RF Ablation a Safe Alternative Option for Treating Lung Cancer

Lung cancer patients unable to undergo surgery have another safe and effective treatment option: radiofrequency (RF) ablation, according to a new study.

The Brown Medical School and Rhode Island Hospital study showed that RF ablation used to treat early-stage, inoperable cancer resulted in outcomes that were equal to or better than those achieved through external beam radiation (EBT), a decades-old alternative to the surgical removal of cancerous tissue.

“In our study, RF ablation produced meaningful results in terms of both survival and tumor control,” said Damian E. Dupuy, M.D., director of tumor ablation at Rhode Island Hospital and professor of diagnostic imaging at Brown Medical School in Providence. “The best two-year survival rate for early-stage lung cancer using EBT is 51 percent, compared to 57 percent with ablation.”

Lung cancer is a leading cause of death in the United States. The National Cancer Institute estimates that in 2007, more than 213,000 Americans will be diagnosed with lung cancer and more than 160,000 deaths will result from the disease. Patients with primary lung cancer, in which cancerous cells first develop in the lung, often are of advanced age and have highly diseased lungs and impaired heart function, making them poor candidates for invasive surgery. The same conditions can also make it difficult for patients to be treated with EBT, which directs focused beams of radiation at a tumor to destroy the abnormal cells.

“Conventional EBT therapy involves 33 treatments over a six-week period and can often lead to side effects including radiation pneumonia and the permanent loss of lung tissue,” said Dr. Dupuy. “RF ablation, which uses high-frequency electrical currents to heat and destroy abnormal cells, is performed in a single day as an outpatient procedure, is minimally invasive and has few side effects.”

In his study, Dr. Dupuy and a research team evaluated the outcomes of 153 patients who underwent computed tomography (CT)-guided RF ablation for 189 inoperable lung cancers, including 116 primary lung cancers and 73 metastases to the lung from other cancers. The majority of the patients, who ranged in age from 17 to 94, also suffered from severe cardiopulmonary disease.

The one, two, three, four and five-year survival rates for stage I, non-small cell lung cancer treated with RF ablation were 78 percent, 57 percent, 36 percent, 27 percent and 27 percent, respectively. A recent study reported that patients with similar cancers who underwent conventional EBT had a three-year survival rate of 34 percent.

Patients with colorectal pulmonary metastasis, in which cancer began in the colon and spread to the lung, had a 57 percent five-year survival rate following RF ablation, which is better than some surgical studies.

“It’s important for physicians to know that RF ablation is a treatment option for their sickest and elderly patients,” Dr. Dupuy said.

The study also showed that RF ablation helped control the progression of patients’ tumors. Tumors three centimeters or smaller took an average of 45 months to grow following treatment; tumors larger than three centimeters progressed in an average of 12 months.

“As the means of detecting early-stage lung cancer improves, we will see less invasive treatment options such as ablation replace surgery during our lifetime,” Dr. Dupuy said.

Indian Pharma Authorized to Market New Anti-TB Drugs

The World Health Organization (WHO) has approved four new drugs manufactured by the Macleods of India for treatment of tuberculosis, agency reports say. And one of the four would be used against some strains of TB resistant to standard treatment.

The addition of these four medicines will reinforce efforts to scale up access to anti-tuberculosis medicines in high-burden areas, the WHO said in a statement.

The medicines are the first TB products to be added to the list in two years.

One of the new products, Cycloserine, is particularly important because it is a second-line medicine, necessary for cases that are resistant to standard treatment, WHO said.

Macleods is a large generics manufacturer, with an annual turnover of over three billion US dollars. The new approval could mark a significant stage in the fight against TB.

The latest reports by the WHO itself have indicated that the drug-resistant strains are proving a great challenge to health administrators worldwide.

XDR-TB is a "super bug" which resists three or more classes of second-line tuberculosis drugs. It has been identified in 28 countries worldwide, with cases concentrated in the United States, Latvia and South Korea. In South Africa, the XDR strain has killed nearly 200 people since September.

