If that thought made you feel sick, can you imagine a group of them enjoying your food on the dining table? Or spending time touring your kitchen?  

Here are a few tips to keep flies at bay:

1. Clean your home and working areas (especially places where you eat or cook like the kitchen, dining table etc.) regularly with a good disinfectant solution. Bleach based or chlorine based cleaners are the best options.
2. Dispose of stored waste regularly, and keep dustbins covered at all times. Garbage cans are a fly’s favorite breeding ground, so cutting the source would help reduce them in numbers.
3. Keep all food stuffs covered, this includes fruits, that are either cut or whole. This will also reduce the number of fruit flies.
4. If you have indoor plants, try not to over water them. Prune them well and discard any dead plant matter.
5.  Use window screens, this way you can enjoy the cool breeze while keeping the flies out
6. Use insect repellant sprays in the house. Make sure you keep the spray away from children and food.
7. If you have pets, make sure their waste is cleaned immediately. Also ensure that they are given a bath regularly. You could also wipe their paws after they enter the house from outside.

Don’t want to invest in expensive repellants? Here are some simple home remedies to keep flies out:

1. Camphor is a great deterrent for flies. Just place a piece of it in bowls and keep them in the  four corners of the room. If you have too many flies, you could light the camphor and spread the fumes throughout the room.
2. Tulsi/basil is a common plant in many Indian households. Apart from all its medicinal properties, it is also a good deterrent for flies. Planting tulsi or basil at home can help in reducing the number or flies.
3. If you want to invest in something low cost yet effective, a fly swat is the way to go. You now get the electric version in the market.
4. Natural oils like lavender oil, eucalyptus oil, peppermint oil and lemon grass oil, are another great way to keep flies at bay. Soak a piece of cloth or sponge in the oil and store it in an airtight container. Keep the container open in the room that you want fly free. After use replace the lid and store. You should replenish the oils before every use. 

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What is carpal tunnel syndrome?

Carpal tunnel syndrome or CTS is a painful hand and arm condition which is caused due to pinched nerves in one’s wrist. Basically, the carpal tunnel is a narrow passageway on the palm side of your wrist which consists of bones, ligaments and most importantly the median nerve that controls the movement of your fingers. When these nerves get pinched or compressed, they result in numbness, tingling and weakness.

Some common symptoms include:

• Pain and tingling in the wrist (known as the ‘pains-and-needles’ sensation) which is similar to sensation when your hand ‘falls asleep’.
• Weakness in the thumb and first two fingers which makes it harder to hold objects or make fist
• Sensation problems that cause numbness in the hands and feeling of swollen fingers even when there’s no swelling.

What causes carpal tunnel syndrome?

Experts find it hard to pinpoint one definitive cause. Women are three times as likely to get it as men and some diseases like diabetes, gout, hypothyroidism and rheumatoid arthritis can cause the condition. While it’s widely believed that frequent typing causes the condition, the truth is that it’s observed it’s far more common among factory’s assembly line workers and those that frequently use vibrating tools. It’s also been observed among regular office workers who use keyboards for a long period of time.

What are treatment options?

The basic treatment involves resting the hand and wrist and wearing a brace. Also non-steroidal anti-inflammatory drugs like ibuprofen along with cold compresses to reduce pain. In more severe cases doctors give steroids to temporarily reduce inflammation around the media nerve. Sometimes local anaesthesia is used to relieve the symptoms. Sometimes patients might end up needing surgery.

Once the symptoms subside, you will most likely be taught strengthening and stretching exercises to prevent pain, numbness and weakness from coming back. He or she is also likely to ask you to change the way you perform certain tasks to prevent the symptoms.

Caused due to a viral, bacterial or parasitic infection, gastroenteritis is most commonly transmitted through contaminated food or water. During the monsoons, an overflow of sewage lines leads to puddles of sewer water on the roads, causing further spread of the bacterium. Another common reason is open defecation. Runoff from various sources, carry the bacterium from feces into puddles and water stagnating on the road. Flies and other pests also contribute to the spread of the condition.

Gastroenteritis, as the name suggests, is a condition that is a result of irritation and inflammation of the inner lining of the stomach, due to an infection. Once infected, the lining swells up leading to severe vomiting and diarrhoea.

