While Covid-19
did not cause much harm to children, yet those affected are likely to suffer
from Long Covid which is affecting their daily life with dizziness, fatigue,
and brain fog, according to a study.
The
study from the Kennedy Krieger Institute, in the US, showed that the majority
of children with Long Covid are likely to experience orthostatic intolerance
(OI) -- a condition that causes the body to struggle with regulating blood
pressure and heart rate when standing up.
As a
result, children often feel dizzy, lightheaded, fatigued, and may experience
"brain fog" or cognitive difficulties.
The
team examined nearly 100 children and found that dizziness (67 per cent),
fatigue (25 per cent), and body pain (23 per cent) were the common symptoms,
which used to worsen while standing but improved when lying down.
These
symptoms can make it difficult to perform everyday activities like exercising,
attending school, and socialising, severely impacting their quality of life.
Further,
the research reveals that OI is prevalent among children dealing with the
long-term effects of SARS-CoV-2, the virus responsible for Covid-19. The team
found 71 per cent of the patients studied at the Institute experienced at least
one orthostatic condition.
The
findings explain the relevance of screening paediatric long Covid patients for
OI, as many have symptoms that could be missed without proper testing, said Dr.
Laura Malone, Director of the Pediatric Post-Covid-19 Rehabilitation Clinic at
Kennedy Krieger.
"Research
proves this condition is common," she said, urging for "early
diagnosis and treatment" which will help the children to recover and
return to their normal routines.
While
calling for a multi-faceted approach to treatment, the researchers stressed the
need to increase salt and fluid intake, exercise training, and physical therapy
among children, in addition to medications that manage heart rate and blood
pressure.
However,
Malone says more research is needed to fully understand OI.
The
liver is one of the most vital organs responsible for functions like aiding
digestion, metabolism, detoxification, regulating hormones, storing essential
nutrients, and producing proteins and enzymes for the body’s natural chemical
reaction. As such, ignoring a fatty liver can be hazardous for overall
well-being, as the condition is indicative of various underlying health issues.
“Fatty
liver (steatosis) occurs when fat accumulates around the liver cells, and the
process of breaking down fat slows down. This condition often goes unnoticed
due to its asymptomatic nature,” stressed Dr Mallikarjun Sakpal, consultant,
HPB and transplant physician, Aster CMI Hospital, Bangalore.
As
such, this vital organ responsible for metabolising fats “becomes compromised
and overburdened. This can further lead to inflammation (steatohepatitis),
scarring (fibrosis), and potentially severe complications like cirrhosis or
liver cancer,” said Dr Sakpal.
As
the liver becomes more scarred, the risk of developing cirrhosis—a condition
where the liver is permanently damaged—significantly increases, asserted Dr
Chandan Kumar K N, senior consultant hepatologist and lead, Gleneagles
Hospitals, Lakdi Ka Pul, Hyderabad. “Cirrhosis can lead to liver failure,
requiring a liver transplant in severe cases,” said Dr Kumar.
There
are various factors contributing to a fatty liver such as “diabetes, obesity,
high levels of bad cholesterol, malnutrition, drinking too much alcohol, rapid
weight loss, and taking certain medications”, shared Dr Rajiv Kovil, head of
diabetology, Zandra Healthcare and co-founder of Rang De Neela initiative.
Here’s what to consider
Over
time, this excessive buildup of fat around the liver can trigger inflammation
while indicating the risk of non-alcoholic steatohepatitis (NASH). “It can
increase your risk of developing health problems like fibrosis, cirrhosis,
permanent liver damage, kidney diseases, high blood pressure, heart attack,
stroke, type 2 diabetes, and even liver cancer,” said Dr Kovil.
One
can experience symptoms like fatigue, abdominal discomfort, nausea, loss of
appetite, unintended weight loss, jaundice, and digestive problems. “Eating
fried, processed, and unhealthy food that contains heaps of sodium, added
sugar, and preservatives like chips, French fries, pasta, pizzas, cupcakes,
bread, candy, sodas, panipuri, and vada pav can encourage the early onset of
fatty liver,” noted Dr Kovil.
What can help?
Early
detection is crucial, said Dr Sakpal, as fatty liver disease is often linked to
metabolic syndrome, which encompasses conditions such as hypertension, high
blood sugar, and abnormal cholesterol levels. Lifestyle modifications,
including diet, exercise, and weight management, can effectively reverse the
early stages of the disease. ”
Eating
a clean and healthy diet can help maintain overall well-being. One can prevent
the risk of developing fatty liver by indulging in exercise for more than 45
minutes per day, regulating a healthy weight, and limiting alcohol. “Hydration
is crucial; one should consume at least 2-3 liters of water a day,” said Dr
Sakpal.
