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Sep 11

Low self-esteem leads to obesity

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Children with self-esteem problems are more likely to be obese as adults, a research team has found.

A study of 6,500 participants in the 1970 British Birth Cohort Study found that 10-year-olds with lower self esteem tended to be fatter as adults.

The affect was particularly true for girls, researchers from King's College London reported.

One obesity expert said the results highlighted that early intervention was key to tackling obesity.
The children had their weight and height measured by a nurse at the age of 10 and they self-reported when they were 30.

Their emotional states were also noted, the researchers reported in the journal BMC Medicine.

Children with a lower self-esteem, those who felt less in control of their lives, and those who worried often were more likely to gain weight over the next 20 years, the results showed.

Professor David Collier, who led the research, said: "What's novel about this study is that obesity has been regarded as a medical metabolic disorder - what we've found is that emotional problems are a risk factor for obesity.

"This is not about people with deep psychological problems, all the anxiety and low self-esteem were within the normal range."


Another researcher, Andrew Ternouth, said: "While we cannot say that childhood emotional problems cause obesity in later life, we can certainly say they play a role, along with factors such as parental weight, diet and exercise.

"Strategies to promote the social and emotional aspects of learning, including the promotion of self-esteem, are central to a number of recent policy initiatives.

"Our findings suggest that approaches of this kind may carry positive benefits for physical health as well as for other aspects of children's development."

Dr Ian Campbell, of the charity, Weight Concern, said: "This study presents some disturbing evidence that, as we suspected, childhood psychological issues have an influence on future weight gain and health.

"Many of the adults we work with have identifiable underlying emotional and self esteem issues and are often resistant to treatment.

"The message here is that early intervention, in childhood, can be the key to combating adult obesity.

"That requires much more than health practitioners can deliver alone and needs greater alertness from parents, teachers, and anyone involved in the welfare of children."

Source: bbc.com

Sep 06

SiJack Software introduces iVeda 1.0 for iPhone and iPod Touch

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SiJack Software is proud to introduce iVeda 1.0, their new personal Ayurveda evaluation tool for iPhone and iPod Touch. Designed specifically to leverage the iPhone’s peerless interface, iVeda is a unique health-based evaluation tool for a personal Ayurvedic consultation. The application also provides various information on the three dosha types and an overview of Ayurveda.

Ayurveda is an ancient art of preventative health and healing, and a philosophy for living in harmony with nature. The art has been practiced for thousands of years in countries such as Sri-Lanka and India, and is widely considered to be the oldest form of health care in the world. iVeda gives an informational overview of Ayurveda and the three doshas, along with a personal consultation for users to discover their own personal ayurvedic constitution and the methods in which they can keep their doshas in balance.

Feature Highlights:
* An introduction to Ayurveda and the three doshas
* A self-diagnosis tool to determine Ayurvedic constitution
* Suggested grocery listings for dual dosha types
* Suggested grocery listings for individual dosha types
* Information on the dosha personalities
* Information on how to recognize when doshas fall out of balance and ways in which to remedy these imbalances

“The name iVeda is really a play on words, while adhering to the Apple ‘iSomething’ standard format,” said Simon Green, founder of SiJack Software Ltd. “Even when said out loud, iVeda sounds quite similar to Ayurveda. The concept of having an Ayurvedic application of this type, was a collaberation between myself and my partner who teaches Ayurveda. We saw that no one else had written a consultation tool for Ayurveda on iPhone. Although there are a couple of eBooks, we wanted to do something different and more interactive.”

The iVeda application is not an e-book on the subject of Ayurveda, but rather an evaluation tool for personal consultation. It’s for anyone who is interested or wants to learn more about Ayurveda. iVeda embraces the three doshas, and provides useful information on how to recognise when doshas fall out of balance and ways in which to remedy these imbalances, including daily routines. The application features suggested grocery listings for individual and dual dosha types.

System Requirements:
* iPhone, 3G, 3GS or iPod Touch 2.2.1 or later

Pricing and Availability:
iVeda 1.0 is £2.99 and available exclusively through the App Store.

Sep 06

Night eating affects weight gain

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The time you eat plays a significant role both in your energy levels and metabolism.  In Traditional Chinese Medicine and Ayurveda it is recommended that the biggest meals are consumed during the early part of the day, breakfast and lunch, and something lighter early in the evening.