Once infected the condition can manifest in about 24 to 48 hours. Some of the most common symptoms include – severe diarrhoea, vomiting, abdominal pain,cramps and dehydration.

Although the condition gets resolved with time, it is best to visit a doctor to get the right diagnosis and medication. In order to diagnose the condition, most doctors will rely on the patient’s symptoms alone, but in some cases he/she may order a stool test. This test will check for the presence of the organism causing the condition.

In most cases the treatment will depend on the type of organism causing the condition, but other medication will is prescribed for symptomatic relief. The patient will be advised to have  rehydrating liquids like electoral, antipyretics (medication that controls fever) and painkillers.  Adequate rest and staying away from foods that are difficult to digest, are the best methods to recover quickly.  

One of the most common complications of gastroenteritis is severe dehydration, which can be life threatening  in the elderly, young children and people with suppressed immune systems. Dehydration can lead to organ failure and death.

Here are some things you can do to keep gastroenteritis at bay:

1. Keep your surroundings clean. Disinfect common surfaces (like, table tops, door handles etc.) with a chlorine based, or bleach based cleaner.
2. Make sure you wash your hands well after using the bathroom. This is very important if you use a common bathroom, either at work or any other place.
3. Wash your hands well and regularly— especially before eating or cooking any food.
4. Avoid eating food prepared at roadside stalls or places where there is an unknown water source.
5. Make sure that drinking water is properly boiled, and treated with chlorine.
6. Avoid eating undercooked or raw fish.
7. Do not eat pre-cut fruits, available on the streets. Make sure you cut and peel the fruits yourself, and store them in well washed vessels.
8. If you get wet in the rain and walk in puddles of water, wash your hands and feet well as soon as you get the chance, without touching anything else. This will minimize the transmission of the organism through fomites (inanimate objects).
9. Remove your shoes outside your house, if you have walked in puddles. This is a good way to avoid carrying bacteria from puddles into your home. Another option is to remove your shoes and carry them to the place of storage.
10. If you work on a computer or laptop, make sure you clean your keyboard and mouse well before use, as they are common agents that can spread the bacterium. 
11. Try to lower your stress levels. Excessive stress has been known to lower one’s immunity, making you more susceptible to contracting diseases.

 To know more about your health, watch our related videos:

Cough causes lifestyle problems

When you cough all the time, it can be difficult to converse or finish speaking your part with clarity. People around you may exhibit an impatience or irritation with your coughing. Persistent coughing interferes with the ability to sleep during the night and this means daytime fatigue and a constant sense of irritation. All that pressure building up in the throat and mouth can induce severe headaches. People given to chronic cough often find themselves short of breath and in turn, this drains them of energy. Another common problem is urinary incontinence caused due to chronic cough which happens because the bladder is subjected to continuous pressure. ^[2] All these factors put together mean lifestyle problems that have no solution unless you manage to get rid of the cough.

Cough can cause physical damage ^[3]

If you have noticed, a persistent cough is often accompanied by chronic muscular pain in the chest and back. Every time you have a coughing fit, a strong pressure is generated within the chest cavity and this strains the muscles there and causes muscle pain. Women who have weak bones have been known to crack ribs when coughing very hard. Delicate blood vessels in the anus and the nose and recent surgical wounds may also burst leading to haemorrhage.

Acute cough poses health risks ^[4]

Cough present for a short time is called an acute cough. It is either in infections such as viral fever, sinusitis, bronchitis, whooping cough and pneumonia or non-infectious conditions such as asthma, allergies to environmental conditions such as pollution or cigarette smoke. And these, if untreated, can lead to further complications.

Cough easily infects people around us ^[5]

Every time a person with an infection coughs – even if he or she covers the mouth with a handkerchief or the hands – there is a strong likelihood of letting loose infectious organisms that can attack other people in the vicinity. People with a weakened immune system are especially prone to such air-borne infections.