Doctors
also urge scheduling regular health check-ups to know more about liver health.
Pregnancy is a
transforming period in a person's life during which the body undergoes rapid
physiological adjustments to prepare for parenthood, as we all know. What the
broad hormonal alterations caused by pregnancy do to the brain is still a
mystery.
Researchers
in Professor Emily Jacobs' group at UC Santa Barbara have created the
first-ever map of a human brain during pregnancy, shedding insight on this
understudied area.
"We
wanted to look at the trajectory of brain changes specifically within the
gestational window," said Laura Pritschet, lead author of a paper just
published in Nature Neuroscience (link) . Previous studies had taken snapshots
of the brain before and after pregnancy, she said, but never have we witnessed
the pregnant brain in the midst of this metamorphosis.
The
researchers studied one first-time mother's brain every few weeks, beginning
before pregnancy and continuing for two years after childbirth. The results,
gathered in partnership with Elizabeth Chrastil's team at UC Irvine, show
changes in the brain's grey and white matter throughout gestation, implying
that the brain is capable of remarkable adaptability well into adulthood.
Their
precision imaging approach allowed them to capture dynamic brain reorganization
in the participant in exquisite detail. This approach complements early studies
that compared women's brains pre- and post-pregnancy. The authors noted,
"our goal was to fill the gap and understand the neurobiological changes
that happen during pregnancy itself."
The
most pronounced changes the scientists found as they imaged the subject's brain
over time was a decrease in cortical gray matter volume, the wrinkly outer part
of the brain. Gray matter volume decreased as hormone production ramped up
during pregnancy. However, a decrease in gray matter volume is not necessarily
a bad thing, the scientists emphasized. This change could indicate a
"fine-tuning" of brain circuits, not unlike what happens to all young
adults as they transition through puberty and their brains become more
specialized. Pregnancy likely reflects another period of cortical refinement.
"Laura
Pritschet and the study team were a tour de force, conducting a rigorous suite
of analyses that generated new insights into the human brain and its incredible
capacity for plasticity in adulthood," Jacobs said.
Less
obvious but just as significant, the researchers found prominent increases in
white matter, located deeper in the brain and generally responsible for
facilitating communication between brain regions. While the decrease in gray
matter persisted long after giving birth, the increase in white matter was
transient, peaking in the second trimester and returning to pre-pregnancy
levels around the time of birth. This type of effect had never been captured
previously with before-and-after scans, according to the researchers, allowing
for better estimation of just how dynamic the brain can be in a relatively
short period of time.
"The
maternal brain undergoes a choreographed change across gestation, and we are
finally able to see it unfold," Jacobs said. These changes suggest that
the adult brain is capable of undergoing an extended period of neuroplasticity,
brain changes that may support behavioral adaptations tied to parenting.
"Eighty-five
percent of women experience pregnancy one or more times over their lifetime,
and around 140 million women are pregnant every year," said Pritschet, who
hopes to "dispel the dogma" around the fragility of women during
pregnancy. She argued that the neuroscience of pregnancy should not be viewed
as a niche research topic, as the findings generated through this line of work
will "deepen our overall understanding of the human brain, including its
aging process."
The
open-access dataset, available online, serves as a jumping-off point for future
studies to understand whether the magnitude or pace of these brain changes hold
clues about a woman's risk for postpartum depression, a neurological condition
that affects roughly one in five women. "There are now FDA-approved
treatments for postpartum depression," Pritschet said, "but early
detection remains elusive. The more we learn about the maternal brain, the
better chance we'll have to provide relief."
And
that is just what the authors have set out to do. With support from the Ann S.
Bowers Women's Brain Health Initiative, directed by Jacobs, their team is building
on these early discoveries through the Maternal Brain Project. More women and
their partners are being enrolled at UC Santa Barbara, UC Irvine, and through
an international collaboration with researchers in Spain.
"Experts
in neuroscience, reproductive immunology, proteomics, and AI are joining forces
to learn more than ever about the maternal brain," Jacobs said.
"Together, we have an opportunity to tackle some of the most pressing and
least understood problems in women's health."
A small new study suggests that time-restricted eating
may bring benefits for blood sugar control.
Time-restricted eating
involves eating all your meals and snacks within a window of 8-12 hours,
and consuming no calories outside that window.
It may have benefits
including boosting metabolism, encouraging weight loss, and decreasing the
risk of some health conditions.
Now, a small study has shown
that restricting eating to an 8-hour window at any time of day could help
people control their blood glucose levels, decreasing their risk of type 2
diabetes.
