Health

why-ageing-jumps-at-44-and-60-and-what-you-can-do

Sat May 02 15:45:53 IST 2026

cervical-cancer-prevention-hpv-vaccination-screening

Sat May 02 15:41:01 IST 2026

virtual-patients-real-results-how-digital-twins-are-reshaping-medicine

Sat May 02 15:36:04 IST 2026

the-unseen-battles-a-surgeons-reflection-on-emotional-aftermath-of-cancer-surgery

Mon May 04 16:57:13 IST 2026

high-five-with-anju-bobby-george-i-always-have-a-plan-a-b-and-c

Sat May 02 15:27:46 IST 2026

beyond-hot-flashes-why-menopause-demands-a-neurological-focus

Mon May 04 13:05:34 IST 2026

when-your-baby-falls-understanding-tumbles-and-infant-safety

Sat May 02 15:01:52 IST 2026

from-pharmd-student-to-innovator-surya-maguluris-journey-with-litemeds-curapod

Sat Mar 28 19:13:35 IST 2026

Back when he was a doctor of pharmacy (PharmD) student, Surya Maguluri spent long hours poring over case sheets and counselling patients. Years later, that deep clinical exposure would spark an idea about using light as medicine.

As so was born Curapod, a wearable light-therapy device developed by Litemed, the startup Maguluri co-founded with Sri Velliyur. Built on photobiomodulation (a form of light therapy), the device, launched in 2023, challenges conventional approaches to pain management.

“When I started in 2008, the course (PharmD) had just been introduced in India,” he says. “There were no clear career pathways.” That uncertainty pushed him to look beyond textbooks—he would attend conferences, network with industry experts and try to understand where health care innovation was headed.

A recurring piece of advice stayed with him: find a problem and solve it.

His first attempt was not in medicine, but in tackling air pollution. He built early prototypes, including an “Ambient Air Pollution Curtailer” and a bike-based device called “Pollution Zero”. But real-world testing exposed fundamental flaws. A filter attached to a vehicle’s silencer, for instance, restricted exhaust flow and affected engine performance.

The failure forced him to rethink the very nature of solutions. “That’s when I started thinking about ‘formless’ approaches—solutions that don’t physically obstruct systems,” he says. Chemical interventions were explored and discarded. Eventually, he turned to light. “I realised that light could influence biological processes. That’s when the idea clicked—light could be used as a form of medicine,” he says.

This led him to photobiomodulation, a technology with an existing body of research but limited consumer applications. At its core, the science is straightforward: when cells are stressed—due to injury, inflammation or chronic conditions—their energy production drops, triggering pain pathways. Light, when applied at specific wavelengths, stimulates mitochondrial activity, restoring cellular respiration and ATP (Adenosine Triphosphate, the primary energy-carrying molecule) production. The result is reduced pain and improved healing.

But translating this science into a usable product posed challenges. Photobiomodulation devices typically struggle with three factors: penetration depth, coverage area and personalised dosing. Lasers penetrate deeply but cover limited areas, while LEDs offer broader coverage but typically lack depth.

Litemed’s solution, says Maguluri, lies in a proprietary approach called “constructive superimposition”, which enables deeper penetration while maintaining wider coverage.

If the science was complex, manufacturing was even more so. Moving from small batches to mass production required redesigning processes, strengthening supply chains and implementing rigorous quality controls. Shrinking the technology into a compact, wearable device without compromising performance added another layer of difficulty.

The company claims to have more than 25,000 daily users of the product—priced at 8,399—which targets over 30 musculoskeletal conditions.

The company now has a multidisciplinary team—engineers on the product side and clinicians who feed real-world insights into development. This feedback loop, says Maguluri, is critical to refining both the technology and its applications.

Looking ahead, Litemed is working on what it calls an adaptive pain management system, in which the device can personalise treatment based on factors such as body metrics and user feedback. The company is also preparing to enter global markets, and is confident of taking this Indian solution to the world.

high-five-with-jerry-pinto-balancing-diet-exercise-and-passion

Sat Mar 28 18:36:04 IST 2026

with Jerry Pinto, author and poet

1. What do you eat in a day?

I try to be as sensible as possible, so a lot of fruit and vegetables, but a lot of meat and fish as well. I try to keep my carbohydrate intake low, but I love rice and wheat, too, and in the worst possible forms, like white polished rice and maida. So I eat a lot of them, but I try to be as sensible as possible.

2. How do you stay fit?

I have a yoga routine. I do the Tibetan rites. I do some walking and I go to the gym and maybe four times a week I do some light weight training to keep my bone density up.

3. What do you do in your me-time?

My me-time is my work time. I discovered that I love writing. I love translating. I love poetry. I love all the things that I do. So, if I have free time, I do my work.

Other than that, there is a wonderful channel called Mubi. And I watch strange films from all across the world… that would never get commercial release. It is like having a film festival at your fingertips.

4. One unhealthy thing that you will never be caught doing?

I would never be caught doing drugs because I like being in control of my mind. I have no judgement against people who smoke weed or anything like that. But I don't like being out of control. I like what my mind is like right now. So, I am happy.

5. One mantra you swear by?

Lots of sleep. Lots of fruit. Lots of work that you love. Lots of love. If you have all four of those, you are fine.

when-we-support-mothers-we-support-generations-eamon-mccrory

Sat Mar 28 18:31:56 IST 2026

Interview/ Eamon McCrory, CEO of Anna Freud (a mental health charity), and professor of developmental neuroscience and psychopathology, University College London

For generations, trauma has often been understood as a single event, an incident that begins and ends in one lifetime. But as per neuroscientist Eamon McCrory, research in neuroscience, psychology and perinatal mental health shows that early adversity can recalibrate the body’s stress systems, shape attachment patterns and influence how safety, trust and intimacy are experienced well into adulthood.

Speaking on the sidelines of the Mpowering Minds Summit, held in Bengaluru, he threw light on how closely personal histories and caregiving are intertwined. In a conversation with THE WEEK, he explores how trauma echoes across generations, how resilience is built and what it truly takes to support new mothers, not just for their wellbeing, but for the generations that follow. Excerpts:

Q/ How does childhood trauma shape women’s mental health later in life? In what ways can these effects quietly pass from one generation to the next?

Childhood trauma can shape how a woman experiences safety, trust and connection across her entire life. Early adversity can recalibrate stress systems in the brain, making someone more sensitive to threat, more vigilant in relationships or more prone to withdrawal. These adaptations often make sense in the original environment, but later they can increase vulnerability to anxiety, depression or relational conflict.

The transmission across generations is often quiet. It happens through patterns, through how distress is responded to, through whether emotions are spoken about or silenced, and through hypervigilance that becomes the emotional climate of a home. Children do not only inherit stories. They inherit nervous systems shaped inside relationships. That is how trauma can echo forward without being consciously passed on.

Q/ What do we now understand about the biological and emotional pathways through which trauma is transmitted across generations, especially from mothers to daughters?

We now understand that there are overlapping pathways. Biologically, chronic stress can shape how the brain processes threat and reward. During pregnancy, maternal stress physiology can influence foetal development. There is emerging research into epigenetic mechanisms, but the evidence in humans remains complex and not deterministic.

Emotionally and relationally, attachment is central. A mother who carries unresolved trauma may find certain moments in caregiving more overwhelming, not because she does not love her child, but because her own stress system is activated. That can shape patterns of responsiveness. The good news is that these pathways are not fixed. When mothers are supported to reflect on their own histories and feel safe themselves, transmission patterns can change.

Q/ How early should we intervene to break intergenerational cycles of trauma? What forms of early support are most effective for mothers and babies?

The earlier the better. Pregnancy and the first years of life are periods of enormous brain plasticity. They are also moments when old wounds can resurface.

The most effective early supports are relational—perinatal mental health services, home visiting programmes, parent-infant psychotherapy and peer support groups, practical support that reduces isolation. What matters most is not a single technique, but whether a mother feels safe, seen and supported. When caregivers are regulated, babies benefit. Breaking cycles is not about perfect parenting; it is about consistent repair and support at the right time.

Q/ How does a mother’s mental health during pregnancy and postpartum period influence her child’s emotional development, even when the child hasn’t experienced adversity directly?

During pregnancy, maternal stress hormones cross the placenta and can influence foetal stress regulation systems. After birth, infants depend entirely on caregivers to help regulate their emotions.

If a mother is experiencing depression, anxiety or unresolved trauma, it can make responsiveness more difficult. Babies are exquisitely sensitive to emotional tone. Over time, repeated patterns of interaction shape how a child comes to experience the world: as safe or unpredictable, soothing or overwhelming.

Importantly, this is not about blame. Maternal distress is often the result of structural pressures and lack of support. When mothers receive help, children’s outcomes improve.

Q/ Culturally, mothers are often expected to be endlessly strong. How do these expectations shape women’s vulnerability to stress and trauma across generations?

The expectation of endless strength can become a burden. When vulnerability is equated with weakness, women may hide distress, delay seeking help and carry chronic stress silently.

That silence has consequences. Chronic stress affects sleep, mood, immune function and emotional availability. When a mother feels she must be invulnerable, she may have fewer opportunities for repair and reflection. Over time, daughters may internalise the same message: endure, do not disclose. That is one way cultural narratives can quietly reinforce intergenerational patterns.

Q/ What role does chronic stress—the daily, invisible kind many women carry—play in heightening trauma sensitivity in both mothers and their children?

Chronic stress is often underestimated because it lacks a dramatic event. But daily overload, caregiving strain, financial pressure and emotional labour can keep the stress system activated.

When stress is persistent, the brain can become more threat-sensitive and less reward-responsive. That affects patience, sleep, mood and relationships. Children living in that environment absorb the tone. Chronic stress does not need to be extreme to shape development. It is the accumulation that matters.

Q/ You have spoken about how love and mental illness can coexist. How can unresolved trauma affect bonding? What long-term patterns might we see in daughters when this isn’t addressed?

Love and trauma can absolutely coexist. A mother can love deeply and still struggle to regulate her own emotional responses.

Unresolved trauma may make certain infant cues feel overwhelming. It can reduce a parent’s capacity to mentalise under stress, to interpret a child’s distress accurately and respond calmly. When this happens repeatedly without repair, daughters may grow up feeling uncertain about safety in relationships.

In adulthood, that can show up as fear of abandonment, mistrust or difficulty sustaining intimacy. Again, these are patterns, not destinies. When addressed, they can shift.

Q/ In societies where maternal distress is often hidden or stigmatised, how does silence itself become a carrier of trauma from one generation to another?

Silence teaches. When distress cannot be named, children still sense it. They notice tension, mood shifts, unspoken grief. Without explanation, children often assume responsibility or develop their own narratives.

Silence can also prevent help seeking. If trauma is hidden, support is delayed. Over time, the absence of language becomes part of the inheritance. Breaking silence in safe ways can interrupt that transmission.

Q/ From your research on brain development, how might emotional inheritance shape a daughter’s ability to form secure relationships or build resilience in adulthood?

Early relational environments shape neural systems involved in threat detection, reward processing and social understanding.

If a child grows up in an environment marked by unpredictability or emotional volatility, the brain may adapt toward vigilance. That can make adult relationships feel risky.

But resilience is also relational. One stable, supportive relationship can recalibrate expectations. Protective experiences accumulate. Emotional inheritance shapes vulnerability, but relational experiences shape recovery.

Q/ If we want to truly disrupt intergenerational trauma, what structural changes—in health care, community support, and public awareness—are most urgently needed to support maternal mental health?

We need to move beyond crisis response toward prevention and relational investment. That includes universal perinatal mental health screening, accessible trauma-informed care, community-based peer support and workplace policies that recognise caregiving demands.

We also need public narratives that reduce stigma and normalise help seeking. Maternal mental health is not a private issue. It is a public health and societal issue. When we support mothers, we support generations.

proactive-ipv-detection-how-ai-is-changing-health-care-interventions

Sun Mar 29 10:13:31 IST 2026

Intimate partner violence (IPV)—abuse or aggression in a romantic relationship—is a significant yet under-discussed public health issue worldwide. The term ‘intimate partner’ includes both current and former spouses as well as dating partners. IPV can range from a single episode of violence to chronic and severe abuse that lasts over several years. It includes physical violence, sexual violence, stalking, and psychological aggression intended to harm a partner mentally or emotionally or to exert control over them.

Intimate partner violence often lead to injuries and can even be fatal. In India, IPV remains widely under-reported. Nevertheless, data from the National Family Health Survey-5 indicates that one in three married women aged 18–49 has experienced spousal violence at least once. Reports from around the world suggest that a significant share of homicide victims are killed by an intimate partner.

A team of researchers supported by the National Institutes of Health in the US has developed an AI tool that provides decision support to clinicians by predicting whether patients are at risk of IPV. Using data routinely collected during medical visits, the team trained a machine-learning model that showed high accuracy in detecting IPV among patients in a study.

As part of the study, a research team led by Harvard Medical School developed three AI models for IPV detection in health care settings and compared how well they predict risk. The study notes that many IPV cases go unnoticed, limiting chances for early intervention. Existing screening tools capture only a small share of cases, while clinical records and imaging data offer important clues. The AI works by identifying factors such as the location of injuries and signs of older trauma, and then assessing whether a patient has a high or a low risk of IPV. Radiologists, in particular, are often better at spotting patterns of injury linked to IPV.

An Indian-origin emergency radiologist, Bharti Khurana, is the senior author of this NIH-supported study. Khurana, who was born and raised in New Delhi, began working on IPV about a decade ago, initially aiming to publish a single paper exploring whether radiological scans could help diagnose IPV and raise awareness among radiologists.

As part of the study, researchers analysed several years of hospital data from about 850 affected women and 5,200 matched controls. They built two separate models—one using structured data (such as tables) and another using unstructured data from medical notes, including radiology reports. They also created a third, multimodal model that combines both data types.

All three models performed well, but the multimodal model was the most accurate, correctly identifying IPV risk 88 per cent of the time. Both the tabular and multimodal models could flag risk more than three years before patients entered hospital-based intervention programmes. While the tabular model detected risk slightly earlier, the multimodal model identified more cases overall.

According to the researchers, this AI approach aims to shift IPV detection from reactive disclosure to proactive risk recognition within routine clinical care. By analysing patterns already present in health care data, it can help clinicians initiate earlier, safer, and more informed conversations with patients.

The research team now plans to develop a decision-support tool based on these AI models, which can be integrated into electronic medical record systems to provide real-time IPV risk assessments in clinical settings.

the-humbling-truths-of-medical-internship

Sat Mar 28 18:21:29 IST 2026

Senior consultant, head and neck surgical oncology, Aster Medcity, Kochi. He is also director, Aster Head & Neck Oncology Network (Kerala cluster)

Internship humbles you.

No matter how many textbooks you have memorised, the first weeks of house surgency make one truth painfully clear: you know very little.

Suddenly, you are the junior-most person in the hospital hierarchy. Even the nurses, especially the nurses, often know more than you in practical matters. They move through procedures with an ease you are still trying to learn step by step. Postgraduates juggle admissions, emergencies, ward rounds and surgeries with a calm efficiency that feels unreachable.

Professors, once only lecturers, now appear as clinicians of another order altogether. In medical college, they were teachers. In internship, they become doctors. That distinction matters. They don’t just teach medicine anymore. They deliver it.

The postgraduates become our immediate heroes. We assist them, learn from them, try to make ourselves useful. They carry crushing workloads, and they quickly learn who they can depend on. Favourites emerge, not out of sentiment, but necessity.

For interns, the realisation comes in layers. First, how little you know. Then, the unsettling question: will I ever reach there?

You look around and see brilliance, reputation, confidence. Some people seem destined to become stars. Some quietly do their work. Some never quite find their footing. And somewhere in that landscape, you begin to wonder where you will land.

I decided early not to chase outcomes. I focused instead on the patient in front of me. Drawing blood. Inserting cannulas. Writing investigations. Giving medicines. Small tasks. But each carried its own complexity.

Finding a vein is not just technical, it is human. Thin veins. Deep veins. Anxious patients. Crying children. The art of reassurance. The patience of second attempts. The humility to ask for help. The responsibility of making someone feel safe while you are still learning yourself.

To many, these were routine. To me, they were fascinating. Each vein felt like a small challenge. Each successful cannulation, a quiet victory. Despite the exhausting hours, I genuinely enjoyed internship.

We were also lucky. Our batch had stayed together since MBBS, grouped by something as arbitrary as alphabetical roll numbers. Anatomy cadaver tables had turned into ward teams. Familiar faces became anchors in unfamiliar territory. We were not just classmates anymore. We were comrades.

But while the hospital was teaching me medicine, life was teaching me fragility. My niece was seriously ill. Phone calls came between ward rounds—about investigations, admissions, costs, uncertainty. My father had health issues. During internship, he passed away.

There was no dramatic pause in hospital schedules for personal grief. You finished your duties. You wrote your notes. You went back to the wards. Between inserting cannulas and clerking patients, I was learning what it meant to carry sorrow quietly.

At the same time, another uncertainty hovered over me: my future. Many of my colleagues were clear. “I want to be a physician,” said one. “I want to be a surgeon,” said another. Some had already chosen cardiology. Some orthopaedics. Some neurosurgery. They spoke about careers with confidence. I couldn’t.

I loved medicine—the logic, the detective work, the way diagnosis emerged from careful listening and observation. I loved surgery—the action, the decisiveness, the privilege of physically correcting what was wrong. I wanted to be both. But medicine doesn’t allow that luxury.

People had opinions. About degrees. About entrances. About which paths were “useful”. I was told more than once that an MBBS alone meant little, that specialisation was everything. I listened, nodded, and went back to work. I didn’t have the emotional space to absorb advice. I was too busy becoming.

One day, a fellow intern needed blood investigations—recently married, likely pregnancy-related. She also needed an IV cannula. Her veins were faint and fragile, and despite being a doctor herself, she was quietly afraid of how much it might hurt.

Naturally, everyone suggested anaesthesia residents. Some suggested senior nurses experienced in cannulation. That was the standard route. She listened quietly and said, simply, “No.” Then, in front of everyone, she said, “Shawn will do it.”

I was taken aback. I wasn’t an expert. I was still learning. And here she was, choosing me over seasoned anaesthesia residents. It was a small moment. But it mattered.

I examined her veins. Not easy. My first attempt failed. I punctured the vein. I paused. Adjusted. Tried again. The second time, the cannula slid in smoothly. She didn’t flinch. Later, laughing with friends, she said, “It was hard to see. But it was the right decision. Even Shawn punctured.”

Everyone laughed. So did I. But inside, something shifted. She probably forgot that moment soon after. I didn’t. Because at a time when my father was gone, my future uncertain, and my confidence fragile, someone had trusted my hands.

Medicine will give you critics. Life will give you competition. People will question you, compare you, test you. That seems inevitable. But once in a while, someone does the opposite. They lift you. Often without realising it.

That day, she gave me more than procedural practice. She gave me belief. And I learned something important: we grow not just through mentors. Sometimes, we grow through peers. Through shared exhaustion. Through quiet faith. Through colleagues who say your name when easier options exist.

I learned early that courage doesn’t arrive suddenly in operating theatres. It begins quietly, sometimes with a cannula in a crowded ward.

co-sleeping-dangers-why-doctors-advise-room-sharing-for-your-baby-safety

Sat Mar 28 18:14:24 IST 2026

It was a standard 2am wake-up call. I blinked and squinted at the clock, as I began the instinctive mid-sleep search for the warm, swaddled bundle that was supposed to be tucked safely beside me.

My hand hit empty sheets.

Panic struck! I sat bolt upright, only to find her at the other end of the bed. It was a relatively large bed—about six feet wide—and luckily, it was pushed against the wall. She was only about three months old then, and I never imagined a human that small was capable of inchworming her way across the bed as if in a cross-country race.

Sleep was her absolute priority from day one. I would often pause and stay still for hours after she finally drifted off, terrified that even a twitch would ruin the hard-won silence. I am sure mothers everywhere curse the noise that leaves their little ones' sleep ruined. Don’t even get me started on the aunties who would just turn up to wake them up—“She has been sleeping for too long, hasn't she? It is okay to wake her now.” Uff!

As is the way in our families, I was looking forward to the snuggles and the ‘emotional bond’ of having her sleep next to me, but she had other plans. My ‘Lady Gaga’ was never one for snuggle sleeping; she wants her space, and more often than not, she can be seen curled up in a corner of the bed, far from my skin. Seeing this girl care less about my snuggles than Beth Dutton (Yellowstone series) walking into a boardroom she is about to set on fire has kept me up many nights.

But then, is contact sleeping the benchmark for bonding with your child? If you think that sleeping next to your child is the popular, and therefore correct, method, doctors may have some news for you.

Co-sleeping, the kind where the mother sleeps next to the baby on the same bed, is not recommended by doctors. It carries many risks, including Sudden Infant Death Syndrome (SIDS). Room sharing is the recommended alternative, where the baby sleeps separately in a crib or bassinet in the same room as the mother.

“Evidence has shown that co-sleeping increases the risk of SIDS,” said Dr Geeta Gathwala, head, paediatrics and neonatology, Amrita Hospital, Faridabad. “So, if the mother is co-sleeping with the baby, especially in situations where the baby is a pre-term or born with low birth weight, the risks of SIDS are higher.” She added it is a risky time for babies till they are four to six months old.

Though room sharing is commonly seen as a western practice, doctors point out that the recommendations are backed by evidence and it applies to India as well.

The Indian Academy of Pediatrics and the American Academy of Pediatrics recommend room sharing. Though SIDS cases are rare in India compared to the west, cases do emerge.

Gathwala recalls a case around 11 years ago, when a newborn, sleeping next to the mother in bed, was found dead.

“The initial days after birth, mothers would be extremely tired and in deep sleep,” explained Dr Rojo Joy, head of neonatology, Lourdes Hospital, Kochi. “Any mishap can happen. Maybe a hand coming on top of the baby can lead to smothering and hamper the baby’s breathing.”

Then, there is the question of emotional bonding. Should you worry that your baby may not bond with you if she sleeps at a distance? Not really. Bonding occurs during breastfeeding and physical contact when both the mother and the baby are awake and alert. “The baby can be kept close when they are awake. During sleep, as per recommendations, it is better to practise rooming in, not bedding in,” added Joy.

Seven months ago, Joy recalls a case where a two-and-a-half-month-old baby was brought dead to the hospital. That morning, the mother, on waking up, found the baby lying next to her unresponsive. No one knows what happened during the night.

Doctors advise that pillows, soft bedding and unnecessary clothes around the baby on the bed can also increase the risk of SIDS. There is also the risk of babies falling down from the bed.

“Parents should ensure that their baby always sleeps on its back and not tummy,” said Gathwala.

Ultimately, every baby is different, and a mother is usually best equipped to make the final call. Still, it is a lot to ask of a mother to navigate these high-stakes choices when she is already depleted and vulnerable. Sometimes, the bravest thing we can do is follow the safety guidelines even when our hearts—and our traditions—are pulling us toward the snuggle.

surviving-dengue-a-survivors-account-of-recovery-and-resilience

Sat Feb 21 17:04:55 IST 2026

Life can change its course like a ship in the blink of an eye with hard starboard or hard port. I had always prided myself on leading a disciplined lifestyle, with two hours of daily exercise, a balanced diet and a belief that these would be enough to keep a 58-year-old biological body shipshape, ready to weather any storm. Little did I imagine that I would one day drop anchor in a hospital bed.

Alas! I was caught in a perfect Tropical Revolving Storm named Dengue. When I was admitted to the Command Hospital, I found myself in a place that ran like a taut ship—professional, compassionate and precise. The doctors and staff worked in seamless coordination, navigating patients through their darkest hours with calm assurance.

Yet, despite the hospital’s efficiency, my mind was anything but calm. As I lay in that bed—my body drained of strength, my thoughts adrift—I realised how fragile even the most well-maintained vessel can be when one small standard operating procedure fails. I had been meticulous in taking preventive measures against dengue season. But somewhere, somehow, a single lapse allowed the enemy to board my ship.

A hospital bed is a curious place for introspection. Like a ship anchored in turbulent sea, it rocks gently between wakefulness and sleep, between memories and the starkness of reality. Time slows down. Hours become days. Hunger fades. Sleep eludes. You find yourself yearning for the mundane—a simple walk, a hearty meal or just a peaceful night's sleep.

Dengue, often called haddi tod bukhar in Hindi (bone-breaking fever) is caused by a virus transmitted through the bite of infected mosquitoes. It brings with it high fever, unbearable pain in the joints, back and legs, and a deep sense of fatigue that drains both body and spirit. While many recover within a few days, severe dengue can quickly become a medical emergency.

On the fifth day of fever, I found myself in such a crisis. My face was drained of colour, gums had started bleeding, red spots appeared on my legs and my platelet count had plummeted to 13,000—dangerously low. I was like a ship battered in a tempest, struggling to stay afloat. It was then that my wife forced me to get admitted in hospital.

When my platelet count continued to fall, the doctors decided to transfuse platelets. I learned then that these vital components of blood have an incredibly short lifespan—barely seven to nine days—and are constantly replenished by the bone marrow. In other words, my own body had to start producing enough platelets to save itself. It was a battle that no medicine could fight for me—my body had to take command once again. And, slowly, it did. Day by day in the hospital, the tide began to turn. My platelet count started an upward journey, my strength began to return slowly and I could finally sense the storm easing. I was allowed to leave the hospital with strict instructions to take rest, replenish and stay hydrated for the next 10 to 15 days. Recovery, like sailing after a storm, brings a new perspective.

As I lay in that hospital bed, grateful for the doctors, nurses, and the quiet resilience of the human body, I realised how fragile and precious health truly is. No matter how disciplined we are, life always finds a way to remind us of our vulnerability. But it also reminds us of our strength—the power to endure, heal and to rise again. The ship that weathered the TRS Dengue now sails again—humbled, wiser and more grateful than ever.

The writer is commander, Coast Guard Region (northeast).

how-ayurveda-supports-bodys-defences-against-neurodegeneration

Sat Feb 21 17:00:27 IST 2026

India is witnessing a silent neurological shift—a stroke every three minutes, a doubling of Parkinson’s cases, and dementia in the 40s and 50s. These numbers point to a deeper truth. Brain health cannot rely solely on emergency interventions or imaging; it demands metabolic stability, daily rhythm, digestive governance and personalised prevention. Ayurveda brings this perspective through agni (innate metabolism), ama (inflammation) and swasthya (good health). It has consistently supported better vitality and functional gains in stroke rehabilitation while helping slow down the trajectory of Parkinson’s and dementia by aligning diet, lifestyle and individualised treatment.

Erratic lifestyle—including irregular meals, late nights, processed snacking and continuous cognitive load—weakens agni. When agni diminishes, ama forms. This metabolic residue silently blocks microchannels, influencing mood, clarity, memory and sleep. Strengthening agni therefore becomes essential for neuroprotection. Efficient digestion ensures proper nutrient assimilation, stable hormones and balanced immunity. Ayurveda positions these functions as prerequisites for long-term neurological health.

How ayurveda can help in promotive, preventive and adjuvant care in these conditions.

Stroke: Act fast with FAST and support with ayurveda

A stroke hits because blood flow to a part of the brain is interrupted. In the beginning, patients may notice abrupt weakness on one side of the body, imbalance, blurred vision, difficulty in speaking, or a sudden inability to understand simple sentences. These early changes occur because the affected brain cells lose oxygen within minutes, disrupting movement, speech and coordination almost instantly. This is why recognising a stroke quickly is critical.

The FAST signals:

1. Face drooping: A smile appears flat on one side

2. Arm weakness: Arms drift downward when raised.

3. Speech difficulty: Slurred or confused words.

4. Time: Rush to hospital, as every minute saves brain cells.

After the emergency treatment, ayurveda can play a crucial role in strengthening the body’s resilience through everyday habits. Warm, timely, easy-to-digest meals support agni, while avoiding late-night eating and processed-heavy combinations can prevent ama formation. Keeping blood pressure, blood sugar and inflammatory markers stable through routine and moderation further protects vascular health. Light daily movement and mindful breathing reduce sympathetic overload, and tracking swasthya indicators like digestion, sleep and mood helps in catching early deviations. All these behaviours build a stronger baseline and support smoother recovery without disrupting ongoing medical care. These micro-habits won’t replace emergency care, but they strengthen your brain’s defences and support recovery.

Parkinson’s and dementia: The slow rise with co-morbid drivers

Compared with many other conditions that are highly symptomatic, Parkinson’s and dementia do not announce themselves loudly. They surface gradually through subtle tremors, the slowing of daily movements, shrinking recall, disturbed sleep, irritability, difficulty with multitasking and changes in digestion. These conditions rarely act alone; they unfold faster when supported by metabolic and lifestyle co-morbidities. For example, diabetes and insulin resistance impair cellular fuel supply, hypertension reduces cerebral blood flow, and anxiety or depression shifts neurochemical balance. Sleep disruption, alcohol and nicotine load, sleep apnoea and chronic inflammation further strain neuronal systems. Gut dysbiosis (an imbalance in the gut microbiota like bacteria, fungi and viruses) alters the signalling between the gut and the brain, adding another layer of vulnerability. Ayurveda reads these disturbances as systemic shifts that require whole-person correction, not isolated symptom management.

A real-life illustration of when life moves faster than health

Let’s step into a moment many of you may recognise. After four hours of fragmented sleep following a late call, an early flight awaits. Your mind is already scattered across tasks, while hypertension, borderline diabetes and low-grade inflammation simmer in the background. Breakfast is skipped, caffeine becomes the first intake of the day and screens dominate the time before boarding.

Ayurveda instantly reads this situation not as carelessness, but as a predictable point where agni falters, ama accumulates, and the mind slips into a rajasic, hyper-reactive state. Even here, ayurveda offers stability. Having something warm and a light meal before travel prevents the metabolic dip. Avoiding caffeine on an empty stomach calms the system and sipping warm water through the journey reduces ama build-up. A short breathing pause before boarding drops sympathetic overdrive, and postponing high-stakes decisions prevents errors born of fatigue. Reducing sensory noise from screens stabilises attention. These adjustments protect the physiology in environments where disease often begins. These are not elaborate rituals. They are micro-decisions, your way of staying centred amid unpredictability.

The foundation for neuroprotection

1. Daily digestion-first living: A neuroprotective lifestyle begins with simple metabolic discipline, like avoiding incompatible combinations such as milk with fish or fruit-heavy smoothies as they prevent metabolic overload. Eating warm, freshly prepared meals at consistent times stabilises digestion. Keeping dinner light and having it early supports natural detox cycles, while leaving adequate gaps between meals helps the body reset. Regular observation of bowel patterns reinforces gut health, and sleeping by 10pm aligns the body with natural hormonal rhythms. Small practices such as intentional breathing, reducing screen overload, and short post-meal walks help regulate glucose and calm the nervous system. Ayurveda also encourages exercising within capacity, roughly half of one’s strength, to avoid fatigue that weakens agni. These choices collectively prevent ama accumulation and maintain metabolic clarity.

2. Ingredients to include in your diet: It is important to nurture the body with ojas (innate immunity) through nourishing and vata-balancing foods. Kushmanda, brahmi, ksheer, sarpi and shankapushpi, along with fruits like avocado, pomegranate, banana and vegetables like ash gourd, beetroot, carrots, sweet potato, spinach and drumstick collectively support long-term cognitive resilience.

3. Swasthya checklist: A brief self-check each morning helps detect early imbalances. A steady appetite, comfortable elimination, a sense of physical lightness, mental clarity, restful sleep, emotional stability, absence of bloating and natural energy indicate balanced physiology. Any variation in these patterns is an early sign of agni disturbance and rising ama. Addressing it promptly prevents deeper disruptions.

The takeaway

Stroke, Parkinson’s and dementia demand precision diagnostics and systemic correction. Modern medicine promotes acute management, monitoring and pharmacological support. Ayurveda strengthens the terrain by restoring metabolic balance, aligning circadian rhythms and personalising diet and lifestyle to support long-term neurological function.

This dual approach creates a pragmatic path where emergency medicine offers rapid intervention and disease control, while ayurveda ensures that the underlying physiology remains stable enough to support recovery, prevent progression and sustain cognitive vitality.

The writer is chief medical officer, Apollo AyurVAID Hospitals

magictouch-how-an-indigenous-innovation-is-redefining-heart-care

Wed Mar 18 17:40:16 IST 2026

A stable job is every middle class family’s dream. So when Manish Doshi, born into one such family, decided to quit a campus placement job in the late 1980s, it left his parents and siblings anxious and disappointed. India was yet to open up its economy, and walking away from a stable job was widely seen as reckless. Doshi, however, was determined to break free from that mindset, trusting his intuition and inventive spirit to chart his entrepreneurial path. A textile engineering graduate, he began his journey in chemical trading. Over the next three decades, he would evolve into a visionary medtech entrepreneur, building innovative, life-saving medical technologies in India for the global market.

It was in the late 2000s that Doshi began pursuing the challenge of developing a drug-coated balloon that used sirolimus, an immunosuppresant that also prevents abnormal cell growth.

The need was undeniable. Heart disease remains one of the world’s leading killers, driven largely by coronary artery disease, in which fatty deposits narrow or block blood vessels supplying the heart. While stents and conventional drug-coated balloons have transformed care, they are not without limitations. Metal stents permanently cage the artery, impairing its natural movement and sometimes triggering late complications such as restenosis (re-narrowing of the blood vessel) or thrombosis (clotting). Earlier drug-coated balloons, largely reliant on paclitaxel, act quickly but lack sustained biological effect. These shortcomings are particularly acute in small vessels, complex lesions, bifurcations and in-stent restenosis—precisely the cases where physicians need better, implant-free solutions.

It was this unmet clinical gap that led Doshi to found Concept Medical and develop MagicTouch, the world’s first sirolimus-coated balloon. The philosophy behind the technology marked a fundamental shift: treat the disease inside the artery without leaving anything behind. Instead of relying on a permanent scaffold or a short-acting drug burst, MagicTouch aimed to trigger biological healing of the vessel itself—allowing the artery to recover its natural function once the therapy was delivered.

At the core of MagicTouch is nanolute technology, a proprietary drug-delivery platform designed to overcome sirolimus’s known challenges. Sirolimus, long considered the gold standard in interventional cardiology, offers controlled inhibition of abnormal cell growth, reduced inflammation and support for natural healing. “However, sirolimus is unstable and poorly lipophilic (washes out quickly), making it hard to deliver. Even today, among 20–30 drug-coated balloons globally, only two use sirolimus,” notes Doshi. “We reduced the drug particle size from about 90 microns to 0.35 microns, studied arterial tissue porosity and delivered the drug deep into the vessel wall, where it acts as a reservoir. We also developed an excipient that improves drug binding and bioavailability.” With this engineered solution, the artery itself becomes a drug reservoir, enabling sustained release long after the balloon is removed.

“By 2009, we had completed our first animal studies for what later became MagicTouch. Between 2008 and 2009, I filed patents aggressively to avoid repeating past mistakes. Today, 132 patents are granted globally, giving us full freedom to operate,” says Doshi.

Today, Concept Medical’s drug-coated stents and related drug-delivery technologies are commercially available and used in over 80 countries. “Our innovation earned major milestones: Concept Medical became the first Indian medical device company to receive five Investigational Device Exemption (IDE) approvals—required for pivotal clinical trials—from the US FDA. Clinical trials are currently ongoing in the US. MagicTouch’s commercial entry in Japan is expected this year, and the US commercial launch is projected for 2028,” says Doshi.

Doshi asserts that in percutaneous coronary intervention (PCI)—the procedure used to restore blood flow to the heart without open-heart surgery—drug-coated balloons represent the future. “In India, 90 per cent of PCI procedures still use stents,” he says. “In Europe, nearly 30 per cent have already shifted to balloons. Market studies suggest that by 2034, 70–80 per cent of PCI procedures will be implant-free.”

Doshi himself underwent a stent-free angioplasty using MagicTouch four years ago. “MagicTouch already addresses most coronary problems,” he says, adding that Concept Medical is expanding its application into other critical areas, including below-the-knee vascular disease, erectile dysfunction, carotid artery disease, ischemic stroke and urethral strictures.

us-withdrawal-from-who-an-opportunity-for-india-to-take-leadership-in-global-health-lawrence-gostin

Sat Feb 21 16:06:37 IST 2026

Interview/ Lawrence Gostin, director, World Health Organization Collaborating Center on Public Health Law & Human Rights at Georgetown University

With the United States officially leaving the World Health Organization, concerns are mounting over what this could mean for global health cooperation, and for countries like India that rely on WHO for disease surveillance, technical guidance and emergency coordination.

The US has historically been one of WHO’s largest funders and most influential political actors, and its exit comes at a time when the world remains vulnerable to pandemics and emerging infections.

Lawrence Gostin, director, World Health Organization Collaborating Center on Public Health Law & Human Rights at Georgetown University, tells THE WEEK how the US withdrawal weakens WHO’s capacities, why densely populated countries such as India should be concerned, and why this moment could also open the door for India to step into a larger leadership role in global health.

Does the US withdrawal weaken WHO’s authority, or primarily its financial and political leverage?

The US withdrawal primarily weakens WHO’s financial position. Stopping US funding has resulted in about a 20 per cent reduction in WHO staffing and capacities. It means that the WHO has to cut back on vital programmes such as pandemic preparedness and response, including surveillance in key areas like influenza and measles. Technically, the US withdrawal should not weaken WHO's authority because it gains its authority through the WHO constitution and World Health Assembly, which won't change. But politically it will make it much harder for the WHO to leverage its influence if the United States is not on board, or worse, if the US is actively opposing WHO initiatives.

How could this decision affect countries like India?

WHO will be in a weaker position to offer technical and scientific assistance and guidance to middle-income countries like India. WHO is losing scientific and other experts and is stretched thin without US funding and participation. The absence of scientific expertise from the US Centers for Disease Control and Prevention is especially concerning.

Is there a risk that global disease surveillance and early-warning systems could be weakened? What would that mean for densely populated countries such as India?

Much of the reductions in financing and capacities will occur in the areas of disease surveillance and outbreak detection and response. For a densely populated country like India, this is of grave concern, as there are heightened vulnerabilities to infectious diseases.

Does the US withdrawal set a concerning precedent for other countries to disengage from multilateral health institutions?

As a matter of law, the US is the only country that is permitted to withdraw under the WHO constitution. This is due to a joint resolution of the US Congress that grants the US the power to withdraw but only if it pays its existing dues. President Donald Trump has not paid his current financial obligations.

How might this reshape global health governance going forward?

The US has been highly influential in global health governance and diplomacy. The US withdrawal will certainly weaken overall governance and international negotiations.

What could this shift mean for India’s role and influence within the organisation?

I would make a plea for India to see the US withdrawal as an opportunity to assert its influence in global health policy. India should significantly increase its funding of WHO and become reenergised in WHO policy and governance. This is a unique opportunity for India to take leadership in global health. It makes sense as India is one of the world's most accomplished scientific powers, including in the manufacturing of vaccines and medicines. I would rather see India leading on science, health and equity at WHO than China.

what-is-epstein-barr-virus-and-why-is-new-research-so-important

Fri Feb 27 14:08:04 IST 2026

While the world debates the shocking allegations and criminal details in the ‘Epstein files’, the medical research community has shed new light on a highly contagious virus that also bears the Epstein name. The Epstein-Barr virus (EBV) is named after two scientists—Michael Anthony Epstein and Yvonne Barr—who discovered the tiny herpes-family viral particles in 1964 while studying a rare African childhood cancer called Burkitt lymphoma. EBV—the first virus linked to human cancer—is also one of the most common human viruses and spreads through body fluids, primarily saliva. Most people are infected at some point in their lives, usually in childhood, and experience no symptoms. In that sense, EBV behaves like a long-buried story: it can remain unnoticed for years, only revealing itself when conditions allow it to reactivate.

Interestingly, Epstein identified the virus only three years after obtaining the biopsy samples he suspected might contain it, and largely by accident. In 1961, after attending surgeon Denis Burkitt’s lecture on a mysterious “jaw tumour” common in equatorial Africa, he suspected a viral cause and secured tumour samples, but found no viral particles.

The breakthrough came in late 1963 when a flight carrying a sample from Uganda was delayed, extending the transit time. By the time it arrived, the specimen looked cloudy and nearly contaminated and was close to being discarded. Instead, Epstein examined it and found free-floating tumour cells that had loosened during the long journey and began growing in culture. Working with Barr and pathologist Bert Achong, he used electron microscopy on these cultured cells and, in 1964, observed the EBV for the first time.

Those with weakened immune systems are more prone to EBV reactivation. When that happens, symptoms can vary in severity, ranging from sore throat and fatigue to skin rashes, swollen lymph nodes and an enlarged spleen or liver. If viral genes begin altering the growth cycle of infected cells, they can also contribute to cancer.

Recently, a landmark study by AstraZeneca and Memorial Sloan Kettering Cancer Center, published in Nature, identified 22 genetic variants that influence how effectively the immune system controls persistent EBV levels in the blood. Using large genomic and health-data libraries alongside innovative computational methods, the researchers measured EBV levels across hundreds of thousands of individuals and found that certain genetic differences—many in immune-related genes—make it harder for the body to keep the virus in check. People carrying these variants are more likely to have higher viral loads, which are linked to increased rates of chronic disease.

This latest finding, too, echoed the virus’s own accidental discovery. Because the team analysed fragments of genome-sequence data that are usually discarded in routine human genetic studies and turned them into meaningful insights at an unprecedented scale. After publication, Caleb Lareau, principal investigator at Memorial Sloan Kettering Cancer Center, described the approach as turning “trash into treasure”.

high-five-with-anuja-chauhan-why-getting-off-the-internet-is-the-best-self-care

Fri Feb 27 14:08:38 IST 2026

1. What do you eat in a day?

I eat papaya, dal, chicken/paneer, veg stir-fry or light sabzis, roti, rice, peanuts and dahi.

2. How do you stay fit?

I do yoga and lift weights mostly.

3. What do you do in your me-time?

Doing things that get me off the internet. Wandering around the garden with a mug of coffee, checking every morning for new leaves and new buds, weeding, pruning, training creepers on to walls and fences is pure, rejuvenating bliss. I also paint walls and furniture—the smell of water-based paint is lovely. It costs so little and yet a new lick of paint literally wipes the slate clean and is so therapeutic for a cluttered mind. Chatting with my grown-up children is great, too. They are living the life I used to live long ago—with clients and bosses and love interests. It is very interesting to see the adult world through their Gen Z lens.

4. One unhealthy thing you will never be caught doing?

Drugs!

5. One mantra you swear by?

Never overeat or over-imbibe alcohol on holiday—it is the fastest way to totally ruin your much-anticipated vacation.

why-doctors-say-no-to-sugar-and-salt-for-babies

Sun Feb 22 12:09:17 IST 2026

keralas-tech-revolution-how-advanced-healthcare-is-fuelling-medical-tourism

Sat Jan 24 15:23:07 IST 2026

For decades, Kerala has set the benchmark for public health care in India—anchored in a robust public health care infrastructure, a strong focus on primary care, and effective last-mile delivery. Today, driven by a strategic embrace of cutting-edge medical technologies, the state is steadily transforming into a global destination for advanced health care.

Over five lakh international patients are estimated to visit Kerala each year, drawn by high-quality, cost-effective treatment. Notably, a growing share of these patients seek technologically advanced procedures that rival—and in some cases surpass—those offered by traditional global health care hubs, both in quality and delivery. In Kochi’s private hospitals, medical tourism currently accounts for up to 30 per cent of revenue, underscoring the sector’s expanding influence on health care economy.

Strengthening Kerala’s appeal is its rapid adoption of advanced medical technologies, including robotic-assisted surgery, 3D printing, and augmented reality (AR) in surgical planning.

Robotic-assisted surgery

The wider adoption of robotic-assisted surgery has become one of the most significant advances in Kerala’s health care landscape. State-of-the-art technologies such as the da Vinci system are now routinely used across specialities including urology, gynaecology and oncology. These systems enable surgeons to perform complex procedures with far greater precision, reduced blood loss, and minimal postoperative pain. Features such as 3D high-definition vision and wristed instruments enhance surgical accuracy by offering superior depth perception and greater dexterity compared to conventional surgical techniques. The proven effectiveness of robotic procedures has also encouraged more surgeons to pursue specialised training, helping the technology gain a firm foothold across the state, both in government as well as private hospitals.

Patients, particularly those from overseas, are increasingly seeking out these procedures because they offer faster recovery, fewer complications and better outcomes. This rising demand has strengthened Kerala’s reputation for advanced, high-quality care and created a supportive ecosystem for robotic-assisted surgery. Equally assuring is the end-to-end care, from advanced pre-operative diagnostics to structured post-surgical rehabilitation.

Alongside robotics, emerging innovations like 3D printing for customised implants and prosthetics, and augmented reality for surgical planning are increasingly being integrated into treatment protocols. These tools allow doctors to personalise care, particularly in complex cases such as spinal surgery, tumour removal and facial reconstruction. With digital models and virtual simulations, surgeons can anticipate challenges and ensure the best possible care for patients expecting world-class results.

The global opportunity ahead

Kerala’s medical value travel industry currently generates around 40 crore in hospital revenue a month. By placing a stronger focus on technology and specialised care, we could witness this figure increase significantly, even triple.

Stronger partnerships between the government, private hospitals and academic institutions can help strengthen Kerala’s position as a leading destination for medical tourism. Joint research initiatives and training programmes not only improve the quality of care, but also equip the next generation of doctors and surgeons to use advanced technologies with confidence.

By continuing to combine medical expertise with advanced digital tools and a patient-centric approach, Kerala has the potential to compete with international health care hubs like Singapore and Turkey. It can also set a new benchmark for affordable care that is accessible to patients from around the world.

Dr Moopen is the founder chairman & MD of Aster DM Healthcare.

how-a-paediatricians-relentless-fight-got-fake-ors-drinks-banned

Tue Jan 27 16:18:36 IST 2026

In 1978, Lancet called oral rehydration salt/solution (ORS) “potentially the most important medical advance of this century”. Discovered by Indian scientist Hemendra Nath Chatterjee, its usage was eventually developed and used across the world. It is estimated that ORS has so far saved more than 50 million children. As part of their global diarrhoeal disease control programme, the World Health Organization and UNICEF standardised ORS in 1975 and further popularised its use.

India’s population made it a major beneficiary of ORS. However, its wide use bred a commercial version. In 2003, Bengaluru-based Jagdale Industries made a sugary drink that tasted like ORS, named it ORS-L, and marketed it as a rehydration drink for children. Sold almost like a medicine, it earned an estimated Rs100 crore annually for Jagdale and was bought for Rs750 crore by Johnson & Johnson in 2014.

The American brand sensed the business opportunity, rooted in a genuine health need. It renamed the brand ORSL and pushed it aggressively, onboarding medical stores, supermarkets, e-commerce websites and even doctors, especially paediatricians. But, one paediatrician understood the danger and took up the fight.

“In one case, the parents followed every instruction precisely—correct food, correct fluids—yet the child did not get better,” said Dr Sivaranjani Santosh. “The diarrhoea persisted and dehydration worsened. One day, one of the parents asked me if ORS and ORSL were the same. I said they could be, but also asked them to bring the tetra pack they were using. When I examined the label, it was not the WHO-recommended ORS at all.”

In paediatric medicine, few principles are as firmly established as ‘diarrhoea rarely kills, dehydration does’. If dehydration is prevented, a child usually survives. “Even glucose cannot be given directly to sick children; it needs the right amount of sodium and water,” said Sivaranjani. The balance ORS should have is measured in osmolarity (concentration of a fluid). It is key because, in the body, water always moves from a diluted fluid to a concentrated one. When ORS has the right osmolarity—about 0.245 osmoles per litre (osm/l)—it is lower than blood (0.275-0.295osm/l), and water flows from the gut to the body, improving hydration. But, when so-called ORS drinks have high osmolarity—often 0.300-0.600osm/L—water is pulled from the body to the gut, speeding up dehydration and worsening diarrhoea.

“I realised it after observing cases and eventually heard from other paediatricians of how the sugary drinks failed to provide rehydration and caused dehydration among the sick children,” said Sivaranjani. These sugary drinks are “hyperosmolar”—they are dangerously skewed in terms of composition (see table).