Chronic cough could indicate deep-seated problems

Cough in most people can be attributed to infections, allergies or other minor problems. Rarely, in some chronic cases (cough that lasts greater than three weeks) is an indicator of some underlying medical condition such as tuberculosis ^[6] or other lung diseases including cancer, congestive heart failure, ear infections, gastro oesophageal reflux disease, etc. People on ACE inhibitor type of drugs for hypertension may also suffer from chronic cough as a reaction to the medicine. ^[7]

In Indian homes, it is quite common to find people treating cough with natural remedies such as turmeric in hot milk, or crushed garlic sautéed in ghee or ginger and tulsi juice mixed with honey. OTC cough formulations like Benadryl are also widely used for symptomatic relief from decades.Even after a week, if you do not find relief and find the cough getting worse, visit a doctor who will help treat the root cause for the cough.

Source

[1] Management of chronic cough by Ian D Pavord and Kian Fan Chung in the Lancet

[2]National Kidney and Urological Diseases Information Clearinghouse: “Urinary Incontinence in Women.”

[3]What are the dangers of coughing? (Live Strong)

[4]National Heart, Lung and Blood Institute of National Health Institute, US

[5] Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel. July 15, 2010, CDC

[6]Textbook of Pulmonary Medicine by D. Behara

[7] Iron supplementation in ACE inhibition as a treatment for cough: is it really inoffensive? [Hypertension. 2001]

We talked to Dr Pankaj Chaturvedi, cancer surgeon at the Tata Memorial Hospital, Mumbai to find out more about this revolutionary treatment plan and how it can benefit people. Excerpts from the interview:

What exactly is metronomic chemotherapy? How is it different?

Dr Pankaj Chaturvedi: Metronomic chemotherapy is defined as prolonged administration of low dose chemotherapy drugs to the cancer patients with lesser side effects and few treatment breaks. This mainly works by slowing the growth of blood vessels in the tumour and stimulating the immune response of the body against the tumour. This is in sharp contrast to the routine chemotherapeutic drugs where high doses are given to kill tumour cells but with significant side effects.

This treatment plan is used in cases where the first line of chemotherapeutic drugs has failed and is used for recurrent or metastatic disease (spread of cancer from one body part to another).  The therapy is used as palliative chemotherapy for various cancers like multiple myeloma, ovarian, prostate, breast, head and neck cancer.

How is it taken? What are the different drugs that are used?

Dr Pankaj Chaturvedi: The drugs are usually given orally unlike routine chemotherapy drugs which are injected. Some the drugs being used include methotrexate, gefitinib and cyclophosphamide. These drugs are easy to use as they can be taken home and consumed orally with the symptoms in control and also because they don’t hamper a person’s life much and has few side-effects. Even in terminally ill patients, it’s a good method of palliative care (a method to alleviate the symptoms rather than the underlying cause). 

What is surrogacy? How is it done?

The word ‘surrogate’ means substitute or replacement and a surrogate mother is one who lends her uterus to another couple so that they can have a baby. In the West, where fewer and fewer babies are offered for adoption, surrogacy is gaining popularity, despite controversial legal and ethical hassles. India is fast becoming the surrogacy capital of the world* because IVF surrogacy in India is much less expensive than in other parts of the world.

Why is surrogacy so popular? What kinds of people need surrogacy?  Why do women choose to become a surrogate?

Surrogacy is popular for those who can’t conceive children in the ‘natural way’. The most common reason people opt for a surrogate is when the woman is missing a uterus. It can absent from birth (Mullerian agenesis) or may have been surgically removed (hysterectomy for life-saving reasons, such as excessive bleeding during a caesarean). Also women who’ve suffered multiple miscarriages, or who have failed repeated IVF attempts for unexplained reasons. Surrogacy is also an effective treatment option for gay couples and single men.

Women who agree to become surrogates may do so for compassionate reasons. This includes a sister, mother or close friend of the couple. They may also do so for financial remuneration – this could be a woman, with or without children, known or unknown to the couple, who rents her womb for a fee.

What are the different kinds of surrogacy?

There are two main kinds of surrogacy:

1. Where the surrogate mother provides the egg: In this case, the surrogate is inseminated artificially with the husband’s sperm. Here, the infertile woman has no genetic relationship to the baby. This was called traditional surrogacy, and is illegal in most parts of the world.
2. Where the infertile woman provides the egg: The egg is then either transferred to the surrogate mother by GIFT (gamete intra-fallopian transfer) along with her husband’s sperm, or the egg is fertilised in the woman’s uterus by IVF with her husband’s sperm. After fertilisation occurs, the embryo is transferred into the surrogate’s uterus, which then acts as an incubator for the next nine months. If she does not have any eggs, it is possible to perform donor egg surrogacy, using an egg donor.

