Study finds new cellular component important for sense of smell

Organelles are distinct ‘workstations’ inside cells that can be compared to different organs of the body

In the neurons that our noses utilise to detect smell, scientists at Umea University in Sweden have found a previously unidentified cellular component called an organelle. The discovery may spur more studies into the COVID-19 symptom of poor smell perception.

“A prerequisite for finding a treatment for impaired sense of smell is to first understand how the sense of smell works, said Staffan Bohm.” Professor at the Department of Molecular Biology at Umea University.

The so-called organelle that the researchers have uncovered is one that has never before been seen inside nerve cells. Multivesicular transducosome is the name the researchers have given to the newly discovered organelle. Umea University’s distinctive microscope facility was important in the discovery.

What the researchers have discovered is a so-called organelle inside nerve cells, that has not previously been observed. The newly discovered organelle has been given the name multivesicular transducosome by the researchers. The discovery was made possible thanks to Umea University’s unique microscopy infrastructure.

Organelles are distinct ‘workstations’ inside cells that can be compared to the different organs of the body, i.e., different organelles have different functions in the cell. Most organelles are common to different cell types, but there are also organelles with specific functions that only occur in certain cell types. Olfactory nerve cells have long projections, i.e., cilia, that protrude into the nasal cavity and contain the proteins that bind odorous substances and thus initiate nerve impulses to the brain. The conversion of odour into nerve impulses is called transduction and the newly discovered organelle, contains only transduction proteins.

The role of the transductosome is to both store and keep transduction proteins separate from each other until they are needed. Upon olfactory stimulation, the outer membrane of the organelle ruptures, releasing the transduction proteins so that they can reach the cilia of the neuron, and smell is perceived.

The researchers also discovered that the transductosome carries a protein called retinitis pigmentosa 2, RP2, which is otherwise known to regulate transduction in the eye’s photoreceptor cells. If the RP2 gene is mutated, it can cause a variant of the eye disease retinitis pigmentosa that damages the eye’s light-sensitive cells.

“A question for further research is whether the transductosome has a role in vision and whether it is present in brain neurons that are activated by neurotransmitters and not light and smell. If so, the discovery may prove even more significant,” said Staffan Bohm.

The transducosome was discovered when researcher Devendra Kumar Maurya used a new technique called correlative microscopy. The technique combines electron microscopy and confocal microscopy so that a cell’s internal structures and the location of different proteins can be imaged simultaneously. Crucial to the discovery was Devendra’s method development, which enabled the technique to be used to analyse intact neurons in tissue sections.

https://www.tribuneindia.com/news/health/study-finds-new-cellular-component-important-for-sense-of-smell-468589

Covovax to get approval as booster in 10-15 days: SII CEO Adar Poonawalla

Says the vaccine works very well against Omicron variant of coronavirus

Serum Institute of India’s Chief Executive Officer Adar Poonawalla has said their Covovax vaccine will get approval as a booster against COVID-19 in the next 10 to 15 days.

The vaccine works very well against the Omicron variant of coronavirus, Poonawalla told reporters on the sidelines of an event at the Bharti Vidyapeeth University here on Sunday.

Asked about states and districts not getting Covishield vaccine, he said there is ample stock with the Union Government for supply.

“Covovax will be approved as a booster in the next 10-15 days. It is actually the best booster because it works very well against Omicron, more than Covishield,” he said.

Poonawalla said everyone was looking at India, not just in terms of healthcare but because the country managed to take care of a huge and diverse population and also helped 70 to 80 nations during the COVID-19 pandemic.

“This was all possible because of the leadership of our central government, our state governments, healthcare workers, manufacturers, all of whom worked together with one common goal,” he said.

On the occasion, Poonawalla was conferred with the first Dr Pantangrao Kadam Memorial Award at the hands of Nationalist Congress Party (NCP) chief Sharad Pawar and Maharashtra Deputy Chief Minister Devendra Fadnavis.

The event was held to mark the birth anniversary of Kadam, the late minister and education baron from western Maharashtra.

Appealing to students who wished to pursue education abroad, Poonawalla said there was no place like India to fulfil dreams due to the presence of institutions like Bharti Vidyapeeth and others.

“Even if you have to go abroad, come back as soon as possible,” he said.

https://www.tribuneindia.com/news/nation/covovax-to-get-approval-as-booster-in-10-15-days-sii-ceo-adar-poonawalla-468825

COVID's XBB.1.5 vs. Omicron BF.7: Is one more dangerous than the other? Note the symptoms

Just as we thought the worst was behind us, the rising number of COVID cases in China has raised alarms in and around the world. New variants have emerged, which are wreaking havoc in different parts of the globe including India. According to the Indian SARS-CoV-2 Genomics Consortium (INSACOG), India's coronavirus monitoring body, five cases of the XBB.1.5 variant of the coronavirus have been detected in the country. On the other hand, four cases of Omicron subvariant BF.7 were detected in West Bengal on Wednesday.

While protecting yourself against all types of variants is key, you must also understand the difference between the two highly contagious variants and know whether one is more concerning than the other.

What is COVID's XBB.1.5?

The XBB.1.5 variant of COVID-19 is a sub-variant of XBB. It is said to be a new recombinant strain that was made from a combination of BA.2.75 and BA.2.10.1. The new sublineage is said to be more immune evasive and more contagious than BQ and XBB variations.

What is Omicron BF.7?

Omicron BF. 7 or BA.5.2.1.7. is one of the latest subvariants of the Omicron’s BA.5 variant, first detected in Northwest China's Inner Mongolia Autonomous Region. Also known as the 'Omicron spawn', this new variant is fast spreading and has been detected in several other countries including the United States, UK, Australia and Belgium.

XBB.1.5 vs Omicron: Which is more dangerous?

According to a December study in the journal Cell, XBB is better at evading immune defenses gained from vaccination and prior infection, compared to other variants, which is why the new XBB.1.5 appears to be highly transmissible, as it has picked up some key mutations from its parent strain.

