Soldier who lost 4 limbs has double-arm transplant

On Facebook, he describes himself as a "wounded warrior...very wounded."

Brendan Marrocco was the first soldier to survive losing all four limbs in the Iraq War, and doctors revealed Monday that he's received a double-arm transplant.

Those new arms "already move a little," he tweeted a month after the operation.

Marrocco, a 26-year-old New Yorker, was injured by a roadside bomb in 2009. He had the transplant Dec. 18 at Johns Hopkins Hospital in Baltimore, his father said Monday.

Alex Marrocco said his son does not want to talk with reporters until a news conference Tuesday at the hospital, but the younger Marrocco has repeatedly mentioned the transplant on Twitter and posted photos.

"Ohh yeah today has been one month since my surgery and they already move a little," Brendan Marrocco tweeted Jan. 18.

Responding to a tweet from NASCAR driver Brad Keselowski, he wrote: "dude I can't tell you how exciting this is for me. I feel like I finally get to start over."

The infantryman also received bone marrow from the same dead donor who supplied his new arms. That novel approach is aimed at helping his body accept the new limbs with minimal medication to prevent rejection.

The military sponsors operations like these to help wounded troops. About 300 have lost arms or hands in Iraq or Afghanistan.

Unlike a life-saving heart or liver transplant, limb transplants are aimed at improving quality of life, not extending it. Quality of life is a key concern for people missing arms and hands — prosthetics for those limbs are not as advanced as those for feet and legs.

"He was the first quad amputee to survive," and there have been four others since then, Alex Marrocco said.

The Marroccos want to thank the donor's family for "making a selfless decision ... making a difference in Brendan's life," the father said.

Brendan Marrocco has been in public many times. During a July 4 visit last year to the Sept. 11 Memorial with other disabled soldiers, he said he had no regrets about his military service.

"I wouldn't change it in any way. ... I feel great. I'm still the same person," he said.

The 13-hour operation was led by Dr. W.P. Andrew Lee, plastic surgery chief at Johns Hopkins. It was the seventh double-hand or double-arm transplant done in the United States.

Lee led three of those earlier operations when he worked at the University of Pittsburgh, including the only above-elbow transplant that had been done at the time, in 2010.

Marrocco's "was the most complicated one" so far, Lee said in an interview Monday. It will take more than a year to know how fully Marrocco will be able to use the new arms.

"The maximum speed is an inch a month for nerve regeneration," he explained. "We're easily looking at a couple years" until the full extent of recovery is known.

While at Pittsburgh, Lee pioneered the immune-suppression approach used for Marrocco. The surgeon led hand-transplant operations on five patients, giving them marrow from their donors in addition to the new limbs. All five recipients have done well, and four have been able to take just one anti-rejection drug instead of combination treatments most transplant patients receive.

Minimizing anti-rejection drugs is important because they have side effects and raise the risk of cancer over the long term. Those risks have limited the willingness of surgeons and patients to do more hand, arm and even face transplants.

Lee has received funding for his work from AFIRM, the Armed Forces Institute of Regenerative Medicine, a cooperative research network of top hospitals and universities around the country that the government formed about five years ago. With government money, he and several other plastic surgeons around the country are preparing to do more face transplants, possibly using the new immune-suppression approach.

Marrocco expects to spend three to four months at Hopkins, then return to a military hospital to continue physical therapy, his father said. Before the operation, he had been fitted with prosthetic legs and had learned to walk on his own.

He had been living with his older brother in a specially equipped home on New York's Staten Island that had been built with the help of several charities. Shortly after moving in, he said it was "a relief to not have to rely on other people so much."

The home was heavily damaged by Superstorm Sandy last fall.

Despite being in a lot of pain for some time after the operation, Marrocco showed a sense of humor, his father said. He had a hoarse voice from the tube that was in his throat during the long surgery and decided he sounded like Al Pacino. He soon started doing movie lines.

"He was making the nurses laugh," Alex Marrocco said.