Certain guidelines have been laid down to try to minimize the misuse of the surrogacy technique. This requires a surrogate motherhood contract to be drawn up, which should specify that the child will become the legitimate adopted child of the infertile couple – the intended parents. The contract needs to be signed by the couple, the surrogate and her husband. The legal waters of surrogate motherhood will continue to be murky, and most Indian clinics follow the ICMR (Indian Council of Medical Research) guidelines.

It is vital that the surrogate and the couple consider the future of the child. The receiving mother should ideally be present at the birth and care for the baby in hospital. She can even be prepared for breastfeeding (induced lactation) by hormone treatment.

What are the complex issues raised by surrogacy?

Surrogacy has spawned a host of legal and emotional issues to which there are no ‘right’ answers like:

• What will you do if the surrogate insists on keeping the child?
• How much should you pay the surrogate?
• If she gets ill as a result of the pregnancy who will pay the medical costs?
• Is it possible to put the receiving mother’s name as mother on the birth certificate?
• Will you tell the child about the surrogacy?
• Will surrogates undertake pregnancy for profit?
• What happens if the child is handicapped and is unwanted by the couple and the surrogate mother?
• What happens if the surrogate dies during child birth?

Many people are worried about the possibility of the surrogacy technique being misused. They feel it may allow the exploitation of poor women who may be used as ‘mother machines’ to bear babies – much like the wet nurses of yesteryear.

Surrogacy has received quite a lot of bad press recently – especially when the contract goes sour and there is a dispute over the baby between the commissioning parents and the surrogate mother. The Courts then need to have the Wisdom of Solomon to assign the rights of the ‘genetic’ mother, the ‘birth’ mother, and the ‘social or rearing’ mother. Nevertheless, we must remember that surrogacy does offer one method of achieving parenthood to a few couples who could never have a baby by any other means. The road to surrogacy is a rocky one and requires much thought. It is perhaps the most complex and difficult way to achieve parenthood.

Why is Bollywood fraternity opting for surrogacy? Is it an easier method to have a child?

No, surrogacy is an expensive and complex treatment option, which is best reserved for women without a uterus. When a couple opts for surrogacy they do so only after they have exhausted all their options. Calling it an easier method to have a child, would not be right, because these couples go through a lot before they get to this point.

How does one find a surrogate mother?

For any couple looking to opt for this form of treatment, they will have to approach an agency.  They must be careful to choose a certified agency that will provide them with all the information they require. There are a number of ‘fake’ agencies out there, and for such an expensive treatment, choosing the right one could mean the difference between finding the joy of parenthood and heartbreak. If you are interested in surrogacy, you can visit indiansurrogates.in for more information.

*source: indiansurrogates.in 

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Cough – why so serious?

One of the most recalled scenes with a cough in it is when the charming Madhuri Dixit uses it to get the attention of a surprisingly muscle-less and good-looking young Salman Khan in Hum Aapke Hai Kaun?

On the other hand, most other movies both in India and abroad have movie directors who seem to live under the impression that humans are incapable of coughing without going on to die from lung cancer, tuberculosis or some other disease. The only other coughers you’d find on the big screen who survive the ending are either smokers or marijuana users.

 Yawn or cough?

 Benjamin Franklin, of the founding fathers of America had once famously said, ‘The art of acting consists in keeping people from coughing.’ This remark was actually made to indicate that audiences are more prone to have a coughing fit during boring acts and it’s the actor’s job to be so skilled that it doesn’t happen during his act. A non-coughing audience would thus indicate the show’s success and the elevated thespian skills of the actors.

Ahem! *cough*

Coughing whenever someone else says something preposterous has become part and parcel of everyday interactions. Take for example M.S Dhoni saying that his owning a part of the sports firm that manages four other Indian players doesn’t indicate a conflict of interest of any sort. An appropriate reaction would be *COUGH*.