The data from the U.S. Centers for Disease Control and Prevention (CDC) suggests that XBB.1.5 accounted for 40.5% of new sequenced COVID-19 cases in the U.S..

Scientists from the World Health Organization (WHO) confirmed on Wednesday that XBB.1.5 has a higher "growth advantage" than other sub-variants. However, the experts said that there was no indication that it is more serious or dangerous than previous Omicron variants.

XBB.1.5 - ‘most transmissible subvariant of Omicron to date'

Maria Van Kerkhove, an epidemiologist who is the WHO’s technical lead on COVID-19 noted that XBB.1.5, which was first detected in the United States, has spread to at least 29 countries and “is the most transmissible form of Omicron to date.”

“We do expect further waves of infection around the world, but that doesn’t have to translate into further waves of death because our countermeasures continue to work,” she said.

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/covids-xbb-1-5-vs-omicron-bf-7-is-one-more-dangerous-than-the-other-note-the-symptoms/photostory/96761109.cms?picid=96761118

Research reveals genetic effect on response to treatment for obesity

Research finds that ‘waist-hip ratio’ genetic risk score is associated with less weight loss after intervention

According to a study conducted by the University of Galway and Brunel University London, patients with severe and complicated obesity respond differently to a dietary weight management programme based on their genes.

The GERONIMO project studied patients attending the obesity clinic at Galway University Hospital who were undergoing an intensive short-term programme of medically supervised dietary restriction in order to attempt to reverse some of the medical problems with severe obesity.

During the research scientists were able to analyse small variations in hundreds of genes that are known to be associated with obesity. By combining information from these measured gene variations together, a ‘genetic risk score’ was calculated for six different obesity-related traits.

Professor Francis Finucane, senior lecturer in the School of Medicine at University of Galway and Consultant Endocrinologist at Galway University Hospitals who led the clinical study, said, “Mechanistic studies like these, which help us to understand why some people respond better than others to the same intervention, are really important in providing more personalised and effective treatments for people with obesity.” “We know that in general, heritability and ‘genetics’ play a huge role in influencing body weight and the risk of obesity-related complications like diabetes, but finding the genes that account for this risk has been a challenge,” he said.

Professor Alex Blakemore, Professor in Human Genomics at Brunel University London, said: “No-one chooses their genes, so, as a society, we need to recognise that when it comes to maintaining a healthy weight, the challenge is greater for some people than for others. This study reveals just a small part of the picture of how our genes can help or hinder us in reaching our health goals.” The GERONIMO project involved 93 patients who volunteered for the study. They were monitored while taking part in a meal replacement programme.

Their average body mass index at the start of the study was 52kgm-2, which means that they weighed more than twice their maximum ‘healthy weight’.

The participants lost an average of 16% of their body weight, or 21 kg after 24 weeks.

The research found that the ‘waist-hip ratio’ genetic risk score, which measures an individual’s genetic tendency to hold on to central or abdominal fat, was associated with less weight loss after the intervention.

Speaking about next stages in the research Professor Finucane said: “This work is exciting and important because it is the first Irish study to demonstrate a genetic effect on the response to a treatment for obesity.

“The genetic effects we found here were subtle, but we think it would be good to explore this further, in larger studies and with different obesity treatments, such as drug therapy or ‘metabolic surgery’,” he added.

https://www.tribuneindia.com/news/health/research-reveals-genetic-effect-on-response-to-treatment-for-obesity-467711

Does Covid change body's response to other threats? Your gender decides

Researchers find that immune system of men who had recovered from mild cases of Covid responded more robustly to flu vaccines than women

Does Covid change body's response to other threats? Your gender decides

The emergence of the Covid-19 pandemic in 2020 allowed researchers to test the theory -- does Covid changes the body's response to other threats, and the answer they found was that it "depends on the individual's gender".

John Tsang, a professor of immunobiology and biomedical engineering at Yale University, has long believed that the immune system reverts to the previous stable baseline after viral infection.

According to a study published in the journal Nature, a team led by Tsang systematically analysed the immune responses of healthy people who had received the flu vaccine. From that data, they then compared the responses between those who had never been infected by SARS-CoV-2, the virus that causes Covid-19, and those who experienced mild cases but recovered.

The team found that the immune systems of men who had recovered from mild cases of Covid-19 responded more robustly to flu vaccines than women who had had mild cases or men and women who had never been infected, said the study.

Moreover, the study authors said that the baseline immune statuses in men previously infected with SARS-CoV-2 were altered in ways that changed the response to an exposure different from SARS-CoV-2.

"This was a total surprise. Women usually mount a stronger overall immune response to pathogens and vaccines, but are also more likely to suffer from autoimmune diseases," said Tsang.

After contracting the Covid-19 virus, men were much more likely than women to die from an overactive immune response, according to the study.The new findings suggest that even mild cases of Covid-19 may trigger stronger inflammatory responses in males than females, resulting in more pronounced functional changes to the male immune system even after recovery.

"Our findings point to the possibility that any infection or immune challenge may change the immune status to establish new set points," said lead author Rachel Sparks, from the US-based National Institute of Allergy and Infectious Diseases.

"The immune status of an individual is likely shaped by a multitude of prior exposures and perturbations," she added.

https://www.tribuneindia.com/news/health/does-covid-change-bodys-response-to-other-threats-your-gender-decides-467712

How vitamin D deficiency can pose a risk to heart health

Vitamin D has anti-inflammatory properties which can directly help in maintaining blood pressure and ultimately reducing the risk of cardio-vascular diseases caused by its deficiency, says Dr Bimal Chhajer, cardiologist, former consultant at AIIMS and founder of SAAOL Heart Institute

Vitamin D is a fat-soluble prohormone which interacts with vitamin D receptors (VDR) to regulate a variety of physiological processes. (Photo: Getty Images/Thinkstock)

If you thought that a sedentary lifestyle poses a risk of cardiovascular diseases (CVDs), which it does, several studies have now found that deficiency of Vitamin D can also be a trigger.

