Glaucoma is an eye disorder in which internal eye pressure (Intraocular pressure-IOP) is very high. In this condition, eye has too much aqueous humor pressure either because of over production of fluid or of improper draining. This leads to damage of optic nerve results in Vision loss. This nerve acts like an electric cable with over a million wires. It is responsible for carrying images from the eye to the brain.
According to World Health Organization, Glaucoma is the second leading cause of blindness (behind cataracts).

GLAUCOMA SYMPTOMS:
Glaucoma, known as “silent thief of sight” as it causes no pain and shows no symptoms in early stages and quietly causes vision loss. As no symptoms occur, the best way to diagnose this form of glaucoma is by periodic eye examination. Onset of any of symptoms like blurred vision, severe eye pain, red eyes, headache, nausea and vomiting is the warning alarm for eyes.

GLAUCOMA CAUSE:
A clear fluid flows in and out of the space at the front of the eye, nourishing nearby tissues. Glaucoma causes the fluid to pass through too slowly or to stop draining altogether. As the fluid builds up, the pressure inside the eye increases, causing damage to the optic nerve and vision loss.

RISK FACTORS:
Age: Glaucoma is more common among older people. People above 40 are 6 times more likely to get glaucoma.
Family History: The most common type of glaucoma, primary open angle glaucoma, is hereditary. Family history of glaucoma increases the risk of glaucoma four to nine times.
Indiscriminate use of Steroids: Studies indicate Steroids increase intraocular pressure. These could be in the form of Oral medications, Steroid Inhalers and Steroid Eye Drops used for long periods of time.
Injury to Eye: Injury to the eye may cause secondary open angle glaucoma. This type of glaucoma can occur immediately after the injury or years later.

CARE, NUTRITION AND SUPPLEMENTS:
Glaucoma is controlled and treated if detected in early stages. Early detection of Glaucoma save the patient form vision loss and eye damage. Glaucoma is control with Medicines (Oral and eye-drops) and Laser Surgery.

Other than Medicines and Surgery, following care, nutrition and supplements are required to keep eye healthy and free from eye problems:

1. Exercise: Regular physical activity can lower intra ocular pressure by a little bit.

2. Food & Diet: Carrots, Spinach, Green leafy vegetables, citrus fruits, blueberries, cherries, tomatoes, whole milk, egg, lean meat and seafood should be taken to keep eye healthy and full of vision. And should limit the intake of caffeine, alcohol and smoking.

3. Nutritional Supplements: There are few supplements known to improve the clinical condition of Glaucoma.

A. Alpha Lipoic Acid (ALA): Alpha Lipoic Acid (ALA) is very powerful antioxidant and this antioxidant property is helpful in improving eye conditions like glaucoma, cataract and diabetic retinopathy. Clinical studies shows that, regular intake of 150 mg of Alpha Lipoic acid improves visual acuity and colour perception by 45- 47% in glaucoma patients. ALA shows strong neuroprotective properties which significantly prevent ischemic optic nerve damage and improves fluid discharge.

Ref.: Filina AA, et al. Lipoic acid as a means of metabolic therapy of open-angle glaucoma. Vestn Oftalmol 1995; 111:6-8.

B. Omega-3 Fatty Acids: Studies show direct association between Omega 3 fatty acid and eye health. Omega 3 fatty acid is helpful in inflammatory and intraocular pressure (IOP) conditions. It is studied that with the regular consumption of Omega 3 fatty acid leads to decrease in IOP with age by increasing the aqueous outflow in glaucoma patients. Omega 3 fatty acid helps to decrease the eye inflammation by reducing the production of inflammatory cellular signaling molecules.

Ref.: 1. Cellini M, Rossi A & Moretti M. The use of polyunsaturated fatty acids in ocular hypertension. Acta ophtalmol Scand 1999;77 (suppl. 229):54-55
2. Dietary omega 3 fatty acids decrease intraocular pressure with age by increasing aqueous outflow. Invest Ophthalmol Vis Sci. 2007.