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Associated Press Writer Stephanie Nano in New York contributed to this report.

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Online:

Army regenerative medicine:

http://www.afirm.mil/index.cfm?pageid=home

and http://www.afirm.mil/assets/documents/annual_report_2011.pdf

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Follow Marilynn Marchione at http://twitter.com/MMarchioneAP .

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Immigration Plan Includes Path to Citizenship

A bipartisan group of senators on Monday formally unveiled their proposal to drastically overhaul the nation's immigration system, with the hope of passing a bill out of the Senate by late spring or early summer.

"We believe this will be the year Congress finally gets it done," Sen. Chuck Schumer (D-N.Y.) one of the members of the so-called "Gang of Eight" said during a press conference on Capitol Hill.

See Also: Transcript: Framework for Immigration Reform

Five of the eight members of the group -- Schumer, Bob Menendez (D-N.J.), Dick Durbin (D-Ill.), Marco Rubio (R-Fla.), and John McCain (R-Ariz.) -- appeared at the press conference intended to outline their immigration proposal. The proposal would provide a path to citizenship for many of the nation's 11 million undocumented immigrants while upping border security and cracking down on businesses that hire workers who are not legally present in the U.S.

Sens. Jeff Flake (R-Ariz.), Lindsey Graham (R-S.C.), and Michael Bennet (D-Colo.) were the members not in attendance.

The senators all expressed optimism that their legislation could pass both the House and the Senate. Schumer added that he hopes to have an actual piece of legislation done by the end of March, and then have the Senate act on it right away.

Saul Loeb/AFP/Getty Images

But while some conservatives have signaled support for the Senate framework, many others have resisted any plan that could grant a pathway to citizenship to undocumented immigrants, saying it amounts to amnesty for people who broke the law.

The Senate's plan does not grant undocumented immigrants automatic "amnesty," rather it requires them to go through an arduous process that includes undergoing a background check, paying fines, back taxes and learning English and American civics over the course of a number of years. The new law would grant eligible undocumented immigrants permission to live and work in the U.S. legally, but would not confer permanent legal status, or a green card, until the border is deemed to be secure. Young people brought into the U.S. illegally as minors and some agricultural workers would face an easier path to citizenship.

"We will never put these people on a path to citizenship until we have secured the border," Schumer said.

McCain, who helped lead the last effort on a comprehensive immigration bill in 2007 said, "We have been too content for too long to allow individuals to mow our lawns, grow our food, clean our homes, and even watch our children while not affording them any of the benefits that make our country so great."

Senators in both political parties suggested that the reason that some Republicans have had a change of heart was because of the results of last November's election, when seven in 10 Latino voters backed President Barack Obama over Republican Mitt Romney.

"The politics on this issue have been turned upside down," Schumer said. "For the first time ever, there is more political risk in opposing immigration reform, than in supporting it."

Perhaps more than anyone on the stage, McCain understands this. While he backed comprehensive immigration reform five years ago, he backed away from it during his 2010 run for Senate, just as his home state was considering the SB 1070 crackdown law on undocumented immigrants.

McCain went so far as to say that the current plan is a "testimonial" to bill he worked on with Sen. Ted Kennedy (D-Mass.), the late liberal icon, in 2007.

Another member of the group, Marco Rubio, had not always voiced support for a pathway to citizenship for undocumented immigrants during his Senate career. But on Monday, he said that Congress needs to "address the reality" of the massive undocumented population in the U.S.

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Nightclub fire kills 233 in Brazil

SANTA MARIA, Brazil (Reuters) - A nightclub fire killed at least 233 people in southern Brazil early on Sunday when a band's pyrotechnics show set the building ablaze and fleeing partygoers stampeded toward blocked and overcrowded exits in the ensuing panic, officials said.

The blaze in the university town of Santa Maria was ignited by sparks from pyrotechnics used by the band for visual effects. They set fire to soundproofing on the ceiling and the club rapidly filled with toxic smoke, local fire officials said.