Although numerous studies are still required to come to any conclusive takeaway, the pointers are there in many studies which have found a correlation between lower levels of vitamin D and a higher rate of cardiac events and strokes. For example, early last year, Prof Elina Hyppönen, director of the Australian Centre for Precision Health at the University of South Australia Cancer Research Institute, and her team found evidence that vitamin D deficiency can increase blood pressure and the risk of CVD. “However,” she added, “increasing vitamin D concentrations will only be helpful for those participants who ‘need it,’ and further benefits from elevating concentrations beyond the nutritional requirement are going to be modest, if they exist.”

Vitamin D is a fat-soluble prohormone that interacts with vitamin D receptors (VDR) to regulate a variety of physiological processes. It has a significant impact on the metabolism of calcium and bones and in addition, it performs a variety of other crucial functions in the body, such as those regulating inflammation and immune function. Sufficient vitamin D consumption may promote healthy immune function and lower the risk of autoimmune disorders. On the other hand, its insufficiency is a prevalent condition that has been linked to numerous health problems, including skeletal and non-skeletal disorders.

Lack of vitamin D has been associated with both musculoskeletal (such as rickets, bone fractures, osteomalacia, osteopenia, and muscle weakness) and non-skeletal problems. Cardiovascular conditions and risk factors such as hypertension, impaired systolic and diastolic function, abdominal aortic aneurysm in older men, nonvalvular AF, and congestive heart failure are some examples of non-skeletal consequences.

Additionally, it was linked to burn injuries, type 1 diabetes, type 2 diabetes, insulin resistance, multiple sclerosis, rheumatoid arthritis, multiple sclerosis, inflammatory bowel diseases, cancers, schizophrenia, depression, cognitive deficits, common obesity, non-alcoholic fatty liver disease, cystic fibrosis, and metabolic syndrome. Other adults are at a much higher risk of Vitamin D deficiency due to reduced Vitamin D intake and decreased cutaneous synthesis.

Vitamin D is known to provide several health benefits in the human body along with having anti-inflammatory properties which can directly help in maintaining blood pressure and ultimately reducing the risk of CVD cases caused by its deficiency. Adequate levels of Vitamin D keep your heart and blood vessels in good working condition. It strengthens the lining of blood vessel walls to allow blood to flow freely. A study by Ohio University used tiny sensors, about 1,000 times smaller than a human hair, to look at blood vessel cells while injecting them with a form of vitamin D, called vitamin D3. The study showed that vitamin D3 can repair damage to the heart and blood vessels caused by high blood pressure.

HOW SHOULD WE MAKE UP FOR THE DEFICIENCY?

Thankfully, only moderate levels of Vitamin D are enough to maintain cardiac health. The sun is the main source of our Vitamin D consumption but sometimes people living in urban areas, especially after the pandemic, have not been able to soak up enough Vitamin D from the outdoors. So, supplementation is required to make up for the deficit.

As Vitamin D is an essential nutrient, some of the good sources of getting Vitamin D are oily fish such as salmon, sardines, herring and mackerel, along with red meat, egg yolks and fortified foods such as fat spreads and breakfast cereals. Also, supplementation can be done through natural means and should never be above optimal levels.

Both animal and human studies have looked into the connection between low vitamin D levels and cardiovascular illnesses and risk factors. However, there are conflicting findings in the research and trials on the impact of vitamin D supplementation through pills on cardiovascular risk factors and hypertension. Consequently, large, powerful randomised controlled trials are necessary which, if successful, can improve our health and give us a simple and affordable method of vitamin D supplementation. A 2018 study called VITAL found that you do not need more vitamin D than what is required for bone health in order to have optimal heart health. And moderate to high vitamin D supplementation did not appear to reduce the risk of heart attacks or strokes.

https://indianexpress.com/article/lifestyle/health-specials/how-vitamin-d-deficiency-can-pose-a-risk-to-heart-health-8356164/

Japanese research reveals physical strain helps bone growth

We are frequently told to "take a load off" when things get too much, but when it comes to bone maintenance, doing the opposite can be beneficial. Some important processes for how physical strain induces bone formation have been uncovered by Japanese researchers.

Researchers from the National Cerebral and Cardiovascular Center Research Institute have shown that load affects the expression of the peptide osteocrin (OSTN), which increases when load is applied and decreases when it is reduced, in a study that was published in the journal 'Cell Reports'.

Bones and skeletal muscles are strengthened by the load associated with exercise, preventing bone and muscle atrophy, and maintaining bone and muscle strength is important for maintaining physical activity. The growth of long bones, such as the femur and tibia, is a very complex process controlled by genetic and environmental factors, such as exercise and gravity.

"Not much is known about how mechanical force initiates biochemical signals to control bone growth," says lead author of the study Haruko Watanabe-Takano. "We investigated how load is related to the metabolic balance adjustment of bone maintenance." Bone is maintained by the balanced activities of two types of cells - osteoblasts, which make bone, and osteoclasts, which break down bone - and is thought to be made in response load demand.

Specifically, the team investigated the expression of OSTN, a peptide produced by osteoblasts, in mice. OSTN is critical to the regulation of bone growth, as well as physical endurance.

The researchers found that OSTN was very strongly expressed in bones such as the tibia, radius, and ulna, and in the region where the load was applied. Additionally, they showed that OSTN was secreted by the periosteal osteoblasts in these bones. The periosteum is a membrane found on the outer surface of bones, except at the joints of long bones, and is involved in bone remodeling and production, especially during growth.

"We also found that OSTN expression decreased when load was reduced, and was increased by load stimulation," says Watanabe-Takano. "Moreover, when we genetically engineered mice lacking OSTN, we found that they had reduced bone mass compared with normal mice and lacked load-induced recovery of bone mass after prolonged load reduction.

https://www.tribuneindia.com/news/health/japanese-research-reveals-physical-strain-helps-bone-growth-467336

Nasal swab can provide early warning of emerging viruses: Research

Findings reveal that testing for an antiviral protein made by the body can help pinpoint which nasal swabs are more likely to contain unexpected viruses.

As the Covid-19 pandemic demonstrated, potentially harmful novel viruses can spread across the population long before the system for monitoring global public health is able to catch them.

