What should you do if you are alone and have a heart attack?

‘You can take any standard aspirin tablet (300 mg), Clopidogrel (300 mg) and Atorvastatin (80 mg) at the same time,’ says Dr T S Kler, Chairman, Fortis Heart and Vascular Institute, Fortis Memorial Research Institute, Gurugram

Patients with a heart attack present symptoms like chest pain, pain in the jaw or shoulder, breathing difficulty, palpitations and a sense of impending doom 

A heart attack doesn’t come with warning signs and given our nuclear existence these days, chances are that some of us, mostly the elderly, may experience an episode when we are alone at home. So how do you know you are having an event?

https://indianexpress.com/article/health-wellness/what-should-you-do-if-you-are-alone-and-have-a-heart-attack-8400472/

Antidepressants may cause ‘emotional blunting’: Study

Patients report feeling emotionally dull and no longer finding things as pleasurable as they used to

Common antidepressants can cause many users to feel emotionally ‘blunted’, according to a study that offers new insights into how the drugs work and their possible side-effects.

The research, published on Monday in the journal Neuropsychopharmacology, shows that the drugs affect reinforcement learning, an important behavioural process that allows us to learn from our environment.

A widely-used class of antidepressants, particularly for persistent or severe cases, is selective serotonin reuptake inhibitors (SSRIs). These drugs target serotonin, a chemical that carries messages between nerve cells in the brain and has been dubbed the 'pleasure chemical'.

One of the widely-reported side effects of SSRIs is ‘blunting', where patients report feeling emotionally dull and no longer finding things as pleasurable as they used to, the researchers said.

Between 40-60 per cent of patients taking SSRIs are believed to experience this side effect, they said.

"Emotional blunting is a common side effect of SSRI antidepressants," said Professor Barbara Sahakian, senior author of the study from the University of Cambridge in the UK.

"In a way, this may be in part how they work -- they take away some of the emotional pain that people who experience depression feel, but, unfortunately, it seems that they also take away some of the enjoyment," Sahakian said.

The study shows that this is because people become less sensitive to rewards, which provide important feedback.

Most studies of SSRIs to date have only examined their short term use, but, for clinical use in depression these drugs are taken chronically, over a longer period of time.

Researchers at Cambridge in collaboration with the University of Copenhagen, Denmark recruited healthy volunteers who were administered escitalopram, an SSRI known to be one of the best-tolerated, over several weeks.

They assessed the impact the drug had on their performance on a suite of cognitive tests. In total, 66 volunteers took part in the experiment, 32 of whom were given escitalopram while the other 34 were given a placebo.

Volunteers took the drug or placebo for at least 21 days and completed a comprehensive set of self-report questionnaires and were given a series of tests to assess cognitive functions including learning, inhibition, executive function, reinforcement behaviour, and decision-making.

The team found no significant group differences when it came to ‘cold' cognition – such as attention and memory.

There were no differences in most tests of ‘hot' cognition – cognitive functions that involve our emotions.

However, the key finding was that there was reduced reinforcement sensitivity on two tasks for the escitalopram group compared to those on placebo, the researchers said.

Reinforcement learning is how we learn from feedback from our actions and environment, they said.

"Our findings provide important evidence for the role of serotonin in reinforcement learning," said Christelle Langley, joint first author also from Cambridge University.

"We are following this work up with a study examining neuroimaging data to understand how escitalopram affects the brain during reward learning," Langley said.

https://www.tribuneindia.com/news/health/antidepressants-may-cause-emotional-blunting-study-473029

After Co-WIN, govt launches U-WIN to digitise India’s universal immunisation programme

Platform that replicates Co-WIN launched on January 11 in 65 districts

Carrying vaccination cards of children and pregnant women, struggling to keep a tab on the next jab and other such hassles may soon become a thing of the past.

After the success of the Co-WIN platform, the government has now replicated it to set up an electronic registry for routine vaccinations.

Named U-WIN, the programme to digitise India’s Universal Immunisation Programme (UIP) has been launched in a pilot mode in two districts of each state and Union Territory.

The platform will be used to register and vaccinate every pregnant woman, record her delivery outcome, register every newborn delivery, administer birth doses and all vaccination events thereafter, official sources told PTI.

The platform that replicates Co-WIN, which has served as the “digital backbone” for India’s COVID-19 vaccination programme, was launched on January 11 in 65 districts.

The U-WIN is going to be the single source of information for immunisation services, updating vaccination status, delivery outcome, planning of RI sessions and reports like antigen-wise coverage, etc.

“There will be digital registrations of all pregnant women and newborns for individualised tracking for vaccination, reminders for upcoming doses and follow-up of dropouts.

“Healthcare workers and programme managers will be able to generate real-time data of routine immunisation sessions and vaccination coverage for better planning and vaccine distribution,” an official explained.

For pregnant women and children, vaccine acknowledgement and immunisation card linked to ABHA ID (Ayushman Bharat Heath Account) will be generated and all states and districts can access a common database to track and vaccinate beneficiaries.

Besides, through the platform citizens can check nearby ongoing routine immunisation sessions, and book appointments, the official told PTI.

All states and UTs have been sensitised on U-WIN functionalities and objectives for the pilot in 65 districts and staff and healthcare workers have been trained on all modules of U-WIN.

“With this the entire vaccination system including records will get digitised, easing the tracking of beneficiaries.

“Vaccination records under UIP are being maintained manually as of now. So this will do away with the hassle of keeping a physical record. It will enable the digitisation of session planning, and updating vaccination status on a real-time basis.

“Beneficiaries would be able to book slots for vaccination in advance. Also, it will allow mobility.

“Once the whole immunisation programme is digitised, beneficiaries will get certificates on the spot and they can also download them if they want to. These certificates will be stored in digi-lockers,” an official elaborated.

An effective surveillance system will help create an evidence base to enable planning and deployment of effective interventions.

https://www.tribuneindia.com/news/nation/after-co-win-govt-launches-u-win-to-digitise-indias-universal-immunisation-programme-473039

WHO urges ‘immediate action’ after cough syrup deaths

‘These contaminants are toxic chemicals used as industrial solvents and antifreeze agents that can be fatal even taken in small amounts, and should never be found in medicines’

The World Health Organisation has called for “immediate and concerted action” to protect children from contaminated medicines after a spate of child deaths linked to cough syrups last year.

In 2022, more than 300 children - mainly aged under 5 - in Gambia, Indonesia and Uzbekistan died of acute kidney injury, deaths that were associated with contaminated medicines, the WHO said in a statement on Monday.

The medicines, over-the-counter cough syrups, had high levels of diethylene glycol and ethylene glycol.

"These contaminants are toxic chemicals used as industrial solvents and antifreeze agents that can be fatal even taken in small amounts, and should never be found in medicines," the WHO said.

It said seven countries had reported finding the contaminated syrups in the last four months, and called for action across its 194 member states to prevent more deaths.

"Since these are not isolated incidents, WHO calls on various key stakeholders engaged in the medical supply chain to take immediate and coordinated action," WHO said.

The WHO has already sent specific product alerts in October and earlier this month, asking for the medicines to be removed from the shelves, for cough syrups made by India's Maiden Pharmaceuticals and Marion Biotech, which are linked with deaths in Gambia and Uzbekistan respectively.

It also issued a warning last year for cough syrups made by four Indonesian manufacturers, PT Yarindo Farmatama, PT Universal Pharmaceutical, PT Konimex and PT AFI Pharma, that were sold domestically.

The companies involved have either denied that their products have been contaminated or declined to comment while investigations are ongoing.

The WHO reiterated its call for the products flagged above to be removed from circulation, and called more widely for countries to ensure that any medicines for sale are approved by

competent authorities. It also asked governments and regulators to assign resources to inspect manufacturers, increase market surveillance and take action where required.

It called on manufacturers to only buy raw ingredients from qualified suppliers, test their products more thoroughly and keep records of the process. Suppliers and distributors should check for signs of falsification and only distribute or sell medicines authorised for use, the WHO added. 

https://www.tribuneindia.com/news/world/who-urges-immediate-action-after-cough-syrup-deaths-473060

A novel test may help in early diagnosis of Parkinson’s

A team from IIT-B, led by Prof Samir Maji, has developed a technology that can measure toxic protein aggregates

One of the most potent causes of PD is a special form of toxic protein aggregates (amyloids) formed by alpha-synuclein, which kills neuronal cells in the brain.

It is now a well-known fact that early diagnosis of Parkinson’s Disease (PD) can help a patient reduce the risk of progression and live long and productively enough with this neuro-degenerative condition. It is this quest for detecting early signs that drove researchers at the Indian Institute of Technology-Bombay (IIT-B) to develop a blood-based assay. And now they have achieved a 95 per cent accuracy in detecting the disease early enough in a small cohort of patients at the KEM Hospital.

https://indianexpress.com/article/health-wellness/novel-test-early-diagnosis-parkinsons-disease-8396226/

India’s plan to eradicate measles, rubella

Will the country be able to achieve the new target of 2023? Why was the earlier goal of 2020 unattainable? How fatal are the viruses? What needs to be done with the vaccination programme? What are the various challenges India’s health system faces?

A health worker administers a dose of the Measles-Rubella vaccine to a student during the special vaccination drive at a government school in Malda on January 14, 2023.