Most of those who died were suffocated by fumes, fire brigade Sergeant Robson Muller told Reuters. Others were crushed in the stampede.

"Smoke filled the place instantly, the heat became unbearable," survivor Murilo Tiescher, a medical student, told GloboNews TV. "People could not find the only exit. They went to the toilet thinking it was the exit and many died there."

Fire officials said at least one exit was locked and that club bouncers, who at first thought those fleeing were trying to skip out on bar tabs, initially blocked patrons from leaving. The security staff relented only when they saw flames engulfing the ceiling.

The tragedy, in a packed venue in one of Brazil's most prosperous states, comes as the country scrambles to improve safety, security and logistical shortfalls ahead of the 2014 World Cup soccer tournament and the 2016 Olympics, both intended to showcase the economic advances and first-world ambitions of Latin America's largest nation.

In Santa Maria, a city of more than 275,000 people, rescue workers and weary officials wept alongside family and friends of the victims at a local gymnasium being used as a makeshift morgue.

"It's the saddest, saddest day of my life," said Neusa Soares, the mother of one of those killed, 22-year-old Viviane Tolio Soares. "I never thought I would have to live to see my girl go away."

President Dilma Rousseff cut short an official visit to Chile and flew to Santa Maria, where she wept as she spoke to relatives of the victims at the gym.

"All I can say at the moment is that my feelings are of deep sorrow," said Rousseff, who began her political career in Rio Grande do Sul, the state where the fire occurred.

News of the fire broke on Sunday morning, when local news broadcast images of shocked people outside the nightclub called Boate Kiss. Gradually, grisly details emerged.

"BARRIER OF THE DEAD"

"We ran into a barrier of the dead at the exit," Colonel Guido Pedroso de Melo, commander of the fire brigade in Rio Grande do Sul, said of the scene that firefighters found on arrival. "We had to clear a path to get to the rest of those that were inside."

Officials said more than 1,000 people may have been in the club, possibly exceeding its legal capacity. Though Internet postings about the venue suggested as many as 2,000 people at times have crammed into the club, Pedroso de Melo said no more than half that should have been inside.

He said the club was authorized to be open but its permit was in the process of being renewed.

However, Pedroso de Melo did point to several egregious safety violations - from the flare that went off during the show to the locked door that kept people from leaving.

The club's management said in a statement that its staff was trained and prepared to deal with any emergency. It said it would help authorities with their investigation.

When the fire began at about 2:30 a.m., many revelers were unable to find their way out in the chaos.

"It all happened so fast," survivor Taynne Vendrusculo told GloboNews TV. "Both the panic and the fire spread rapidly, in seconds."

Once security guards realized the building was on fire, they tried in vain to control the blaze with a fire extinguisher, according to a televised interview with one of the guards, Rodrigo Moura. He said patrons were getting trampled as they rushed for the doors, describing it as "a horror film."

Band member Rodrigo Martins said the fire started after the fourth or fifth song and the extinguisher did not work.

"It could have been a short circuit, there were many cables there," Martins told Porto Alegre's Radio Gaucha station. He said there was only one door and it was locked. A band member died in the fire.

CLUB OWNER QUESTIONED

One of the club's owners has surrendered to police for questioning, GloboNews reported.

TV footage showed people sobbing outside the club before dawn, while shirtless firefighters used sledge hammers and axes to knock down an exterior wall to open up an exit.

Rescue officials moved the bodies to the local gym and separated them by gender. Male victims were easier to identify because most had identification on them, unlike the women, whose purses were left scattered in the devastated nightclub. Local authorities said 120 men and 113 women died in the fire.

Piles of shoes remained in the burnt out club, along with tufts of hair pulled out by people fleeing desperately. Firemen who removed bodies said victims' cell phones were still ringing.

The disaster recalls other incidents including a 2003 fire at a nightclub in West Warwick, Rhode Island, that killed 100 people [ID:nL1N0AW2NR], and a Buenos Aires nightclub blaze in 2004 that killed nearly 200. In both incidents, a band or members of the audience ignited fires that set the establishment ablaze.

