Tuesday, July 3, 2012

Stay Hungry, Stay Foolish….

Steve-JobsAs my mind wanders through the uncertainties of life, i found this inspiring speech by Steve Jobs.

Steve Jobs' 2005 commencement address at Stanford University.

      I am honoured to be with you today at your commencement from one of the finest universities in the world. I never graduated from college. Truth be told, this is the closest I've ever gotten into a college graduation. Today I want to tell you three stories from my life. That's it. No big deal. Just three stories.The first story is about connecting the dots.I dropped out of Reed College after the first 6 months, but then stayed around as a drop-in for another 18 months or so before I really quit. So why did I drop out?It started before I was born. My biological mother was a young, unwed college graduate student, and she decided to put me up for adoption. She felt very strongly that I should be adopted by college graduates, so everything was all set for me to be adopted at birth by a   lawyer and his wife. Except that when I popped out they decided at the last minute that they  really wanted a girl. So my parents, who were on a waiting list, got a call in the middle of the  night asking: "We have an unexpected baby boy; do you want him?" They said: "Of course."My biological mother later found out that my mother had never graduated from college and that my father had never graduated from high school. She refused to sign the final adoption papers. She only relented a few months later when my parents promised that I would someday go to college.And 17 years later I did go to college. But I naively chose a college that was almost as expensive as Stanford, and all of my working-class parents' savings were being spent on my college tuition. After six months, I couldn't see the value in it. I had no idea what I wanted to  do with my life and no idea how college was going to help me figure it out. And here I was spending all of the money my parents had saved their entire life. So I decided to drop out and trust that it would all work out OK. It was pretty scary at the time, but looking back it was one  of the best decisions I ever made. The minute I dropped out I could stop taking the required classes that didn't interest me, and begin dropping in on the ones that looked interesting.It wasn't all romantic. I didn't have a dorm room, so I slept on the floor in friends' rooms,  I returned coke bottles for the 5¢ deposits to buy food with, and I would walk the 7 miles across town every Sunday night to get one good meal a week at the Hare Krishna temple. I loved it.And much of what I stumbled into by following my curiosity and intuition turned out to be priceless later on. Let me give you one example:Reed College at that time offered perhaps the best calligraphy instruction in the country.Throughout the campus every poster, every label on every drawer, was beautifully hand calligraphed. Because I had dropped out and didn't have to take the normal classes, I decided to take a calligraphy class to learn how to do this. I learned about serif and san serif typefaces, about varying the amount of space between different letter combinations, about what makes great typography great. It was beautiful, historical, artistically subtle in a way that science can't capture, and I found it fascinating.None of this had even a hope of any practical application in my life. But ten years later, when we were designing the first Macintosh computer, it all came back to me. And we designed it all into the Mac. It was the first computer with beautiful typography. If I had never dropped in on  that single course in college, the Mac would have never had multiple typefaces or proportionally spaced fonts. And since Windows just copied the Mac, it's likely that no personal computer would have them. If I had never dropped out, I would have never dropped in on this calligraphy class, and personal computers might not have the wonderful typography that they do. Of course it was impossible to connect the dots looking forward when I was in college. But it was very, very clear looking backwards ten years later.Again, you can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.

            My second story is about love and loss.I was lucky — I found what I loved to do early in life. Woz and I started Apple in my parents garage when I was 20. We worked hard, and in 10 years Apple had grown from just the two of us in a garage into a $2 billion company with over 4000 employees. We had just released our finest creation — the Macintosh — a year earlier, and I had just turned 30. And then I got  fired. How can you get fired from a company you started? Well, as Apple grew we hired someone who I thought was very talented to run the company with me, and for the first year or so things went well. But then our visions of the future began to diverge and eventually we had a falling out. When we did, our Board of Directors sided with him. So at 30 I was out. And very publicly out. What had been the focus of my entire adult life was gone, and it was devastating.I really didn't know what to do for a few months. I felt that I had let the previous generation of entrepreneurs down - that I had dropped the baton as it was being passed to me. I met with David Packard and Bob Noyce and tried to apologize for screwing up so badly. I was a very public failure, and I even thought about running away from the valley. But something slowly began to dawn on me — I still loved what I did. The turn of events at Apple had not changed that one bit. I had been rejected, but I was still in love. And so I decided to start over.I didn't see it then, but it turned out that getting fired from Apple was the best thing that could have ever happened to me. The heaviness of being successful was replaced by the lightness of being a beginner again, less sure about everything. It freed me to enter one of the most creative periods of my life.

