- Global Alliance for Genomics and Health - 246 organisations; 28 countries

* (2015, Feb24, BS) - Waiting for PMs word on GM - On #GMcrops #India - "Regrettably, the sane and well-founded counsel of the scientific community is being largely disregarded." --
* (2015, Feb24, BL) - Dangerous Experiments - closure of Astra Zeneca lab, Blr

* Raghuram Rajan on India's Political Economy --,-Raghuram-Rajan-warns:-A-strong-govt-may-not-move-in-the-right-direction

* Cool devices --
- Digital silence -- Digital Silence DS-101A

* The science of cool design --

* Caravan -- Why India's approach to regulating GM crops is a cause for concern --

* Superbugs --
- Some 16 new antibiotics were approved from 1983 to 1987, but the rate of new drugs coming to market has fallen since then. From 2008 to 2012, just two were approved, according to a study published in the journal Clinical Infectious Diseases.
- While drugmakers charge more than $100,000 for the latest cancer treatments, antibiotics command far less. Cubist Pharmaceuticals Inc., an antibiotic developer bought by Merck & Co. for $8.4b this year, charges between $2,000 and $4,500 for its therapies.
- The Centers for Disease Control and Prevention estimates that each year at least 2 million people are infected with antibiotic-resistant bugs in the US.

* Drone attack in graphics --

* CSS Puns --

* Rema on H1N1 Swine Flu --
- (2010, ET) -- Did WHO experts fuel swine-flu scare? --

* On Sivaratri - Devdatt Pattnaik --

* Mothers - photography --!/index/G0000Wm35big.yVE

* What makes You --

* EMOTIV - story of a bioinformatics co founder -

* Obama's pharma deal in India --

* Idioms -

* Japan's Debt -

* Pronouncing place names correctly --

* Testosterone Check-
- The other was of 1,300 people who had had the lengths of their index and ring fingers measured. The ratio of these lengths indicates the effect on an individual of exposure to testosterone in the womb. (A long ring finger compared to the index finger means a big effect.) This ratio corresponds, throughout the primates as a group, to the amount of promiscuity found in a species’s mating system.

* Delhi Elections - the funny side -
* Election Tweets - funny -
* Kerjiwal documentary -

* 12 Cognnitive Biases --

* "Encouraged flattery and chamchagiri" - @Ram_Guha takes a dim view of #Indian leaders who set a poor example

* Memory -

* Farmers, migrant workers -

* Bengal Famine -

* India -- 28 Reasons Why You Should Never Ever Visit India --

* Catepillar - Snake Mimicry -

* #Polio - how a #Vaccine programe carried on despite "“one of the worst pharmaceutical disasters in U.S. history” -

Tuesday, February 24, 2015

H1N1 Swine Flu - The Burden of Import Dependent Diagnosis

(Note: When this piece started out as a prospective op-ed article, the H1N1 death-count was around 650. Today - 18Mar15 -  it has crossed 1800)

Your child has developed a fever. Could it be Swine Flu? Perhaps it is Bird Flu or Monkey Flu?  

It is difficult not to panic when you have been getting bombarded with daily reports on skyrocketing infections, a rising death toll, shortages of diagnostic kits and medicines.

Unfortunately, our nationwide response to the spread of H1N1 Swine Flu has been just that - reactive rather than proactive. There has been a sudden rush to procure diagnostic kits; an increase the number of ‘authorised outlets’ selling drugs; A DGCI letter to requesting states to ensure that  diagnostic kits and drugs are available at the “right price”, and an awareness campaign that leaves you with more questions than answers.

Meanwhile, the number of deaths has climbed to 1537, and the number of confirmed cases has shot up to over 27,000. The list now includes film stars, top bureaucrats, and senior politicians.

Accurate Diagnosis is the Key

Accurate diagnosis is the first and most critical step in disease control.