Around 2015, Sivaranjani realised ORS was not being diluted by medical ignorance, but by commercial confusion. The massive marketing machine continued its blitz, until, owing to increasing objections from the medical fraternity, J&J started printing the warning: “Do not give during diarrhoea”—in tiny font.

Sivaranjani intensified the awareness effort. In campaigns at schools, she warned parents about the sugary drinks. In 2017, she posted her first YouTube video on the difference between ORS and ORSL.

Meanwhile, other companies entered the space with brands like Rebalanz VITORS (launched in 2018) and ORSFIT (2019). These were sold to unsuspecting parents across the country, mostly through medical stores.

Sivaranjanai escalated the issue in 2021, writing multiple letters to the Central Drugs Standard Control Organisation. The CDSCO first asked for proof, then said that the problem did not fall under its jurisdiction as the drinks were not drugs. So, she filed a complaint with the Food Safety and Standards Association of India in February 2022. Following the efforts of Sivaranjani and other paediatricians, the FSSAI barred sugary drinks from using the term ORS on labels in April 2022.

It was a decisive win, but it did not last long. In July, the authority reversed course—allowing ORS terminology with the diarrhoea disclaimer.

The FSSAI took cover behind the Controller General of Patents, Designs and Trade Marks, Mumbai, stating it was the CGPDTM that granted trademarks such as ORSL. “This flip-flop was devastating,” Sivaranjani said. All through, she was also flagging the issue to the Union health ministry. She complained several times on the Prime Minister’s Office website, too, but there was no response.

The FSSAI and the health ministry maintained communication with Sivaranajani, but the officials were mostly asking for more proof or continued the inconsequential talk. “I could see no action; it was truly baffling,” she said. “Despite medicine, public health and ethics on our side, the government agencies refused to act.”

When contacted, neither the FSSAI nor Kenvue, which was spun off from J&J in 2023 and currently owns the rehydration product, responded. Former FSSAI CEO Pawan Agarwal said: “Though it was a drink and the issue fell under the FSSAI’s purview, ORSL was a trademark. So, at the time, the best FSSAI could do was to highlight that it was not ORS as per WHO standards. The recent decision to ban the use of ORS in trademarks was prompted by medical shops selling ORSL when the customers asked for ORS.”

In September 2022, fed up with the lack of response from the FSSAI and the health ministry, Sivaranajani filed a public interest litigation in the Telangana High Court. “As the case dragged on, I felt isolated,” she said. “I wondered why the judiciary was taking so much time on the topic that was so clear from the beginning.”

Then, before the first hearing, she posted a video on social media requesting people to wish her luck. The response was staggering. It may have started with concerned parents amplifying her message, but it was soon taken up by Anchor Ravi, a well-known TV personality in the Telugu states. Actors Samantha Ruth Prabhu and Nani took the campaign to the next level. Dozens of paediatricians and scores of social media influencers joined the movement. The campaign spread rapidly across south India. The public scrutiny shifted the balance.

Meanwhile, the Endocrine Society of India and Women Pediatricians Forum joined her case. The ESI’s petition was accepted while the WPF’s was denied.

Finally, the FSSAI banned the use of ORS in brand names on October 14, 2025. But, within two days, the Delhi High Court asked it to respond to JNTL Consumer Health (India) Pvt Ltd, a Kenvue subsidiary. JNTL had told the court that stock worth Rs180 crore was in the market and calling it back could cause reputational damage. “I could not understand how the FSSAI agreed to this,” said Sivaranjani. “This was taking the public’s health for granted and playing with the childrens’ lives.”

The response from FSSAI was slow, prompting the Delhi High Court’s Justice Sachin Datta to remark the order was intended to give the regulator two to three days to act and that he might not have granted it if he had known the FSSAI would take longer. Eventually, the FSSAI upheld its earlier ban, calling the drinks a public health hazard. Though Dr. Reddy’s, which owns Rebalanz VITORS, tried to challenge the ban, the Delhi High Court did not entertain the plea. It also reiterated that it will not interfere in the FSSAI’s ban as people could mistake the branding for ORS, leading to a public health hazard.

However, despite the ban, the drinks remain on the market. The FSSAI has conducted raids across the country and seized stock in some states. But, the issue persists. ORSL has even rebranded to ERZL (the ‘e’ designed to look similar to ‘o’ and the ‘z’ to ‘s’). Sivaranjani is reaching out to the ministry of commerce and industry and the FSSAI to not allow the rebranding.

Meanwhile, the case in the Telangana High Court is still active, with the prosecution seeking a court directive to the companies to obey the FSSAI’s ban. Sivaranjani also wants all stock recalled and distribution stopped. Amid her battles for public health, she still wonders how products endangering millions of children stayed in circulation for so long.

why-younger-people-are-getting-cataract-causes-symptoms-and-treatment

Sat Jan 24 14:48:06 IST 2026

Deepali R., a Mumbai homemaker, thought menopause was her only worry as she approached her late 40s. Little did she know that she would soon join her septuagenarian uncle in wearing post-cataract surgery spectacles. She experienced persistent haziness in vision, but thought it was stress-related and ignored it. “It was a jolt,” she says. “I hadn’t even greyed fully. But thankfully, my vision has been revitalised.”

Cataract, the gradual clouding of the eye’s lens, has always been a part of the ageing process. But today, people in their 40s are signing up for surgery. “Previously, the approach to cataract surgery was to delay it till blindness set in or until there was a sudden dramatic depletion in vision,” says Mumbai ophthalmologist Dr Himanshu Mehta. “Cataract never happens suddenly. Technology, too, wasn’t developed back then.”

EMERGING AWARENESS

Mehta believes people today, especially professionals, feel a more pressing need for excellent vision. Earlier, elderly members of a household who didn’t need to read or see much ignored the symptoms. “A 50-year-old corporate guy facing vision problems might find it a hindrance at the workplace, not being able to clearly read presentations,” he says. “‘I can’t see’ is no excuse.”

Delhi-based perfumer Mukul Gundhi, 54, believes that along with a sound nose, a good pair of eyes is a non-negotiable to his livelihood. He couldn’t afford gradually depleting vision while handling daily customers, reading online orders and maintaining accounts at his heritage perfumery. Following successful cataract surgeries for both eyes, he now enjoys an improved quality of life.

“The cataract concept has changed over the years,” says Delhi ophthalmologist Dr Rajib Mukherjee, who operated on Gundhi. “In the 1980s and 1990s, people waited until the cataract completely matured, which could take decades. That era was devoid of computer and phone screens. Today’s visual demands are far greater. Can you sacrifice identifying things on your phone? Today, we don’t look at mature cataracts, but rather at lifestyles.”

EARLY INDICATIONS

“More than even screens, early diabetes causes early cataract,” says Dr Ronnie Jacob George, senior ophthalmologist at Chennai’s Sankara Nethralaya. “The number of young Indians with diabetes has sadly increased over the years.”

Fluctuating blood sugar level causes imbalances in the intraocular (in the eyeball) fluid, leading to swelling of the lens. “When the concentration of sugar increases, the lens tends to absorb water and swells,” says George. “The lens is clear due to the proteins being arranged in a particular way. In this case, the protein arrangement is changed and vision becomes hazy.”

Uncontrolled blood sugar, extensive exposure to ultraviolet radiation, smoking and tobacco consumption of any kind, he says, affect eye health. “Farmers, for instance, are known to suffer from early cataract due to continuous UV exposure,” he says. “That’s why wearing sunglasses is essential. Airline pilots always do, considering intense UV exposure at high altitudes.”

Although cataract and ageing are directly connected, many babies are born with the condition, too. “If the mother suffers from infections like rubella during the second trimester, the child can be born with cataract,” says Mehta. While his oldest cataract patient was 108, his youngest was just two.

FROM ‘SODA GLASSES’ TO SAFE AND SMOOTH

“At the outset, the term ‘surgery’ gave me jitters,” says Gundhi. “However, after the first eye’s cataract was smoothly removed, I was completely fearless for the second.” The post-operative pain, he says, was like a needle-prick during a blood test.

With technical advancements, cataract surgery is no longer painful, cumbersome and stressful. “Earlier, sandbags were placed on either side of the head [to restrict movement] while the patient lied down,” says Mehta. “There was risk of infection. Many lost eyes. There was no lens replacement, but instead ‘soda glasses’ (thick lenses) with convex lenses of a whopping +30 power. With those, everything looked magnified. While crossing the street, one experienced a ‘jack in the box’ phenomenon (an optical illusion). A car would appear, then disappear only to suddenly reappear, causing confusion and often accidents.”

Today, with evolved technology, things look brighter. “Modern techniques include phacoemulsification surgery that began in the 1990s,” says Mehta. “It involves a ‘phaco machine’ which, through a tiny ultrasonic needle, breaks the cataract at a high speed and suctions it out. No stitches are involved.”

Laser surgeries, however, are the most advanced and near-painless, he says, especially FLACS (Femtosecond laser-Assisted Cataract Surgery). “Even when we perform a laser surgery, the fragments are finally removed by the phaco machine. The robot makes it more precise and perfect. Laser is a safe procedure and hence consistently repeatable,” he says.

Comparatively, phacoemulsification without femtosecond laser (a precise infrared laser) is more affordable and not many Indian centres are equipped with the latter. “Less than 5 per cent of patients choose femtolaser. For them, an iPhone is more important than the eye,” says Mehta with a chuckle.

PRICELESS PRECISION

“Cataract is the most frequently performed surgery globally,” says George. “Around 40 years ago, surgeries involved opening the eye to remove the cataract and lens replacement wasn’t common. Today, sophisticated procedures are performed with high-end technology. Eye drops have replaced injections and stitches. Incisions are as minute as 2.2mm.”

There are also highly precise algorithms to estimate the patient’s lens power. “Error rates have decreased,” he adds. “Along with providing the power your eye needs, we can also correct your spectacle errors, even cylindrical ones, to enable you to be as spectacle-independent as possible.”

The most commonly implanted artificial lenses during cataract surgery include monofocal (allows you to see only at one particular distance), multifocal (vision at multiple distances), toric (to correct astigmatism) and extended depth of focus (continuous range of vision).

SURGERY AND RECOVERY

At the outset, the pre-operative ‘workup’, Mukherjee explains, involves examining the health of the eye structure. “The eye is shaped like a globe. We have to observe it from front to back,” he says. “If, for instance, the patient has a weak cornea, the surgical plan would be designed accordingly, to make it safer.”

The second step, he says, is lens selection based on the patient’s lifestyle and the outcome the lens offers.

Cataract surgeries usually take between 10 and 30 minutes, depending on how complicated the case is. The anaesthesia administered can either be local or ‘topical’, an advanced method that involves just eye drops. An echocardiogram and a series of blood tests are ordered before surgery.

“Today, immediately post-surgery, the patient is ambulatory (can walk),” he says. “I encourage them to enjoy life with their renewed vision.”

For safety, a pad is placed on the patient’s eye for a couple of hours after surgery. Many ophthalmologists recommend post-operative clear spectacles to avoid infections; some don’t.

“Many misleading advertisements promise an immediate return to office following surgery,” says Mukherjee. “We have to consider patient safety and long-term outcomes.” After surgery, medication includes eye drops for at least six to eight weeks. The patient has to keep water from entering the eye for about five days.

“Recovery has many indicators, like the patient’s mobility and reasonably improved vision from the first day after surgery,” he says. “They can go out after a few days of being home-bound.”

Bilateral cataract surgery (operating on both eyes together) is often practised abroad. “Our situation in India is different,” says Mukherjee. “Patient safety is prioritised. It pays to leave a gap of around a week between the surgeries.”

Mehta recommends a simple, regular home test—cup each eye (even with spectacles on) to test the vision of the other. “Cataract is a once in a lifetime surgery,” he says. “Once removed, it never recurs."

high-five-how-to-combat-a-sedentary-lifestyle-with-this-simple-health-mantra

Sat Jan 24 17:06:54 IST 2026

With Dr Manan Vora, orthopaedic surgeon

1 What do you eat in a day?

I am going to answer this question by saying I personally eat 1,700 calories a day with 1.6g per kg of protein. The reason I have answered like this is because everything that I put in my mouth is measured to the T on a food weighing scale and my protein is accounted for. So I would much rather answer it like this to let people know principally that this is something they should consider doing.

2 Your fitness regime?

Ninety minutes a day of strength training four days a week. One hour in the evening is either football or racket sport. And I do not sleep till my smartwatch shows I have completed 10,000 steps a day.

3 What do you do in your me time?

I am not too proud of it, but I am addicted to my phone. So, I am watching Shark Tank videos on YouTube or a suspense thriller show on Netflix. That's what I do in my me time. I am counting this as me time, apart from following the Indian cricket team or my favourite football team. But I am guilty that my me time does involve a screen.

4 One unhealthy thing that you will be never caught doing.

I have never tried alcohol, not a sip. I have never tried vaping, smoking, hookah and I don't think I would ever touch any of these. I am very proud of that.

5 One health mantra you swear by?

Constant movement. In today's day and age, because of sedentary lifestyles or people crossing a certain age, [they] think that they have to just stay in bed or sit all day, I do not agree. And the number of patients I am seeing with back and neck pain, knee issues, because they have sedentary lifestyle, is so high. So one thing I would strongly promote and advocate is just every hour, get up, move your body, challenge your body. You will be surprised how capable it is to move and be functional when you move it, and try to gain more and more muscle. So the answer is movement.

cribsheet-a-mothers-guide-to-preventing-bone-loss-and-calcium-depletion

Sun Feb 01 19:51:40 IST 2026

migrions-the-secret-viral-packages-that-make-infections-more-severe

Fri Feb 27 14:17:32 IST 2026

A group of Chinese researchers has found that viruses are using a technique strikingly similar to the Trojan Horse—unknown until now—to infiltrate and spread within the body.

At different stages of evolution, viruses have developed diverse strategies to spread and survive. How efficiently a virus moves from one cell to another plays a major role in how severe an infection becomes. The two main ways viruses spread are cell-free diffusion—virus particles are released into the space outside cells and go on to infect new ones—and direct cell-to-cell spread, which helps viruses evade the host’s immune system.

Now, a new and more dangerous viral path has been discovered. Researchers found that a newly identified cellular structure called migrasomes forms specifically during cell movement and that the vesicular stomatitis virus can package its genetic material and proteins inside these migrasomes. In effect, viral cargo is cleverly hidden and discreetly loaded in structures linked to cell migration. These virus-like packages, named migrions, are made not only of viral components but also of the host cell’s own material.

When viruses spread using migrions instead of individual virus particles, they grow much faster in newly infected cells. This happens because migrions deliver multiple copies of the viral genetic material at once, allowing replication to begin immediately and in parallel. Therefore, they are far more infectious than free virus particles. When viruses enter the body hidden inside migrions, the disease becomes significantly more severe. Experimental mice developed serious infections in the lungs and brain, often leading to encephalitis and death.

Although Odysseus devised the idea of the Trojan Horse outside the gates of Troy, it was the city’s residents who unwittingly carried the enemy inside. Similarly, viruses appear to be exploiting the body’s migratory machinery to move efficiently, infect cells and survive.

people-think-carefully-about-food-they-also-need-information-diet-yuval-noah-harari

Fri Feb 27 14:18:29 IST 2026

With Yuval Noah Harari, historian and philosopher

1 What do you eat in a day?

I eat mostly vegetarian food. Usually, for breakfast, I eat fruits and porridge. For lunch, probably rice with vegetables or dal, or something similar. In the evening, usually salad and bread. I don’t have a very specific diet.

I would say, though, that the same way people think very carefully about food, they also now need an information diet. You know, information is the food of the mind. Too much food is not good for the body; too much information is also not good for the mind. We need small amounts of high-quality information, and then we need time to digest it. Like with food, you eat for an hour, two hours a day, and then most of the day you just digest the food.

So it is with information as well. You read a book, you watch the news, you have a conversation. Then you need time—you don’t take more information in. You just think and meditate on the information you got; you digest it. And digestion is often the most important part of the entire process.

2 Your fitness regimen?

I try to meditate two hours a day and do some kind of exercise—walking, yoga. I would say that, with regard to both exercise and food, that it is very dangerous to take the regimen of somebody else and adopt it for yourself, because every person is different.

Every person has a different body, a different occupation, lives in a different country. So, if you live in a very cold country and you eat something, and then somebody in a very hot country hears about your diet, eating the same thing may not be good.

I would say people should experiment with food, with exercise, and see what makes them personally feel better, healthier, and then do that instead of trying to copy the exercise regimen or the diet of somebody else.

3 How do you unwind when you are alone?

I meditate—that is one very important thing. I start the work day with an hour of meditation, and at the end of the work day, I do another hour. I spend a lot of time with friends. I watch television. At night, if I want to just completely shut down the mind—not think about anything—I watch some TV series.

4 How do you decide what information to ingest and what not to take?

Yes, first of all we need to develop the ability to tell the difference between reliable and unreliable information, because we are flooded with too much information. The key question is, what is the evidence on which the information is based?

Science is all about evidence. Something can be very attractive, interesting or exciting, but there is no evidence that it is true. So, this is like junk food. It is very tasty, but it does not really do good for your body. So the question is, what is the evidence that this story, article or book is really telling me the truth?

Most information is like junk food; most information is not the truth. The truth is costly. It takes time, money, energy to do research, to gather evidence, to write the truth. Whereas fiction and fantasy and lies, they are very cheap. You just write anything you want. You don’t need to invest anything. So this is why most information is not the truth.

Also, the truth tends to be complicated because reality is complicated. Whereas fiction can be made very, very simple.

5 Fiction is bad?

People prefer simple stories over complicated ones. And the truth is often painful. There are many things we don’t want to know about ourselves, our nation, our world. Fiction can be made very, very flattering. So again, it is all like junk food. It is very tasty, very cheap, but it is not good for your body.

how-a-new-endocannabinoid-could-revolutionise-stroke-pain-treatment

Fri Feb 27 14:19:15 IST 2026

Humans have been using cannabinoids—the active compounds found in the cannabis plant—for medicinal and ritual purposes for at least 5,000 years, with some archaeological evidence suggesting an even longer relationship with the plant. Compounds like THC and CBD—found in cannabis and known as exogenous cannabinoids—have some cousins in the human body. These cannabinoids, produced by our bodies, are called “endocannabinoids”, and since the evolution of the human race, they have been modulating a wide range of physiological and pathophysiological responses. The neuromodulatory network they form, in fact, helps maintain homeostasis—the body’s internal balance.

There are two primary endocannabinoids, and one of them—anandamide—is named after the Indian philosophical concept of ananda, a metaphysical condition related to profound stillness. Often called the “bliss molecule,” in its natural form it is highly unstable and breaks down almost immediately after being produced. The second, 2-arachidonoylglycerol (2-AG), is found abundantly in the body and plays a key role in regulating immune responses and pain signalling. If exogenous cannabinoids like THC and CBD are like a flood that hits every receptor in the brain at once, endocannabinoids are like a precise “surgical strike”: they are released only where and when they are needed and break down quickly.

Now, a group of researchers from Northeastern University in the US has created the first synthetic endogenous cannabinoid compound that would not produce a “high,” but is more potent and stable. The researchers made a strategic modification to the endocannabinoid structure to ensure that it binds to cannabinoid receptors while also blocking the enzymes that would normally break down cannabinoid molecules. The precision of this modified structure also allows the compound to trigger the body’s natural analgesic (pain-killing) pathways without crossing into areas of the brain that produce psychoactive effects. Researchers say that the molecule they developed will have a wide range of applications, and they have begun testing it for protection from strokes and even the “reversal” of stroke effects. It will also be tested soon for pain-relief applications in inflammation, cancer, and neurodegenerative diseases.

indias-mental-health-crisis-how-wellness-gurus-on-social-media-are-fuelling-a-ticking-time-bomb

Sat Jan 03 14:57:22 IST 2026

In a nation of over 1.4 billion, India's mental health landscape is a ticking time bomb. Nearly 197 million Indians—one in seven—live with some form of mental disorder, according to the Global Burden of Disease study.

Depression and anxiety top the list, worsened by rapid urbanisation, economic pressures and the lingering psychological scars of the pandemic. Yet, access to professional help remains a distant dream for most.

India has 0.75 psychiatrists per one lakh people, far below the World Health Organization's recommended three per lakh—although this picture is rapidly changing.

With approximately 9,000-11,000 psychiatrists in India against a required 36,000, it means more than 80 per cent of those with severe mental illness receive no formal care. Stigma, high costs and an acute shortage of professionals have resulted in treatment gaps ranging from 70 to 92 per cent—leaving millions vulnerable.

This vacuum has been eagerly filled by a burgeoning army of self-proclaimed wellness gurus. Social media platforms, such as Instagram, TikTok, and YouTube, are teeming with influencers promising quick fixes for mental anguish. From celebrity life coaches to viral “healers", these people capitalise on desperation, peddling unverified advice in a market projected to reach trillions globally.

In India, where traditional healing blends with modern digital trends, the allure is particularly strong. Beneath the glossy reels, however, lies a perilous underbelly: dubious methods, with little or no scientific backing, often leading to delayed treatment and intense suffering.

Wellness gurus urge followers to "visualise" their worries away, drawing from the law of attraction—a pseudoscientific idea popularised by self-help literature.

Proponents claim positive thoughts alone can rewire the brain to eliminate anxiety disorders. This narrative ignores well-established neurobiological mechanisms such as dysregulated serotonin pathways and chronic stress responses.

Studies show no empirical evidence supporting manifestation as a standalone treatment; instead, it can foster self-blame when it fails—deepening feelings of inadequacy.

In India, influencers with millions of followers promote this through daily affirmations, charging for premium "manifestation workshops" that promise an end to panic attacks without therapy.

A similar oversimplification is seen in the promotion of gratitude journaling as a panacea for depression. Writing down three things one is thankful for each day is often sold as a way to “overcome” clinical depression. While acknowledging positives can serve as a minor adjunct in therapy, it is no substitute for addressing underlying causes such as genetic vulnerability, chronic stressors or unresolved trauma.

Research from leading psychology bodies shows that such simplistic tools lack robust evidence for treating moderate to severe depression—potentially trivialising the condition.

Fads are rampant: crystal healing, where amethysts are said to "absorb negative energy" for better mood; essential oils, claiming to cure insomnia without side-effects; or eating an orange in the shower to "reduce anxiety" through sensory distraction.

These ideas emerge from the wellness industry's scrutiny-free wonderland, blending ancient and modern practices. Beyond these are more dangerous claims—dubious trends include "quantum healing" suggesting consciousness alone heals mental problems, or, the promotion of unregulated supplements as "natural antidepressants”.

In India, social media influencers—often without medical qualifications—push these ideas, creating an infodemic of misinformation.

A recent investigation found that over half of popular mental health content on social media platforms contained inaccuracies or outright falsehoods, frequently promoting quick fixes and questionable products.

Celebrity coaches blend spiritual anecdotes with self-help, but critics question the authenticity and efficacy, labelling it “self-hype".

The government has stepped in, mandating influencers to disclose qualifications when giving health advice, yet enforcement lags.

The perils of these self-sprouting gurus are manifold. First, they exploit vulnerability, using fear-mongering against "big pharma" or fostering dependence through gated online communities.

This erodes trust in science, steering people from evidence-based care. In India, where stigma already deters professional help, such misinformation delays treatment, allowing conditions to worsen—sometimes with tragic consequences.

A recent Gallup snapshot revealed nearly 30 per cent of Indian workers face daily stress, with half considering quitting their jobs, amplifying the crisis. Wellness toxicity also triggers burnout; the pressure to maintain "perfect" habits, like endless journaling, can induce anxiety, turning self-care into a trap.

Financially, it is exploitative: premium courses, apps, and products drain resources without results. Worse, some methods harm—unregulated supplements can interact dangerously with medications, and ignoring symptoms risks severe outcomes. As one expert notes, these influencers are often conspiracy-adjacent, blending wellness with extreme views.

Exposing these charades is crucial, but so is highlighting paths forward. True mental health promotion rests on evidence-based methods—grounded in rigorous research. Cognitive Behavioural Therapy (CBT), for instance, is a gold standard for anxiety and depression, teaching skills to reframe negative thoughts with proven efficacy in reducing symptoms by 50-60 per cent in trials.

Schemes like the National Mental Health Programme should integrate CBT into primary care on a larger scale.

Medication, when prescribed by professionals, plays a vital role; antidepressants have strong evidence for moderate-severe cases, under supervision.

Lifestyle interventions shine, too: regular physical activity, such as 150 minutes of moderate workouts weekly, lowers depression risk by 20-30 per cent.

Quality sleep—7-9 hours every night—regulates mood hormones, while a balanced diet supports brain health.

Social connections are pivotal; evidence shows strong relationships buffer stress, reducing mental disorder onset.

The need of the hour is to evolve a community-based model involving local personnel to promote wellness through peer support. This will help in decreasing distress in rural areas.

Mindfulness-Based Stress Reduction (MBSR), with roots in meditation but backed by Randomised Controlled Trials (RCTs), alleviates anxiety without pseudoscience.

School-based mental health programmes build resilience through evidence-driven education, fostering literacy and coping skills.

Workplace interventions—including stress management training—yield returns: for every rupee invested, up to four are saved in productivity.

Digital tools, when evidence-based, offer accessible therapy modules.

Prevention is key—addressing determinants like poverty and gender inequality through policy can avert disorders.

To bridge the gap, India must invest in training more professionals, de-stigmatise help-seeking, and regulate influencers rigorously.

Dr Alok Kulkarni is senior consultant psychiatrist at the Manas Institute of Mental Health, Hubli.

how-to-control-your-genes-the-science-of-epigenetics-explained

Sat Jan 03 14:49:55 IST 2026

For decades, we believed our health, lifespan and disease risks were fixed at birth—sealed within the double helix of our DNA. Now, that idea has been overturned. The science of epigenetics—the study of how chemical ‘switches’ control gene activity—has reshaped how we and research scientists understand life. If the DNA helices are the hardware in us, then epigenetic switches are the software that control the hardware. This software influence shows that genes are not static codes, but dynamic instructions that respond to our environment, lifestyle and even our emotions. The epigenetic switches—similar to on/off switches—don’t rewrite the instructions in the DNA manual, but they control which parts are to be read and how much, as well as which are to be skipped for effective gene expressions.

So, our biology listens to the life we lead, the thoughts we harbour and the emotions we feel. The prefix ‘epi’ means ‘above’, so epigenetics refers to what happens above our genes. Chemical modifications that decide which genes are switched on or off are mostly: DNA methylation, histone modifications and chromatin remodelling. These affect how tightly the DNA is packed in the cell. When a gene region is tightly wrapped, it’s silent; when it’s open, it’s active. This control system shapes how cells work, how our body ages and even how our brain adapts to stress or trauma.

Think of your DNA as a library of books, each containing instructions for one body part—heart, skin, brain or immune system. But your body doesn’t read every book at once. The epigenetic switches act like bookmarks or sticky notes that tell the cell which pages and which part of the page to read and which to skip. These sticky notes change as life progresses, taking in its fold impacts of all the changes and events we go through. What you eat, how much you move, how you sleep, the air you breathe and even the thoughts you think—all can rewrite these molecular bookmarks. A poor diet or stress can blur or move them, silencing protective genes. Healthy living, meditation and prayer, on the other hand, can add new notes that activate genes promoting repair and resilience. In other words, healthy habits are molecular conversations with our genome to improve it for a better life experience. Our lifestyle, in a very real sense, writes notes on the margins of our DNA to shape our stories.

Remarkably, epigenetic switches can also be inherited and passed on to future generations. The lifestyle choices, mental stress and even the generational experience of famine/drought/social injustice, may influence not only our health, but that of our children and grandchildren, too.

Despite this progress in genetics, we must know that we are only beginning to understand the complexity of the epigenome—the collection of all the epigenetic marks on the DNA in a single cell. Its cell-specific patterns and constant environmental interplay make it one of biology’s most intricate systems.

The science of epigenetics can have a massive real-life impact on public health recommendations by confirming the molecular mechanism of environmental effects. For example, a mother's diet during pregnancy—like adequate folic acid/B vitamins—can impact the child's lifelong risk for diseases like heart disease and diabetes by influencing DNA methylation patterns in the foetus.

Even more exciting is the research area where scientists are learning to “reprogram” the epigenome. Studies show that epigenetic editing can slow biological ageing, repair damaged tissues and even treat/reverse cancer-related changes. There are FDA-approved drugs (histone methyltransferase inhibitors, DNA methyltransferase inhibitors, to name a few) that modify the chemical switches on DNA in patients to “reprogram” a cancerous cell back towards a more normal state or make it sensitive to other treatments.

The diseases that have shown proven clinical results through epigenetic interventions are myelodysplastic syndromes, types of leukaemia, T cell lymphomas and sarcomas.

As this field advances, we are stepping into a new era of medicine, where health and even destiny become choices we can shape. Epigenetics is finding intriguing parallels in ancient Indian philosophy. It shows that our inner and outer worlds continuously shape our biology. Indian spirituality has long held that consciousness governs matter.

The idea of karmic or Akashic records, which hold impressions of all thoughts and actions across lifetimes, finds a poetic mirror in the concept of epigenetic inheritance. Just as experiences can leave molecular imprints on genes passed to future generations, our spiritual traditions teach that karmic patterns influence the soul’s journey.

Empowered with the knowledge of epigenetics, we can now imagine a world where ageing is not inevitable, where cancer risk is reduced by restoring healthy gene function, and where mental wellbeing can be strengthened by nurturing our inner environment. Epigenetics is making this vision real. It shifts biology from being about fixed letters to being about annotations, edits and rewrites—a living script that evolves with every breath, meal and emotion. The epigenome is rewriting the story of life, and for the first time we understand that the pen is in our hands.

The writer is a pathologist and an author.

ditch-the-plank-why-standing-ab-exercises-are-your-new-core-go-to

Sat Oct 25 16:48:36 IST 2025

If you wince when you think of ab workouts, you’re not alone. Pilates enthusiasts aside, most of us don’t enjoy working our core muscles with exercises like planks and crunches, which is why standing ab exercises come in so handy.

Not only can you avoid sweaty gym floors or getting up close and personal with your living room carpet, but they are also the best core exercises to do at home, says Kate Rowe-Ham, a certified personal trainer, women’s fitness coach and strength specialist, who is also the founder of the fitness platform Owning Your Menopause.

“Standing ab exercises train your core in a way that mimics how you use it every day—upright, moving, twisting, rotating and stabilising, so they are more functional than planks,” she explains.

Want to give them a try? Here, Rowe-Ham reveals her favourite three standing ab exercises and how to do them.

What are standing ab exercises?

These are designed to target the core muscles, including the abdominals and obliques, from a standing position. Doing these not only boosts strength in the trunk, but also has benefits for the entire body. “They improve posture and balance while being easier on the wrists, shoulders and lower back,” says Rowe-Ham. “This makes them a brilliant alternative for anyone who struggles with a plank.”

You can do standing ab exercises as part of a dumbbell core workout or a bodyweight workout for beginners, depending on your current fitness levels.

How to do standing ab exercises

Standing wood chop

“[This is a fantastic, full-core move that mimics how we actually move in everyday life, reaching, twisting and lifting,” says Rowe-Ham.

“It builds rotational strength, targets the deep core muscles (like the transverse abdominis), and teaches your body to generate and control force, a skill we use for everything from putting on a seatbelt to carrying shopping bags. It’s powerful, functional, and satisfying.”

How to do it:

Stand with your feet shoulder-width apart and clasp your hands together.

If you’re doing it with a dumbbell or medicine ball, hold it securely.

Start with your arms raised diagonally above one shoulder.

Rotate through your torso and “chop” down across your body towards the opposite hip.

Return to the starting position with control and repeat.

Standing side bend

Don’t underestimate this one, Rowe-Ham warns. It may look easy, but it “directly targets the obliques, improves side-to-side movement and supports better posture and spinal alignment”.

“It’s brilliant for strengthening the muscles around your waist, which help protect your lower back,” she says.

How to do it:

Stand tall with feet hip-width apart.

You can do it with your hands behind your head (bodyweight version) or by holding a dumbbell in one hand down by your side.

From there, slowly bend your torso to one side, as if you’re trying to reach your rib towards your hip.

Squeeze through your obliques to come back up.

Keep your hips square and avoid leaning forward or backwards.

Standing side crunch

We promised no planks, but crunches are still on the menu, and standing side crunches are one of the best. “It’s a brilliant way to fire up both the obliques and the lower abs while also working your balance, coordination and hip mobility,” says Rowe-Ham. “Because you’re moving dynamically, your heart rate lifts, too, so it gives you a little cardio boost alongside core strengthening.”

Here’s how to do a standing side crunch:

Start standing tall with your hands lightly behind your head.

Drive your right knee up towards your right elbow, crunching through the side of your waist.

Lower back down and repeat on the same side before switching, or alternate sides throughout.

To make it harder, hold a light dumbbell or small ball overhead as you bring your elbow and knee together.

Not keen on crunches? You could always try shoulder taps or leg raises instead to fire up your obliques and lower core muscles.

Do standing ab exercises really work?

Yes, they are a great way to improve your core strength and boost full-body stability, mobility and balance, says Rowe-Ham. “They train your core in the way it’s actually designed to function. Unlike floor-based movement, where you’re braced against the ground, standing work forces your muscles to stabilise you against gravity while you move,” she explains.

But the benefits don’t stop there. “They also activate the deep stabilisers, like the transverse abdominis, obliques and muscles around your spine and hips,” she says. “These are the muscles that keep you upright, protect your lower back and help you resist unwanted twists or wobbles when you’re walking, lifting or even just carrying a shopping bag.”

How often should you do standing ab exercises?

Little and often is the key to building a stronger core with standing ab exercises, says Rowe-Ham. “Just 10 to 15 minutes, two to three times a week can make a real difference to your strength, posture and stability,” she says. “The trick is consistency. Try a set of side bend while the kettle’s boiling, a few standing side crunches after you’ve been sitting at your desk for a while, or some wood chops while you’re waiting for dinner to cook.”

It’s the little bursts like this that add up over time, she notes, so you can train your core muscles and reap the benefits without having to spend dedicated time on a dumbbell core workout, for instance.

Standing ab exercises versus plank

Comfort: As Rowe-Ham notes, standing ab exercises don’t put pressure on the lower back, wrists or shoulders like regular planks do, which can make them a great alternative for those with existing discomfort in these areas.

Functionality: Standing ab exercises are functional fitness exercises as they so closely mirror everyday movements, like picking things up off the floor. There’s very little in life that mirrors the classic plank. This makes standing ab exercises one of the best exercises for longevity, too.

Versatile: Both planks and these standing movements are versatile enough to add to a plethora of workouts, whether that’s sessions on the treadmill or traditional weight training. You can also do them anywhere, with no equipment.

Making them harder: It’s a lot easier to make standing ab exercises harder with equipment like cables, resistance bands, dumbbells or kettlebells. The easiest way to make a plank harder is by holding it for longer or balancing a weight plate on your back, but this can lead to injury, and most people will need to do it at the gym.

understanding-alzheimers-disease-symptoms-causes-and-treatment

Sat Oct 25 16:40:18 IST 2025

Alzheimer’s disease is named after Dr Alois Alzheimer, a German psychologist and neuropathologist. His assessment of a female patient with symptoms of pre-senile dementia (those under 65), along with the findings of an autopsy of her brain, led him to two neurological substances—senile plaques and neurofibrillary tangle. These two would later be recognised as markers of the disease.

Alzheimer’s is the most common type of dementia, an umbrella term for conditions that occur when the brain no longer functions properly. While there is no cure for it, symptoms can be alleviated. The average life span after symptoms first appear is eight years.

Understanding Alzheimer’s

A disease that gradually destroys brain cells. Patients eventually lose some cognitive abilities, such as memory and language. This is different from the minor effects on memory that ageing can have.

The most affected

This and other varieties of dementia become more common with age, affecting one in every 14 people over 65.

Comparison with dementia

While dementia is a broad term, Alzheimer’s is a specific condition. It first affects the area of the brain responsible for learning, so early signs may include abnormalities in memory, thinking and reasoning abilities.

What families should look out for

Early in the condition, people might find it difficult to recall recent events. Memory deteriorates over time, accompanied by other symptoms. Non-memory components such as finding the proper word, difficulty interpreting visual imagery and impaired thinking, might indicate early stages.

Symptoms and progression

Alzheimer’s typically begins slowly and worsens over time. It eventually spreads across the majority of the brain. The condition can affect memory, thinking, judgment, language, problem solving, personality and movement.

Behavioural changes

Moodiness, apathy, personality changes, unsocial behaviour and linguistic difficulties are all possible indications of the condition.

Comprehending confusion

Patients might be forgetful and struggle to keep up with conversations. They may grow agitated because of this. Noise, speech, crowds and movement can be overwhelming.

Causes

A combination of hereditary, lifestyle and environmental variables that work together to alter the brain over time. Alzheimer’s is caused by unique genetic abnormalities in less than 1 per cent of the population.

Amyloid plaques and tau (neurofibrillary) tangles

The disease is thought to be caused by an abnormal build-up of proteins in and around brain cells. One of the proteins involved is amyloid, which accumulates in plaques (clumps) around brain cells. The other protein is called tau, whose deposits form tangles within brain cells. These are visible only under a microscope during autopsy.

The risk of misdiagnosis

Vitamin B12, folate, vitamin D deficiency, thyroid problems, depression, sleep disorders, infections and drug side effects can all mimic Alzheimer’s symptoms. Proper testing is necessary to avoid misdiagnosis.

Women more at risk

They are twice as likely as men to develop Alzheimer’s because of biological or genetic variations, as well as societal conditions associated with gender, such as education level, occupation and sexism. (The last includes lower economic and social status, higher levels of stress due to greater caregiving burdens, masking of symptoms, etc.)

Disease progression in women

They have a faster cognitive decline, lose their freedom earlier and spend more time with a higher level of disability. The reasons are most likely biological and societal.

The menopause connection

According to research, fluctuating and declining oestrogen levels following menopause may predispose women to Alzheimer’s disease.

Diagnosis

There is no single test to tell if someone has Alzheimer’s. Physicians use diagnostic methods such as neurological exams, cognitive and functional assessments, brain imaging and cerebrospinal fluid or blood testing, in conjunction with medical history. Current tools detect changes years before symptoms, yet accuracy varies.

Treatment and management

Mainly involves the use of cholinesterase inhibitors (that prevent the breakdown of a specific neurotransmitter, leading to improved communication between nerve cells). These drugs may help improve cognitive ability and memory and maintain capability to carry out daily activities, but they do not stop the disease from progressing. The effectiveness of these medications is variable.

Early diagnosis and treatment make maximum impact; however, most people will need ongoing assessment and dose adjustment.

Lifestyle changes

Regular physical activity helps with blood flow to the brain and may decrease neurodegeneration. A diet rich in antioxidants, omega-3 fatty acids and low in processed food supports brain health. Cognitive stimulating activities, such as completing puzzles, reading books and learning new skills, strengthen neural connections. While lifestyle changes will not cure Alzheimer’s, they can help preserve function, postpone symptom progression when combined with medical management, and improve overall wellbeing.

Occupational therapy or social engagement in care

Occupational therapists—who help patients with daily activities—create individualised schedules and approaches to help sustain independence in daily life. Social interaction through family engagement, support groups or planned activities benefits emotional health and decreases feelings of loneliness, depression and anxiety.

New treatments and research

Focused more than just on symptom relief. Disease-modifying treatments, speci fically monoclonal antibodies directed against amyloid-beta proteins, can slow the neurodegeneration. Non-invasive brain stimulation, gene therapy and stem cell mediated repair of neural circuits are being researched. Additionally, clinical trials are examining anti-inflammatories, neuroprotective agents and personalised treatment approaches. Although this research is still largely experimental, it has the potential to change the trajectory of the disease.

Caring for loved ones

Support independence by creating recognisable routines that lessen confusion and anxiety. Dividing tasks into easy-to-follow steps alongside visual cues and gentle assistance promote independence. Supporting participation in chores, interests or self-care supports confidence. Positive redirection and patience are important, as is balancing supervision with independence.

Managing agitation

Learn the possible triggers, provide reassurance and use distraction or other activities like listening to music or walks. Creating safe spaces, minimising communication and creating regular routines can help reduce frustration and limit challenging behaviours from being exacerbated.

Difficult situations like sundowning

Minimise noise, reduce bright lighting and utilise familiar cues to alleviate confusion or sundowning (feelings Alzheimer’s patients get when the sun sets). Soothing words, familiar routines, plenty of fluids and rest help promote soothing. Avoid arguing, and let them take their time to process information to alleviate agitation and anxiety.

Home safety modifications

Ensure lighting is bright, remove items that could lead to falls and use floor mats. Install door-locking hardware, label rooms, keep medications in a safe place and place sharp objects out of reach.

The impact on relationships

People with Alzheimer’s could become more irritable and impatient, making it difficult for those around them. Caretakers of Alzheimer’s are more likely to experience worry, depression and a lower quality of life than other caretakers.

Use support systems

Adult day care services provide day-to-day help. These choices offer short-term care for a person with dementia while allowing the caregiver to take a break. Day-to-day support may include supervision, home-delivered meals and/or transportation.

The numbers in India

Around 88 lakh people over the age of 60 suffer from dementia; the prevalence is projected to double by 2050.

The rural-urban divide

A study found that the prevalence of dementia was greater in the rural elderly (30 per 1,000) than in seniors in urban areas (20 per 1,000). Lower education level, poorer income and co-morbidities such as diabetes and cerebrovascular illness were the most commonly identified risk factors.

Indian family structures

Joint family systems in India often ensure the care of the elderly with Alzheimer’s or dementia as responsibilities are divided among family members. But traditional gender roles still influence this experience. Women, especially daughters-in-law, have been taking on the lion’s share of this work, which adds to the emotional and physical burden.

Challenges in India

There is a general lack of awareness and understanding of Alzheimer's, which leads to undetected or misdiagnosed cases. This delays therapy. There is an overall stigma associated with mental health. Rural areas have limited access to health care institutions and specialised Alzheimer’s care.

Indian initiatives

The National Dementia Strategy and National Mental Health Programme seek to promote disease awareness while also improving patient treatment and access to mental health services. Memory clinics and dementia day care centres have been established in multiple locations. Furthermore, the Ayushman Bharat initiative includes financial help for Alzheimer’s patients’ treatment.

can-digitoxin-be-a-breakthrough-for-pancreatic-cancer

Fri Feb 27 14:20:32 IST 2026

Could the clue to a future cure lie in the past? It may sound like a philosophical musing, but a group of drug researchers in Sweden is exploring exactly that question—testing whether an archaic drug—digitoxin—could offer new hope in treating pancreatic cancer, one of the deadliest forms of the disease.

The story of digitoxin began not in a laboratory but in ancient and folk medicine, where the foxglove plant (Digitalis purpurea)—from which digitoxin is derived—had been used for millennia. In traditional European herbalism, foxglove leaves were brewed into teas for various ailments. However, its potency often led to accidental poisoning, earning it a reputation as a dangerous “witch’s herb”.

In 1775, William Withering, an English physician and botanist, encountered this folk remedy from ‘Mother Hutton’, an old lady from Shropshire. Mother Hutton’s secret herbal tea, which contained about 20 ingredients including foxglove, was reportedly successful in treating ‘dropsy’—a condition we now recognise as congestive heart failure caused by fluid retention. Intrigued, Withering began experimenting with foxglove extracts on his patients around 1776.

He systematically tested dried foxglove leaf powder, documenting doses, effects and side effects in over 150 cases. Soon, Withering found that foxglove could reduce fluid buildup by strengthening the heart’s contractions, and he also identified the most effective dosage range.

After a decade of trials, Withering published his seminal work in 1785, An Account of the Foxglove and Some of Its Medical Uses: With Practical Remarks on Dropsy and Other Diseases. This book introduced digitalis to mainstream western medicine, standardising its use while warning of its toxicity. Withering didn’t isolate specific compounds—he worked with crude leaf extracts, which contained a mixture of cardiac glycosides (sugar-bound steroids), including digitoxin.

In 1875, German pharmacologist Oswald Schmiedeberg isolated and named digitoxin using chemical fractionation techniques. His work enabled laboratory testing. By the late 1800s, digitoxin was being commercially produced and used worldwide to treat heart conditions.

In 1904, German physician Albert Fraenkel demonstrated its antiarrhythmic effects. However, digoxin (isolated in 1930 from a related plant) later supplanted digitoxin because it was easier to manage clinically. Until recently, the therapeutic efficacy of digitoxin in patients with heart failure and reduced ejection fraction had not been conclusively established in clinical trials. That changed in August 2025, when a trial presented at the European Society of Cardiology Congress showed that digitoxin improves outcomes in advanced heart failure.

Now, researchers are investigating whether digitoxin can be repurposed to treat pancreatic cancer. Laboratory studies have shown that digitoxin can disrupt cancer cell metabolism, interfere with calcium balance and, in some cases, induce cell cycle arrest or cell death.

If these findings hold up in clinical trials, it could mark the rebirth of a centuries-old drug with a new purpose.

how-to-identify-address-and-overcome-burnout-workplace-stress

Sat Oct 25 15:58:11 IST 2025

Burnout is a buzzword which is often bandied about when we feel a bit tired at work and overwhelmed by life. In fact, it is a syndrome with clear symptoms, including exhaustion and feeling cynical about your work, which was recognised by the World Health Organization (WHO) in 2019. It not only affects workers’ lives, but also the economy.

It is not a modern phenomenon, either. Graham Greene’s 1961 novel—A Burnt-Out Case—is about an architect worn down by his job. In 1974, Bob Dylan sang about being “burned out from exhaustion”.

In the same year, Christina Maslach, a professor of psychology at the University of California, started to research the phenomenon. She says: “Someone told me, ‘lawyers call it burnout’ and that term captured the feelings people were expressing to me.”

If you are exhausted, feeling negative and your performance has dropped at work, you may well be suffering from burnout—but how can you get back on track?

What is burnout?

The WHO defines burnout as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed”.

Prof Maslach, who is also the author of 2022 book The Burnout Challenge, explains: “Burnout is a stress response to those chronic job stressors. A stress response is a normal human response to threats or challenges, and it’s a good thing usually. That’s how we cope. But recovery is the issue.”

“When you run a marathon, you recover. Chronic job stressors—we liken them to pebbles in your shoes—are the daily things that are always in the way. But the optimistic note in the WHO definition is that stressors can be managed,” Prof Maslach adds.

Symptoms of burnout

The three main symptoms of burnout are:

1) Exhaustion

2) Feelings of negativity or cynicism towards your occupation

3) Reduced professional efficacy including difficulty processing information or making decisions

Prof Maslach describes the latter as the feeling of, “‘What’s wrong with me, why can’t I do it?’ Burnout is the trifecta of stress, disliking the job and yourself.”

Jacky Francis Walker, burnout specialist and psychotherapist, adds, “You feel more exhausted and lacking in energy as time goes on. It becomes an everyday experience. You are bone-tired—different to fatigue, you feel under temporary stress.”

“Secondly,” he says, “you feel disillusioned about your job and lose your motivation and engagement. There’s a sense of detaching from your commitments to your role. Finally, you might notice you are not as sharp mentally and it’s harder to process information or make decisions. You might work less effectively so you work longer hours.”

Stages and types of burnout

According to Prof Maslach the typical employee profiles are:

* Those who are engaged

* Those with burnout

* Those who are experiencing one of the three symptoms who may be on the road to burnout

In 2022, the American Psychological Association found 26 per cent of workers had a lack of motivation, 32 per cent emotional exhaustion and 44 per cent physical fatigue. According to Mental Health UK’s Burnout Report, 20 per cent of workers in the UK had to take time off work in 2023 due to occupational stress.

Research also suggests there may be differing types of burnout relating to different types of work environment.

1) Frenetic—marked by work overload and often experienced by highly involved, ambitious individuals

2) Underchallenged—experienced by those working in roles with no personal development

3) Worn-out—which occurs in a rigid, hierarchical organisation where workers may have a lack of control or recognition.

Steps towards burnout recovery

It is not as simple as writing up a self-care list. While there are steps the individual can take, workplace stressors need to be sorted too as ineffective coping mechanisms can exacerbate burnout, causing both physical and mental health issues.

Follow these steps:

1 Acknowledge burnout

The first step to recovering from burnout is acknowledging it. But that can be easier said than done when we are hard-wired to keep going.