However, Yale researchers have discovered that examining nasal swabs for the presence of a particular immune system component can help identify stealthy viruses that are missed by conventional tests, they write in the journal Lancet Microbe on January 3.

“Finding a dangerous new virus is like searching for a needle in a haystack,” said Ellen Foxman, associate professor of laboratory medicine and immunobiology and senior author of the study, adding, “We found a way to significantly reduce the size of the haystack.”

Public health officials typically look to a few sources for warning signs of emerging disease. They study emerging viruses in animals that may transmit the infection to humans. But determining which of the hundreds, or thousands, of new viral variants, represent a true danger is difficult. And they look for outbreaks of unexplained respiratory ailments, which was how SARS-Cov-2, the virus that causes Covid-19, was discovered in China late in 2019.

By the time an outbreak of a novel virus occurs, however, it may be too late to contain its spread.

For the new study, Foxman and her team revisited an observation in her lab in 2017, which they thought may provide a new way to monitor for unexpected pathogens. Nasal swabs are commonly taken from patients with suspected respiratory infections and are tested to detect specific signatures of 10 to 15 known viruses. Most tests come back negative.

But as Foxman’s team observed in 2017, in a few cases the swabs of those who tested negative for the ‘usual suspect’ viruses still exhibited signs that antiviral defences were activated, indicating the presence of a virus. The telltale sign was a high level of a single antiviral protein made by the cells that line the nasal passages.

Based on that finding, the researchers applied comprehensive genetic sequencing methods to old samples containing the protein and, in one sample, found an unexpected influenza virus, called influenza C.

The researchers also used this same strategy of retesting old samples to search for missed cases of Covid-19 during the first two weeks of March 2020. While cases of the virus had surfaced in New York State around that same time, testing was not readily available until weeks later. Hundreds of nasal swab samples collected from patients at Yale-New Haven Hospital during that time had tested negative for standard signature viruses. When tested for the immune system biomarker, the vast majority of those samples showed no trace of activity of the antiviral defence system. But a few did; among those, the team found four cases of Covid-19 that had gone undiagnosed at the time.

The findings reveal that testing for an antiviral protein made by the body, even if the tests for known respiratory viruses are negative, can help pinpoint which nasal swabs are more likely to contain unexpected viruses.

Specifically, screening for the biomarker can allow researchers to narrow down the search for unexpected pathogens, making it feasible to do surveillance for unexpected viruses using swabs collected during routine patient care. Samples found to possess the biomarker can be analyzed using more complex genetic testing methods to identify unexpected or emerging pathogens circulating in the patient population and jumpstart a response from the healthcare community.

https://www.tribuneindia.com/news/health/nasal-swab-can-provide-early-warning-of-emerging-viruses-research-467377

Lower influenza prevalence linked with Covid public health measures: Study

Influenza is an acute respiratory infectious disease that can impose a high burden and lead to severe seasonal epidemics or even pandemics

Decreased influenza prevalence may be associated with long-term public health measures against COVID-19 in China, according to a study.

The research, published in the journal Health Data Science, provides preliminary evidence of the long-term relationship between prevention and control measures and influenza transmission in China during the COVID-19 pandemic.

“Since December 2019, various nonpharmaceutical interventions (NPIs) and COVID-19 vaccination have been used to prevent and control the community transmission of COVID-19,” said Zirui Guo from Peking University School of Public Health.

“However, the relationship between the changing influenza epidemic and COVID-19 prevention and control was unclear,” Guo said.

Influenza is an acute respiratory infectious disease that can impose a high burden and lead to severe seasonal epidemics or even pandemics.

However, a marked decrease in influenza activity was registered in Japan and the US, among other regions in the Northern Hemisphere, in early 2020, the researchers said.

Australia, Chile, and other areas in the Southern Hemisphere shared this observation during their influenza season in 2020, they said. “The COVID-19 outbreak changed the epidemic trend and characteristics of influenza, according to our analysis,” said Professor Min Liu, author of the study.

A significant decrease in influenza activity in China was observed during the 2020-2022 COVID-19 pandemic, particularly in winter and spring.

In addition, influenza seasonality was evident from 2010 to 2019 but absent during the 2020/2021 season across China, whether north or south.

The researchers analysed the epidemiology and seasonal patterns of influenza based on the timeline of COVID-19 NPIs in place in China.

They found that reduction of influenza viral infection might be related to everyday COVID-19 public health interventions in the country.

Respiratory diseases frequently occur in winter and spring when COVID-19 and influenza tend to circulate easily.

The resurgence of other respiratory viruses once suppressed under COVID-19 NPIs in 2020-2021 was recognised worldwide, the researchers said.

The entire population has missed the opportunity for enhanced immunity against influenza after a prolonged low flu season during 2020-2022, they said.

As a result, high-risk populations, such as young children and elderly individuals, are more vulnerable to widespread and severe illness from influenza as time goes by, according to the researchers.

To protect these vulnerable populations, besides increasing influenza vaccine coverage, efforts should be paid to strengthen influenza surveillance and establish a comprehensive surveillance system for influenza virus and SARS-CoV-2, they said.

“Given the limitations in our analysis, further studies should be performed to confirm our results,” Liu said.

“More indicators, such as influenza-positive rate and the number of influenza report cases, might supplement and verify our study,” the scientist added.

https://www.tribuneindia.com/news/health/lower-influenza-prevalence-linked-with-covid-public-health-measures-study-467067

Why you should not give up cholesterol-lowering drugs or statins after a heart attack and have them for a lifetime

Only statins can keep LDL cholesterol levels in check and prevent repeat episodes, advises Dr TS Kler, Chairman, Fortis Heart and Vascular Institute, Fortis Memorial Research Institute,

Often, people who have had a heart attack or even stenting mistakenly feel that they do not need cholesterol-lowering drugs anymore. They assume that since their blockage has been addressed through surgical intervention or medication, and they have been prescribed lifestyle modification with heart drugs, chances of their cholesterol levels rising are low. And once they are confident of their body and recovery, misinterpreting their drug-induced limiting effect on cholesterol levels as their natural body function, they often discontinue cholesterol-lowering drugs or statins on their own. And the cholesterol climbs right back.