Mario Raviglione, director of the United Nations agency's Stop TB Department, said recently the strain could cause more widespread deaths among those with HIV/AIDS in the coming years.

New antibiotics and drugs to fight XDR-TB could take more than five years to reach the market, Raviglione had also warned.

Hence the WHO has stressed that countries needed to boost their laboratory capacities and quickly identify which patients have drug-resistant TB strains, for necessary follow up treatmnet.

Any failure to effectively combat the drug-resistant strains could trigger off an epidemic of uncontrollable proportions, it has been noted.

MRI Screening of Other Breast Crucial for Patients Diagnosed With Cancer in One Breast

A multi-center study concludes that women with a recent diagnosis of cancer in one breast should have MRI screening of the opposite breast.

This study was conducted by the Chapel Hill researchers at University of North Carolina.

The international research team found that MRI, or magnetic resonance imaging, detected cancer in the opposite breast in 30 of 969 women (3.1 percent) who had recently been diagnosed with cancer in one breast only. The cancers in the opposite breast were missed by previous mammography and clinical exam.

The authors recommend MRI screening for women at high risk for breast cancer – those who already have the disease, have been recently diagnosed or have a family history of breast cancer. The results appear in the March 29, 2007, issue of The New England Journal of Medicine.

"This study is pretty definitive evidence that the opposite breast needs to be evaluated with MRI," said study co-author Dr. Etta Pisano, a principal investigator and Kenan professor of radiology and biomedical engineering at the UNC School of Medicine. "But no one is recommending that we give up mammography. MRI screening is a very expensive tool that should be used judiciously for high risk populations. The last thing we would want is for every woman to think she should get an MRI," Pisano said.

In addition, MRI does not detect calcifications, one of the earliest signs of breast cancer. Mammography is the only way to detect calcifications.

The study was conducted by the American College of Radiology Imaging Network (ACRIN) at 25 test sites in the U.S. and Canada. The National Cancer Institute funded the research.

Despite negative clinical breast exams and mammography of the opposite breast, up to ten percent of women are later diagnosed with cancer in the opposite breast after having begun treatment for breast cancer, the study said. This means patients must undergo two rounds of cancer therapy (surgery and possibly radiation and/or chemotherapy) rather than one, as would be the case if cancer in the other breast was found at the time of initial diagnosis.

Sixty percent of the cancers uncovered by MRI were invasive, with potential to spread beyond the breast. Such breast tumors "are the most important ones to find," Pisano said. The average tumor size was nearly 11 millimeters.

Pisano, director of the UNC Biomedical Research Imaging Center and a member of the UNC Lineberger Comprehensive Cancer Center, said the percentage of cancers found in the opposite breast was huge. "If you were to screen the opposite breast with mammography in the general population, you would expect to find four to seven cancers per 1,000 patients. This study found three per 100, nearly ten times higher."

Smaller, less rigorous studies at a single center had suggested that MRI would detect otherwise hidden cancers in roughly 5 percent of women with a recent breast cancer diagnosis. But the percentages of additional cancers ranged widely, as did the ability of these studies to correctly identify the absence of cancer. Nor did these studies include a one-year follow-up to determine the breast cancer status of the women in whom MRI did not detect disease.

The ACRIN authors note that the additional cancers detected in their study was not influenced by the patient’s breast density, menopausal status or primary tumor history.

"The reason why dense breasts are a problem is that tissue lies between the tumor and the detector. The beam has to go though a lot of normal tissue, which can hide the tumor. But if you take slices, as MRI does, you get images in focus every few millimeters and the tumor can’t hide," Pisano said.

Special Exams to Help Failing Medical Students

Those failing in their MBBS examinations in Rajasthan need not despair about becoming doctors. Rajasthan Medical University is conducting MBBS examinations once again for these students, a move that is being questioned by many.