“There is denial around burnout and we can lose insight the more burned out we become,” says Walker. Look out for early warning signs like:

Short-temperedness

Irritation with colleagues or frustration with small tasks

If you are in a caring profession, you may feel emotionally detached

“You can feel as if your batteries have been depleted: I say to clients you are not the famous brand of batteries which keep on going, you are the competitor,” adds Walker.

2 Remove stressors

Try to identify your workplace stressors, and remove “the pebbles”.

“Having recognised there is a problem and something needs to change, assess what is possible to change—what is the low-hanging fruit?” says Walker.

The stressor may not be the job per se. In her book The Burnout Challenge, Prof Maslach cites the following factors contributing to the perfect environment for burnout:

*Increased workload

*Lack of control

*Inadequate reward systems

*A toxic community

*Lack of fairness

*Opposing values

Work constructively with colleagues and management in addressing these. Prof Maslach says: “Can you say, ‘[Let’s] make this better?’ Can you make suggestions and be constructive? Can you say, ‘We don’t need patting on the back all the time, but occasionally let people know they have done something well?’”

According to the Mental Health UK survey, 43 per cent of workers cite having a supportive line manager as an effective measure in beating burnout. By law, employers are obliged to identify any risks to your health and must take steps to help prevent or reduce workplace stress.

3 Put boundaries in place

Walker says, “Knowing what your normal time boundaries are at work—when you start, when you finish—helps your brain understand, ‘This is when I normally switch off.’ There might be days when we need to push the boat out, but you need to know what your normal is.”

Being more disciplined about when we stop and start being in work mode, putting an out of hours response on emails, or switching off the work phone, can help.

4 Reassess goals

You may have to have some hard conversations with your employer about what is actually achievable, or with yourself, about the goals you have for your career.

A 2022 review into burnout states, “The expectations that employees have regarding their work are related to the level of burnout, such that higher expectations and higher goal setting lead to greater efforts and thus higher levels of emotional exhaustion and depersonalisation. This mismatch between expectations and realities can lead to frustration and burnout in workers.”

Walker says, “When someone is nearing recovery we look at what brought them to this place and what to put in place to make [their job] more sustainable. Often we need to address their attitude to their expectations of what they should do, would like to do, or ought to do.”

5 Focus on looking after yourself

Here are some tips:

* Eat healthily on and off the job

* Eat regularly, and not skipping meals

* Stay hydrated

Try cardiovascular exercise and yoga, according to a 2015 study both are effective in combatting stress and emotional exhaustion.

* Try meditation or mindfulness

* Try getting eight hours

* Try to have social contact with friends, co-workers, and family

* Try being out in nature and spending a day a month taking yourself out of your usual environment

* Switch off screens (maybe one day a week)

But these measures will not change your stressful situation. Prof Maslach says, “There are coping strategies out there: meditating, mindfulness, doing exercise, getting eight hours of sleep, and being more healthy, which don’t change the stressors, but help you be more rested.”

Remember that taking time out on sick leave or holiday may be a short-term way to cope with burnout, but it is not a long-term path to recovery.

Instead, Walker advises focusing on sustainable recharging strategies: “Start to put some healthy habits in place. Establish what is the non-negotiable bare minimum time away from work you need each week for you to sustainably function and give you enough respite.”

6 Seek professional support

In extreme cases of burnout, seek a therapist.

Cognitive behavioural therapy (CBT) can be effective in reducing burnout, it is a problem-focused talking therapy which gives people tools to cope with current situations and negative thinking patterns. A 2019 study of 60 nurses experiencing burnout showed CBT had an impact on feelings of negativity surrounding both the job and individual performance.

The strategy to overcoming burnout

Try the following techniques:

* Take back control

There is no hard and fast rule as to how long it will take to overcome burnout. Some people recover in three months and others may take years. But evidence shows those who acknowledged they were ultimately in control of their own lives recovered successfully.

A 2015 Finnish study of 12 people who attended a rehabilitation course after suffering burnout noted that, “The entire process of self-recovery represents a shift in clients’ perceptions from denying their burnout symptoms to a realisation they are ultimately in charge of their own physical and mental wellbeing.”

* Make changes to your lifestyle

According to Walker, changes we can make to create that “buffer zone” such as reading, exercising and switching off from workplace and online stress are a key part of a burnout recovery strategy. “We are bombarded with emails with expectations of responding immediately and also with visual stimuli, adverts and social media. It takes up mental load. Our buffer zone has been taken away from us,” he says.

Be careful that relaxation strategies such as socialising—which can be beneficial—do not fall over into negative habits such as self-medicating with alcohol or drugs to cope.

Prioritise quality sleep

Prof Maslach says, “The notion of that eight-hour workday, eight-hour personal time, eight-hour sleep—which is how the 24 should be divided—is actually how we as human beings function.”

A Mental Health UK survey found that 64 per cent of working adults thought that poor sleep was a contributory factor in burnout. Also, a 2021 study found nurses with burnout suffered from daytime sleepiness and poor sleep quality.

Make sure you wind down before bed. Walker says, “If your mind is overactive and you haven’t switched off, it will be hard to sleep. I call it the always-on brain. Build in at least 10-15 minutes before bed where you regroup, and perhaps make a note of what’s floating around in your head [such as worries or priorities for the following day].”

Prioritise activities you love

“Some people might like to go to the gym, cycle or do a hobby, or simply spend time with the family,” says Walker. In a Mental Health UK report, 71 per cent of people cited having a supportive social network as helping to prevent burnout.

Learn stress-management techniques

Walker suggests, “Take mental time out. Whatever works for you, like reading offline material including newspapers or simply closing your eyes, is fine.”

“You may have regular practices like mindfulness which helps you immerse yourself in another world for a period of time,” she adds. A 2023 study showed that diaphragmatic breathing—taking four deep breaths a minute—could improve negative reactions to stress.

If you have lost your commute to work, be mindful you might also have lost a key stress-management technique.

How to avoid burnout in the future

In extreme circumstances, some people with burnout may choose to leave their job. Ideally, you won’t have to take the nuclear option.

If you do, then the key to avoiding burnout in a new workplace is to:

Make sure there is a match between your values and theirs.

Ask sensible questions about the culture and specific examples like, ‘What’s the company’s approach to helping employees have a work-life balance?’

If you have experienced burnout and decide to stay in your job, then be aware of the triggers that led to it last time. “You may feel you have recovered and you are back to normal, but you start to put yourself under the same load, and you go down again,” says Walker.

Remember that it can be a two-way street between employee and employer. A 2020 study examined how employees could contribute to reduce burnout risks. Among these were: seeking out tasks that energise; socialising with co-workers; reducing work-home conflict—especially relevant with the rise of hybrid and flexible working.

No one wants to be stuck in a cycle of repeated burnout, but with collaboration, on both sides, it can be avoided.

medical-research-bias-women-gender-gap-health-feminism

Sat Sep 27 16:42:59 IST 2025

We often think of health as a gender-neutral subject, but in reality, the difference between the sexes in medicine is almost as stark as in athletics. Feminism in health today is a basic need, and not a privilege; it is about questioning systems that disadvantage women.

For decades, medical research has largely been conducted on man (and even male animals), treating male bodies as the ‘default’ model. As a result, the clinical presentation of many diseases, drug dosages as well as side effects and even adverse reactions of surgical implants in women at times vary from the listed ones or the established norms after a study/ trial.

Avoiding the female body in studies has its own reasons—makes the work easier since the hormonal fluctuations in women in various stages of life and a month are complex and any trial taking these variables into consideration is a time- and effort-intensive process.

It is necessary to bridge the gender gaps in the current or past trials, as medicines from past trials are in use today. The studies that were done with remarkable gender imbalance should be identified and re-examined in order to rectify the potential variations in women.

The US Food and Drug Administration did not mandate the inclusion of women in drug trials/ clinical research until the 1990s. The repercussions of that are evident even today. Also, there is no regulatory body mandate for equal participation of both genders, and sex disaggregated data submission is still not an acceptance criterion for a clinical study/trial.

A meta-analysis of data from thousands of medical journals, published in Journal of Clinical Medicine in 2022, found that women are likely to experience adverse drug reactions twice as often as men. They develop higher blood concentration levels and longer drug elimination times, leading to higher degree of side effects.

Here are a few examples to help understand cases of misapplied medicine in women:

The most burning instance is the insomnia drug Zolpidem, which has slow pharmacokinetics (how the body reacts with a drug over time) in women, leading to complications. This drug concentration was higher (three-fold) in women and stayed in blood beyond the morning after its use, leading to drowsy office hours and worse, vehicular accidents. It was only in 2013, after 30 years of its availability in the market, that the FDA halved the recommended dose for women.

So is the case with antidepressants and antipsychotics. As any human anatomy book will reveal, women have higher body fat percentage, so the fat-soluble drugs (like SSRIs, antipsychotics) are stored and released differently, leading to varied or increased side effects.

When it comes to cardiovascular disease, a ‘classic’ symptom documented is chest pain radiating down the arm. But in women, the common symptoms are jaw pain, fatigue, nausea or even back pain. Moreover, aspirin—recommended for heart attack prevention—was found to reduce risk of stroke but not heart attack.

Also, more often clinicians treat chronic pain and even chest pain in women as psychological issues rather than investigating a physical source of the pain.

The story is similar, if not worse, in medical device usage. Since women have different hip angles, bone density and joint sizes, the hip implants tested on men presented with more adversities in women.

In cardiac pacemakers and defibrillators, women have been receiving fewer benefits. Women mostly have smaller heart, and the metabolism of electrical signals generated in these devices often differ in women. A JAMA (2009) meta-analysis reported women being less likely to benefit from intra-cardiac devices (ICDs), and face more complications during or post ICD implantation.

The size and design of artificial heart valves put women more at risk of mismatch between valve size and cardiac anatomy. As per research studies in Circulation (2014), women were at higher risk while undergoing transcatheter aortic valve replacement. Also, women’s smaller coronary arteries make stent placement riskier, with higher chances of restenosis (narrowing of artery) and complications. A study in European Heart Journal (2016) confirmed that women had worse outcomes post stenting.

Also, the clinical system today reflects a poor understanding of menopause—a landmark phase in a woman, with about 40 per cent of her life ahead. Menstruation and mental health around hormonal fluctuations are areas lagging in mainstream care-giving.

Now is the time to revisit stereotypes and ensure prudent policies for both genders. The solution approach to gender discrepancy in health care is enforcing inclusive clinical studies or trials and mandating sex-disaggregated data in every study. Those funding studies and journals publishing them should make this a mandatory requirement. The other best practice would be to include hormonal and life-stage variables in studies, tracking menstrual cycle, stages of pregnancy and menopause and influence of hormone therapy, which alter pharmacokinetics.

Most important, medical education needs reforms to sensitise budding doctors to such gender-related differences in physiology, pathology and in treatment protocols.

Gender equality and equity in health is a matter of scientific accuracy and also justice. Modern medicine has always presented itself as neutral, objective and universal, but it is time to add a female perspective in every research/ trial. This will address historical disparities and ensure well-being of half the world’s population.

The writer is a pathologist and an author.

how-marbles-healths-ease-tdcs-offers-new-path-for-depression-anxiety

Mon Sep 29 16:50:01 IST 2025

John (name changed), 30, was struggling with low mood, crying spells, anxiety and sleep disturbances. Since he had previously experienced serious side effects from psychiatric medication, he was unwilling to take that route again. So when he visited Dr Avinash Desousa, senior consultant, psychiatry, at Sir H.N. Reliance Foundation Hospital, Mumbai, and director of the Desousa Foundation, the doctor had an alternate approach. He turned to a neuromodulation device called EASE, developed by the Indian health-tech startup Marbles Health. The brain is an electrochemical organ: psychiatric drugs act on its chemical messengers, while neuromodulation targets its electrical signals.

EASE, which employs the proven technique of transcranial direct current stimulation (tDCS), is the first licensed neuromodulation device of its kind to be created in India. “[For John], we suggested a trial of tDCS: 10 sessions, five days a week for two weeks,” says Desousa. “If he felt better, we would extend it to 30–40 sessions, followed by maintenance sittings.” The patient eventually underwent 30 sessions, after which he continued maintenance tDCS twice a week, later reducing to once a week. “Now he is stable and doing well. Importantly, the treatment was combined with psychotherapy,” says Desousa.

Witnessing loved ones struggle with mental illness pushed tech entrepreneurs Ramya Yellapragada and Lakshay Sahni to build this device. “We know very little about the brain and what truly works for it,” says Yellapragada. “Pills aren’t always the best or safest option. A huge part of brain function runs on electrical signals, so the question was, how do we harness that to heal?”

Neuromodulation, which involves sending small currents to specific brain areas, emerged as a safe and effective solution. “Licensed technologies already exist and are highly effective, but they are priced in crores,” says Yellapragada. “Most hospitals, especially psychiatric clinics, cannot afford them. That’s what pushed us to create solutions that are effective, affordable and scalable—starting in India, but designed for the world.”

EASE has been designed as a portable, wearable headband. Sahni notes that the upper part delivers tDCS neuromodulation by sending gentle impulses to the brain, while the lower part monitors brain activity using electroencephalogram. “The upper part is therapeutic; the lower part helps with diagnosis,” he explains.

Alongside this, the device also provides an option for Cognitive Emotional Training (CET), which improves cognitive functions. “When you do these training activities while being stimulated, the [therapeutic] effects are compounded,” says Sahni, adding that their medical device has been designed to be operated by mental health professionals or doctors.

Desousa says he is using EASE to develop treatment modalities for managing depression as well as resistant hallucinations in schizophrenia. “Psychotherapy or medication can be combined with tDCS. But in some patients with mild to moderate depression, it can even be used as a stand-alone treatment,” he explains.

Sahni adds that in their trial in India, patients showed a 63.8 per cent decrease in illness scores within two weeks of use, without any adverse side effects.

Yellapragada notes that EASE has also shown strong promise across a range of other psychiatric conditions, including anxiety, obsessive compulsive disorder, phobias and addiction disorders, as well as neurological conditions such as aphasia and mild cognitive impairment. The team is also exploring neuromodulation’s potential in areas from stroke rehabilitation to dementia care. “We have seen doctors themselves identify new areas—where the same brain networks are involved—in which the device could be used,” says Sahni.

The validation study for EASE was conducted at AIIMS Delhi with 25 patients, each undergoing around 20 sessions. Marbles Health founders say it took more than four years to develop EASE, and since its pilot launch earlier this year, they have partnered 40 leading hospitals and clinics in India, delivering thousands of sessions. They have also signed MoUs with the NHS in the UK and are conducting joint studies with two major Indian hospitals.

The founders emphasise that the current version of EASE is about 35 per cent cheaper than foreign alternatives. “We are also developing a further affordable version of the device,” says Sahni. “Our long-term vision is similar to how BP machines moved from clinics into households. One in seven homes worldwide faces a mental or neurological condition, and we hope our device will eventually be used—under medical supervision—in these homes.”

why-cannot-stop-scrolling-phone-infinite-scroll-addiction

Tue Oct 07 11:59:21 IST 2025

Before our thumbs learned the reflex of swiping up and our eyes adjusted to a feed with no end, there was just a small design experiment—and a young designer named Aza Raskin.

In 2006, Raskin was working at a small software company called Humanized. Back then, the internet felt slower, more deliberate. Every time you reached the bottom of a page, you had to stop, move your mouse and click ‘Next’. It was a small interruption, but it broke the spell. Raskin wondered: what if the page didn’t stop? What if it just kept going?

He wasn’t thinking about addiction or attention spans, just a smoother, more seamless web. But that one tweak would cause a ripple across the internet, quietly reshaping how billions of us now spend our days and nights. We call it the infinite scroll.

For many people, scrolling is no longer a conscious decision. It is a reflex—something your hand does without waiting for your mind to catch up. And once you start, you rarely notice how deep you have gone.

Every night, Delhiite Shreya Arora, 27, tells herself the same lie: just five minutes. Ninety minutes later, she is still lying in the dark, the pale blue glow of her phone casting across her face, her thumb moving like it has a mind of its own. “It is like my brain checks out,” she says quietly. “But my hand keeps going.”

Across town, HR manager Rohit Sharma, 43, calls it “time theft”. “I didn’t choose to waste that time,” he says. “It is like the app chose it for me.”

From students delaying assignments to parents grabbing a rare moment of quiet, millions of us are caught in the same loop. What starts as a quick peek turns into an hour. Or two. Or more.

One evening, Tarun Katyal, 38, a finance analyst in Gurugram, came home tired. He dropped on to the sofa, phone in hand, and opened a short video “just to unwind”. One reel turned into five. Five turned into 30. When he finally looked up, two hours had slipped by. His dinner sat cold on the table, his head was pounding, and he felt empty. “I didn’t even like what I was watching,” he says. “I just couldn’t stop. It was like I had been hypnotised.”

Vartika Mehra, 25, who lives in Lucknow, knows the feeling all too well. After a breakup, she felt hollow—no energy for friends, no words for therapy. So she turned to her feed. One ‘glow-up’ reel became another. Sad songs. Healing quotes. Strangers crying into their cameras.

At first, it felt like comfort, as if someone out there was hurting alongside her. “It felt like therapy,” she says. “But then it just felt like nothing. I wasn’t crying anymore. I wasn’t feeling anything. I was just gone.”

Akshay Jain, 17, from Noida doesn’t even pretend anymore. Most nights, he watches ‘study with me’ videos instead of studying—strangers working in cafés with soft background music. It looks and feels productive, but it isn’t.

It might feel like you are making those choices—opening the app, swiping, tapping—but much of it was decided for you long before your thumb moved. The truth is, the scroll isn’t just a habit. It is design.

The design that never lets you stop

“This isn’t happening by chance,” says Prof Mohit Bhardwaj, head of user interface (UI)/user experience (UX) at the Indian School of Design and Innovation in Mumbai. He explains that infinite scroll is a powerful mechanism that turns scrolling into a low-effort, almost mindless activity while algorithms quietly curate what you see. “The feed never ends, so your brain never gets the message that it is time to stop,” he says.

He points to a UX principle called progressive disclosure—revealing information gradually in small, easy-to-digest chunks so your brain doesn’t have to work too hard. Because there is no natural break in the feed, there is nothing to slow you down. “No friction means no pause,” he says.

Bhardwaj also talks about completion bias—our urge to finish things to get closure. “Unfortunately, here there is no finish line,” he says. It is like a story with no last page, keeping your brain waiting for an end that never comes.

In his classes, Bhardwaj starts with what not to do—dark patterns, manipulative prompts and design tricks that trap people. Only after that does he move to accessibility, inclusion and ethical design. “Users are people, not just numbers on a dashboard,” he tells his students.

If Bhardwaj focuses on the “how” of infinite scroll, Manish Goyal, UX Designer-1 at Onething Design Studio, zeroes in on the feeling it creates.

“Vertical scrolling feels natural to the brain,” he says. “It takes less mental effort, it feels smooth, and it keeps the content coming. But that sense of control you think you have? It is an illusion—the system is choosing what you see next, not you.”

Personalisation, he explains, is another powerful hook. Algorithms learn what makes you pause and feed you more of it, creating the impression that the app truly knows you.

“Wellness tools exist—time-limit pop-ups, usage dashboards—but they are buried deep in the settings menu,” says Goyal. “The tools that keep you engaged? Those are the defaults.”

For him, ethical design isn’t a fantasy. He points to examples already in play: LinkedIn lets you mute updates and even reach the bottom of your feed. Brave Browser blocks trackers without fuss. Notion sends you summaries without dangling endless notifications. Even Instagram offers time-limit reminders—though, as Goyal notes, most people never turn them on.

And it is not just designers who notice. Developers see it happening in real-time. For Bhumik Virmani, a full stack developer team lead at EchoWave Media, it comes down to friction, or rather the lack of it. “The fewer clicks or taps you need, the longer you will stay,” he says. “Auto-play starts the next video before you have even decided if you want to watch it. Pull-to-refresh works like a slot machine—a skeuomorphic design that mimics the motion of pulling a lever. That unpredictability keeps the brain curious.”

And the loop is only getting tighter. Instagram is now testing an auto-scroll toggle for both reels and regular posts, so the feed keeps moving without you even swiping—the design does the scrolling for you.

Virmani is quick to point out that ethical alternatives exist. Snapchat, for example, now offers in-app mental health resources when certain topics are searched. “It is proof,” he says, “that you can design for engagement without trapping people.”

Those design choices work because they tap into something deeper—the brain’s own built-in reward system, where psychology takes over from design.

The mind’s own slot machine

“Scrolling and tapping on social media have a similar effect on the nervous system as slot machines or spin wheels,” says Dr Jyoti Kapoor, senior psychiatrist and founder of Manasthali. “As you scroll, anticipation builds for what might come next. Each tap triggers a release of dopamine—a short burst of pleasure—and you repeat the process to feel it again. It is not what you see, but what you might see that keeps you hooked.”

Most people, she says, don’t realise they are in this loop until someone points it out and, by then, the habit is well-worn. “Like any addiction, compulsive social media use replaces activities that truly build you up—reading, creative work, conversations with family, exercise, even quiet moments alone. Social media doesn’t relax you; it overstimulates you. That leads to burnout and a lower tolerance for stress.”

The toll isn’t just mental. Hours hunched over a phone strain the neck, shoulders, thumbs and fingers. Blue light throws sleep cycles off balance, which in turn makes you more likely to pick up your phone late at night, restarting the loop. She points to research showing a rise in anxiety, mood disorders and even suicide among teens and young adults over the past two decades. “The correlation,” she says, “is hard to ignore.”

Kapoor’s prescription is simple but firm: start with awareness, track your usage, set alarms, replace scrolling with screen-free hobbies, prioritise face-to-face interactions, create a phone-free bedtime routine and switch off the internet for a few hours each day.

There is also an emotional side to the scroll—one that psychologist Dr Shweta Sharma, founder of Mansa Global Foundation, calls “intermittent reinforcement”, the same pattern that makes gambling addictive. But it is not just about dopamine. “Scrolling often works as a buffer against discomfort: boredom, loneliness, anxiety, fatigue. It feels like movement, but it is really avoidance.”

Over time, explains Sharma, that avoidance dulls emotional rhythms, scatters attention and weakens impulse control. For younger users, it can even replace the ability to sit still and process emotions. “If you have never learned to just be with your feelings, scrolling becomes your go-to escape.”

That kind of emotional avoidance, says Prachi Saxena, clinical psychologist and cofounder of The Emotional Wellness Initiatives, can also show up as a “flight” response—the brain’s way of dodging difficult emotions. “Instead of sitting with them, we grab the phone and flood ourselves with something that hooks us instantly,” she says.

She explains that platforms know this and use “primitive cues” to exploit it—red notification dots, bright animations and sounds that mimic alerts from the natural world. The human brain, she warns, “is not designed to be constantly bombarded with irrelevant information”. Processing it all “drains your mental energy, making you less able to solve problems or adapt.” Blue light from screens, she adds, disrupts the brain’s natural rhythms, leaving people physically tired but mentally wired.

Her advice is simple: get comfortable with a little discomfort. “Set a short timer before you start scrolling, and stop when it goes off,” says Saxena. When boredom creeps in, call a friend. When you crave something new, step outside and let your senses wake up—notice the air, the sounds, the colours around you. And when anxiety is what’s driving you to reach for your phone, put pen to paper. Writing it down activates the same parts of the brain that help regulate emotion. Little by little, you take back control from the scroll—one pause, one choice, one word at a time.

Some people only notice this pattern when it is broken, often by accident. That’s what happened to Shreya Arora. The turning point came one night when her phone died mid-scroll. She stared at the black screen in her hands and realised she couldn’t remember the last time she had just sat with her thoughts. Since then, she has been taking pauses—walking without headphones, switching her phone off before bedtime. She still scrolls, but now she notices when she is doing it. “Sometimes,” she says, “that’s enough.”

Bhardwaj calls these moments “breaks in the loop”—brief interruptions that allow people to see the system for what it is. “The design is built so you never reach the end,” he says. “When you stop, even for a minute, you notice yourself again.”

And one last thing: It’s okay to still scroll

You’re not weak for scrolling—these platforms were built to keep you here. Remember it is by design, and it hasn’t changed much since that tweak in 2006. But you have—now you know how it works. And sometimes, that’s all it takes to choose when to stop.

Healthy scroll habits to break the loop

• Set a 20-minute scroll timer—pause before continuing

• Move social apps off your home screen to reduce temptation

• Log out after use to add a moment of reflection

• Replace scroll breaks with grounding activities—walk, stretch, journal

• Use built-in tools: ‘You’re All Caught Up’ nudges, screen time limits

• Let boredom breathe—don’t fill every quiet moment with a swipe

94.2% of internet users (ages 16–64) access the web via smartphones

11.3% of social media users globally meet clinical criteria for addiction

Users spending 3+ hours/day are 4.7x more likely to face relationship issues

Children under 5 years spend 2.2 hours/day on screens, twice the recommended safe limit: ICAN study

female-cardiovascular-risks-women-heart-attack-symptoms

Sat Sep 27 15:58:27 IST 2025

A woman’s heart may be deep in feeling, but anatomically it is smaller than a man’s. Its walls are thinner and its blood vessels finer, even when body size is matched. Functionally, women have a faster heart rate and a higher ejection fraction (the proportion of blood pumped per beat), but their overall cardiac output—the total volume of blood pumped per minute—remains lower than in men.

Female hearts are not simply scaled-down versions of male hearts; differences in wall thickness and chamber proportions mean many features do not reduce proportionally with body size. Women’s hearts also show greater contractility, and sex hormones shape their response to stress and regulate calcium, producing distinct rhythm patterns and metabolism. These differences influence how men and women experience, present, and are diagnosed with heart disease. In India, men show a higher prevalence of heart disease, particularly ischaemic heart disease (IHD), and are affected at younger ages. In women—especially post-menopause—heart disease carries higher mortality rates and worse outcomes after cardiovascular events.

Most common conditions: For both sexes, these are IHD, valvular heart disease, and congenital heart disease. IHD, also known as coronary artery disease, occurs when cholesterol builds up in the coronary arteries. Severe obstruction deprives the heart muscle of oxygen, causing angina (chest pain). A rupture and a blood clot results in a heart attack. Valvular heart disease arises when one or more of the heart’s four valves do not function properly, either because of birth defects or childhood infections.

Heart attacks in women: Half of the women have atypical symptoms. Instead of the classic chest pain, they may experience excessive sweating, palpitations, nausea, vomiting, epigastric discomfort, backache, breathlessness, or extreme fatigue.

The risk of misdiagnosis: Women’s symptoms are frequently mistaken for gastritis or psychological symptoms. Greater vigilance is crucial: tests like ECG and echocardiography and treadmill tests should be done to catch early signs.

Cardiac arrest vs heart attack: The first is the condition where heart stops functioning totally. Heart attack occurs when the coronary artery is totally obstructed and causes decreased blood supply to the cardiac muscle. Heart attack can lead to cardiac arrest.

A time of increased vulnerability: Women become increasingly vulnerable to heart disease after 40-45 years, especially post-menopause. Women with diabetes and uncontrolled hypertension are prone to heart problems at a younger age. With menopause and the resultant lowering of oestrogen, women become more prone to heart problems than men.

The oestrogen connection: Oestrogen is beneficial for metabolism and increases good cholesterol. It also dilates the coronary blood vessels, improving the circulation to the heart. So women in their reproductive years are protected from heart problems because of oestrogen. But this shield is lost if they have diabetes and hypertension.

Differences in recovery: When treated early, women recover as well as men. But if treatment is delayed, outcomes become relatively poor. Smaller vessel size and more advanced disease at presentation also makes cardiac procedures like coronary angioplasty or bypass surgery less successful.

The menopause connect: As oestrogen levels come down, cholesterol levels go up. Those with high blood pressure and onset of secondary diabetes are at increased risk of heart problems. Reduced oestrogen and increased cholesterol level causes blood vessels to stiffen further, putting the heart at greater risk.

Effect of birth control pills: Use of these, especially in post-menopausal women, has yielded conflicting results. If you use these long term, they can cause an increase in clotting tendencies and cause blood clotting in the limb vessels, which can go to the lungs and cause pulmonary embolism. But contraceptive pills with low oestrogen and progesterone have been shown to have fewer detrimental effects.

Hormone replacement therapy: HRT initiated early after menopause, that is within the first two years, can benefit patients with definitive indication of heart problems. Women aged 60 and above are found to have more cardiovascular complications with HRT.

Pregnancy and heart health: Most women do not exhibit heightened heart problems during pregnancy. But those who have valvular or congenital heart disease can have complications because of the increase in volume of the heart and other physiological changes during pregnancy. Those who have narrowed valves can develop signs of heart failure in the second trimester. They should have regular evaluations to catch early complications.

Peripartum cardiomyopathy: This is a variant of heart myocardium, which is seen during the later stages of pregnancy (about 28 weeks) and up to six months post-delivery. This occurs when the heart muscle becomes weak, decreasing the heart’s pumping ability to pump. It can cause signs of heart failure or arrhythmia (irregular heart beat). Women who fall pregnant very early (before 20) or late are at greater risk.

As women age: Women over 65 can have increased cardiac risk because most of them tend to develop diabetes, hypertension or have high levels of bad cholesterol.

The Indian scenario: Indians develop heart disease about 10 years earlier than western populations—between 40–60 for men and 50–60 for women. High levels of lipoprotein, early onset of diabetes and hypertension, and dyslipidemia (elevated cholesterol) increase the risk.

Indian women’s unique risks: Hypertension often appears earlier and at lower body weight. Diets high in junk food and trans fats, sedentary jobs and stress raise risks.

Triple threat—diabetes, high blood pressure and thyroid disorders: High blood pressure stiffens blood vessels and reduces blood supply. Diabetes increases cholesterol deposition and vessel thickness, causing stiffening that can lead to early heart attacks. Thyroid disorders elevate blood pressure and add to cardiac risks.

Lifestyle changes are key: Your diet should contain large amount of fresh fruits and vegetables, and nuts and proteins. Reduce intake of carbohydrates. Exercise at least 30 minutes per day for five days a week, or 45 minutes four days a week. Implement these changes as early as possible.

Beyond the heart: A healthy heart is also crucial for a healthy brain. Deterioration of brain function increases risk of strokes. Women with poor cardiac health tend to have a higher incidence of miscarriages or premature deliveries. Other complications during pregnancy include heart failure, arrhythmias and pulmonary embolism (when a blood clot travelling through the bloodstream blocks an artery in the lung).

Heart disease and mental health: Women who have severe anxiety or depression are more prone to heart problems. Heightened levels of stress lead to increased heart rate. Depression can lead women to adopt unhealthy eating and sedentary habits. The risk of hypertension increases correspondingly.

Acute and chronic stress: Increasing levels of stress affect women’s health by increasing the incidence of hypertension and diabetes, which in turn compounds cardiac risks. Meditation, good music and books can help lower stress and reduce heart problems in the long run.

Questions women must ask doctors: Women should inquire about their risk of heart problems, especially those who have a family history of cholesterol, hypertension and diabetes. They must ask when they need to start getting evaluated based on their risk factors.

Links with autoimmune diseases: Autoimmune disorders like lupus and rheumatoid arthritis, besides bringing pain and stiffness, can cause vasculitis (inflammation in blood vessels). This can cause heart attacks and strokes.

The polycystic ovary syndrome connect: Because of impaired glucose tolerance and higher risk of diabetes, PCOS tends to increase cardiac risk. Optimal management of PCOS can prevent heart problems.

low-oxygen-parkinsons-treatment-hypoxia-research

Fri Feb 27 14:21:11 IST 2026

There is a saying that even amrut (nectar), when taken in excess, can become poison. The same is true of oxygen. At abnormally high levels, oxygen can damage tissues and organs. A new study in Nature Neuroscience reports that in Parkinson’s disease, cellular dysfunction leads to an accumulation of oxygen in the brain, which, in turn, drives neurodegeneration. Interestingly, the potential solution may lie in a low-oxygen environment—similar to the thin air at Mount Everest’s base camp.

Researchers from Harvard Medical School, Massachusetts General Hospital and the Broad Institute of MIT and Harvard found that exposing mice with a Parkinson’s-like condition to reduced oxygen levels helped restore their movement, reduced anxiety-like behaviours and halted further loss of neurons in the brain.

Parkinson’s disease affects more than 10 million people worldwide. It is marked by the progressive loss of neurons in the brain, leading to tremors and slowed movements. These neurons gradually accumulate toxic protein clumps called Lewy bodies, which are believed to disrupt mitochondrial function that powers the cell.

Anecdotal evidence show that people with Parkinson’s often report doing better at high altitudes. Similarly, long-term smokers—who typically have elevated carbon monoxide and lower oxygen levels in their tissues—appear to have a lower risk of developing Parkinson’s, though smoking carries significant risks for many other diseases.

However, researchers caution that the neurological recovery seen in mice has not yet been verified in humans. They also warn that unsupervised exposure to low-oxygen air can be dangerous and may even worsen Parkinson’s disease.

Still, the findings in mice open the door to an entirely new paradigm for treating Parkinson’s. Researchers in the team had previously observed that low oxygen could ease neurological symptoms in rare mitochondrial disorders such as Leigh syndrome and Friedreich’s ataxia.

In the latest study, researchers placed mice in a hypoxic environment after Parkinson’s symptoms had already appeared. As the mice showed a rebound in motor skills and a halt in neuron loss, scientists suggest that early intervention could potentially restore neural function in Parkinson’s patients.

To probe the underlying mechanism, the team analysed mouse brain cells. They found that mice with Parkinson’s symptoms had significantly higher oxygen levels in certain brain regions compared to the healthy mice and those exposed to low oxygen. This excess oxygen likely accumulates because dysfunctional mitochondria are unable to use it efficiently, leading to damaging levels.

Building on these findings, researchers are now developing experimental ‘hypoxia-in-a-pill’, designed to mimic the protective effects of low oxygen. They believe this approach may hold promise for other forms of neurodegeneration, too.

genrobotics-ai-robotics-solutions-bandicoot-g-gaiter-innovation

Tue Sep 02 13:58:16 IST 2025

It all began with a college project—an Iron Man–like suit, a wearable machine that could lift heavy loads and help soldiers in remote, harsh terrains. What four friends—Vimal Govind MK, Arun George, Nikhil NP, and Rashid K.—once built in youthful spirit has today grown into Genrobotics, a company developing breakthrough technologies that address challenges impacting not just people’s health, but also their livelihoods, dignity, and social inclusion.

“Our main idea has always been to use robotics and AI to address real problems in society,” says Vimal Govind, CEO and director of the Kerala-based firm that created pathbreaking robots. Developing a full-fledged exoskeleton and taking it to market required years and massive funding. So, the team repurposed a part of that project—the arm section—to create their first product, Bandicoot, a robot designed to clean manholes and sewers, replacing the hazardous work of sanitation workers.

The robot tackled not just the social stigma of manual scavenging but also its medical toll. “Manual scavenging is an inhumane practice that still claims a life every five days in India,” says Govind. “It is often tied to marginalized communities, where workers die young—often before 50—due to occupational diseases. When parents die early, their children are forced into the same work, trapping families in a vicious cycle. By introducing robotics, we’ve broken that cycle for many.”

Genrobotics then created its first product for disability rehabilitation, G-Gaiter, repurposing the technology originally developed for the leg section of the exoskeleton.

“At the core, the technology and vision were similar, and so was the impact—whether giving mobility back to a disabled person or freeing someone from a degrading, inhumane job, we were restoring dignity and independence,” says Govind.

G-Gaiter evolved into a world-class technology, giving Genrobotics a niche position in the physical medicine and rehabilitation segment. Govind notes that traditional gait training—heavily dependent on manual support—was largely inefficient, as walking involves the coordination of six limbs, which is nearly impossible for a therapist to control accurately with just their hands. The robot solved this challenge.

In both Bandicoot and G-Gaiter, government partnerships played a pivotal role. The Kerala Water Authority (KWA) was Bandicoot’s first client, while G-Gaiter has been deployed in both private and government hospitals.

Today, Genrobotics’ robots are employed across 22 Indian states and in four countries. In the gait trainer segment, Govind points out that G-Gaiter is four times cheaper than comparable foreign alternatives. “With new plants coming up in multiple locations, large-scale manufacturing will further reduce costs,” he says.

Genrobotics is now rapidly expanding its product portfolio. In sanitation and industrial robotics, products like the G-Spider robot are automating waste removal from canals. In healthcare, the focus remains on physical medicine and rehabilitation. “Within the next three months, we will launch an upper-body rehab device, complementing our existing robots to create a complete rehab ecosystem.

Additionally, our R&D team is working on humanoid and semi-humanoid robots, which we expect to launch in about a year. Our overarching vision remains improving mobility, delivering quality rehab, and creating advanced robotics solutions for society,” says Govind.

hangover-science-remedies-alcohol-aftereffects-solutions

Sat Aug 30 16:50:50 IST 2025

Interestingly, while hangovers are the most commonly reported negative effect of alcohol use, scientific study into the condition remains a niche interest.

Dr Sally Adams of The University of Birmingham is one of the few academicians involved in hangover research. “There is so much research on the effects of alcohol on the body, but nothing on the effects the following day,” she said, “This is an area that potentially has really serious consequences for physical and mental health. It costs the economy a fortune. It is an under-investigated topic, probably because we look at it in a trivial way.”

Anyone who has suffered a hangover knows that there is nothing trivial about them.

What are the symptoms of a hangover?

As hangovers are not a specific illness but are a combination of different reactions to the way your body reacts to excessive alcohol consumption, and as everyone reacts to alcohol in different ways, people experience hangovers in different ways. Genetics also play a role as genes determine how efficiently people metabolise ethanol, which is the form of alcohol found in beverages.

A survey published in the journal Alcohol and Alcoholism followed 1,410 Dutch students with hangover symptoms. It listed 47 symptoms, and the top 10 were:

* Fatigue

* Thirst

* Drowsiness

* Sleepiness

* Headache

* Dry mouth

* Nausea

* Weakness

* Reduced alertness

* Concentration problems

Also listed were: apathy, agitation, gastrointestinal problems, tremors, regret, guilt, depression, anxiety and vomiting. Symptoms will also depend on how much you have drunk and what you have drunk.

Cask-aged and matured beverages like whisky and cognac for example, contain complex compounds called congeners.

In his book Drink? The New Science of Alcohol and Your Health, David Nutt, professor of neuropsychopharmacology, wrote: “The longer whisky is stored, or aged, the more some of the alcohols will join together to form more complex alcohols called congeners.” It is thought that these may create worse hangovers.

Is there really a hangover cure? The bad news is, there is no definitive cure. But there is plenty you can do to treat the symptoms.

“If there was a miracle hangover cure, it would have to address all the symptoms,” said Adams, “and it would be very difficult for one thing to address the stomach irritation, the dehydration, the anxiety, the effect on the brain.”

In Las Vegas, Hangover Heaven is a hangover clinic which also sends medics to hotel rooms to deliver a regime of treatments that promises to get even the most debilitated revellers back on their feet within two hours. But the process is not simple. “Patients” are treated with a combination of drugs and therapies which include oxygen, Propranolol, a beta-blocker that slows heart rate, vitamin infused IV drips, Zofran, an anti-nausea medicine widely used in chemotherapy recovery and Toradol, a powerful painkiller.

But in the absence of prescription meds and IV drips, there are simple measures you can take to treat the main symptoms.

Hangover cures

Here are some at-home measures you can take:

1. Water (with added electrolytes)

This can be in the form of a sports drink. Dr Howard LeWine, from Harvard Medical Publishing, said: “Alcohol promotes urination because it inhibits the release of vasopressin, a hormone that decreases the volume of urine made by the kidneys. If your hangover includes diarrhoea, sweating, or vomiting, you may be even more dehydrated.”

“Although nausea can make it difficult to get anything down, even just a few sips of water might help your hangover,” he said.

2. Anti-inflammatories

Prof Nutt said, “Take ibuprofen when you go to bed and/or when you wake up, ideally with food as it can be harsh on the stomach lining.”

3. Stomach settler

Heartburn from an irritated stomach can be treated with an antacid, some of them also help to rehydrate. And some also contain aspirin and paracetamol for headaches and pain, and caffeine for drowsiness.

4. Positivity

Low mood and anxiety are overlooked symptoms but can also be profound, lasting long after physical symptoms abate. Adams recommends doing something that is gentle but enjoyable, like watching a comedy. “Psychologically, it helps to do something that is going to make you feel good. Whatever normally helps you if you feel low or anxious, engage in that,” she said.

5. Sleep

Alcohol has sedative properties which work for around four hours after which people commonly wake with a headache, feeling alert and unable to get back to sleep. “This is because your brain knows being intoxicated is potentially dangerous,” said Nutt. “As soon as you started drinking the night before your brain started to change.”

Although it can be hard, try to get a good night’s sleep after a drinking session.

6. Food

While it may be hard to keep food down initially, it is a good idea to try and eat something. One study investigated the effect of the amino acid L-cysteine on alcohol/acetaldehyde related after-effects. It concluded a dose of between 600mg and 1,200mg could help with symptoms of nausea, headache, stress, and anxiety.

L-cysteine is found in high protein food including eggs and cheese. Carbohydrates such as toast can help replenish depleted blood sugar levels.

7. B vitamins and zinc

A study published in The Journal of Clinical Medicine evaluated diets for 24 hours before and after excessive drinking occurred. Although it was a small cohort, with results based on the participants describing what they ate, rather than them being fed under supervision, the study did find that people whose food and beverage consumption contained greater amounts of zinc and B vitamins had less severe hangovers.

It might be worth a try, but don’t expect miracles.Some products market themselves as cures. It contains a range of compounds including “bacteria, L-Cysteine and vitamin B12” and claims to “contribute to the reduction of tiredness and fatigue and helps to support the immune system and contributes to normal energy levels”.

Dr Adams is cynical though, as some of them are a food supplement, not a medicine, and so can make claims without having to undergo rigorous peer reviewed testing.

Hangover myths

Myth 1: Just drink water. “One of the biggest myths is that water will solve everything, and that a hangover is only dehydration,” said Adams. “Water isn’t a miracle cure.”

Myth 2: Have a drink the morning after. Experts also dismiss drinking more alcohol to alleviate a hangover, a practice commonly known as “hair of the dog”. Prof Nutt said it “as the very worst thing you can do”.

“You are delaying your hangover by putting alcohol back into your brain,” he wrote.

Adams said: “You are just chasing the drugs.” She said that while reaching for more alcohol the next day may not indicate addiction, the transition from using alcohol to experience pleasure to using it to escape feelings is an unhealthy pattern of behaviour.

What causes hangover symptoms anyway?

Hangovers are a combination of conditions—both physical and psychological—caused by the excessive consumption of ethanol in alcohol. Different processes in the body contribute to different symptoms which vary in intensity depending on several factors, including the amount and type of alcohol consumed and the circumstances in which it is drunk.

A number of factors can contribute to hangover symptoms.

Dehydration. “Alcohol is a diuretic, so quite often there is dehydration and an electrolyte imbalance, particularly if you have been sick,” said Dr Adams.

Inflammation of the gastrointestinal tract. “[Around] 80 per cent of alcohol is absorbed by the stomach and small intestine, so the inflammation of those areas can also cause gastric symptoms.”

Acetaldehyde production. One of the ways alcohol is metabolised in the body is by an enzyme called alcohol dehydrogenase (ADH). This breaks down the ethanol and creates a compound called acetaldehyde during the process.“This is toxic for humans and is responsible for the sweating, heart-racing, vomiting and nausea you feel.”

Release of neurotransmitters. Excessive consumption creates an imbalance in neurochemicals. “The brain will try to put that right and get everything back to correct levels but sometimes that doesn’t happen, and we get a lot of neurotransmitters released that cause us to feel anxious and low the next day”. This psychological aspect of a hangover creates what has been termed “hangxiety” or “beer fear” and can affect judgement and reactions long after a breathalyser will deem it safe for you to drive.

Other factors that cause hangovers are inflammation and mitochondrial damage, particularly in the liver. Mitochondria are the energy-producing elements in every cell and are susceptible to damage from the free radicals produced by acetaldehyde.

FAQs

How long do hangovers last?

This can vary for people and depends on many factors. But generally, hangover symptoms can last 24 hours or longer.

Does drinking water help with a hangover?

Yes, drinking even small sips can help with a hangover. Be wary that drinking water alone won’t ‘cure’ it though. Try to have water with added electrolytes.

Can I be biologically more likely to have a hangover?

Genetics may play a role in how a person reacts to alcohol and experiences a hangover. This is because our genes can determine how efficiently we metabolise ethanol.

diabetes-management-india-holistic-care

Sat Aug 30 16:02:17 IST 2025

India is the diabetes capital of the world. World Health Organisation data says there are 7.7 crore adult diabetics (type 2) and nearly 2.5 crore prediabetics in the country. More worrying is that half the population is unaware of its diabetic status.

Diabetes is a complex metabolic disorder that needs a nuanced understanding of genetics, lifestyle and modern medical management.

Layman’s definition

Think of it as a problem with the body’s ‘sugar control system’. Usually, insulin—made in the pancreas—acts like a key, helping sugar from our food enter the body’s cells to be used for energy. In diabetes, either the pancreas isn’t making enough of that key, or the key doesn't fit well any more, so sugar stays in the blood.

The spectrum

Type 1 diabetes is an autoimmune condition where the body’s defence system attacks insulin-producing cells. The exact cause is not known but research suggests it’s a mix of genetic predisposition and certain environmental factors—viral infections being one possible trigger. This form typically appears suddenly in youngsters and requires lifelong insulin therapy.

Type 2 diabetes develops differently, with the body gradually becoming resistant to insulin’s effects or the pancreas struggling to keep up with demand. Being overweight, physically inactive, having a family history, and ageing, all increase the odds. It can start with no obvious symptoms.

Gestational diabetes occurs during pregnancy when hormonal changes reduce insulin effectiveness. Women with a history of gestational diabetes, those who are overweight or who have a strong family history face higher risks.

The Indian context

India’s diabetes epidemic is the result of a convergence of genetics, rapid urbanisation and changing lifestyles. Indians have a genetic predisposition to develop diabetes at lower body weights compared with western populations.

Regional variations

Urban south Indians show particularly high diabetes rates, partly because of genetics and dietary patterns. Certain ethnic groups, like Punjabis and Gujaratis, are also more vulnerable. While rural areas had lower rates, prevalence is rising rapidly as lifestyle changes penetrate these regions.

Our relationship with food

Food occupies a central place in Indian social life, which creates unique challenges for diabetes prevention and management. White rice, deep-fried snacks and sweets feature prominently in both daily and festive meals, and refusing food can be seen as rude in social settings. Many Indians also eat dinner late, which affects blood sugar control. There can be workarounds such as switching to brown rice or millet and reducing portion sizes.

The sugar misconception

Complete sugar avoidance isn’t necessary—moderation and overall dietary balance matter more. You might get diabetes even without eating a grain of sugar in your life. White sugar, brown sugar and jaggery all affect blood sugar similarly. While jaggery might contain trace minerals, the amounts are insignificant from a health perspective.

Artificial sweeteners

Most approved artificial sweeteners have undergone extensive testing and are generally safe in moderation. Research is ongoing about their effect on gut health and metabolism, so the key lies in using them as part of a broader strategy to reduce cravings rather than as a magic solution.

Recognise warning signs

Several classic signs warrant attention—unusual thirst, frequent urination (especially at night), unexplained weight loss and persistent fatigue. Some people notice their vision becoming blurry or wounds taking longer to heal.

Beyond obvious symptoms

More subtle changes can also hint at diabetes. Frequent skin infections, particularly in skin folds, can provide early clues. Some people develop dark, velvety patches on the neck or underarms—acanthosis nigricans—often linked to insulin resistance. Women might notice recurrent yeast infections, while men might have erectile dysfunction.

Modern diagnosis and screening

While fasting glucose, post-meal glucose, and HbA1c (which shows average blood glucose level over two to three months) tests remain the diagnostic backbone, screening approaches have become more proactive. For people at higher risk, doctors now recommend earlier and more frequent screening, sometimes starting in the 20s. Continuous glucose monitoring, once reserved for diabetics, is increasingly used to spot slight increases in blood sugar levels that routine tests might miss.

The ripple effect

Over the years, high sugar levels quietly damage the small blood vessels and nerves that keep organs healthy, explaining why no organ system remains unaffected.