Time-restricted eating
(TRE), one of whose most popular iterations is intermittent fasting,
is becoming increasingly popular as a means of weight control.
The
most popular form involves eating only during a period of 8 to 12 hours each
day, and fasting outside that time, consuming only water and other calorie-free
drinks.
Previous
studies have suggested that TRE could have several health
benefits, which may include:
weight loss, particularly in those with
overweight or obesity.
improving cholesterol and triglyceride levels in
the blood, potentially decreasing the risk of cardiovascular disease
The
study, which has not yet been published in a peer-reviewed journal, was carried
out by researchers at Manchester Metropolitan and Newcastle Universities in the
United Kingdom.
Jagdish Khubchandani, PhD, professor of public health at New
Mexico State University, who was not involved in this study, told Medical News Today that:
“On the surface, the findings look interesting and in
line with other studies. One possible mechanism of action could be that TRE
could result in lesser fluctuations in blood sugar, and nutrient shortage over
some hours could increase insulin sensitivity. Some recent
reviews align with these findings.”
The
researchers recruited 15 people into their randomized crossover trial. The nine
women and six men had a mean body mass index (BMI) of 28, which is indicative of
overweight, a sedentary lifestyle, poor dietary habits, and a mean age 52
years, so were at high risk of developing type 2 diabetes.
The
participants alternated between 3 days of habitual eating with an eating window
of at least 14 hours per day, 3 days of early TRE where they ate only between
08.00 a.m. and 4.00 p.m., and 3 days of late TRE, where they ate between noon
and 08.00 p.m. During TRE, they fasted for 16 hours each day.
The
researchers designed eucaloric diets — matching energy intake to energy
expenditure — for the participants during the TRE phases, and they were allowed
to eat normally during the habitual eating days. These eucaloric diets were
made up of 50% carbohydrate, 30% fat and 20% protein.
All
participants wore continuous glucose monitors which assessed how much time was
spent each day with a normal blood glucose concentration — between 3.9 and 7.8
millimoles per liter (mmol/l).
By comparison with
habitual eating, both early and late TRE increased the time that people’s blood
glucose was within the normal range by, on average, 3.3%. It also reduced
markers of glycemic variability.
“Our study found that restricting eating to a window
of 8 hours per day significantly improved the daily time spent in the normal
blood glucose range and reduced fluctuations in blood glucose levels. However,
altering the 8-hour restricted eating period to earlier or later in the day did
not appear to offer additional benefits.”
While
acknowledging that these were encouraging findings, Khubchandani expressed some
concerns about the study, telling MNT that “it is unclear how such a small sample can
cover the heterogeneity among people at risk of diabetes worldwide.”
He
also questioned whether the study’s effects were actually due to TRE,
wondering: “Does TRE also at times equate to reduced consumption of calories?”
Type
2 diabetes is strongly associated with overweight and obesity. According
to Diabetes UK, overweight and obesity account for up to 85% of
the risk of developing type 2 diabetes, and people with obesity are up to 80
times more likely to develop type 2 diabetes than those with a BMI of 22 or
under.
So,
if a person with overweight or obesity finds that TRE is an effective way to
lose weight it may help to reduce their risk of developing type 2 diabetes.
However, Khubchandani cautioned that some larger
studies have not shown the same benefits as this small study.
Bowden
Davies acknowledged that this was a preliminary study, and that further studies
were needed to determine whether TRE might be effective for some people, saying
that:
“Many people find counting calories hard to stick to
in the long term, but our study suggests that watching the clock may offer a
simple way to improve blood sugar control in people at risk of type 2 diabetes,
irrespective of when they have their 8-hour eating window, which warrants
investigation in larger studies and over the longer term.”
As
well as the potential benefits shown in this study, there may be downsides to
TRE for some people.
One preliminary study of more than 20,000 adults, conducted
by the American Heart Association, found that those following an 8-hour TRE
schedule had a 91% higher risk of death from cardiovascular disease, and no
increase in longevity, compared with those following a standard 12-16 hour
eating schedule.
The
authors of this study suggest that TRE may have short-term benefits, but could
have adverse effects over the long term.
And,
while it might help decrease a person’s risk of developing type 2 diabetes, TRE
is not generally advisable for those with type 1, or
insulin-dependent, diabetes.
If
they have obesity and need to lose weight, it may be recommended under
the close supervision of a health professional to ensure that
their blood glucose levels are constantly monitored.
People
who are older, pregnant, breastfeeding, trying to conceive, have low blood
pressure, or are taking medications for blood pressure or heart disease, should
also consult a healthcare professional before they consider intermittent
fasting.