One of the reasons for eating the bigger meals earlier in the day is that the body's functions are at their peak.  As the day goes by, especially after 7 pm,  digestion starts slowing down preparing for the next phase, that of cleansing and detoxifying the body from all it has accumulated throughout the daily functions.

Now, researchers are demonstrating that night eating plays a role in gaining weight.   As recently reported on BBC News, a team from Northwestern University, Illinois, found that when you eat, not just how you eat, could make a big difference. The study, in the journal Obesity, is said to be the first to show directly that there is a "wrong" time to eat.  Recent studies have suggested that circadian rhythms, the body's internal clock, have a role in how our bodies use up energy. However, this had been difficult to definitively pin down.

Deanna Arble, lead author of the study, said: "One of our research interests is shift workers, who tend to be overweight. "This got us thinking that eating at the wrong time of day might be contributing to weight gain." "Better timing of meals could be a critical element in slowing the ever-increasing incidence of obesity." The scientists now hope they can find out more about how the process works. It is thought that sleep, hormones and body temperature all play a part in how we gain weight.
Sep 03

China approves single-dose swine flu vaccine

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AP,BEIJING: The answer may be at hand to a crucial question about vaccination for the advancing swine flu one shot or two? Chinese officials approved a vaccine Thursday that they say prevents the new flu in a single dose.
If they're right, it would be good news. Many health researchers fear it will take two shots to protect people, vastly complicating efforts to stem the spread of the illness.
The World Health Organization says it is encouraged after reviewing the test details from the vaccine by Beijing-based drug maker Sinovac Biotech Ltd. One of several being developed in China. However, experts said more results are needed from other vaccine makers to determine if one dose would be potent enough.
Australia-based CSL should know within days whether one dose of its vaccine, administered to volunteers in that country in late July, was enough. CSL to date has been mum.
In about two weeks, the U.S. expects to announce initial test results from its vaccine, which is the same type as one of the Chinese versions, said Dr. Anthony Fauci of the U.S. National Institutes of Health.
"From what I've seen and heard of the data, it looks encouraging," Fauci said of the clinical trials of Sinovac vaccine. "This is very good news. Let's hope the material that we're using has similar results."
Most experts agreed.
"Everybody is desperately hoping that one (shot) will do because then that's much easier to administer," said Jodie McVernon, a vaccine expert at the University of Melbourne who is involved in Australian trials of swine flu vaccines for young children. She had not seen the Chinese trial results.
However, James McGlothlin, a member of Purdue University's pandemic planning committee, was cautious about the Chinese report.
"They've got some very good scientists over there, but anything that sounds too good to be true ought to be scrutinized," he said in a telephone interview.
"I'd like to look at some of the clinical trials," that led to the one-dose conclusion, he said. "In China, the rules are a little bit different in terms of human subjects," and it's not clear what safety factors were in place, he said.
China's State Food and Drug Administration said Thursday it approved the vaccine by Sinovac, which completed testing last month.
The vaccine is the first to be approved by the Chinese regulator and is set to be followed by at least one other vaccine this week, made by Hualan Biological Engineering Inc. Another four vaccines were being reviewed, the regulator has said.
Both companies say their studies show one shot of vaccine is effective on people ages 3 to 60. More than 3,000 participated in the trials.
Sinovac says it has the capacity to produce up to 30 million doses of swine flu vaccine in a year, while Hualan said it can make 160 million doses.
Stockpiling vaccines is China's latest move in its aggressive approach to contain the spread of swine flu in the country of 1.3 billion people and relatively limited medical resources. It has quarantined travelers on suspicion of contact with infected people and ordered schools to test students' temperatures.
The Health Ministry says nearly 4,000 cases of swine flu have been confirmed on the mainland none fatal.
China aims to have enough swine flu vaccine for 5 percent of the public by the end of the year, and although health officials have not released detailed vaccination plans, they have said health workers, public service workers and students are priority groups.
Should China export vaccines, however, quality concerns could arise.
Though China is a worldwide manufacturing center for pharmaceuticals, suppliers have been known to substitute cheaper and sometimes lethal ingredients. Tainted cough syrup was linked to several deaths in Central America and blood thinners made with contaminated products are suspected in dozens of deaths in the U.S. in recent years.
Last week, Mexico's health secretary, Jose Angel Cordova, said Mexico is considering buying vaccines from China, which would be more than 40 percent cheaper than other vaccines being offered to the government. But Mexico would want a guarantee that China's vaccine is safe and effective, he said.
The World Health Organization said information provided by Sinovac showed that in studies, the vaccines were tested in three formulations of 15 micrograms per dose, and all gave antibody responses that satisfied regulatory criteria. That vaccine dose is the same amount the U.S. government is testing.
"We have no reason to doubt what Sinovac is reporting," said Melinda Henry, a WHO spokeswoman in Geneva. "Certainly if one dose proves sufficient to produce the desired immune response, this would be very encouraging in terms of augmenting the global supply of vaccine in the near future."
International health experts say swine flu has not been as severe as initially feared. At least 2,185 people have died, but most cases are mild and require no treatment. Worries remain that a rash of new infections could overwhelm hospitals and health authorities, particularly in poorer countries.
White House advisers have estimated that in a worst case scenario, half the U.S. population could become infected and the World Health Organization predicts that within two years nearly one-third of the world's population will have caught it.
Science Writer Randolph E. Schmid reported from Washington, D.C. Medical writers Maria Cheng in London and Lauran Neergaard in Washington contributed to this report
Aug 28