Some years ago, a study of nearly 60,000 people, age 66 and older, which was published in JAMA Cardiology, found how often people stop taking statins after a heart attack. Within two years of having a heart attack, nearly one in five people had stopped taking statins. And nearly two in five did not take the medicine as prescribed. They either took a lower dose or took it less frequently.

People who have had a heart attack or stroke need to take cholesterol-lowering drugs or statins life-long post-event to reduce the risk of them having another event. So, what do statins do? They work by blocking a substance your body needs to make cholesterol. Apart from lowering cholesterol, they stabilise the plaques on blood vessel walls and reduce the risk of blood clots. Most people associate clotting with the heart. But it can happen in any artery of the cardiovascular system, leading to brain strokes and resultant paralysis. Blockages in kidney arteries could lead to kidney problems and those in the limb arteries could even result in amputation. As the plaque closes limb arteries, fresh blood cannot pass to nourish organs and other tissues below the blockage. This causes damage mostly to the toes and feet and is known as Peripheral Artery Disease (PAD) and in serious cases, patients end up losing their limbs.

Cholesterol-reducing drugs or statins are preventive on two counts. First is for primary reasons, where they are prescribed for high-risk patients whose blood markers are not good and are genetically predisposed to heart disease. The secondary reason is the onset of the heart attack itself where it helps prevent repeat episodes in the future.

 After a heart attack, a statin has to be taken for as long as the risk exists, which is life-long. Even without an episode, it is prescribed for people at both low and high risk. You are at low risk when you have a history of atherosclerosis and your LDL requirement is below 70 mg/dL. High risk is when you are young, say 35, have had a heart episode and have a family history. In such a situation your LDL should be below 50 mg/dL, a level which is difficult to maintain without statins.

There are new drugs to reduce LDL cholesterol other than statins. These are PCSK9 inhibitors and are available as injection Repatha. Now, 140 mg injection is given subcutaneously twice a month to keep LDL cholesterol in check. Each injection costs Rs 15,000, so you have to set Rs 30,000 aside. Statins work out cheaper. Another drug is Ezetamide in tablet form, but it is less useful than statins or Repatha.

If statins are causing side-effects you cannot handle, like digestion issues, muscle pain, sleep issues, then ask your cardiologist to tweak the dose in a way that you do not feel any side effects and your body can adjust with the dosage. Some people decide on their own that since they feel better, they do not need the same dosage as before. But they must remember that their ultimate goal is not lesser medication but lesser chances of having another stent, bypass or a heart attack.

https://indianexpress.com/article/lifestyle/health-specials/cholesterol-lowering-drugs-statins-after-heart-attack-8357665/

Avoid panic on Omicron sub-variant XBB 1.5, focus more on genome sequencing: Top experts

'Infection with BA.5 seems to give some protection against infection with XBB. There is not much difference with severe disease, so we can expect a fair number of infections. Severe disease will continue in known risk groups,' says virologist Dr Gagandeep Kang

Top experts have reiterated the need to be vigilant and avoid panic as the US-based Centers for Disease Control (CDC) and Prevention indicates that the Omicron sub-variant XBB.1.5 has led to a rise in cases in the US. Experts have stressed the need for a higher genome-sequencing in the country as INSACOG (Indian SARS CoV2 Genomics Consortium) data has shown up five positive samples for the XBB.1.5 sub-variant. Says noted virologist, Dr Gagandeep Kang, “XBB.1.5 is now more than two-third of all cases in the USA. Since XBB and further sub-lineages have evolved in immunised populations, we should expect them to be able to infect more easily and that is what they are doing. Infection with BA.5 seems to give some protection against infection with XBB. There is not much difference with severe disease, so we can expect a fair number of infections. Severe disease will continue in known risk groups.”

The XBB.1.5 variant of Covid is actually a sub-variant of XBB. It is a combination of BA.2.75 and BA.2.10.1 and was first reported in India.

It is considered more contagious than BF.7, which is driving the current spate of infections in China. It has a greater immune-escape potential.

According to Sanjay Pujari, member of the Indian Council of Medical Research (ICMR) task force, “the XBB.1.5 is a recombinant of the Omicron’s BA.2 sub-variants. This has originated in the USA and the rate of transmission (RT) is 1.8.

Reports are indicating that most hospitalisations are in the elderly population and those who have not taken the booster dose vaccination. So far in India all five cases had mild illness and have recovered well.” He points out that one cannot generalise how geography-specific sub-variants will behave and hence genomic surveillance is important.

Dr Rajesh Karyakarte, coordinator for genome sequencing in Maharashtra, explains that in the USA, a descendant of XBB — that is XBB.1.5 — is replacing the previously dominating BQ.1 and BQ.1.1 sub lineages. Currently XBB.1.5 is growing in New York ahead of others. “We have already seen in Maharashtra that XBB is the most dominant variant and has not allowed BA.5 and its sublineages like BQ.1 to dominate. XBB already has greater immune evasiveness than others and adds more mutations. For example XBB.1.5 ,” says he.

In Maharashtra, no case of the XBB.1.5 sub variant has been recorded so far. Over the last several months, the state has already reported 270 cases of the XBB and top surveillance officer Dr Pradeep Awate told The Indian Express that there has not been a significant rise in cases. These are sublineages and overall the infection has been a mild one.

Dr Shashank Joshi, noted endocrinologist and diabetologist at Lilavati Hospital, Mumbai, argues for vigilance as there seems to be no clinical correlation in terms of hospitalisation and deaths. “There should be no panic at all as all these are Omicron sub-lineages. However it is important to keep a check on cold, cough and respiratory illnesses which are common this time of the year,” he adds. 

https://indianexpress.com/article/lifestyle/health-specials/avoid-panic-omicron-sub-variant-xbb-1-5-focus-genome-sequencing-8359064/

 

Alzheimer's disease: 5 early symptoms you shouldn't ignore

Dementia refers to a cluster of symptoms linked to cognitive decline, affecting your brain function. Further, Alzheimer's disease is a specific brain disease, marked by symptoms of dementia that get worse over time. 