“Given the uncertainty, individuals at risk of
diabetes should consult a qualified doctor. For the general public, get blood
sugar checked regularly. One size doesn’t fit all and diabetes prevention
should be more personalized.”– Jagdish Khubchandani, PhD
Research shows that statins may benefit those over the
age of 70, too.
Statins are a type of medication
that can help lower a person’s “bad” cholesterol, helping reduce their
risk for cardiovascular disease.
Statins are generally
recommended for adults between the ages of 40 and 75 who have heart
disease risk factors.
Despite having higher risks
for cardiovascular disease, fewer older adults use statins.
Researchers from the
University of Oxford found statin treatment was both cost-effective and
correlated to better health outcomes in older adults with or without
previous cardiovascular disease.
Statins are
a type of medication that help lower low-density
lipoprotein (LDL) cholesterol — or “bad” cholesterol — in the
body. This helps keep the arteries clear so blood has an easier way of
traveling throughout the body.
The
U.S. Preventive Services Task Force (USPSTF) recommends adults between the ages of 40 to 75 who have
one or more cardiovascular
risk factors and an estimated 10-year cardiovascular disease
risk take statins to help prevent heart issues.
But
what about older adults over the age of 70 — can statins help them as well?
“Despite
high risks of heart disease and stroke in older people and high need for
preventive treatment such as statins, fewer older people use statins compared
to middle-aged people,” Borislava
Mihaylova, DPhil, associate professor and senior health economist at
the Nuffield Department of Population Health at the University of Oxford,
professor of Health Economics in the Wolfson Institute of Population Health at
Queen Mary University of London told Medical News Today.
“This
is likely due to fewer older people, particularly those without previous heart
attacks and strokes, contributing to the randomized studies of statin therapy
which has led to more limited evidence with larger uncertainty,” she said.
For
this reason, Mihaylova and her colleagues decided to re-examine the value of
statin therapy for older adults using the latest evidence and contemporary
population data.
In
the new study recently published in the journal Heart,
lead author Mihaylova and her team found statin treatment was both
cost-effective and correlated to better health outcomes in older adults with or
without previous cardiovascular disease.
For
this observational study, researchers analyzed data from the U.K. Biobank and Whitehall II study of more than 20,000 adults in the U.K.
70 years and older with or without previous cardiovascular disease.
This
data was then used in the cardiovascular disease simulation model to estimate
study participants’ heart disease risk, survival rate, quality-adjusted
life years, and healthcare costs with and without lifetime standard
or higher intensity statin therapy.
“Heart
disease and stroke are leading causes of disability and death,” Mihaylova said.
“As we age, our risk of having a heart attack or a stroke increases. Having
high levels of LDL or ‘bad’ cholesterol in your blood further increases your
risk. Statins are a type of medicine that lower levels of LDL cholesterol and
reduce risk of heart attacks and stroke.”
According
to researchers, standard statin therapy normally results in a 35-45% reduction
in LDL cholesterol, while higher-intensity treatment lowers LDL cholesterol by
45% or more.
Upon
analysis, scientists found that participants who stayed on standard statin
treatment for their lifetime increased their quality-adjusted life years by
0.24-0.70, and those on higher-intensity statin therapy raised their
quality-adjusted life years by another 0.04-0.13.
“We previously
looked into the effects of statin therapy in middle-aged
people,” Mihaylova said.
“The
effects of statin therapy reported here across people 70 years of age and older
are, as expected, a bit smaller but sizeable. These results complete the
picture of likely substantial health benefits with statin therapy across the
continuum of age and risk levels in the population,” she continued.
When
examining the cost-effectiveness of statin use in older adults, the researchers
report that statins were cost-effective, with the cost per quality-adjusted
life years gained below £3,502 (about $4,560) for standard therapy and below
£11,778 (about $15,340) for higher intensity therapy.
This,
the scientists say, is well under the current threshold for good value
interventions of about £20,000 (about $26,000) per quality-adjusted life years
gained.
“This
finding indicates that statin treatment is likely to be of good value-for-money
across people over 70 years old,” Mihaylova explained.
“The additional cost for the additional health gained
with statin therapy is well under what is considered ‘good buy’ for the NHS. It
was also reassuring to see that statins remained of good value — although with
greater uncertainty — in further analysis assuming smaller risk reductions with
statin therapy in older people without previous cardiovascular disease.
Overall, our findings suggest that more people over 70 years of age should be
considered for statin treatment.”