     During the next five years, I started a company named NeXT, another company named Pixar,and fell in love with an amazing woman who would become my wife. Pixar went on to create the worlds first computer animated feature film, Toy Story  , and is now the most successful animation studio in the world. In a remarkable turn of events, Apple bought NeXT, I returned to Apple, and the technology we developed at NeXT is at the heart of Apple's current renaissance. And Laurene and I have a wonderful family together.I'm pretty sure none of this would have happened if I hadn't been fired from Apple. It was awful tasting medicine, but I guess the patient needed it. Sometimes life hits you in the head with a brick. Don't lose faith. I'm convinced that the only thing that kept me going was that I loved what I did. You've got to find what you love. And that is as true for your work as it is for your lovers. Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love  what you do. If you haven't found it yet, keep looking. Don't settle. As with all matters of the heart, you'll know when you find it. And, like any great relationship, it just gets better and better as the years roll on. So keep looking until you find it. Don't settle.

    My third story is about death.When I was 17, I read a quote that went something like: "If you live each day as if it was your  last, someday you'll most certainly be right." It made an impression on me, and since then,for the past 33 years, I have looked in the mirror every morning and asked myself: "If today were the last day of my life, would I want to do what I am about to do today?" And whenever the answer has been "No" for too many days in a row, I know I need to change something.Remembering that I'll be dead soon is the most important tool I've ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure - these things just fall away in the face of death,leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.About a year ago I was diagnosed with cancer. I had a scan at 7:30 in the morning, and it clearly showed a tumour on my pancreas. I didn't even know what a pancreas was. The doctors told me this was almost certainly a type of cancer that is incurable, and that I should expect to live no longer than three to six months. My doctor advised me to go home and get my affairs in order, which is doctor's code for prepare to die. It means to try to tell your kids everything you thought you'd have the next 10 years to tell them in just a few months. It means to make sure everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.I lived with that diagnosis all day. Later that evening I had a biopsy, where they stuck an endoscope down my throat, through my stomach and into my intestines, put a needle into my  pancreas and got a few cells from the tumor. I was sedated, but my wife, who was there, told me that when they viewed the cells under a microscope the doctors started crying because it turned out to be a very rare form of pancreatic cancer that is curable with surgery. I had the surgery and I'm fine now.This was the closest I've been to facing death, and I hope it's the closest I get for a few more decades. Having lived through it, I can now say this to you with a bit more certainty than when death was a useful but purely intellectual concept:No one wants to die. Even people who want to go to heaven don't want to die to get there.And yet death is the destination we   all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life's change  agent. It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away. Sorry to be so dramatic, but it is quite true.Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma —which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.When I was young, there was an amazing publication called The Whole Earth Catalogue, which was one of the bibles of my generation. It was created by a fellow named Stewart Brand not far from here in Menlo Park, and he brought it to life with his poetic touch. This was in the late1960's, before personal computers and desktop publishing, so it was all made with typewriters, scissors, and polaroid cameras. It was sort of like Google in paperback form, 35years before Google came along: it was idealistic, and overflowing with neat tools and great notions.Stewart and his team put out several issues of The Whole Earth Catalog, and then when it had run its course, they put out a final issue. It was the mid-1970s, and I was your age. On the back cover of their final issue was a photograph of an early morning country road, the kind you might find yourself hitchhiking on if you were so adventurous. Beneath it were the words:"Stay Hungry. Stay Foolish." It was their farewell message as they signed off. Stay Hungry.Stay Foolish. And I have always wished that for myself. And now, as you graduate to begin a new, I wish that for you.

Stay Hungry. Stay Foolish.

Thank you all very much

Saturday, June 30, 2012

FDA approves Myrbetriq for overactive bladder

astellas-040612The U.S. Food and Drug Administration   28th June approved Myrbetriq (mirabegron) to treat adults with overactive bladder, a condition in which the urinary bladder muscle cannot be controlled, squeezes too often or squeezes without warning.

An extended-release tablet taken once daily, Myrbetriq improves the storage capacity of the bladder by relaxing the bladder muscle during filling. Symptoms of overactive bladder include the need to urinate too often (urinary frequency), the need to urinate immediately (urinary urgency), and the involuntary leakage of urine as a result of the need to urinate immediately (urge urinary incontinence).

“An estimated 33 million Americans suffer from overactive bladder, which is uncomfortable, disrupting and potentially serious,” said Victoria Kusiak, M.D., deputy director of the Office of Drug Evaluation III in the FDA’s Center for Drug Evaluation and Research. “Today’s approval provides a new treatment option for patients with this debilitating condition.”

Myrbetriq’s safety and efficacy were demonstrated in three double-blind, placebo-controlled, multicenter clinical trials. A total of 4,116 patients with overactive bladder were randomly assigned to take Myrbetriq at doses of 25 milligrams, 50 mg, 100 mg, or a placebo once daily for 12 weeks.

