Tuesday, March 1, 2011

Michiana woman creates Invitro App for Apple


Facebook, Twitter and Angry Birds are all popular apps. There are apps for almost anything these days, including an app to help you get pregnant.

Yup, there's an app for that and it was designed for Apple by a mom from Michiana.

The sound of a lullaby is music all people wanting to be parents hope to hear. And it's the ring tone alert you will hear when using Apple's Invitro App called "IVF-Baby in the Making."

Granger mom and designer Kim Konopa was motivated to design an invitro app because she knew the pain of trying to become pregnant, saying, "It was actually a personal experience with invitro fertilization and I just thought the need was there."

So Konopa, who works in sales decided to put her organization skills to work. She did her homework and found a software developer to work with her and her 22-year-old son, JR, who is one of her partners.

She explains how it works.

"The main component is the calendar and, because you're taking so many medications and making so many appointments, we've pre-loaded those into the iPhone app so it's very simple to use. So, let's say you have a doctor's visit. You can put the location in. Let's say you're going to add a medication, you do the same thing. You choose from a pre-populated list of all the medications they could give you."

And because women often feel so alone going through invitro, Konopa has that covered too.

"We built in a blog so that people can kind of get together and share their experiences. We also built in a resources section, things like how to inject, which I was naïve about too at the time."

And since invitro isn't cheap and not always covered by insurance, the application is also practical.

"It has a budget tracker, which allows you to easily enter your invoices so when you enter them it keeps track of the remaining budget and then it just keeps a running balance."

You can also personalize your app.

"It has a photo and journal section so when they hand you your embryo picture, or when you have an ultrasound --a lot of people are excited-- and want to share that. So you can journal about it and share it on facebook or email if you want too."

And in the three months Apple has offered the Invitro App, Konopa says the response has been steady in the U.S., U.K., Australia and Japan.

Konopa says becoming a mother is the best thing that happened to her and she's hoping her app may give other women the same experience.

"I love it. It allows me somewhere to put my energy that's extremely positive and hopefully it helps other become successful in their journey to become pregnant."

Hoping her Baby in the Making app will give more moms-and-dads-to-be their own bundle of joy, with a little help from technology.

Konopa consulted with her own reproductive endocrinologist while working on the invitro app.

Monday, February 28, 2011

Granulocyte-colony stimulating factor (G-CSF) significantly improves inadequate endometrium

During in vitro fertilization (IVF) cycles, treatment with a medication called granulocyte-colony stimulating factor (G-CSF) significantly improves inadequate endometrium (lining of the uterus), according to a report published electronically on February 15 in Fertility and Sterility - the official journal of the American Society for Reproductive Medicine (ASRM). The reported case series also suggests that G-CSF treatment may, in general, improve IVF pregnancy chances.

G-CSF is a cytokine (protein molecules that facilitate communication between cells) that has already been FDA approved for other clinical indications.

Researchers from New York City-based Center for Human Reproduction (CHR) and a second NY fertility center reported on four women with highly inadequate endometrium, unresponsive to conventional treatments and facing IVF cycle cancellation. In all four cases, endometrial perfusion of G-CSF expanded the endometrium to a minimal thickness of 7mm within approximately 48 hours, allowing for embryo transfer. Surprisingly, all four patients also conceived.

In approximately 1% of all IVF cycles, the endometrium stays too thin for embryos to successfully implant, even with treatment. In such IVF cycles, patients and physicians face two poor options: they either accept lower pregnancy chances and transfer embryos despite inadequate endometrium, or they can cancel the embryo transfer and freeze all embryos in hope of better future cycles. Unfortunately, women with inadequate endometrium often show inadequate endometrium again in future cycles. This situation was demonstrated by two patients in this reported case series with histories of repeat IVF failures due to thin endometrium.

"Conventional treatments for inadequate endometrium have had spotty success at best. Without G-CSF perfusion, these patients, likely, would not have reached embryo transfer," explains David Barad, MD, Director of Clinical ART at CHR and one of the senior authors of the report. "That all of them also conceived was a big surprise, and is, of course, quite remarkable."

"The efficacy of G-CSF in improving endometrium, and possibly pregnancy rates in general, still needs to be confirmed in randomized controlled trials," adds Norbert Gleicher, MD, lead author of the report and Medical Director of CHR. "Indeed, we already started two such trials to test both hypotheses; but until first results become available later in 2011, we caution against over-interpreting results of this small pilot study."