The Rhode Island fire shocked local and federal officials because of the rarity of such incidents in the United States, where enforcement of safety codes is considered to be relatively strict. After the Buenos Aires blaze, Argentine officials closed many nightclubs and other venues and ultimately forced the city's mayor from office because of poor oversight of municipal codes.

The fire early on Sunday occurred in one of the wealthiest, most industrious and culturally distinct regions of Brazil. Santa Maria is about 186 miles west of Porto Alegre, the capital of a state settled by Germans and other immigrants from northern Europe.

Local clichés paint the region as stricter and more organized than the rest of Brazil, where most residents are a mix descended from native tribes, Portuguese colonists, African slaves, and later influxes of immigrants from southern Europe.

Rio Grande do Sul state's health secretary, Ciro Simoni, said emergency medical supplies from all over the state were being sent to the scene. States from all over Brazil offered support, and messages of sympathy poured in from foreign leaders.

(Additional reporting by Guillermo Parra-Bernal, Gustavo Bonato, Jeferson Ribeiro, Eduardo Simões, Brian Winter and Guido Nejamkis.; Writing by Paulo Prada and Anthony Boadle; Editing by Todd Benson, Kieran Murray and Christopher Wilson)

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Fired workers protest at South Korean embassy in Iran

TEHRAN: Around 1,000 workers laid off by Iran's Entekhab group demonstrated outside the South Korean embassy in Tehran on Sunday after an acquisition deal for Daewoo Electronics fell through because of sanctions.

Entekhab had to let them go when it shut down a manufacturing line, the company said.

Three months ago, employees demonstrated at the embassy in the hope that Seoul would intervene to refund a downpayment of $70 million (53 million euros) Entekhab paid in 2011 to Daewoo.

In November 2010, the privately run Entekhab Industrial Group signed a contract sealing its acquisition of Daewoo for $518 million (397 million euros), the manufacturer maintains.

"Today, around 1,200 laid off workers from our company gathered again in front of the South Korean embassy after we did not get the money back," Entekhab's media spokesman Eshsan Fadaee said.

Daewoo Electronics, a former subsidiary of the now-defunct Daewoo Group, has been under a debt rescheduling programme since 1999 when its parent company collapsed.

Entekhab's deal to acquire Daewoo Electronics came unstuck in September 2010 when Seoul, reportedly under pressure from Washington, slapped sanctions on the Islamic republic over its controversial nuclear programme.

Entekhab, located in the central province of Isfahan, produces domestic appliances including refrigerators, washing machines and televisions under the brand names Snowa and Haier.

Under the punitive measures, South Korea has suspended the operations of Iran's Bank Mellat.

The United Nations, European Union, United States, and several other countries have imposed sanctions on Iran for its refusal to halt uranium enrichment, which world powers suspect masks an atomic weapons drive despite Tehran's denials.

- AFP/de

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CDC: Flu seems to level off except in the West

New government figures show that flu cases seem to be leveling off nationwide. Flu activity is declining in most regions although still rising in the West.

The Centers for Disease Control and Prevention says hospitalizations and deaths spiked again last week, especially among the elderly. The CDC says quick treatment with antiviral medicines is important, in particular for the very young or old. The season's first flu case resistant to treatment with Tamiflu was reported Friday.

Eight more children have died from the flu, bringing this season's total pediatric deaths to 37. About 100 children die in an average flu season.

There is still vaccine available although it may be hard to find. The CDC has a website that can help.

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CDC: http://www.cdc.gov/flu/

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Brazil Nightclub Fire: 232 Dead, Hundreds Injured

Flames raced through a crowded nightclub in southern Brazil early Sunday, killing more than 230 people as panicked partygoers gasped for breath in the smoke-filled air, stampeding toward a single exit partially blocked by those already dead. It appeared to be the world's deadliest nightclub fire in more than a decade.