The story so far: As the new year dawned, so did a crucial target for India. India had set a target to eliminate measles and rubella (MR) by 2023, having missed the earlier deadline of 2020, due to a variety of reasons, exacerbated by disruptions due to the pandemic. An earlier target that was set for 2015 was also missed. It was in 2019 that India adopted the goal of measles and rubella elimination by 2023, anticipating that the 2020 goal could not be reached.

The measles virus is one of the world’s most contagious human viruses that kills more than 1,00,000 children every year globally, and rubella is a leading vaccine-preventable cause of birth defects, according to the World Health Organization (WHO). Both measles and rubella can be prevented by just two doses of a safe and effective vaccine. Over the past two decades, the measles vaccine is estimated to have averted more than 30 million deaths globally, as per the WHO’s statistics. In both diseases, the symptoms are a rash and fever. While measles has a high fatality rate, rubella infection in a pregnant woman will have an impact on the foetus, resulting in birth defects.

https://www.thehindu.com/sci-tech/health/explained-indias-plan-to-eradicate-measles-rubella/article66418395.ece

Simple nasal spray significantly reduces snoring and breathing difficulties in children: Study

Snoring and breathing difficulties about 12 per cent of children and can cause significant long-term issues impacting cognitive function, behaviour and cardiovascular health.

A simple nasal spray significantly reduced snoring and breathing difficulties in children and halved the number needing to have their tonsils removed, according to a new study.

The research, led by the Murdoch Children's Research Institute and published in JAMA Pediatrics, found a saline (salt water) nasal spray was just as effective as an anti-inflammatory steroid nasal spray at easing sleep-disordered breathing in children after six weeks of treatment.

The findings stated both nasal sprays cleared symptoms while asleep in about 40 per cent of cases and those assessed by a surgeon as needing their tonsils and/or adenoids removed was reduced by half. The randomised-controlled "MIST" trial of the sprays involved 276 children, aged 3-12 years, and was carried outat The Royal Children's Hospital and Monash Children's Hospital.

Tonsillectomy is the most common paediatric elective surgery for children in Australia with more than 40,000 performed each year. Commonly used to treat children's snoring, the procedure is costly, painful and a significant burden on hospital resources.

Murdoch Children's Dr Alice Baker said Victorian children typically waited more than a year in the public system for surgery to remove tonsils and adenoids, prompting a need to look for an alternative treatment for sleep-disordered breathing. Some children may also be having their tonsils and adenoids out unnecessarily, she said.

"Nasal sprays work by cleaning the nose and/or reducing inflammation not just in the nose but all the way down the back of the throat to the adenoids and tonsillar tissue to alleviate the symptoms," Dr Baker said.

Snoring and breathing difficulties during sleep affect about 12 per cent of children and can cause significant long-term issues impacting cognitive function, behaviour and cardiovascular health.

Murdoch Children's Associate Professor Kirsten Perrett said the study found a substantial number of children with sleep disordered breathing could initially be managed by their GP and may not require referral to specialist services as currently recommended.

"A large proportion of children who snore and have breathing difficulties could be managed successfully by their primary care physician, using six weeks of an intranasal saline spray as a first-line treatment," she said.

"Using this cheaper and readily available treatment would increase the quality of life of these children, reduce the burden on specialist services, decrease surgery waiting times and reduce hospital costs." Stephen Graham and Emily Tuner-Graham said their son, Thomas, 7, had stopped snoring and no longer needed his tonsils removed since taking part in the trial.

"From three years of age Thomas started snoring and we were concerned that he would eventually need surgery," they said.

"Prior to joining the trial, a specialist recommended having his tonsils out. It's a such huge relief that by just using a nasal spray his breathing difficulties have cleared." Researchers from the University of Melbourne, The Royal Children's Hospital, Royal Hospital for Children in Glasgow, Monash Health and Monash University also contributed to the findings.

https://www.tribuneindia.com/news/health/simple-nasal-spray-significantly-reduces-snoring-and-breathing-difficulties-in-children-study-471531

High BMI may metabolise Vitamin D differently, could diminish supplement effects: Study

Vitamin D is an essential nutrient involved in many biological processes, most notably helping our body absorb minerals, such as calcium and magnesium.

Scientists have uncovered new evidence that vitamin D may be metabolised differently in people with an elevated body mass index (BMI), diminishing the impact of supplementation in such individuals, according to a new study.

The study, by researchers from Brigham and Women’s Hospital, US, is a new analysis of data from the VITAL trial, a large nationwide clinical trial led by Brigham researchers that investigated whether taking vitamin D or marine omega-3 supplements could reduce the risk of developing cancer, heart disease, or stroke, it said.

“The analysis of the original VITAL data found that vitamin D supplementation correlated with positive effects on several health outcomes, but only among people with a BMI under 25,” said first author Deirdre K. Tobias.

“There seems to be something different happening with vitamin D metabolism at higher body weights, and this study may help explain diminished outcomes of supplementation for individuals with an elevated BMI,” said Tobias.

The study appears in the Journal of American Medical Association (JAMA) Network Open.

Vitamin D is an essential nutrient involved in many biological processes, most notably helping our body absorb minerals, such as calcium and magnesium.

While some of the vitamin D we need is made in the body from sunlight, vitamin D deficiencies are often treated with supplementation.

Evidence from laboratory studies, epidemiologic research and clinical research has also suggested that vitamin D may play a role in the incidence and progression of cancer and

cardiovascular disease, and it was this evidence that prompted the original VITAL trial, the study said.

The VITAL trial was a randomized, double-blind, placebo-controlled trial in 25,871 U.S. participants, which included men over the age of 50 and women over the age of 55. All participants were free of cancer and cardiovascular disease at the time of enrolment, the study said.

While the trial found little benefit of vitamin D supplementation for preventing cancer, heart attack, or stroke in the overall cohort, there was a statistical correlation between BMI and cancer incidence, cancer mortality, and autoimmune disease incidence, the study said.

Other studies suggest similar results for type 2 diabetes.

The new study aimed to investigate this correlation.

The researchers analyzed data from 16,515 participants from the original trial who provided blood samples at baseline (before randomization to vitamin D), as well as 2,742 with a follow-up blood sample taken after two years, the study said.

The researchers measured the levels of total and free vitamin D, as well as many other novel biomarkers for vitamin D, such as its metabolites, calcium, and parathyroid hormone, which helps the body utilize vitamin D, the study said.

“Most studies like this focus on the total vitamin D blood level,” said senior author JoAnn E. Manson.

The researchers found that vitamin D supplementation increased most of the biomarkers associated with vitamin D metabolism in people, regardless of their weight. However, these increases were significantly smaller in people with elevated BMIs.

“We observed striking differences after two years, indicating a blunted response to vitamin D supplementation with higher BMI,” said Tobias.

“This may have implications clinically and potentially explain some of the observed differences in the effectiveness of vitamin D supplementation by obesity status,” said Tobias.

“This study sheds light on why we’re seeing 30-40 per cent reductions in cancer deaths, autoimmune diseases, and other outcomes with vitamin D supplementation among those with lower BMIs but minimal benefit in those with higher BMIs, suggesting it may be possible to achieve benefits across the population with a more personalized dosing of vitamin D,” said Manson.

“These nuances make it clear that there’s more to the vitamin D story,” said Manson.

https://www.tribuneindia.com/news/health/high-bmi-may-metabolise-vitamin-d-differently-could-diminish-supplement-effects-study-471535

Discovery of new protein could provide rare insights for breast cancer treatments: Study

The discovery could provide new insights into how breast cancer cells acquire resistance to cell death in non-permissive environments

Discovery of new protein could provide rare insights for breast cancer treatments: Study

Photo used for representational purpose only. iStock

Scientists in the UK have discovered a protein that kick-starts milk production after breastfeeding is over, unlocking clues that they say could potentially be vital for breast cancer treatments.

A study by the University of Sheffield in the UK discovered a protein called Rac1, which is a critical switch to kick-start milk production in breast cells when lactation has stopped and when the breasts have already begun returning to their pre-pregnancy state.

Once babies start eating solids, the breasts wind down the production of milk and undergo a process of shrinkage to return back to in-activity, the study said.

The milk-producing units are dismantled through cellular suicide to remove the redundant tissues, it said.

During intermittent feeding, the shrinking breast can remarkably reverse to reinitiate lactation if suckling resumes.

Until now it was not known how this process happened, the university said in a press release.

Dr Nasreen Akhtar and her team from the University of Sheffield's Department of Oncology and Metabolism, investigated mouse mammary glands -- which are structurally similar to humans.

They discovered that when the Rac1 protein is present cell death occurs with autophagy -- a process in which cells start eating their own parts in a desperate bid to survive.

The study, published in the journal PLOS Biology, revealed that half-dead, half-alive cells with autophagy can be brought back to life to recommence milk production, upon suckling but cells without the Rac1 protein cannot.

The discovery could provide new insights into how breast cancer cells acquire resistance to cell death in non-permissive environments.