The heart connection

Blood vessels can develop blockages earlier in diabetics, increasing the risk of heart attacks and strokes. Blood pressure and cholesterol monitoring are as crucial as glucose control in diabetes management.

Kidney complications

The microscopic filters that clear waste from the blood can thicken and scar, allowing protein to escape into the urine—an early sign that can progress to kidney failure if left untreated.

Eye problems

The fine vessels feeding the retina might start to leak or develop fragile new branches that break easily, threatening vision over time. Regular eye exams can detect these changes.

Nerve damage

Reduced blood flow and chemical changes from persistently high blood sugar levels interfere with nerve signalling, leading to tingling, burning or numbness, most commonly in the feet.

Emergency situations

Hypoglycaemia (low blood sugar) is one of the most immediate diabetes-related dangers. It can cause sweating, trembling, confusion or even brief loss of consciousness, requiring immediate correction with something sugary.

Diabetic ketoacidosis occurs more often in people with type 1 diabetes when the body has too little insulin and begins breaking down fat rapidly, producing harmful acids in the blood. This causes nausea, vomiting, rapid breathing and drowsiness, requiring immediate treatment.

Be vigilant

Family members should be able to recognise when something is off—for example, if the person suddenly seems quiet, confused or starts sweating. Many clinics now encourage caregivers to attend sessions to practise real-life emergency situations.

Gender and age

Men are often diagnosed earlier, sometimes during heart health check-ups, while women may have menstrual irregularities or recurrent infections as early warning signs. Women with diabetes face a relatively higher risk of heart disease. Blood sugar control influences fertility and pregnancy outcomes, with poorly controlled diabetes increasing chances of miscarriage or premature delivery.

Schools need to develop support systems

While some urban schools have begun implementing support measures—such as staff trained to help with glucose monitoring or emergency responses—this is far from standard practice. In many cases, parents still have to explain the child's needs to teachers and classmates. Wider awareness, clear school policies and basic health training for staff would make a significant difference.

Management targets

For most diabetics, home glucose monitoring involves checking fasting and post-meal levels several times weekly, while HbA1c testing occurs every three to six months in clinical settings. Generally, HbA1c below 7 per cent indicates good control for adults, though children, elderly patients and those with other medical conditions may have adjusted targets.

Beyond glucose monitoring, diabetes care includes annual eye examinations, kidney function tests, foot checks for nerve damage, blood pressure and cholesterol reviews, and dental visits.

Exercise is medicine

At least 150 minutes of moderate activity weekly—such as brisk walking, cycling or swimming—provides significant benefits, while strength training twice weekly offers additional advantages. Ask your doctor what exercise is best for you.

Common management mistakes

Skipping glucose checks allows gradual changes to go unnoticed until they become serious. Many people make medication adjustments based on single readings without consulting health care providers, while others eliminate all carbohydrates instead of practising portion control or lean on ‘diabetic-friendly’ packaged foods that still raise blood sugar levels.

Misconceptions

Dangerous misconceptions include believing that starting insulin means the situation is hopeless, or that herbal remedies alone can cure diabetes. While some traditional practices may support overall health, they cannot replace established medical treatment.

The technology revolution

Continuous glucose monitoring provides real-time information, helping reveal patterns that occasional finger-stick tests might miss. Automated insulin pumps can adjust delivery based on glucose readings, while smartphone apps help track food intake, exercise and medication adherence. These technologies are particularly valuable for young adults and those with variable schedules.

Looking ahead

Early detection through improved screening, better understanding of genetic and environmental risk factors, and advancing treatment options provide hope for millions. The key lies in moving beyond individual responsibility to create supportive environments—from schools that accommodate children with diabetes to workplaces that encourage healthy eating and physical activity. Health care systems must provide culturally sensitive education while families learn to balance tradition with health needs.

Research frontiers

Artificial pancreas systems combining continuous glucose monitoring with automated insulin delivery are transforming Type 1 management. Stem cell research aims to replace destroyed insulin-producing cells. Personalised medicine approaches recognise that diabetes isn’t identical in everyone. Gut microbiome research may reveal new prevention and treatment targets.

abortion-india-stigma-cost-mtp-challenges

Thu Jan 08 21:13:14 IST 2026

Richa Saxena walked the hospital corridor, whispers trailing behind her—not of care or concern, but of judgment.

She was at the health centre for an abortion. A doctor herself—a third-year resident in Maharashtra—she felt each gaze sear into her. She was unmarried. The news spread quickly among the nurses.

“I was six weeks pregnant,” she says. “I was mentally prepared, but not for the slut-shaming and the expense.”

The hostility and comments from nurses and taunts from bystanders about her ‘missing husband’ left her humiliated—even within her own profession.

Richa’s ordeal mirrors what countless women in India continue to endure.

Decades of progressive policies have enabled women to strive for equality. But when it comes to control over their own bodies, do they truly have the final say?

Though abortion is legal in India with certain conditions, the emotional toll, social stigma, legal hurdles and health risks make it a tumultuous experience.

Dr Veena J.S., assistant professor, department of forensic medicine and toxicology, PSG Institute of Medical Sciences and Research, Coimbatore, recalled cases from recent years. After talking to the women involved and the investigating officers, she realised that the issue with medical termination of pregnancy (MTP) in the country was deep rooted. “One common element I could see was that all of them pleaded with gynaecologists in a government hospital for abortion; among them, two were unmarried,” says Veena. “They went to the government doctors because they could not afford private clinics. They were well within three months of pregnancy, but all doctors denied abortion, saying that it was not legal to terminate after three months. And, they pointed out, there was no clause for terminating pregnancy in unmarried women.”

Many women look beyond government hospitals for reasons that include privacy and the wait period, with marital status, too, being a contributing factor. A study on abortion care-seeking practices in India, published by peer-reviewed journal Cureus, found that, among married women, about half of the respondents sought abortions in private facilities while over a quarter did so at home. Among unmarried women, around 90 per cent turned to private clinics or home abortions. Previous studies had reported how women hesitated to seek help from public facilities because of the requirement of repeated visits, longer waiting and confidentiality issues.

Dr Gayathri Sanjeev from Delhi had a positive personal experience of abortion at a private clinic. “I paid Rs1,000, including consultation and post-MTP care, like antiemetics (drugs that prevent vomiting) and painkillers,” she says. “The doctor never asked for my partner, nor tried to guilt me into continuing the pregnancy. I felt respected for my decision. A board in the clinic said: 'MTP/abortion is done here'.” But, she is aware that her case is an exception rather than the norm. “I get to hear from many patients from different parts of the country about the trauma they had to go through because they decided to abort the foetus,” she says.

Adding to the misery, the financial burden, including costs like post-abortion care and mental health support, puts a woman in a spot. The rates vary from place to place and can be exceptionally high if access and societal support are missing.

“I spent around Rs20,000 for the tablets and the complete procedure, including scans and consultation, left me with a bill of Rs30,000,” says Richa. “I was speechless as I know that the pills do not cost more than Rs500. Why the loot?”

The Cureus study also observed that women belonging to lower social and economic classes undergo abortions at home rather than at a health facility, and suggested that women with financial constraints avoid using abortion services from health care facilities because of direct or indirect costs.

While some medical experts feel that private hospitals take advantage of the urgency of the patient and charge exorbitant prices, a Mumbai-based doctor, speaking on condition of anonymity, justified the prices, saying that there was no ethical issue as long as the price was transparently discussed. What would be unacceptable, he says, would be charges that are not declared before the procedure. “When you look at MTP as a taboo, the prices are bound to rise,” he said. “Rather, if it is [seen as] just another procedure, the prices would come down.”

Dr Jayasree A.K., professor, community medicine at the Medical College in Kerala’s Kannur, believes cultural and religious sentiments are some of the reasons for the stigmatisation of MTP. The toxic social attitude needs to be eliminated, she says, while stressing the need for women to be able to make their choices without hesitation and have autonomy over their bodies. She also agrees that there needs to be some form of regulation in private hospitals to monitor MTP prices.

The horrendous experience of seeking MTP and the lack of accessibility often drive many to prefer dropping the foetus through unsafe methods. Religious teachings frowning upon the concept of abortion add to a lack of awareness.

While recurrent abortions may lead to infertility, the risk is higher if it is done under unsafe circumstances. Maternal mortality related to childbirth is much higher than the mortality associated with safe abortion.

What will happen if the state does not intervene to resolve the stigma related to abortion rights? “Mortality and morbidity related to lack of safe abortion will rise if measures are not taken to resolve the stigma,” says Veena of PSG, who works extensively for abortion rights. “The mental health of women will have a huge impact on future generations because, even now, child care is considered the sole duty of mothers. Another danger would be that the private sector will have more authority over women's autonomy.”

Australia-based gynaecologist Dr Joseph Johnson says that despite the liberalisation of MTP in India, religious and cultural influences, social stigma and access barriers remain significant hurdles. From a patient’s perspective, he says, India can take pride in having a progressive legal framework that compares favourably with countries like the UK and Australia, and, to a large extent, surpasses the policies of many US states. Nevertheless, access to safe and legal MTP remains uneven across the country, especially in situations when maintaining confidentiality is paramount.

“Many gynaecologists remain reluctant to offer MTP services, particularly for non-medical indications,” he says. “In cities like Kochi, only a handful of specialists offer comprehensive MTP care in reputable hospitals when the termination is sought for personal or socioeconomic reasons. This limited access has contributed to the rise of smaller clinics, which charge steep prices and operate in a largely financially unregulated manner. But one should still appreciate the fact that even in these small clinics, procedures are performed by qualified specialists.”

An earlier study on abortion care from Jharkhand, published in the Economic and Political Weekly, had observed that women who could not afford to pay for a qualified private physician sought care from unlicenced or government facilities.

“When affordability is denied, abortion service in the private sector becomes a money-minting option,” says Veena. “An abortion medicine kit, which can be self-administered and costs not more than 1,000, will change to a days-long hospital stay, minting money for the private sector. Women who cannot afford the service will be forced to approach quacks or take loans.”

While the abortion laws in India have evolved to recognise a woman’s right to choose, the ground reality is harsher. It is often a choice that comes at a steep price.

chinas-artificial-womb-robot-a-glimpse-into-future-of-human-birth

Fri Feb 27 14:21:45 IST 2026

Chinese researchers have announced that they are developing a humanoid robot with an artificial womb designed to replicate the entire process of human pregnancy—from conception to birth. Led by Dr Zhang Qifeng of Kaiwa Technology, the project was unveiled at the 2025 World Robot Conference in Beijing. The artificial womb, filled with synthetic amniotic fluid and connected to a nutrient delivery system, is intended to support foetal growth through a full-term gestation. A prototype is expected by 2026, with an estimated cost of about 1,00,000 yuan (around Rs12 lakh).

The idea builds on earlier work, like the 2017 “biobag” experiment in Philadelphia, where researchers kept premature lambs alive for up to four weeks in a fluid-filled bag that mimicked the womb. Not surprisingly, the project has triggered heated ethical debates—ranging from concerns over disrupted maternal bonding and psychological effects on children to questions about sourcing eggs and sperm. Supporters, however, see it as a breakthrough for infertility treatment and a way to reduce pregnancy-related health risks.

Artificial wombs are an idea that is at least a century old. In the 1920s, British-born Indian scientist J.B.S. Haldane, a pioneer in evolutionary biology, predicted that by 2074 most births could be ectogenic (development of an embryo outside the body), freeing women from pregnancy and reshaping society. Literature and fiction also embraced the concept. For instance, in Aldous Huxley’s 1932 dystopian novel Brave New World, artificial gestation plays a central role. Modern research for artificial wombs builds on this vision.

European philosopher and medical ethicist Anna Smajdor is someone who had studied extensively the potential of artificial wombs to alter human reproduction and its evolutionary implications. She argues that if childbirth no longer depended on the birth canal, the evolutionary pressure against larger foetal heads or brains would weaken, since complications like obstructed labour would no longer act as a filter. This could mean that human reproduction faces major shifts, allowing traits like larger heads or brains to persist.

Genes related to uterine function or pelvic adaptations are under selective pressure because they are critical for successful vaginal delivery. If artificial wombs make natural pregnancy rare, these genes could accumulate mutations over many generations, as their functionality becomes less critical for reproductive success. This is analogous to the evolutionary loss of function in vestigial structures like the human appendix.

Smajdor also looks at the social and ethical dimensions of ectogenesis, arguing that it could separate reproduction from women’s biology, which may challenge traditional gender norms and lessen the physical and social burdens of pregnancy. She sees this potential separation as a form of liberation for women. However, critics raise concerns about the commodification of reproduction and the weakening of the maternal-foetal bond because of artificial gestation. Nevertheless, thinkers like Smajdor believe that a full shift to artificial wombs is unlikely without global mandates. She believes that cultural and ethical barriers would remain, making a mix of natural and artificial reproduction a more realistic scenario for the coming decades.

dementia-proofing-your-brain-a-neurologists-lifestyle-guide

Sat Jul 26 18:32:36 IST 2025

Dr Dale Bredesen, a neurologist who has worked in many of California’s major universities, is known for boldly claiming that Alzheimer’s disease can be reversed, even in the case of severe degeneration after several years of living with the condition.

In 2014, Bredesen was touted as the first doctor to have successfully reversed memory loss in people diagnosed with the disease, after a small study he led at the University of California, Los Angeles. He has since written two books about the power of a dementia treatment regimen he has designed, called ReCODE.

He has now written a third, called The Ageless Brain. It is no less defiant of the current medical consensus. Research has shown that “there is no reason why anyone should get dementia in the first place,” Breseden claims, “and the idea that there is nothing that can be done for people who already have the disease is just outdated at this point”. With dementia cases set to triple worldwide by 2050, this is exactly the news that many of us are desperate to hear. But could such a thing really be true?

That our lifestyles go a long way in determining our dementia risk is solid scientific fact. “There is some evidence that certain diets, such as the MIND diet which is based on the traditional Mediterranean diet, can help to prevent dementia or slow cognitive decline,” says Barbara Sahakian, a professor of clinical neuropsychology at the University of Cambridge. “I am yet to see any method that can reverse Alzheimer’s symptoms, however.”

“There is currently no cure for any type of dementia,” agrees Dr Richard Oakley, an associate director of research and innovation at the Alzheimer’s Society, though “around 45 per cent of dementia cases could be prevented or delayed with lifestyle and societal-level changes”. Engaging in just 35 minutes of physical exercise per week, for example, has been associated with a 41 per cent lower risk of developing dementia compared with a completely sedentary lifestyle.

The earlier in life we adopt a regimen of clean eating and frequent exercise the better for the health of our brains. But there is much we can do in midlife, says Bredesen, who is far more optimistic than most of his colleagues in the field.

In fact, “your forties and fifties are really the sweet spot when it comes to dementia prevention,” says Bredesen. Though we are living for longer, “our brain spans aren’t yet matching our lifespans,” he explains, and our 40s and 50s are the right time to make sure that you stay sharp into your eighties and beyond.

“People find that they are pretty healthy throughout their 30s, but that things start to feel different when they hit 40, and then andropause and menopause comes in from around 50 and make everything different again,” says Bredesen. “This is when the first signs of cognitive decline might set in, like slower mental processing and worsened memory, and at this point, there really is a tremendous amount that you can do to reverse them and make sure you never get dementia.”

That said, it won’t be easy. “Reversing or preventing dementia is extremely difficult, because it involves wholesale change in the way a person is living their life, what they are eating, how they are exercising, socialising and sleeping,” explains Bredesen. The good news is that “getting even a few of these right is enough to massively reduce your risk of developing Alzheimer’s”.

Here is Bredesen’s prescription for a lifestyle that could successfully ward off dementia.

Make sure you eat the right diet (and it isn’t the one you think)

What we eat affects the health of our brains, and most of us know that now. But the best diet for your brain goes a step beyond the Mediterranean diet and the advice is to eat lots of vegetables and oily fish, according to Bredesen. His ReCODE protocol includes a ketogenic (high fat, low carbohydrate) diet, with a small amount of fasting, both “to reset the body’s sensitivity to insulin” and avoid insulin resistance in the future.

Insulin resistance is thought to affect up to 40 per cent of people aged over 40. Those who are overweight and inactive are most at risk, but this issue is typically identified through a blood test. Insulin resistance is problematic when it comes to dementia risk because it can lead to a build-up of amyloid and tau, two proteins that are thought to damage brain cells. Meanwhile, ketones, a type of chemical produced by the liver in the process of breaking down fat, may be helpful in delaying or preventing the onset of Alzheimer’s disease, according to some research. “The purpose of this diet is to restore insulin sensitivity and to restore your body’s ability to make ketones when needed,” explains Bredesen.

For this, the doctor prescribes a diet that is heavy in cruciferous vegetables like Brussels sprouts and cabbage, as well as fermented food such as sauerkraut, though produce sprayed with insecticides and herbicides is to be avoided (as these can contribute to toxic exposure, another risk factor for dementia). Low-mercury fish, pastured chicken and eggs are in, while grains, dairy products and simple carbs like white bread are out. Fibre and healthy omega-3 fats from sources such as avocados, nuts and seeds are given a starring role—both “help your gut microbiome, which we know now is crucial in protecting your brain,” says Bredesen.

It is also best for your brain, Bredesen believes, to fast for 12 hours overnight, and for at least three hours before bed—if you eat dinner at 7pm, you should have breakfast at 7am the next day, no earlier and no later. A small amount of fasting before bed and in the morning helps to regulate your glucose levels, a key factor in insulin sensitivity. He, however, doesn’t advise people who want to ward off dementia to try intermittent fasting or fast for much longer than 12 hours at a time, as “you don’t want to starve your body of the energy it needs”.

Exercise a lot, in different ways

When it comes to dementia, any amount of movement is far superior to none at all, as shown by a recent study from the Johns Hopkins Bloomberg School of Public Health, which found that just five minutes of “moderate to vigorous” exercise a day can cut dementia risk by over 40 per cent (if stuck to every day of the week for four years). The reason for this seems to be that exercise increases blood flow, stimulating the growth of new brain cells and reducing inflammation, the chronic sort of which is linked to increased risk of cognitive decline.

But most of us struggle to find the time to exercise, and it only becomes less appealing as you age. So how can you get the most bang for your buck? Bredesen advises people to aim for at least 30 to 40 minutes of exercise a day, five times a week, and to include three to four strength training sessions for no more than 20 minutes at a time and regular cardio.

“The two kinds of exercise are very complementary in what they do for the brain,” says Bredesen. “Running is especially great because it improves your coordination. Any kind of aerobic exercise improves blood flow and promotes better sleep, while strength training improves insulin sensitivity. Anyone who is physically able to do so should be trying to build or at least maintain muscle and strength.”

Those in midlife should consider incorporating some high-intensity interval training (HIIT), adds Bredesen. The practice combines the most useful aspects of aerobic and strength training, he explains in his book, and the combination of short bursts of exercise and short breaks “does seem to do something special in the brain”, though HIIT shouldn’t be treated as a full replacement for longer aerobic or strength training sessions.

Bredesen also recommends exercise with oxygen therapy to anyone with vascular problems, a predictor for dementia, as this can improve the oxygenation of a person’s bloodstream and lower blood pressure. “But that can be pretty expensive, and it is still important that people just get out if this is outside of their budget.”

At the end of the day, “you just want to aim to get your heart rate up at least five times a week, every week,” says Bredesen. “A very gentle walk won’t cut it, but going slightly uphill or more quickly than is comfortable is enough.” The best kind of exercise is the one that you will stick to. “Figure out what works well for you, and then add to that if you can. I like to play pickle ball or some tennis with my wife,” he says.

Get enough sleep (but not too much)

Most people in midlife could do with getting a bit more sleep, women especially. Perimenopausal women get less sleep than both postmenopausal and pre-menopausal women, according to some research, with more than half getting less than seven hours of sleep per night—deemed the minimum for good brain health.

The sweet spot for sleep is in fact seven hours, “with at least an hour of deep sleep and an hour and a half of REM (rapid eye movement) sleep,” advises Bredesen. But too much sleep is bad for the brain; regularly sleeping for nine hours or more “is associated with risk for dementia”.

All this is because sleep helps to “cleanse and restore” the brain, ridding it of unhelpful influences and preparing it for the next day. REM sleep, when dreaming occurs, seems especially important. Research suggests that for every percentage decrease in the REM sleep we get, dementia risk rises by 9 per cent. Deep sleep, meanwhile, seems to be the crucial period in which the brain rids itself of waste products.

To know whether you are actually getting enough sleep each night, and enough deep sleep and REM sleep at that, it isn’t enough to simply count the hours between your bedtime and your morning alarm. Though we might not remember it, the average person wakes between two and five times in the night, cutting the time actually spent sleeping.

“It is well worth investing in a fitness tracker that has a sleep function,” says Bredesen.

Train your brain with big and small challenges

Fitness is a matter for your brain as well as your body, says Bredesen, and to protect yourself from dementia, you must challenge it over the course of your life. Research now shows that “cognitive reserve” isn’t enough. Instead you must constantly present your brain with new tasks and challenges.

That doesn’t always have to mean putting your brain through a structured boot camp. Bredesen recommends that people in midlife “take on a small cognitive challenge each day, a medium cognitive challenge each month, and a big cognitive challenge each year”. It needn’t be complicated, “but some degree of intentional brain training has been shown time and time again to help prevent dementia”. The point is that each challenge encourages you to go about your life slightly differently, making your brain work harder and remain “plastic”, in a more flexible state of growth.

Examples of a small challenge include trying a new kind of puzzle (making the switch to sudoku if you are a regular crossword-er), visiting a new coffee shop or simply “setting up your desk in a new part of the house if you are someone who works from home,” says Bredesen.

A medium challenge, meanwhile, might entail cooking recipes from a cuisine you haven’t yet tried your hand at, or listening to a new kind of music. “But the key is that the nature of the challenge has to change each month,” says Bredesen.

A hard challenge, your year-long project, should involve “true mastery” of a subject, says Bredesen. Learn a language, become a chess expert or finally learn how to do algebra, “so long as it has nothing to do with your day job, as you won’t find the benefits of a more plastic brain here”.

lissun-mental-health-india-tech-empathy-distribution-healthcare

Sat Jul 26 18:25:25 IST 2025

Technologists Krishna Veer Singh and Tarun Gupta share striking parallels: both worked in the US, held roles at internet giants, and met while working at Uber, where they bonded over shared values. But it was their personal struggles with mental health—and the lack of accessible solutions—that inspired them to build LISSUN in 2021, a tech-driven mental health platform for India.

“These gaps exist at multiple levels—awareness, acceptance, access and affordability,” says Singh. “From the start, our goal was to reach large, underserved populations using technology.”

But the duo knew that building a mental health app wouldn’t guarantee use. “That’s why we focused on distribution from day one. First-time entrepreneurs build products; second-time ones build distribution. We consider ourselves 1.5-timers—we’ve learned from both ends,” Singh adds.

Instead of offering therapy as a standalone service, the Gurugram-based LISSUN integrates it into real-life care journeys. They began with high-stress domains like infertility and maternity. “We embedded our services in IVF clinics, maternity hospitals, cancer care and dialysis centres—places where patients already face intense emotional strain,” says Singh.

Next, they entered the student wellness space, particularly among those preparing for competitive exams like JEE and NEET. LISSUN partnered with coaching centres in Kota, Indore, Vashi, Shakarpur and other tier-2 or tier-3 towns, becoming one of the largest mental health support providers in this segment.

Their third focus was children with special needs, such as those with ADHD, autism and developmental delays. LISSUN began launching dedicated physical centres to support this group.

Operating in a hybrid model—both digitally and physically—LISSUN’s in-house therapists offer psychotherapy, physiotherapy, clinical psychology, assessments and pharmacological support. Meanwhile, their AI-based tools enhance care delivery—analysing session data, tracking outcomes and suggesting interventions. Predictive models are also in development to flag at-risk users early.

Despite rising need, stigma around mental health persists. Singh says this makes their embedded approach essential. “A diabetic patient is fine taking pills but hesitates to see a psychologist. By integrating mental health into their regular care path, we sidestep stigma rather than confront it head-on,” he says.

Singh believes the younger generation offers hope. “Even 10- to 12-year-olds are open to discussing mental health,” he says. “In small towns, too, we see this shift. As today’s teens become financially independent adults, help-seeking behaviour will become the norm.”

Interestingly, women still seek support more than men—not because they need more help, but because they’re more open. “Men tend to suppress and deny the need,” says Singh.

Another insight: the metro vs. non-metro divide is narrowing. “The awareness gap is closing fast,” he says.

However, regulation remains a challenge. “Mental health is still evolving as a policy priority. There’s a lack of standardisation in therapy practices, qualifications and digital care delivery. We need frameworks that support innovation while protecting users,” says Singh.

LISSUN’s journey shows how empathy, tech and distribution can come together to fill deep systemic gaps in mental health care—making it accessible, contextual and stigma-free.

india-healthcare-rare-diseases-government-action-rare-diseases

Sat Jul 26 18:20:15 IST 2025

For a person living with a rare disease, what should be the ultimate eligibility criteria for timely access to approved and available treatments? Should it be their ability to pay? Their nationality? A biased estimate of potential improvement? Or, perhaps an assumption about their future contribution to the nation?

At the age of one, I was diagnosed with spinal muscular atrophy (SMA), a rare progressive neurodegenerative disorder. At the time, there was no definitive treatment available—only supportive care and symptom management. In 2017, when I was 18, I developed pneumonia, which led to respiratory failure. Since then, I have relied on a tracheotomy tube to breathe, along with regular nebulisation, BiPAP therapy and supportive medication.

In the weeks following my tracheotomy, my pulmonologist tried to keep me hopeful, saying I would recover soon. But the infections kept recurring. I still remember him telling my parents in disappointment, “The girl is taking so much effort... but the problem is that every time she takes a step forward, she stumbles three steps back.” What else can happen when you live with a disorder that keeps progressing?

The first treatments for SMA—nusinersen and onasemnogene abeparvovec—were approved by the US FDA in 2016 and 2019, respectively. Nusinersen is a lifelong treatment administered at regular intervals and costs about Rs92 lakh per injection. Onasemnogene abeparvovec is a one-time intravenous gene therapy for children under two and costs approximately Rs16 crore.

In 2020, the FDA approved risdiplam, the first oral drug for SMA. It is also a lifelong treatment taken daily. Currently, risdiplam is the only SMA drug marketed in India. One bottle is priced at Rs6.2 lakh. Even at the discounted rate offered to the Indian government, the cost for a patient weighing more than 20kg is at least Rs60 lakh per year. The Central government’s National Policy for Rare Diseases provides a maximum of Rs50 lakh in financial assistance—insufficient for continued treatment.

While none of these medicines can cure SMA, they are highly effective in slowing its progression and preventing life-threatening complications, leading them being regarded as life-saving drugs. Access to these drugs can significantly improve patients’ health and quality of life. Continued access, particularly to treatments like nusinersen and risdiplam, is vital.

Rare disease patients in India have long struggled to access these exorbitantly priced life-saving drugs. Since early 2021, courts have been hearing petitions demanding affordable treatment for all. A landmark judgment came on October 4, 2024, when the Delhi High Court ruled on a batch of petitions (titled Master Arnesh Shaw v Union of India) filed by patients with rare diseases like SMA, Duchenne muscular dystrophy, and Gaucher’s disease. The ruling included detailed directions to the National Rare Diseases Committee, the Union government and pharmaceutical companies.

It was disheartening, however, when the Supreme Court later stayed this judgment.

Proper support for rare disease patients must begin with awareness and include a well-coordinated system for diagnosis, treatment administration, rehabilitation and creating accessible environments. India still lacks a complete registry of rare disease patients. Though 12 centres of excellence have been approved for treatment, many patients—especially children and those with severe health issues—cannot easily travel long distances to register or attend follow-ups. More hospitals need to be added to the network.

Ensuring treatment for all rare disease patients will require active negotiation with pharmaceutical companies and better budget allocation and use. The Rs50 lakh financial assistance cap must be removed to ensure uninterrupted access to lifelong therapies. The government must also invest in developing indigenous drugs and strengthening the generic drug industry.

Patent monopolies play a major role in keeping prices unaffordably high. Life-saving drugs should not be treated as profit-generating commodities. If negotiations fail to bring prices down, the government should not hesitate to invoke the public interest safeguards under the Indian Patents Act.

As Martin Luther King Jr said in 1966, “Of all the forms of inequality, injustice in health is the most shocking and inhumane.” The government must act swiftly and effectively—not by prioritising certain patients or delaying decisions, but by ensuring fair access to treatment for all those living with rare diseases.

The writer is a 26-year-old artist, writer and blogger living with SMA type 2. Bedridden since 2017, she is actively raising awareness about the lived realities of people with disabilities.

how-brain-directs-blood-mosso-fmri-connection

Fri Feb 27 14:23:54 IST 2026

In the late 1800s, Italian physiologist Angelo Mosso made a curious observation while studying a patient with a skull defect that left part of the brain exposed. He noticed that when the patient became angry, the exposed area visibly swelled with blood. This led Mosso to explore the idea that changes in cerebral blood flow could reflect mental activity.

He had already observed that in newborns, the fontanelles—the soft spots where the skull has not yet fully fused—pulsate with the heartbeat, and noted similar pulsations in adults attending his clinic. Mosso devised a graphic recorder to document these pulsations and demonstrate that blood pressure changes in the brain caused by mental exertion occur independently of pressure changes elsewhere in the body.

Mosso’s groundbreaking observations would, nearly a century later, lay the foundation for the development of functional magnetic resonance imaging (fMRI), a brain scan that measures blood flow to different regions as a proxy for neural activity during various tasks.

Notably, the brain is one of the body’s most energy-hungry organs. Though it makes up just 2 per cent of body weight, it consumes nearly 20 per cent of the body’s energy. To meet this demand efficiently, the brain must direct blood flow to the regions that need it most. This targeted delivery of blood in real time is an evolutionary adaptation. It has been observed that this mechanism is impaired in cases of neurodegeneration.

Interestingly, the precise mechanism behind this dynamic distribution of blood remained a mystery for a long time. Now, researchers at Harvard Medical School have uncovered key details of how the brain directs blood to active areas as they work. Their findings are published in Cell.

The researchers conducted a series of experiments in mice, revealing a cellular signalling highway that supports this mechanism, involving a couple of key genes. They found that the brain rapidly signals the need for more blood in specific areas via endothelial cells, which line blood vessels in the brain. These endothelial cells then communicate quickly through “gap junctions”—tiny channels connecting neighbouring cells.

Using this wide-reaching and coordinated signalling system, which runs through the inner linings of blood vessels, the brain instructs the vessels when to dilate or contract, depending on need. The researchers note that since the brain’s vascular network is similar across mammals, the same system likely operates in humans. The Harvard team suggests that if these findings hold true in humans, they could significantly improve the interpretation of fMRI scans, potentially offering new insights into the relationship between blood flow and neural activity.

understanding-neurodivergence-explained

Sat Jul 26 17:39:29 IST 2025

DR AJIT SINGH BAGHELA

Consultant, paediatric neurology, Artemis Hospitals. His extensive experience in diagnosing and managing neurodevelopmental conditions focuses on early intervention strategies and family-centred care, besides battling stigma. A nature lover, he enjoys swimming and trekking.

Neurodivergence encompasses natural variations in human cognition, including autism, attention-deficit/hyperactivity disorder (ADHD), dyslexia and other neurological differences. Fifteen to twenty per cent of the global population is considered neurodivergent. According to the World Health Organization, one in 100 children worldwide is diagnosed with autism spectrum disorder (ASD). Recent studies indicate that about one in 100 children in India under age 10 may has autism, and nearly one in eight have at least one neurodevelopmental condition.

Understanding neurodivergence

It refers to the natural differences in how people’s brains work and process information. Think of the brain as a complex computer system—while most computers run on similar operating systems, neurodivergent brains operate on different, equally valid systems. These differences affect how individuals think, learn and communicate with the world.

Spectrum of conditions

The most common neurodivergent conditions include ASD, ADHD, dyslexia and other learning differences. Autism affects social communication and behaviour, often accompanied by repetitive patterns and intense interests. ADHD causes difficulties with attention, impulse control and hyperactivity. Dyslexia primarily impacts reading and language processing abilities. These conditions frequently overlap—someone with autism may also have ADHD, or a person with ADHD might struggle with dyslexia. Comprehensive evaluation by trained professionals is crucial for identifying all conditions. Anxiety and depression are common among neurodivergent individuals. Other co-occurring conditions include obsessive-compulsive disorder, bipolar disorder and epilepsy.

Dual perspective

Neurodivergence exists in a unique space—it is both a natural variation in human brain function and, when necessary, a medical condition requiring support. This dual understanding is crucial. On one hand, neurodivergence represents the natural diversity of human cognition, much like how people have different heights, eye colours or physical abilities. It is not something that needs to be ‘fixed’ or ‘cured’. On the other hand, many neurodivergent individuals face genuine challenges in daily life that benefit from medical support, therapeutic interventions and environmental accommodations. This balanced perspective helps reduce stigma while ensuring people get help.

The Indian context

In India, ASD, ADHD and learning differences like dyslexia are the most frequently encountered neurodivergent conditions. The number of diagnosed cases has increased significantly over recent years, due to growing awareness among parents, teachers and health care professionals. Urban areas show higher diagnosis rates, partly due to better access to specialists and diagnostic facilities.

Challenges

Many families, particularly in rural areas, still attribute neurodivergent behaviours to supernatural causes or poor parenting. Social stigma remains strong, often preventing families from seeking help. The lack of trained specialists outside major cities creates significant barriers to diagnosis and treatment. Additionally, many learning disorders go undetected in schools that lack proper screening programmes.

Age-related manifestations

Neurodivergent conditions present differently across age groups, making early recognition crucial. In young children with ADHD, hyperactivity and difficulty concentrating are prominent, while adults may struggle more with organisation and restlessness. Autism in early childhood often manifests as difficulties with social interaction and communication, but teenagers and adults may face challenges interpreting social cues and maintaining relationships. Dyslexia typically becomes apparent when children struggle with reading and writing, though adults may continue to find reading tasks particularly challenging. Understanding these developmental changes is essential for providing appropriate support at each life stage. What works for a child may not be effective for an adult, and interventions must evolve with the individual’s changing needs.

Hidden signs

Many neurodivergent individuals learn to mask or hide their differences, making recognition challenging. A person with autism might mimic social behaviours without fully understanding them, appearing socially competent while struggling inside. Someone with ADHD might seem engaged externally while battling focus issues internally. Others experience sensory sensitivities or anxiety that aren’t immediately apparent. These masked presentations can lead to delayed diagnosis and inadequate support. Girls and women are particularly prone to masking, often resulting in under-diagnosis.

Role of genetics and family history

Genetics play a significant role in neurodivergence, with conditions like autism, ADHD and dyslexia frequently running in families. If one family member has a neurodivergent condition, the likelihood of others being neurodivergent increases. However, genetics is only part of the story—environmental factors and developmental influences also shape how these conditions manifest. Family history assessment helps health care providers evaluate risk and implement early support.

Environmental influences

During pregnancy and early childhood, environmental factors can influence neurodivergent development. Exposure to harmful substances like lead or alcohol during pregnancy, maternal infections, poor nutrition or high stress levels can increase risks. Birth complications, premature birth or low birth weight may also contribute to neurodevelopmental differences. While these factors are important, neurodivergence typically results from complex interactions between genetics and environment. Understanding these influences helps promote healthier pregnancies and supports early intervention strategies.

Early warning signs

Parents and teachers should watch for several key indicators that may suggest neurodivergence. These include delayed speech or motor skills, difficulty with eye contact, challenges focusing or staying still and struggles in social situations. Other signs include repetitive behaviour, heightened sensitivity to sounds or textures, and difficulties with reading, writing or following directions. These signs can vary significantly between children and often appear in early childhood.

Timing of diagnosis

Some neurodivergent conditions can be reliably identified as early as 18 to 24 months, particularly ASD. Others like ADHD or dyslexia may not become apparent until preschool or early school years (ages 4-7), when attention, reading and learning challenges become more evident.

Diagnostic process

This typically begins with developmental screenings by paediatricians or specialists, who assess behaviour, communication and learning abilities. If concerns arise, comprehensive evaluations follow, including detailed interviews, standardised questionnaires and direct observation. A team of professionals may be involved, including developmental paediatricians, child psychiatrists, clinical psychologists, neurologists, speech-language pathologists and occupational therapists.

Diagnostic tools and their limitations

Current diagnostic tools, such as the Autism Diagnostic Observation Schedule and Vanderbilt ADHD Rating Scales, are generally reliable when used by trained professionals. However, they have limitations. Many rely on observation and caregiver reports, which can be subjective. Cultural differences, masking behaviours and co-occurring conditions can complicate diagnosis. Some tools may not fully capture how neurodivergence presents in girls or adults. This is why comprehensive, multi-step evaluations are essential for accurate diagnosis.

Gender differences in diagnosis

Boys are diagnosed with certain neurodivergent conditions more frequently than girls, partly because their symptoms are often more obvious or disruptive. Girls may show subtler signs like inattentiveness or daydreaming rather than hyperactivity, or they may be better at masking their difficulties through social mimicry. Traditional diagnostic tools, largely based on male presentations, may miss these subtler manifestations in females.

Hormonal and developmental factors

Hormones like testosterone and oestrogen influence brain development during prenatal and early childhood periods. Exposure to different hormone levels in the womb may affect social behaviour and cognitive patterns, potentially influencing the likelihood of developing conditions like autism or ADHD. Some researchers suggest that girls may require stronger genetic or environmental triggers to manifest these conditions, possibly due to protective effects of oestrogen.

Educational accommodations

India’s education system is slowly adapting to accommodate neurodivergent students. The Rights of Persons with Disabilities Act of 2016 mandates inclusive education, allowing children with disabilities to attend mainstream schools with appropriate support. Project Inclusion has trained over 3.6 lakh teachers to better understand and support neurodivergent students. Challenges remain, including rigid curricula, limited resources and insufficient teacher training. Progress continues toward creating more flexible learning environments and providing specialised support for diverse learning needs.

Treatment approaches

Effective treatment for neurodivergence typically involves individualised approaches combining behavioural therapies, educational support and sometimes medication. Applied Behaviour Analysis can help individuals with autism develop social and communication skills. ADHD may be managed with medication and behavioural strategies. Dyslexia responds well to specialised reading programmes and educational accommodations. Early intervention and personalised treatment plans are crucial for optimal outcomes. The goal is not to eliminate neurodivergent traits but to help individuals develop coping strategies and maximise their potential.

Family and community support

They can better support neurodivergent individuals by learning about and accepting different ways of thinking and behaving. Education about neurodiversity reduces stigma and increases empathy. Creating inclusive environments at home and in public spaces helps neurodivergent people feel valued and understood. Flexibility, patience and open communication are essential. Joining support groups and community programmes provides valuable resources and shared experiences.

Long-term outcomes and support systems

Neurodivergent individuals may face challenges in education, employment and relationships due to differences in communication, sensory processing and social interaction. However, with appropriate support systems, many can achieve successful outcomes. Beneficial support systems include inclusive education programmes, workplace accommodations, mentorship programmes and community awareness initiatives.

what-happens-to-your-body-when-you-fall-in-love

Sat Jul 05 15:43:47 IST 2025

It is the topic that has occupied the minds of poets and philosophers since time immemorial: love. With Shakespeare famously writing: “The course of true love never did run smooth.” Love can drive us to distraction, but what is actually going on in our brains and bodies?

Dr Helen Fisher, biological anthropologist and author of Anatomy of Love, says, “When you fall in love, there are a lot of bodily responses. The neurotransmitter norepinephrine, which plays a key role in arousal and alertness, causes increased heart rate, increased blood pressure, and dilation of pupils.” Norepinephrine and adrenaline can cause sweaty palms and butterflies in the stomach, she says.

Fisher says the first thing we need to be clear about is what drives the feeling of romantic love. This, she says, is foremost: dopamine—a neurotransmitter and hormone that acts in the brain to give feelings of pleasure, satisfaction and motivation.

In 2005, she and her colleagues from the New York-based Albert Einstein College of Medicine, were the first to put people in love into brain scanners and study the brain circuitry of romantic love.

“We found increased activity in a little factory near the base of the brain that makes dopamine and sends it to many regions in the brain, giving you the focus and energy, motivation and craving for a particular person, and the belief that this person is totally special,” says Fisher, “You can talk until dawn, you have euphoria when you’re with them and despair when you’re not.”

In contrast to this, she says the feelings of lust and attachment, although similar, are different systems in the brain.

“Lust is driven largely by testosterone and initially evolved to create the desire to start the mating process. Dopamine enabled our forebears to focus on just one person. Together, lust and romantic love evolved to pass on our DNA. Then deep attachment, driven largely by oxytocin, evolved to enable us to stick together long enough to ensure the survival of our young,” she says.

Long-term love and positive illusions

In 2011, Fisher and her team also looked at long-term love, studying 10 women and seven men who were married an average of 21 years and said they were still in love with their partner.

“We put them in the brain scanner and the brain regions for lust, romantic love and attraction all became activated when they looked at a photo of their long-term partner. We were able to prove that you can remain in love long-term.”

She also studied happiness, finding that those who scored very high on the partnership happiness scale also showed more activity in three other brain regions: those associated with empathy, with controlling your own stress and emotions, and with the ability to overlook the negative points of your partner.

“We are built to remember the negative, known as negativity bias,” says Fisher. “But when you are in love, activity in this brain region reduces, known as positive illusions. You overlook the negative and think of the positive things about your sweetheart.”

But Fisher’s view that dopamine is the driver of love, and that love, lust and attachment are led by three different brain systems is hotly contested.

Dr Adam Bode, a romantic love researcher at the Australian National University in Canberra, believes that love is much more complicated—and that far from dopamine, it is actually the neurotransmitter opioids that actually drive love.

He says, “My colleagues and I believe love is much more complex and that love, lust and attachment are highly interlinked. We also believe that opioids are very important in the feeling of being in love, more so than dopamine.”

Lust vs. love

Dr Anna Machin, an evolutionary anthropologist and author of Why We Love: The Definitive Guide to Our Most Fundamental Need, also agrees that love is a very complicated science. She has spent 20 years looking at love from a biological and evolutionary perspective, mostly at the University of Oxford.

Is love at first sight a real thing? She says, “Love is where you develop a psychological attachment for someone. It’s a very complicated phenomenon, led by opioids. It definitely does not occur when you first set eyes on someone, that’s different chemicals at work, chiefly dopamine, oxytocin and serotonin. So, I am sorry to break it to people, but there is no such thing as love at first sight. It is lust at first sight.”

She explains that while lust is “an unconscious drive related to reproduction” love involves both unconscious and conscious cognition.

The unconscious area—essentially the limbic part of the brain—is ancient and drives lust, passion and nurture, the drives we share with other mammals.

“Attraction is a completely unconscious drive, a quick, sensory process that will reward you to cross the room and say hello to someone you fancy,” she says.

In contrast, love also engages the conscious brain, or neocortex, which gives us empathy, trust, abstract ideas about our relationship and the ability to love in the absence of the other person.

“This is what separates humans from other animals in terms of love, in that our love uses both those areas of the brain,” she says.

In her research, she has looked at the physiological effects of love and lust on the body.

She says, “The adrenalin causes all the bodily effects we know of—the racing heart, the butterflies. But in long-term love, the butterflies and racing heart are replaced by bio-behavioural synchrony. This is when every mechanism in your body comes into synchrony with your partner when you interact with them.”

She explains that if two people who are in love spend five minutes together, their neurochemical levels will become the same, as will their blood pressure, body temperature and heart rates.

“We see this with children and parents as well, which is why a baby is laid on a parent’s chest, to get its bodily mechanisms to match the parents,” she adds.

A whole body experience

Machin reiterates that the one thing we really need to know about love, is that it is not just in the brain or heart.

“The neurochemicals released in love are also released when we physically hurt ourselves, it’s a natural painkiller. But it’s also released in the physical interactions, when we touch, hug or laugh with people,” she says.

Love and its neurochemicals processes apply consistently in all ages, she says. “You can fall in love as profoundly when you are 21 as when you’re 55. And it really is a whole-body experience, not just in your brain,” she says.

staying-fit-when-young-could-reduce-risk-for-9-cancers

Sat Sep 23 15:01:09 IST 2023

People with high cardiorespiratory fitness when young have a lower risk of developing nine types of cancer, including head and neck, lung, kidney, bowel, liver, oesophagus, stomach, rectum and pancreas. Cardiorespiratory fitness indicates a person’s ability to do aerobic exercises, such as running, cycling and swimming for long periods.

For the study published in the British Journal of Sports Medicine, researchers analysed Swedish data up to the end of 2019, that included background information, medical diagnoses and deaths for more than a million conscripts who started their military service between 1968 and 2005. They were between 16 years and 25 years when they started their service. As many as 3,65,874 had a low level of cardiorespiratory fitness; 519,652 had a moderate level and 340,952 had a high level.

During an average follow up of 33 years, 84,117 people (7 per cent) developed cancer in at least one site. Higher cardiorespiratory fitness was linearly associated with a lower risk of cancer, specifically a 42 per cent lower risk of lung cancer; 40 per cent had lower risk of liver cancer; 39 per cent a lower risk of oesophageal cancer; 21 per cent a lower risk of stomach cancer; 20 per cent a lower risk of kidney cancer; 19 per cent a lower risk of head and neck cancer; 18 per cent a lower risk of bowel cancer; 12 per cent a lower risk of pancreatic cancer; and 5 per cent a lower risk of rectal cancer.

Oddly, higher cardiorespiratory fitness was also associated with a 7 per cent increased risk of prostate cancer and a 31 per cent increased risk of skin cancer. Prostate cancer screening and exposure to sunlight might account for these findings, researchers suggested.

Daily aspirin can prevent recurrent heart attack

PEOPLE WHO HAVE HAD a heart attack are advised to take low-dose aspirin daily to prevent a second heart attack or stroke, but most patients fail to do so long term.

According to Danish research presented at the European Society of Cardiology Congress, heart attack patients who do not take daily aspirin are more likely to suffer another heart attack, a stroke or die compared with those who consistently take the drug. The study included 40,114 patients, aged 40 and above, who had a first heart attack between 2004 and 2017. They were treated with a coronary stent and took aspirin during the first year after their heart attack.

Aspirin use and incidence of heart attack, stroke or death were evaluated at two, four, six and eight years after the first heart attack. Those who took aspirin 80 per cent or less of the time were considered to be non-adherent, while those on aspirin for more than 80 per cent of the time were considered adherent.

Adherence to aspirin progressively declined over the years, from 90 per cent at two years after a heart attack to 84 per cent at four years, 82 per cent at six years and 81 per cent at eight years. Patients who consistently took aspirin were less likely to experience a negative outcome compared with those who stopped the medication. Patients who discontinued aspirin had a 29 per cent, 40 per cent, 31 per cent and 20 per cent higher likelihood of a negative outcome at two, four, six and eight years, respectively.

A related study published in the Journal of the American Medical Association found that only 40.3 per cent of patients worldwide who have had a heart attack or stroke take daily aspirin. In low-income countries, only about 16.6 per cent of those who have had a heart attack or stroke take aspirin daily. The compliance is about 24 per cent in lower middle-income countries; 51 per cent in upper middle-income countries; and 65 per cent in high-income countries.

Do opposites really attract?

ACCORDING TO A STUDY published in Nature Human Behavior, opposites do not attract. Instead, birds of the feather may actually flock together.

Researchers analysed 199 published studies involving millions of heterosexual couples, dating back to 1903. They also used the UK Biobank to analyse over 130 traits in 79,074 couples in the UK. In up to 89 per cent of the traits analysed, partners were much more likely to be similar than different. On average, they differed only in 3 per cent of the traits. Couples were most similar in their political and religious beliefs, education, certain IQ measurements as well smoking and drinking habits.

Traits like height and weight, medical conditions and personality traits also showed positive correlations but at a lower level. There were only a few traits where partners differed. One was sleeping habits: early risers more often paired with night owls. Even seldom-studied traits, like how many sexual partners a person had had or whether they had been breastfed as a child, showed some correlation.

“These findings suggest that even in situations where we feel like we have a choice about our relationships, there may be mechanisms happening behind the scenes of which we aren't fully aware,” the study said.