— Borislava Mihaylova, DPhil
“Cardiovascular
disease remains a leading cause of disability and death. In addition to statin
treatment, people at high cardiovascular risk need further effective and
cost-effective treatments to reduce their risks. We are currently studying such
treatments — how well they work and whether they are of good value for (the)
money in categories of people, including older people,” she said.
MNT also spoke with Yu-Ming Ni,
MD, a board certified cardiologist and lipidologist at MemorialCare
Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley,
CA, about this study.
“This
is not really surprising,” Ni said. “We’ve known for a very long time that
statins prevent heart disease. They’re especially effective for patients who
already have heart disease to prevent a recurrent event — that means another
heart attack, stroke, or leg artery blockage. Patients benefit from these
medications by reducing their risk for events, it improves the quality of life,
and reduces symptoms from those events, and the result is that people live
longer and healthier.”
“It seems clear to me from this study it appears that
patients still get a benefit from being on a statin into their 70s. Something
that I took away from this (study) is that patients who are on statins already
with prior cardiovascular disease stand to maintain their benefit as they
continue through into their 70s. And I think that’s important because we often
ask ourselves whether we really need to take this medication as we’re getting
older and there are other competing factors, other medical admissions.”—
Yu-Ming Ni, MD
“We
know that a lot of people, as you get older, take a lot of medications. They
can get tired of taking pills, but this study helps to suggest that the benefit
from the statin persists, so those who already have heart disease should
continue to take their medication unless there’s a strong reason to stop the
statin. I generally recommend continuing taking the statin well into older
years,” Ni added.
The AI system
can be used to support nurses and doctors in providing high-quality care, says
expert
A team of researchers, led by one of
Indian origin, has developed a novel artificial intelligence (AI) based system
that can help reduce the risk of unexpected deaths by identifying hospitalised
patients at high risk of deteriorating health.
Rapid deterioration among hospitalised
patients is the primary cause of unplanned admission to the intensive care unit
(ICU).
But CHARTWatch, acted as an early warning
system to improve patient health, and alert healthcare workers to reduce
unexpected deaths, said the team in the paper published in CMAJ (Canadian
Medical Association Journal).
"As AI tools are increasingly being
used in medicine, it is important that they are evaluated carefully to ensure
that they are safe and effective,” said lead author Dr Amol Verma, a
clinician-scientist at St. Michael's Hospital, Unity Health Toronto, Canada.
“Our findings suggest that AI-based early
warning systems are promising for reducing unexpected deaths in
hospitals," Verma said.
CHARTWatch's efficiency was evaluated on
13,649 patients aged 55-80 years who were admitted to the general internal
medicine (GIM) (about 9,626 in the pre-intervention period and 4,023 used
CHARTWatch). About 8,470 admitted to subspecialty units did not use CHARTWatch.
Regular communications helped reduce
deaths as CHARTWatch engaged clinicians with real-time alerts, twice-daily
emails to nursing teams, and daily emails to the palliative care team, said the
researchers.
A care pathway was also created for
high-risk patients which prompted increased monitoring by nurses, and enhanced
communication between nurses and physicians. This encouraged physicians to
reassess patients.
The AI system, Verma said, can be used to
support nurses and doctors in providing high-quality care.
Co-author Dr Muhammad Mamdani, director of
the University of Toronto said that the study evaluates the outcomes associated
with the complex deployment of the entire AI solution.
Understanding the real-world impacts of
this promising technology is important, Mamdani said.
Experts
call for diagnostic tests-based prescription drugs and a holistic framework for
infection control
Sepsis deaths occur when one's
immune system has a dangerous reaction to a bacterial infection and without
treatment, can lead to organ failure.
When a 60-year-old patient
with leukaemia was admitted to the emergency department with high fever and low
blood pressure, he was immediately started on broad-spectrum antibiotics.
However, the drugs didn’t work, complicating his condition. A blood culture
later revealed a drug-resistant Klebsiella infection, which required a
combination of drugs to bring it under control.
“The
patient’s condition deteriorated because of antimicrobial resistance (AMR), a
condition where bacteria and parasites become resistant to medicines that were
previously effective against them,” said Dr Abdul Ghafur, infectious diseases
expert at Apollo Hospital, Chennai.
Overuse or wrongful use of
antibiotics is exacting a toll on the health of Indians, with a latest Lancet
study showing that 60 per cent of the 29.9 lakh sepsis deaths in the country in
2019 were caused by bacterial infection.
Of this, nearly 10.4 lakh
sepsis deaths (33.4 per cent) were linked to bacterial AMR that year, with 2.9
lakh sepsis deaths directly attributable to it. Sepsis deaths occur when one’s
immune system has a dangerous reaction to a bacterial infection and without
treatment, can lead to organ failure.