However, by taking statins, one or more patients will develop diabetes and 20% or more will experience disabling symptoms, including muscle weakness, fatigue, and memory loss

Ref: JAMA 2012; 307: 1489-4532

Even if it is considered top-of-the-line HGH supplements, it can still contain some negative insights from users. HGH is highest in developing adolescents and the older we get, the much less we generate. Other health improvements include an increased metabolism, weight loss and increased muscular mass, that’s why it can be therefore preferred among athletes and bodybuilders. But using a “releaser” or stimulator product, your. The HGH throughout Sytropin is natural it can be enhanced by six growth factors and eight amino acid releasers to enhance great and bad the compound and how your body reacts the idea.

Some people experienced a rise in regrowth, but no harmful effects. By like the following ingredients their own specific dosage – L-Glutamine 200 mg. All I want, but, to be able to remain younger on the lookout for somewhat added time. So you see that a persons human growth hormone may be very much a significant portion of body of a human and growth system. although it could possibly, if you’re willing to stop paying it.

That way, you might be keeping yourself completely informed and could be certain you’re getting the easiest product an individual. More importantly it can be a superbly legal approach to obtain HGH. Since treatments itself utilizes synthetic compounds which will cause serious unwanted side effects and complications to astonishingly, you might be putting yourself any serious risk if you take HGH injections. Pills and sprays are wonderful choices to injections, and so they offer numerous advantages. The higher regarding human growth hormone can improve heart function, boost metabolism, strengthen the defense mechanisms, reduce body fat, stabilize blood sugar and increase energy.

The Food Safety and Standards Act. 2006 has come into force with effect from 05^th August. 2011. It defines a Food Business Operator (FBO) as a person engaged in the business of food manufacture, processing, packaging, transportation, distribution, storage and import etc. and includes food services, catering services and sale of food or food ingredients.

REGISTRATION AND LICENSING

• All Food Business Operators (FBO) in the country have to be registered or licensed in accordance with the cutoff limits laid down in the Food Safety and Standards (Licensing and Registration of Food Business) Regulations, 2011.
• A milk producer whose production capacity of the Milk & Meat Products is less than 100 Kg/Ltr. per day, or is handling milk less than 500 Ltr. per day, meat or meat products producer in the capacity for slaughter of maximum 2 large animal or 10 small animals or 50 poultry birds per day or any other FBO where annual turnover is less than Rs 12 Lakh is termed as Petty Food Business Operator (PFBO) and is required to be registered.
• Schedule 1 of the Regulations defines the businesses that will be licensed by FSSAI Regional offices. All other businesses will have to obtain license from the local District Designated Officer of the state.
• Application can be filed online at foodlicensing.fssai.gov.in for central licensing.

EXISTING LICENSEES

■                    Convert your existing food licenses / registration into FSSAI license Registration before 5^th August, 2012

■                    No license registration fee will have to be paid for the remaining period of the validity of the earlier license or registration.

■                    All FBO should have valid license at all time.

• If the existing license registration has expired after 5″ August. 2012 apply for its renewal immediately.

■                    No pre – inspection required.

■                    A New FSSAI license number will be issued.

• Comply with existing provisions of Food Safety and Standards (Licensing and Registration of Food Business) Regulations, 2011.

For further details visit fssai.gov.in or Dial-Toll free helpline 1800112100

Issued in Public interest by

Food Safety and Standards Authority of India

FDA Bhawan, Kotla Road,

New Delhi – 110002

CoQ10: Every day, you chew a supplement that contains 60mg of coenzyme Q10, or CoQ10, an antioxidant that helps maintain the soft tissues in your body-including your gums. Some early research suggests that taking CoQ10 can even help shrink the pockets caused by gum disease.

Calcium: Calcium, a mineral found in your jawbone. If you don’t get enough calcium, your jaw weakens, loosening your teeth. Men and women from ages 19 to 49 need 1,000mg of calcium, daily, while those over 50, require 1,200mg. A cup of milk or yogurt packs about 300mg and an ounce of most cheeses has around 200mg.