Does cardiac arrest have warning signs?

IT IS OFTEN THOUGHT that cardiac arrest happens suddenly without warning.

But according to a US study published in The Lancet Digital Health, 50 per cent of patients who suffer sudden cardiac arrest experience a telling symptom 24 hours prior to their cardiac event. The warning symptoms are different for men and women. While the most prominent symptom of an impending sudden cardiac arrest for women was shortness of breath, for men, it was chest pain. Smaller groups of men and women experienced abnormal sweating and seizure-like activity.

Researchers reviewed data from two studies that evaluated the prevalence of symptoms in people who had used emergency medical services for cardiac arrest and compared them with those in people who sought emergency care for similar symptoms but did not experience cardiac arrest. The studies showed that 50 per cent of the 823 people who had a sudden cardiac arrest witnessed by a bystander or emergency medicine professional experienced at least one telltale symptom before their deadly event.

Ninety per cent of people who experience a sudden cardiac arrest outside of a hospital die within minutes. Identifying the warning signs of cardiac arrest and educating people can encourage patients to seek immediate help, thereby reducing mortality.

Surge in cancer among people under 50

CANCER IS NO LONGER a disease of old age.

From 1990 to 2019, new cases of cancer have increased 79 per cent worldwide among people under 50, according to a report published in BMJ Oncology. Cancers of the windpipe and prostate have seen the fastest increase. The heaviest death toll was from breast, windpipe, lung, bowel and stomach cancer. The findings were based on data from the Global Burden of Disease 2019 study for 29 cancers in 204 countries and regions.

There were 3.26 million new cancer diagnoses among the under 50s in 2019, a 79.1 per cent increase from 1.82 million in 1990. More than a million under 50s died of cancer in 2019, an increase of about 28 per cent from 1990.

Overall, breast cancer accounted for the largest number of new cases and associated deaths in 2019 followed by cancer of the windpipe, lung, stomach and bowel. The steepest increases in deaths were among people with kidney or ovarian cancer. However, liver cancer fell by about 3 per cent each year.

Globally, the number of new early onset cancer cases is estimated to rise by an additional 31 per cent and associated deaths by 21 per cent, in 2030. Those in their 40s will be at the greatest risk.

While genetic factors could play a role, poor diets that are high in red meat and salt and low in fruit and milk; alcohol consumption and tobacco use are the main risk factors, researchers said. Physical inactivity, excess weight and high blood sugar are contributory factors.

"Encouraging a healthy lifestyle, including a healthy diet, the restriction of tobacco and alcohol consumption and appropriate outdoor activity could reduce the burden of early-onset cancer," the study concluded.

Did You Know?

The risks of major medical complications, hospital readmission and death were less likely when female surgeons performed the procedure compared with male surgeons

JAMA Surgery

Excessive screen time linked to development delays in babies

LETTING YOUR BABIES spend too much time with screens can lead to development delays in communication and problem-solving, according to a new Japanese study published in JAMA Pediatrics. Screen time refers to the amount of time spent watching television, playing video games or using mobile phones, tablets, or other electronic devices. The study was based on 7,097 kids whose mothers answered questions about screen time and development milestones.

The mothers were asked about their kids’ daily screen time as one-year-olds and that information was used to analyse the children’s development milestones at ages two and four. The more screen time babies had, the more likely they were to have development delays. Compared with one-year-olds who had less than an hour of daily screen time, those who had one to two hours of screen time were 61 per cent more likely to have communication development delays at age two.

Communication development delays were twice as likely if they had two to four hours of daily screen time as one-year-olds and about five times more likely if they had four or more daily hours of screen time. One-year-olds with more daily screen time were also more likely to miss milestones as two-year-olds in fine motor, personal, social and problem-solving skills. By age four, development delays remained only in the communication and problem-solving areas.

The American Academy of Pediatrics recommends no screen time at all for children younger than 18 to 24 months, except for video chatting and a limit of an hour or less per day for children between the ages of two and five.

Clearing all arteries benefits older adults after heart attack

AFTER A HEART ATTACK, patients aged 75 and above who had complete revascularisation (clearing all the narrowed arteries) and not just the one that caused the heart attack had better health outcomes. “This could be a real change in the practice because the actual standard of care in most older patients is just to treat the culprit lesion, because physicians are worried about complications. Basically, the idea was that the prognosis was worse if we do more," the lead researcher explained. Complete revascularisation is already the standard of care in younger patients.

For the Italian study published in the New England Journal of Medicine, the researchers randomly assigned 1,445 patients, to complete revascularisation or to have only the culprit artery unblocked. The average age of the participants was 80 years, and 36.5 per cent were women.

Among patients who had complete revascularisation, only 8.9 per cent had another heart attack or died from cardiovascular causes within a year, compared with 13.5 per cent of patients who only had the culprit artery opened. Complete revascularisation was associated with a 36 per cent reduction in risk.

When all the outcomes were considered together—death, another heart attack, stroke or needing another procedure, 15.7 per cent of those who had complete revascularisation had one of those events within a year compared with 21 per cent of those who had only one artery unblocked—a 27 per cent reduction in risk.

The was no difference in safety outcomes between the two groups.

Did You Know?

Women who maintained a stable body weight after age 60 were more likely to live past their 90th birthday

Journal of Gerontolgy: Medical Sciences

Just 20 minutes of exercise can lower depression risk

According to an Irish study published in the journal JAMA Network Open, even moderate levels of daily physical activity can reduce the risk of depression in older adults. Depression is increasingly prevalent among older adults and has significant risk factors for major chronic conditions, including cognitive and functional decline, cardiovascular disease and chronic pain and increased risk of all-cause mortality and suicide.

Researchers followed 4,016 adults with an average age of 61 for 10 years, who were evaluated every two years for depressive symptoms. They also answered questions about their physical activity and exercise levels. Depression rates increased from a mean of 8.2 per cent to 12.2 per cent during follow up. The use of prescribed antidepressant medications also increased during this time.

Those who did as little as 20 minutes a day of moderate to vigorous physical activity (brisk walking) for five days a week had a 16 per cent lower risk of depressive symptoms and a 43 per cent lower risk of major depression compared with those who did not exercise. The risk of depression went down as their physical activity level increased. Two hours a day of physical activity was associated with a 23 per cent reduction in depressive symptoms and a 49 per cent lower risk of major depression.

Even people with chronic diseases saw similar benefits from exercise.

Did You Know?

Microwaving plastic baby food containers could release billions of tiny plastic particles into the food

Environmental Science & Technology

Can certain vaccines reduce the risk of Alzheimer’s?

ACCORDING TO A US STUDY published in the Journal of Alzheimer’s Disease, several routine adult vaccinations are associated with a reduced risk of developing Alzheimer’s disease. People who received the shingles vaccine, pneumococcal vaccine or the tetanus and diphtheria shot, with or without an added pertussis vaccine, had up to a 30 per cent reduced risk of developing Alzheimer’s.

The study was based on the medical records of 1.6 million people who were at least 65 years old at the start of the eight-year study period and did not have dementia in the prior two years. The researchers compared the incidence of Alzheimer’s between two groups: those vaccinated against tetanus and diphtheria, with or without an added pertussis vaccine, herpes zoster (shingles) or with pneumococcal vaccines and those who remained unvaccinated.

Those who received the pertussis vaccine were 30 per cent less likely to develop Alzheimer's disease, compared with their unvaccinated peers. Shingles vaccination was associated with a 25 per cent reduced risk of developing Alzheimer's disease and the pneumococcal vaccine was associated with a 27 per cent lower risk.

An earlier study by the same group found that people who received at least one influenza vaccine were 40 per cent less likely to develop Alzheimer's disease. For comparison, three new anti-amyloid antibodies used to treat Alzheimer's slow disease progression by 25 per cent, 27 per cent and 35 per cent, the study noted.

"Vaccines may change how the immune system responds to the build-up of toxic proteins that contribute to Alzheimer's disease, such as by enhancing the efficiency of immune cells at clearing the toxic proteins or by 'honing' the immune response to these proteins so that 'collateral damage' to nearby healthy brain cells is decreased,” the study explained.

one-drink-a-day-may-raise-blood-pressure

Sat Aug 26 15:03:44 IST 2023

With each additional alcoholic beverage consumed per day, blood pressure may increase more rapidly over the years, even in healthy adults without hypertension, finds a study published in the journal Hypertension.

High blood pressure is a major risk factor for cardiovascular diseases such as heart attack and stroke. To analyse the impact of alcohol on blood pressure, the researchers examined data from seven studies in the US, Korea and Japan that included a total of 19,548 adults, aged 20 to early 70s.

None of the participants had high blood pressure at the start of the study, and they were followed for more than five years. Compared to non-drinkers, both systolic and diastolic blood pressure rose more in people who drank. In people who drank an average of 12 grams of alcohol per day (12 ounces of regular beer, 5 ounces of wine or a 1.5 ounce shot of distilled spirits contain about 14 grams of alcohol in the US) systolic blood pressure rose 1.25 mmHg and diastolic blood pressure rose 1.14 mmHg over the study period.

In people who drank an average of 48 grams of alcohol per day, systolic blood pressure rose 4.9 mmHg and diastolic blood pressure rose 3.1 mmHg.

While the link between alcohol and systolic blood pressure was seen in both men and women, the link between diastolic blood pressure and alcohol was seen only in women. Participants with blood pressure in the high normal range had a stronger link between alcohol intake and blood pressure changes over time.

Popular heartburn meds linked to increased dementia risk

Findings of a new study published in the journal Neurology finds that long-term use of common acid reflux medications called proton pump inhibitors can increase the risk of dementia. “Proton pump inhibitors are a useful tool to help control acid reflux. However, long-term use has been linked in previous studies to a higher risk of stroke, bone fractures and chronic kidney disease,” the study author said. “Still, some people take these drugs regularly, so we examined if they are linked to a higher risk of dementia.”

Common proton pump inhibitors include the drugs esomeprazole, lansoprazole, and omeprazole.

The study included 5,712 adults, aged 45 and older, who did not have dementia at the start of the study. The average age was 75 years, and 58 per cent were women. Twenty-six per cent of the participants had taken the drugs, and they were divided into four groups based on their usage of the drugs: non-users; those who took them for up to 2.8 years; those who took them for 2.8 to 4.4 years; and people who took them for more than 4.4 years.

During a median follow up of 5.5 years, 585 people, or 10 per cent, developed dementia. People who had been taking acid reflux drugs for more than 4.4 years had a 33 per cent higher risk of developing dementia than people who never took the drugs after adjusting for factors such as age, sex and race, high blood pressure and diabetes. People who took the drugs for fewer than 4.4 years did not have an increased risk.

People with acid reflux can first try other options such as taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, the author suggested.

Did You Know?

Lower fibre intake during pregnancy was associated with an increased risk for neurodevelopmental delays in offspring, in four key areas—communication, problem-solving, and personal-social and fine motor skills.

Frontiers in Nutrition

Hearing aids may slow cognitive decline

Age-related hearing loss affects about two-thirds of adults aged over 60 globally, but only 10 to 30 per cent of them use hearing aids. Untreated hearing loss contributes to around 8 per cent, or 8,00,000 of the nearly 10 million new cases of dementia diagnosed each year.

To study whether a hearing intervention could reduce cognitive decline, the researchers randomised 977 adults, aged 70 to 84 years, with untreated hearing loss to either receive audiological counselling and hearing aids or generalised counselling on healthy ageing. None of them had substantial cognitive impairment at the onset. But one group had more risk factors for cognitive decline, including lower education and income, higher rates of diabetes and high blood pressure, lower baseline cognitive scores and they were living alone.

The participants were followed up every six months over three years. Researchers tested executive function, language, and memory at the start of the study and then annually.

At the end of the three years, those who had more risk factors for cognitive decline and had received hearing aids had a 48 per cent slower cognitive decline.

An added bonus was that all the participants who received hearing aids reported improved communication skills and social functioning, which could have a positive impact on overall health. The findings of the study were published in The Lancet.

A simple solution to stop nail biting

Body-focused repetitive behaviours, or BFRB, such as nail biting, hair pulling, or skin picking affect about 5 per cent of the world’s population.

According to a study published in JAMA Dermatology, a simple strategy called habit replacement may help control these behaviours. Habit replacement approach involves gently rubbing the fingertips, palm or back of the arm at least twice a day or whenever there is an urge to perform the unwanted habit.

The study included 268 people, average age 36.8 years, who had the habit of repeatedly biting their nails or the inside of their cheeks, or plucking out hair when they were stressed. Half the participants were taught a habit replacement strategy, while the others were placed in a control group and told they were on a wait list for treatment, which they received after the study ended. The study period was six weeks.

About 53 per cent of the participants in the treatment group experienced some improvement compared with about 20 per cent of those in the control group.

Nail-biters seemed to benefit the most: about 80 per cent of those in the treatment group said they were satisfied with the training, and 86 per cent said they would recommend it to a friend.

Keep walking to live longer

Do you need 10,000 steps a day to reap health benefits? Maybe not.

According to the largest analysis on the subject published in the European Journal of Preventive Cardiology, you can start to see health benefits with as few as 2,337 steps a day. But the more you walk, the greater the benefits.

According to the World Health Organization, physical inactivity is the fourth most frequent cause of death in the world, accounting for 3.2 million deaths a year. The researchers analysed data of 2,26,889 people from 17 studies around the world.

The average age of the study participants was 64 years, and 49 per cent were female. They were followed up for an average of seven years.

Walking at least 3,967 steps a day reduced the risk of dying from any cause, and 2,337 steps a day reduced the risk of dying from cardiovascular diseases, including heart attack and stroke. Every 1,000-step increment a day was associated with a 15 per cent reduced risk of all-cause mortality, while a 500-step increment was associated with a 7 per cent reduced risk of dying from cardiovascular diseases.

People younger than 60 years old saw greater reductions in risk of death: a 49 per cent reduced risk was seen in those who walked between 7,000 and 13,000 steps a day. People older than 60 years who walked between 6,000 and 10,000 steps a day reduced their risk of death by 42 per cent. The most steps per day analysed in the study was 20,000.

Did You Know?

People who follow a vegetarian diet have a 50 per cent higher risk of hip fracture compared to regular meat-eaters and pescatarians.

BMC Medicine

FDA approves first pill for postpartum depression

The US FDA has approved zuranolone (Zurzuvae), the first pill to treat postpartum depression (PPD).

The pill is taken once a day for 14 days, in the evening with a fatty meal. In clinical trials, patients saw significant improvements in as few as three days whereas, a standard antidepressant typically takes many weeks to start showing full effect.

“Postpartum depression is a serious and potentially life-threatening condition in which women experience sadness, guilt, worthlessness—even, in severe cases, thoughts of harming themselves or their child. And, because postpartum depression can disrupt the maternal-infant bond, it can also have consequences for the child’s physical and emotional development,” the FDA stated.

The only other available treatment for PPD is brexanolone which is given as an IV injection over a period of 60 hours, for approximately 2.5 days, in a healthcare setting.

Zuranolone was found effective for the treatment of PPD in two randomised, double-blind, placebo-controlled, multicentre studies. In the latest study published in The American Journal of Psychiatry, 196 patients were randomised to receive either 50 mg of zuranolone or placebo once daily in the evening for 14 days. Patients were monitored for at least four weeks after the 14-day treatment.

Patients who received the pill showed significant improvement in depressive symptoms at days 3, 15, 28, and 45 compared to those who received the placebo. The treatment effect was maintained four weeks after the last dose.

The most common adverse events were sleepiness, dizziness and sedation. No loss of consciousness, withdrawal symptoms, or increased suicidal ideation or behaviour were observed. Patients should not drive or operate heavy machinery for at least 12 hours after taking zuranolone.

Did You Know?

The risk of dying from dementia is 28 per cent lower among people who consume more than half a tablespoon of olive oil per day.

American Society for Nutrition

What is the most effective acne treatment?

Acne is a common skin disorder affecting about 9.4 per cent of the global population. It can cause mental distress and negatively impact self-esteem.

What is the most effective treatment?

To find out, Taiwanese researchers reviewed 221 studies that included 65,601 patients with acne. The average age of the patients was 20 years, and the median duration of treatment was 12 weeks. The researchers compared the efficacy of 37 acne treatments and there was a clear winner.

The most effective treatment was oral isotretinoin. This was followed by a triple therapy containing a topical antibiotic, a topical retinoid and benzoyl peroxide and another triple therapy containing an oral antibiotic, a topical retinoid and benzoyl peroxide.

For single therapies, both oral/topical antibiotics and topical retinoids showed comparable effectiveness for inflammatory lesions, but antibiotics had only limited efficacy for non-inflammatory lesions and should be avoided due to the risk of bacterial resistance, the study suggested.

Not everyone can take isotretinoin due to its potential side effects, including risk for severe birth defects and concerns about depression, serious eye damage, and liver problems. It is not recommended for women who are pregnant, women who are trying to conceive, and women who are breast feeding.

Losing a parent is harder for boys

Losing a parent before age 21 is strongly linked to poor mental health and lower income and unemployment in adulthood for both sexes, but is more pronounced in boys, suggests a Finnish study published in the Journal of Epidemiology & Community Health.

To analyse the cumulative effects of parental death, the researchers used data for 9,62,350 Finns born between 1971 and 1986, who had reached at least the age of 30 by 2016. About15 per cent had lost a parent by age 31. About 12 per cent lost their father, while less than 5 per cent lost their mother.

Fathers were nearly three times more likely to die before their children turned 21 than mothers. About 65,797 people lost a parent before age 21 and they were more likely to be admitted to a hospital for mental health issues than those who lost a parent after age 30. Men were 70 per cent more likely to be admitted to a hospital compared to 52 per cent of women.

Substance use disorders and intentional self-harm were the most common reasons for hospital admission. Early maternal death was also associated with an 88 per cent increase in stress disorders. The use of medication for mental health disorders among those who lost a parent early was between 18 per cent and 33 per cent higher for both sexes.

Losing a parent early was also associated with fewer years in school, lower annual earnings, and more periods of unemployment at ages 26-30 for both sexes.

The effects on earnings and employment were generally larger for men. Among men, early death of a father was associated with an almost 16.5 per cent reduction in annual earnings and 6 per cent lower likelihood of regular employment. For women, these were 11 per cent and 4 per cent, respectively.

Did You Know?

Eating breakfast after 9am increases the risk of developing Type 2 diabetes by 59 per cent compared to eating breakfast before 8am.

International Journal of Epidemiology

Sugary drinks raise odds of liver disease, cancer

A study published in the Journal of the American Medical Association has found that women who drink one or more sodas or other sugar sweetened beverages daily have an increased risk of developing liver cancer and dying from chronic liver disease.

This observational study included 98,786 postmenopausal women, aged 50 to 79 years, who reported their daily intake of soft drinks and fruit drinks (excluding fruit juice) at the start of the study. Intake of artificially sweetened beverages was assessed at three years.

During a median follow-up of 20.9 years, 207 women developed liver cancer and 148 died from chronic liver disease, such as fibrosis, cirrhosis, chronic hepatitis, nonalcoholic fatty liver disease, or alcoholic liver diseases.

Only 6.8 per cent of the women consumed one or more sugar-sweetened beverages daily, but they had an 85 per cent higher risk of liver cancer and 68 per cent higher risk of death from chronic liver disease compared to those who had fewer than three servings per month. However, daily consumption of artificially sweetened beverages did not significantly increase the incidence of liver cancer or chronic liver disease mortality.

According to the US Center for Disease Control and Prevention, frequently drinking sugar-sweetened beverages is associated with weight gain, obesity, type 2 diabetes, heart disease, kidney diseases, non-alcoholic liver disease, tooth decay and cavities, and gout, a type of arthritis.

six-foods-to-lower-the-risk-of-heart-disease

Sat Jul 29 15:38:45 IST 2023

Regular consumption of certain foods can lower your risk of cardiovascular diseases, such as heart attack and stroke, and premature death. For the global study published in the European Heart Journal, Canadian researchers analysed data from multiple studies that included 2,45,000 people in 80 countries.

The researchers created a new diet score (PURE Healthy Diet Score) to analyse the health impact of six foods—fruits, vegetables, legumes, nuts, fish, and whole-fat dairy products—each of which has been linked with longevity. The PURE diet recommends two to three daily servings of fruit; two to three daily servings of vegetables; one daily serving of nuts; two daily servings of whole fat dairy products; three to four weekly servings of legumes; and two to three weekly servings of fish. Moderate amounts of whole grains and unprocessed meats could also be included.

During an average follow-up of 9.3 years, the healthiest diet (score of 5 or more) was linked with a 30 per cent lower risk of death, 18 per cent lower risk of cardiovascular disease, 14 per cent lower risk of heart attack, and 19 per cent lower risk of stroke compared with the least healthy diet (score of 1 or less).

“The connection between the PURE diet and health outcomes was found in generally healthy people, patients with CVD, patients with diabetes, and across economies. The associations were strongest in areas with the poorest quality diet, including South Asia, China and Africa, where calorie intake was low and dominated by refined carbohydrates. This suggests that a large proportion of deaths and CVD in adults around the world may be due to undernutrition, that is, low intakes of energy and protective foods, rather than overnutrition,”said Professor Salim Yusuf, principal investigator of PURE.

Breast cancer survivors can safely pause treatment to have a baby

PAUSING ENDOCRINE THERAPY to have a baby does not increase the risk of cancer recurrence for breast cancer survivors, according to a US study published in the New England Journal of Medicine.

The standard treatment for women with early-stage hormone receptor positive breast cancer involves five to 10 years of endocrine therapy that blocks oestrogen activity and reduces the odds of recurrence. Women are advised not to get pregnant while taking these medications and for young women this could encompass their childbearing years.

To analyse pregnancy outcomes and safety of temporarily halting endocrine therapy to pursue pregnancy, the researchers recruited 516 breast cancer patients aged 42 or younger from 116 centres across 20 countries on four continents. The women had been diagnosed with early-stage breast cancer and had completed between 18 and 30 months of endocrine therapy following surgery for breast cancer. The women could stop hormone therapy for up to two years to try to get pregnant, after which they were advised to restart the therapy.

Overall, 368 (74 per cent) had at least one pregnancy, and 317 (63.8 per cent) had at least one baby. A total of 365 babies were born and 43 per cent of the women used assisted reproduction because they had frozen their eggs, or embryos, before cancer treatment to preserve their fertility.

The rates of conception and childbirth were similar or higher than rates in the general population. Also, the babies did not have an increased risk of birth defects. Over three years of follow up, 8.9 per cent of patients had a breast cancer recurrence which is similar to the 9.2 per cent rate seen in a different group of breast cancer patients who had not paused their endocrine therapy.

The younger a person gets diabetes the higher the dementia risk

THE YOUNGER YOU develop type 2 diabetes, the higher your risk of dementia, according to a US study published in the journal Diabetologia. Prediabetes, a condition where blood sugar is higher than normal but not high enough to be defined as diabetes, often precedes diabetes. About 70 per cent of people with prediabetes will eventually develop type 2 diabetes. The age at which this transition happens may impact a person’s risk of dementia.

The study included 11,656 people, average age 56.8 years, who did not have diabetes at the start of the study. But 20 per cent of them had prediabetes. Their cognitive abilities were assessed for nearly three decades. Those who progressed from prediabetes to type 2 diabetes before age 60 were three times more likely to develop dementia. This increased risk dropped to 73 per cent for those who developed diabetes between the ages of 60 to 69 years and fell further to 23 per cent for those who developed diabetes between the ages of 70 to 79 years. Developing diabetes at age 80 and beyond was not associated with an increased risk of dementia.

Did You Know?

Fruits such as apples and blackberries that contain a particular flavanol called quercetin could lower your chances of developing frailty as you age.

The American Journal of Clinical Nutrition

Statin alternative lowers cholesterol, heart disease risk

A NEW DRUG could provide an alternative for people with high LDL cholesterol who cannot tolerate statins. According to a study published in the Journal of the American Medical Association, bempedoic acid, a new statin alternative cholesterol-lowering drug, was effective in reducing LDL cholesterol and significantly reducing the risk of major adverse cardiovascular events such as heart attacks and strokes as well as death from heart diseases.

Statins are recommended for people with high cholesterol who are at an increased of heart attack and stroke. However, some patients cannot take them due to adverse side effects, especially muscle pain or weakness. An earlier analysis of the study, which included 13,970 statin-intolerant patients, showed that bempedoic acid lowered LDL cholesterol levels on average by 21 per cent and reduced cardiovascular events, including heart attack, stroke, and procedures to open blocked blood vessels to the heart, by 13 per cent.

The current analysis focused on 4,206 patients with high risk for heart disease, like diabetes, but had not yet had a cardiovascular event.

During a median follow up of 39.9 months, bempedoic acid reduced LDL cholesterol by 21.3 per cent; inflammation measured by C-reactive protein by 21.5 per cent; major cardiovascular events by 30 per cent; heart attacks and death from heart disease by 39 per cent; and all-cause mortality by 27 per cent compared with a placebo.

Adverse effects with bempedoic acid included a higher incidence of gout and gallstones.

Did You Know?

College students who limited their social media usage to 30 minutes a day for two weeks scored significantly lower for depression, anxiety, loneliness and fear of missing out, and had a brighter outlook on life compared with a control group that did not limit their social media usage.

Technology, Mind, and Behavior

Kids who read for pleasure will have sound minds in adolescence

CHILDREN WHO START READING for pleasure early in childhood tend to perform better on cognitive tests and have fewer behavioural and mental problems in adolescence. The optimal amount of reading? 12 hours a week.

For the study published in Psychological Medicine, the researchers focused on 10,243 kids, aged 9 to 13. Parents answered questions about their children’s reading habits. About half the children were early readers. They had started reading somewhere between three and ten years. The remaining either did not read for pleasure or started reading much later in childhood.

Early readers scored higher on cognitive tests that measured verbal learning, memory, and speech development, as well as academically. They also had better mental and emotional wellbeing: showing fewer signs of stress and depression, as well as improved attention, and had fewer behavioural problems, like aggression and rule breaking. They spent less time watching TV or using their smartphones or tablets and also got more sleep.

Brain scans of early readers showed moderately larger total brain areas and volumes, especially in brain regions that are crucial for cognitive function. Brain regions related to improved mental health, behaviour and attention were also different in that group.

Are gas stoves safe?

ACCORDING TO A STANFORD UNIVERSITY study published in the journal Environmental Science & Technology, cooking with gas stoves can increase indoor levels of cancer-causing chemical benzene that has been linked to a higher risk of leukaemia and other blood cell cancers. The researchers tested gas and propane stoves and ovens in 87 homes.

A single gas stove burner on high or a gas oven set to 350 degrees Fahrenheit can increase indoor levels of benzene above those seen with secondhand tobacco smoke. Benzene can drift to other rooms in the house far from the kitchen and linger for hours in the air. Concentrations of benzene measured in bedrooms far exceeded national and international health benchmarks for hours after the stove was turned off.

However, the food being cooked did not emit benzene. All benzene emissions came from the fuel used. Gas and propane burners and ovens emitted 10 to 25 times more benzene than electric stoves. Induction cooktops did not emit any detectable benzene.

The study also found that exhaust fans were often ineffective at reducing concentrations of benzene and other pollutants.

Gas stoves can also expose users to pollutants, such as nitrogen dioxide, which can trigger respiratory diseases. A previous study showed that children who live in homes with gas stoves have a 42 per cent greater risk of asthma than children living in homes without gas stoves. Proper ventilation with a range hood or open window can reduce pollutant concentrations when cooking with a gas stove.

Did You Know?

Oral contraceptive usage in adolescence was linked to a 130 per cent greater risk of depression, while adult users had 92 per cent greater risk, during the first two years of use.
Epidemiology and Psychiatric Sciences

Once a week insulin vs daily injections for type 2 diabetes

A WEEKLY INSULIN DOSE may be significantly better at helping people with type 2 diabetes manage their blood sugar levels, according to two new studies.

One study published in The New England Journal of Medicine compared once-weekly icodec, a basal insulin, to once-daily insulin glargine U100. The 78-week phase 3a trial included 984 people with type 2 diabetes who were randomly assigned to receive one of the two treatments. The participants’HbA1c was between 7 to11 per cent at the start of the study and none of them had previously received insulin. HbA1c is a blood test that measures average blood sugar levels over the preceding three months. An HbA1c of 6.5 per cent or above indicates diabetes.

At the end of the study period, those on the weekly regimen saw their HbA1c drop from 8.50 per cent to 6.93 per cent, while those on the daily regimen saw a drop from 8.44 per cent to 7.12 per cent. The difference of percentage points between the two groups confirmed the superiority of icodec.

The percentage of time spent with blood glucose levels in the target range was significantly higher with icodec than with glargine U100. While the rates of hypoglycemia were higher in the icodec group, other adverse events were similar between the two groups.

The second study published in JAMA compared the efficacy of once-weekly icodec to once-daily insulin degludec in 588 people with type 2 diabetes who had never received insulin. After 26 weeks, HbA1c levels among participants in the icodec group fell from an average of 8.6 per cent to 7 per cent compared to an average drop of 8.5 per cent to 7.2 per cent in the degludec group. As with the previous study, the rates of hypoglycemia were higher in the icodec group.

Social isolation can be fatal

A REVIEW OF 90 STUDIES involving more than 2.2 million people, aged 18 years or older, published in Nature Human Behavior has found that social isolation and loneliness were associated with a higher risk of premature death from all causes, including cancer and heart disease. Social isolation increased the risk of all-cause mortality by 32 per cent, and loneliness increased the risk of death by14 per cent.

Social isolation increased the risk of death from cancer by 24 per cent, and from cardiovascular diseases by 34 per cent, while loneliness increased the risk of cancer mortality by 9 per cent. There was a 28 per cent increased risk of all-cause mortality in socially isolated individuals with cardiovascular diseases. Socially isolated breast cancer patients had a 51 per cent increased risk of all-cause mortality and 33 per cent increased risk of cancer specific mortality.

Social isolation may be linked to elevated levels of the stress hormone cortisol, as well as inflammation and weakened immune systems. Socially isolated people may be more likely to smoke, consume alcohol and suffer from depression and less likely to eat heathy, stay physically active and receive routine medical care.

have-hypertension-lift-more-weights

Sat Jul 01 17:36:14 IST 2023

Strength training exercises like lifting weights two or three times a week can help lower high blood pressure, according to a Brazilian study published in the journal Scientific Reports.

Cardiovascular diseases are the leading cause of death worldwide, and high blood pressure accounts for 13.8 per cent of deaths from such diseases. About a billion people in the world have high blood pressure. Previous studies have shown that aerobic exercise can help lower high blood pressure. To examine the impact of strength training on high blood pressure, the researchers analysed 14 studies that included 253 participants with hypertension. The average age was 59.

On average, moderate to vigorous strength training at least twice a week for a minimum duration of eight weeks was associated with significant reduction in blood pressure, with systolic pressure dropping by an average of 10 mmHg and diastolic pressure decreasing by 4.79 mmHg.

Strength training was more effective in lowering blood pressure in those aged 18-50 years than those aged 51-70. Nevertheless, strength training can be beneficial for older folks, too.

“Strength training interventions can be used as a non-drug treatment for arterial hypertension, as they promote significant decreases in blood pressure,” the study concluded.

Longer breastfeeding linked to better academic test scores

How long you breastfeed may have an impact on your child’s academic test scores later in life. According to a British study published in the journal Archives of Disease in Childhood, children who were breastfed for longer periods were more likely to achieve better results in their General Certificate of Secondary Education (GCSE) tests at age 16, compared with those who were not breastfed.

The researchers followed 4,940 kids born in 2000-2002 through high school and looked at the results in English and mathematics. As many as 41.7 per cent of those who were never breastfed failed their English exams compared with just 19.2 per cent of those who were breastfed for at least 12 months. For the mathematics exam, 41.9 per cent of those never breastfed failed compared with only 23.7 per cent who were breastfed for at least 12 months.

After accounting for people's socio-economic status and their parents' intelligence, kids breastfed for at least a year were 39 per cent were more likely to have a high pass in both maths and English. “Breastfeeding should continue to be encouraged, when possible, as improvements in academic achievement constitute only one of its potential benefits," the study concluded.

Did You Know?

The World Health Organization is advising people to skip sweeteners as there is no evidence that sugar substitutes help reduce body fat, and long-term use may even increase the risks of type 2 diabetes, cardiovascular diseases and mortality in adults

Mental illness linked to heart attack, stroke

People diagnosed with a mental health disorder in their 20s or 30s have up to a threefold increased risk of heart attack or stroke later in life, according to a study published in the European Journal of Preventive Cardiology.

The researchers used data from more than 6.5 million South Korean adults aged 20 to 39 without a history of heart attack or stroke. About 13.1 per cent participants had at least one mental disorder at the onset, including anxiety and depression. During a median follow-up of 7.6 years, there were 16,133 cases of heart attack and 10,509 cases of stroke.

The risk of having a heart attack was 58 per cent higher and the risk of having a stroke was 42 per cent higher among people with mental illness, compared with people with no mental health problems. Lifestyle behaviour did not explain the excess risk.

The risk of heart attack was elevated for all mental disorders but was highest among people with a diagnosis of post traumatic stress disorder, followed by schizophrenia, substance use disorder, bipolar disorder, personality disorders, eating disorders, depression, anxiety and somatoform disorders (a group of psychiatric disorders that cause unexplained physical symptoms). The risk of stroke was highest among those with personality disorders, followed by schizophrenia, bipolar disorder, substance use disorder, depression, anxiety and somatoform disorders.

“Patients with mental health problems are known to have a shorter life expectancy than the general population, with the majority of deaths caused by physical illnesses,” said the study. “The findings indicate that such individuals should receive regular health checkups and medication, if appropriate, to prevent myocardial infarction and stroke.”

Afternoon exercise best for people with type 2 diabetes

A US study published in the journal Diabetes Care has found that people with type 2 diabetes achieve greater improvements in blood sugar levels if they exercise in the afternoon. The study included 2,416 overweight/obese people with type 2 diabetes, mean age 59, who wore waist accelerometers that tracked physical activity for a week at the start of the study and four years later. They were grouped based on the time of day they exercised.

Those who engaged in moderate-to-vigorous physical activity in the afternoon, between 2pm and 5pm, had the greatest reduction in blood sugar levels at one year, which was maintained after four years. The extent of the reduction was 30 per cent to 50 per cent more than other groups. Additionally, the afternoon exercise group was more likely to no longer need glucose-lowering medications.

People with type 2 diabetes have an increased risk of heart disease, vision impairment and kidney disease. Lifestyle interventions such as a healthy diet and regular physical activity are often recommended to manage blood glucose levels. “We have known that physical activity is beneficial, but what our study adds is a new understanding that the timing of the activity may be important, too,” said the study.

Did You Know?

An analysis of 10,528 heart attack patients admitted to hospitals across Ireland found that deadly heart attacks were highest on Mondays

Research presented at the British Cardiovascular Society conference.

Multivitamins may improve memory in older adults

Taking multivitamin supplements daily can improve memory and slow cognitive ageing in older adults, according to a US study published in the American Journal of Clinical Nutrition.

The study included 3,562 adults over 60 who were randomly assigned to take the multivitamin or a placebo, daily, for three years. The participants took online tests that assessed memory and cognition annually for over three years.

The participants in the multivitamin group did significantly better on the memory tests at the one-year mark, and the benefits were sustained over three years of follow-up.

Taking multivitamins for a year appeared to fend off the equivalent of 3.1 years of age-related mental decline compared with the placebo. Participants with a history of cardiovascular diseases benefited the most.

The findings of this study are consistent with another recent study of 2,262 older adults that found that taking a daily multivitamin improved cognition, episodic memory and executive function compared with placebo and the benefits were more pronounced in those with a history of cardiovascular disease.

“Multivitamin supplementation holds promise as a safe and accessible approach towards maintaining cognitive health in older age,” the study concluded.

Regular mammograms save lives

Women who follow guidelines and get regular mammogram screenings are more likely to survive a breast cancer diagnosis, according to a study presented at the annual meeting of the American Society of Clinical Oncology.

The study included 37,079 women aged 40 to 69 from nine Swedish counties who had between one and five opportunities for screening mammograms before they were diagnosed with breast cancer between 1992 and 2016. As many as 4,564 of them subsequently died of breast cancer. Participants who underwent all five screening exams as per guidelines were 72 per cent less likely to die of the disease compared with women who had no mammograms.

The risk of dying from breast cancer increased with the number of recommended mammograms the women missed. Delays in screenings “can contribute to being diagnosed with advanced disease and may be life-threatening,” said the study.

According to the American Cancer Society, women who are not at high risk for breast cancer should do mammogram annually from age 45 to 54. Women 55 and older can continue yearly mammograms or switch to every other year.

Did You Know?

A diet low in flavanols, nutrients found in berries, apples, grapes, citrus fruits, spinach, tea and dark chocolate can drive age-related memory loss

Proceedings of the National Academy of Sciences

Heart attack may accelerate brain ageing

People who suffer heart attack may experience a significantly faster decline in cognition over the following years. The US study published in JAMA Neurology included 30,465 people, with an average age of 64 years, who did not have a heart attack, stroke or dementia at the start of the study. Women constituted 56 per cent of the participants.

Over a median follow up of 6.4 years, 1,033 of them had a heart attack, and 137 of those had a second heart attack. Researchers assessed the participants' global or overall cognition as well as memory and executive functioning at the start of the study and over time. While having a heart attack was not associated with an immediate decline in cognition, those who suffered one had faster declines in global cognition, memory and executive function over the years, compared with those who did not suffer one.

The eventual decline in global cognition after a heart attack was equivalent to about six to 13 years of cognitive ageing. Women showed a slower rate of decline in cognitive function.

Since cardiovascular diseases are the leading cause of death globally, the researchers hope that the results of this study “will serve as a wake-up call for people to control vascular risk factors like high blood pressure and elevated cholesterol as soon as they can, since having a heart attack increases the risk of decreased cognition and memory later on in life.”

Eye drops may delay myopia in children

Nightly use of atropine eye drops may delay or prevent the onset of myopia or nearsightedness in children. Around 30 per cent of the global population has myopia, and it is estimated that by 2050, half the world’s population will have the condition.

Elongation of the eye leads to myopia. It starts in young children and continues to progress into adolescent years before levelling off in most people. Apart from life-long use of glasses or contacts, nearsightedness can also increase the risk for retinal detachment, macular degeneration, cataracts and glaucoma.

For the phase-3 clinical trial published in JAMA Ophthalmology, 489 children aged six to 10 years were randomly assigned to a daily drop in each eye at bedtime of 0.01 per cent atropine, 0.02 per cent atropine or placebo eyedrops for three years. Atropine is used to dilate the pupils during an eye check.

The application of 0.01 per cent atropine turned out to be most effective in slowing the progression of myopia by limiting eyeglass prescription changes and slowing down the elongation of the eyeball. Though the 0.02 per cent atropine was also better than placebo, the results were less consistent.

The safety of the drug was assessed in a larger group of 573 children aged three to 16 years. Both doses were safe and well tolerated.

kids-born-via-assisted-reproduction-grow-up-fine

Thu Jun 01 15:53:28 IST 2023

A BRITISH STUDY did not find any differences in the psychological wellbeing and quality of family relationships of kids born by assisted reproduction and those born naturally.

The study published in Developmental Psychology examined the long-term effects of assisted reproduction on parenting and child adjustment.

The researchers followed 65 families with children born via assisted reproduction (22 by surrogacy, 17 by egg donation and 26 by sperm donation) from infancy until the child turned 20. They were compared with 52 families with children conceived naturally during the same period.

“The absence of a biological connection between children and their parents does not interfere with the development of positive mother–child relationships or the psychological wellbeing of the children,” the study found.

The findings are consistent with previous assessments the researchers made at ages one, two, three, seven, 10 and 14.

However, telling the children about their biological origins before they start school is important for healthy adjustment.

Most of the parents told their children about their biological origins by age four, and the children were not bothered by the news.

Mothers who did so had more positive relationships with their kids, and the mothers showed lower levels of anxiety and depression.

Only 7 per cent of moms who had disclosed by age seven reported problems in family relationships, compared with 22 per cent of those who told their kids after age seven.

Similarly, only 12.5 per cent of the young adults who were told about their origins before age seven reported problems in family relationships, compared to 50 per cent who were told about their birth at later ages.

"There does seem to be a positive effect of being open with children when they're young―before they go to school―about their conception. It's something that's been shown by studies of adoptive families too," the study author added.

Which diabetes drugs are good for heart?

PEOPLE WITH TYPE-TWO diabetes have an increased risk for adverse cardiovascular events such as heart attack, heart failure and stroke or cardiovascular death.

There are many medications for type two diabetes. But which class of drugs provides the most cardiovascular benefits for people without heart disease?

To find out, the researchers tested three newer classes of diabetes medications―GLP1RA, DPP4, and SGLT2i.

GLP1 receptor agonists include medications such as exenatide, liraglutide and semaglutide; SGLT2 inhibitors include empagliflozin, dapagliflozin and canagliflozin; DPP4 inhibitors include alogliptin, linagliptin, saxagliptin and sitagliptin.

The study published in the Annals of Internal Medicine included about 1,00,000 adults, average age 67 years, who were taking diabetes medications, such as metformin, insulin, or sulfonylurea. One of the three newer medications were added to their regimen.

Those who added GLP-1 receptor agonists had about a 20 per cent reduced risk of major adverse cardiovascular events and heart failure hospitalisation compared to DPP4 inhibitors in people without prior heart disease.

SGLT2 inhibitors did not reduce cardiovascular events and heart failure hospitalisations compared to DPP4 inhibitors.

The study did not examine the use of these newer medications as first-line treatment for type-two diabetes.

"We believe this study is an important contribution to patient care and adds to what we as clinicians know about treating diabetes and heart disease prevention,” the senior author of the study said.

Beta blockers after heart attack questioned

A NEW SWEDISH study published in the journal Heart is questioning the standard practice of prescribing beta blockers for years after a heart attack to lower the risk of recurrence and other cardiovascular complications.

Beta blockers are a class of drugs that are predominantly used to treat abnormal heart rhythms, heart failure, angina and recurrent heart attacks.

The study included 43,618 Swedish adults who had suffered a heart attack but did not have heart failure or left ventricular systolic dysfunction (LVSD). Their average age was 64 years and about 25.5 per cent were women.

The study said 34,253 of the participants were taking beta blockers a year after hospitalisation, while 9,365 were not.

The researchers compared differences in the incidence of deaths from any cause, recurrent heart attacks, heart failure and revascularisation (a procedure to restore blood flow to parts of the heart) between the two groups.

There was no noticeable difference in the rates of these events between the two groups during an average follow up of 4.5 years. Long-term treatment with beta blockers was not associated with improved cardiovascular outcomes.

Since beta blockers are associated with several side effects such as depression, dizziness and fatigue, the researchers think, “It is time to reassess the value of long-term treatment with these drugs in heart attack patients who don’t have heart failure or LVSD.”

Did You Know?

DASH, Mediterranean, pescetarian and vegetarian diets are better at promoting cardiovascular health, while the popular palaeo and ketogenic diets are the worst
Circulation

Internet use and dementia risk

OLDER ADULTS who regularly surf the web have about half the risk of dementia compared to non-regular users, according to a study published in the Journal of the American Geriatrics Society.

The study included 18,154 dementia-free adults who were between the ages of 50 and 65 at the start of the study.

The cognitive health and internet usage habits of the participants were analysed. About two-thirds of the participants were regular internet users.

During a maximum follow up of 17 years and a median of 7.9 years, 4.68 per cent of the participants were diagnosed with dementia. About 8 per cent died without developing dementia, while more than 87 per cent remained dementia free.

Regular internet users had a 43 per cent reduced risk of developing dementia compared to non-regular users. The difference in risk remained regardless of education, race-ethnicity, sex, and generation.

The researchers found a u-shaped relationship when they examined the association between dementia risk and daily hours of usage.

The lowest risk was seen among adults with two or fewer hours on the internet. The risk was highest in people who spent the least and the most time online (between six and eight hours a day).

“Excessive online engagement may lead to reduced opportunities for in-person social interactions and disengagements from the real world in favour of virtual settings, which may in turn adversely affect cognitive health,” the authors wrote.

"Online engagement may help to develop and maintain cognitive reserve, which can in turn compensate for brain ageing and reduce the risk of dementia.”

Did You Know?

Overweight boys tend to have lower testicular volume which could lead to poorer sperm production and infertility issues in adulthood
European Journal of Endocrinology

Endoscopic procedure to end insulin use

A GROUNDBREAKING ONE-TIME ENDOSCOPIC procedure could eliminate the need for insulin in people with type-two diabetes.

In this one hour minimally invasive procedure, controlled electrical pulses are delivered to make changes to the duodenum, a portion of the lining of the small intestine just below the stomach.

The study, presented at the Digestive Disease Week meeting, included 14 type two diabetes patients. They were discharged on the same day after the surgery. They had to follow a calorie-controlled liquid diet for the next two weeks after which they started taking semaglutide, a diabetes medicine.

Of the 14 patients, 12 maintained their blood sugar in the normal range for a year without the need for insulin.

“The potential for controlling diabetes with a single endoscopic treatment is spectacular," the study's lead researcher said.

"While drug therapy is ‘disease-controlling', it only reduces high blood sugar as long as the patient continues taking the medication. This one procedure is 'disease-modifying' in that it reverses the body's resistance to its own insulin, the root cause of the type-two diabetes."

The researchers are planning a double-blind randomised controlled trial to confirm these results. If the results are similar, the procedure could be a game changer in the treatment of type-two diabetes.

Four symptoms of early colon cancer

RESEARCHERS HAVE IDENTIFIED four symptoms thar could indicate an increased risk of early onset colon cancer.

Being aware of these symptoms could be vital for early detection, diagnosis, treatment and improved survival for adults under age 50.

While the death rate from colorectal cancer has been dropping in older adults due to regular colonoscopies and improved treatment, colon cancer cases in younger adults have nearly doubled in recent years. Younger people are mostly diagnosed at advanced stages, and many are dying.

After analysing data from 5,075 patients with early onset colon cancer, the researchers identified four telltale symptoms, which are abdominal pain, rectal bleeding, diarrhoea and iron deficiency anaemia. Having any of these symptoms between three months and two years before diagnosis could signal an increased risk of colon cancer in those under age 50.

Having just a single symptom almost doubled the risk of cancer, while having two symptoms increased the risk by more than 3.5 times; and having three or more increased the risk by more than 6.5 times.

Two symptoms in particular―rectal bleeding and iron deficiency anaemia―should be evaluated with an endoscopy.

Some young adults in the study had symptoms for up to two years before their diagnoses. “That may be part of the reason many of these younger patients had more advanced disease at the time of diagnosis than what we normally see in older people who get screened regularly,” the study author said.

“It is crucial to recognise these red-flag signs and symptoms promptly and conduct a diagnostic work-up as soon as possible.”

The findings were published in the Journal of the National Cancer Institute.

Did You Know?

Poverty is the fourth leading cause of death in the United States, after heart disease, cancer and smoking

JAMA Internal Medicine

How long should you nap?

AN AFTERNOON NAP can make you more alert and improve your mood. But is there an ideal amount of time to nap?

According to a study published in the journal Obesity, taking long naps can increase your risk of obesity and metabolic syndrome, a group of conditions including high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels, all of which can increase your risk of heart disease, stroke and type-two diabetes.

The researchers analysed data from 3,275 Spanish adults, with an average age of 40 years, of whom 78 per cent were women.

Information about their siestas, or afternoon naps, and other lifestyle factors were collected.

Those who napped longer than 30 minutes were more likely to have a higher body mass index and metabolic syndrome compared to those who did not nap.

Long siestas were also associated with eating and sleeping later at night, increased energy intake at lunch and cigarette smoking.

People who took shorter naps (less than 30 minutes) did not have any of the metabolic conditions, were not obese, and had an even lower risk of elevated systolic blood pressure than those who took no siestas.

A previous study by the same group had also found that siestas were associated with an increased risk of obesity and high blood pressure.

“This study shows the importance of considering siesta length and raises the question whether short naps may offer unique benefits,” the study author said.

harsh-parenting-can-harm-kids-mental-health

Fri Apr 28 16:58:47 IST 2023

CHILDREN WHOSE PARENTS discipline them harshly are more likely to develop lasting mental health problems, finds a study published in the journal Epidemiology and Psychiatric Sciences.