Saturday, February 26, 2011

Bribeless In Bihar

Bureaucrats in India’s most corrupt state are facing the heat from their own chief minister

by K.P. Narayana Kumar

Raghuvansh Kunwar could not believe it. For the motor vehicle inspector based in the Aurangabad district of Bihar, the news item in the Hindi daily was more chilling than the December morning. The government was going to throw him out of his
house and start a school there. The announcement was made by Bihar’s human resources development minister, P.K. Sahi,
at a public meeting.

“I was shocked to read the news item,’’ says Kunwar in a tone that barely conceals fear. “I have lived in this house for 20 years
with my wife, children and three brothers and suddenly I was being told to hand over my house.”

The vehicle inspector did not realise then that he was the first prey caught in a new anti-corruption drop-trap devised by
the state government and hailed as a model for other states to follow. Kunwar had been booked under a new law allowing
for summary confiscation of property of government officials found to be having more assets than their income justified.

The state vigilance department, the government’s internal watchdog, had found in 2008 that Kunwar owned property
worth Rs. 54 lakh but was unable to explain how he could afford it. The department has lined up 18 more such cases to
confiscate property valued at Rs. 21 crore before the special courts created under the new legislation, the Special Courts
Act 2009. It is reviewing another 87 cases for possible confiscation of assets.

Kunwar’s case was the first headline-grabber from the Nitish Kumar regime that returned to power with a resounding
mandate that many say was an endorsement of the chief minister’s reputation as a leader with a cause. In its first innings, the administration locked up 54,000 people in a bid to break the criminal-politician nexus that had plunged Bihar into such an anarchic mess — a place that everybody knew where it was but nobody wanted to go, even those who had fled from their ‘native place’ for greener pastures. The third axis in the unholy nexus was the government official for whom the general public is the golden goose.

Blunt Axe No Good

It was not that Nitish Kumar avoided them in his first term. His attempt was to hit all three simultaneously, though the
babudom — cocooned in rules and procedures — turned out to be the most resilient. Kumar set up a Special Vigilance Unit (
SVU) in 2006 to go after the big fish in the government. It was a crack team of former Central Bureau of Investigation (CBI)
officials with a separate headquarters on the rather quirkily named Serpentine Road. The unit soon made headlines as it caught several senior government officials such as a police chief Narayan Mishra and state drug controller Y.K. Jaiswal, with enough wealth to finance the annual budgets of entire villages. State vigilance squads trapped about 400 government officials in the next four years. However, much of it came to nothing as only two of them have been convicted so far. News reports suggest that even the elite SVU managed to file only five First Information Reports (FIRs) in four years.


Meanwhile, Nitish Kumar was regularly besieged by villagers with tales of corruption on his frequent countryside tours. In
Bihar, big ticket deals are few. The corruption that is endemic is petty. For the general public, it is difficult to get government
certificates and entitlement documents without paying touts. Unlike big deals where money is often received and stashed in
numbered accounts in safe havens or as stocks and bonds, in Bihar the nature of corruption is localised. Ill-gotten money
hardly leaves the country and is invested mostly in real estate or gold. That means empowered officers can easily help track it
down. A vigilance officer pointed out the case of a milk-vendor in Patna. The man is said to own a dozen cars, wealth that he
acquired by laundering money for government officers and politicians. “Most government departments have their own
paan-wallahs, ice-cream vendors and traders who act as collectors for the babus,” says the officer who did not wish to be
identified.

Bureaucrats who own black money typically invest it in real estate projects outside Bihar; Bangalore and Noida are particular favourites. But junior level officers such as block development officers, panchayat members and clerks keep their cash in bank accounts and lockers apart from building houses in their village. Having cash stashed in the mattresses also helped if they got caught. They could use the same money to pay off investigators and the game could go on.