Vitamin D: To absorb calcium, your body needs vitamin D. According to the WHO recommendation, a full third of Indians don’t get enough. You must follow the recommendation and get at least 400IU daily. Milk has about 100IU per cup and a 3-ounce serving of fattier fish, like salmon or mackerel, contains about 300IU. If you don’t drink milk or eat fish, you could probably use a supplement of 400 IU daily.

Vitamin C: There’s one more super-important nutrient for your teeth: Vitamin C. It’s a building block for collagen, which helps keep your teeth attached to your gums. A study in the Journal of Periodontology found that men and women who consumed less than 60mg of vitamin C daily were 150 percent more likely to have gum disease than people who took in at least 180mg. Fruit and veggies are the major sources of vitamin C (One orange alone has 60mg). You get enough C in your diet, but if you don’t, consider taking a supplement.

Omega-3 fatty acids: Studies shows that “People with low intake (of DHA) had an approximately 1.5 times higher incidence rate ratio of periodontal disease progression”. Regular intake of Omega-3 supplements is helpful in the treatment of periodontal disease and other gum diseases. Its anti-inflammatory effects effectively reduce the chances of gum inflammation, weak gum and teeth.

Probiotics & Prebiotics: Probiotics are potential therapy for maintaining oral health. It is used to reduce dental caries and periodontal diseases. Probiotics significantly maintains healthy balance of the bacteria flora in the mouth. Microbial growth promotes serious tooth decay and bad breath. Daily intake of probiotics in early childhood may result in less dental carries. Probiotics suppress the odor-producing bacteria, resulting in a decrease in the foul smelling gases arising in the mouth. It also helps to reduce the gum inflammation and plague formation caused by microbial growth. Prebiotics give the probiotics to exert their influence by aiding and boosting immunity.

Tip: AVOID FIZZY SUPPLEMENTS

Don’t buy the chewable Vitamin-C tablets or any kind of supplement that fizzes when you dissolve it in water. Chewable and fizzy vitamins lower the pH in your mouth and erode your tooth enamel big time. In fact, a recent study from the University of Helsinki found that fizzy supplements, including those containing calcium, caused teeth to lose minerals. The worst offenders were the fizzy vitamin-C supplements-they corroded the teeth so much that the layer below the enamel was exposed.

A healthy smile can help you look years younger. Just think about your diet, and weigh your need for six favorite supplements.

Walnuts have long been known to influence the brain and in the natural health world, they’re known as a key brain food. Now, according to research published in the British Journal of Nutrition, eating walnuts regularly can significantly increase critical thinking and especially what’s called inferential reasoning.

Inferential reasoning is the ability to infer truth from other known truth and it is also the ability to deduce information based on prior experience and context. It’s sometimes thought that there are two fundamental types of reasoning. So dramatically improving one is an enormous step in the right direction, and it’s nice that it can be done by an easy dietary addition.

This research was done at Andrews University and led by Peter Pribis, associate professor of nutrition and wellness. Two groups of Andrews students were used: the students either ate banana bread with ground walnuts in it or a similar looking and tasting banana bread without walnuts. Then, after eight weeks of either eating walnuts or not, the students were tested for inferential reasoning and other cognitive skills. And especially for inferential reasoning, the results were impressive.

According to Pribis, “We discovered that students who consumed walnuts experienced improvement in critical thinking, specifically inferential reasoning.” They actually found that eating a half cup of walnuts a day for eight weeks led to an 11.2 percent increase in inferential reasoning skills, which is the difference between an A or a B, or a B and a C.

According to the researchers, walnuts contain a wide number of neuroprotective compounds including vitamin E, folate, melatonin, polyphenolics, and significant amounts of a-linolenic acid, or ALA. Because ALA is the precursor for EPA and DHA, with plenty of ALA our bodies can make more EPA and DHA too.