Hostile parenting involves frequent yelling and physical punishment as well as punishing children depending on the parent’s mood and damaging their self esteem.

The study included 7,507 Irish children whose mental health was assessed at ages three, five and nine. The researchers studied both internalising symptoms such as anxiety and social withdrawal and externalising symptoms such as impulsivity, aggression and hyperactivity. About 10 per cent of the children fell into a high-risk group for poor mental health. Children who experienced hostile parenting at age three were 1.5 times more likely to be in that group by age nine. Girls and children with single parents were also more likely to be in the high-risk group.

“The fact that one in 10 children was in the high-risk category is a concern and we ought to be aware of the part parenting may play in that,” the study author said. “We are not for a moment suggesting that parents should not set firm boundaries for their children’s behaviour, but it is difficult to justify frequent harsh discipline, given the implications for mental health.”

Risk of heart attack increases after flu

PEOPLE ARE SIX times more likely to have a heart attack the week after getting the flu compared with the year before or after, according to a Dutch study presented at the European Congress of Clinical Microbiology and Infectious Diseases.

The researchers analysed test results from 16 labs, covering nearly 40 per cent of the Dutch population, along with death and hospital records. Of the 26,221 confirmed flu cases, 401 people suffered a heart attack within one year before or after an infection (some had multiple heart attacks; the total number was 419). Of the 419, 34.7 per cent died from any cause within a year of their flu diagnosis. Twenty five heart attack cases occurred in the first seven days after flu diagnosis, 217 in the year before and 177 in the year after.

Based on the findings, people were 6.16 times more likely to have a heart attack in the week following a flu diagnosis.

The influenza virus can increase blood clotting, which, along with inflammation triggered by the body’s immune response, could contribute to arterial plaque ruptures that can lead to a heart attack, the researchers explained.

The results emphasise the importance of getting vaccination to prevent influenza infection and for physicians and flu patients to be aware of heart attack symptoms.

Did You Know?

For those 70 and older, the risk for heart disease, stroke and heart failure dropped by 14 per cent for every 500 steps walked each day

Study presented at the American Heart Association's Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Conference

Prostate cancer treatment can wait

DELAYING TREATMENT FOR localised prostate cancer does not increase mortality risk, according to a British study published in The New England Journal of Medicine. Long-term survival rates were similar whether patients chose active monitoring, radiotherapy or surgery.

The study findings are reassuring for men who would like to avoid the incontinence and sexual problems associated with surgery and radiotherapy. As many as 1,643 men between 50 and 69, who were diagnosed with localised prostate cancer, were randomly assigned three major treatment options—active monitoring, radical prostatectomy or radical radiotherapy.

During an average followup of 15 years, the researchers analysed mortality rates, cancer progression and the impact of treatment on quality of life. Survival rate was nearly 97 per cent, regardless of the treatment.

Although men in the active monitoring group were more likely to see their cancer spread and went on to receive active treatment, that did not translate into increased risk of death—24.4 per cent of these men stayed alive and did not need any invasive treatment.

Overall quality of life, in terms of general mental and physical health, was similar across all three groups. But the negative effects of radiotherapy and surgery on urinary, bowel and sexual function persisted for up to 12 years.

“It’s clear that, unlike many other cancers, a diagnosis of prostate cancer should not be a cause for panic or rushed decision making,” the lead researcher said. “Patients and clinicians can and should take their time to weigh the benefits and possible harms of different treatments in the knowledge that this will not adversely affect their survival.”

Delaying surgery after breast cancer diagnosis affects survival

DELAYING SURGERY BY more than eight weeks after breast cancer diagnosis is associated with worse overall survival, according to a US study published in the journal JAMA Surgery.

To examine the association between time from diagnosis to surgery and overall survival, the researchers analysed data from 3,73,334 women diagnosed with stage I to III breast cancer who underwent surgery as the first line of treatment. Women who had chemotherapy before surgery were not included.

Nearly 90 per cent of the women had surgery within eight weeks of diagnosis. During five years of followup, no link was seen between the time from diagnosis to surgery and overall survival until nine weeks after diagnosis.

Compared with women who had surgery within four weeks of diagnosis, those who waited for nine or more weeks were more likely to die within five years.

The longer the time to surgery, the worse survival outcomes were.

“Based on our findings, we recommend surgery before eight weeks from breast cancer diagnosis,” the researchers concluded.

Did You Know?

Eating a handful of nuts/seeds (about 30gm) every day is associated with a 20 to 25 per cent lower risk of cardiovascular disease

Food & Nutrition Research

No health benefits to drinking alcohol

A CANADIAN STUDY published in JAMA Network Open questions the popular belief that a daily beer or glass of wine could reduce the risk of heart disease.

Instead, the study found that moderate alcohol consumption was not associated with protection against heart disease or death from all causes.

Alcohol use has been linked to at least 22 specific causes of death, including some cancers, liver disease, stroke, heart disease and premature death as well as deaths from accidents, homicides and suicides.

To examine the relationship between alcohol use and death, the researchers evaluated 107 studies that included nearly 50 lakh people.

The notion that alcohol is good for your health is based on studies that are flawed. For example, many studies tend to place former drinkers in the same group as lifetime abstainers. But many former drinkers would have quit drinking because they have health problems and including them with abstainers could skew the results.

The current analysis found that occasional or moderate drinkers did not have a reduced risk of death compared with lifetime abstainers.

People who had around three drinks daily had a slightly increased risk of death, while those who had more than four drinks a day had a 35 per cent higher risk of death than occasional drinkers.

The risk was even greater for women and at even lower levels. Women who had more than four drinks daily had a 61 per cent increased risk of death.

Widowhood more deadly for men

ACCORDING TO A Danish study published in PLOS One, men are much more likely to die within a year of losing a spouse. The researchers followed 9,24,958 Danish citizens 65 and older, of whom 55.4 per cent were women.

During six years of followup, 77,722 individuals lost a spouse. On average, survivors were between 77 and 79 when their spouse died; 6.4 per cent of the men lost their spouse, compared with 10 per cent of the women.

The increased risk of death was highest in the first year after bereavement. Overall, men who became widowed between 65 and 69 were 70 per cent more likely to die in the year that followed compared with similarly aged men who did not lose a spouse. However, among widowed women, the risk was only 27 per cent in the first year, and normalised after that. Women who lost a spouse after the age of 70 did not have a higher risk of dying.

The study also found that health care expenditure for the surviving spouse increased following bereavement and it was higher in men.

Did You Know?

Following a Mediterranean diet, which includes food like whole grains, fruits, vegetables, seafood, beans and nuts, may help reduce the risk of dementia by about 25 per cent, independent of genetic predisposition

BMC Medicine

Statin alternative reduces heart attack risk

STATINS ARE COMMON cholesterol-lowering drugs that are routinely prescribed for people with elevated LDL cholesterol. They are highly effective and also prevent heart attacks and strokes. But up to 29 per cent of people cannot or will not take the drugs due to side effects like muscle pain, headaches or weakness.

A new US study published in The New England Journal of Medicine suggests that a different kind of cholesterol lowering drug called bempedoic acid may be more tolerable and provide moderate protection against heart attack and stroke.

The study included 13,970 patients from 32 countries who had high cholesterol and had, or were at high risk for, cardiovascular disease.

None of the participants could tolerate statins. They were randomly assigned to take 180mg of bempedoic acid or a placebo daily and were followed for an average of over three years. Taking bempedoic acid reduced the combined risk of cardiovascular death, heart attack, stroke, or coronary revascularisations (procedure to open blocked arteries) by 13 per cent.

When analysed separately, the drug lowered LDL cholesterol by 21 per cent and reduced the risk of heart attack by 23 per cent.

“Until now, there have not been any drugs designed specifically for statin-intolerant patients,” the study’s lead author said. “While statins remain the cornerstone of risk reduction in patients with elevated LDL cholesterol, this is a major step forward for a population who need statins but suffer troublesome side-effects.”

Spinal cord stimulation may help with diabetic neuropathy

SPINAL CORD STIMULATION could provide significant relief to people with painful diabetic neuropathy, according to a study presented at the American Academy of Neurology’s annual meeting.

About a quarter of people with diabetes may develop diabetic neuropathy, a type of nerve damage that can cause significant pain and numbness, typically in their hands and feet. “Diabetic neuropathy often results in poor quality of life, depression, anxiety and impaired sleep, and the available medications can be ineffective for many people or cause side effects that people can't tolerate,” the study author explained.

As many as 216 people with diabetic neuropathy symptoms for at least one year, who were not responding to medication, were included in the study. Half of them received spinal cord stimulation plus regular treatment for six months, while the other half received only regular treatment.

Spinal cord stimulation involves implanting a device under the skin that blocks pain signals to the brain. At six months, those who received stimulation had a 76 per cent reduction in their pain and a 62 per cent improvement in their motor function, sensation and reflexes. On the other hand, people in the control group had a 2 per cent increase in pain and a 3 per cent improvement in function.

People had the option to switch treatments after six months—93 per cent of those in the medication-only group opted for an implant. After two years, the implant group reported 80 per cent reduction in pain and 66 per cent improvement in motor function, sensation and reflexes. Five people had their devices removed due to infection.

“This study demonstrates that high-frequency stimulation provides long-term pain relief with acceptable safety,” the study author concluded.

Did You Know?

Dog owners who share a bed with their pet are more likely to have sleep apnoea and other sleep disorders, and wake up feeling unrested. Those who share a bed with their cats are more likely to snore and have leg jerks, and have trouble falling and staying asleep

Human-Animal Interactions

New nasal spray for migraine

THE US FDA has approved a new nasal spray for the acute treatment of migraine in adults. Pfizer’s nasal spray, zavegepant (zavzpret), will provide patients with a fast-acting alternative to oral medications to treat severe headaches.

The approval was based on the results of a phase three clinical trial published in the journal Lancet Neurology, which showed that those who took the medication saw pain relief in as little as 15 minutes and were more likely to return to normal function within 30 minutes to two hours.

The trial included 1,269 patients who were randomised to receive a single 10mg dose of either zavegepant or a placebo—24 per cent of those who used the spray reported pain relief within two hours compared with 15 per cent of those who took a placebo. And 40 per cent were free of their worst symptoms within two hours compared with about 31 per cent of those on a placebo.

The nasal spray was well tolerated. Side effects included an altered sense of taste, nasal discomfort and nausea.

Zavzpret blocks the release of calcitonin gene-related peptides, a type of protein that is elevated during a migraine. Unlike many of the older drugs for migraine, the new spray is also safer for people at risk of heart attack or stroke.

smartwatches-could-interfere-with-pacemakers

Sat Mar 25 15:12:26 IST 2023

SMARTWATCHES and fitness trackers can interfere with implantable cardiac devices. According to a US study published in the journal Heart Rhythm, electronic fitness gadgets such as smartwatches, rings and scales emit electrical currents that can interfere with cardiac implantable electronic devices such as pacemakers, implantable cardioverter defibrillators and cardiac resynchronisation therapy devices, and cause them to malfunction.

Many of these fitness gadgets use bioimpedance, a sensing technology that emits a very slight, imperceptible current of electricity into the body so a sensor can determine a person’s body composition, such as muscle mass or fat mass, or level of stress. Even slight electrical currents from these gadgets can interfere with the proper functioning of cardiac implantable devices. For instance, pacemakers send small electrical impulses to the heart when it is beating too slowly. “The bioimpedance's tiny electrical current could trick the heart into thinking it is beating fast enough, preventing the pacemaker from doing its job when it is supposed to. If the pacemaker gets confused by interference, it could stop working during the duration that it is confused. If that interference is for a prolonged time, the patient could pass out or worse,” said the study author.

The level of interference was greater with smartwatches than with smart rings and smart scales.

A pill to curb binge drinking?

TAKING A PILL before consuming alcohol can help curb binge drinking, according to findings of a study published in the American Journal of Psychiatry.

The drug, naltrexone, is already being used to treat people with severe alcohol disorders.

Binge drinking is defined as consuming five or more drinks on an occasion for men and four or more for women. It is a risk factor for many major diseases and injuries, and it also increases the risk of alcohol use disorder. Hundred and twenty men who had a habit of bingeing but were not severely alcohol dependent were included in the study.

In the double-blinded, randomised control trial, half of the participants were asked to take a 50 mg naltrexone pill before drinking while the other half received a placebo. Neither the participants nor the scientists knew which pill they were taking.

Those given naltrexone reported significantly fewer binge drinking days, fewer weekly binge drinking episodes, fewer total drinks consumed and reduced alcohol cravings than those who had been given a placebo and the benefits lasted up to six months. “Targeted use of naltrexone, or taking it on an as-needed basis, can be an important tool for people interested in cutting down heavy alcohol use,” said the study author.

Best medication for lower back pain

LOWER BACK PAIN is a leading cause of disability worldwide. Which non-opioid medications are the most effective for treating lower back pain? To find out, German researchers analysed 18 randomised controlled trials that included 3,478 patients who had pain for less than 12 weeks. The trials examined the efficacy of muscle relaxants (myorelaxants), nonsteroidal anti-inflammatory drugs (NSAIDs), and paracetamol.

Both muscle relaxants and NSAIDs, which included aspirin, ibuprofen and naproxen, could effectively reduce pain and disability within a week. The combination of NSAIDs and paracetamol was associated with a greater improvement than the use of NSAIDs alone. But paracetamol alone did not provide any significant improvement.

The findings were published in the Journal of Orthopaedic Research. “This is a first step towards the optimisation of the management of acute lower back pain. However, specific patient characteristics such as having allergies and comorbidities must always be taken into consideration,” said the study author.

Did You Know?

Sleep irregularity, or sleeping and waking up at different times and irregular sleep durations, may increase the risk for atherosclerosis, or hardened arteries, a known risk factor for cardiovascular diseases.
Journal of the American Heart Association

Reducing social media usage improves teens’ body image

TEENS AND YOUNG adults who cut their social media usage for just a few weeks saw significant improvement in body image, according to a Canadian study published in the Psychology of Popular Media. Young adults spend about six to eight hours a day on screens, mostly social media, where they are exposed to thousands of images including those of celebrities, “which leads to an internalisation of beauty ideals that are unattainable for almost everyone, resulting in greater dissatisfaction with body weight and shape,” the lead author explained.

To find out if reducing social media use can improve body image, the researchers recruited 220 undergraduate students aged 17–25. About 76 per cent were women. All the participants regularly used social media for at least two hours a day and also had symptoms of depression or anxiety. During the first week, all the participants used social media as they normally would. For the next three weeks, half the participants were asked to reduce their social media usage to no more than 60 minutes a day. At the start and end of the experiment, participants responded to questions about their overall appearance and weight.

Participants who reduced their social media use had significant improvement in how they regarded both their overall appearance and body weight compared with the control group. The findings showed that reducing social media use reaps comparable benefits in body esteem for both males and females.

Focused ultrasound for Parkinson’s treatment

A MINIMALLY INVASIVE procedure called focused ultrasound ablation was effective in treating dyskinesia and motor impairment in patients with Parkinson's disease, according to a study published in the New England Journal of Medicine.

Some patients with Parkinson’s develop dyskinesia―a side effect of Parkinson's medications that can cause involuntary, erratic movements of the body. Motor impairment is a symptom of Parkinson’s.

Focused ultrasound is already being used for patients with essential tremor. The procedure is painless and does not involve incisions, thus eliminating risks such as infection or brain bleeding associated with surgery. “Using focused ultrasound, we can target a specific area of the brain and safely ablate the diseased tissue,” the study author explained.

The procedure offers an alternative to deep brain stimulation, which requires surgery to implant electrodes in specific areas of the brain to deliver electrical pulses that disrupt abnormal brain activity.

Ninety-four Parkinson’s disease patients with dyskinesia or motor impairment were randomly assigned to undergo either focused ultrasound ablation (69 patients) or a sham procedure (25 patients). Over three months, 69 per cent of the patients in the focused ultrasound group achieved improved motor function or reduced dyskinesia compared to 31 per cent in the control group. Additionally, 75 per cent of patients in the focused ultrasound group who responded to treatment maintained their results for up to one year. Adverse effects were infrequent and included speech difficulty, loss of taste, visual disturbance, gait difficulty and facial weakness.

Did You Know?

People with depression and anxiety who engaged in acts of kindness experienced greater improvement for social connection, life satisfaction and depression/anxiety symptoms compared to standard cognitive behavioural therapy.
The Journal of Positive Psychology

Exercise more effective than drugs to treat depression, anxiety

EXERCISE SHOULD BE the first line of treatment for depression and anxiety. According to an Australian study published in the British Journal of Sports Medicine, physical activity is 1.5 times more effective than counselling or the leading medications to manage depression, anxiety and psychological distress.

The researchers examined the impact of physical activity on mental health by evaluating data from 1,039 trials that included 1,28,119 participants. The greatest benefits of exercise on mental health were seen among people with depression, pregnant and postpartum women, and people diagnosed with HIV or kidney disease. Higher intensity exercise had greater improvements for depression and anxiety. Longer durations had smaller effects when compared to short and mid-duration bursts.

All types of exercise were found to be beneficial. But resistance training was found to be more effective for depression, while yoga and other mind–body exercises were more effective for reducing anxiety. “We hope this review will underscore the need for physical activity, including structured exercise interventions, as a mainstay approach for managing depression and anxiety,” said the study author.

Can ED drugs boost men’s heart health?

ERECTILE DYSFUNCTION (ED) medications like Viagra may have cardioprotective benefits, according to a US study published in The Journal of Sexual Medicine.

To analyse the cardiovascular health benefits of ED drugs that contain phosphodiesterase type 5 inhibitors (PDE-5i), the researchers studied health records of 72,498 relatively healthy men with ED. Some 24,000 of them were taking PDE-5i drugs which include sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis) and avanafil (Stendra).

Men who took ED drugs experienced significantly lower rates of major adverse cardiovascular events and death compared to men with ED who did not take these drugs. Specifically, they had a 39 per cent lower rate of death from heart disease and a 25 per cent lower rate of death from all causes. They also had a 22 per cent lower rate of unstable angina, 17 per cent lower rate of heart failure, 15 per cent lower rate in the need for revascularisation procedures such as angioplasty, stenting and bypass surgery, and a 13 per cent lower rate of a major cardiovascular event such as heart attack or stroke.

Among men who took ED drugs, cardiac events were lowest in men who took the largest amount of these drugs over the study period. They had a 55 per cent reduced rate of a major cardiac event and a 49 per cent reduced rate of overall mortality.

Did You Know?

Breast MRI is superior to standard methods at detecting breast cancer in women with dense breasts and negative mammogram who have an average risk or intermediate risk for breast cancer.
Radiology

Spinal cord stimulation helps stroke patients regain arm mobility

ELECTRICALLY STIMULATING the spinal cord instantly improved arm function and hand mobility in patients affected by moderate to severe stroke, report researchers from the University of Pittsburgh and Carnegie Mellon University in the journal Nature Medicine.

Stroke is a leading cause of paralysis. About 25 per cent of the global population over the age of 25 will suffer a stroke in their lifetime. About 75 per cent of them will suffer lasting impairments in motor control of their arm and hand. Spinal cord stimulation technology is already being used to treat chronic pain as well as to restore movement to the legs after spinal cord injury. The innovative technology was tested on two stroke patients who lost hand and arm movement.

A set of thin metal electrodes were placed on the surface of the spinal cord to deliver pulses of electricity that activate nerve cells inside the spinal cord. The stimulation immediately improved strength, range of movement and function of the arm and hand. “The sensory nerves from the arm and hand send signals to motor neurons in the spinal cord that control the muscles of the limb,” the study co-senior author explained. “By stimulating these sensory nerves, we can amplify the activity of muscles that have been weakened by stroke. Importantly, the patient retains full control of their movements: The stimulation is assistive and strengthens muscle activation only when patients are trying to move.”

The stimulation enabled participants to perform tasks of different complexity, like opening and closing their fist, lifting their arm above their head and grasping common household objects.

Keto diet may double the risk of heart attack, stroke

THE KETO DIET involves consuming very low amounts of carbohydrates and higher intake of fat, which helps the body burn fat for energy. A study presented at the American College of Cardiology’s annual meeting included 305 people who followed a low-carbohydrate, high-fat (LCHF) diet, like a keto diet. They were matched by age and sex with 1,220 people who ate a standard diet. About 73 per cent of the participants were women and the average age was 54.

During 11.8 years of follow up, 9.8 per cent of keto dieters experienced a new heart event, compared to 4.3 per cent of people on a standard diet. People who followed the LCHF diet had more than double the risk of major cardiovascular events, such as chest pain (angina), blocked arteries requiring stenting, heart attack, stroke and peripheral arterial disease. They also had significantly higher levels of both LDL cholesterol and apolipoprotein B (apoB), which could increase the risk of cardiovascular disease.

“Our study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of LDL cholesterol―or 'bad cholesterol'―and a higher risk of heart disease,” said the lead author.

six-lifestyle-choices-that-can-slow-memory-decline

Sat Feb 25 15:10:54 IST 2023

ADHERING TO SIX healthy lifestyle factors, especially a healthy diet, is associated with a slower rate of memory decline and risk of dementia. The protective effects were even seen in people who had the apolipoprotein E (APOE) gene, which is the strongest known risk factor for Alzheimer’s disease, finds a study published in The BMJ.

To explore the effect of a healthy lifestyle on memory in later life, the researchers used data from 29,072 adults over 60 years of age with normal cognitive function who were part of the China Cognition and Aging Study―49 per cent of the participants were women.

Memory function was measured at the start of the study and participants were also tested for the APOE gene―20 per cent were carriers of the gene. The participants were followed-up with periodic assessments over the following 10 years.

A healthy lifestyle score included six factors: healthy diet, regular exercise, active social contact (seeing friends and family at least twice a week), cognitive activity (writing, reading, playing games at least twice a week), non-smoking, and not drinking alcohol.

Based on their score, ranging from 0 to 6, participants were assigned to different lifestyle groups: favourable (4 to 6 healthy factors), average (2 to 3 healthy factors), or unfavourable (0 to 1 healthy factors) and into APOE carrier and non-carrier groups.

Each individual healthy behaviour was associated with a slower-than-average decline in memory. A healthy diet had the strongest effect on slowing memory decline, followed by cognitive activity and physical exercise.

People with 4 to 6 healthy behaviours and 2 to 3 healthy behaviours were almost 90 per cent and almost 30 per cent less likely to develop dementia or mild cognitive impairment compared to those with an unfavourable lifestyle. Even those with APOE genes who followed a healthy lifestyle had slower memory decline.

Pregnancy complications can increase cardiovascular disease risk

MAJOR PREGNANCY COMPLICATIONS, such as gestational hypertension, preeclampsia and preterm birth, can put women at risk for future cardiovascular diseases such as stroke and heart attack, according to two studies.

The first study presented at the American Stroke Association's International Stroke Conference finds that women who had complicated pregnancies are more likely to suffer a stroke at an earlier age than women without such complications. The study was based on data from 1,30,764 women and included 2,85,545 births.

About 15 per cent of the women (19,442) had one adverse pregnancy outcome and about 3 per cent (3,639) had multiple adverse outcomes―7,006 women suffered a stroke.

The median age for a first stroke was 59 years for women without pregnancy complications compared to 55 years for women who had one complicated pregnancy and 51 years for women who had multiple complicated pregnancies. Women with two or more complicated pregnancies had double the risk for stroke before age 45.

The second study published in The BMJ finds that women who had complicated pregnancies have an increased risk of ischaemic heart disease up to 46 years. Ischemic heart disease, also called coronary heart disease, can lead to heart attack and cardiac arrest. The study included more than 2.1 million Swedish women with no history of heart disease who had given birth to a single live infant at an average age of 27. The participants were followed for an average of 25 years.

Heart disease was diagnosed in 83,881 of the women at an average age of 58. In the 10 years after delivery, relative rates of heart disease rose twofold in women with other hypertensive disorders of pregnancy; 1.7-fold in those with preterm delivery; 1.5-fold in women with preeclampsia; 1.3-fold in those with gestational diabetes and 1.1-fold in those who delivered a baby with low birthweight. Women who had multiple adverse pregnancy outcomes showed further increases in risk.

Ultra-processed foods linked to increased cancer risk and mortality

REGULAR CONSUMPTION of ultra-processed foods may increase the risk of developing and dying from a variety of cancers, especially ovarian cancer, according to a British study published in the journal eClinicalMedicine.

Ultra-processed foods like cookies, cereals and packaged meals are very convenient and relatively cheap. Consumption of these foods have increased dramatically worldwide. But these foods contain artificial additives and preservatives, and are generally high in salt, unhealthy fats and sugar. These foods have already been linked to a number of poor health outcomes including obesity, type 2 diabetes and cardiovascular disease.

The researchers used data from about 2,00,000 adults, average age 58 years. During a median follow-up of about 10 years, 15,921 people developed cancer and 4,009 died of cancer.

Higher consumption of ultra-processed foods was associated with a greater risk of developing overall cancer and specifically ovarian and brain cancers, as well as increased risk of dying from overall cancer and especially ovarian and breast cancers. Every 10 per cent increase in ultra-processed food in a person's diet increases the overall risk of cancer by 2 per cent and ovarian cancer by 19 per cent. It also increased the overall risk of dying from cancer by 6 per cent, with a 16 per cent and 30 per cent increased risk of dying from breast cancer and ovarian cancer, respectively.

Single dose of a common antibiotic prevents maternal sepsis

PREGNANCY-RELATED INFECTIONS account for about 10 per cent of maternal deaths worldwide. Sepsis, a life-threatening complication of infections, is a major cause of maternal and newborn deaths, especially in low- and middle-income countries. A new study published in the New England Journal of Medicine finds that a single oral dose of the common antibiotic azithromycin can reduce the risk of postpartum sepsis or death by 33 per cent in women who deliver vaginally.

The study was conducted in India, Bangladesh, the Democratic Republic of the Congo, Guatemala, Kenya, Pakistan and Zambia―29,278 women planning to deliver vaginally were randomly assigned to receive either a single 2g dose of oral azithromycin or placebo during labour. Only 1.6 per cent of the women who received azithromycin developed sepsis or died within six weeks after delivery, compared to 2.4 per cent of those who received placebo.

Women who received azithromycin were also less likely to develop endometritis (infection of the lining of the womb), wound infections and other infections. They also had fewer hospital readmissions and unscheduled healthcare visits. Azithromycin, however, did not reduce the risk of stillbirth, newborn sepsis or newborn death.

Could yogurt be the answer for bad breath?

ACCORDING TO A STUDY published in the journal BMJ Open, eating fermented foods like yogurt could reduce bad breath. Halitosis, or bad breath, is mainly caused by volatile sulphuric compounds which are produced by mouth bacteria resulting from bacterial mixing and food debris linked to poor dental hygiene. Mouthwashes, chewing gum, teeth scaling, and tongue scraping are the common solutions used to combat bad breath.

Growing evidence suggests that probiotic bacteria may be an effective alternative. To find out, the researchers reviewed seven clinical trials, involving 278 people aged 19 to 70 years who took probiotic supplements like Lactobacillus salivarius, Lactobacillus reuteri, Streptococcus salivarius, and Weissella cibaria for 2 to 12 weeks.

OLP (Oral Lichen Planus) scores, which measures breath odour at various distances from the mouth, dropped significantly in those who took probiotics compared with those in the control group, irrespective of the length of the monitoring period. A similar result was observed for the levels of volatile sulphuric compounds detected, but the observed effects were relatively short-lived.

“Probiotics may inhibit the decomposition of amino acids and proteins by anaerobic bacteria in the mouth, so curbing the production of smelly by-products,” the researchers explained.

Did You Know?

Regular physical activity can significantly reduce depressive symptoms in teens and children
JAMA Pediatrics

Vitamin D may lower the risk of diabetes

VITAMIN D SUPPLEMENTS may reduce the risk of diabetes in millions of people with pre-diabetes. A person with pre-diabetes has blood sugar levels that are higher than normal, but not high enough for a diagnosis of type 2 diabetes. Observational studies have shown that people who have low levels of vitamin D in their blood are more likely to develop diabetes.

For the US study published in the Annals of Internal Medicine, researchers reviewed three clinical trials that compared the use of vitamin D supplements with placebo in 4,000 adults with pre-diabetes. During three years of follow-up, adults who received vitamin D supplements had a 15 per cent reduced risk of progressing to type 2 diabetes.

While 15 may appear to be relatively small, it has significant public health implications because there are about 400 million adults worldwide who have pre-diabetes. The study suggests that vitamin D supplementation could delay the development of type 2 diabetes in more than 10 million people.

Did You Know?

More than a quarter of people with diabetes worldwide have osteoporosis, underscoring the importance of prevention and treatment of osteoporosis in diabetic patients
BMC Endocrine Disorders

UV nail polish dryers and cancer risk

MANICURES WITH GEL nail polish are popular because they tend to last longer. But are they safe?

According to a US study published in the journal Nature Communications, the ultraviolet light-emitting devices commonly used in salons to dry gel nail polish can lead to cell death and cause cancer-causing mutations in human cells. The effect of these devices on human cells at the molecular and cellular levels had not been studied until now, the study co-author said.

The researchers decided to conduct the study after reading about a young beauty pageant contestant with a rare form of skin cancer on her finger. They also found a number of other reports in medical journals about people who get gel manicures frequently, like pageant contestants and aestheticians, getting very rare cancers in the fingers, suggesting that there could be a link.

Cells from mice as well as humans were exposed to these devices in a lab. Just one 20-minute exposure caused 20 to 30 per cent of exposed cells to die, while three consecutive 20-minute exposures caused 65 to 70 per cent of cell death. Exposure also caused mitochondrial and DNA damage in the remaining cells and resulted in mutations with patterns that can be observed in skin cancer in humans. “Our experimental results and the prior evidence strongly suggest that radiation emitted by UV nail polish dryers may cause cancers of the hand and that UV nail polish dryers, similar to tanning beds, may increase the risk of early-onset skin cancer,” the authors wrote.

Remove fallopian tubes to avoid ovarian cancer

OVARIAN CANCER is often diagnosed at advanced stages of the disease when survival rates are much lower. Women with genetic mutations such as BRCA1 and BRCA2 have an increased risk for ovarian cancer. Doctors currently recommend that women with these mutations have their ovaries and fallopian tubes removed once they are done having children.

The Ovarian Cancer Research Alliance, a leading research organisation, is now recommending all women who have finished having children, even those without a genetic mutation, to have their fallopian tubes removed if they are undergoing pelvic surgeries for benign conditions such as a hysterectomy, tubal ligation, cysts or endometriosis.

The new advice replaces the decades-old focus on symptom awareness and screening. Findings of an earlier clinical trial in the UK that followed more than 2,00,000 women showed that the current screening methods do not reduce the risk of mortality.

The new recommendations are based on increasing evidence that ovarian cancer mostly start in the fallopian tube and removing them can dramatically reduce the risk for later developing the disease, even for those without genetic risks of the disease. The recommendation suggests that average risk women do not have to have their ovaries removed as well. Keeping the ovaries in place can prevent surgical menopause but reduce the risk of developing ovarian cancer. Even after menopause, ovaries continue to produce hormones that are beneficial in reducing the risk of heart disease, osteoporosis and sexual dysfunction.

Did You Know?

Carrying excess weight around the waist in middle age can double the risk of physical frailty in older age which can increase the odds of falls, disability, hospitalisation, reduced quality of life and premature death

BMJ Open

Anti-inflammatory diets improve fertility

ANTI-INFLAMMATORY DIETS such as the Mediterranean diet are known for their health benefits. A new study published in the journal Nutrition suggests that it may also improve fertility and boost chances of couples trying to conceive.

The Mediterranean diet encourages eating foods such as vegetables, fruits, whole grains, extra virgin olive oil, legumes, beans, seeds and nuts, moderate amounts of fish, cheese and yogurt and limiting red and processed meats, added sugar and refined grains.

“Research shows inflammation can affect fertility for both men and women, affecting sperm quality, menstrual cycles, and implantation. So, in this study, we wanted to see how a diet that reduces inflammation―such as the Mediterranean diet―might improve fertility outcomes,” the study author said.

A review of evidence found that the diet’s anti-inflammatory properties increase conception chances by boosting fertility in men and women. It improved sperm quality in men and success rates of assisted reproductive measures, such as IVF. “Modifying your diet is a non-intrusive and affordable strategy that could potentially improve infertility and reduce the need for prolonged or intensive pharmacological or surgical interventions,” the study concluded.

digital-pacifiers-may-impact-childrens-emotional-development

Sat Jan 28 10:46:33 IST 2023

MOST PARENTS TRY to calm a cranky child by letting her use electronic devices. While it may calm them, doing so too often could hinder the child’s ability to regulate emotions properly. According to a US study published in JAMA Pediatrics, frequent use of digital pacifiers to calm upset children can lead to increased emotional dysregulation, especially in boys.

The study included 422 parents and 422 children aged 3-5 years. Parents were asked how often they used electronic devices as a calming tool. The researchers compared the frequency of use and symptoms of emotional reactivity or dysregulation, such as rapid shifts between sadness and excitement, a sudden change in mood or feelings and heightened impulsivity, over a six-month period.

Those who were frequently given devices to calm down were more likely to show signs of emotional reactivity. The association was particularly stronger among boys and children who already experienced hyperactivity, impulsiveness or a strong temperament. “Using a distractor like a mobile device doesn’t teach a skill—it just distracts the child away from how she is feeling. Kids who don’t build these skills in early childhood are more likely to struggle when stressed out in school or with peers as they get older,” said the study author.

Shingles up risk for heart attack, stroke

PEOPLE WHO HAVE had shingles have a significantly higher long-term risk for a major cardiovascular event, such as heart attack or stroke, and this risk may last 12 or more years after a shingles outbreak, according to a US study published in the Journal of the American Heart Association.

Shingles, also known as herpes zoster, is marked by painful rashes that can occur anywhere on the body. It is caused by the varicella zoster virus, which also causes chickenpox. The virus remains dormant in the body of anyone who has had chicken pox and reactivates later as shingles.

The study included 2,05,030 adults without a history of stroke or coronary heart disease. During up to 16 years of follow-up, 3,603 participants suffered a stroke, and 8,620 developed heart disease.

Overall, people who had shingles were up to 38 per cent more likely to suffer a stroke, and the risk was greatest five to eight years post-shingles. Similarly, they had up to 25 per cent greater risk of heart disease, including heart attack, and the risk was highest nine to 12 years after they had shingles.

Shingles vaccine is more than 90 per cent effective and it is recommended that adults 50 years and older get two doses. Since so many adults are “at risk for this painful and often disabling disease and the availability of an effective vaccine, shingles vaccination could provide a valuable opportunity to reduce the burden of shingles and reduce the risk of subsequent cardiovascular complications,” the author said.

Stay hydrated for healthy ageing

STAYING WELL HYDRATED in middle age may slow down the ageing process, lower the risk of chronic diseases such as heart and lung ailments and help you live longer, according to a US study published in eBio Medicine.

The findings are based on data collected from 11,255 adults during five medical visits over 30 years. Their first two visits were between the ages of 45 and 66, and the last between 70 and 90.

The researchers analysed the participants’ serum sodium levels (blood salt levels)—which go up when fluid intake goes down—and correlated it with biological ageing. This was assessed through 15 health markers, which included factors such as systolic blood pressure, cholesterol and blood sugar, which provide insight into a person's cardiovascular, respiratory, metabolic, renal, and immune health.

Normal serum sodium levels ranged from 135 to 146 milliequivalents per litre. Adults with serum sodium levels at the higher end of the normal range had up to 50 per cent higher odds of being biologically older than their chronological age and a 21 per cent increased risk of premature death than those at the lower end of the normal range. They also had up to a 64 per cent increased risk for developing heart failure, stroke, atrial fibrillation and peripheral artery disease, chronic lung disease, diabetes and dementia.  

It is recommended that women consume eight to nine cups of fluids daily, while men eight to 12 cups, which can be done with water as well as other fluids.

Did You Know?

Consuming even very little alcohol during pregnancy can alter the unborn baby’s brain structure, affecting areas involved in language development and social cognition, and delay brain development.

Study presented at a meeting of the Radiological Society of North America

Limit coffee intake if you have severe hypertension

IF YOU HAVE SEVERELY high blood pressure, you should think twice before reaching for that second cup of coffee. According to a Japanese study published in the Journal of the American Heart Association, drinking two or more cups of coffee a day may double the risk of dying from a heart attack, stroke or other type of cardiovascular disease among people with very high blood pressure.

Earlier studies have shown that coffee may have cardiovascular benefits. The aim of the current study was to examine if the protective effects of coffee also applies to people with varying degrees of hypertension and also examine the effects of green tea in the same population, the study author explained.

The study included 6,574 men and 12,035 women between 40 and 79 years of age from 30 Japanese communities. They were grouped into five blood pressure categories: 130/85 or lower (normal); 130-139/85-89 (high normal); 140-159/90-99 (grade 1 hypertension); 160-179/100-109 (grade 2 hypertension); and 180/110 mm Hg (grade 3 hypertension).

During nearly 19 years of follow-up, 842 cardiovascular-related deaths were reported.

Participants with severe hypertension (160/100 mm Hg or higher) who drank two or more cups of coffee a day had twice the risk of dying from cardiovascular diseases, compared to those who didn't drink coffee. Drinking one cup of coffee or any amount of green tea a day did not increase the risk of death from cardiovascular diseases across any blood pressure categories. The increased risk did not apply to people with lower blood pressure levels.

“These findings may support the assertion that people with severe high blood pressure should avoid drinking excessive coffee because caffeine's harmful effects may outweigh its protective effects,” said the author.

Best time to exercise

PEOPLE WHO EXERCISE in the morning have the lowest risk of heart disease and stroke regardless of the total amount of daily physical activity, according to a Dutch study published in the European Journal of Preventive Cardiology.

To find out the impact of timing of exercise on cardiovascular disease outcomes, the researchers used data from 86,657 adults aged 42 to 78 years who did not have cardiovascular disease at baseline. They wore an activity tracker that monitored physical activity patterns for seven days. Fifty-eight per cent of the participants were women.

During six to eight years of follow-up, 2,911 participants developed coronary artery disease and 796 had a stroke. Those who were most active between 8am and 11am had the lowest risks of both heart disease and stroke. Those who were most active in the early morning or late morning had 11 per cent and 16 per cent lower risks of coronary artery disease. Exercising in the late morning was associated with a 17 per cent decreased risk of stroke.

Morning exercise was particularly beneficial for women. They had a 22 per cent to 24 per cent lower risk of coronary artery disease and a 35 per cent lower risk of stroke.

Did You Know?

Early retirement can accelerate cognitive decline, and social isolation could be the key contributing factor.

Journal of Economic Behavior and Organization

Fast food linked to fatty liver disease

REGULARLY EATING FAST FOOD can put you at risk of nonalcoholic fatty liver disease, also known as liver steatosis, which could be fatal. Nonalcoholic fatty liver disease can cause cirrhosis, which can lead to liver cancer or failure.

Fast food consumption is already associated with greater risk of diabetes and cardiovascular disease. For the study published in Clinical Gastroenterology and Hepatology, the researchers compared fast-food consumption, including pizza, with the fatty liver measurements of 4,000 adults. About 52 per cent of the participants consumed some fast food. Of those, 29 per cent got at least one-fifth of their daily calories from fast food. About 29 per cent had a rise in liver fat levels.

People who were obese or had diabetes and consumed 20 per cent or more of their daily calories from fast food had severely elevated levels of fat in their liver compared to those who consumed less or no fast food. Even people who were not obese or diabetic had moderate increase of liver fat when one-fifth or more of their diet was fast food.

“If people eat one meal a day at a fast-food restaurant, they may think they aren't doing harm,” said the study author. “However, if that one meal equals at least one-fifth of their daily calories, they are putting their livers at risk.”

How to offset the health risks of sitting

PROLONGED SITTING is an established health hazard and can increase your risk of cardiovascular disease, obesity, and other chronic illnesses, even if you exercise regularly.

A US study published in the journal Medicine & Science in Sports & Exercise suggests that you can offset the negative effects of prolonged sitting by moving more. But how often and how long should you move around?

To find out, the researchers recruited 11 participants who came to a lab and sat for eight hours on five separate days and followed one of five exercise “snacks” that they were assigned to: one minute of walking after every 30 minutes of sitting; one minute every 60 minutes; five minutes every 30; five minutes every 60; and no walking.

The participants could work on a laptop, read, and use their phones during the sessions and were provided standardised meals. Their blood pressure and blood sugar (key indicators of cardiovascular health) were assessed throughout the sessions.

The optimal amount of movement needed to offset some of the negative effects of prolonged sitting was five minutes of walking every half an hour. This walking pattern significantly lowered both blood sugar and blood pressure and was associated with a 58 per cent reduction in blood sugar spikes after large meals.

Any amount of walking reduced blood pressure by 4 to 5 mmHg compared with sitting all day. “This is a sizeable decrease, comparable to the reduction you would expect from exercising daily for six months,” the study author said.

Did You Know?

Up to 1.35 billion teens and young adults are at risk of hearing loss because they use headphones and other personal listening devices at unsafe levels and listen to loud music at concerts.

BMJ Global Health

Is vaping safer than smoking?

VAPING IS JUST as bad for your heart as cigarettes. Two studies presented at the American Heart Association’s Scientific Sessions say the negative impact of vaping on cardiovascular function was similar to that of smoking tobacco products for nearly 20 years.

The first study examined the short-term effects of vaping and cigarette smoking and compared them with matched peers who did not use nicotine in any form. Both e-cigarette and combustible cigarette users had greater increases in blood pressure, heart rate and blood vessel constriction, immediately after vaping or smoking, compared to people who did not use any nicotine. They also performed significantly worse on treadmill stress tests that assess heart disease risk which they took 90 minutes after they vaped or smoked.

The findings are especially concerning because the negative impact on cardiovascular function among the people who vaped was similar to that of people who used combustible cigarettes, even though those who vaped were much younger (27.4 years vs 42 years) and had vaped for nearly 20 years less than the smokers (average 4.1 years vaping vs 23 years smoking). “People should know that e-cigarettes and combustible cigarettes contain addictive nicotine and toxic chemicals that may have adverse effects on their cardiovascular system and their overall health,” said the study author.

Did You Know?

People who eat food such as berries, green leafy vegetables, citrus fruits, apples, pears, legumes, broccoli, tomatoes, olive oil, and drink tea, all rich in antioxidant flavonols, may have a slower rate of memory and cognitive decline as they age.

Neurology

Smoking linked to mid-life memory loss, confusion

PEOPLE WHO SMOKE are much more likely to experience memory loss, confusion and cognitive decline in middle age compared to nonsmokers. But the risk is lower for those who have quit.

The findings of the study published in the Journal of Alzheimer’s Disease was based on data from a one-question self-assessment survey that asked 1,36,018 people aged 45 or older if they experienced problems such as growing memory loss or confusion. The researchers compared subjective cognitive decline measures among current smokers, recent former smokers, and people who had quit years earlier. About 11 per cent reported cognitive decline.

The prevalence of cognitive decline among smokers was 1.9 times that of nonsmokers. For those who had quit less than 10 years ago, it was 1.5 times that of nonsmokers. Subjective cognitive decline among those who quit more than a decade before the survey was only slightly above the nonsmoking group, suggesting that quitting earlier had more brain benefits.

“It is also one more piece of evidence that quitting smoking is good not just for respiratory and cardiovascular reasons, but also to preserve neurological health,” said the study author.

adding-yoga-to-regular-exercise-may-boost-heart-health

Sat Dec 24 15:18:05 IST 2022

ADDING YOGA TO YOUR regular exercise can improve cardiovascular health and reduce the risk of heart disease. For the three-month pilot study published in the Canadian Journal of Cardiology, researchers recruited 60 adults diagnosed with high blood pressure and metabolic syndrome (a combination of high blood pressure, high cholesterol, diabetes and obesity) for an exercise training programme.

The participants were divided into two groups: in addition to 30 minutes of aerobic exercise five times a week, one group performed 15 minutes of structured yoga while the other group did stretching exercise.

Blood pressure, heart rate and other cardiovascular disease risk factors were assessed at the start and end of the study. Both groups had reductions in resting systolic and diastolic blood pressure, mean arterial blood pressure and heart rate at the end of three months. But systolic blood pressure was reduced by 10 mmHg with yoga vs 4 mmHg with stretching. The yoga approach also reduced resting heart rate and improved 10-year cardiovascular risk.

“This study provides evidence for an additional non-pharmacologic therapy option for cardiovascular risk reduction and blood pressure control in patients with high blood pressure,” noted the study.

NSAIDs/ steroids worsen knee arthritis

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) and corticosteroid knee injections are commonly prescribed for knee osteoarthritis pain and inflammation. But according to a study presented at a meeting of the Radiological Society of North America, common anti-inflammatory painkillers like ibuprofen, naproxen and aspirin may actually worsen the condition.

Researchers compared 277 patients with knee arthritis who took NSAIDs regularly for at least a year with 793 patients not treated with the drugs. All the participants had knee MRI scans done at the start of the study and then four years later. Taking NSAIDs did not slow progression of the disease. In fact, joint inflammation and cartilage quality had worsened for patients who had been taking NSAIDs compared with patients not taking the drugs, after four years.

"The use of NSAIDs for their anti-inflammatory function has been frequently propagated in patients with osteoarthritis in recent years and should be revisited, since a positive impact on joint inflammation could not be demonstrated," the study cautioned.

Two other studies presented at the same meeting showed that while corticosteroid injections did provide temporary symptomatic pain relief for knee osteoarthritis, the injections were associated with significant progression of the condition. Both studies compared the efficacy of corticosteroids injections with hyaluronic acid injections which are also used in patients with knee arthritis.

While both drugs provided symptomatic pain relief, MRI scans and X-rays showed that only hyaluronic acid slowed progression of knee osteoarthritis and alleviated long-term effects, two years post-injection. Corticosteroid knee injections, on the other hand, were associated with significant progression of osteoarthritis in the knee, specifically in the lateral meniscus, lateral cartilage and medial cartilage.

Did You Know?

Faking a smile can improve our mood and make us feel happier

Nature Human Behavior

Acupuncture may ease back pain during pregnancy

A STUDY PUBLISHED in BMJ Open suggests that acupuncture may significantly relieve lower back and pelvic pain experienced by up to 90 per cent of women during pregnancy. Chinese researchers reviewed 10 randomised controlled trials that compared acupuncture with other treatments in 1,040 healthy women who were, on average, 17 to 30 weeks into their pregnancy and had lower back and/or pelvic pain.

The trials were conducted in the US, Sweden, the UK, Spain and Brazil. Seven of the trials described body acupuncture and the other three ear lobe acupuncture. Acupuncture significantly relieved pain and improved quality of life in women with lower back/pelvic pain during pregnancy when compared with other or no interventions. Additionally, acupuncture was safe and there were no observable severe adverse effects on the newborns.

Expectant moms reported minor side effects such as pain, soreness and bleeding at the needle site and drowsiness. But most of them viewed it favourably and were willing to repeat it, if necessary.

The researchers conclude that acupuncture could be a viable option for pregnant women because it would be preferable to drugs because of their potential side effects for mother and baby.

Pausing breast cancer treatment for pregnancy

BREAST CANCER PATIENTS who paused hormone therapy to have children did not have an increased risk of recurrence and most were able to conceive and deliver healthy babies.

While breast cancer is most commonly diagnosed in post-menopausal women, about 5 per cent of new cases each year are diagnosed in women aged 40 or younger. Of these patients, 40 to 60 per cent are concerned about their potential loss of fertility and ability to have children. Young patients with early-stage hormone receptor-positive breast cancer are often treated with endocrine therapy or anti-oestrogen therapy that lower oestrogen levels or block oestrogen receptors.

To find out if pausing endocrine therapy to pursue pregnancy would increase the risk of recurrence, researchers recruited 518 women aged 42 or younger who wished to become pregnant. They opted to pause the treatment for about two years to try to get pregnant. The women had completed between 18 and 30 months of adjuvant endocrine therapy before pausing the treatment.

Of this group, 44 participants had experienced a recurrence of breast cancer during a median follow-up of 41 months, The three-year recurrence rate of 8.9 per cent was similar to a 9.2 per cent rate among a control group of patients who continued their treatment. Among the 518 women, 368 (74 per cent) had at least one pregnancy and 317 (63.8 per cent) had at least one live birth.