These examinations are being considered in view of the increasing number of failures in MBBS and to help those students who are finding it hard to clear the examination.

As many as 25 students from Jaipur's SMS Medical College and 10 to 15 students from other medical college are appearing in these special examinations.

Theory examinations are already over while practical examinations will be conducted shortly.

However, final year MBBS students believe that these examinations hold no significance as the main and the supplementary examinations were conducted respectively in April and October last year.

"Students have already been given two chances and there is no use of conducting the examination over and over again," says a final year medical student of the college on condition of anonymity.

The university administration says that everything is being done under the university rules.

"Discussions have taken place at different levels regarding conducting these special examinations. There is nothing illegal in it and everything is being done within the rules," said P.P.S. Mathur, vice-chancellor of Rajasthan Medical University.

Those appearing in the special examination have alleged that they were victims of bias of the teachers.

Students said that they had earlier lodged their protest with Governor Pratibha Patil and had demanded a special examination so that they can appear in the pre-PG examination scheduled this year.

TB Vaccines: Ring Out the New, Bring in the Old

Old may be gold, according to the journal Proceedings of the National Academy of Sciences. The report states that the present TB vaccines are losing their efficiency in preventing tuberculosis, and scientists may do well to resurrect older versions of the vaccine.

The scientists led by Dr. Roland Brosch of the Institut Pasteur opine that modern BCG or bacillus Calmette Guerin vaccines used in immunization of 2 million children around the world weekly, are losing their power, probably due to changes in the genetic strains used.

The evolution of these strains and the subsequent loss of certain genes, are creating weaker immune reactions, note the scientists.

French scientists originally developed the BCG vaccine, which has been running for the last 90 years, in 1908. They managed to make a strain of tuberculosis (TB) less potent by growing it in a glycerin-potato mixture.

This meant when used in a vaccine it would produce an immune response without causing the actual disease. Once they found it was safe, they began to distribute the vaccine around the world.

Since the 1960s, there have been reports of the declining efficacy of the BCG vaccine.

A study in babies published in 2006 found that the early Japan strain prompted a stronger immune reaction than three newer strains that are used in 66% of modern immunizations.

Study leader, Dr Roland Brosch, senior researcher at the Institut says: "The earlier strains have undergone fewer genetic changes.

"The later strains were selected because they had the least side effects but maybe the efficiency has become less and less."

Brosch advises more research into the matter coupled with methods of making the present vaccines more effective.

The Health Protection Agency of U.K welcomed the research and added that EU sponsored clinical trials were in the process of re-evaluating older strains.

The agency was quoted: "A number of other approaches are being actively investigated to improve the protection provided by the current BCG vaccine strains.

"Clinical trials over the next five to seven years will provide evidence as to which approach will be most successful."

TB rates have skyrocketed since the 1980s in places such as the former Soviet Union and sub-Saharan Africa.

Dr. Marcel Behr of Montreal's McGill University says the new study is "a clarion call to create a better vaccine." He said one option is to recreate the original BCG genome and "reconstruct something more closely resembling the original bacterium."

The World Health Organization estimates 1.7 million people died from TB in 2004.

Making Sense of the World Through a Cochlear Implant

Scientists at University College London and Imperial College London have shown how the brain makes sense of speech in a noisy environment, such as a pub or in a crowd. The research suggests that various regions of the brain work together to make sense of what it hears, but that when the speech is completely incomprehensible, the brain appears to give up trying.

The study was intended to simulate the everyday experience of people who rely on cochlear implants, a surgically-implanted electronic device that can help provide a sense of sound to a person who is profoundly deaf or who has severe hearing problems.

Using MRI scans of the brain, the researchers, funded by the Wellcome Trust and the Medical Research Council, identified the importance of one particular region, the angular gyrus, in decoding distorted sentences. The findings are published in the Journal of Neuroscience.