Ageing is one of the biggest known risk factors of developing Alzheimer’s. However, this does not mean that this condition should be a normal part of aging. Here are some early warning signs of Alzheimer’s. Recognising them promptly and seeking treatment can help you deal with these troubling symptoms. 

According to the Alzheimer’s Association, US, here are five warning signs that shouldn’t be ignored:

Difficulty to work with numbers or solving problems 

A lot of adults master managing their finances or household bills with time and practice. However, if you suddenly find yourself struggling to work with numbers, making errors here and there, it could be an early sign of Alzheimer’s. 

Difficulty completing familiar tasks 

Another important symptom is becoming suddenly clueless with familiar tasks. Things you’ve done a hundred times might suddenly become foreign, such as following a recipe you have cooked before or driving to a familiar location. Alzheimer’s can also cause problems concentrating, which can make it difficult for the patient to complete simple daily tasks as smoothly as they did before. 

Confusion with time or place 

It is easy to forget what day it is when you are on a holiday break. Or it is relatable for many to lose track of time when having a good time. 

However, people with Alzheimer’s can forget not just what date it is, but what season it is. In fact, they may even forget where they are and how they even got there. 

Problems in speaking or writing 

Patients with Alzheimer’s can struggle in speaking and writing, in both thought and vocabulary. Sometimes, they stop in the middle of a conversation and have no idea how to continue. Repeating what they have already said is another similar sign. 

When struggling with words, they might start using the wrong names for things, or have trouble naming a simple, familiar objects. 

Misplacing things 

Losing your things too frequently is another early sign of Alzheimer’s disease. Further, patients are unable to recall anything to be able to find the misplaced objects. As the disease progresses, they may even accuse others of stealing their things. It is important to pay attention to these early signs of Alzheimer’s and consult your doctor if you experience any of these. 

Early detection matters 

If you notice one or more signs in yourself or another person, it is important to talk about it with other family members and consult your doctor. It is important to take action to figure out what’s going on and how you can improve your condition.

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/high-cholesterolbeware-of-these-warning-signs-in-your-feet/photostory/96678163.cms

50-70 pc of those under 19 years globally still susceptible to SARS-CoV-2: Study

Highest seroprevalences in different pandemic waves estimated for South-East Asia—17.9 to 81.8 per cent 

Fifty to 70 per cent “children” below 19 years globally were susceptible to the SARS-CoV-2 infection by the end of 2021 and before the Omicron wave, showing a need for more effective vaccines and better vaccination coverage, according to a study. 

It also found that worldwide seroprevalence estimates varied from 7.3 per cent in the first wave of the COVID-19 pandemic to 37.6 per cent in the fifth wave and 56.6 per cent in the sixth wave. 

The highest seroprevalences in different pandemic waves were estimated for South-East Asia -- 17.9 to 81.8 per cent—and the African region -- 17.2 to 66.1 per cent—while the lowest seroprevalence was estimated for the Western Pacific region between 0.01 and 1.01 per cent, the study said. 

Seroprevalence estimates were higher in children at older ages, in those living in underprivileged countries or regions, and in those of minority ethnic backgrounds, the study published in eClinicalMedicine said. Seroprevalence was defined as the number of children who tested positive for specific antiSARS-CoV-2 serum antibodies, using a well-designated threshold in the assay, divided by the total number of children tested, it said. 

Scientists conducted a systematic review and meta-analysis in which they searched international and pre-printed scientific databases from December 1, 2019, to July 10, 2022, said the study, conducted to assess SARS-CoV-2 seroprevalence and determinants in children worldwide. 

They searched databases such as PubMed, Embase, Web of Science Core Collection, and Scopus and preprint repositories such as MedRxiv, BioRxiv and SSRN for articles. 

The higher hospitalisation rates of those aged zero to 19 years, referred to as “children” by the study, observed since the emergence of the immune-evasive Omicron variant and sub-variants along with the persisting vaccination disparities, highlighted a need for in-depth knowledge of SARS-CoV-2 sero-epidemiology in children, scientists involved in the study said. 

Pooled seroprevalences were estimated according to World Health Organization (WHO) regions using random-effects meta-analyses, the study said. 

“Findings indicate that, by the end of 2021 and before the Omicron wave, around 50–70 per cent of children globally were still susceptible to SARS-CoV-2 infection, clearly emphasising the need for more effective vaccines and better vaccination coverage among children and adolescents, particularly in developing countries and minority ethnic groups,” it said. 

The study said associations with SARS-CoV-2 seroprevalence and sources of heterogeneity were investigated using sub-group and meta-regression analyses. The protocol used in this study has been registered in PROSPERO (CRD42022350833). 

The study included 247 publications containing 302 datasets involving 7,57,075 children from 70 countries in six WHO-defined regions. Most of the datasets, 144, were from Europe, and the least, 14, were from the Western Pacific region, the study said. 

The rapid transmission of the SARS-CoV-2 Omicron variant has led to unprecedented COVID19 cases and hospitalisation, especially among children. The lower risk of disease in children “pre-Omicron”, combined with concerns about vaccine safety and parental hesitancy, led to limited vaccine uptake and slow implementation of vaccination in children globally, particularly for children under 12 years of age. 

Vaccines for children were also largely inaccessible in many parts of the world that were lagging behind in the vaccination of adults, particularly in low and middle-income countries. To date, children remain the largest unvaccinated group worldwide, the study noted. 

With the emergence of Omicron, an increasing number of children requiring critical care have been observed in developed countries such as the US, England and Germany, with sufficient vaccine supplies, it said. 

There is evidence that available vaccines do not protect children adequately against SARSCoV-2 Omicron infection and the waning of both natural infection and vaccine protection are well documented. 