For many known diseases the diagnosis and treatment protocols are centred on something called Antigen-Antibody Reactions. Antigens and antibodies are molecules with unique shapes that tend to lock into one another. Antibodies act like policemen in our blood-stream, waiting to ‘handcuff’ any foreign antigens that slip in. Most vaccines contain antigens that provoke our immune systems to produce more antibodies, in case of a real attack. Diseases like measles, for instance, have only one antigenic-type, and this makes the vaccines relatively easy to make, and are therefore quite affordable.

Indian vaccine manufacturers are quite strong in this area. They supply 90 per cent of all measles vaccines worldwide, as well as half of WHO’s requirement for DPT and BCG vaccines against tuberculosis.

Influenza or Flu is caused a much smarter virus. It keeps changing its cell-surface proteins so frequently that detecting it accurately and then formulating drugs to counter them becomes rather difficult.  According to the US Centre for Disease Control there are now more than 800 different influenza viruses. This flu season, the annual influenza vaccine in USA proved only 23% effective. Last year, it was about 60% effective.

When it comes to diagnosis, the only reliable way identifying the flu virus comes from a method called Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR).

Why is RT-PCR Test so Expensive?

RT-PCR is a technique that amplifies genetic material to get a detectable signal. Its accuracy and reliability has made it the cornerstone of modern molecular biology.

The starting point for this test is Deoxyribonucleic acid (DNA), a molecule that encodes the genetic instructions used in the development and functioning of all known living organisms and many viruses.

Despite its unwieldy name, the RT-PCR machine is essentially a hi-tech heater. It ‘melts’ DNA strands at high temperatures and re-joins them again at lower temperatures using special enzymes called polymerases.

Every organism has certain nucleotide sequences which are unique to it. These ‘signature sequences’ are first carefully identified and recreated as “primers”. Detection of H1N1 Swine Flu usually begins with the DNA extracted from a sample of body fluids of an infected person.  It is mixed with H1N1 primers and probes are introduced into a RT-PCR machine.  If the primer finds a match, the machine creates multiple copies of it. Over time – usually 24 hours – there is enough of the genetic material that can be detected by running it through a device called gel chromatograph.

Most of the RT-PCR machines used in India are imported. Apart from the high cost of these machines, the cost of critical consumables - imported primers, probes, enzymes and assays - continue to drive the high cost of accurate diagnosis.  So even the minimum cost for a test comes to about Rs.4,500.

We also have home-grown pioneers like Molbio (Goa) and RAS LifeSciences (Hyderabd) who have developed indigenous, portable PCR kits that lower the cost of the tests to Rs. 800. Despite getting clearances from DCGI and ICMR, the state governments prefer to procure imported kits.

This state of affairs in not unique to diagnostic devices. According to a KPMG report (2011), even though there are about 700 medical device makers in the country, India imports approximately 75 percent of devices.

Is There a Better Way Forward?

Coming soon after the Ebola scare, our tardy response to the H1N1 influenza ought to set the alarm bells ringing.

As the number of nationwide flu-related deaths crosses 1600, we need to ask ourselves if we are sufficiently prepared to tackle the new cohorts of emerging drug-resistant diseases.

We already have world class facilities for manufacture of vaccines and pharmaceuticals. Will the ongoing Budget Session of Parliament introduce the much needed amendments to the Drugs and Cosmetics Act, 1940 – especially with respect to medical devices? Can the on-going ‘Make in India’ initiative pull together the key players in the Government and the private sector, to create the right policy environment for reducing our dependence on expensive, imported diagnostic kits?

Unless we get our act together, we are bound to lurch helplessly from one round of infections and pandemics, to another.

·         DGCI Notice to states - H1N1 / SwineFlu Diagnostic Kits being sold at exhorbitant prices --
·         National Centre for Disease Control (NCDC) --
- Procurement of RT-PCR kits -- (11,12) --
·         Dr. Path Labs – List of Molecular Diagnostic Tests -
·         (28Feb15) -
·         (9Mar15) - DRDO-RAS diagnostic for SwineFlu --

Saturday, February 21, 2015

Swiss Dance

Wish I could understand modern dance.