WHAT’S
THE STATUS OF ANTIMICROBIAL RESISTANCE (AMR)?
“AMR is the result of
overuse of antibiotics earlier in the patient’s lifetime or wrongful use. With
rising rates of drug-resistant bacteria in India, treatment options are
becoming increasingly limited, posing a public health challenge,” said Dr
Ghafur.
Already widely recognised
as a major global health challenge, AMR is anticipated to worsen in the coming
decades with Lancet predicting that more than 39 million people around the
world could die from antibiotic-resistant infections over the next 25 years.The
report, based on a new study by the Global Research on Antimicrobial Resistance
(GRAM) Project, is the first global analysis of antimicrobial resistance trends
over time.
“Understanding how trends
in AMR deaths have changed over time, and how they are likely to shift in
future, is vital to make informed decisions to help save lives,” said study
author Dr Mohsen Naghavi, Team Leader of the AMR Research Team at the Institute
of Health Metrics (IHME), University of Washington, USA.
Estimates for the study
came from 22 pathogens, 84 pathogen-drug combinations and 11 infectious
syndromes (including meningitis, bloodstream infections, and other infections)
among people of all ages in 204 countries and territories, including India.
WHY
IS THE STUDY RELEVANT FOR INDIA?
The three most common
resistant pathogens in India are e.coli, which can cause gut infections;
Klebsiella pneumoniae, which can cause pneumonia and urinary tract infections;
and Acinetobacter baumannii, which is mainly associated with hospital acquired
infections.
According to Dr Ghafur,
AMR happens because of indiscriminate use of antibiotics over the counter. Many
do not follow the prescribed dose as advised by the doctor, abandoning them
midway, or use them for similar symptoms that may arise later, ignoring the
doctor’s advisory. Lack of diagnostics at the local level to identify the
disease-causing bacteria means broad spectrum antibiotics are prescribed, which
do not target the specific bacteria.
“Rational antibiotic use
requires adequate laboratory infrastructure to guide decision-making, such as
determining whether antibiotics are necessary and identifying the appropriate
antibiotic when they are.
Unfortunately, access to
such diagnostic facilities is often limited, especially in resource-constrained
settings… Inadequate sanitation leads to the spread of infections, which in
turn drives the demand for antibiotics and contributes to resistance,” Dr
Ghafur said. In some industries, like aquaculture, antibiotics are used to save
on production losses, so they enter your system through food.
WHAT
ARE RESISTANT BUGS?
The Lancet study shows
that lower respiratory infections and related infections in the thorax
accounted for most cases of sepsis deaths in India – about 27 per cent of the
total.
Of the five lakh deaths
due to sepsis in children under five in 2019, 3.25 lakh children succumbed to
bacterial infection. The deadliest bacterial infection among children under
five was streptococcus pneumoniae.
Deaths due to
methicillin-resistant S. aureus (MRSA) increased the most globally, leading
directly to 130,000 deaths in 2021 – more than double the from 57,200 deaths in
1990. Among gram-negative bacteria – some of the most resistant to
antimicrobial drugs – resistance to carbapenems increased more than any other
type of antibiotic, from 127,000 in 1990 to 216,000 in 2021.
In India, the drug-bug
combination with the highest fatal risk was the aminopenicillin-resistant
E.coli. At least 6.8 lakh deaths were associated with six leading
drug-resistant pathogens.
“A robust and enforceable
framework for infection control, alongside mandatory public reporting of
healthcare-associated infections (HAIs) by all accredited hospitals, is crucial
for transparency and accountability. By doing so, we can monitor progress and
identify gaps in care delivery,” said Dr Ghafur, adding that investments in new
antibiotics and rapid point-of-care diagnostics are also essential to combat
sepsis and other life-threatening infections.
Dr Kamini Walia, programme
officer of AMR and senior scientist at the Indian Council of Medical Research
(ICMR), said the government is already investing in improving laboratory
infrastructure and now it is mandatory to provide culture facilities in
district hospitals.
A team of
researchers on Monday said that exposure to arsenic and other toxic metals may
accelerate the progression toward diabetes.
In a
study of over 500 Mexican Americans living in southern Texas in the US,
researchers from University of Illinois Chicago found that high levels of toxic
metals in urine predicted faster increases in blood sugar over subsequent
years.
The
study, published in Diabetes Care, highlights an underappreciated risk factor
for diabetes.
Environmental
exposures have largely been neglected as drivers of the diabetes epidemic.