UN warns over swine flu in birds

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The discovery of swine flu in birds in Chile raises concerns about the spread of the virus, the UN warns.

Last week the H1N1 virus was found in turkeys on farms in Chile. The UN now says poultry farms elsewhere in the world could also become infected.

Scientists are worried that the virus could theoretically mix with more dangerous strains. It has previously spread from humans to pigs.

However, swine flu remains no more severe than seasonal flu.

Safe to eat
Chilean authorities first reported the incident last week. Two poultry farms are affected near the seaport of Valparaiso.

Juan Lubroth, interim chief veterinary officer of the UN Food and Agriculture Organization (FAO), said: "Once the sick birds have recovered, safe production and processing can continue. They do not pose a threat to the food chain."

Chilean authorities have established a temporary quarantine and have decided to allow the infected birds to recover rather than culling them.

It is thought the incident represents a "spill-over" from infected farm workers to turkeys.

Canada, Argentina and Australia have previously reported spread of the H1N1 swine flu virus from farm workers to pigs.

Dangerous strains
The emergence of a more dangerous strain of flu remains a theoretical risk. Different strains of virus can mix together in a process called genetic reassortment or recombination.

So far there have been no cases of H5N1 bird flu in flocks in Chile.

However, Dr Lubroth said: "In Southeast Asia there is a lot of the (H5N1) virus circulating in poultry.

"The introduction of H1N1 in these populations would be of greater concern."

Colin Butter from the UK's Institute of Animal Health agrees.

"We hope it is a rare event and we must monitor closely what happens next," he told BBC News.

"However, it is not just about the H5N1 strain. Any further spread of the H1N1 virus between birds, or from birds to humans would not be good.

"It might make the virus harder to control, because it would be more likely to change."

William Karesh, vice president of the Wildlife Conservation Society, who studies the spread of animal diseases, says he is not surprised by what has happened.

"The location is surprising, but it could be that Chile has a better surveillance system.

"However, the only constant is that the situation keeps changing."
Source: By Sudeep Chand
Science reporter, BBC News
Aug 27

Sleep Perception Affects Quality of Life

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By David Douglas

NEW YORK (Reuters Health)  - Lower self-reported sleep quality is associated with reduced quality of life, even when polysomnography does not reflect problems, researchers report in the August issue of Sleep.

"The study results," lead investigator Dr. Graciela E. Silva told Reuters Health "showed that abnormalities in quality of sleep had an important impact on quality of life. Subjective quality of sleep was associated with lower quality of life."

Dr. Silva of Arizona State University, Phoenix and colleagues studied data on 3078 patients with coronary heart disease or respiratory disease who had polysomnography at baseline and approximately 5 years later.

During this period, there was only a modest increase in sleep-disordered breathing. The mean respiratory disturbance index increased from 8.1 to 10.9.

However, said Dr. Silva, "Those subjects who reported having difficulty initiating and maintaining sleep... and those who reported being excessively sleepy during the day had lower quality of life than subjects who did not report having these symptoms."