Explaining why this discovery could have important implications in breast cancer treatments, Akhtar said: “The risk of most breast cancer progression is the highest in the post-pregnancy years – perhaps caused by an altered activity during the post-weaning remodelling stage. It could expose potential pathways and proteins that cancer cells exploit to survive and grow.”

https://www.tribuneindia.com/news/health/discovery-of-new-protein-could-provide-rare-insights-for-breast-cancer-treatments-study-472161

Upcoming body movement can be predicted by high-frequency brain wave patterns in motor cortex, says study

Researcher hopes the work will help inform how researchers and engineers decode motor information to build better brain-machine interfaces

Professor of Organismal Biology and Anatomy at the University of Chicago, Nicholas G. Hatsopoulos, PhD, has long been fascinated by space. Specifically, the physical space occupied by the brain.

“Inside our heads, the brain is all crumpled up. If you flattened out the human cortex into a single 2D sheet, it would cover two and a half square feet of space—roughly the size of four pieces of paper. You would think that the brain would take advantage of all that space when organizing activity patterns, but aside from knowing that one patch of the brain controls the arm and another controls the leg, we’ve mostly ignored how the brain might use that spatial organization,” he says.

Now, in a new study published on January 16 in Proceedings of the National Academy of Sciences, Hatsopoulos and his team have found evidence that the brain does indeed use the spatial organisation of high frequency propagating waves of neuronal activity during movement.

The presence of propagating waves of neuronal activity has been well-established, but they are traditionally associated with the general behavioral state of an animal (such as awake or asleep).

This study is the first evidence that spatially organized recruitment of neuronal activity across the motor cortex can inform details of a planned movement.

https://www.tribuneindia.com/news/health/upcoming-body-movement-can-be-predicted-by-high-frequency-brain-wave-patterns-in-motor-cortex-says-study-472416

First Indian intranasal Covid vaccine to be launched on January 26

Homegrown vaccine for lumpy skin disease in cattle, Lumpi-ProVacInd, likely to be launched next month

Homegrown vaccine maker Bharat Biotech will launch its intranasal Covid-19 vaccine iNCOVACC, the first of its kind in India, on January 26, the company’s chairman and managing director Krishna Ella said here on Saturday.

Interacting with students at the India International Science Festival in Bhopal, Ella also said that the homegrown vaccine for the lumpy skin disease in cattle, Lumpi-ProVacInd, is likely to be launched next month.

“Our nasal vaccine will be officially launched on January 26, on Republic Day,” Ella said, participating in the ‘Face-to-Face with New Frontiers in Science’ segment of the IISF, organised at the Maulana Azad National Institute of Technology (MANIT).

In December, Bharat Biotech had announced that it would sell the intranasal vaccine for Rs 325 per shot for procurement by the government and Rs 800 per shot for private vaccination centres.

https://www.tribuneindia.com/news/nation/first-indian-intranasal-covid-vaccine-to-be-launched-on-january-26-472462

New protein target found which pancreatic cancer cells leverage to resist therapy

Previous research has shown that pancreatic cancer treatment resistance is caused by differing responses to conventional agents

New protein target found which pancreatic cancer cells leverage to resist therapy

Scientists have found a new protein target, leveraged by pancreatic cancer cells usually to suppress tumours, but here instead to help them evade therapy and, thus, grow more quickly, according to a new study.

Scientists revealed that this is another way in which the most-resistant pancreatic cancer cells defy treatment, the study said.

The international team of researchers was led by University of California San Diego School of Medicine and the Sanford Consortium for Regenerative Medicine, the study said.

Previous research has shown that pancreatic cancer treatment resistance is caused by differing responses to conventional agents, fuelled by the heterogeneity, or diversity, of tumour cells - and in particular, stem cell characteristics that encourage therapy resistance.

In this study, senior author Tannishtha Reya and colleagues investigated how shifting epigenomics, or the multitude of proteins that tell the genome what to do, rather than genomic changes might be driving resistance. Genomic changes are changes specific to the genes themselves.

The paper is published in the journal Nature Communications.

Pancreatic cancer is the third deadliest cancer in the United States, after lung and colorectal, though far less common. It is also among the hardest to effectively treat, with pancreatic cancer stem cells quickly developing resistance to conventional and targeted treatments, such as chemotherapy and emerging immunotherapies.

As a result, the 5-year survival rate for people diagnosed with pancreatic cancer is just 10 per cent, the study said.

“Pancreatic cancer stem cells, which are aggressive cancer cells that can resist conventional therapies and drive tumour relapse, rely upon epigenetic regulation to protect themselves and promote survival and growth,” said Reya, Columbia University.

“We wanted to identify the underlying tools and mechanisms that cancer stem cells use to better understand treatment resistance - and perhaps how they might be circumvented,” said Reya.

According to the study, Reya and colleagues zeroed in on SMARCD3, a member of the SWI/SNF family of proteins that regulate chromatin, a mixture of DNA and proteins that form chromosomes and are required for stem cell function in development.

But while SWI-SNF subunits often act as tumour suppressors, the researchers found that SMARCD3 was amplified in cancer, notably abundant in pancreatic cancer stem cells and upregulated or increased in the human disease, the study said.

And when researchers deleted SMARCD3 in models of pancreatic cancer, the loss of the protein reduced the growth of tumours and improved survival, especially in the context of chemotherapy, the study said.

“Importantly, we found that SMARCD3 helps control lipid and fatty acid metabolism, which are associated with therapy resistance and poor prognosis in cancer,” said Reya.

“Our data suggest that therapy resistant pancreatic cancer cells depend upon SMARCD3 to help ensure a metabolic landscape in which they can avoid anti-cancer treatments and grow aggressively. That makes SMARCD3 an exciting new target for potential therapies,” said Reya.

https://www.tribuneindia.com/news/health/new-protein-target-found-which-pancreatic-cancer-cells-leverage-to-resist-therapy-472417

Cervical cancer is the fourth most common cancer among women

As per the World Health Organisation (WHO) data, cervical cancer caused 342 000 deaths in 2020. According to the GLOBOCAN 2018 report, every year, 96,922 women are diagnosed with cervical cancer in India and 60,078 die from the disease.

More than 95% of the cervical cancer cases are due to the human papillomavirus, which causes infection in the reproductive tract mostly.

"It takes 15 to 20 years for cervical cancer to develop in women with normal immune systems. It can take only 5 to 10 years in women with weakened immune systems, such as those with untreated HIV infection," the WHO report says.

Early signs of cervical cancer you should never ignore

"It started like a simple twinge, like a cramp, in my lower right abdomen"

Rose T, a cervical cancer survivor, ignored the initial symptoms like abdominal cramps and "just accepted that it was part of growing older".

She was 37 years old when she was diagnosed with cervical cancer, a form of cancer that starts in the cells of the cervix and is the fourth most common cancer among women globally.

A local marathon made her realize that something was "off". A runner, since the age of 12, she could barely finish the 5k run. "That’s when I knew something was “off.” I decided to see my sports medicine doctor because I noticed a limp in my stride and some back pain during the race. What followed was a regimen of physical therapy and rest, but things did not get better," she writes about her journey which is available on the website of the US CDC.

It was after getting excruciating pain and heavy bleeding after being intimate with her husband one night she went to the emergency room.

"In August, 2010, when I was in the hospital finally having the back surgery, an urologist discovered I had a rather large solid mass, approximately 6 to 8cm in size. He was unsure if it was on my cervix or my ovary. Then I had another grand mal seizure, which put me in the ICU [intensive care unit]. There, it was discovered that I had cervical cancer, diagnosed as stage IV, inoperable, and terminal," Rose writes.

After a series of surgery and treatment procedures, Rose emerged a winner.

"I went in for my annual gynecological exam and got a Pap test; the results came irregular"

Jennie was diagnosed with cervical cancer in 1964 when she was 32 years old. "I did not have any symptoms. I went in for my annual gynecological exam and got a Pap test. My results came back as irregular so the doctor recommended more testing. The results showed that I had cervical cancer," she has shared her story on the US CDC portal.

"I had the same type symptoms that you have going through menopause"

For Nancy Fawn Downing, the symptoms of cervical cancer were similar to those seen during menopause.Taking her experience to Quora, Nancy writes: I had cervical cancer growing for about 30 years before I learned I had it.I was in my late fifties. I had been in menopause for two years.I had the same type symptoms that you have going through menopause but nothing that made me think I needed to see a doctor.I hadn’t had sex in many years and I also hadn’t had regular Pap smears.Now that everyone has insurance, the best advice I can give is to be

tested regularly.I didn’t have strong enough symptoms or insurance for many years.I’m a stage 3 without chemo or radiation- just surgery, and I’m doing quite well in year 3.

Cervical cancer is curable

Cervical cancer can be treated if the disease is diagnosed at an early stage. Early medical intervention can check the progress of the disease and can help the patient recover."A major cause of high burden of cervical cancer in India is lack of awareness and lack of cervical screening due to which many cases are detected in advanced stages leading to high mortality rates. Before cancer manifests itself, screening can detect abnormalities in the cervix. It can also detect cervical cancer at an early stage, when it has not spread and is amenable to curative treatable," says Dr. Neha Kumar, Senior Consultant, Gynecologic Oncology, Amrita Hospital, Faridabad."Every three years, women between the ages of 21 and 29 should get a Pap test. From the age of 30, the optimal method of screening is to undergo testing every five years with a Pap test and an HPV test, OR every three years with a Pap test, until the age of 65," she recommends.