The researchers also tell us that DHA is important for brain membrane stability, brain plasticity, and gene expression. Further, DHA increases the speed of brain signal transmissions while increasing serotonin and dopamine concentrations. Serotonin and dopamine are essential for brain and mood health and many brain medications manipulate these natural compounds.

Mifepristone is a synthetic  19-nor steroid compound with a bulky p-(dimethylamino)phenyl substituent above the plane of the molecule at the 11β-position responsible for inducing or stabilizing an inactive receptor conformation and a hydrophobic 1-propynyl substituent below the plane of the molecule at the 17α-position that increases its progesterone receptor binding affinity.

It is a progesterone receptor antagonist used as an abortifacient in the first months of pregnancy, and in smaller doses as an emergency  contraceptive.

In the presence of progesterone, mifepristone acts as a competitive progesterone receptor antagonist (in the absence of progesterone, mifepristone acts as a partial agonist).

Mifepristone is also a powerful glucocorticoid receptor antagonist and a weak androgen receptor antagonist  and has occasionally been used in refractory Cushing’s Syndrome (due to ectopic/ neoplastic ACTH/Cortisol secretion).

Mifepristone’s relative binding affinity at the progesterone receptor is more than twice that of progesterone, its relative binding affinity at the glucocorticoid receptor is more than three times that of dexamethasone and more than ten times that of cortisol; its relative binding affinity at the androgen receptor is less than one third that of testosterone. It does not bind to the estrogen receptor or the mineralocorticoid receptor.

PHARMACOLOGY

Pharmacodynamics

The anti-progestational activity of mifepristone results from competitive interaction with progesterone at progesterone-receptor sites.Mifepristone inhibits the activity of endogenous or exogenous progesterone leading to  termination of pregnancy .

Doses of 1 mg/kg or greater of mifepristone have been shown to antagonize the endometrial and myometrial effects of progesterone in women. During pregnancy, the compound sensitizes the myometrium to the contraction-inducing activity of prostaglandins.

Mifepristone also exhibits  antiglucocorticoid and weak antiandrogenic activity. Doses of 4.5 mg/kg or greater in human beings resulted in a compensatory elevation of adrenocorticotropic hormone (ACTH) and cortisol.

Pharmacokinetics

Absorption

Following oral administration mifepristone is rapidly absorbed, with a peak  plasma concentration  occurring approximately 90 minutes after ingestion.

Distribution

Mifepristone is 98% bound to plasma proteins, albumin and alpha 1 -acid glycoprotein. Binding to the latter protein is saturable, and the drug displays nonlinear kinetics with respect to plasma concentration and clearance.

Following a distribution phase, elimination of mifepristone is slow at first (50% eliminated between 12 and 72 hours) and then becomes more rapid with a terminal elimination half-life of 18 hours.

Metabolism

Metabolism of mifepristone is primarily via pathways involving N-demethylation and terminal hydroxylation of the 17-propynyl chain.                                                                                                                                                                      CYP450 3A4 is primarily responsible for the metabolism. The three major metabolites identified in humans are:

(1) N- monodemethylated metabolite most widely found in plasma,

(2) Results  from the loss of two methyl groups from the 4-dimethylaminophenyl in position 11ß  and

(3) Results from terminal hydroxylation of the 17-propynyl chain.

Excretion

83% of the drug is excreted  by the faeces and 9% by the urine. Serum levels are undetectable

Indications

1. Medical termination of intrauterine pregnancies of up to 49 days gestation

2. Softening and dilatation of the cervix prior to mechanical cervical dilatation for pregnancy termination

3. Labor induction in fetal death in utero.

4. Regular long-term use as an oral contraceptive

5.To treat Endogenous Cushing’s syndrome –Recently FDA approved

Undesirable effects

Women typically experience abdominal pain, including uterine cramping and vaginal bleeding or spotting.

Other commonly reported side effects are nausea, vomiting and diarrhoea. Pelvic pain, fainting, headache, dizziness ,fever and asthenia occurred rarely.