In an ordinary setting, where background noise is minimal and a person's speech is clear, it is mainly the left and right temporal lobes that are involved in interpreting speech. However, the researchers have found that when hearing is impaired by background noise, other regions of the brain are engaged, such as the angular gyrus, the area of the brain also responsible for verbal working memory – but only when the sentence is predictable.

'In a noisy environment, when we hear speech that appears to be predictable, it seems that more regions of the brain are engaged,' explains Dr Jonas Obleser, who did the research whilst based at the Institute of Cognitive Neuroscience (ICN), UCL. 'We believe this is because the brain stores the sentence in short-term memory. Here it juggles the different interpretations of what it has heard until the result fits in with the context of the conversation.'

The researchers hope that by understanding how the brain interprets distorted speech, they will be able to improve the experience of people with cochlear implants, which can distort speech and have a high level of background noise.

'The idea behind the study was to simulate the experience of having a cochlear implant, where speech can sound like a very distorted, harsh whisper,' says Professor Sophie Scott, a Wellcome Trust Senior Research Fellow at the ICN. 'Further down the line, we hope to study variation in the hearing of people with implants – why is it that some people do better at understanding speech than others. We hope that this will help inform speech and hearing therapy in the future.'

Surgeon Develops Procedure to Prevent Arm Swelling in Breast Cancer Patients

A surgeon has developed a new procedure to prevent one of the most common side effects associated with breast cancer treatment – lymphedema or swelling of the arms due to faulty drainage of the lymph nodes.

V. Suzanne Klimberg, M.D., director of the UAMS breast cancer program, led a study of breast cancer patients at risk for developing lymphedema.

'The removal and analysis of the lymph nodes under the arm remains the most important factor in determining the severity of disease in breast cancer patients,' Klimberg said. 'In the past, surgery to remove the lymph nodes and most of the fat and tissue in the armpit often resulted in complications, including lymphedema.' Five percent to 50 percent of women undergoing surgical treatment for breast cancer have developed lymphedema, mainly dependent upon the extent of surgery.

At the ACRC, surgeons determined that the draining of the first lymph node, known as the sentinel lymph node, is capable of predicting if the cancer has spread to the remaining armpit lymph nodes, known as axillary lymph nodes. This is a less invasive surgery and reduces the likelihood of complications.

However, the lymph node system is at risk of disruption during either a sentinel lymph node biopsy or an axillary lymph node dissection, which often leads to swelling in the arm.

To prevent the arm swelling, Klimberg has developed the Axillary Reverse Mapping (ARM) procedure. The new technique evaluates the ways in which fluid drains through the lymph node system in the arm through the injection of blue dye. The dye is used to map the drainage of the arm.

Gene Therapy To The Aid Of Cystic Fibrosis

Cystic fibrosis is an incapacitating condition which chokes the lungs with mucus. This is one of the common life threatening diseases which affect more than 7500 people in the United Kingdom.

Researchers at University College London (UCL) are trying to find a cure for this condition by using a modified version of HIV. If this procedure is successful, it might help the babies get rid of this ailment while developing in the womb itself.

Scientists are currently attempting to replace the faulty gene which is responsible for this condition. Their line of work is engaged in developing vector-viruses which can incorporate the right gene into the abnormal and diseased body cells.

Suzie Buckley, the geneticist from UCL will be presenting her work at the British Society for Gene Therapy conference at Warwick. Her current technique of using vector in the disabled version of HIV to avert it from expressing as any disease has shown positive results. This has helped in the effective delivery of genetic material to the lungs of adult mice.

Gene therapy techniques are also reported to have benefits in treating severe immunodeficiency diseases. This condition is characterized by a lack of immune system in new born babies. Dr. Bobby Gaspar who will also be presenting his paper at the conference said that he has used genetic approach to treat 13 children suffering from this ailment and has been successful.

Medical Personnel Can Save More Lives by Screening for Oral Signs of Disease

Most of us may not view the dentists and dental hygienists as lifesavers, but Dr. Gwen Cohen-Brown differs in her view. She is an assistant professor of dental hygiene at New York City College of Technology.