Witnesses said a flare or firework lit by band members started the blaze in Santa Maria, a university city of about 225,000 people, though officials said the cause was still under investigation.

Television images showed smoke pouring out of the Kiss nightclub as shirtless young men who had attended a university party joined firefighters using axes and sledgehammers to pound at windows and walls to free those trapped inside.

Guido Pedroso Melo, commander of the city's fire department, told the O Globo newspaper that firefighters had a hard time getting inside the club because "there was a barrier of bodies blocking the entrance."

Teenagers sprinted from the scene desperately seeking help. Others carried injured and burned friends away in their arms.

"There was so much smoke and fire, it was complete panic, and it took a long time for people to get out, there were so many dead," survivor Luana Santos Silva told the Globo TV network.

The fire spread so fast inside the packed club that firefighters and ambulances could do little to stop it, Silva said.

Germano Roratto/AFP/Getty Images

Another survivor, Michele Pereira, told the Folha de S. Paulo newspaper that she was near the stage when members of the band lit flares that started the conflagration.

"The band that was onstage began to use flares and, suddenly, they stopped the show and pointed them upward," she said. "At that point, the ceiling caught fire. It was really weak, but in a matter of seconds it spread."

Guitarist Rodrigo Martins told Radio Gaucha that the band, Gurizada Fandangueira, started playing at 2:15 a.m. "and we had played around five songs when I looked up and noticed the roof was burning"

"It might have happened because of the Sputnik, the machine we use to create a luminous effect with sparks. It's harmless, we never had any trouble with it.

"When the fire started, a guard passed us a fire extinguisher, the singer tried to use it but it wasn't working"

He confirmed that accordion player Danilo Jacques, 28, died, while the five other members made it out safely.

Police Maj. Cleberson Braida Bastianello said by telephone that the toll had risen to 233 with the death of a hospitalized victim — he said earlier that the death toll was likely made worse because the nightclub appeared to have just one exit through which patrons could exit.

Officials counted 232 bodies that had been brought for identification to a gymnasium in Santa Maria, which is located at the southern tip of Brazil, near the borders with Argentina and Uruguay.

Federal Health Minister Alexandre Padhilha told a news conference that most of the 117 people treated in hospitals had been poisoned by gases they breathed during the fire. Only a few suffered serious burns, he said.

Brazil President Dilma Roussef arrived to visit the injured after cutting short her trip to a Latin American-European summit in Chile.

"It is a tragedy for all of us," Roussef said.

Most of the dead apparently were asphyxiated, according to Dr. Paulo Afonso Beltrame, a professor at the medical school of the Federal University of Santa Maria who went to the city's Caridade Hospital to help victims.

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Riots over Egyptian death sentences kill at least 32

PORT SAID, Egypt/CAIRO (Reuters) - At least 32 people were killed on Saturday when Egyptians rampaged in protest at the sentencing of 21 people to death over a soccer stadium disaster, violence that compounds a political crisis facing Islamist President Mohamed Mursi.

Armored vehicles and military police fanned through the streets of Port Said, where gunshots rang out and protesters burned tires in anger that people from their city had been blamed for the deaths of 74 people at a match last year.

The rioting in Port Said, one of the most deadly spasms of violence since Hosni Mubarak's ouster two years ago, followed a day of anti-Mursi demonstrations on Friday, when nine people were killed. The toll over the past two days stands at 41.

The flare-ups make it even tougher for Mursi, who drew fire last year for expanding his powers and pushing through an Islamist-tinged constitution, to fix the creaking economy and cool tempers enough to ensure a smooth parliamentary election.

That vote is expected in the next few months and is meant to cement a democratic transition that has been blighted from the outset by political rows and street clashes.

The National Defense Council, which is led by Mursi and includes the defense minister who commands the army, called for "a broad national dialogue that would be attended by independent national characters" to discuss political differences and ensure a "fair and transparent" parliamentary poll.