"Interestingly," she added, "when we measured the subjects' sleep by polysomnogram -- objective sleep -- we did not find this association, signaling to the importance of sleep perception."

"Many subjects who suffer from diseases such as coronary heart disease, respiratory diseases, arthritis, and others," she concluded, "will experience poor quality of sleep and therefore adequately treating the subject's disease with additional therapy to improve their sleep quality will ultimately improve their quality of life."
Source: https://www.medscape.com/viewarticle/707430?src=mp&spon=25&uac=103636DX
Aug 13

Stem cells may offer promise for damaged hearts

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In a field largely still in its infancy, scientists are making headway toward using stem cells to treat heart ailments.

The major focus of stem cell research in cardiology is promoting regeneration of the heart or preventing scar formation, said Jeffrey Karp, who runs a stem cell biology lab at Harvard University.

One study reporting successful results in humans involves harvesting patients' own stem cells, purifying them, and injecting them directly into the heart muscle. The stem cells have a surface marker called CD34, which means they are capable of growing new blood vessels.

The study, sponsored by Baxter Inc., is the largest adult stem cell study for heart disease in the U.S., said Dr. Douglas Losordo, cardiologist at Northwestern Memorial Hospital in Chicago, Illinois, who is leading the trial. The researchers will present their one-year findings from Phase II of the trial in September, Losordo said.

"It's important to point out that this is a use of a patient's own body's repair capabilities," Losordo said.

If everything goes well, it's conceivable this treatment could be widely available in a little over four years, he said. The target patient population, consisting of end-stage cardiac patients who have tried all other available therapies, is about 300,000 to 900,000 people, he said.

So far, researchers have not found side effects from this method, Losordo said. However, because it is an invasive surgical procedure in which stem cells are delivered through a catheter, there is a risk of perforation of about 1 percent, he said. There is also a small risk of blood clotting from the drug, GCSF, which mobilizes stem cells.

Injecting stem cells into the heart muscle carries the risk of arrhythmia, said Techung Lee, associate professor of biochemistry at the State University New York at Buffalo. But Losordo said this risk is theoretical in his trial, and is believed to be very low with CD34 cells in general.

Lee and colleagues are working on a less-invasive technique. In a study in mice, they injected stem cells from bone marrow into skeletal muscles of limbs. They found that the stem cells produced growth factors that traveled to the heart, in addition to stimulating the muscle itself to make growth factors that also improved cardiac function.

The challenge for translating this method to humans would be that, while each mouse needed only a few million stem cells, each human patient would need close to a billion stem cells for the therapy -- which would be far too expensive and logistically difficult.

"This is a problem that's been experienced by everyone in the field," Lee said. He estimates that his method could be available clinically in five years, after researchers find ways to reduce the required number of cells by a factor of 10 or even 100.

Another therapeutic possibility is giving a patient an IV of stem cells, which would come from a stem cell bank or a company. The challenge is that the cells may not have the right homing receptors to land in the heart, Karp said.

Karp's group is working on an approach to chemically modify the surface of cells to enhance their targeting to specific sites. Results from animal models have shown promising results for targeting sites of inflammation, he said.

"Essentially we know the ZIP code of vessels within a certain tissue, we can program the address on the surface of the cell," he said.

Lee's and Karp's teams use adult mesenchymal stem cells, which may develop into connective tissue, lymphatic tissue, and blood vessels. These stem cells are largely interchangeable between patients and don't require matching, as organ transplants do. However, as more becomes known about the relatively new field of stem cell therapy, a more specific matching system may be required, said Dr. Joon Lee, cardiologist at the University of Pittsburgh Medical Center.

Some stem cell therapies for the heart are being tested in human clinical trials. Osiris Therapeutics Inc. is enrolling patients in a phase II trial for Prochymal, which contains mesenchymal stem cells. The company intends to use this drug, which gets injected into the vein, to repair heart damage in patients who have just experienced their first heart attack.

More than 90 percent of research on using stem cells to repair the human heart involves adult stem cells, Lee said.

That means the controversy about using stem cells derived from human embryos is largely absent from this line of research. For developing treatments that involve transplanting stem cells from adults, there is no ethical concern about the use of embryos, Lee said.