It was clear to Nitish Kumar that merely catching a culprit was not enough. A major handicap was that under the Prevention of
Corruption Act, vigilance officials had to get clearance to prosecute an errant bureaucrat from his own department. That took time. He realised that the only way to deter corruption was to take away the wealth itself — ASAP. Kumar put his then attorney general P.K. Sahi on the job. (Sahi would go on to become Nitish Kumar’s minister in the second term).After consulting experts and studying the provisions of the Prevention of Corruption Act, Sahi prepared a draft bill by the end of 2008 and it was passed by the Bihar Assembly in February 2009. It then languished in the union home and law ministries for a year. The delay often prompted Bihar politicians to snigger that the Centre did not want Nitish Kumar to have one more feather in his cap. “The Centre kept asking for one clarification after the other. The delay meant that we could not swing into action before the state elections and the CM himself had to repeatedly follow-up with the Centre,’’ says Sahi. The Bihar Special Courts Act, 2009, was eventually signed into law by the President in March 2010.




Slash And Burn

The Bihar law is not a pioneering one. That credit goes to Orissa, which passed a similar law in 2008 and also set up two special courts. However, it was challenged in court and until recently its validity was uncertain. In Bihar, the Act comes into play when investigating agencies are convinced that an official owns assets in excess of his known sources of income. Now, even as it pursues a corruption case against an official, the state separately seeks to take control of the assets owned by the person. Bihar
has set up six special courts that exclusively deal with this. The vigilance department files a declaration with a special
court that the target has amassed unexplained wealth. The special courts then conduct speedy trials and decide within six months whether the property should be confiscated or not. The property would be returned with interest (at 5 percent
annually) if the person is acquitted.

The Prevention of Corruption Act does not provide for attachment of property and instead has a provision enabling a judge to also impose a fine depending on the value of the ill-gotten property. Former CBI director Joginder Singh says the nation should follow Bihar. “If the property of the accused is confiscated in advance, it will make a huge difference. This will help serve as
a deterrent to officers and also ensure that the accused are not able to influence investigations using money,” says Singh, who has investigated several high-profile cases of corruption, including the fodder-scam in which Lalu Prasad Yadav was prosecuted. A.K. Chauhan, principal secretary, vigilance, says that he has not come across any instance of politicians or high-level officials trying to influence a case. “They know that we report to the CM. So there has not been any attempt so far,” says
Chauhan, who has earlier worked as secretary for co-ordination in the state cabinet and is considered to be someone who
enjoys the chief minister’s trust.

“MLAs have also been warned that they should not call up officers directly and try to influence these cases. The Chief
Minister has made it clear within his own party as well that he will not tolerate anyone trying to influence the officers,”
says Rajya Sabha member Ali Anwar, who is considered to be a close confidant of Nitish Kumar. The results are yet to
show, but the tremors are already being felt.Of course, the law has been challenged in court. Narayan Mishra, the police chief booked by the SVU and facing confiscation of property, has moved the High Court arguing that the law is unconstitutional. “It is a draconian rule with no regard for constitutional rights,” says Mishra. Lawyer Abhinav Shrivastava, who represents six officials
who have challenged the validity of the Act, says the main problem with the legislation is that there is no laid down
procedure to decide which cases under the Prevention of Corruption Act would be transferred to the special courts for attachment. “This would make the entire process subjective and arbitrary,” says the lawyer.A state bureaucrat, who spoke on condition of anonymity, said that there was palpable fear among officials after the government lined up cases for confiscation of property. “The officers are in fear of a crackdown and that is good for the health of the system,” he says.


Hindi daily Prabhat Khabar reported that over Rs. 100 crore had been withdrawn from banks in the capital, Patna, in the fortnight following the confiscation of Kunwar’s property. A top bank official confirmed that there has been an increase in
withdrawals from bank branches across the city but was unsure whether panic-driven officials were behind the trend.The state capital, which had acquired a reputation as a crime-hub during Lalu Prasad’s regime, also gained a reputation for scams and middlemen as Bihar led the list of corrupt states in almost every survey carried out between 2000 and 2005.