Results showed that Myrbetriq 25 mg and 50 mg effectively reduced the number of times a patient urinated and the number of times a patient had wetting accidents during a 24-hour period. Patients taking Myrbetriq 50 mg also expelled a greater amount of urine, demonstrating the drug’s effectiveness in improving the storage capacity of the bladder.

The most common side effects observed in the trials were increased blood pressure, common cold-like symptoms (nasopharyngitis), urinary tract infection, constipation, fatigue, elevated heart rate (tachycardia), and abdominal pain. Myrbetriq is not recommended for use in those with severe uncontrolled high blood pressure, end stage kidney disease or severe liver impairment.

Source: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm310096.htm

Friday, June 1, 2012

Photodynamic therapy increases survival in Malignant Pleural Mesothelioma

   PDT lights_0    Mesothelioma is a malignant cancer usually associated with asbestos exposure. The development of mesothelioma may take longer than 10 to 15 years after the persistent exposure of asbestos.It usually affects pleura,lungs and it is extremely aggressive.The treatment is not satisfactory for mesothelioma.Only 3-4 out of 10 patients survive for more than an year after treatment.The treatment usually involves lung sparing surgery.

  Recently a group of researchers from the Perelman School of Medicine, University of Pennsylvania reported in Annals of Thoracic Surgery that Photodynamic therapy besides lung sparing surgery in cases of malignant mesothelioma increases the survival up to 2years.

The researchers proposed that mesothelioma is bound to recur in treated patients, but if they can have functional lungs they can sustain treatment in case of recurrence. So photodynamic therapy helps in having functional lungs in spite of treatment and thus increasing the survival rates in mesothelioma patients.

Source: http://ats.ctsnetjournals.org/cgi/gca?allch=&SEARCHID=1&AUTHOR1=Joseph%2BFriedberg&FIRSTINDEX=0&hits=10&RESULTFORMAT=&gca=annts%3B93%2F5%2F1658&allchb=

PCSOA 2011 - Raising age of consent for sex to 18

        child-sexual-offences-bill-140512Protection of Children from Sexual Abuses act 2011. The parliament of India passed this bill recently and raised the age for consent for sex from 16yrs to 18yrs. Recently a trial court has termed this law which raises the age for consent for sex from16 to 18yrs as ‘undemocratic’ and regressive’. It also stated that this act can be used as a tool by law enforcing authorities to harass minors especially boys.

       The court clarified that it was against teenage sex but raising the age is not the solution. "Good virtues cannot be inculcated and good conscience cannot be imbibed in a child by legal provisions. It would be better and wiser to leave this job to parents and school teachers...Children need to be imparted sex education in the schools," said the court. These observations made by the court in the case of Sandeep Paswan ,facing trial for kidnapping and raping a minor girl who had eloped with him.

    As already the bill has been passed in the parliament, the Govt. should think on these lines and reconsider the raising of age for consent for sex.

You can get the full text of PCSOA 2011 here

http://164.100.24.219/BillsTexts/RSBillTexts/asintroduced/protection%20children.pdf

Thursday, May 31, 2012

Abacavir and Autoimmunity

        Recently FDA led team has discovered Autoimmunity caused by Abacavir in at-risk patients on ART.Abacavir acts on HLA B*5701 which helps the immune system to distinguish between the 'self' and the 'foreign' antigens. By acting on HLA B*5701 the body starts recognizing its own tissues as foreign and thus autoimmunity comes into picture. This discovery is a break through discovery  in the knowing, why certain drugs cause allergic reactions in certain patients.

Source: http://journals.lww.com/aidsonline/pages/default.aspx
          
            http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm305067.htm

Life se panga mat le yaar...


Life is so precious.... Shaan being brand ambassador for anti tobacco campaign sings 'Life se panga mat le yaar'

Tobacco industry interference

     31st May is world No Tobacco Day. People consume Tobacco under status mania, peer pressure or depending on the environment where the person lives. Govt agencies have taken initiative to discourage people from using tobacco products. But in the age of marketing and commercialization , the efforts by lawmaking authorities and few NGOs is being negated by the aggressive interference of tobacco industry by means of ads and marketing.So theme of this year's World No Tobacco day is 'Tobacco industry interference'.
       According to a recent research smoking could cause 40 million excess deaths among smokers, who also suffer from tuberculosis (TB) by 2050. The study, led by Sanjay Basu from the University of California, San Francisco, used a maths model to determine the effect of smoking on future TB rates, the BMJ (British Medical Journal) reports. Tt shows that from 2010 to 2050 smoking could lead to 40 million excess TB deaths worldwide – from 61 to 101 million.
They also conclude that if current smoking trends continue, the number of excess TB cases could rise from 256 to 274 million – 18 million new cases in total. “Aggressively lowering the prevalence of tobacco smoking could reduce smoking attributable deaths from tuberculosis by 27 million by 2050,” Basu said, according to a California statement.
    Nearly one-fifth of the world’s population smokes and that most cigarettes are smoked in countries with high TB prevalence. Given this, the authors wanted to predict how much impact smoking will have on future TB rates. Researchers found that smoking may have a substantial impact on future TB rates because a moderate increase in individual risk translates into a large population-level risk.