Overall, 365 babies were born. The rates of conception and childbirth were similar to or higher than rates seen in the general public.

Green Mediterranean diet better at reducing visceral fat

GREEN MEDITERRANEAN diet can reduce twice as much visceral fat as traditional Mediterranean diet, according to an Israeli study published in BMC Medicine.

Visceral adipose tissue is a type of fat that accumulates around internal organs and is much more dangerous than fat around the waist. It produces hormones and other toxins that have been linked to heart disease, diabetes, dementia and premature death.

The study included 294 participants who were randomly assigned to one of three diets: traditional Mediterranean diet, green Mediterranean diet or a regular, healthy diet, for 18 months.

A traditional Mediterranean diet includes olive oil, fish, fruit, vegetables, nuts, seeds and a minimal amount of red and processed meat. A green Mediterranean diet is similar to a traditional one but is further enriched with polyphenols. Participants on that diet also consumed 28 grams of walnuts (about seven), three to four cups of green tea and 100 grams of duckweed green shake daily and reduced red meat intake.

While both Mediterranean diet groups achieved similar moderate weight and waist circumference loss, the green Mediterranean group lost double the visceral fat, independent of age, sex, waist circumference or weight loss. The green Mediterranean diet reduced visceral fat by 14 per cent, the Mediterranean diet by 7 per cent and the non-Mediterranean healthy diet by 4.5 per cent.

“We learned from the results of our experiment that the quality of food is no less important than the number of calories consumed and the goal today is to understand the mechanisms of various nutrients, for example, positive ones such as the polyphenols and negative ones such as empty carbohydrates and processed red meat, on the pace of fat cell differentiation and their aggregation in the viscera," the study said.

US FDA approves new vitiligo treatment

THE US FOOD AND DRUG Administration has approved topical cream ruxolitinib for the treatment of vitiligo in people aged 12 and older.

Vitiligo is a chronic autoimmune disorder that causes depigmentation of the skin. The approval was based on data from two phase 3 clinical trials evaluating the safety and efficacy of ruxolitinib. The trials included 674 patients, aged 12 and older, who had nonsegmental vitiligo with depigmentation involving 10 per cent or less of total body-surface area.

Patients were randomly assigned to treatment with 1.5 per cent ruxolitinib cream or placebo cream twice daily for 24 weeks, followed by another 28 weeks of treatment with ruxolitinib for all participants.

At the end of 24 weeks, 30 per cent of ruxolitinib patients had at least 75 per cent improvement in the facial Vitiligo Area Scoring Index, compared with 10 per cent of placebo patients. At week 52, about 50 per cent of ruxolitinib treated patients showed improvement. The most common side effects included application site acne, itching and redness; common cold, headache, urinary tract infection and fever.

Ruxolitinib, which belongs to a class of drugs known as Janus kinase (JAK) inhibitors, is the first and only FDA-approved treatment that can restore pigment in vitiligo patients. It is applied twice daily to affected areas. Satisfactory results may require treatment for more than 24 weeks. The findings of the study were published in the New England Journal of Medicine.

Did You Know?

The use of hearing aids and cochlear implants by people with hearing loss was associated with a 19 per cent reduced risk of subsequent cognitive decline and a 3 per cent improvement in cognitive test scores

JAMA Neurology

Is intermittent fasting healthy?

INTERMITTENT FASTING, or eating during a brief period in a day, is a widely popular dietary trend. But new research published in the Journal of the Academy of Nutrition and Dietetics suggests that skipping meals, fasting and eating meals too closely together may be associated with increased risk of mortality.

US researchers analysed data from more than 24,011 adults, aged 40 and above, who participated in the National Health and Nutrition Examination Survey from 1999 to 2014. About 40 per cent of the participants ate fewer than three meals a day. Eating only one meal per day was associated with increased all-cause and cardiovascular disease compared with eating three meals per day.

Skipping breakfast increased the risk of cardiovascular disease mortality and missing lunch or dinner increased the risk of premature death from all causes. Among those who eat three meals daily, eating meals closer than 4.5 hours apart was associated with a higher risk of all-cause mortality.

Skipping meals usually means eating more at one time which can aggravate blood sugar regulation and lead to metabolic issues. This could also explain why a shorter meal interval can increase mortality risk, as a shorter time between meals would result in a larger energy load in the given period. “The results support the role of eating at least three meals per day and a waiting time of 4.5 hours or more between two daytime meals in relation to better cardiovascular health,” the study concluded.

Did You Know?

Worldwide, there has been more than a 50 per cent decline in sperm count over the past 46 years, which, if not mitigated, could threaten the survival of humanity. Sperm concentration and total sperm count are declining at a rate of over 1 per cent each year

Human Reproduction Update

Quit smoking by age 35 to reverse risks

CIGARETTE SMOKING is a known risk factor for premature mortality, especially from cardiovascular and respiratory diseases and cancer. Does quitting reverse this risk and do they vary by race, ethnicity and gender?

To find out, researchers used data from 5,51,388 US adults, average age 48.9 years. During an average follow-up of 11 years, 74,870 people died. Among people who were current or former smokers, about 44 per cent of the deaths from any cause, 52.2 per cent of cancer deaths, 34.7 per cent of heart disease deaths and 86.9 per cent deaths from lower respiratory diseases were attributable to smoking.

Current smokers were more than twice as likely to die from any cause during the study period compared with never smokers, irrespective of race, ethnicity or sex. However, quitting smoking at any age reduced the excess mortality risk associated with continued smoking for all groups. But people who quit at younger ages saw larger reductions.

Those who quit smoking before age 35 had similar death rates as those who never smoked. The excess mortality risk associated with continued smoking was reduced by 90 per cent for those who quit before age 45 and 66 per cent for those who quit between the ages of 45 and 64.

“Among former smokers in each racial and ethnic group, whether male or female, quitting was associated with reductions of approximately 80 per cent of the excess mortality associated with continued smoking,” the authors wrote in JAMA Network Open.

Did You Know?

Strict parenting can cause changes in children’s brains that can increase their risk for depression later in life

Study presented at the European College of Neuropsychopharmacology meeting

Statins may reduce risk of stroke

CHOLESTEROL LOWERING drugs called statins are known to protect the heart and reduce the risk of heart attacks and strokes caused by blood clots. A Danish study published in the journal Neurology suggests that statins may also reduce the risk of intracerebral haemorrhage, a deadly type of stroke which involves bleeding in the brain.

According to the American Association of Neurological Surgeons, intracerebral haemorrhages account for about 15 per cent to 30 per cent of strokes. The researchers looked at the health records of 989 people who had an intracerebral haemorrhage in the lobe area of the brain which includes most of the cerebrum, including the frontal, parietal, temporal and occipital lobes. They were compared to 39,500 people who did not have this type of stroke and were similar in age, sex and other factors.

The researchers also compared 1,175 people who had an intracerebral haemorrhage in the non-lobe parts of the brain to 46,755 people who did not have this type of stroke. The non-lobe area includes the basal ganglia, thalamus, cerebellum and brainstem.

Prescription data was used to determine statin use. People taking statins had a 17 per cent lower risk of stroke in the lobe areas of the brain and a 16 per cent lower risk of stroke in the non-lobe areas of the brain after adjusting for risk factors such as high blood pressure, diabetes and alcohol use.

The risk was even lower with long term use. Taking statins for more than five years was associated with a 33 per cent lower risk of stroke in the lobe area and a 38 per cent lower risk of stroke in the non-lobe area of the brain. “It is reassuring news for people taking statins that these medications seem to reduce the risk of bleeding stroke as well as the risk of stroke from blood clots,” the study added.

meditation-as-medication-for-anxiety-disorders

Fri Nov 25 19:09:04 IST 2022

In the first head-to-head comparison, mindfulness meditation was as effective as a standard medication for treating anxiety disorders.

The findings of a US study published in JAMA Psychiatry included 276 patients, average age 33 years, who were randomly assigned to either mindfulness-based stress reduction (MBSR) or escitalopram, a medication used to treat depression and generalised anxiety disorders.

MBSR included weekly two and a half hour classes for eight weeks, a day-long retreat weekend class during the fifth or sixth week, and 45-minute daily practice at home.

The participants anxiety levels were assessed before enrolment, after completing the intervention at eight weeks, and at 12 and 24 weeks.

Anxiety symptoms were rated on a scale of 1 to 7, with 7 being severe anxiety levels. The average anxiety score was 4.5 at enrolment.

Anxiety symptoms dropped by an average of 1.35 points for the meditation group and 1.43 points for the medication group.

Severity of anxiety symptoms dropped by a significant 30 per cent for both groups.

Another study presented at the American Heart Association annual meeting found that mindfulness training can help people stick to healthy lifestyle choices that would help them manage their high blood pressure.

Participants who followed an eight-week customised mindfulness programme lowered their systolic blood pressure by nearly six points during a six-month follow-up period, which could translate to a 10 per cent lower risk of heart attack and stroke.

Supplements ineffective at lowering cholesterol

Six commonly used dietary supplements that are promoted as heart healthy were found to be ineffective in lowering cholesterol compared with a low-dose statin, according to a US study published in the Journal of the American College of Cardiology.

The purpose of the study was to compare the efficacy of a low-dose statin with a placebo and six dietary supplements in lowering low-density lipoprotein (LDL) cholesterol as well as their effects on other cholesterol levels and markers of inflammation.

One hundred and ninety adults, aged 40 to 75, with no history of cardiovascular disease, were randomly assigned to a low-dose statin medication rosuvastatin (5mg daily), a placebo, or one of six common supplements which included fish oil, cinnamon, garlic, turmeric, plant sterols or red yeast rice, for a month.

People in the statin group had an average 37.9 per cent decrease in bad LDL cholesterol and an average 24 per cent decrease in total cholesterol, whereas none of the supplements had a significant decrease in LDL cholesterol compared to the placebo.

Rosuvastatin also resulted in a 19 per cent decrease in blood triglycerides while supplements made no difference in triglycerides.

There were no significant adverse events with the use of rosuvastatin. But two of the supplements could be potentially harmful: the garlic supplement increased LDL cholesterol and the plant sterols lowered “good” HDL cholesterol levels.

“This study sends an important public health message that dietary supplements commonly taken for ‘cholesterol health’ or ‘heart health’ are unlikely to offer meaningful impact on cholesterol levels. The results also indicate that a low-dose statin offers important beneficial effects on one’s cholesterol profile,” the study author added.

Exercise on an empty stomach to burn more fat

People who exercised on an empty stomach burned about 70 per cent more fat than those who exercised two hours after eating, suggests a British study published in the International Journal of Sport Nutrition and Exercise Metabolism.

More people prefer to exercise in the evening even though studies have shown that exercising in the morning after an overnight fast yields more benefits than doing the same exercise after a meal.

The researchers wanted to find out if fasted evening exercise would yield similar benefits.

Sixteen healthy men and women performed a 30-minute cycling exercise at moderate intensity at 6.30pm and a performance test which involved cycling as far as they could in 15 minutes.

They did this on two separate days: once after a seven-hour fast (had lunch at 11:30) and once two hours after eating a meal.

The researchers also accounted for how much food they ate at dinner, after exercising.

People who exercised after fasting burned more fat much like those who exercise after an overnight fast. The amount of fat burned increased by about 70 per cent—from 4.5 grams to 7.7 grams.

While those in the fasted group consumed about 100 kcal more calories at dinner, they consumed on average 440 kcal less calories over the course of the day.

But fasting seemed to reduce exercise performance, readiness, pre-exercise motivation and enjoyment, which may make it difficult for some people to stick with it long term.

“Combining exercise and fasting can be a potent way to increase the benefits of exercise,” the study author said.

Did You Know?

Moms to be who drink just one cup of coffee or consume any caffeine products including chocolate, tea, energy drinks and soda may have shorter kids compared to children of women who consumed no caffeine during pregnancy

AMA Network Open

Hair straightening products linked to uterine cancer

Women who use chemical hair straightening products frequently are at an increased risk of uterine cancer compared to women who never use these products, according to a study published in the Journal of the National Cancer Institute.

The study included 33,947 women, aged 35-74, who were followed for almost 11 years during which 378 women were diagnosed with uterine cancer.

Women who frequently used hair straightening products, defined as more than four times a year, were 2.5 times more likely to develop uterine cancer, compared to those who did not use the products.

While the risk of developing uterine cancer by age 70 was 1.64 per cent for women who never used hair straighteners, for frequent users, that risk was more than doubled at 4.05 per cent.

The use of other hair products, including hair dyes, bleach, highlights, or perms, were not associated with an increased risk.

Previous studies have shown that hair straighteners can increase the risk of hormone-sensitive cancers, including breast and ovarian cancer.

Chemical exposure from straighteners could be more concerning than other personal care products due to increased absorption through the scalp which may be exacerbated by burns and lesions caused by straighteners, the researchers noted.

Uterine cancer is the most common cancer of the female reproductive system.

Shorter sleep in later years linked to multiple diseases

Adults over 50, who sleep five hours or less per night, have an increased risk of developing multiple chronic diseases compared to those who sleep seven hours.

The study published in the journal PLOS Medicine included 7,864 men and women who were 50 years old and disease free when the study started in 1985.

The researchers analysed the impact of sleep duration on mortality and the risk of being diagnosed with two or more of 13 chronic diseases (multimorbidity) such as heart disease, stroke, cancer, dementia, diabetes, heart failure, chronic obstructive pulmonary disease, kidney disease, liver disease, depression, mental disorders, Parkinson’s and arthritis.

Over 25 years of follow up, 4,446 participants developed their first chronic disease, 2,297 progressed to multimorbidity, and 787 subsequently died.

Those who slept five hours or less at age 50 had a 30 per cent greater risk of multimorbidity compared with those who slept for seven hours. At age 60, shorter sleepers had a 32 per cent greater risk and at 70, a 40 per cent greater risk.

Sleeping longer than nine hours at age 60 and 70 was also associated with an increased risk of chronic diseases, but the diseases could be the reason for the longer sleep times.

The study highlights the importance of optimal sleep duration for good health in midlife and old age.

Intermittent fasting leads to eating disorders?

According to a Canadian study published in the journal Eating Behaviors, though intermittent fasting is a popular dietary trend that promotes weight loss, it may not be as safe as generally thought.

Intermittent fasting may lead to dangerous eating disorder behaviours among adolescents and young adults.

The researchers analysed data from 2,762 adolescents and young adults from the Canadian Study of Adolescent Health Behaviours.

Intermittent fasting was associated with all disordered eating behaviours for women, including binge-eating, as well as compensatory behaviours like vomiting and compulsive exercise. Men who did intermittent fasting were more likely to engage in compulsive exercise.

Intermittent fasting was very popular among study participants: 47 per cent of women, 38 per cent of men, and 52 per cent transgender or gender non-conforming individuals engaged in intermittent fasting an average of 100 days over the previous 12 months.

“We need more education in healthcare settings and greater awareness in popular culture, including social media, of the potential harms of intermittent fasting,” the study author warned.

Did You Know?

Children born to parents who are younger than 20, or those born to mothers older than 35 and fathers older than 45 are at increased risk of being diagnosed with bipolar disorder later in life

European Neuropsychopharmacology

Exercising during chemo helps with recovery

Exercising during chemotherapy can improve cardiorespiratory fitness in cancer patients and help them recover faster from the gruelling effects of the treatment.

During cancer treatment, peak oxygen uptake, an indicator of cardiorespiratory fitness, declines by up to 25 per cent. Cancer treatment can also cause extreme fatigue and cardiovascular morbidity and impair the quality of life.

The Dutch study published in the journal JACC: CardioOncology included 266 patients undergoing chemotherapy for testicular, breast, or colon cancer or non-Hodgkin's lymphoma.

The participants were randomly assigned to a six-month exercise programme either during their chemo treatment, or after treatment.

Exercise included 30 minutes of cardio on a stationary bike or treadmill 3 days a week, 20 to 30 minutes of weight training twice a week, and a recreational sport like indoor hockey, soccer, or badminton once a week.

After chemotherapy was completed, those who exercised during the treatment had significantly lower decreases in peak oxygen uptake and muscle strength and reported less fatigue and more physical activity, which hastened their return to normal life, compared to those who exercised after treatment.

Those who began exercising after chemotherapy also showed some improvement. In fact, participants in both groups returned to their baseline cardiorespiratory fitness one year after completing the exercise regimen.

“These findings suggest that the optimal timing of physical exercise is during chemotherapy. However, initiating a physical exercise programme after chemotherapy is a viable alternative when exercising during chemotherapy is not possible,” the study concluded.

Did You Know?

Following a low-carbohydrate diet helped participants whose blood sugar ranged from prediabetic to diabetic levels and who were not on diabetes medication to significantly lower their hemoglobin A1c by 0.23 per cent compared to those following their regular diet

JAMA Network Open

Hospital room may impact recovery

Certain hospital room features such as the number of patients per room and the distance from a nurse’s station may impact recovery outcomes after undergoing high-risk surgeries, according to a US study presented at the Scientific Forum of the American College of Surgeons Clinical Congress.

The study included 3,964 patients who underwent one of 13 high-risk surgical procedures, including colectomy, pancreatectomy, and kidney transplant.

Patient rooms were coded based on their features, such as window or no window, single occupancy or double occupancy, distance to the nursing station, and line of sight to clinicians.

Health records were used to analyse clinical outcomes, including mortality and length of stay, related to room design.

Patients had better recovery and higher survival rates if they had a single occupancy room; their room was closest to a nursing station on their floor; and in a location with a clear line of sight where providers could see into the room.

Compared to those who were admitted to rooms that had all the above features, people in rooms that had none of these features were 50 per cent more likely to die post-surgery.

A double room occupancy increased mortality risk by 35 per cent, while patients in rooms farther from a nursing station had nearly 36 per cent increased risk of death.

Mortality rates were 20 per cent higher if patients were admitted to a hospital room without a window than if they were in a room with a window.

health-benefits-of-meditation-yoga

Mon Oct 31 16:51:47 IST 2022

TWO new studies explain the health benefits of mind-body practices such as yoga and meditation.

According to the first study published in the Journal of Integrative and Complementary Medicine, mind-body practices can help people with type 2 diabetes reduce their blood sugar. Researchers analysed data from 28 randomised controlled trials from around the world in which people with type 2 diabetes engaged in mind-body practices including meditation, qigong, yoga and mindfulness-based stress reduction, in addition to taking medication and compared them with people who only took medications.

All mind-body practices significantly reduced blood sugar levels. Yoga provided the greatest benefit–about 1 per cent reduction in HbA1c over the past three months. This was similar to the benefits of metformin, the most prescribed diabetes drug, which reduces HbA1c by 1.1 per cent on average.

A second study published in JAMA Neurology suggests that meditation may help older adults preserve their cognitive skills and protect them from memory problems like Alzheimer’s disease. In the study, 137 French men and women, over 65, were assigned to one of three groups: two-hour weekly sessions of meditation or English classes (non-native language training) or a control group, for 18 months. The meditation and English classes group also practised at home for at least 20 minutes a day.

Meditation helped boost “attention, emotion regulation, socio-emotional and self-knowledge capacities,” all of which can decline with age and lead to dementia.

White rice can increase heart disease risk

EATING white rice daily can be as unhealthy as consuming a lot of “unhealthy sugars and oils,” finds an Iranian study presented at the American College of Cardiology Middle East 2022. High intake of refined grains can increase the risk of developing premature coronary artery disease (PCAD). It refers to plaque buildup in the arteries at a younger age, which can lead to heart attacks.

While whole grains such as brown rice contain the entire grain, refined grains are milled into flour or meal, and they lose important nutrients in the process. To analyse the relationship between different types of grain intake and PCAD, researchers used data from 1,369 patients with obstruction of at least 75 per cent in a single coronary artery or at least 50 per cent in the left main coronary artery and a control group of 1,168 patients with normal coronary arteries.

Women in the study were aged 70 years and younger and men 60 years and younger. A higher intake of refined grains was associated with an increased risk of PCAD, while whole grain consumption was inversely related to a reduced risk.

Did You Know?

Night owls are more likely to develop type 2 diabetes and heart disease than people who go to bed and wake up early because their bodies have a reduced ability to burn fat for energy.

Experimental Physiology

Best method to help babies stop crying

RESEARCHERS in Japan have figured out the best strategy to calm crying babies and put them to sleep.

According to a study published in the journal Current Biology, walking around for five minutes while carrying the infants and then sitting while holding them for another eight minutes before laying them down to sleep is the most effective method. The study included 21 babies, with an average age of three months, and their mothers.

Researchers tried four approaches to soothe a crying baby: being held by their walking mothers, held by their sitting mothers, lying in a still crib, or lying in a rocking cot. The crying infants calmed down and their heart rates slowed within 30 seconds when the mother walked around while carrying the baby. A similar calming effect happened when the infants were placed on a rocking cot, but not when the mother held the baby while sitting, or when the baby was placed in a still crib. This shows that just holding a baby might not be sufficient to soothe her.

All crying babies in the study stopped crying, and nearly half of them fell asleep when the mothers walked around for five minutes. But more than a third of the babies woke up within 20 seconds when their mothers put them to bed.

All babies produced physiological responses, including changes in heart rate that can wake them up when their bodies were detached from their mothers. But they were less likely to wake up if they were asleep for a longer period before being laid down.

Pandemic lockdowns may have impeded babies’ development

BABIES born during Covid-19 lockdowns may have development delays, especially in social communication skills. During the lockdowns, babies hardly interacted with people outside their homes and “access to visual and facial cues for language development” was restricted by mask wearing.

For the study published in the Archives of Disease in Childhood, Irish researchers assessed ten development outcomes at 12 months for 309 babies born during the first three months of the pandemic and were part of the CORAL (Covid-19 Risks Across the Lifespan) study, and compared them with those of 1,629 infants born before the pandemic (BASELINE group).

As many as 25 per cent of the CORAL babies hadn’t met another child their own age by the time they reached 12 months. Fewer CORAL babies reached communication milestones such as, saying one definite and meaningful word, pointing at objects and waving bye-bye, during the first year of life.

But more CORAL infants were able to crawl than BASELINE babies which could be because they must have spent more time indoors and on the ground. “Lockdown measures may have impacted the scope of language heard and sight of unmasked faces speaking to them, while also curtailing opportunities to encounter new items of interest which might prompt pointing, and the frequency of social contacts to enable them to learn to wave,” the lead researcher said.

Researchers suggest that though communication skills may improve as social interactions increase, the children should be followed up to school age to ensure that the impact is not long lasting.

Take 10,000 steps a day for a healthy life

TAKING 10,000 steps a day can lower your risk of dementia, heart disease, cancer and premature death, according to two studies published in the journals JAMA Neurology and JAMA Internal Medicine.

The study included 78,500 healthy adults, 40 to 79 years old, who wore accelerometers that tracked their physical activity. For every 2,000 steps taken, up to about 10,000 steps per day, the risk of early death dropped by 8 per cent to 11 per cent. Similar benefits were seen for cardiovascular disease and cancer incidence.

The greatest benefit was seen with 9,800 steps which was linked to a 50 per cent reduced risk of dementia. But every step mattered. Those who logged 3,800 steps a day reduced their risk of dementia by 25 per cent.

Walking at a faster pace was associated with even greater benefits for all outcomes (dementia, heart disease, cancer and death) above and beyond the total number of daily steps.

Did You Know?

Exercising regularly and sitting down less can reduce the risk of breast cancer.

British Journal of Sports Medicine

Antidepressant use is safe during pregnancy

TAKING antidepressants during pregnancy does not increase the risk for neurodevelopment disorders such as autism and ADHD (attention-deficit hyperactivity disorder) in children, according to a study published in JAMA Internal Medicine.

Researchers analysed data from 1,45,702 women who took antidepressants during pregnancy and 30,32,745 women who did not take antidepressants. Their children were followed from birth up to the age of 14. While the first-glance results suggested an increased risk, there was no increased risk after accounting for potential variables. Antidepressant use during pregnancy was not associated with any neurodevelopment disorders, including autism spectrum disorder, ADHD, specific learning disorders, speech/language disorders, developmental coordination disorder, intellectual disability or behavioural disorders.

The results were also similar when researchers compared antidepressant exposed siblings with unexposed siblings.

Your diet can contribute to menstrual pain

ACCORDING to a study presented at the North American Menopause Society’s annual meeting, eating food that promote inflammation can contribute to menstrual pain. About 90 per cent of adolescent girls have menstrual pain which is the leading cause of school absences, the author said. Dysmenorrhea, or menstrual pain is triggered by prostaglandin, chemicals which promote inflammation.

To find out if anti-inflammatory diet might help reduce inflammation and menstrual pain, researchers analysed studies on the impact of diet on menstrual pain. Food high in omega-6 fatty acids increased the presence of prostaglandins in the body and led to more uterine contractions and pain. On the other hand, food high in omega-3 fatty acids reduced inflammation.

Food items that promote inflammation and contribute to an increased risk of dysmenorrhea include meat, processed food, coffee, and food high in sugar, salt and oil. Fruits and vegetables, fish, nuts, seeds and olive oil reduced inflammation. People who followed a vegan diet, which excluded animal fat, had the lowest rates of inflammation.

“It is advisable to adopt a diet that avoids inflammatory food to remedy dysmenorrhea,” the study concluded.

Did You Know?

Feeling hopeless, unhappy, and lonely accelerates ageing, even more than smoking.

Aging-US

Time your meals to reap health benefits

TWO new studies published in the journal Cell Metabolism suggest that there is an optimal time to eat. According to the first study, eating dinner late at night can increase hunger, decrease calories burned and cause changes to fat tissue, all of which can increase the risk of obesity. To find out if the time we eat matter when everything else is kept the same, researchers recruited 16 overweight people.

The participants ate the exact same meals on two different schedules: an early meal schedule, and the other about four hours later in the day. People reported being hungrier when they ate a late dinner and had cravings for energy dense food such as starchy and salty food, meat and dairy. Blood tests showed that late eating decreased levels of the hormone leptin, which helps people feel full, while levels of the hormone ghrelin, which increases appetite, rose. Late eaters also burnt calories at a slower rate. Eating late also altered fat tissue which could increase the chance of less fat breakdown and more fat storage.

The second study that included 137 firefighters suggests that eating meals within a 10-hour window has immense health benefits. The participants followed a Mediterranean diet for 12 weeks. Half of them ate during a 10-hour window, while the other half within a 14-hour window. The 10-hour eating window significantly decreased bad cholesterol, improved mental health and reduced alcohol intake by roughly three drinks per week. It also decreased blood pressure and blood sugar levels in participants who had high blood pressure and diabetes at the start of the study.

are-artificial-sweeteners-healthy

Sun Sep 25 15:15:16 IST 2022

ACCORDING TO A FRENCH study published in the BMJ, artificial sweeteners may increase your risk of cardiovascular diseases, including heart attack and stroke.

Artificial sweeteners are widely used in foods and drinks as a low calorie alternative to sugar.

Consumption of artificial sweeteners or artificially sweetened beverages has already been linked to weight gain, high blood pressure, and inflammation.

To examine the role of artificial sweeteners in the risk of cardiovascular diseases, the researchers used data for 103,388 participants, average age 42 years.

Artificial sweeteners such as aspartame, acesulfame potassium, and sucralose from all dietary sources including beverages, tabletop sweeteners and dairy products were included in the analysis.

About 40 per cent of the participants consumed artificial sweeteners regularly.

During an average follow-up of nine years, 1,502 cardiovascular events occurred, including heart attack, stroke, angina and angioplasty.

Artificial sweetener intake was associated with an increased risk of cardiovascular diseases, specifically cerebrovascular diseases. As also conditions such as stroke which affect the blood flow to the brain.

While aspartame intake increased the risk of cerebrovascular events, acesulfame potassium and sucralose were associated with increased coronary heart disease.

“The findings indicate that these food additives, consumed daily by millions of people and present in thousands of foods and beverages, should not be considered a healthy and safe alternative to sugar,”the study concluded.

Brain zaps may boost memory

A NON-INVASIVE electrical brain stimulation can improve both short-term and long-term memory in older adults for at least one month, according to a study published in Nature Neuroscience.

The study included 150 adults aged 65 to 88 who did not have a diagnosis of Alzheimer’s.

During 20 minute sessions on four consecutive days, the participants were asked to recall five lists of 20 words while low dose electrical signals were delivered through electrodes in a wearable cap that was hooked up to a brain stimulation device.

The researchers used two brain stimulation protocols—“one for selectively improving short-term memory via low-frequency parietal stimulation, and another protocol for selectively improving long-term memory via high-frequency prefrontal stimulation.”

Participants who received the brain stimulation recalled more words with each passing day and did about 50 per cent better on memory tests compared to the placebo group who did not receive the treatment.

People who scored worse at the beginning of the study showed the greatest improvement from the brain stimulation.

The benefits remained a month later. More research is needed to determine if these gains last longer, the researchers said.

“Our findings demonstrate that the plasticity of the ageing brain can be selectively and sustainably altered using these two treatments,”the study author said.

Did You Know?

Teenagers whose parents smoke are about 55 per cent more likely to try e-cigarettes and about 51 per cent more likely to try smoking

Study presented at the European Respiratory Society International Congress

Is there a correct way to take a pill?

ACCORDING TO A STUDY published in the journal Physics of Fluids, pills taken while lying on your right side are broken down and absorbed 2.3 times faster than those taken in an upright position. Lying on the left side was the worst. It can delay pill absorption by more than an hour.

To evaluate how body positioning affects pill absorption, the researchers used a model called StomachSim which uses physics, biomechanics and fluid mechanics to mimic the process of drug dissolution inside the stomach.

They tested four different body positions: upright, lying on your back, on your right side, and on your left side.

Most pills start working when the stomach ejects their contents into the intestine. A pill that lands closer to the antrum, the lower part of the stomach, is dissolved faster and emptied into the duodenum, the first part of the small intestine. Posture is critical to both gravity and the natural asymmetry of the stomach for the pill to land in that part of the stomach.

A pill that takes about 10 minutes to dissolve when taken while lying on the right side, could take 23 minutes to dissolve when taken in an upright posture and over 100 minutes when taken lying on the left side.

Dissolution rate of a pill when taken while lying straight back tied with taking it in an upright position.

"For elderly, sedentary or bedridden people, whether they're turning to left or to the right can have a huge impact," the lead researcher said.

Exercise more to live longer

REGULAR PHYSICAL ACTIVITY is associated with a lower risk of cardiovascular diseases and premature death.

According to current guidelines, adults should aim for 150-300 minutes of moderate physical activity like walking every week or 75-150 minutes of vigorous physical activity like jogging, running, swimming or bicycling.

A new study published in the journal Circulation found that people who surpassed the weekly requirements had a significantly reduced risk of dying from cardiovascular diseases and other causes.

The findings were based on 30 years of medical records and mortality data for 116,221 adults taking part in two large studies. The participants routinely provided information about their physical activity intensity and duration.

It was recorded that 47,596 participants died during the study period. Overall, mortality risk was lower among those who exercised regularly even when factors such as body weight, dietary habits and smoking status were considered.

People who met the recommended exercise requirements were about 22 to 31 per cent less likely to die of heart disease or stroke and had a 15 to 20 per cent reduced risk of death from non-cardiovascular causes.

The longevity benefits were much greater for those who exceeded the recommended requirements.

Participants who exercised two to four times above the minimum recommendations had a 27 to 38 per cent lower risk of cardiovascular mortality and a 19 to 27 per cent lower risk of death from non-cardiovascular causes, for an overall 21 to 31 per cent lower risk of death from all causes.

Mode of delivery won’t affect sex life

DOES METHOD of childbirth impact future sexual enjoyment? According to a study published in BJOG: An International Journal of Obstetrics and Gynecology, sexual enjoyment following childbirth is not affected by the way in which the baby is delivered.

The researchers wanted to see if Caesarean sections maintain sexual wellbeing better compared to vaginal delivery due to the reduced risk of tearing and the maintenance of vaginal tone.

British researchers followed the mothers of more than 14,000 babies born in the UK for up to 18 years. There was no difference between women who gave birth via C-section and those who delivered vaginally when it comes to sexual wellbeing outcomes, including sexual enjoyment and sexual frequency at any timepoint postpartum. However, some women who had C-sections reported pain in the vagina during sex at 11 years postpartum.

“Rates of Caesarean section have been rising over the last 20 years due to many contributing factors and, importantly, it has been suggested that caesarean section maintains sexual wellbeing compared to vaginal delivery. This research provides expectant mothers, as well as women who have given birth, with really important information and demonstrates that there was no difference in sexual enjoyment or sexual frequency,”the lead author added.

Cancers in people under 50 increasing dramatically

THE INCIDENCE OF EARLY onset cancers—those diagnosed before age 50—has drastically increased around the world.

Cancers of the breast, colon, oesophagus, kidney, liver, and pancreas among others have shown this dramatic increase beginning around 1990.

"We found that this risk is increasing with each generation. For instance, people born in 1960 experienced higher cancer risk before they turn 50 than people born in 1950 and we predict that this risk level will continue to climb in successive generations," the study author said.

For the study published in Nature Reviews Clinical Oncology, the researchers analysed global data on 14 cancer types that have shown increased incidence in adults before age 50 from 2000 to 2012.

Early life exposure, including diet, lifestyle, weight, environmental exposures, and microbiome, have changed considerably over the last few decades.

While early detection through cancer screening could partly explain this rise in early onset cancer, westernised diet and lifestyle could possibly be contributing to this epidemic.

Cancer risk factors such as consumption of highly processed food and sugary beverages, obesity, type 2 diabetes, sedentary lifestyle, smoking and alcohol consumption have all increased since the 1950s.

“Among the 14 cancer types on the rise that we studied, eight were related to the digestive system. The food we eat feeds the microorganisms in our gut. Diet directly affects microbiome composition and eventually these changes can influence disease risk and outcomes.”

“Raising awareness of the early onset cancer epidemic and improving the early life environment should be our immediate goals: these are likely to reduce the burden of both early onset and later-onset cancers,”the study concluded.

Did You Know?

The US FDA is alerting consumers against the use of skin-lightening products that contain hydroquinone, which can cause side effects such as rashes, facial swelling and permanent skin discoloration

A big breakfast and light dinner may not help with weight loss

DOES THE SAYING "breakfast like a king, lunch like a prince and dine like a pauper" hold true?

The saying is based on the belief that eating your biggest meal earlier in the day will help you burn calories more efficiently and help you lose weight.

But according to a Scottish study published in the journal Cell Metabolism, timing of eating does not have any bearing on how our body metabolises calories or weight loss.

The researchers recruited 16 men and 14 women who were healthy, but overweight or obese.

The participants were randomly assigned to eat either a morning-loaded or an evening-loaded diet based on 30 per cent protein, 35 per cent carbohydrate, and 35 per cent fat. The total daily calorie intake was fixed.

After four weeks on this diet, the participants took a one week break and then switched to the opposite diet for four weeks.

There was no difference in total weight loss and energy metabolism between the two eating patterns. The participants lost an average of just over 3 kg during each of the four-week periods.

But the participants reported feeling less hungry on the days they ate a bigger breakfast. And this greater suppression of hunger could help people trying to lose weight comply with their weight loss regime.

Hormone therapy for prostate cancer may increase heart risks

HORMONE THERAPY, a common treatment for prostate cancer, may increase the risk of dying from cardiovascular disease, especially in older men.

For the study published in the journal The Aging Male, researchers used data from a Lithuanian cancer registry for 13,343 men aged 40 to 79 who were diagnosed with prostate cancer—3,797 patients received hormone-lowering drugs and 9,546 did not. The risk of death from cardiovascular disease was assessed over an average follow-up period of about five years.

Men who received hormone therapy had a more than twofold increased risk of death from cardiovascular disease. The risk of heart disease-related death increased from the second year of cancer diagnosis.

Patients aged 70 to 79 who had hormone therapy had an almost fivefold higher risk.

When the researchers assessed specific types of cardiovascular disease, men treated with hormone therapy had a 42 per cent higher risk of dying from coronary heart disease and a 70 per cent higher risk of dying from stroke.

Ultra-processed food linked to cancer, heart disease

ACCORDING TO TWO studies published in The BMJ, high consumption of ultra-processed foods can increase the risks of cardiovascular disease, colorectal cancer and death.

Ultra-processed foods like baked goods and snacks, fizzy and energy drinks, sugary cereals, and pre-cooked meals often contain high levels of added sugar, fat, salt, additives and preservatives, but lack essential vitamins and fibre.

Previous studies have already linked ultra-processed foods to increased risks of obesity, high blood pressure, cholesterol, and some cancers.

The first study was based on 46,341 men and 1,59,907 women whose eating habits were assessed every four years; 3,216 colorectal cancer cases were documented over a period of 24-28 years.

Men who ate the most ultra-processed foods had a 29 per cent higher risk of developing colorectal cancer than those who ate the least. While a similar association was not seen in women, higher consumption of ready-to-eat dishes was associated with an increased risk of colorectal cancer in women.

Colon cancer is increasing among young people and the increased intake of processed food could be the reason.

The second study analysed the association between quality of diet and the risk of death from cardiovascular causes and all causes in 22,895 Italian adults, average age 55 years. Over a 14-year period, 2,205 deaths were documented.

People who consumed the least healthy diet had a 19-per cent higher risk of death from any illness and a 32 per cent greater risk of death from cardiovascular disease compared to those who ate the healthiest diet.

vegetarian-women-at-greater-risk-of-hip-fracture

Sun Sep 04 14:28:59 IST 2022

Middle-aged women who are vegetarian are more likely to suffer a hip fracture compared with women who regularly eat meat. The UK study published in the journal BMC Medicine, analysed rates of hip fractures in 26,318 women aged 35 to 69. The women were grouped based on their eating habits: regular meat eaters; occasional meat-eaters (ate less than five times a week); pescatarians (ate fish but not meat) and vegetarians. During an average of 22.3 years of follow-up, there were 822 hip fractures, which were confirmed from hospital records.

Vegetarians were the only group who had an elevated risk of hip fracture after adjusting for other factors known to increase the risk such as smoking and age. They had a 33 per cent elevated risk than regular meat-eaters. According to the researchers, low body mass index and nutritional deficiencies could play a role. Vegetarian diets often have lower intakes of nutrients such as protein, calcium, vitamin D, vitamin B12 and other micronutrients that promote bone and muscle health. "Low intake of these nutrients can lead to lower bone mineral density and muscle mass, which can make you more susceptible to hip fracture risk,” the study said.

The average BMI among vegetarians was also slightly lower than that of regular meat eaters. A lower BMI can indicate people are underweight, which can mean poor bone and muscle health and higher risk of hip fracture.

Cornea implant made from pig skin restores vision

In a pilot study, a cornea implant made of collagen protein from pig's skin restored vision in 20 patients with diseased corneas, most of whom were blind before the procedure. About 12.7 million people around the world are blind due to damaged or diseased corneas. The only remedy for these patients is to receive a donated human cornea transplant. However, just one in 70 people can get a cornea transplant.

The new bioengineered corneas are affordable, can be mass produced and can be stored for up to two years, while donated corneas from humans must be used within two weeks. Swedish researchers from Linköping University used the experimental implant to treat 20 patients in India and Iran with the disease keratoconus, in which the cornea becomes so thin that it can lead to blindness. Fourteen of the participants were completely blind before the surgery and six of them were partially blind.

Two years after surgery, none of them is blind anymore and three of the Indian participants who had been blind prior to the study have perfect (20/20) vision. Normally a keratoconus (cornea becoming thin and developing a cone-like bulge) patient's cornea is surgically removed and replaced with a donated cornea, which is sewn into place using sutures. The patient must also use immunosuppressive eye drops for at least a year or even longer, to avoid rejection. But the new implant can be inserted into the existing cornea, without removing existing tissue, after a small incision is made with advanced laser, and no stitches are required.

No complications were reported during surgery or during two years of follow-up. The patients only needed eight weeks of treatment with immunosuppressive eye drops to prevent rejection of the implant. “This work demonstrates restoration of vision using an approach that is potentially equally effective, safer, simpler and more broadly available than donor cornea transplantation,” the study published in the journal Nature Biotechnology concluded.

Take blood pressure readings from both arms

Taking blood pressure readings from both arms and considering the higher reading would be better at identifying and managing patients at risk of high blood pressure and related cardiovascular issues, suggests a study published in the journal Hypertension. Although current guidelines recommend checking blood pressure in both arms and adopting the higher arm readings, it is not routinely followed. The researchers analysed data from 23 international studies that included 53,172 adults with an average age of 60.

When the higher arm's reading was considered, 12 per cent of people were reclassified as having hypertension. They would have fallen below the threshold for diagnosis and treatment of hypertension if only the lower arm’s reading was used. Using the higher arm reading also reclassified about 1,700 people as being at a higher risk for cardiovascular disease. Using the higher arm blood pressure readings was a better predictor of future cardiovascular risks as well as all-cause mortality and cardiovascular mortality, the study found.

“Failure to measure both arms and using the higher reading arm will not only result in under-diagnosis and under-treatment of high blood pressure, but also underestimation of cardiovascular risks for millions of people worldwide,” the study said.

Did You Know?

A study that included 25,871 participants found that vitamin D supplements did not reduce the risk of bone fractures in generally healthy middle aged and older adults, when compared with a placebo

The New England Journal of Medicine

Adding HPV vaccine to surgical removal of cervical lesions cuts cancer risk

Giving women the human papillomavirus (HPV) vaccine when surgically removing precancerous cervical lesions can further reduce their risk of developing cervical cancer. HPV vaccines are highly effective in preventing HPV infection and many countries offer HPV vaccination to girls and boys around the age of 11 or 12 to protect them from future infections and HPV related cancers. But their effectiveness in women with ongoing infections is not clear. Even after removal of high-grade precancerous lesions, women still have a high risk of recurrent cervical lesions and other malignancies related to HPV infection.

The study published in The BMJ analysed 18 studies to examine the effect of HPV vaccination after surgical treatment in preventing the risk of HPV infection or recurrent lesions. Overall, the risk of recurrence of high grade preinvasive disease was reduced by 57 per cent in patients who were also vaccinated compared with those who just had the surgical treatment.

When considering the two high-risk types of HPV (HPV16 and HPV18, which cause most cervical cancers), the results were even stronger–a 74 per cent reduction in precancerous lesions.

Did You Know?

Even moderate alcohol consumption was associated with greater iron buildup in the brain, which in turn was associated with worse cognitive functions, including poor working memory, comprehension, reasoning and problem solving and slower reaction speeds

PLOS Medicine

Salt substitutes lower risk of heart attack and stroke

Your risk of heart attack, stroke and death from all causes can be reduced significantly by using salt substitutes, according to a study published in the journal Heart. Cardiovascular disease is a leading cause of death worldwide, and high blood pressure is a major contributing factor. In salt substitutes, a proportion of sodium chloride is replaced with potassium chloride which can help lower blood pressure.

A recent Chinese study showed that salt substitutes reduced the risk of heart attacks, stroke and early death. To find out if the benefits would apply to people in other parts of the world, the researchers used data from 21 international clinical trials involving 31,949 participants from Europe, the western Pacific region, the Americas and southeast Asia.

Using salt substitutes lowered blood pressure among all participants irrespective of geographical regions, age, sex, history of high blood pressure, weight, baseline blood pressure and baseline levels of urinary sodium and potassium. Overall, systolic blood pressure dropped by 4.61 mm Hg and diastolic blood pressure by 1.61 mm Hg. Each 10 per cent reduction of sodium chloride in the salt substitute was associated with a 1.53 mm Hg and a 0.95 mm Hg greater reduction in systolic and diastolic blood pressure, respectively. The drop in blood pressure further facilitated a reduced risk of heart attack, stroke and death from all causes.

Using salt substitutes lowered the risk of heart attack or stroke by 11 per cent and risk of dying from cardiovascular disease by 13 per cent and death from any cause by 11 per cent. Higher intake of dietary potassium was not associated with any adverse effects.

Men are more likely to get cancer than women

Men are more likely to develop cancer than women, and this could largely be due to biologic differences rather than behavioural factors, such as smoking, alcohol use, diet and physical activity, according to a US study published in the journal Cancer.

To assess differences in risk between men and women for 21 shared cancer sites, the researchers used data from 1,71,274 men and 1,22,826 women between the ages of 50 and 71 who were enrolled in a diet and health study from 1995 to 2011. As many as 17,951 new cancers were diagnosed in men and 8,742 were found in women during the study period. Men had a greater than two-fold higher risk for most cancers; they had lower rates only for thyroid and gallbladder cancers. The risks were 1.3 to 10.8 times higher in men than women at other anatomic sites. The greatest difference in risks were seen for oesophageal cancer (10.8 times higher), larynx (3.5 times higher), gastric cardia–part of the stomach closest to oesophagus (3.5 times higher) and bladder cancer (3.3 times higher).

Men had a greater risk for most cancers even after accounting for a wide range of risk behaviour and carcinogenic exposure, pointing to biologic differences as the major contributing factor for the increased risk. Understanding these biologic mechanisms could lead to better prevention and treatment.

Did You Know?

Globally, almost half of deaths due to cancer, in both men and women, can be attributed to preventable risk factors, including smoking, alcohol use or having a high body mass index

The Lancet

FDA approves first hair loss drug to treat alopecia areata

The US Food and Drug Administration has approved the first pill to treat adults dealing with the hair loss disorder alopecia areata, an autoimmune disorder that affects about 147 million people worldwide. It causes the body to attack its own hair follicles, causing patchy or complete hair loss and sometimes eyebrows, eyelashes, facial hair and body hair.

Olumiant (baricitinib), a once daily pill, offers systemic treatment for the condition–it treats the entire body rather than a specific spot. Olumiant is a Janus kinase (JAK) inhibitor that is already approved for the treatment of rheumatoid arthritis. The drug was approved based on two phase-3 clinical trials that included 1,200 patients with at least 50 per cent hair loss for more than six months.

The most common side effects included upper respiratory tract infections, headache, acne, high cholesterol, increase of an enzyme called creatinine phosphokinase, urinary tract infection, liver enzyme elevations, inflammation of hair follicles, fatigue, lower respiratory tract infections, nausea, genital yeast infections, anaemia, low number of certain types of white blood cells, abdominal pain, shingles and weight gain.

Olumiant should not be used in combination with other JAK inhibitors or any other potent immunosuppressants, the FDA warned. The drug comes with a boxed warning for serious infections, mortality, cancer, major adverse cardiovascular events and thrombosis. The findings of the clinical trial were published in the New England Journal of Medicine.

Napping regularly linked to hypertension, stroke

According to a Chinese study published in the journal Hypertension, napping regularly is associated with an increased risk of high blood pressure and stroke. The researchers analysed data from the UK Biobank that included genetic and health information from more than five lakh participants aged 40-69.

After excluding participants who already had hypertension or suffered a stroke at the start of the study, the researchers focused on 3,58,451 participants and divided them into groups based on frequency of napping– usually, sometimes, and never/rarely and followed them for 11 years.

People who napped frequently had a 12 per cent higher risk of developing high blood pressure and 24 per cent higher risk of having a stroke compared with those who never napped. When napping frequency increased by one category–from never to sometimes or sometimes to usually–the risk of high blood pressure increased by 40 per cent. While napping itself may not be the issue, it could be a sign of poor nighttime sleep and other underlying health problems, the researchers suggested.

A majority of the frequent nappers were men, and reported smoking, daily drinking, insomnia, snoring and being an evening person compared with people who napped sometimes or never.

gardening-can-boost-mental-wellbeing

Sun Jul 31 12:50:53 IST 2022

GARDENING and being in nature have been linked to physical and mental wellbeing, especially in people with medical or mental challenges.

A new US study published in the journal PLOS ONE found that tending to plants lowered stress, anxiety and depression, and improved mental health, even for healthy people who had never gardened before.

The study included 32 healthy women aged 26 to 49 who did not have any chronic health conditions, did not use tobacco and drugs and were not prescribed medication for anxiety or depression.

The participants were randomly assigned to either gardening or art-making sessions, for one hour twice a week for four weeks.

“Both gardening and art activities involve learning, planning, creativity and physical movement, and they are both used therapeutically in medical settings. This makes them more comparable, scientifically speaking, than, for example, gardening and bowling or gardening and reading,” the lead researcher explained.