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/how-i-knew-i-had-cervical-cancer-survivors-share-early-symptoms/photostory/97126801.cms

Simple nasal spray significantly reduces snoring and breathing difficulties in children: Study

Snoring and breathing difficulties about 12 per cent of children and can cause significant long-term issues impacting cognitive function, behaviour and cardiovascular health

A simple nasal spray significantly reduced snoring and breathing difficulties in children and halved the number needing to have their tonsils removed, according to a new study.

The research, led by the Murdoch Children's Research Institute and published in JAMA Pediatrics, found a saline (salt water) nasal spray was just as effective as an anti-inflammatory steroid nasal spray at easing sleep-disordered breathing in children after six weeks of treatment.

The findings stated both nasal sprays cleared symptoms while asleep in about 40 per cent of cases and those assessed by a surgeon as needing their tonsils and/or adenoids removed was reduced by half. The randomised-controlled "MIST" trial of the sprays involved 276 children,

aged 3-12 years, and was carried outat The Royal Children's Hospital and Monash Children's Hospital.

Tonsillectomy is the most common paediatric elective surgery for children in Australia with more than 40,000 performed each year. Commonly used to treat children's snoring, the procedure is costly, painful and a significant burden on hospital resources.

Murdoch Children's Dr Alice Baker said Victorian children typically waited more than a year in the public system for surgery to remove tonsils and adenoids, prompting a need to look for an alternative treatment for sleep-disordered breathing. Some children may also be having their tonsils and adenoids out unnecessarily, she said.

"Nasal sprays work by cleaning the nose and/or reducing inflammation not just in the nose but all the way down the back of the throat to the adenoids and tonsillar tissue to alleviate the symptoms," Dr Baker said.

Snoring and breathing difficulties during sleep affect about 12 per cent of children and can cause significant long-term issues impacting cognitive function, behaviour and cardiovascular health.

Murdoch Children's Associate Professor Kirsten Perrett said the study found a substantial number of children with sleep disordered breathing could initially be managed by their GP and may not require referral to specialist services as currently recommended.

"A large proportion of children who snore and have breathing difficulties could be managed successfully by their primary care physician, using six weeks of an intranasal saline spray as a first-line treatment," she said.

"Using this cheaper and readily available treatment would increase the quality of life of these children, reduce the burden on specialist services, decrease surgery waiting times and reduce hospital costs." Stephen Graham and Emily Tuner-Graham said their son, Thomas, 7, had stopped snoring and no longer needed his tonsils removed since taking part in the trial.

"From three years of age Thomas started snoring and we were concerned that he would eventually need surgery," they said.

"Prior to joining the trial, a specialist recommended having his tonsils out. It's a such huge relief that by just using a nasal spray his breathing difficulties have cleared." Researchers from the University of Melbourne, The Royal Children's Hospital, Royal Hospital for Children in Glasgow, Monash Health and Monash University also contributed to the findings.

https://www.tribuneindia.com/news/health/simple-nasal-spray-significantly-reduces-snoring-and-breathing-difficulties-in-children-study-471531

High BMI may metabolise Vitamin D differently, could diminish supplement effects: Study

Vitamin D is an essential nutrient involved in many biological processes, most notably helping our body absorb minerals, such as calcium and magnesium High BMI may metabolise Vitamin D differently, could diminish supplement effects: Study

Scientists have uncovered new evidence that vitamin D may be metabolised differently in people with an elevated body mass index (BMI), diminishing the impact of supplementation in such individuals, according to a new study.

The study, by researchers from Brigham and Women’s Hospital, US, is a new analysis of data from the VITAL trial, a large nationwide clinical trial led by Brigham researchers that investigated whether taking vitamin D or marine omega-3 supplements could reduce the risk of developing cancer, heart disease, or stroke, it said.

“The analysis of the original VITAL data found that vitamin D supplementation correlated with positive effects on several health outcomes, but only among people with a BMI under 25,” said first author Deirdre K. Tobias.

“There seems to be something different happening with vitamin D metabolism at higher body weights, and this study may help explain diminished outcomes of supplementation for individuals with an elevated BMI,” said Tobias.

The study appears in the Journal of American Medical Association (JAMA) Network Open.

Vitamin D is an essential nutrient involved in many biological processes, most notably helping our body absorb minerals, such as calcium and magnesium.

While some of the vitamin D we need is made in the body from sunlight, vitamin D deficiencies are often treated with supplementation.

Evidence from laboratory studies, epidemiologic research and clinical research has also suggested that vitamin D may play a role in the incidence and progression of cancer and cardiovascular disease, and it was this evidence that prompted the original VITAL trial, the study said.

The VITAL trial was a randomized, double-blind, placebo-controlled trial in 25,871 U.S. participants, which included men over the age of 50 and women over the age of 55. All participants were free of cancer and cardiovascular disease at the time of enrolment, the study said.

While the trial found little benefit of vitamin D supplementation for preventing cancer, heart attack, or stroke in the overall cohort, there was a statistical correlation between BMI and cancer incidence, cancer mortality, and autoimmune disease incidence, the study said.

Other studies suggest similar results for type 2 diabetes.

The new study aimed to investigate this correlation.

The researchers analyzed data from 16,515 participants from the original trial who provided blood samples at baseline (before randomization to vitamin D), as well as 2,742 with a follow-up blood sample taken after two years, the study said. The researchers measured the levels of total and free vitamin D, as well as many other novel biomarkers for vitamin D, such as its metabolites, calcium, and parathyroid hormone, which helps the body utilize vitamin D, the study said.

“Most studies like this focus on the total vitamin D blood level,” said senior author JoAnn E. Manson.

The researchers found that vitamin D supplementation increased most of the biomarkers associated with vitamin D metabolism in people, regardless of their weight. However, these increases were significantly smaller in people with elevated BMIs.

“We observed striking differences after two years, indicating a blunted response to vitamin D supplementation with higher BMI,” said Tobias.

“This may have implications clinically and potentially explain some of the observed differences in the effectiveness of vitamin D supplementation by obesity status,” said Tobias.

“This study sheds light on why we’re seeing 30-40 per cent reductions in cancer deaths, autoimmune diseases, and other outcomes with vitamin D supplementation among those with lower BMIs but minimal benefit in those with higher BMIs, suggesting it may be possible to achieve benefits across the population with a more personalized dosing of vitamin D,” said Manson.

“These nuances make it clear that there’s more to the vitamin D story,” said Manson.

https://www.tribuneindia.com/news/health/high-bmi-may-metabolise-vitamin-d-differently-could-diminish-supplement-effects-study-471535

 

 

Coronavirus: Expert reveals COVID variants 'most likely' to rule over UK; how India can prepare itself

In light of the recent COVID-19 outbreak in China, it is accurate to say that the pandemic is not over yet. The rest of the world continues to battle new emerging coronavirus variants that are not only fast-spreading, but also have the ability to evade natural and vaccine-induced immunity. Currently, the XBB.1.5, nicknamed as Kraken, is said to be a dominant strain of the coronavirus, with the World Health Organization (WHO), referring to it as the most transmissible variant so far.

Two COVID variants likely to 'take over' UK

While the US Centres for Disease Control and Prevention (CDC) recently announced that 43 percent of all COVID cases in the US were the XBB.1.5 in the week beginning January 8, the UK Health Security Agency (UKHSA) has confirmed that the same strain is likely to 'take over' the UK.

Not just that, as per the health body, along with XBB.1.5, CH.1.1 will replace the BQ.1 variant as the most dominant.

In a statement, the UKHSA said, “The analysis shows that coronavirus (COVID-19) cases in the UK are primarily made up of BQ.1 and its sublineages, consistent with the UKHSA risk assessment published in October.

“Two variants, CH.1.1 and XBB.1.5, appear to have a growth advantage in the UK.

“Both are variants in the Omicron family. 

“XBB.1.5 remains at very low prevalence in the UK, so estimates of growth are highly uncertain.

“The risk assessment conducted by UKHSA together with academic partners found that CH.1.1 and XBB.1.5 are currently the variants most likely to take over from BQ.1 as the next dominant variant in the UK, unless further novel variants arise.”

Also read: Omicron XBB.1.5 variant: Top COVID symptoms seen in infections caused by the 'most transmissible variant'

Vaccinated people more at risk of XBB.1.5 variant

In a recent report, it was revealed that the Omicron subvariant XBB.1.5 may be more likely to infect people who have been vaccinated or already had COVID-19.

"Omicron subvariant XBB.1.5 now accounts for 73% of all sequenced COVID-19 cases in NYC. XBB.1.5 is the most transmissible form of COVID-19 that we know of to date and may be more likely to infect people who have been vaccinated or already had COVID-19," read a tweet by the official account of the NYC Department of Health and Mental Hygiene.

However, the health experts continue to urge people to get vaccinated.

How India can stay prepared

Besides vaccines, following a COVID-appropriate behavior is still key in curbing the spread of the virus.

Wearing a well-fitted mask, maintaining social distance, avoiding crowds and following proper hand hygiene are some of the essential measures you can take.

Vigilance is extremely crucial, especially because the vulnerable in the society continue to be at huge risk of severe illnesses.

Role of vaccination

COVID-19 vaccines have remained a debatable subject. While doctors and medical experts have hailed the available jabs for preventing severe coronavirus illness, many question the effectiveness of the vaccine shots.

Although breakthrough infections are still prevalent, experts continue to encourage people to take the jabs so as to reduce the risk of hospitalization and death.