Dr. Gwen is on a mission to routinely conduct periodontal evaluations and oral cancer and vital sign screenings as well as how to recognize the clinical signs of such systemic diseases as HIV/AIDS. She also persuades her students, hygienists, physicians, physician assistants, nurse practitioners and hospital HIV/AIDS counselors to follow the same.

"Dental health providers can be the first line of care when it comes to oral health," she says. “The mouth is the portal to the body and a reflection of general health. We as health providers need to be able to recognize things like a yeast infection that doesn’t go away or specific tumors and be able to bring up such subjects with our patients.”

Statistics bear out her concern. According to the American Dental Association, only about seven percent of dentists offer the mouth and neck exams they should.

Dr. Cohen-Brown, who became a dentist in the mid-1980s when the AIDS crisis reached epidemic proportions and saw many patients with HIV/AIDS, makes this point when she speaks at hospitals, prisons, clinics, health care conferences, training programs and rehab, medical and mental health centers in the tri-state area, which she does as often as time permits. She also offers in-person health care provider continuing education on HIV-related topics through Cicatelli Associates.

Cells in Good Cheer With Vitamin C

Vitamin C has long been known to give a boost to the body’s immunity especially in fighting common cold, and in ensuring good health. Now, a Christchurch researcher has delved into the scientific reasons behind the blessing of Vitamin C, demonstrating that apart from maintaining the body’s cells, Vitamin C may also help fight cancer.

Margaret Vissers from the Free Radical Research Group, along with a team from the Angiogenesis Research Group at the Christchurch School of Medicine and Health Sciences, showed that Vitamin C has an important part to play in all healthy cells. Infact it impacts cell activity positively.

Dr Vissers' work, sponsored by the Health Research Council, has demonstrated that key enzymes in the cell require Vitamin C to kick start; low levels of the vitamin means that enzymes may not be able to do their work. The enzymes influence cell growth, death and the response to stress.

Dr Vissers said, "This also means that a lack of vitamin C increases tumor growth and prevents effective treatment. It follows that restoring vitamin C to normal levels means less tumor growth and more successful chemotherapy."

Gene Study Offers Hope of Potent Anti-cancer Drugs

A study has opened the way for a new generation of drugs to combat the genes that give rise to the growth of cancer tumors.

Scientists have carried out the widest survey yet of the genetic errors that causes tumors to grow. The findings will be used to design anti-cancer drugs targeted at counteracting mutations in a patient's DNA.

All cancers are thought to result from an accumulation of mutations in one or another of the 30,000 genes in the human genome. These mutations cause a cell to multiply uncontrollably to form a tumor that can then spread to other parts of the body.

Scientists have identified about 350 genes that have been implicated in the development of different cancers but, until now, have not had a clear idea about how many mutations in these genes were directly involved in triggering cancer.

The latest study analyzed 200 samples of cancerous tissue, surveying 500 genes and sequencing more than 250 million letters of the DNA code. An international team of more than 60 scientists led by Michael Stratton of the Wellcome Trust Sanger Institute in Cambridge identified 158 mutations in 120 genes that they believe can be implicated in cancer development.

Professor Stratton said the number of mutations that appear to be involved in driving the growth of cancerous tumors was larger than expected, but ultimately the technique will allow scientists to acquire a complete catalogue of all the mutations involved in each class of cancer.

Green Tea may Help to Fight Lung Cancer

Green tea may help fight lung cancer, the leading cause of cancer deaths in both women and men throughout the world, shows a recent study.

Qing-Yi Lu, PhD, of the Center for Human Nutrition at the University of California at Los Angeles (UCLA) and other researchers exposed a sample of human lung cancer cells to a decaffeinated green tea extract, reported the online edition of health magazine "WebMD".

The lung cancer cells marinated in the green tea extract for up to three days. The extract remodelled a certain protein in the cells. As a result, they became more likely to stick together and less likely to move, the study found.