Embryonic stem cells are advantageous in research because they can be grown more easily than adult stem cells in a culture, and are pluripotent, meaning they can develop into any of the various cell types of the body, according to the National Institutes of Health. But it is not yet known whether tissues derived from embryonic stem cells would cause transplant rejection, whereas this does not seem to be a problem with adult stem cells.

The U.S. Food and Drug Administration regulates which adult stem cell techniques are allowed to go into clinical trials and sets the requirements for more routine use. Whether the FDA will become more or less lenient in these respects is unclear, Lee said.

It's not unfathomable that within the next two to five years, some FDA-approved stem cell treatments will be available for cardiovascular disease, Lee said.

Karp has a longer view -- five to 10 years before stem cell treatments become widely available for heart problems, he said.

The biology of stem cell treatments for the heart is not well understood, said Dr. Ronald Crystal, chief of the Division of Pulmonary and Critical Care Medicine at New York-Presbyterian Hospital/Weill Cornell Medical Center.

One of the challenges is that once a stem cell gets put into a person's body, no one can get it out, Crystal said. This is the opposite of other kinds of medications -- for instance, a person may get sick from taking too many aspirin, but eventually the drug leaves the system. Not so with stem cells, he said.

Crystal expressed general caution about the future of stem cell research, which is still experimental, for heart patients.

"This is a good idea, but patients and families should not expect immediate results," he said.
Souce: cnn.com
Aug 11

Optimistic women live for longer

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Women who are optimistic have a lower risk of heart disease and death, an American study shows.

The latest study by US investigators mirrors the findings of earlier work by a Dutch team showing optimism reduces heart risk in men.

The research on nearly 100,000 women, published in the journal Circulation, found pessimists had higher blood pressure and cholesterol.

Even taking these risk factors into account, attitude alone altered risks.

Optimistic women had a 9% lower risk of developing heart disease and a 14% lower risk of dying from any cause after more than eight years of follow-up.
In comparison, cynical women who harboured hostile thoughts about others or were generally mistrusting of others were 16% more likely to die over the same time scale.

One possibility is that optimists are better at coping with adversity, and may, for example take better care of themselves when they do fall ill.

In the study, the optimistic women exercised more and were leaner than pessimistic peers.

Lead researcher Dr Hilary Tindle, assistant professor of medicine at the University of Pittsburgh, said: "The majority of evidence suggests that sustained, high degrees of negativity are hazardous to health."

A spokeswoman for the British Heart Foundation said: "We know that hostile emotions can release certain chemicals in the body which may increase the risk of heart disease, but we don't fully understand how and why.

"Optimistic or hostile attitudes can be linked to health behaviours such as smoking or poor diet, which may also influence heart health.

"A good thing for all women is that regardless of your outlook, making healthy choices such as not smoking and eating well, will have much more of an impact on your heart health than your outlook.

"More research is needed to explore how and why these psychological attitudes may affect health."
source: bbc.com
Aug 07

Cow colostrum could help arrest spread of H1N1

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Calling Gau piyush' or cow colostrum a powerful nutritional immunity solution that could help arrest the spread of the H1N1 flu, noted
computer scientist Vijay Bhatkar on Wednesday said that the solution should not be considered a cure but a supplement to other medication.

Cow colostrum is a thick lemon yellow coloured secretion produced by cows for about 72 hours after the birth of a calf.

Addressing a news conference here along with a few medical practitioners in the city, Bhatkar pointed out that this solution, that has its origins in Ayurveda, was now available in capsule form.

Bhatkar's recently founded Institute of Integrative Healthcare (IIHc) started research on this solution almost three years ago. "But we started focusing on the H1N1 flu only a few months ago. Our focus was on nutritional immunology inspired by Ayurveda rather than vaccine-based immunology. Different countries have different conditions, so it is vital for each and every country to look for a solution to the illness themselves," said Bhatkar.

Stressing the fact that the solution was only meant to be a supplement to the medication for H1N1 and not a replacement, Bhatkar said that it could be taken by both those suffering from H1N1 and those who want to take some kind of preventive measures.

The task force formed by the institute to conduct research on the solution include a mix of medical practitioners and Ayurveda practitioners and G T Phanse, the former deputy director of the National Chemical Laboratory (NCL). "The colostrum contains about 20 specific antibodies and it also has antibacterial properties," said Ramesh Patil, a member of the task force.