"We do not know yet whether XBB.1.5 may cause more severe disease. Getting the COVID-19 vaccine — including the updated booster — is still the best way to protect yourself from hospitalization and death from COVID-19, including from these new variants," reads the tweet by the NYC Department of Health and Mental Hygiene.

Know your symptoms

Anyone can be prone to COVID-19 illness. If you have got infected, you must take necessary steps to avoid spreading it further. First and foremost, recognize the symptoms. According to the UK Zoe Health Study app, the most common COVID symptoms include:

- Runny nose

- Headache

- Fatigue (mild or severe)

- Sneezing

- Sore throat

In case you develop these symptoms, do not make the mistake of socializing with others. Regardless of whether or not you have COVID, isolate yourself. Best to take a COVID test and wait until the results read 'negative'.

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/coronavirus-expert-reveals-covid-variants-most-likely-to-rule-over-uk-how-india-can-prepare-itself/photostory/97090071.cms

Top 10 effective yoga poses for cervical spondylosis

People are experiencing an alarming increase in illnesses of the neck and spine. The muscles in our bodies naturally deteriorate as we age. However, we may maintain our vitality and activity far into our later years with the right care, nutrition, exercise, and rest. We rarely use the full range of motion that our bodies are capable of. Physical inactivity causes widespread issues including cervical spondylitis and other conditions.

Himalayan Siddha Akshar, Yoga guru, Founder of Akshar Yoga Institutions, says, “The disorder known as cervical spondylitis or cervical spondylosis affects more than 85% of adults over 60. These neck and spine conditions are primarily brought on by bad lifestyle choices. This includes bad posture, inactivity, prolonged periods of inactivity, slouching or hunching when using a phone, etc. One of the main causes of stiffness in the neck and spine regions can be poor posture. Yoga is a holistic science created to help us in many areas of our lives to battle this. Yoga asanas, pranayama, meditation, mudras, and other yogic practices help the practitioner's physical, mental, emotional, and spiritual well-being.”

Try these yoga asanas for relief from cervical pain:

Savitriasana

Formation of the Posture

Gently drop your knees down

Lift both arms upward

Look in between your palms

Keep your back straight

Sukhasana Variation 2

Start by sitting in any comfortable position such as sukhasana. Keep your back straight and extend your arms up with an inhale. Interlock your fingers and exhale as you place them behind your head. Hold this posture for 30 seconds.

Sukhasana Variation 3

Sitting in sukhasana, place your fingertips on your shoulders and make complete rotations front to back trying to touch your elbows each time in the front. Reverse the circular motion and repeat for another set rotating your shoulders the other way around.

Marjariasana

Urdhva Mukhi Marjari Asana

Get down on your knees, place palms under shoulders and knees under hips

Inhale, curve your spine to look up

Adho Mukhi Marjari Asana

Exhale, curve your spine to form an arch of the back and allow your neck to drop down

Focus your gaze down

Ustrasana

Formation of the Posture

Kneel on the yoga mat

Arch back and slide your palms over your feet till the arms are straight.

Keep your neck in a neutral position.

Stay in this posture for a couple of breaths.

Exhale back to the initial pose.

Hastha Uthanasana

Stand with your feet under your hips and raise both arms up. Do this as you inhale, then bend back with your arms extended. Keep your eyes open, and align your head in between your arms. Avoid bending the knees. Start with 30 degrees and slowly increase along with Sukshma Vyayam.

Tadasana

This causes stretching of the entire body. Legs, thighs, and knees become strong. Along with this, it makes the spinal cord flexible. To do this asana, first, stand upright and keep a distance of 6 inches between the two legs. After this, interlock the fingers of your two hands and pull your hands up slowly and lift the body with it.

Vajrasana-Savithriasana: Bring your knees on the floor and rescue pelvis on your skills to sit in vajrasana. From vajrasana lift your pelvis of the heels, straighten your back and lift both hands up looking up between your Palms. Repeat this movement a few times lifting up from vajrasana to savitri looking up and sitting back in vajrasana.

https://timesofindia.indiatimes.com/life-style/health-fitness/top-10-effective-yoga-poses-for-cervical-spondylosis/photostory/97094070.cms

 

What your period is trying to tell you about your thyroid

Periods are a reflection of overall health of a woman’s reproductive system and are impacted by a number of factors, including insulin sensitivity, digestion, immunological system, digestion and the thyroid hormone imbalance. The thyroid gland produces thyroid hormones that have many functions in the body, including controlling temperature and energy levels. When your thyroid hormone production is inadequate, numerous body processes slow down and you may have constipation, weariness, depression, dry skin, thinning hair, cold intolerance, muscular cramps, joint pain, unexplained weight gain and irregular menstruation.

How are Thyroid levels related to periods?

Dr Amit Gupta, Senior Consultant Paediatrician & Neonatologist, Motherhood Hospital, Noida, says “Your thyroid impacts your ovaries directly and indirectly interacts with sex hormone-binding globulin (SHBG). Though the thyroid gland is technically a member of the endocrine system, not the female reproductive system, the thyroid gland's hormones contribute to the proper functioning of the female reproductive system. When the thyroid gland produces either too little or too much thyroid hormone, it could result in thyroid related issues like your menstrual cycles could be erratic, too light, or too heavy. It could also lead to amenorrhea, which is defined as the absence of a period for 90 days or longer, and early menopause can also be brought on by thyroid dysfunction i.e menopause before 40 years of age.”

Here’s what your periods is trying to tell you

If you experience heavy menstrual bleeding, i.e if you need to change your pad or tampon less than 2 hours or pass clots very often it could be due to hypothyroidism i.e. your thyroid gland doesn’t produce enough thyroid hormones.

If you experience frequent menstrual bleeding or have menstrual periods that last longer, it could be due to hypothyroidism.

If you experience premenstrual spotting i.e period stains days before your actual menstrual cycle begins it could be a sign of an underactive thyroid gland i.e hypothyroidism.

If you have irregular menstrual cycles or often miss your periods, it could be due to hypothyroidism or hyperthyroidism i.e. it could be due to either the thyroid gland is producing too little or too much thyroid hormone.

If you do not get your periods at all i.e. the menstrual cycles are absent it could also be due to hypothyroidism or hyperthyroidism

If you experience very little bleeding during your menstrual cycle or the bleeding is too light and for a shorter duration than the typical cycle, it could be due to hyperthyroidism, i.e. due to an overactive thyroid gland.

What makes treatment of thyroid issues so crucial?

Dr. Gupta says “It is better to start treatment for hypothyroidism and hyperthyroidism to avoid a range of health issues. The symptoms of hypothyroidism might be mild and hard to identify or severe and damaging to your quality of life.”

If untreated hypothyroidism can result in serious problems like:

Infertility

Heart diseases

Nerve Damage

Goiter

Birth flaws

Could affect your mental health

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/what-your-period-is-trying-to-tell-you-about-your-thyroid/photostory/97090694.cms

WHO reduces isolation period for Covid-19 patients?

 For those who test positive for Covid-19 but do not have any signs or symptoms, WHO now suggests five days of isolation in the absence of testing, compared to 10 days previously.

The World Health Organisation in revised guidelines on Covid 19 has said a Covid-19 patient can be discharged from isolation early if they test negative on an antigen-based rapid test.

“Without testing, for patients with symptoms, the new guidelines suggest 10 days of isolation from the date of symptom onset. Previously, WHO advised that patients be discharged 10 days after symptom onset, plus at least three additional days since their symptoms had resolved,” the world body said.

For those who test positive for Covid-19 but do not have any signs or symptoms, WHO now suggests five days of isolation in the absence of testing, compared to 10 days previously.

“Isolation of people with Covid-19 is an important step in preventing others from being infected. This can be done at home or at a dedicated facility, such as a hospital or clinic.

Masks continue to be a key tool against Covid-19,” a WHO guideline said.

It continues to recommend the use of masks by the public in specific situations, and recommends their use irrespective of the local epidemiological situation, given the current spread of the COVID-19 globally.

“Masks are recommended following a recent exposure to Covid-19, when someone has or suspects they have Covid-19, when someone is at high-risk of severe Covid-19, and for anyone in a crowded, enclosed, or poorly ventilated space. Previously, WHO recommendations were based on the epidemiological situation,” the WHO added.

https://www.tribuneindia.com/news/nation/who-reduces-isolation-period-for-covid-19-patients-470676

Fast food consumption linked to liver disease

Researchers find that people with obesity or diabetes who consume 20% or more of their daily calories from fast food have severely elevated levels of fat in their liver.

A study published in Clinical Gastroenterology and Hepatology by Keck Medicine at USC provides more motivation for people to minimise their fast-food consumption.

The study found that eating fast food is associated with nonalcoholic fatty liver disease, a potentially life-threatening condition in which fat builds up in the liver.

Researchers discovered that people with obesity or diabetes who consume 20% or more of their daily calories from fast food have severely elevated levels of fat in their liver compared to those who consume less or no fast food. And the general population has moderate increases of liver fat when one-fifth or more of their diet is fast food.