Antioxidants in green tea may have tweaked the cancer cell protein, but it's not clear whether one antioxidant deserves all the credit or whether several antioxidants worked together, the researchers note in the study, which appeared online in the journal "Laboratory Investigation".

The study doesn't prove that drinking green tea curbs lung cancer in people. However, it may be possible to make new lung cancer drugs based on green tea extract, Lu's team suggests.

Such drugs would target the lung cancer protein remodelled by the green tea extract in the lab tests.

Those who consume green tea on an average of 1.2 litres a day get several health benefits, a previous study by the Yale School of Medicine had indicated. The study by Bauer Sumpio and other researchers had found that tea can also improve gastrointestinal functions, alcohol metabolism, kidney, liver and pancreatic functions, protect the skin and eyes and alleviate arthritis.

Soy Isoflavones Linked to Lower Prostate Cancer Risk

Increased intake of soy isoflavones significantly reduced the risk of prostate cancer amongst Japanese men by as much as 50 per cent, says a new study.

"To our knowledge, this is the first prospective study to report an inverse association between isoflavone and localized prostate cancer in Japanese, whose intake of soy food is high," wrote lead author Norie Kurahashi from Japan's National Cancer Center.

Over half a million news cases of prostate cancer are diagnosed every year world wide, and the cancer is the direct cause of over 200,000 deaths. More worryingly, the incidence of the disease is increasing with a rise of 1.7 per cent over 15 years.

"The incidence of prostate cancer is much lower in Asian than Western populations… Although isoflavones have been suggested to show a preventive effect against prostate cancer in animal experiments, the results of epidemiologic studies are inconsistent," stated the researchers in the journal Cancer Epidemiology Biomarkers & Prevention.

The study recruited 43,509 Japanese men (average age 57) with a generally high soy isoflavone intake. Dietary assessment was performed using a validated 147-item food frequency questionnaire.

During the five years of follow-up, 307 men were newly diagnosed with prostate cancer (74 cases were advanced), and 220 cases were organ localized. While no relationship between total prostate cancer risk and dietary intakes of genistein, daidzein, miso soup, and soy food was observed, all four food items were associated with significant risk reduction for localised prostate cancer.

Shortage of Human Cadavers for Medical Training

The Royal College of Surgeons have expressed concern about the paucity of donor bodies, which is a setback to medical teaching. Nearly 1000 bodies are required annually to teach anatomy to medical students.

In the present academic year, the college has already predicted a 30% shortage in the number of bodies.

The Chief Medical Officer has urged doctors to encourage their patients to donate their bodies for the cause of medical research. Anatomy classes are incomplete without practical lessons on the human body.

Donor consent cards are carried by many, yet few are aware of the procedures required to donate their bodies to medical schools. The crisis escalates when donated bodies are found unsuitable for study due to effects of surgeries or hospital infections that manifest when people live a ripe age.

Explaining the importance of human cadavers in medical teaching,Dick Rainsbury, the RCS director of education, said: "The college currently receives about 60 cadavers a year. They are hugely important to us in the teaching of anatomy. Visual demonstration is not enough. If the UK is to produce high-quality surgeons, the teaching of anatomy has to be of the highest standard."

Artificial Vein to Boost Surgery and Ease Patient Trauma

Doctors have for long relied on veins taken out of a person’s body to replace narrowed, blocked or damaged blood vessels. Not anymore if a doctor’s invention; a plastic vein, makes its way, to store shelves.

Dr. Peter Stonebridge from Ninewells hospital in Dundee has developed an artificial vein, which he claims could boost surgery, and avoid patient trauma. This is by eliminating the need to extract veins needed for an operation from the patient himself.

According to Stonebridge and colleagues who created this artificial vein, blood will flow in exactly the way it does through the human body- in a twisting or spiraling action.

The artificial vein has been created from a polymer called ePTFE. It is grooved on the inside akin to a gun barrel, which Stonebridge says encourages the spiraling flow of blood.