Renewed Growth


Nitish Kumar’s two terms, when he first re-established law and order and then began weeding out corruption, have brought
new hope to Biharis in the state and those living outside. For long, Patna seemed to be relatively untouched by India’s economic transformation. There are no glitzy malls or international brands that embellish the other cities. There are no hip eating joints or clubs. There is no evidence of any sort of nightlife or even entertainment for families.But the city is changing, slowly. Women move about fearlessly in areas where they would not have dared to venture out just a few years ago. People come out for
shopping and socialising. There is a clear buzz of a consumer economy blooming.The story of change is particularly evident in the new apartment buildings springing up across the city. Real estate developer Narendra Kumar says that property rates in
Patna are comparable to rates in Noida as there is a huge demand and there is shortage of land.“The boom is not entirely fuelled by black money and there is a genuine increase in demand,” says Kumar, who has built and sold over a dozen apartment complexes in the city in the past three years. He says most of the money coming into construction is from people of Bihari origin who live outside the state but are now beginning to hope for a prosperous Bihar. Academician Shaibal Gupta, considered an expert on governance in Bihar, says tough times are ahead for bureaucrats. Next the state is planning to enact a Right to
Services law to ensure efficient government service. Officials will be punished for failure to provide time-bound service.
“There is a lot of pressure on the bureaucracy now like never before,” says Gupta.

This article appeared in Forbes India Magazine of 11 February, 2011

Friday, February 25, 2011

The world's biggest family

Ziona Chana lives with all of them in a 100-room mansion.His wives take turns to share his bed. It takes 30 whole chickens just to make dinner. He is head of the world's biggest family - and says he is 'blessed' to have his 39 wives.

Ziona Chana also has 94 children, 14-daughters-in-law and 33 grandchildren. They live in a 100-room, four storey house set amidst the hills of Baktwang village in the Indian state of Mizoram, where the wives sleep in giant communal dormitories.

The family is organised with almost military discipline, with the oldest wife Zathiangi organising her fellow partners to perform household chores such as cleaning, washing and preparing meals. One evening meal can see them pluck 30 chickens, peel 132lb of potatoes and boil up to 220lb of rice. Coincidentally, Mr Chana is also head of a sect that allows members to take as many wives as he wants.

He even married ten women in one year, when he was at his most prolific, and enjoys his own double bed while his wives have to make do with communal dormitories. He keeps the youngest women near to his bedroom with the older members of the family sleeping further away - and there is a rotation system for who visits Mr Chana's bedroom.Rinkmini, one of Mr Chana's wives who is 35 years old, said: 'We stay around him as he is the most important person in the house. He is the most handsome person in the village. She says Mr Chana noticed her on a morning walk in the village 18 years ago and wrote her a letter asking for her hand in marriage.

Another of his wives, Huntharnghanki, said the entire family gets along well. The family system is reportedly based on 'mutual love and respect'

And Mr Chana, whose religious sect has 4,00 members, says he has not stopped looking for new wives. 'To expand my sect, I am willing to go even to the U.S. to marry,' he said. One of his sons insisted that Mr Chana, whose grandfather also had many wives, marries the poor women from the village so he can look after them.





Thursday, February 24, 2011

Myo-Inositol Helps Women To Conceive With PCOS



Myo-inositol is a unique vitamin B-like substance that has become highly regarded as a novel way to help women with PCOS to conceive. It can also help to reduce miscarriage risks and to minimize the risks of severe ovarian hyper-stimulation syndrome (OHSS) in IVF/ART.

Thirty to forty percent of PCOS women have irregularities in their glucose / insulin control mechanisms which is where Myo-inositol works it's magic. Inositol is integral to properly functioning insulin-receptors and providing extra inositol seems to profoundly improve insulin levels and reduce the associated high androgen levels (testosterone and DHEA) without side-effects or toxicity.

Women with PCOS are known to have a defect in their insulin-signaling pathways which are heavily dependent upon inositol-containing substances (phosphoglycan mediators). Supplying extra myo-inositol appears to temporarily correct the mal-functioning insulin pathways and reduce the signs and symptoms of insulin resistance.

Interestingly, inositol has been used in other studies for panic disorders and can have a profoundly calming effect upon the nervous system. Also studies show (6) that high levels of myo-inositol within follicles may be a marker for good follicular development and good oocyte or egg quality.

As there seems to be some confusion regarding exactly how to use Myo-Inositol - and how it can be used alongside IVF/ART - here is a brief overview of the studies to date that can help you to understand Myo-inositol's unique value to PCOS women.