"Healthy livers contain a small amount of fat, usually less than 5%, and even a moderate increase in fat can lead to nonalcoholic fatty liver disease," said Ani Kardashian, MD, a hepatologist with Keck Medicine and lead author of the study, adding, "The severe rise in liver fat in those with obesity or diabetes is especially striking, and probably due to the fact that these conditions cause a greater susceptibility for fat to build up in the liver." While previous research has shown a link between fast food and obesity and diabetes, this is one of the first studies to demonstrate the negative impact of fast food on liver health, according to Kardashian.

The findings also reveal that a relatively modest amount of fast food, which is high in carbohydrates and fat, can hurt the liver. "If people eat one meal a day at a fast-food restaurant, they may think they aren't doing harm," said Kardashian, adding, "However, if that one meal equals at least one-fifth of their daily calories, they are putting their livers at risk." Nonalcoholic fatty liver disease, also known as liver steatosis, can lead to cirrhosis, or scarring of the liver, which can cause liver cancer or failure. Liver steatosis affects over 30% of the U.S. population.

Kardashian and colleagues analyzed the most recent data from the nation's largest annual nutritional survey, the 2017-2018 National Health and Nutrition Examination Survey, to determine the impact of fast-food consumption on liver steatosis.

The study characterized fast food as meals, including pizza, from either a drive-through restaurant or one without wait staff.

The researchers evaluated the fatty liver measurement of approximately 4,000 adults whose fatty liver measurements were included in the survey and compared these measurements to their fast-food consumption.

Of those surveyed, 52% consumed some fast food. Of these, 29% consumed one-fifth or more daily calories from fast food. Only this 29% of survey subjects experienced a rise in liver fat levels.

The association between liver steatosis and a 20% diet of fast food held steady for both the general population and those with obesity or diabetes even after data was adjusted for multiple other factors such as age, sex, race, ethnicity, alcohol use and physical activity.

"Our findings are particularly alarming as fast-food consumption has gone up in the last 50 years, regardless of socioeconomic status," said Kardashian, adding, "We've also seen a substantial surge in fast-food dining during the COVID-19 pandemic, which is probably related to the decline in full-service restaurant dining and rising rates of food insecurity. We worry that the number of those with fatty livers has gone up even more since the time of the survey." She said she hoped the study will encourage health care providers to offer patients more nutrition education, especially to those with obesity or diabetes who are at higher risk of developing a fatty liver from fast food. Currently, the only way to treat liver steatosis is through an improved diet.

https://www.tribuneindia.com/news/health/fast-food-consumption-linked-to-liver-disease-469453

WHO issues medical alert involving Indian drugs, second in 3 months

The firm was previously shut for operations by the Indian drug regulator after Uzbekistan flagged children’s deaths after consumption of these medicines in higher-than-prescribed doses format

In less than three months since it flagged the Sonepat-based Maiden Pharma products as sub-standard and unsafe, the WHO on Wednesday night issued a global medical alert naming two cough syrups manufactured by Noida-based Marion Biotech.

The firm was previously shut for operations by the Indian drug regulator after Uzbekistan flagged children’s deaths after consumption of these medicines in higher-than-prescribed doses format.

The latest WHO Medical Product Alert refers to two sub-standard (contaminated) products, identified in Uzbekistan and reported to WHO on December 22, 2022.

Sub-standard medical products are products that fail to meet quality standards or specifications and are, therefore, "out of specification".

“The two products are Ambronol syrup and DOK-1 Max syrup. The stated manufacturer of both products is Marion Biotech Private Limited, (Uttar Pradesh, India). To date, the stated manufacturer has not provided guarantees to WHO on the safety and quality of these products. Laboratory analysis of samples of both products, undertaken by national quality control laboratories of the Ministry of Health of the Republic of Uzbekistan found both products contained unacceptable amounts of diethylene glycol and/or ethylene glycol as contaminants,” the WHO said

It said both these products may have marketing authorisations in other countries in the region. They may also have been distributed, through informal markets, to other countries or regions.

Accordingly, the WHO has asked the nations to recall the products.

The sub-standard products referenced in this latest alert, the WHO said, “are unsafe and their use, especially in children, may result in serious injury or death. Toxic effects can include abdominal pain, vomiting, diarrhoea, inability to pass urine, headache, altered mental state and acute kidney injury which may lead to death”.

In advice to regulatory authorities and the public, the WHO said it is important to detect and remove these sub-standard products from circulation to prevent harm to patients.

India has sampled the allegedly contaminated products from the Noida firm and reports of the lab tests are awaited.

https://www.tribuneindia.com/news/nation/who-alert-on-2-indian-cough-syrups-after-uzbekistan-children-deaths-calls-it-substandard-469734

Study finds neurodegenerative disease progression linked to proteins in brain

Accumulation of tau and tubulin proteins in the brain is mostly responsible for advancement of neurodegenerative diseases

Many neurodegenerative illnesses, including Alzheimer’s and Parkinson’s, are mostly caused by tau and tubulin proteins. The accumulation of these proteins in the brain is mostly responsible for the advancement of neurodegenerative diseases.

Jiali Li, a professor of physics at the University of Arkansas, and her team developed a unique silicon nitride nanopore-based sensing device as a result of one of her doctorate students’ desire to investigate tau and tubulin proteins.

In Journal of Applied Physics, from AIP Publishing, Acharjee et al. present the device, which is designed to provide volume information about tau and tubulin protein molecules and their aggregation states at the single-molecule level within their native environment.

To create the sensor, the team explored how the proteins change the current and voltage flowing through a nanopore system.

“Ohm’s Law is the basic physics that enables the nanopore device to sense protein molecules,” said Li. “A tiny hole—from 6 to 30 nanometers—is made in a thin silicon nitride membrane and supported by a silicon substrate. When that is placed into a solution with salt ions, applying an electric voltage drives the ions’ flow through the hole, or nanopore. This, in turn, generates an open pore ionic current.” When a charged protein molecule—often thousands of times larger than the ions—is near the nanopore, it also gets driven into the nanopore and blocks the flow of some ions. This causes the open pore current to drop.

“The amount of current drop produced by a protein molecule is proportional to the protein’s volume or size and shape,” said Li. “This implies that if protein A binds to protein B, they will cause a current drop proportional to the volume of A+B, and an aggregated protein A will cause approximately multiple amounts of current drop.” This allows Li and her group to look at the protein binding and aggregation within a nanopore device. The amount of time a protein stays in a nanopore is inversely proportional to its charge, which also provides useful information about a protein molecule.

“Our study shows that a silicon nitride nanopore device can measure volume information of tau and tubulin protein molecules and their aggregation under different biological conditions, and this gives us a better understanding of the protein aggregation process, as well as developing drugs or other therapeutic methods to treat neurodegenerative diseases,” said Li.

Using their solid-state nanopore device, along with other nanotechnology tools, “we plan to study the mechanism of protein aggregation under different biological conditions systematically, such as temperature, pH, and salt concentration,” she said.

https://www.tribuneindia.com/news/health/study-finds-neurodegenerative-disease-progression-linked-to-proteins-in-brain-469452

WHO alert on 2 Indian cough syrups after Uzbekistan deaths, calls it 'sub-standard

Uzbekistan found both products contained unacceptable amounts of diethylene glycol and /or ethylene glycol as contaminants

WHO alert on 2 Indian cough syrups after Uzbekistan deaths, calls it 'sub-standard'

WHO recommends not using two cough syrups of Noida-based Marion Biotech in Uzbekistan.

The World Health Organisation (WHO) has recommended that two cough syrups made by Noida-based company Marion Biotech should not be used for children in Uzbekistan.

In a medical product alert on Wednesday, the WHO said the "substandard medical products", manufactured by Marion Biotech, "are products that fail to meet quality standards or specifications and are therefore out of specification."

"This WHO Medical Product Alert refers to two substandard (contaminated) products, identified in Uzbekistan and reported to WHO on 22 December 2022. Substandard medical products are products that fail to meet quality standards or specifications and are therefore out of specification," the WHO said in an alert released on its website.

"The two products are AMBRONOL syrup and DOK-1 Max syrup. The stated manufacturer of both products is MARION BIOTECH PVT. LTD, (Uttar Pradesh, India). To date, the stated manufacturer has not provided guarantees to WHO on the safety and quality of these products," the alert added.

Noida-based pharma Marion Biotech has come under a cloud as reports emerged about the death of children after consuming cough syrup came in from Uzbekistan.

According to WHO, laboratory analysis of samples of cough syrups, undertaken by national quality control laboratories of the Ministry of Health of the Republic of Uzbekistan found both products contained unacceptable amounts of diethylene glycol and /or ethylene glycol as contaminants.

"Both of these products may have marketing authorisations in other countries in the region. They may also have been distributed, through informal markets, to other countries or regions," the WHO alert added.

The UN health agency added that "the substandard products referenced in this alert are unsafe and their use, especially in children, may result in serious injury or death." On December 22, Uzbekistan alleged that 18 children had died after consuming medicines manufactured by Marion Biotech company. On Tuesday, Uttar Pradesh Food Safety and Drug Administration department suspended the production licence of Marion Biotech company linked to Uzbekistan's deaths of 18 children.

"We have suspended the production license of Marion Biotech company after not providing enough documents, show-cause notice was also given by the state licensing authority depending upon the documents asked during the inspection which they didn't provide," said Gautam Buddh Nagar Drug inspector Vaibhav Babbar.

He further said that sample results are still pending.