"These
data support using environmental policy as a new tool to mitigate the
devastating burden of diabetes on individuals and society at large," said
Margaret Weiss, first author of the study.
Based
on these results, individuals with the highest levels of arsenic in their urine
were projected to qualify as prediabetic 23 months earlier and diabetic 65
months earlier than those with the lowest exposure to the toxic metal.
The
study emphasised that this risk factor can be addressed by reducing exposure to
contaminated food, water and other products.
On
average, blood sugar levels increased in all participants. But in those who
initially exhibited higher urinary levels of arsenic, selenium, copper,
molybdenum, nickel or tin, blood sugar increased at a faster rate over the
three years.
This
acceleration puts those who started with normal blood sugar levels at risk of
developing prediabetes and diabetes earlier than others in their population.
In
clinical medicine, time really matters. The earlier you develop diabetes, the
worse the complications are. The longer you have diabetes, the worse the
complications are. It underscores the need to engage these folks sooner in the
clinic," said Dr Robert Sargis, associate professor in the College of
Medicine.
How
arsenic and other metals increase the risk of diabetes isn't completely
understood.
Other
metals, namely cobalt and zinc, were associated in the study with lower blood
sugar in subsequent years, suggesting a potentially protective effect of some
elements.
However,
the alarming results with arsenic and other toxic metals suggest they are
environmental risk factors that could be new targets to prevent the disease.
Even as
injectable weight loss drugs have become a popular option for people struggling
with obesity, 1 in 4 or 25 per cent consider using them without consulting
their doctor, exposing themselves to several health risks, finds a study on
Tuesday.
Cost
and lack of insurance coverage are some reasons for seeking prescription
alternatives, said the team from The Ohio State University, US, who surveyed
1,006 adults in America.
"Some people are skipping the doctor's office and reaching out to
potentially unreliable sources such as unlicensed online pharmacies or
telehealth sites, which could expose patients to risks," the team said.
Cost (18 per cent)
is the major reason identified in the survey, followed by not being covered by
insurance (15 per cent), inability to get a prescription from their doctor (9
per cent), and lack of availability through a pharmacy (6 per cent).
"It's really
important for those who want to lose weight to first discuss options with their
doctor. It is not one size fits all, and every medication can have risks and
side effects," said Shengyi Mao, an Ohio State internal medicine
physician.
Mao said doctors
will "go through a patient's medical history" and prescribe
medications by assessing "their particular risks and benefits".
Recently developed
weight loss drugs called GLP1-RA (with brand names Ozempic and Wegovy) help in
weight loss because they can curb appetite and slow emptying of the stomach.
The medication
which comes with Semaglutide salt has been approved by the US FDA for reducing
cardiovascular risk in adults who are overweight or obese and have established
cardiovascular disease.
But the regulator
also issued two warnings about compounded Semaglutide including reports of
dosing errors resulting in hospitalisation and ineffective ingredients.
Compounded drugs
are custom-made alternatives to brand names and made in state-licensed
pharmacies instead of by drug manufacturers when a drug is in short supply.
Mao said
"Obesity is a serious and complex chronic disease" and should be
addressed by a "comprehensive weight management programme".
"These weight
loss drugs may be effective for some people but they can cause serious side
effects and the weight may return after they stop taking them."
New research suggests that there may be more than
10.5 million people in the United States living with atrial fibrillation, that
is, three times more cases than experts had previously estimated.
Previous
studies have reported that about 3 million people in the United States
have atrial fibrillation (AFib).
Researchers
from the University of California – San Francisco discovered that AFib is
three times more common in the U.S. than previously thought.
Over
the course of the study, scientists found that people with AFib tended to
be younger, less likely to be female, and more likely to have high blood
pressure and diabetes.
Previous studies have reported that about 3.3 million
people in the
United States have atrial
fibrillation (AFib) — a condition that causes the heart to beat
in an irregular pattern or very rapidly.
However, that number may be a lot more than we have
thought, says researchers from University of California – San Francisco.
AFib
estimates updated for the first time in over 2 decades
Over the last few
years, previous research has reported a rise in AFib
cases, with one review published in
February 2024 stating that about one in every three to five people over the age
of 45 is at risk.
While AFib is generally considered a condition for
older adults over the age of 60, studies have reported an increase of AFib
occurring in people at a younger age.
“Atrial fibrillation is a major contributor to the
burden of disease, especially in elderly,” Jean Jacques Noubiap, MD, PhD, a postdoctoral
scholar at the University of California – San Francisco with a specialty in
global cardiovascular health and first author of this study told Medical News
Today.
“However,
prevalence estimates of atrial fibrillation from large populations had not been
updated for more than 2 decades,” he added.