In an Italian study in 2007 (1) researchers followed 25 women with oligo-amenorrhea (irregular menses) or amenorrhea (no menses) due to PCOS. Myo-inositol and folic acid were given daily as 'Inofolic' 2g twice a day for 6 months. Eighty eight percent of the women who were treated had at least one menstrual cycle, and of these, seventy two percent continued ovulating normally. Forty percent of the women became pregnant and the study concluded that:

"Myo-inositol is a simple and safe treatment that is capable of restoring spontaneous ovarian activity and consequently fertility in most patients with PCOS. This therapy did not cause multiple pregnancy."

Another Italian study (2) in 2010 compared the effects of Myo-inositol or metformin in PCOS women and then compared these two treatments with the addition of gonadotrophin (r-FSH) for ovulation induction. One hundred and twenty patients took either 1500 mg/day of metformin or a combination of folic acid 400 mcg and Myo-inositol 4 g per day.

In the women that did not conceive a low dose of FSH (37.5 units/day) was added for up to three cycles. Of the women taking just metformin, fifty percent resumed ovulation and eighteen percent became pregnant. FSH treatment was administered to the 'metformin-only' women who did not conceive and a further twenty six percent conceived producing a total pregnancy rate of 36.6%.

Of the women taking myo-inositol and folic acid, sixty-five percent resumed ovulation and thirty percent conceived. FSH was administered to the myo-inositol women who did not conceive and a further twenty nine percent conceived producing a total pregnancy rate of 48.4%.

This study - which showed that myo-iositol can out-perform metformin - concluded that:

"Both metformin and MYO, can be considered as first line treatment for restoring normal menstrual cycles in most patients with PCOS, even if MYO treatment seems to be more effective than metformin."

In yet another Italian study (3) in 2009, Myo-inositol (MYO) was studied as a novel solution to symptoms of PCOS such as hirsutism (excess body hair), acne and hair loss. Fifty PCOS women were give Myo-inositol for six months and after only three months levels of LH, testosterone and free testosterone and insulin were significantly reduced. At the end of the six months hirsutism and acne had decreased also and the study concluded that:

"MYO administration is a simple and safe treatment that ameliorates the metabolic profile of patients with PCOS, reducing hirsutism and acne."

Back to Italy again, in 2008 Myo-inositol was studied (5) specifically with PCOS women who were overweight. Twenty overweight women with PCOS were treated and after 12 weeks of myo-inositol demonstrated that levels of LH, prolactin, testosterone, insulin, LH/FSH, insulin sensitivity and glucose-to-insulin ratios could change significantly. Menstrual cycles were restored in all the patients with irregular or no menstruation. The study concluded that:

"Myo-inositol administration improves reproductive axis functioning in PCOS patients reducing the hyperinsulinemic state that affects LH secretion."

Lastly, a randomized double-blind trial (7) - the gold standard of research - gave 92 women either 400 mcg of folic acid as a placebo or 4 g myo-inositol plus 400 mcg folic acid as the treatment arm. They discovered likewise that ovulation significantly increased as did the frequency of normal progesterone values in the luteal phase and estradiol levels in the myo-inositol group.

This study noted less metabolic benefits to those women who were overweight but also that the myo-inositol group lost a significant amount of weight and had lowered leptin levels. The study concluded that:

"These data support a beneficial effect of myo-inositol in women with oligomenorrhea and polycystic ovaries in improving ovarian function."


References:

(1) Gynecol Endocrinol 2007 Dec;23(12):700-3. Epub 2007 Oct 10. Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Papaleo E, et al.
(2) Gynecol Endocrinol 2010 Apr;26(4):275-80. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Raffone E, et al.
(3) Gynecol Endocrinol 2009 Aug;25(8):508-13. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Zacche MM, et al.
(4) 2008 Mar;24(3):139-44. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Genazzani AD, et al.
Eur J Obstet Gynecol Reprod Biol 2009 Dec;147(2):120-3. Epub 2009 Oct 2.
Contribution of myo-inositol to reproduction. Papaleo E et al. Eur Rev Med Pharmacol Sci 2007 Sep-Oct;11(5):347-54.
Randomized, double blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Gerli S, et al. European Review for Medical and Pharmacological Sciences 2007; 11: 347-354

Wednesday, February 23, 2011

Amazing Electron Microscope Shots

All these pictures are from the book 'Microcosmos', created by Brandon Brill from London. This book includes many scanning electron microscope (SEM) images of insects, human body parts and household items. These are the most amazing images of what is too small to see with the naked eye.