Last month, Union Health Minister Mansukh Mandaviya said that all manufacturing activities of the Noida-based pharma company have been stopped in view of the reports of contamination in cough syrup Dok1 Max.

https://www.tribuneindia.com/news/nation/who-alert-on-2-indian-cough-syrups-after-uzbekistan-children-deaths-calls-it-substandard-469734

Knee health: The worst exercises for knees and how to know if your workout is hurting your bones

It is said that we can strengthen our bones and joints by working out but what if our workouts end up giving us joint issues and tears due to our negligence? Pushing yourself too hard and not knowing when to stop can be detrimental for your bone health. So how do we know what’s safe and what’s not? We tried to seek answers from Dr. Ramneek Mahajan, Senior Director and Head of Joint Replacement Unit (Knee & Hip), Max Smart Super Speciality Hospital, Saket, New Delhi.

When does our body really start to decline?

Believe it or not, your body starts to decline after the age of 30. That decline is likely to get more aggressive after passing every year. After 40s with an inactive lifestyle, people are more susceptible to develop some health issues such as blood pressure, obesity, poor heart health, osteoporosis and arthritis. You may also start losing one percent muscle every year. It's not too

late to start a fitness journey. But you should avoid running in the beginning as it may put strain on your knee, hip joints and lead to abrupt bone fracture. It is best to go for brisk walking. HIIT exercising (high intensity interval training) is an effective way of getting fit, fast but there are potential risks that go hand in hand with it. While doing these exercises, you’re on your feet a lot so lower limb joints like knees, your ankles and your hips are more likely to be affected. In the early stage, you should refrain from overdoing it as it may cause soft tissue injuries to your joints. The ligaments, the tendons, and the muscles around the joints might get stretched, sprained and torn. So consult your doctor before beginning any new program if you suffer from hip or knee problems.

Worst exercise for people with bad knees

The worst exercises for people with bad knees are full-arc knee extension (using the machine at the gym), full-deep lunges, deep squats, and Hurdler’s stretches as these exercises put excessive strain on the knee joints, increasing pain and causing injury. If not performed perfectly, these exercises may also raise risk of injury. The best exercises to better strength, flexibility and knee function are partial squats, step-ups, side lying leg lifts, inner-thigh leg lifts, calf-raises, straight leg raises, short-arc leg extensions and hamstring stretching.

Reg flags to watch out for during workouts

Some people can experience muscle burn or sharp pain while working out, it can occur due to poor form, too heavy weights and even stretching incorrectly. Pain is like a signal, warning us to relax. If you push constantly, you’re more prone to injury. Weightlifting helps increase bone density and joint strength, which may lower your risk of osteoporosis and other skeletal issues that come with age. Lifting can be detrimental for your joints if you have poor form. Stop exercising immediately if you get injured and seek medical advice before doing a workout again. Overlooking weightlifting pain can lead to additional inflammation and trauma to the tissue in and around the joints. It can also cause more chronic degenerative issues over time like wear and tear of the joints and cartilage, degeneration of the tendons, and early-onset arthritis.

During exercise, your knee joints meet with additional pressure. It can harm the joint structures over time. High-impact exercise involving knees may raise risk of soft tissue tears and the wearing down of the protective cartilage that cushions your joints. The bones of your joint may start rubbing together without cartilage. It may create friction, causing persistent inflammation and ultimately chronic knee pain. Workout damage may also lead to joint deformities if neglected. Break away from weight machines as these may restrict specific muscles in your body from helping you lift, which can cause knee inflammation and pain.

Tips to safeguard knees while workout

If you’re new to exercise or already have difficulty with your knees, start with low-impact exercises (swimming or walking) before attempting strenuous activities like running or squats. Low-impact activities not only safeguard your knee from injury, but also make your joints strong over time, so you can harmlessly transition to higher-impact activities.

Warm up your knee joints with a slow jog or stretches appropriately before starting any workout. Warmups help to increase your blood circulation and lower risk for unintended muscle strains or tissue tears that may negatively affect your joint function.

Refrain from working out on cement or other hard surfaces as your knees may absorb the shock of your movements. Instead, try to work out on a soft track or a grassy area.

You may also opt for shoes with plenty of support or consider adding orthotics to protect your joints.

Seek medical attention if you suffer from knee pain that doesn’t go away with rest. You may be recommended to undergo nonsurgical treatments such as braces, physical therapy and certain medicine to alleviate joint inflammation in your knee. If required, you may have to undergo a joint replacement surgery. Nowadays surgeries are being performed using robots with added advantages over normal joint replacement surgery.

Diet to build strong bones

To make your bones strong, incorporating nutrients such as Calcium, vitamin D and protein is essential. You should eat a varied and healthy range of foods, including 3–5 servings of calcium every day as calcium is important for making your bones strong. Dairy products (milk, cheese and yoghurt), green leafy vegetables (broccoli, kale, bok choy, mustard greens, okra, spinach and celery are high in calcium) are great sources of calcium.

https://timesofindia.indiatimes.com/life-style/health-fitness/fitness/knee-health-the-worst-exercises-for-knees-and-how-to-know-if-your-workout-is-hurting-your-bones/articleshow/96861444.cms

Indian generic drug Paxlovid in high demand in China amid Covid surge

As Covid cases in China continue to rise, Beijing will soon start distributing Pfizer's Covid-19 drug Paxlovid to the community health centres in the coming days, the CNN reported citing state media.

According to the state-run China News Service, after getting trained, community doctors would dispense the medicine to Covid-19 patients and also disseminate information on how to use it.

"We have received a notice from officials but it is not clear when the drug will arrive," CNN cited a worker at a local community health centre in Beijing's Xicheng district as saying.

Paxlovid remains the only foreign Covid drug that has been approved by China's regulator for nationwide use, but access to the medicine is a challenging process.

China's National Health Security Administration informed on Sunday that Pfizer's Paxlovid oral medicine, which is used to deal with Covid-19, couldn't be included in the "register of drugs in the basic medical insurance", as the corporate's citation was too excessive, media reports said.

Meanwhile, the demand for Indian generic drugs has shot up in China amid the ongoing Covid surge in the country, with specialists cautioning that dubious variations of those drugs were flooding the market.

Due to the large and quick supply of Paxlovid, demand for Indian generic variations via Chinese e-commerce platforms has gone up.

"On the Chinese e-commerce platforms... At least four generic Covid drugs produced in India -- Primovir, Paxista, Molnunat, and Molnatris -- have been listed for sale in recent weeks. Primovir and Paxista are both generic versions of Paxlovid, while the other two are generic versions of Molnipiravir," Chinese media outlet Sixth Tone reported.

Following countrywide demonstrations over its 'Zero Covid' policy, China abruptly abandoned it last month after nearly three years of lockdowns, quarantines, and mass testing.

The rapid policy change has triggered panic buying of fever and cold medications, resulting in significant shortages at pharmacies and online shopping platforms. Long lineups have become the norm outside fever clinics and hospital wards in the country's capital, Beijing, and elsewhere, according to CNN.

After China abandoned its 'Zero Covid' policy about two weeks ago, regional numbers of infected persons with coronavirus point to explosive outbreaks and overstretched healthcare systems, wrote Chang Che, Asia technology correspondent for The New York Times (NYT).

However, the intensity and magnitude of the country's first nationwide outbreak have remained a mystery as official figures from the central government remain low.

China's healthcare system, catering to 1.4 billion people, is reportedly under tremendous strain because of the steep prices of drugs manufactured by multinational pharmaceutical giants.

As things stand, the hospitals are all full, whether government or private, a report said, adding that there is no place for more patients to get admission.

Getting a bed is out of the question, while walkways and aisles are full of patients lying on damp floors, the report said.

The majority of the patients are left to their fates outside of the government health apparatus, the report said, adding that millions do not have access to medicine, oxygen, respiratory machines or other medical equipment.

The only thing they access is a medical drip, it said.

Fears of the elderly losing their lives either to the infection or their comorbidities are growing because of these inadequacies, reported The HK Post, adding that most of the elderly patients are developing other health complications, especially lung infections.

https://www.tribuneindia.com/news/health/indian-generic-drug-paxlovid-in-high-demand-in-china-amid-covid-surge-468856

Nearly 15% protein supplements unsafe for consumption: Survey

Of the 144,345 samples tested during the survey conducted by the country’s food regulator, 4,890 were found to be unsafe.

Nearly 15% of protein supplement samples tested for quality were found to be unsafe for consumption in a survey conducted by the food safety and standards authority of India (FSSAI), people familiar with the matter said on Monday.

FSSAI, the country’s top food regulator, conducted the survey between 2021 and 2022, in a bid to curb sale and distribution of substandard dietary supplements, which have gained popularity among fitness enthusiasts.

Of the 144,345 samples tested during the survey, 4,890 were found to be unsafe, and 16,582 were found to be substandard, the people said, citing the results of the survey.

Another 11,482 samples were found to have labelling defects and misleading information on the packaging, the people said.

Protein powder is usually consumed as a dietary supplement for building muscle, and formulations typically involve a wide variety of additives.

The food regulator has initiated criminal proceedings against at least 4,900 defaulters, with civil cases being initiated in 28,906 other cases, said the people.