“Atrial fibrillation substantially increases the risks
of death, stroke, heart failure, heart attack, chronic
kidney disease,
and dementia, and results in
lower quality of life, especially when undiagnosed and untreated,” Noubiap
continued. “Therefore, it is crucial to detect atrial fibrillation and
appropriately treat it to prevent its complications.”
At least
10.55 million U.S. adults have AFib
For this study,
Noubiap and his team analyzed data from almost 30 million adult patients who
had received some type of acute or procedural care in California from 2005 to
2019.
Of those study participants, about 2 million of them
received an AFib diagnosis with the numbers increasing over time from 4.49% of
participants treated between 2005 and 2009, to 6.82% receiving treatment
between 2015 to 2019.
After
standardizing this data for the entire U.S., researchers estimated that the
current AFib prevalence nationwide is at least 10.55 million or about 5% of the
population, which is three times more than previously thought.
Researchers also found that during the course of their
study, people with AFib tended to be of a younger age, less likely to be
female, and more likely to have high blood
pressure and diabetes.
“Our findings are not very surprising,” Noubiap said.
“They reflect what we see in clinical practice, an increasing number of
patients who have atrial fibrillation. Previous studies suggested that there
would [be] a rise in the number of people with atrial fibrillation. However,
our data objectively demonstrate that prior projections severely underestimated
the true prevalence of atrial fibrillation in U.S. adults.”
Are AFib
cases on the rise in younger adults?
The scientists also
discovered that over the length of the study’s time frame, participants with
AFib skewed younger, were less likely to be female, and were more likely to
have high blood pressure and diabetes.
As to why that may be the case, Noubiap explained
that:
“It is likely that atrial
fibrillation is diagnosed earlier due to enhanced detection. Increased
healthcare utilization among females or patients with various comorbidities
such as hypertension and diabetes might heighten their likelihood of having
atrial fibrillation diagnosed during their healthcare encounters.”
However, “[t]he most important driver [for AFib] is
population aging,” he noted.
“In fact, increasing age is the strongest risk factor
for atrial fibrillation,” said Noubiap. ”Furthermore, enhanced atrial
fibrillation detection and improved survival of affected patients also result
in [an] increased number of cases.”
”Finally,” he added, ”the rise in common risk factors
for atrial fibrillation, such as hypertension, obesity,
or diabetes might partly explain the increasing prevalence of atrial
fibrillation.”
After reviewing this study, Nikhil Warrier, MD, a board-certified cardiac
electrophysiologist and medical director of electrophysiology at MemorialCare
Heart & Vascular Institute at Orange Coast Medical Center in Fountain
Valley, CA, told MNT that the authors should be commended as it
shows a glimpse into what we see in our day-to-day patient encounters.
“Namely, increased diagnosis of AFib in younger
patients with significant comorbidities,” Warrier continued. “I suspect that
the prevalence is higher — improved accuracy from wearable devices will likely
[lead] to earlier diagnosis, which will continue to increase the volume of
patients seeking care.”
While “it
is deeply concerning to see an increased prevalence of AFib in younger patients
but known risk factors such as hypertension, obesity, sleep apnea, and alcohol
consumption likely
play a role here,” he further explained.
“Successful programs are great at addressing these
risk factors which lead to improved clinical outcomes for all patients,” Said
Warrier.
MNT also
spoke with Yuriy Dudiy, MD, surgical
director and the Adult ECMO Program in the Department of Cardiac Surgery at
Hackensack University Medical Center in New Jersey, about this study.
“The study reveals a significant rise in A-fib cases,
exceeding prior estimates,” Dudiy, who was also not involved in this research,
told us. “This conservative figure excludes diagnoses from ambulatory clinics
and likely undetected AFib, making the issue even more pressing.”
In his opinion:
“This
is a wake-up call for the medical community, policymakers, and the public.
Policymakers need to address AFib as a major public health concern and allocate
resources, especially since younger patients are increasingly affected, leading
to higher long-term healthcare costs. Medical community must prioritize
prevention, early detection, and effective management of AFib to ensure a
healthier future and reduce the burden on the healthcare system.”
For those looking to lower their risk for AFib, Warrier
said that the adage “prevention is better than the cure” applies here, and
Dudiy commented that preventing AFib can be more manageable with some simple
lifestyle changes and healthy habits.
To help lower a person’s AFib risk, recommendations from
both doctors include:
following a balanced
diet rich in fruits, vegetables, whole grains, and lean
proteins, while avoiding excessive sugar, salt, and unhealthy
fats
improving hypertension control through
medications/diet