Sing the ‘Cough Syrup’

Our favourite point has to be this catchy 2008 song called Cough Syrup by Indie American alternative rock group Young The Giant with lead Indo-American lead vocalist Sameer Gadhia who used to be a Human Biology student at Stanford and was thinking of going to medical school to become a doctor.

The song according to Gadhia is a ‘kind of cry for help’ to ‘break free, not necessarily from oppression but the common symptoms of suburbia (urban living) like boredom, normality and homogeneity.’ The video concept, Gadhia said centred on viscosity (perhaps like a physical cough syrup) ‘the friction of fluids and the obstacles that everyone, any object, has to face in order to evolve.’

Beware of cough-power

Researchers found that the average human cough expels enough air to fill up 75% of a 2-litre cola bottle or 1.5 litres! This air that shoots out of the lungs is capable of travelling several feet. Coughing also forces out thousands of tiny droplets of saliva – one cough can expel 3,000 droplets and some of them fly at the speed of 80 km/h or 50 miles/h.

A cough can be as noisy as a loud radio or an underground train and can measure up to 90 decibels!

Source: Live Science

Sometimes a violent cough could actually do some serious damage. Coughing violently can actually break a rib! Of course this would indicate that you’re suffering from a disease or condition that has weakened your bones like cancer or osteoporosis. Coughing can also tear some muscles in the chest, diaphragm and sides and damage nasal veins and those in the anus!

Source: Live Strong

Have cough syrup?

In the 19^th Century, cough medicines for adults and children actually used to contain the highly addictive morphine and it wasn’t well till the end of the century that society realised the grave dangers of addiction. If that wasn’t enough, one of the world’s biggest pharma companies Bayer actually made its fortunes by commercialising heroin as cough medicine! Heroin was actually actively marketed as a cough reliever and over-the-counter medication for children! Thankfully, society woke up to the grave dangers of these addictive drugs and heroin was first made prescription-only in 1914 and completely banned by the USFDA in 1924.

Source: Business Insider and BBC News

How in earth?!!

While drinking a cup of hot cocoa or taking a hot steamy shower seems effective cough remedies, there are more bizarre ones out there like wrapping a wet washcloth around the throat, putting ice cubes in the mouth, rubbing vaporub on the feet and putting on socks and even raising both hands!

 Source: Yahoo

 Giraffes immune to cough?

 Well, this post wouldn’t be complete without having an animal fact. We don’t exactly know why giraffes don’t cough. However, there are some theories about the fact that their lungs are other structures which are required for a cough to originate to be too far down their really long throats. Others however believe that giraffes do cough but the human ear can’t perceive the sound. However, the male giraffes are known emit cough-like sounds during courtship!

Source: Hyper Media and Wikipedia

1.  If I donate blood I am susceptible to contract diseases like HIV

No, that is not true. The Central Drugs Standard Control Organisation (CDSCO) and state licensing authorities issue various licenses for import, manufacture, sale and testing of blood. It also issues certifications like GMP (good manufacturing practices) as per WHO norms.  Apart from this the ministry of health has laid down rules for blood banks, where the state Drug Controllers are authorized to issue certificates based on the quality of their service.

Therefore during a blood donation drive, the organization carrying out the drive, will make sure they follow all the proper precautions to ensure your safety – like using disposable needles etc. Since diseases like HIV can spread only through direct transmission, a fresh, sterilized needle will keep you safe.  To be sure, you can ask the technician to open the sealed pack containing the needle in front of you, and dispose of it in a portable incinerator.

2.      I suffer from diabetes, I cannot donate blood

Not true again. If you are on oral medication for diabetes and are not insulin-dependent, you are a good candidate to donate blood. All you need to do is keep a few of these parameters in mind before you donate. You should not have donated blood for at least 56 days, and  should be generally healthy. If you suffer from high blood pressure or any other heart disease, make sure to consult your doctor before you donate blood.

3.      I have already donated blood once this year, I can’t donate again

According to Dr Sabhyasachi Bal, pulmothoracic surgeon at Fortis, ‘A voluntary donation is the best thing that one can do because it will help the medical community in treating patients who are in need.  One of the most common myths which acts as a hindrance in blood donation is that ‘blood donation weakens  either the health or is harmful for the health’, this is not true at all ; if people donate blood , their blood is made up within 7-14 days. One can donate blood every three-six months.’