Apart from dietary supplements, the food regulator has also been working with stakeholders to implement curbs on circulation of nutraceuticals, which are sold as alternatives to pharmaceuticals with properties of both pharmaceutical and nutritional products, and to regulate mislabelling of ingredients.

In 2016, the regulator began the process of reigning in sale of these products by way of formulating rules for eight categories of foods, which included carrying detailed descriptions of their composition.

The categories involved were health supplements, nutraceuticals, foods for special dietary use, foods for special medical purposes, specialty food containing plants or botanicals, foods containing probiotics, foods containing prebiotics and novel foods.

Under the rules, Food Safety Standards and Regulations, 2016, these foods were not permitted to contain hormones, steroids or psychotropic ingredients.

These foods may use approved colours and additives as permitted in Schedule VF of these regulations, and natural, nature identical or synthetic flavours as permitted in the Food Safety and Standards (Food Product Standards and Food Additives) Regulations, 2011.

The quantity of nutrients added to these food items shall not exceed the recommended daily allowance as specified by the Indian Council of Medical Research and accepted by FSSAI.

The rules came into effect from January 1, 2018.

FSSAI also roped in the Confederation of Indian Industry (CII), to establish a Resource Centre for Health Supplements and Nutraceuticals (ReCHaN), in partnership with International Alliance of Dietary/Food Supplement Associations, and initiated dialogue with stakeholders on accepting internationally recognized practices.

“Quality assurance of products in market is of primary concern of the food regulator and surveys are commissioned often to known the situation on ground like a national level milk survey was also commissioned a few years ago that provided an insight into what was being sold in markets across the country,” said a senior central government official, requesting anonymity.

Experts emphasised on quality checks for health supplements.

“Consumption of health supplements and micronutrients without medical supervision anyway can lead to health consequences, and if the quality of the product is substandard then it can further increase the harmful effects to your kidneys and other vital organs. FSSAI has become strict with regulatory compliance,” said Ritika Sammadar, regional head, dietetics, Max Healthcare.

https://epaper.hindustantimes.com/Home/ShareArticle?OrgId=101b39cb3f5&imageview=0

Assisted reproductive technology clinics and sperm banking facilities should consider assessing the semen of Covid-infected males, note researchers

Infection with the SARS-CoV-2 virus may negatively impact semen quality, according to a study on 30 males conducted by researchers at the All India Institute of Medical Sciences.

The team led by researchers at AIIMS Patna noted that COVID-19 can lead to multiorgan damage through the angiotensin-converting enzyme-2 receptor (ACE2), abundant in testicular tissue.

ACE2 acts as the receptor for the SARS-CoV-2 spike protein, through which the virus gains entry into the host cells.

However, little information is available regarding the shedding of SARS-CoV-2 in semen—the thick, white fluid that contains sperm—and its impact on sperm formation and fertility potential.

The study, published in the Cureus Journal of Medical Science, investigated the presence of SARS-CoV-2 in the semen of COVID-19 males.

The researchers also analysed the effect of the disease on semen quality and sperm DNA fragmentation index, which reflects the integrity of and the damage to the DNA, thereby detecting potential sperm damage.

Thirty COVID-19 male patients aged 19-45 registered to AIIMS Patna hospital participated in the study between October 2020 and April 2021.

“We conducted a real-time reverse transcriptase test on all the semen samples. Detailed semen analysis, including the sperm DNA fragmentation index, was done at first sampling that is during COVID-19,” the authors of the study said.

“After 74 days of the first sampling, we obtained the second sampling and repeated all the tests,” they said.

The study, including researchers from AIIMS Managalagiri and AIIMS New Delhi, found that all semen samples collected in the first and second sampling tested with real-time reverse transcription-polymerase chain reaction (RT-PCR) were negative for SARS-CoV-2.

In the first sampling, semen volume, vitality, total motility, sperm concentration, and total sperm count were significantly lower, the researchers said.

In contrast, semen agglutination or formation of sperm heaps, head defect, DNA fragmentation index, liquefaction time, semen viscosity, and leukocytes or white blood cells, were increased.

Liquefaction time is a measure of the time it takes for the semen to turn into liquid while viscosity is the thickness of the seminal fluid.

These results were reversed at the second sampling but not to the optimum level, according to the resaerchers.

The findings were statistically significant suggesting “COVID-19 negatively affects semen parameters, including sperm DNA fragmentation index,” the authors noted.

“Although we could not find SARS-CoV-2 in the semen, the semen quality remained poor until the second sampling,” they said.

The researchers noted that assisted reproductive technology (ART) clinics and sperm banking facilities should consider assessing the semen of COVID-19 infected males.

ART includes all fertility treatments in which either eggs or embryos are handled.

These clinics should exclude men with a positive history of SARS-CoV-2 until their semen quality returns to normal, the researchers added.

https://www.tribuneindia.com/news/health/covid-infection-may-impact-semen-quality-in-men-aiims-study-467714

New drug slows Alzheimer’s but comes with caveats

 A new Alzheimer’s drug is hitting the market — the first with clear-cut evidence that it can slow, by several months, the mind-robbing disease.

It’s a long-needed new treatment, but experts also are voicing a lot of caution: The drug isn’t a cure, it’s only intended for early-stage patients, requires IV doses every two weeks, and comes with some safety concerns.

It’s not even clear just how noticeable that modest benefit will be in people’s everyday lives. Still, “it’s a landmark,” said Dr. Richard Hodes, director of the National Institute on Aging.

“It’s not enough, but it’s encouraging that there’s something we can do.” Here are some things to know about the Food and Drug Administration’s approval of lecanemab, to be sold under the brand name Leqembi:

HOW DOES THE NEW DRUG WORK?

The drug, made by Japan’s Eisai and its U.S. partner Biogen, is designed to target and clear away a sticky protein called beta-amyloid that builds up into brain-clogging plaques—one key hallmark of Alzheimer’s disease.

It targets a slightly different form of that amyloid, possibly explaining why it proved successful in a rigorous study while a long list of prior amyloid-targeting drugs have failed, said Dr. Sam Gandy, an Alzheimer’s expert at New York’s Mount Sinai Hospital.

The FDA cleared a similar drug named Aduhelm in 2021 even though studies never proved it really helped patients, a move that triggered scathing criticism from a congressional investigation.

HOW EFFECTIVE IS IT?

In Eisai’s 18-month study of nearly 1,800 people, Leqembi appeared to delay early-stage patients from getting worse by about five months.

That was measured on an 18-point scale that tracks cognitive and functional abilities. People who got the drug still worsened but not as rapidly as those given dummy versions — a difference of nearly half a point on that scale by the study’s end.

Experts are divided over how meaningful a benefit that is. It may be hard for families to tell if a loved one’s decline has slowed, Gandy said.

Other experts say slowing the disease early on, when people still function well, is important even if it’s not that easy to spot.

“Several months with better cognition, what’s that worth to you?” Hodes asked. “I think there you can get a strong argument: If I can interact with my family, be independent for months ... that’s a very meaningful outcome.”

WHAT ARE THE RISKS?

Like other amyloid-targeting medications, Leqembi can cause brain swelling or small brain bleeds. In Eisai’s study, 13% of drug recipients had swelling and 17% has small brain bleeds.

The likely reason: Amyloid plaques usually form around nerve cells in the brain but sometimes the gunk gets inside blood vessels, too. Pulling amyloid out of those blood vessels can weaken them, making them leaky, Gandy explained.

While the brain swelling and bleeds may cause only minimal symptoms such as dizziness and vision problems, they occasionally can be severe — and several Leqembi users have died while taking the drug, including two who were on blood-thinning medications.

Eisai has said the deaths can’t be attributed to its Alzheimer’s drug. But Gandy said the greatest risk of serious bleeding would be among Leqembi users who also take blood thinners, which are commonly used by older adults to prevent or treat strokes.

Patients also may experience temporary reactions after the infusions that can include fever, flu-like chills, nausea and blood pressure fluctuations.

WHO IS ELIGIBLE?

The drug is only intended for people in the very early stages of Alzheimer’s who also have that tell-tale amyloid buildup.

The FDA warned doctors to use caution if they prescribe Leqembi to people who use blood thinners. Patients also will be urged to get brain scans several times over the course of treatment.

As patients gradually worsen, it’s not clear how long they should continue getting the twice-a-month IV infusions. Study participants are being tracked for longer periods, and other research is exploring even earlier use — before people with amyloid buildup show symptoms.

WHEN WILL IT BE AVAILABLE?

Eisai says the drug should be available by Jan. 23, but most patients will likely have to wait months to get it.

That’s because health insurers are expected to scrutinize the drug’s effectiveness before deciding whether to cover it, for which patients, and what testing they may require to confirm they are good candidates.

And Medicare, which covers most people with Alzheimer’s, is not expected to pay for the drug until later this year. That’s because the plan for seniors only pays for Alzheimer’s drugs that have received full approval from the FDA — while the agency granted Leqembi’s approval using a shortcut based on preliminary study results. The FDA is set to review that larger 18-month study soon, in anticipation of full approval later this year.

The IV drug will cost about $26,500 for a typical year’s worth of treatment. If insurers cover it, most people won’t pay anywhere near that much — although people with insurance that requires them to shoulder a larger portion of their drug costs could pay thousands a year.

https://www.tribuneindia.com/news/health/new-drug-slows-alzheimers-but-comes-withcaveats-468324