The National Salvation Front of liberal-minded groups and other Mursi opponents cautiously welcomed the call.

THREATS OF VIOLENCE

Clashes in Port Said erupted after a judge sentenced 21 men to die for involvement in the deaths at the soccer match on February 1, 2012. Many were fans of the visiting team, Cairo's Al Ahly.

Al Ahly fans had threatened violence if the court had not meted out the death penalty. They cheered outside their Cairo club when the verdict was announced. But in Port Said, residents were furious that people from their city were held responsible.

Protesters ran wildly through the streets of the Mediterranean port, lighting tires in the street and storming two police stations, witnesses said. Gunshots were reported near the prison where most of the defendants were being held.

A security source in Port Said said 32 people were killed there, many dying from gunshot wounds. He said 312 were wounded and the ministry of defense had allocated a military plane to transfer the injured to military hospitals.

Inside the court in Cairo, families of victims danced, applauded and some broke down in tears of joy when they heard Judge Sobhy Abdel Maguid declare that the 21 men would be "referred to the Mufti", a phrase used to denote execution, as all death sentences must be reviewed by Egypt's top religious authority.

There were 73 defendants on trial. Those not sentenced on Saturday would face a verdict on March 9, the judge said.

At the Port Said soccer stadium a year ago, many spectators were crushed and witnesses saw some thrown off balconies after the match between Al Ahly and local team al-Masri. Al Ahly fans accused the police of being complicit in the deaths.

Among those killed on Saturday were a former player for al-Masri and a soccer player in another Port Said team, the website of the state broadcaster reported.

TEARGAS FIRED

On Friday, protesters angry at Mursi's rule had taken to the streets for the second anniversary of the uprising that erupted on January 25, 2011 and brought Mubarak down 18 days later.

Police fired teargas and protesters hurled stones and petrol bombs. Nine people were killed, mainly in the port city of Suez, and hundreds more were injured across the nation.

Reflecting international concern at the two days of clashes, British Foreign Office Minister for the Middle East Alistair Burt said: "This cannot help the process of dialogue which we encourage as vital for Egypt today, and we must condemn the violence in the strongest terms."

European Union foreign policy chief Catherine Ashton urged the Egyptian authorities to restore calm and order and called on all sides to show restraint, her spokesperson said.

On Saturday, some protesters again clashed and scuffled with police in Cairo, Alexandria and other cities. In the capital, youths pelted police lines with rocks near Tahrir Square.

In Suez, police fired teargas when protesters angry at Friday's deaths hurled petrol bombs and stormed a police post and other governmental buildings including the agriculture and social solidarity units.

Around 18 prisoners in Suez police stations managed to escape during the violence, a security source there said, and some 30 police weapons were stolen.

"We want to change the president and the government. We are tired of this regime. Nothing has changed," said Mahmoud Suleiman, 22, in Cairo's Tahrir Square, the cauldron of the 2011 anti-Mubarak revolt.

Mursi's opponents say he has failed to deliver on economic pledges or to be a president representing the full political and communal diversity of Egyptians, as he promised.

"Egypt will not regain its balance except by a political solution that is transparent and credible, by a government of national salvation to restore order and heal the economy and with a constitution for all Egyptians," prominent opposition politician Mohamed ElBaradei wrote on Twitter.

The opposition National Salvation Front, responding to the Defense Council's call for dialogue, said there must be a clear agenda and guarantees that any deal would be implemented, spokesman Khaled Dawoud told Reuters.

The Front earlier on Saturday threatened an election boycott and to call for more protests on Friday if demands were not met. Its demands included picking a national unity government to restore order and holding an early presidential poll.

Mursi's supporters say the opposition does not respect the democracy that has given Egypt its first freely elected leader.

The Muslim Brotherhood, which propelled Mursi to office, said in a statement that "corrupt people" and media who were biased against the president had stirred up fury on the streets.

The frequent violence and political schism between Islamists and secular Egyptians have hurt Mursi's efforts to revive an economy in crisis as investors and tourists have stayed away, taking a heavy toll on Egypt's currency.