The solution has already been tried on 7,000 patients successfully during the course of the research, 20 per cent of them displayed influenza-like symptoms. "We have not been able to obtain the necessary permission to test it on those suffering from the H1N1 flu but we are in talks with various authorities including the Pune Municipal Corporation (PMC) who have promised to get back to us," said Bhatkar.

On being asked about the effectiveness of the solution, another task force member, Vinod Marathe, said that it starts taking effect within an hour after it is consumed. "It quickly builds up your immunity system and the effect only gets stronger. The antibodies start functioning immediately," he added. He also clarified that the solution was not advisable for those who were lactose intolerant.
Aug 04

New strain of HIV derived from gorillas

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 French researchers have identified a new human immunodeficiency virus, the first derived from gorillas, a report said Monday.
A new virus is difficult to detect by tests because it is not closely related to the other three HIV variants.
The three previous HIV variants came from chimpanzees. The new findings indicate that gorillas, in addition to chimpanzees, are likely sources of HIV, the researchers concluded in a report published in the weekly Nature Medicine journal.
The new virus, called RBF 168, was detected in a 62-year-old woman who moved to Paris, France, from the western Africa nation of Cameroon, the report says. She tested positive for HIV in 2004, and researchers led by Jean-Christophe Plantier identified the virus as being closely related to a recently discovered simian immunodeficiency virus (SIV).
The new gorilla virus "has many of the biological properties necessary for human infection," the report says.
"The human case described here does not seem to be an isolated incident, as before coming to Paris the subject had lived in the semiurban area of Yaounde, the capital of Cameroon, and reported no contact with apes or bush meat," the researchers said.

  That would indicate that the woman contracted the virus from another human.
The significance of the latest findings is difficult to determine without more information, said Robert C. Gallo, who co-discovered HIV in 1984.
"It's yet to be known," Gallo said. "It could be zero. ... Let's see a more full report on this individual and let's see wider testing."
Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, calls the latest HIV variant "an oddity" but said it's not surprising that it cropped up, because the virus has been circulating in non-human primates for centuries.
The three previous HIV variants are labeled M, N and O. The new one has been classified P. The N and O variants, Fauci said, are extremely rare.
"It's not significant unless it establishes itself as a predominant strain," he said. "We have not seen that with N and O."
Fauci lumps the new P variant with the rare group because it has been detected in only one patient.
If it were widespread, Fauci said, "we would already know about it. When these things happen, you see a lot of them around."
Even if the new variant proves lethal, it's not likely to increase AIDS infections, said Gallo, director of the Institute of Human Virology at the University of Maryland School of Medicine. There are so many HIV variations, he said, that one more is not likely to make a difference.
The new virus is difficult to detect by conventional tests because it is not closely related to the other three HIV variants.
"This demonstrates that HIV evolution is an ongoing process," co-researcher David Robertson of the University of Manchester said in a release. "The virus can jump from species to species, from primate to primate, and that includes us; pathogens have been with us for millions of years and routinely switch host species."
HIV can lead to acquired immunodeficiency syndrome, which attacks the body's immune system, giving rise to lethal infections. Patients diagnosed with HIV can take medications to delay or stop HIV from developing into AIDS. There are 33 million confirmed cases of AIDS worldwide.
The unnamed woman has no signs of AIDS and remains untreated, Nature Medicine said.
The most likely explanation for the emergence of the new virus is gorilla-to-human transmission, though researchers say they cannot rule out the possibility that the chimpanzee SIV gave rise to the new strain "either indirectly by transmission to gorillas and then to humans or directly by transmission to humans and also to gorillas."
Researchers said they don't know how widespread the virus is among humans.

"The human prevalence of this new lineage remains to be determined," the report says, adding that "it could be circulating unnoticed in Cameroon or elsewhere."
Western Central Africa bears close watching, the researchers suggest.
"In conclusion, our findings indicate that gorillas, in addition to chimpanzees, are likely sources of HIV-1," the report states. "The discovery of this novel HIV-1 lineage highlights the continuing need to watch closely for the emergence of new HIV variants, particularly in western central Africa, the origin of all existing HIV-1 groups."
Co-researcher Robertson noted that the new virus may not be restricted to Africa.
"It also highlights how human mobility can rapidly transfer a virus from one geographical location to another as has been dramatically evident with the recent emergence of swine flu," he said.
source: cnn.com

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