Sunday, March 11, 2012

FDA approves new silicone gel-filled breast implant

Approval conditioned on post-approval safety studies

    On 9th March 2012, the U.S. Food and Drug Administration approved a silicone gel-filled breast implant manufactured by Sientra Inc. to increase breast size (augmentation) in women at least 22 years old and to rebuild breast tissue (reconstruction) in women of any age.

As a condition of approval, Sientra is required to conduct post-approval studies that will assess long-term safety and effectiveness outcomes as well as the risks of rare disease outcomes.

Silicone gel-filled breast implants are medical devices implanted under the breast tissue or under the chest muscle for breast augmentation or reconstruction. These implants have a silicone outer shell that is filled with silicone gel. They come in different sizes and have either smooth or textured shells.

Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the result of a primary breast reconstruction surgery.

Breast augmentation includes primary breast augmentation to increase the breast size, as well as revision surgery to correct or improve the result of a primary breast augmentation surgery.

With today’s approval, there are now three FDA-approved silicone gel-filled breast implants in the U.S. manufactured by Allergan, Mentor and Sientra.

“Data on these and other approved silicone gel-filled breast implants continue to demonstrate a reasonable assurance of safety and effectiveness,” said William Maisel, M.D., M.P.H., deputy director for science in the FDA’s Center for Devices and Radiological Health.

“It’s important to remember that breast implants are not lifetime devices. Women should fully understand risks associated with breast implants before considering augmentation or reconstruction surgery, and recognize that long-term monitoring is essential.” said Maisel.

The FDA based its Sientra approval on three years of clinical data from 1,788 participants. Complications and outcomes reflected those found in previous studies of other breast implants and included tightening of the area around the implant (capsular contracture), re-operation, implant removal, an uneven appearance (asymmetry), and infection.

In June 2011, the FDA released a report that included preliminary safety data from post-approval studies from earlier breast implant approvals. The experience collecting and analyzing data from these studies informed the design and structure of post-approval studies for Sientra breast implants.

In addition to other post-approval conditions, Sientra will:

  • continue to follow the 1,788 clinical trial participants in their pre-market study for an additional 7 years;
  • conduct a 10-year study of 4,782 women receiving Sientra silicone gel-filled breast implants to collect information on long-term local complications such as capsular contracture, as well as less common disease outcomes, such as rheumatoid arthritis and breast and lung cancer; and
  • conduct five case-control studies that will evaluate the association between Sientra’s silicone gel-filled breast implants and five rare diseases: rare connective tissue disease, neurological disease, brain cancer, cervical/vulvar cancer, and lymphoma.

“The design of these post-approval studies will require Sientra to collect valuable safety information with adequate enrollment and follow-up,” said Maisel. “The FDA is committed to working with breast implant manufacturers to collect useful post-market data on long-term safety and effectiveness.”

Sientra Inc. is based in Santa Barbara, Calif.

Source:http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm295429.htm

Friday, March 2, 2012

Indian Academy of Pediatrics Immunization Schedule

   Vaccination-Schedule  Immunization has become an essential component of primary health in India since long time.There is Universal Immunization program which has been adopted to Indian situation and with slight modifications National immunization program has been implemented by the Govt of India. But Indian Academy of Pediatrics recommends few extra vaccines and protocols for immunization.The IAP Immunization schedule as follows….

  

iap 1iap 2

iap3

Source: http://www.iapindia.org/immunisation/immunisation-schedule

Weight loss prevents urinary incontinence in obese women with type 2 Diabetes

       urge_incontinence The Look AHEAD (Action for Health in Diabetes) trial recently came out with conclusion that moderate weight loss in obese/overweight type 2 diabetic women. The study determined the effect of weight loss on the prevalence, incidence and resolution of weekly or more frequent urinary incontinence in overweight/obese women with type 2 diabetes after 1 year of intervention.

     The urinary incontinence is one of the prominent problems in obese women with DM Type 2 though incontinence doesn’t depend on the weight. Women in this substudy (2,739, mean ± SD age 57.9 ± 6.8 years, body mass index 36.5 ± 6.1 kg/m2) were randomized into an intensive lifestyle weight loss intervention or a diabetes support and education control condition.

      Moderate weight loss reduced the incidence but did not improve the resolution rates of urinary incontinence at 1 year among overweight/obese women with type 2 diabetes. Weight loss interventions should be considered for the prevention of urinary incontinence in overweight/obese women with diabetes.

Source:http://www.sciencedirect.com/science/article/pii/S0022534711054620