The scientists said against this background and the race for the development of a new generation of vaccines that protect against a wide range of variants, including new ones, “we aimed to provide estimates for the proportion of children with detectable antibodies and to identify sources of heterogeneity in SARS-CoV-2 seroprevalence in children for various regions of the world”.

https://www.tribuneindia.com/news/health/50-70-pc-of-those-under-19-years-globally-stillsusceptible-to-sars-cov-2-study-466213

Study reveals good fluid intake aids healthier ageing of body

Adults who stay hydrated seem to be fitter and live longer than those who may not get enough fluids.

 Hydration is an essential part of healthy bodily functioning. Fluids make up 1/3rd of the human body and hence, it’s quite important to maintain the fluid intake to keep up a well-functioning and agile body. However, it has recently been revealed that well-hydrated bodies also age healthier than others.

 According to a study published in the journal 'eBioMedicine', which was carried out the National Institutes of Health, adults who stay hydrated seem to be fitter as they develop fewer chronic conditions such as heart and lung disease, and live longer than those who may not get enough fluids. 

Using health data gathered from 11,255 adults over a 30-year period, researchers analyzed links between serum sodium levels - which go up when fluid intake goes down - and various indicators of health. They found that adults with serum sodium levels at the higher end of a normal range were more likely to develop chronic conditions and show signs of advanced biological aging than those with serum sodium levels in the medium ranges. Adults with higher levels were also more likely to die at a younger age. 

"The results suggest that proper hydration may slow down aging and prolong a disease-free life," said Natalia Dmitrieva, Ph.D., a study author and researcher in the Laboratory of Cardiovascular Regenerative Medicine at the National Heart, Lung, and Blood Institute (NHLBI), part of NIH.  

The study expands on research the scientists published in March 2022, which found links between higher ranges of normal serum sodium levels and increased risks for heart failure. Both findings came from the Atherosclerosis Risk in Communities (ARIC) study, which includes sub-studies involving thousands of Black and white adults from throughout the United States. The first ARIC sub-study started in 1987 and has helped researchers better understand risk factors for heart disease, while shaping clinical guidelines for its treatment and prevention. 

For this latest analysis, researchers assessed information study participants shared during five medical visits - the first two when they were in their 50s, and the last when they were between ages 70-90. To allow for a fair comparison between how hydration correlated with health outcomes, researchers excluded adults who had high levels of serum sodium at baseline checkins or with underlying conditions, like obesity, that could affect serum sodium levels. They then evaluated how serum sodium levels correlated with biological aging, which was assessed through 15 health markers. This included factors, such as systolic blood pressure, cholesterol, and blood sugar, which provided insight about how well each person's cardiovascular, respiratory, metabolic, renal, and immune system was functioning. They also adjusted for factors, like age, race, biological sex, smoking status, and hypertension. 

They found that adults with higher levels of normal serum sodium - with normal ranges falling between 135-146 milliequivalents per liter (mEq/L) -- were more likely to show signs of faster biological aging. This was based on indictors like metabolic and cardiovascular health, lung function, and inflammation. For example, adults with serum sodium levels above 142 mEq/L had a 10-15% associated increased odds of being biologically older than their chronological age compared to ranges between 137-142 mEq/L, while levels above 144 mEq/L correlated with a 50% increase. Likewise, levels of 144.5-146 mEq/L were associated with a 21% increased risk of premature death compared to ranges between 137-142 mEq/L. 

Similarly, adults with serum sodium levels above 142 mEq/L had up to a 64% increased associated risk for developing chronic diseases like heart failure, stroke, atrial fibrillation and peripheral artery disease, as well as chronic lung disease, diabetes, and dementia. Conversely, adults with serum sodium levels between 138-140 mEq/L had the lowest risk of developing chronic disease. 

The findings don't prove a causal effect, the researchers noted. Randomized, controlled trials are necessary to determine if optimal hydration can promote healthy aging, prevent disease, and lead to a longer life. However, the associations can still inform clinical practice and guide personal health behavior. 

"People whose serum sodium is 142 mEq/L or higher would benefit from evaluation of their fluid intake," Dmitrieva said. She noted that most people can safely increase their fluid intake to meet recommended levels, which can be done with water as well as other fluids, like juices, or vegetables and fruits with a high water content. The National Academies of Medicine, for example, suggest that most women consume around 6-9 cups (1.5-2.2 liters) of fluids daily and for men, 8-12 cups (2-3 liters). 

Others may need medical guidance due to underlying health conditions. "The goal is to ensure patients are taking in enough fluids, while assessing factors, like medications, that may lead to fluid loss," said Manfred Boehm, M.D., a study author and director of the Laboratory of Cardiovascular Regenerative Medicine. "Doctors may also need to defer to a patient's current treatment plan, such as limiting fluid intake for heart failure."

The authors also cited research that finds about half of people worldwide don't meet recommendations for daily total water intake, which often starts at 6 cups (1.5 liters). 

"On the global level, this can have a big impact," Dmitrieva said. "Decreased body water content is the most common factor that increases serum sodium, which is why the results suggest that staying well hydrated may slow down the aging process and prevent or delay chronic disease.

" This research was supported by the Division of Intramural Research at NHLBI. The ARIC study has been supported by research contracts from NHLBI, NIH, and the Department of Health and Human Services.

https://www.tribuneindia.com/news/health/study-reveals-good-fluid-intake-aids-healthierageing-of-body-466762 

‘Covid-19 virus is getting faster and stronger in its ability to infect. However, it is less severe in its lethality’

RESEARCH ON THE BF.7 VARIANT IS STILL IN THE WORKS. BASED ON PREVIOUS DATA, IT CAN BE ESTIMATED THAT THE EFFICACY OF CURRENT VACCINES AGAINST THE NEW VARIANTS HAS DECLINED IN VARYING DEGREES, SAYS DR RAJESH PAREKH, HON. DIRECTOR, MEDICAL RESEARCH, JASLOK HOSPITAL AND RESEARCH CENTRE, AND AUTHOR OF TWO NATIONAL BESTSELLERS ON COVID-19 AND VACCINATION

India officially recorded 188 new coronavirus cases on Wednesday, December 28, compared to 65 exactly a week ago.