4.      I am a woman, I can’t donate blood

According to statistics, 94 per cent of blood donations in the county are made by men while women contribute only six per cent. Being a woman does not hamper your ability to donate blood. Although, due to physiological factors, women may be more prone to conditions such as anaemia, pre-donation counselling will help you decide if you should or shouldn’t donate. Dr. Anju Verma, Chief Medical Officer at Rotary Blood Bank says, ‘The percentage of Indian women donating blood is low as they are deferred due to physiological problems. Most of them have a low hemoglobin count and fail to meet the minimum requirements to donate blood and hence the percent count is low.

 70 percent of blood in our body gets utilized for various bodily functions, rest 30 percent is initialized, if we take out 350 or 450 ml of blood, it will not hamper any bodily functions. Pre–donation counseling is very important to check the problem of low blood donation in India.’

5.      If I donate blood, I will fall ill

Blood donation does not make people ill. Yes, after you donate, you might feel a bit dizzy but that can be taken care of by including certain foods in your diet before and after you donate. Annapurna Agrawal, a nutritionist at Snap Fitness India says, ‘ Before you donate blood, make sure you include iron rich foods and foods that contain Vitamin C into your diet. Also, make sure you have enough fluids before and after you donate. This will help keep the body hydrated and reduce any weakness you might feel after. After you have finished donating, make sure you have foods that contain folic acid, vitamin B6 and B2. These foods contain components that will help raise your hemoglobin levels.’ She also advises people to stay away from carbonated drinks and fatty foods for 24 hours before blood donation. Fatty foods tend to increase the fat content in the blood, making it unfit for pre-donation testing.

How does cough spread?

Every time we cough, there are droplets being released into the atmosphere. Even when we cover our mouth, the droplets rest on our hands and go on to infect the things or people we subsequently touch.

So how can we prevent it from being transmitted?

Dr Gyanshankar Mishra, renowned pulmonologist practising in Nagpur and a member of the European Respiratory Society, and Dr Mandar Kubal, director at the Infectious Diseases & Pulmonary Care Pvt Ltd, give us some tips.

In a country like ours, the biggest challenge in preventing the transmission of cough lies in educating people about the ways in which it can spread from one person to the other. In order to prevent cough from spreading to others, people need to learn the concept of cough etiquette. ‘There is lack of awareness about the concept of cough hygiene and cough etiquettes. People seldom take rest for episodes of lower respiratory tract infections like cough and cold, and continue their normal routine activities. They thus end-up spreading the infections to more number of people around them,’ says Dr Gyanshankar Mishra.

He advises people to cover their nose and mouth with elbows when they cough. ‘Ideally a person with cold and cough should wear a mask to prevent the transmission to others,’ recommends Dr Mishra.

Dr Mandar too gives some pointers to prevent the passing of cough germs. He says, ‘While coughing or sneezing, always use a tissue or a handkerchief. If you are using a handkerchief, use a separate one for coughing and do not use the same to wipe your hands or face. Discard the used tissues in a separate container and never leave them lying on your desk or table at home or office. Also, do not touch surfaces at your workplace or home before washing your hands as you may spread the germs to your colleagues or family.’

In addition to this, he further advises to always wash hands thoroughly with running water and soap for 30 seconds after coughing or handling a tissue. If water is not available, it is a good idea to carry an alcohol based hand sanitiser for the same. They are easily available in a pharmacy or departmental store.

Most people also transmit the illness while travelling to their workplace by means of public transport. In order to curb this, here’s what he suggests.  ‘If you are in a crowded place or travelling in train or bus and cannot use a tissue, turn your head away from other people and cough into your upper sleeve, never into your palms,’ he says.

Every time a person with an infection coughs – even if he or she covers the mouth with a handkerchief or the hands – there is a strong likelihood of letting loose infectious organisms that can attack other people in the vicinity. People with a weakened immune system are especially prone to such air-borne infections.

How can one avoid ‘catching’ the infection from others?

When travelling, cover your mouth and nose with a scarf or tissue. And wash your hands as soon as reach your destination.