He lists other advantages as reduced wear and tear of the device, lesser chances of clogging and aid in the removal of blockages.

According to Stonebridge, the device is ideal as an alternative in bypass operations and very helpful for patients suffering from peripheral arterial disease. The latter develops when fatty material builds up, and begins to narrow the blood vessels. It can lead to serious mobility problems and, in very severe cases, the need for limb amputation. It can also cause heart attacks and strokes.

Though synthetic grafts have been developed for use in operations to bypass clogged blood vessels many get clogged up with fatty deposits themselves, and often fail within two years, causing surgeons to rely on taking blood vessels from the patient's body.

Chinese Health Ministry Okays KFC

After a food scare that swept the nation off KFC last week, the Chinese Ministry of Health has come out with a clarification expected to be met with sighs of relief, from the fast food chain.

There was public furor over reports of a chemical used in the filters to purify cooking oil. The chemical in question, magnesium silicate or talc, was reported as highly unhealthy by the Chinese media and this sparked off nation-wide wrath.

Responding to the protests, the Ministry of Health, conducted tests at six outlets of KFC.

The ministry has now, come out with the verdict that the chemical is of no danger to human health when consumed.

The present food scare follows one in 2005, where it was found that the company was using a possibly carcinogenic food dye, in some of its chicken products. Media and public wrath forced KFC to withdraw the food additive and Yum Brands- the parent fast food group, had to tender a public apology.

KFC has more than 1,700 restaurants in China and claims it is the largest and fastest-growing fast food chain in the country.

Manufacturers of Infant Formula Milk Asked to Do Away With Exaggerated Nutritional Claims

If you look at the promotional literature of most popular brands of infant formula milk, claims of it being an alternative to breast milk is a definite read. These claims have been questioned by the Governments food standards agency, and have been termed ‘most misleading’ to new mothers.

To enable the correct information to new mothers and mothers-to-be, many breast milk activist groups have begun championing the cause of breast milk over formula milk. As per the recent enforcement from the Government's Food Standards Agency (FSA) and the national lead body for trading standards officers, LACORS, manufacturers of infant formula milk have been asked to do away with nutritional claims that seek to glorify formula milk; this would mean making changes in their marketing campaigns and in the packaging of formula milk.

The claims which read thus ‘closer than ever to breast milk’ and 'helps growth and the immune system' are to be done away with. This will mean that the packaging and marketing literature of popular brands like SMA, Farleys, APtamil, Cow and Gate etc will need to be altered, failing which the companies are liable to face prosecution.

Policy expert at LACORS, Les Bailey, said: 'The Department of Health has a policy to encourage breastfeeding because of its proven health benefits. It contains beneficial antibodies that are not found in infant formula. Various compositional claims, like closer to breast milk, found on packs of infant formula will no longer be allowed. They will have to go from packs and advertising. The aim is to ensure that new mothers are not unduly influenced when deciding their feeding practices. The legislation is framed in a way that it doesn't matter whether they are correct or not. It is designed to promote breastfeeding.'

Afghanistan Reports Fresh Bird Flu Cases

Afghanistan has reported thirteen fresh cases of bird flu, taking the total toll to 17, health officials confirmed.

According to Assadullah Azhari, a spokesman for the United Nations Food and Agriculture Organization (FAO) in Kabul, nearly nine birds were found to suffer the lethal H5N1 strain of bird flu.

To contain the disease, the Afghan government has forbidden the import of poultry products from Pakistan and other countries which have reported the presence of avian influenza. Additionally, an extensive poultry immunization programme has been launched in Kabul and in the two provinces which reported bird flu.

"We have completed vaccination and culling in many poultry farms and have now started a similar process in households [backyard poultry]," Dr Azizullah Usmani, director of Afghanistan's Department of Animal Health and Production, said.

Afghanistan is also facing a cash crunch which has affected the nation’s efforts to curb the deadly virus. The government has sought the assistance of the World Bank to tide over the crisis.