Should we worry about the new surge of Omicron in China and far-eastern and Southeast Asian nations given our geographical proximity? But given that the BF.7 variant has a greater immune escape potential and a shorter incubation period, the Government is in alert mode, preparing healthcare infrastructure and making testing mandatory for all travellers coming from five countries to begin with. Prevention is the best strategy against a rapidly evolving and adaptive virus, says Dr Rajesh Parekh, Hon. Director, Medical Research, Jaslok Hospital and Research Centre, and author of two national bestsellers on COVID-19 and Vaccination. He even recommends a fourth vaccine shot for frontline healthcare workers.

The BF.7 variant has previously been detected in India but did not spread as much. Is it likely to cause a surge?

Indeed. Not a worrisome one, though. India officially recorded 188 new coronavirus cases on Wednesday, December 28, compared to 65 exactly a week ago. A surge is expected in January 2023. The BF.7 variant has the strongest infection ability of all Omicron sub-variants like BA.1 and BA.2.

Its R0 (the rate of infectivity) is estimated to be higher than 10, possibly even R18.6. This, on the lower side of the estimate, translates into one case becoming a billion cases in nine steps. Besides, BF.7 has a higher immune escape capability and a shorter incubation period than all previous variants. Unfortunately, the virus, like many others, has so far always been a step ahead of us. So, we cannot be certain of what it will do next and when. We should always be prepared for a worst case scenario while hoping for the best.

With Omicron variants mostly leading to upper respiratory tract infection, what is the most effective way of maintaining surveillance, given that most people are unlikely to get tested or test using a home kit?

The WHO has provided periodically revised guidelines on ideal surveillance of COVID-19. The purpose of surveillance is to identify changes in epidemiological patterns, trends and to accordingly prepare the healthcare capacity. In their new revision, they have added the importance of genomic surveillance to identify the sub-variants that are in circulation. While it is indeed a challenging task, continuing testing and serosurveys in priority groups are the most effective methods for planning policy. The Tata Institute for Genetics and Society (TIGS), Bengaluru, has been conducting environmental surveillance of COVID-19. It has been collecting wastewater samples from 28 Sewage Treatment Plants (STPs) in Bengaluru since August last year to monitor real-time spread of Covid. Similar testing can be conducted in other areas of India as well.

Is there a need to revert to work-from-home routines and mask mandates to prevent a surge?

Prevention is always a good strategy. Even though India is not seeing a substantial surge at the moment, maintaining social distancing, wearing masks as well as respiratory and hand hygiene measures can go a long way to curtail surges. The Institute for Health Metrics and Evaluation (IHME) estimated that cases are 133 per 100,000 people while the reported cases are 0.74 per 100,000 people. So, there is a substantial gap between reported and estimated cases. Cases can be reduced by half if 80 per cent of the population reverts to wearing masks.

Are the current vaccines effective against BF.7?

Global vaccination campaigns have resulted in considerably improved control of SARS-CoV-2. However, a study in the New England Journal of Medicine on vaccine efficacy against the Omicron B.1.1.529 variant reported ChAdOx1 nCoV-19 (Covishield) did not provide protection after 25 weeks of two doses; the efficacy, however, increased with booster shots. A meta-analysis in the Lancet reported that one month after the primary vaccination (two doses), vaccine effectiveness against severe COVID-19 disease was lower for Omicron compared to other variants. Vaccine effectiveness against Omicron decreased rapidly from one to six months after the primary vaccine series. Research on the BF.7 variant is still in the works. However, based on previous data, it can be estimated that the efficacy of current vaccines against the new variants has declined in varying degrees.

Is there a need for a fourth dose, especially among healthcare workers who are at the frontline?

Yes. A meta-analysis in the Lancet suggested that booster vaccination increased vaccine effectiveness against Omicron-induced severe disease. The immunity built by boosters remained high four months after vaccination.

Does India also need a bivalent vaccine like those that have already been approved outside India?

The new booster is a bivalent vaccine, which means it contains two messenger RNA (mRNA) components of the coronavirus. One half of the vaccine targets the original strain, and the other half targets the BA.4 and BA.5 Omicron sub-variant lineages, which are predicted to continue circulating this fall and winter.

In a preprint published in December 2022 on medRxiv, researchers evaluated the bivalent [encoding spike (S) proteins of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) D614 strain and the Beta variant of concern (VOC)] vaccine efficacy (VE) against the Omicron VOC. India was among the countries the second stage of the study was conducted in. The study found that the bivalent COVID-19 vaccine conferred heterologous immune protection against symptomatic Omicron BA.1 sub-VOC and Omicron BA.2 sub-VOC infections among adult individuals with prior SARS-CoV-2 exposure.

With lakhs of people continuing to get the infection, could a more transmissible or a more virulent variant arise?

It is possible though not probable. There have been four major variants of SARS- CoV -2 and over 50 mutations that have been identified. The virus is rapidly changing and adapting to us. We cannot predict how many variants may emerge and how they may change. The trend so far suggests the virus is getting faster and stronger in its ability to infect. However, it is less severe in its lethality. Vaccination and infection-induced immunity have a major role to play in this as well. We must always keep in mind that the COVID-19 pandemic is NOT over. We need to continue working at the individual and collective levels to emerge triumphant from this monumental disaster.

Why Dr Parekh?

Dr Parekh trained at the K.E.M. Hospital, Mumbai and the Johns Hopkins University School of Medicine, Baltimore. He has over 150 publications in journals such as Lancet, American

Journal of Psychiatry, British Journal of Psychiatry, Archives of General Psychiatry, Archives of Neurology and Stroke and has written 20 book chapters. He has extensive research experience across the world in basic and clinical research, having participated in over 75 research projects. He has been invited to lecture at the Harvard Medical School, the Johns Hopkins University School of Medicine, and the Institute for Research in Neuroscience and Neuropsychiatry in France.

https://indianexpress.com/article/lifestyle/health-specials/covid-19-virus-is-getting-faster-and-stronger-in-its-ability-to-infect-however-it-is-less-severe-in-its-lethality-dr-rajesh-parekh-8351885/