If someone in your house is down with cough, the chances of you catching it are higher. Keep some distance from the affected family member and avoid sharing clothes, utensils, etc with them.

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Angelina Jolie’s double mastectomy following the fact that she had 80% chance of developing breast cancer was in the news recently. She is one of the fortunate few who could prevent falling prey to cancer thanks to genetic testing (the BRCA genes). Though the hype about Angelina Jolie’s decision died down in a few days, the BRCA genes have been in the news constantly.

In a landmark ruling, the US Supreme Court announced that genes cannot be patented. We interviewed Dr. Prasad Raj Dandekar, a renowned radiation oncologist at the L.H.Hiranandani Hospital in Mumbai about the implications of this ruling on genetic testing and what it could mean for the research industry.

How is genetic testing so important, especially so in the case of breast cancers?

It will now be possible to predict the risk of developing breast cancer in patients with family history of breast cancers easily and affordably by a blood test. Some of the patients with breast cancer have a variation in genes called BRCA1 and BRCA2 which significantly increases their chances of developing breast and ovarian cancers. A lady with BRCA gene mutation will have 85% chance of developing breast cancer and 45% of developing ovarian cancer in her lifetime. This is significantly higher that compared to women who are not BRCA gene mutation positive. Women who are detected to be positive can prevent cancer development by taking some hormone therapy such as tamoxifen, or undergoing prophylactic surgery like celebrity Angelina Jolie did or be on regular follow up to detect cancer at early stage. The key factor here is to detect women who are BRCA gene mutation positive and explain them the risks associated.

Is the test for the BRCA genes available in India? And more importantly, is it affordable?

A few months ago when the Angelina Jolie got her bilateral mastectomy done after testing positive for BRCA genes, I received a number of inquiries about the BRCA gene testing. Many patients were worried about outcome of their cancer or concerned about their daughters or sisters getting cancer. But the cost and time involved in doing this test was a major hurdle. Until yesterday the patent for this test was held by a single company in the USA and thus this test was prohibitively expensive for Indian patients. At the cost of nearly 4000$ it was out of reach for even most American women if insurance cover was not covering it. In India this test is available at select laboratories and costs nearly Rs. 65,000 to the patients.

What are the implications of the recent verdict on gene patenting by the US Supreme Court?

In a landmark verdict the USA Supreme court has ruled yesterday that no one can patent human genes, thus making the monopoly claims of the company who currently conducts the tests for BRCA invalid.

This is a major victory for patients and advocacy groups for breast cancer since now this test can be made commercially available at a significantly lower cost and more number of patients could afford it. This will help us to identify women who are at a higher risk of developing cancers and thus many of these cancers can be prevented, saving many lives. Genetic testing for cancers such as breast cancer will be available for even poor patients and will not be limited to rich patients such as Angelina Jolie. Within hours of the verdict, some of the labs in the USA have slashed their rates for BRCA gene testing by 75%!

Apart from the cost and the availability of the ruling on the BRCA genetic testing, are there any other implications you can foresee?

This verdict also has a significant impact on cancer research and new drug development. Most of the research labs could not test for BRCA genes in patients earlier due to the patent. Now a wide spread research looking in to role of BRCA genes and cancers is feasible, without fear of being sued by the patent holding company. Thus a multi gene testing for cancers could be possible with inclusion of BRCA genes. Nearly 3500 to 5000 patents are held by major companies for naturally occurring genes and genetics researchers had great limitations due to inability to explore patented genes. Due to this verdict all the patents will be invalidated and will pave way for wider research in genetics of cancer and many other genetic diseases.

What does this mean for the companies who invested in genetic research? Do they still have any incentive to do so?

There was a silver lining for the industry also in this verdict that the court has allowed patents for the other processes involved in the application of genetics. Even though genes cannot be patented, the use of genes in diagnosis or treatment as well as ways of isolating the gene could be still patented. Thus this verdict will encourage the pharmaceutical companies to pursue genetic research and come up with better treatment and diagnostic options. There is some criticism of this decision that the interest in genetic research may reduce due to loss of financial benefit, but the current level of academic interest and new inventions will hopefully avoid such a negative impact.

This win – win decision will have a long standing impact on the research, diagnosis and treatment of patients as well as on the way pharmaceutical industry operates.