(Additional reporting by Omar Fahmy, Peter Griffiths in London and Claire Davenport in Brussels; Writing by Edmund Blair; Editing by Mark Trevelyan)

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Sailing: Olympic sailing champion visits Singapore

SINGAPORE: Xu Lijia, the 25 year old who became the first Chinese to win a gold medal in the dinghy class after finishing first in the laser radial class at the 2012 London Olympics, is in town.

The Chinese athlete shared her experiences with local sailors at a talk, which attracted 500 participants. The talk also saw the launch of the Character Development Through Sailing programme.

The Shanghai native, who won bronze in the same class at the 2008 Olympics in Beijing, said that it was not just about winning, but also enjoying the journey.

She had to beat many odds including injuries, physical limitations and the lack of a proper support structure for the sport in China.

"It is about promotion, promoting this sport not only in Singapore, China but... in whole of Asia. I hope that Asia can become stronger and stronger and (compete) with the European countries," she said.

- CNA/jc

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Prescribe generic drugs: MCI to doctors

MUMBAI: The Union government and regulatory bodies appear to be serious in ending the pharma-doctor nexus and curb unethical marketing practices. In its latest effort, the Medical Council of India has directed doctors, hospitals and medical colleges to prescribe generic medicines as far as possible. Generic medicines are more affordable versions of branded medicines sold by companies.

In its directive dated January 21 to the principals of medical colleges, director of hospitals and presidents of all state medical councils, the MCI has said that every physician should, as far as possible, prescribe drugs with generic names and ensure that there is a rational prescription and use of drugs. All doctors registered under the MCI act have been asked to comply with the directive.

Over the past couple of years, there have been a slew of efforts to curb unethical marketing practices followed by pharma companies, end the use of branded drugs and bring down the prices of medicines.

MCI chairman K K Talwar said, "The directive is a bid to educate the medical community, including doctors and make them aware about the increased availability of generic drugs and to make them more affordable as well. We need to instill confidence in people about the use of generic versions."

Though the government has opened the retail store, which market generic medicines, "Jan Aushadhi" in certain states, availability of quality generic medicines is a huge concern.

Doctors are of the view that the focus should be on the quality of the drugs prescribed. Says Dr Anoop Misra chairman of Delhi-based Fortis Centre of excellence for diabetes: "For the benefit of patients and to get the best possible results, highest quality drugs with best possible pharmacological properties should be used by all doctors. If the quality of generic drugs is up to high standards, doctors should prescribe generic medicines."

Industry experts, however, said the move may not benefit patients as it may not lead to a significant price reduction. Says Indian Pharmaceutical Alliance, secretary general D G Shah: "If the government is able to ensure the quality of generic medicines, then it will be beneficial. Patients do not know about the quality of medicines and will have to depend on chemists. It may lead to a chemist-pharma nexus from the much-discussed nexus between pharma companies and doctors".

Last year, in a bid to promote generic medicines, the health ministry ordered states to stop issuing licenses in brand names. The move has not benefitted patients much as companies continue to market the medicines in brand names. Also, concerned with increasing complaints of unethical marketing practices, the department of pharmaceuticals initiated an exercise to introduce a code of conduct for the pharma industry, which is yet to be finalized.

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CDC: Flu seems to level off except in the West

New government figures show that flu cases seem to be leveling off nationwide. Flu activity is declining in most regions although still rising in the West.

The Centers for Disease Control and Prevention says hospitalizations and deaths spiked again last week, especially among the elderly. The CDC says quick treatment with antiviral medicines is important, in particular for the very young or old. The season's first flu case resistant to treatment with Tamiflu was reported Friday.

Eight more children have died from the flu, bringing this season's total pediatric deaths to 37. About 100 children die in an average flu season.

There is still vaccine available although it may be hard to find. The CDC has a website that can help.

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CDC: http://www.cdc.gov/flu/

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