Serious bacterial infection, bleeding, ectopic pregnancies that have ruptured and death  including another death from sepsis were recently reported

Drug Interactions 

Although specific drug or food interactions with mifepristone have not been studied, on the basis of drug`s metabolism by CYP 3A4, it is possible that

-Ketoconazole, Itraconazole, Erythromycin, and grapefruit juice may inhibit mifepristone  metabolism (increasing serum levels of it).

-Rifampin, Dexamethasone, , and certain anticonvulsants (phenytoin, phenobarbital, carbamazepine)   may induce mifepristone metabolism (lowering serum levels of mifepristone).

-Based on in vitro inhibition information, coadministration of mifepristone may lead to an increase in serum levels of drugs that are CYP 3A4 substrates. Due to the slow elimination of mifepristone from the body, such interaction may be observed for a prolonged period after its administration. Therefore, caution should be exercised when mifepristone is administered with drugs that are CYP 3A4 substrates and have narrow therapeutic range, including some agents used during general anaesthesia.

 Contraindications

Contraindicated in patients with any one of the following conditions:

-Confirmed or suspected ectopic pregnancy or undiagnosed adnexal mass

- IUD in place

-Chronic adrenal failure

-History of allergy to mifepristone

-Haemorrhagic disorders

-Inherited porphyria

-Anticoagulant or long-term corticosteroid therapy

Endogenous Cushing’s syndrome is a serious, debilitating and rare multisystem disorder.

It is caused by the overproduction of cortisol (a steroid hormone that increases blood sugar levels) by the adrenal glands. This syndrome most commonly affects adults between the ages of 25 and 40.

Mifepristone blocks the binding of cortisol to its receptor. It does not decrease cortisol production but reduces the effects of excess cortisol, such as high blood sugar levels.

Mifepristone is approved for use in patients with endogenous Cushing’s syndrome who have type 2 diabetes or glucose intolerance and are not candidates for surgery or who have not responded to prior surgery.

It should never be used by pregnant women. Although pregnancy is an extremely rare occurrence in Cushing’s syndrome patients because of the suppressive effect of excess cortisol on female reproductive function.

The most common side effects experienced with mifepristone  are nausea, fatigue, headache, arthralgia, vomiting, swelling of the extremities, dizziness and decreased appetite.

Other side effects of mifepristone include adrenal insufficiency, low potassium levels, vaginal bleeding and a potential for heart conduction abnormalities.

There are no other approved medical treatment for this debilitating form of Cushing’s syndrome.

Reason for Antimicrobial resistance

Inappropriate and irrational use of medicines provides favourable conditions for resistant microorganisms to emerge and spread.

For example, when patients do not take the full course of a prescribed antimicrobial or when poor quality antimicrobials are used, resistant microorganisms can emerge and spread.

Antimicrobial resistance a Global Concern

AMR kills

Infections caused by resistant microorganisms often fail to respond to the standard treatment, resulting in prolonged illness and greater risk of death.

AMR hampers the control of infectious diseases

AMR reduces the effectiveness of treatment because patients remain infectious for longer, thus potentially spreading resistant microorganisms to others.

AMR threatens a return to the pre-antibiotic era

Many infectious diseases risk becoming uncontrollable and could derail the progress made towards reaching the targets of the health-related United Nations Millennium Development Goals set for 2015.

AMR increases the costs of health care

When infections become resistant to first-line medicines, more expensive therapies must be used. The longer duration of illness and treatment, often in hospitals, increases health-care costs and the financial burden to families and societies.

AMR jeopardizes health-care gains to society

The achievements of modern medicine are put at risk by AMR. Without effective antimicrobials for care and prevention of infections, the success of treatments such as organ transplantation, cancer chemotherapy and major surgery would be compromised.

AMR threatens health security, and damages trade and economies

The growth of global trade and travel allows resistant microorganisms to be spread rapidly to distant countries and continents