The title of the performance we attended today was - "Re-mapping the Body - hear the movement / see the music", presented by Compagnie Linga, Switzerland, at the FICCI Auditorium. The work was supposed to make use of the 'dominant role of science and technology as adjuncts to the human body'.

The stage setting was quite dramatic. Placed on at centre of were half-a-dozen devices that looked liked pagers with their LEDs blinking. The show started in a rather un-Swiss way -- 15 minutes late -- with sound effects that seemed almost completely out of sync with the movements on stage.

At first we got the impression that the LED devices were movement sensors linked to sound system. This impressed gathered weight when the dancers were seen adjusting the settings carefully from time to time. The ticket had also claimed that the music was to be created entirely by the movements of the dancers. However the sounds seem to emanate from another altogether disjointed universe...

The dancers themselves were superb - each of them was amazingly lithe and agile. Despite the scratchy sound system and the squeaking chairs of FICCI auditorium, they managed to leave a lasting impression.


Caterpillar Snake

(Pic - by Daniel Janzen U-Penn/GrindTV)

Recently, I was stunned to see this photograph -- a caterpillar pretending to be a snake!

Cuckoo's can fool crows into hatching their eggs, hermit-crabs can learn to use discarded shells for protection, and even lung-breathing whales could have evolved over time to life in the oceans. But can an organism that cannot see very well, evolve to mimic one of its numerous predators in the forest?

Can the Theory of Evolution really explain this?

As if to mock this theory, this is what the caterpillar eventually becomes - a drab looking moth (Hemeroplanes triptolemus) that depends on its sense of smell to mate and survive.

(Source - Wikipedia)


Tuesday, February 10, 2015

Self-love of the Great Indian Male

Earlier this month, Ramachandra Guha had written a brilliant piece in the Telegraph.

It started out with the Emperor's new clothes but much of the piece was focussed on the stalwarts of Indian Science & Technology community: CNR Rao's move to get a landmark outside IISc to be named after himself; RA Mashelkar's editorial in Current Science showering praises on his own 'achievements'.

Guha contrasted this with the conduct of scientists like Obaid Siddiqui who founded the National Centre for Biological Sciences (NCBS), and an anecdote starring JBS Haldane - "You only talk about yourself. But science begins with an interest in the world outside yourself."

This reminded me of PK Kelkar, one of the founding fathers of IIT Kanpur who had strongly discouraged any form of sycophancy or hero-worship.

And now we have RK Pachauri of TERI. The 74-year-old scientist is under police investigation for sexually harassing his Research Assistant.

Where are we headed?


* Guha, Ramachandra (2015) - The Self-love of the Great Indian male --

Sunday, February 01, 2015

War - What is it Good For?

Why did Yugoslavia break-up?  According to a Croat "...we had lived in peace and harmony because every hundred meters we had a policeman to ensure that we loved each other very much".

Ian Morris's latest book takes this line of thinking way beyond the alleys of the former Yugoslavia to an analysis of war and conflict across history, and comes to a startling conclusion. According to him, War is good for humanity.

Large-scale, organised violence apparently makes way for extended periods of peace and prosperity. It encourages trade and economies of scale. At their height, the greatest of empires - the Roman in the West, the Han in China and the Mauryan in modern India and Pakistan - each covered about 1.5 - 2 million square miles, governed 30-60 million people.

For some reason, the technology that drove organised violence seems to have grown much faster in Eurasia than in the Americas. Sticks and stones gave way to swords, spears, war-horses, chariots, the composite bow, and then the great jump to cannons, fire-arms and missiles. Morris seems to agree with Jared Diamond's argument about latitudes in Guns, Germs and Steel.

Somehow his arguments seem to fall apart when it comes to explaining how warfare will evolve in the present context. How long can the American globocop control the world through its grip on the internet, and drones raining hellfire through joysticks held in Arizona?

As always, hindsight is 20:20.


* Amazon - Ian Morris - 

* Review in the Telegraph --