Participants in the gardening sessions learned to sow seeds, transplant different kinds of plants, and harvest and taste edible plants, while those in the art-making sessions learned papermaking, printmaking, drawing and collage.

The participants completed a series of tests that measured anxiety, depression, stress and mood. Both gardening and art making were associated with improvements in mental health over time. But the gardeners reported slightly less anxiety than those in the art-making group.

Therapeutic horticulture, or the use of gardening to promote better health and wellbeing, has been around since the 19th century.

Walking Can Prevent Knee Pain from Osteoarthritis

ADULTS with osteoarthritis who walked for exercise were less likely to develop frequent knee pain, according to a US study published in Arthritis & Rheumatology. Walking for exercise is already known to reduce the risk of health problems like heart disease, diabetes, obesity and some cancers.

The study included 1,212 participants aged 50 and older who had osteoarthritis in the knee. They provided information about the amount of time they walked for exercise, symptoms of osteoarthritis and pain levels.

The 73 per cent who walked for exercise were 40 per cent less likely to develop new frequent knee pain compared with non-walkers.

Walking for exercise also appeared to slow some of the structural damage from osteoarthritis that occurs in the knees.

Walking was especially beneficial for people who had radiographic evidence of osteoarthritis, but did not start experiencing pain every day.

“This study supports the possibility that walking for exercise can help prevent the onset of daily knee pain. It might also slow down the worsening of damage inside the joint from osteoarthritis,” the study author added.

Walking for exercise is an easy, simple and free intervention that could modify the structural symptoms of knee osteoarthritis without side effects.

Bariatric Surgery Cuts Cancer Risk

LOSING weight through bariatric surgery can significantly reduce the risk of cancer and cancer-related mortality.

Obesity increases the risk of developing 13 types of cancer, including endometrial cancer, postmenopausal breast cancer, and cancers of the colon, liver, pancreas, ovary and thyroid.

The US study, published in the Journal of the American Medical Association, included 30,318 obese patients, with a median age of 46 years.

5,053 patients who had bariatric surgery were compared with a control group of 25,265 patients who did not have the surgery.

At 10 years, the people who had weight loss surgery lost about 24.8kg more than those who did not have the surgery.

Over the study period, 96 patients (2.9 per cent) in the bariatric surgery group and 780 patients (4.9 per cent) in the non-surgical group developed an obesity-associated cancer, and 21 patients (0.8 per cent) in the surgery group and 205 patients (1.4 per cent) in the non-surgical group died from cancer.

Those findings indicate that weight loss achieved with bariatric surgery was associated with a 32 per cent lower risk of developing cancer and a 48 per cent lower risk of dying from it.

The benefits of bariatric surgery were similarly observed after both gastric bypass and gastric sleeve operations, and among women and men, and young and old.

The study also showed that for patients with fatty liver disease, bariatric surgery reduced the risk of the progression of liver disease and serious heart complications.

“Patients can lose 20 to 40 per cent of their body weight after surgery, and weight loss can be sustained over decades. The striking findings of this study indicate that the greater the weight loss, the lower the risk of cancer,” the lead author added.

Did You Know?

Older adults who gave away money easily to strangers scored significantly lower on cognitive tests known to be sensitive to early Alzheimer's disease.

Journal of Alzheimer's Disease

Can you stand on one leg for 10 seconds?

IF YOU CAN, you may live longer.

According to a Brazilian study published in the British Journal of Sports Medicine, middle-aged and older adults who cannot balance on one leg for 10 seconds are almost twice as likely to die from any cause within the next 10 years.

To find out whether a balance test could predict a person’s risk of death, researchers used data from 1,702 adults aged 51 to75.

The participants were asked to stand on one leg for 10 seconds without any added support. They were asked to place the front of the free foot on the back of the opposite lower leg, while keeping their arms by their sides and looking forward. They were allowed three attempts.

About 20 per cent of the participants failed the balance test. The inability to do so increased with age.

During an average follow up of seven years, 123 (7.2 per cent) people died; 17.5 per cent of those who failed the test died compared to 4.6 per cent of those who aced the test.

After accounting for age, sex, and underlying medical conditions, an inability to balance on one leg was associated with an 84 per cent increased risk of death from any cause within the next decade.

According to the researchers, the balance test should be included in routine health checks for older adults as it “provides rapid and objective feedback for the patient and health professionals regarding static balance and adds useful information regarding mortality risk in middle-aged and older men and women.”

Did You Know?

The odds of preterm delivery are significantly higher for pregnant women with periodontitis, or gum disease.

Study presented at a meeting of the European Federation of Periodontology

Life’s Essential 8

THE AMERICAN Heart Association (AHA) has added sleep duration to its list of healthy behaviours that people can follow to achieve optimum cardiovascular health.

In 2010, the AHA outlined seven health factors and behaviours called Life’s Simple 7 that drive optimal heart and brain health.

They consisted of eating a healthy diet, maintaining a healthy weight, being physically active, not smoking, and controlling blood pressure, cholesterol and blood sugar. Now, the AHA has added sleep duration to the list.

The revised checklist called Life’s Essential 8 was published in the journal Circulation.

“The new metric of sleep duration reflects the latest research findings: sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure or risk for Type 2 diabetes more effectively,” the AHA president said.

According to the new guidelines, adults should get seven to nine hours of sleep each night to maintain a healthy heart. Children ages five and younger should get 10 to 16 hours of sleep, those aged six to 12 should get nine to 12 hours and 13- to 18-year-olds need eight to 10 hours of sleep.

The AHA has also revised four of the original metrics based on new discoveries in heart and brain health and the ways to measure cardiovascular health. For example, nicotine exposure now includes electronic cigarettes (vaping) and exposure to secondhand smoke; non-HDL cholesterol is suggested instead of total cholesterol to measure blood lipids; and the blood sugar measure is expanded to include haemoglobin A1c levels.

Life’s Essential 8 can be assessed by the online My Life Check tool, which has an updated scoring system ranging from 0 to 100. Overall scores below 50 suggest poor cardiovascular health; 50 to 79 indicate moderate cardiovascular health; and 80 and above indicate high cardiovascular health.

According to the AHA, cardiovascular disease is the number one cause of death in the US and worldwide, and more than 80 per cent of all cardiovascular events can be prevented by following a healthy lifestyle and managing known cardiovascular risk factors.

Did You Know?

Frequent video game players have more accurate and faster decision-making skills and functional magnetic resonance imaging (FMRI) showed enhanced activity in key regions of the brain.

Neuroimage: Reports

Adding extra salt at the table linked to premature death

PEOPLE who sprinkle salt on their food at the table are more likely to die prematurely from all causes, according to a study published in the European Heart Journal.

The findings were based on data from 5,01,379 people taking part in the UK Biobank study.

The participants were asked whether they added salt to their food at the table before eating, independent of any salt added during cooking. Analysing this behaviour “provides a unique way to evaluate the association between habitual sodium intake and the risk of [premature] death,” the study author said.

The participants were followed for an average of nine years during which 18,474 premature deaths were reported. A premature death was defined as death before the age of 75 years.

Those who always added salt to their food had a 28 per cent increased risk of dying prematurely compared with those who never or rarely added salt.

They had a significantly higher risk of dying from cardiovascular diseases and cancers.

People who habitually added salt had a lower life expectancy: men lost 2.28 years and women lost 1.5 years at age 50, compared with those who never, or rarely, did.

The increased risks were slightly modified in people who ate a lot of fruits and vegetables. These are major sources of potassium, which has protective effects.

Did You Know?

Consuming one or more sugar-sweetened beverages daily is associated with a 78 per cent greater risk of developing liver cancer.

Study presented at a meeting of the American Society for Nutrition

Are vitamins and supplements beneficial?

PEOPLE spend billions of dollars on vitamins and dietary supplements every year. But are they really beneficial?

According to new guidelines issued by the United States Preventive Services Task Force (USPSTF), vitamins and supplements offer little to no benefit in preventing cardiovascular disease or cancer, the two leading causes of death, and are a waste of money for most people.

The task force reviewed 84 studies that included 7,39, 803 participants to examine the benefits and harms of vitamins and mineral supplements, and their impact on preventing cardiovascular diseases and cancer among healthy, non-pregnant adults.

The USPSTF concludes that there isn’t sufficient evidence to recommend for or against most single and multivitamin supplements for the prevention of heart disease, stroke or cancer. But there was enough evidence to recommend against the use of beta-carotene and vitamin E supplements.

Beta-carotene, with or without vitamin A, was associated with an increased risk for cardiovascular mortality and lung cancer, and there was no benefit to taking vitamin E to prevent cancer or cardiovascular disease.

The recommendations do not apply to people with vitamin deficiencies, children or pregnant women. Women who are pregnant or considering pregnancy should take a daily folic acid supplement.

The draft recommendation statement was published in the Journal of the American Medical Association.

Eating a balanced diet high in fruits and vegetables and exercising regularly are the best ways to reduce a person’s risk of cancer or cardiovascular disease.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

dementia-risk-factors-vary-with-age

Sun Jun 26 18:26:27 IST 2022

FACTORS THAT CAN increase a person’s risk of developing dementia may vary with age, according to an Irish study published in the journal Neurology. The researchers analysed data from 4,899 people who were about 55 years at the start of the study. About half the participants did not develop dementia, and had data available at around age 80. The risk factors for dementia were age-specific. People who had diabetes at age 55 were four times more likely to later develop dementia than people without diabetes at that age. People with hypertension at age 55 had an increased risk for dementia, and the risk increased by about 12 per cent for every 10-point increase in systolic blood pressure. People who had cardiovascular diseases such as a heart attack, but not stroke, at age 65 years were nearly twice as likely to later develop dementia. People who had diabetes or stroke in their 70s were more likely to develop dementia and those who had these conditions in their 80s were about 40-60 per cent more likely to develop dementia.

Lidocaine infusions may reduce chronic migraines

INFUSIONS OF THE LOCAL anaesthetic lidocaine may provide quick and lasting pain relief to people with chronic migraine that does not respond to other treatments, reports a study in the journal Regional Anesthesia & Pain Medicine. To assess the immediate and medium-term benefits of lidocaine, the researchers analysed the hospital records of 609 patients who were admitted with refractory chronic migraine. The patients experienced at least eight debilitating headache days a month for at least six months and failed to respond to other treatments. Of patients treated with lidocaine infusions along with other migraine medications, 87.8 per cent experienced rapid pain relief. The average pain rating reported by patients at the time of admission was 7.0, which decreased to 1.0 by the time of hospital discharge. The patients also reported significant drop in the number of headache days about one month after discharge. Adverse events were mostly mild. Some patients experienced nausea and vomiting during the infusions.

Lipofilling may reduce pain, improve function in finger osteoarthritis

THE TRANSFER OF FATTY tissue to arthritic finger joints could provide lasting pain relief and improved strength, mobility, and hand function, according to a German study published in the journal Plastic and Reconstructive Surgery. Lipofilling is a minimally invasive procedure in which the patient’s own fatty tissue is taken from another part of the body, usually the upper thigh or hip area, and is transferred into the arthritic finger joints. The study included 18 patients, average age 60.8 years, who had tiny volumes of fatty tissue injected into 28 finger joints with osteoarthritis. Patients wore a splint around the treated finger and took pain medicines, as necessary, for a week. There were no infections or other complications. Hand function, pain scores and patient satisfaction were assessed over an average follow-up period of 44 months after treatment. Patients reported significant improvement in pain scores, which fell from a median of 6 points (on a 10-point scale) before treatment to 0.5 points at follow-up. “We believe that for our patients the reduction of pain represents the most striking and important result, which also has the most pronounced and highly significant effect,”the researchers noted. Grip strength of the treated fingers almost doubled, while force of fist closure and hand function to perform daily tasks also improved.

Did You Know?

Compared to non-coffee drinkers, those who consumed moderate amounts of unsweetened or sugar-sweetened coffee every day were up to 30 per cent less likely to die from any cause during an average follow up of seven years

Annals of Internal Medicine

Robotic surgery a safe option for cancer patients

CANCER PATIENTS who had their urinary bladder removed and reconstructed by robot-assisted surgery had fewer complications, faster recovery, less time spent in the hospital, improved mobility and fewer readmissions compared to those who had open surgery. The UK study published in JAMA included 338 patients, average age 69 years, with non-metastatic bladder cancer. Half the participants had robot-assisted radical cystectomy (bladder removal) and reconstruction, while the other half had open radical cystectomy. Open surgery involves large incisions in the skin and muscle. But in robot-assisted surgery, surgeons make small incisions into which they insert minimally invasive instruments and a camera which allows them to work remotely using a console and guided by 3D view. The robot assisted group recovered faster and spent 20 per cent less time in the hospital post-surgery—eight days vs ten. Robotic surgery reduced the chance of readmission by over 50 per cent and patients in the robotic surgery group also had a four-fold (77 per cent) reduced risk of blood clots, which is a significant cause of health decline and morbidity, compared to patients who had open surgery. Secondary outcomes such as wound complications, quality of life, disability, stamina, activity levels, and survival were assessed at 90 days, six months and 12 months post-surgery. Robotic surgery group fared better or, at least equal to open surgery group. Cancer recurrence and overall mortality were similar across both groups.

Best time to exercise differs for men and women

A STUDY PUBLISHED in the journal Frontiers in Physiology finds that the effectiveness of exercise differs between time of exercise, and between men and women. 30 women and 26 men, who were active and healthy with normal weight and between 25 and 55 years old, were included in the study. For 12 weeks, the volunteers participated in various fitness regimens, including resistance, sprint, stretching or endurance training. The participants also followed a specially designed meal plan. One group exercised for an hour between 6am and 8am, while the other group exercised between 6:30pm and 8:30pm. The participants’aerobic power, muscular endurance, flexibility, balance, and strength were assessed at the start and end of the study. Blood pressure and body fat as well as blood biomarkers, such as insulin and total and ‘good’HDL cholesterol were also assessed over the course of the study. All the participants improved their cardio-metabolic and mood health as well as performance over the trial period, irrespective of the time of the exercise. But the study clearly showed that exercise effectiveness differed for men and women depending on the time of day. The study found that morning exercise was best for women interested in enhancing total and abdominal fat loss, reducing blood pressure and increasing lower body muscle power, whereas evening exercise was ideal for women who wanted to improve upper body muscle strength, power and endurance, as well as overall mood and food intake. For men, exercising in the evening improved heart and metabolic health, as well as emotional wellbeing. Evening exercise helped lower systolic blood pressure and fatigue, and stimulated fat oxidation compared to morning exercise.

Did You Know?

In addition to cancers of the lungs and throat, and respiratory diseases, men who smoke have a significantly increased risk of osteoporosis, with a 37 per cent increased risk of bone fractures which can further increase the risk of early death

Scientific Reports

Antidepressants might not improve long-term quality of life

ANTIDEPRESSANTS are widely prescribed. But how effective are they in the long run? According to a Saudi Arabian study published in the journal PLOS ONE, taking antidepressants over a long term did not improve physical or mental health-related quality of life. The researchers used data from 17.47 million American adult patients with depression and compared the changes in quality of life reported by those who took antidepressants against those who did not take the medications. The average age of the participants was 48 years, and 57.6 per cent of the patients were treated with antidepressant medications. Quality of life surveys were used to assess both mental and physical health outcomes of the participants for two years following their diagnosis. The physical health issues surveyed included overall physical function and limitations, pain, overall health status, energy levels and fatigue. Mental health issues surveyed included the ability to socialise, emotional and psychological issues and overall wellbeing.

While antidepressants did help treat depression disorder, there was no significant difference in the overall wellbeing and quality of life between those who used antidepressants and those who did not. The results indicate that antidepressants do not help improve physical or mental quality of life over time.

Did You Know?

Being tall is linked to an increased risk for atrial fibrillation, varicose veins, peripheral neuropathy as well as skin and bone infections, and a lower risk of coronary heart disease, high blood pressure and high cholesterol

PLOS Genetics

Adults sleep better when they share a bed

There is a growing trend among couples to sleep in separate rooms for a better night's sleep. But, according to a US study published in the journal Sleep, adults who share a bed with a partner sleep better than those who sleep alone. The findings of the study, which was based on data collected from 1,007 working-age adult, showed that those who shared a bed with a partner reported less severe insomnia, less fatigue, and more sleep time. They fell asleep faster, stayed asleep longer and had reduced sleep apnea risk. They also reported as having lower levels of depression, anxiety, and stress, and had greater social support and satisfaction with life and relationships. However, sharing bed with a child or sleeping alone did not confer similar benefits. Those who shared a bed with a child reported more severe insomnia, higher risk of sleep apnoea, less control over their sleep, as well as more stress. Sleeping alone was associated with higher depression, lower social support, and low satisfaction with life and relationships. They also reported greater insomnia severity, more sleepiness, more fatigue. and greater apnoea risk.

three-steps-to-reduce-cancer-risk

Sun May 29 12:12:11 IST 2022

TAKING VITAMIN D3 and Omega-3 fish oil supplements in combination with a simple home strength exercise programme (SHEP) can reduce the risk of cancer by 61 per cent in older adults.

The findings of the Swiss study published in Frontiers in Aging come from the DO-HEALTH trial of three-years which included 2,157 participants aged 70 or older.

To test the individual and combined benefits of the three interventions in cancer prevention, the participants were divided into eight groups.

One group received 2,000 IU (international units) per day of Vitamin D3, 1g per day of Omega-3s, and participated in SHEP three times per week. Participants in the other groups had either Vitamin D3 and Omega-3s; Vitamin D3 and SHEP; Omega-3s and SHEP; Vitamin D3 alone; Omega-3s alone; SHEP alone or a placebo.

The participants had check-up phone calls every three months and standardised examinations of health and function at the start of the study and once every 12 months.

Each of the interventions had a small benefit, but when all three interventions were combined, there was a 61 per cent overall reduced risk of cancer.

Intermittent fasting not superior to calorie restriction

INTERMITTENT FASTING HAS become very popular with people trying to lose weight. But a new study published in the New England Journal of Medicine has found that time-restricted eating (eating within a narrow time window) is no better than a daily calorie-restricted diet for weight loss.

Chinese researchers assigned 139 obese participants to a daily calorie-restricted diet for 12 months that consisted of 1,500 to 1,800 calories per day for men and 1,200 to 1,500 calories per day for women.

Half the participants were randomly assigned to follow a time-restricted eating (eating only between 8am and 4pm) pattern also.

Both groups lost weight at the end of 12 months: the time restriction group lost a mean of 8kg and the calorie restriction only group lost a mean of 6.3kg.

There was no significant difference in the amounts of weight lost between the two groups, nor in measures of waist circumference, body fat, body lean mass, blood pressure, and metabolic risk factors such as cholesterol and blood sugar.

Did You Know?

Human trials of a new, non-hormonal birth control pill for men could begin later this year. The pill was safe and 99 per cent effective in preventing pregnancy in mice.

A study presented at a meeting of the American Chemical Society

Seven hours of sleep is ideal in middle and old age

SEVEN HOURS OF sleep per night is ideal for people in middle and old age, according to a British study published in the journal Nature Aging.

Sleep plays an important role in maintaining our cognitive and psychological functions. The researchers examined data from nearly 5,00,000 adults aged 38-73 years from the UK Biobank. The participants answered questions about their sleeping pattern, mental health and wellbeing, and participated in a series of cognitive tests. Brain imaging and genetic data were available for nearly 40,000 of the participants.

Seven hours of sleep was optimal for cognitive performance and good mental health.

Both too little and too much sleep was associated with impaired cognitive performance, such as processing speed, visual attention, memory and problem-solving skills as well as poor mental health.

People who did not sleep for seven hours experienced more symptoms of anxiety and depression and worse overall wellbeing. The researchers also found greater changes in the structure of brain regions involved in cognitive processing and memory in people with greater than or less than seven hours of sleep.

Remove infected heart devices

MOST PATIENTS WHO develop an infection related to a cardiac-implanted electronic device (CIED) such as a pacemaker or a defibrillator do not have them removed, which significantly increases their risk of death.

For the study, US researchers analysed data for nearly 1.1 million patients who received a cardiac implantable electronic device between 2006 and 2019.

About 11,619 (1.1 per cent) of the patients developed an infection during a median follow up of around 5 years. Only 13 per cent of the patients had the devices removed within six days of the infection. Another 5 per cent had them removed between day seven and day 30.

Eighty two per cent of the patients did not have their infected devices removed and were treated only with antibiotics, even though getting the device removed is the recommended treatment guideline.

The death rate for those who did not have their devices removed in the year after an infection was diagnosed was 32.4 per cent compared to 18.5 per cent for patients whose device was removed within six days, and 23 per cent for those whose devices were removed between seven and 30 days.

Getting the devices promptly removed is associated with a 43 per cent lower risk of death.

The findings were presented at the 2022 American College of Cardiology Scientific Sessions.

Early menopause may raise the risk of dementia

WOMEN WHO ENTER menopause early are more likely to develop dementia later in life compared to women who begin menopause at an average menopause onset age of 50 to 51 years.

For the Chinese study presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Conference, the researchers compared the age at menopause onset and the diagnosis of dementia of all types, including Alzheimer’s disease and vascular dementia, among 1,53,291 postmenopausal women with an average age of 60 years.

There were 1,688 cases of all-cause dementia during an average follow-up of 11.7 years.

Women who entered menopause before the age of 40 were 35 per cent more likely to have been diagnosed with dementia.

Women who entered menopause before the age of 45 were 1.3 times more likely to have been diagnosed with dementia before they were 65 years old. But women who entered menopause at age 52 or later had similar rates of dementia as those who began menopause at the age of 50-51 years.

Women who experience early menopause can reduce their risk of dementia by adopting a healthy lifestyle which includes exercising regularly, maintaining a healthy weight, participating in leisure and educational activities, and not smoking or drinking alcohol.

Did You Know?

High blood pressure, obesity and physical inactivity are the three risk factors that have the greatest influence on the risk of dementia.

American Heart Association's epidemiology and prevention, lifestyle and cardiometabolic health conference

New early signs of Parkinson’s disease

BRITISH RESEARCHERS HAVE identified, for the first time, hearing loss and epilepsy as two early signs of Parkinson’s disease.

For the study published in the journal JAMA Neurology, researchers explored the early symptoms and risk factors for Parkinson’s disease among over a million people living in East London.

The study found that symptoms of Parkinson's, including the two newly identified symptoms—hearing loss and epilepsy—can appear up to a decade before an actual diagnosis.

Established symptoms such as tremors appeared up to 10 years before a diagnosis and memory problems up to five years before a diagnosis.

Midlife risk factors such as hypertension and Type 2 diabetes were also associated with increased odds of developing Parkinson's.

Mammograms may help predict cardiovascular disease risk

MAMMOGRAMS CAN PROVIDE clues about your risk for heart attacks and strokes, according to a study published in the journal Circulation: Cardiovascular Imaging. The study says that finding breast arterial calcification, which appears as white spots in the breast's arteries on a mammogram, indicates calcium build-up and is associated with an increased risk of cardiovascular disease in postmenopausal women.

Breast arterial calcification occurs as women age and is related to Type 2 diabetes, high blood pressure and inflammation. It is different from the calcification of the inner layer of the arteries that is found in people who smoke or those with high cholesterol levels.

For the study, researchers reviewed health records of 5,059 postmenopausal women, aged 60 to 79 years who had at least one digital mammogram screening. None of the women had a history of cardiovascular disease or breast cancer.

They were followed for about six and a half years. Women whose mammogram showed breast arterial calcification were 51 per cent more likely to develop heart disease or have a stroke compared with women who did not have breast arterial calcification.

Also, they were 23 per cent more likely to develop any type of cardiovascular disease, including heart disease, stroke, heart failure and peripheral artery disease.

Did You Know?

People who had severe Covid-19 may suffer persistent cognitive impairment in areas like memory, attention, or problem solving, which is similar on average to that sustained with 20 years of ageing, between 50 and 70 years of age, and is equivalent to a 10-point drop in IQ.

eClinicalMedicine

Obesity linked to a higher risk of prostate cancer death

AN OXFORD UNIVERSITY study published in the journal BMC Medicine has linked obesity and body fat (adiposity) to an increased risk of death from prostate cancer.

The researchers analysed data on 2.5 million men from 19 published studies, as well as data from 2,18,237 men in the UK Biobank study.

The participants did not have prostate cancer at the onset and their weight was assessed using body mass indWex (BMI), waist circumference, waist-to-hip ratio, and body fat percentage.

Overall, the risk of death increased with higher total and central adiposity.

With every five-point increase in BMI, the risk of dying from prostate cancer increases by 10 per cent.

Similarly, a man's odds of dying from prostate cancer increased by 7 per cent for every 10cm (3.9 inches) increase in belly fat.

There was a 3 per cent increased risk of death with every 5 per cent increase in total body fat percentage and with each 0.05 increase in waist to hip ratio the risk of fatal prostate cancer increased by 6 per cent.

People who are overweight or obese are at greater risk for many diseases, including 13 types of cancer, diabetes, high blood pressure, cardiovascular diseases, as well as death from all causes.

Urinary symptoms in older men linked to a shorter lifespan

LOWER URINARY TRACT symptoms (LUTS) such as incontinence, frequent urination and incomplete bladder emptying are associated with an increased risk of death in men over the age of 50, finds a Finnish study published in The Journal of Urology.

The researchers analysed LUTS in more than 3,000 Finnish men who were 50, 60, or 70 years old in 1994 when they enrolled in the study; 1,167 of the men were followed for 24 years; about half the men died during this period.

Lower urinary tract symptoms were analysed as a risk factor for death, adjusting for age and other medical conditions.

Men with moderate to severe bladder emptying symptoms such as hesitancy, weak stream, or straining had a 20 per cent increased risk of death during the study period. Men with storage symptoms, such as frequent daytime urination, nocturia (waking up at night to urinate), or incontinence had a 40 per cent increased risk of death.

Generally, mild LUTS did not increase mortality risk. However, mortality risk was increased by 30 per cent among men with daytime frequency and 50 per cent for those with nocturia, irrespective of the severity of the symptoms.

Frequent urinary incontinence had a “particularly strong” association, which more than doubled the risk of death.

The study found that the link between LUTS and mortality risk was found even when urinary symptoms are not very bothersome for the patient and did not require treatment.

erectile-dysfunction-drugs-linked-to-serious-vision-problems

Sun May 01 11:03:52 IST 2022

TAKING ERECTILE DYSFUNCTION (ED) drugs such as Viagra, Cialis, Levitra and Stendra regularly can put you at risk for three serious vision-damaging conditions—serous retinal detachment (SRD), retinal vascular occlusion (RVO) and ischaemic optic neuropathy (ION)—according to a Canadian study published in JAMA Ophthalmology.

The researchers analysed health insurance claim records of 2,13,000 US men who did not have any of these eye problems in the year before they started taking ED medications regularly.

They then followed the medical records of these men to see how many of them developed one or more of these vision problems and compared it with men who did not use these medications.

The risk of developing any one of these serious eye conditions increased by 85 per cent for regular users of ED drugs. Erectile dysfunction medication users had a more than 2.5 times greater risk of developing SRD, a condition characterised by the sudden appearance of floaters or spots in the field of vision and light flashes; a 1.4 times higher risk of RVO, symptoms of which include sudden loss or blurring of vision, dark spots or floaters; and a 2.02 times greater risk of ION, symptoms of which include loss of mostly central vision.

Diabetes drug linked to birth defects

BABY BOYS BORN to fathers who took the widely prescribed diabetes drug metformin in the three months before conception are more likely to have genital birth defects, according to a study published in the Annals of Internal Medicine.

The researchers used Denmark's national birth registry to analyse data on over one million babies born between 1997 and 2016. They wanted to compare the risk of birth defects in children whose fathers were treated with different diabetic medications, including insulin, metformin or a class of drugs called sulfonylureas, before conception.

When fathers took metformin during the window of sperm development and maturation—a process that takes about three months before conception—their babies had a 40 per cent higher risk of birth defects.

5.2 per cent of children whose fathers took metformin were born with malformations compared to 3.3 per cent of children whose fathers did not take the diabetes drug.

Most of the malformations were in the genitals of male children, who had three times the risk of malformations.

Children whose fathers took insulin did not have a higher rate of malformations. While children whose fathers took sulfonylurea had a slightly increased risk—it was not statistically significant.

Metformin taken before or after the three months of sperm development was not associated with an increased risk of malformations.

Quit smoking, add five years to your life

HEART DISEASE patients who quit smoking can gain five additional healthy years of life. Quitting is as effective as taking three medications to prevent future heart attacks and strokes.

Cigarette smoking is responsible for nearly 50 per cent of all preventable deaths in smokers, half of which are due to cardiovascular disease. Smokers with heart disease are especially at an increased risk of having another heart attack or stroke.

The study, presented at a meeting of the European Society of Cardiology, included 989 patients aged 45 years and older who continued to smoke at least six months after suffering a heart attack and/or undergoing stent implantation or bypass surgery. Among them, 23 per cent were women.

The researchers used the SMART-REACH model to estimate how many years the patients will gain without a heart attack or stroke, if they quit smoking, or if they continued smoking but took three additional drugs to prevent cardiovascular disease. The medications included Bempedoic acid and PCSK9 inhibitors, which lower LDL (“bad”) cholesterol, and the anti-inflammatory drug colchicine.

The patients would gain 4.81 event-free years by quitting smoking or 4.83 event-free years if they took the three medications.

Did You Know?

Adults who meet the recommended physical activity (equivalent to 2.5 hours per week) have a 25 per cent lower risk of depression.

JAMA Psychiatry

Artificial sweeteners linked to increased cancer risk

ARTIFICIAL SWEETENERS touted as excellent sugar substitutes that reduce sugar and calorie intake without compromising on sweetness, are used in many food and beverage brands worldwide and are consumed by millions of people.

A French study published in PLOS Medicine suggests that some artificial sweeteners can increase the risk of cancer.

To examine the association between artificial sweetener intake and cancer risk, the researchers analysed data from 1,02,865 French adults participating in the ongoing NutriNet-Santé study.

Soft drinks with no added sugars, table-top sweeteners, and yoghurt/cottage cheese were the most popular products with artificial sweeteners. There were 3,358 new cancer diagnoses during a median follow up of 7.8 years.

Participants who consumed large quantities of artificial sweeteners, especially aspartame and acesulfame-K, had a 13 per cent higher risk of developing cancer than non-consumers.

Why are Alzheimer’s patients drowsy?

ALZHEIMER’S PATIENTS are often drowsy and tend to sleep a lot during the day. The common explanation is that Alzheimer’s patients are trying to compensate for poor sleep at night.

But according to a US study published in JAMA Neurology, the real reason is the degeneration of a type of neuron that keeps a person awake. The researchers studied sleep issues in two neurodegenerative conditions—Alzheimer's disease and progressive supranuclear palsy (PSP)—that are at “opposite ends of the sleep-disturbance spectrum.”

Alzheimer’s patients have difficulty staying awake and PSP patients have difficulty sleeping.

The study included 33 patients with Alzheimer's, 20 with PSP, and 32 volunteers who had healthy brains through the end of life.

The volunteers had their sleep monitored with an electroencephalogram and donated their brains after they died. The brain has both wake-promoting neurons and sleep-promoting neurons, each tied to neurons controlling circadian rhythms.

In Alzheimer’s patients who are sleepy all the time, “the system in their brain that would keep them awake is gone.” On the other hand, in patients with PSP, neurons that make them feel tired are damaged and they are unable to sleep.

The researchers measured the amounts of two proteins often associated with the neurodegenerative process—beta-amyloid and tau—and concluded that the tau protein was responsible for sleep disturbances.

Did You Know?

Just one night of sleeping with moderate light exposure can impair cardiometabolic function—it can increase nighttime heart rate, decrease heart rate variability and increase insulin resistance in the morning when compared to sleeping in a dimly lit environment.

Proceedings of the National Academy of Sciences

Magnets in electronic devices may interfere with implanted cardiac devices

MANY HIGH-TECH PORTABLE devices are equipped with powerful magnets which can interfere with the proper functioning of implanted cardiac devices (ICD) such as a pacemaker and impair their ability to regulate dangerous irregular heart rhythms, according to new research published in the journal Circulation: Arrhythmia and Electrophysiology.

As part of the study, the researchers tested the magnetic field output of the Apple AirPods Pro, and their wireless charging case, the Microsoft Surface Pen and the Apple Pencil (2nd Generation).

Magnets in these devices can activate a switch prohibiting the ICD from delivering life-saving shocks. Earlier research on the iPhone 12 Pro Max had shown that its magnetic field can disrupt the operation of an implanted pacemaker or ICD when held within an inch.

“These devices can cause a problem when carried in your shirt or jacket pocket in front of the chest, as well as when you are lying on the couch and resting the electronic device on your chest, or if you fall asleep with the electronic device,” said the study.

Is knee replacement surgery safe for people over 80?

ACCORDING TO A STUDY presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, total knee arthroplasty (TKA), or knee replacement surgery could be a safe option for people over 80.

The researchers compared knee replacement surgery outcomes in more than 1.7 million people aged 65 and older. The patients were divided into two groups—the study group included patients 80 years and older and the control group included patients 65-79 years old.

While the overall odds of developing any medical complication were similar across both groups, the incidence of certain medical complications, such as cerebrovascular accidents, pneumonia, and acute kidney failure was higher among the octogenarians.

They also had higher readmission rates and longer hospital stays following surgery than those aged 65-79.

But octogenarians had a lower incidence of implant-related complications compared to the control group.

"These data will be helpful as surgeons advise patients on the decision of whether to undergo TKA. For older patients, it can be reassuring to know they can have similar outcomes to a 65-year-old and improve their quality of life,” said the study.

Treating hypertension during pregnancy benefits mom, baby

TREATING PREGNANT WOMEN with mildly elevated high blood pressure was associated with better pregnancy outcomes for both mother and child, according to a study published in the New England Journal of Medicine.

More than 2 per cent of women enter pregnancy with chronic hypertension which can triple their risk for severe complications such as preeclampsia and preterm births. About 80 per cent of them have mild chronic hypertension.

While there is consensus on treating pregnant women with severe hypertension—around 160/110 mmHg or higher, there are no clear guidelines on how to manage mild hypertension. There have been concerns that it might impair foetal growth.

The trial included 2,408 women with mild chronic high blood pressure who were less than 23 weeks into their pregnancy.

Half the participants were randomly assigned to receive anti-hypertensive medication to keep their blood pressure below 140/90 mmHg. The other half were started on medication only if their blood pressure rose to 160/105 mmHg or higher.

Women who were treated with medications had about a 20 per cent reduction in the combined rate of severe preeclampsia, preterm birth before 35 weeks, placental abruption and foetal or newborn death compared with pregnant women who did not receive treatment.

Also, taking antihypertensive medication did not impair foetal growth. The birth weights of babies remained similar across both groups.

Did you know?

Employees who use lots of emojis and pictures in their communications at work are perceived as less powerful compared to those who use words only.

Organizational Behavior and Human Decision Processes

Lumpectomy as effective as mastectomy for younger breast cancer patients

ACCORDING TO A STUDY presented at the American Society of Breast Surgeons Annual Meeting, survival outcomes were similar for young patients with breast cancer who had a lumpectomy or a mastectomy.

Breast cancer before age 40 is usually more aggressive and diagnosed at an advanced stage compared to breast cancer at a later age. The study included 591 women younger than 40 who were treated for nonmetastatic breast cancer (cancer that had not spread to other parts of the body).

Among them, 64.5 per cent of the women underwent a mastectomy (removal of one or both breasts), whereas 35.5 per cent underwent lumpectomy or breast-conserving surgery, where only the tumour and some surrounding tissues are removed.

During a median follow-up of 67 months, 72 women died.

There was no difference in survival outcomes between women who underwent mastectomy vs lumpectomy.

However, post-surgery treatments had an impact. Women with hormone-sensitive cancers (hormone receptor-positive/HER2-negative) who did not receive hormonal therapy had a 2.9-fold increased risk for death compared to women who received it.

signs-in-your-eyes

Sun Mar 27 14:13:13 IST 2022

ACCORDING TO a study published in the British Journal of Ophthalmology, people whose retina age faster than their real (chronological) age are more likely to die early.

Though the risks of illness and death increase with chronological age, they vary considerably among people of the same age, suggesting that a person’s biological age which is unique to each individual may be a better indicator of current and future health, the researchers explained.

The researchers used the deep learning technique to accurately predict a person’s retinal age from images of the fundus, the internal back surface of the eye.

They wanted to see whether a difference between the biological age of the retina and a person’s real age (retinal age gap) might be linked to an increased risk of death.

The researchers examined 80,169 fundus images taken from 46,969 adults aged 40 to 69.

They analysed the accuracy of their model using about 19,200 fundus images taken from the right eyes of 11,052 healthy participants. The researchers assumed that their retinal biological ages would be close to their chronological age.

The model predicted the retinal age with an overall accuracy of within 3.5 years to the real age.

The retinal age gap of the remaining 35,917 participants was then assessed. During an average follow up of 11 years, 1,871(5 per cent) participants died: 321(17 per cent) of cardiovascular disease; 1,018 (54.5 per cent) of cancer; and 532 (28.5 per cent) of other causes including dementia. And 51 per cent had a retinal age gap of more than three years, 28 per cent had a gap of five years, and 4.5 per cent had a gap of more than 10 years.

Those who had large retinal age gaps had a 49 per cent to 67 per cent higher risk of death, from causes other than cardiovascular diseases or cancer.

Did You Know?

Tall people might be at an increased risk for colorectal cancer. Height should be considered as a risk factor for colorectal cancer screening.

Cancer Epidemiology Biomarkers & Prevention

A clue about final moments

AN ACCIDENTAL recording of a dying man’s brain suggests that our lives may flash before our eyes as we die. The recordings showed that brain wave patterns in the 30 seconds before and after death were similar to those occurring during dreaming, memory recall, and meditation.

The researchers came upon this unexpected discovery when an 87-year-old patient with epilepsy suffered a heart attack and passed away during electroencephalography (EEG)—a test that detects abnormalities in the brain waves. This allowed the scientists to record the brain activity of a dying person for the first time.

The researchers had recordings of 900 seconds of brain activity around the time of death. They focused on the 30 seconds before and after the heart stopped beating.

“Just before and after the heart stopped working, we saw changes in a specific band of neural oscillations, so-called gamma oscillations, but also in others such as delta, theta, alpha, and beta oscillations,” the lead researcher said. “Through generating oscillations involved in memory retrieval, the brain may be playing the last recall of important life events just before we die, similar to the ones reported in near-death experiences.”

The study was published in the journal Frontiers in Aging Neuroscience.

Stay active in your seventies

JUST 20 minutes of daily exercise in your early 70s may help prevent major heart disease in your 80s. For the study published in the journal Heart, researchers examined whether exercise in early old age can help ward off heart disease and stroke in late old age.

The health and physical activity levels of 3,099 Italians, aged 65 and older, were first assessed between 1995 and 1997. Follow-up assessments were done four and seven years later.

Women were more likely to have more than four coexisting health conditions, including osteoarthritis, osteoporosis, and chronic kidney disease. Chronic obstructive pulmonary disease and diabetes were more common among men.

Walking, bowling and fishing were considered moderate physical activities, and vigorous physical activity included gym workouts, cycling, dancing and swimming.

The health of all participants was tracked via hospital records and death certificates up to the end of 2018.

Complete data were available for 2,754 participants, of whom 1,398 (60 per cent) were women. During the study period, 1,037 participants were diagnosed with heart disease, heart failure or stroke. Increasing levels of physical activity and maintaining an active lifestyle were linked to reduced risks of cardiovascular disease and death in both men and women. The biggest reduction was for coronary heart disease and heart failure in late old age.

Regular physical activity was associated with a 52 per cent lower risk of cardiovascular disease among men.

The greatest health benefits were seen in participants who exercised at age 70. The benefits were trending down after age 75, suggesting that exercising earlier in old age might have the most impact.

Bad days after a breakup

MEN ARE at an increased risk of mental illness, such as anxiety, depression, and suicide after a breakup.

For the Canadian study published in the journal Social Science and Medicine–Qualitative Research in Health, researchers interviewed 47 men who went through a recent breakup.

Most men developed new or worsening mental illness symptoms during and after a difficult relationship. Men often downplayed issues in their relationships, further worsening their problems. Their primary goal was to avoid conflict.

Stereotyped masculinity plays a major role in preventing men from seeking help. Following a breakup, men in distress often turned to alcohol and other substances to cope with feelings such as anger, regret, sadness, shame and guilt.

On the positive side, the study found that most men eventually sought help for their distress post-breakup. They utilised a variety of resources, including reading, exercise, therapy or support groups.

Did You Know?

An analysis of data from 204 countries and territories revealed that antimicrobial-resistant bacterial infections were directly responsible for more than 1.2 million deaths worldwide in 2019.

The Lancet

Radiofrequency ablation relieves chronic pain after knee replacement

ARTHRITIS of the knee is a major cause of disability, especially in the elderly. Many patients opt for total knee arthroplasty, or replacement, to cope with the intense pain and immobility associated with the condition. But up to 30 per cent of people who get a knee replacement continue to suffer from chronic and debilitating pain and stiffness in the knee.

A minimally invasive procedure called cooled radiofrequency ablation (C-RFA) was found to provide long-lasting pain relief after knee replacement surgery, according to a study presented at the annual meeting of the Radiological Society of North America.

A probe is guided through an introducer needle to target specific nerve locations around the knee while the patient is under local anaesthesia. The probe then imparts a low voltage current, or radiofrequency, to the deep sensory nerves around the knee.

The study included 21 patients who were suffering from persistent chronic pain after total knee replacement. They filled out questionnaires that assessed pain severity, stiffness, functional activities of daily living and use of pain medication before and after the procedure.

Questionnaire results up to a year after the C-RFA procedure showed that the patients experienced significantly less pain and stiffness, and they reported a statistically significant improvement in the quality of life.

Did You Know?

Mortality data from 21 countries from March 2020 to October 2021 shows that about 5.2 million children worldwide have lost a parent or caregiver to
Covid-19.

The Lancet Child & Adolescent Health

A better clot-buster

A NEWER clot-busting medication, tenecteplase, might be safer than the current standard medication, alteplase, for treating patients who suffered a stroke.

Stroke patients treated with tenecteplase were less likely to suffer serious complications involving bleeding into the brain compared to those given alteplase.

The majority of strokes are ischaemic strokes which are caused when a clot in a blood vessel obstructs blood flow to the brain. Alteplase has been the standard clot-dissolving drug for treating ischaemic strokes.

For the study published at the American Stroke Association's annual meeting, the researchers analysed data on 6,429 patients who received alteplase and 1,462 patients who received tenecteplase. On average, patients in both groups had experienced moderate ischaemic strokes.

Intravenous thrombolysis remains the mainstay treatment for acute ischaemic stroke. Symptomatic intracerebral haemorrhage (sICH) is one of the most feared complications of the treatment.

Researchers found that sICH was 43 per cent lower among patients who received intravenous thrombolysis with tenecteplase compared to those who received alteplase. Tenecteplase is also much easier to administer than alteplase.

Reduce meat consumption, reduce cancer risk

PEOPLE WHO do not eat meat or limit meat consumption have a reduced risk of cancer, according to a British study published in the journal BMC Medicine.

To examine the relationship between diet and cancer risk, the researchers analysed data collected from 4,72,377 British adults aged 40-70 who were cancer-free at the onset.

The participants reported how often they ate meat and fish. Among them, 52 per cent ate meat more than five times a week; 44 per cent ate meat less often; 2 per cent ate fish, but no meat; and 2 per cent were either vegetarian or vegan.

The researchers calculated the incidence of new cancer diagnoses over an average period of 11.4 years. 54,961 participants (12 per cent) developed cancer—including 5,882 colorectal, 7,537 postmenopausal breast, and 9,501 prostate cancers.

Overall, cancer risk was 2 per cent lower among those who ate meat five times or less per week; 10 per cent lower among those who ate fish but not meat, and 14 per cent lower among vegetarians and vegans, compared to those who ate meat more than five times per week.

IUDs as effective as tubal ligation for pregnancy prevention

INTRAUTERINE devices (IUDs) are as effective as tubal ligation in preventing pregnancies and causing fewer side effects, according to a US study published in the Journal of General Internal Medicine.

This study questions the widely held notion that tubal ligation is more effective than an IUD to prevent unwanted pregnancies. Tubal ligation requires surgery and is permanent, while an IUD can be easily removed when pregnancy is desired. To compare the safety and effectiveness of the two contraceptive methods, the researchers examined six years of insurance claims data from more than 83,000 recipients who received either a tubal ligation or an IUD to see how many of them became pregnant within a year.

It was revealed that 2.4 per cent of those who got levonorgestrel (hormonal) IUDs and 2.9 per cent of those who got copper IUDs got pregnant, compared to 2.6 per cent of those who got tubal ligations.

Those with IUDs were less likely to get infections or have procedure-related complications, and more than six months later, had less pelvic, abdominal and genitourinary pain compared to those who had tubal ligations.

“Patients should be encouraged to try IUD before going to the operating room for a permanent procedure,” said the study author.

Did You Know?

Drinking as little as a pint of beer or a glass of wine daily was associated with reductions in brain volume equivalent to two years of ageing. The more drinks a person had, the greater the shrinkage in brain volume.

Nature Communications

Drugs of double purpose

ACCORDING to a British study published in the journal Alzheimer’s & Dementia, erectile dysfunction drugs like Viagra may also help treat vascular dementia and preserve brain health. These drugs treat erectile dysfunction by increasing blood flow to the penis. The researchers wanted to test if these drugs can also increase blood flow to the brain in older people with narrowing of the brain arteries, which can lead to vascular dementia and strokes.

"Narrowing of the brain arteries is a common contributor to cognitive decline in older people and currently has no treatment," the lead researcher said.

The researchers recorded the brain blood flow of the participants after they received either a single dose of tadalafil, a drug like Viagra, or a placebo.

While there wasn't any considerable difference in brain blood flow between the two groups, participants older than 70 showed increased blood flow in the white matter of the brain, the area most important for vascular dementia.

daily-meditation-can-boost-immunity

Sun Feb 27 12:08:44 IST 2022

THE POSITIVE EFFECTS of daily meditation on mental and physical health have been well documented.

According to a new US study published in the Proceedings of the National Academy of Sciences, intense meditation can boost the immune system and help ward off viruses and diseases associated with a weakened immune system like multiple sclerosis.

The study led by Vijayendran Chandran, an assistant professor of paediatrics and neuroscience at the University of Florida’s College of Medicine, wanted to explore the “potential molecular mechanisms and critical genes involved in this beneficial outcome.”

The study involved 106 people enrolled in an Inner Engineering retreat, which focuses on meditation and yoga, conducted at the Isha Institute of Inner Sciences in McMinnville, Tennessee.

The eight-day retreat was intense: the participants had to remain silent for eight days, meditate more than 10 hours a day, eat vegan meals and follow a regular sleep schedule.

Blood samples from the participants were drawn five to eight weeks before the retreat, just before and after the retreat, and three months after the retreat was completed.

Several immune-related and other cellular pathways changed after the retreat. Post retreat analysis showed increased activity in 220 genes involved in regulating immune response, including 68 genes associated with interferon signalling.

Increased activity among interferon-signalling genes is especially significant because it is a “key part of the body’s anti-virus and anti-cancer responses.”

Recent studies have shown that patients with severe Covid-19 and multiple sclerosis patients have insufficient interferon activity. Meditation produced beneficial gene activity comparable to conventional interferon treatments given to multiple sclerosis patients, the study found.

"This is the first time anyone has shown that meditation can boost your interferon signalling. It demonstrates a way to voluntarily influence the immune system without pharmaceuticals,” Chandran said.

Is a moulded cast effective?

USING A TRADITIONAL plaster cast to fix a broken wrist is as good as using metal pins, according to a British study published in the BMJ.

Wrist fractures are extremely common, especially in older adults. If the fracture involves bone fragments that have moved out of their normal alignment, they must be put back in place and are usually held in position while they heal using either a moulded plaster cast or surgical implants such as pins, plates, and screws.

Pins, also known as K-wires, require surgery which can be expensive and pose some risk to the patient. While a moulded cast is much cheaper, is it equally effective?

To find out, the researchers randomly assigned 500 adults with a displaced wrist fracture to receive a cast (255) or surgical fixation with K-wires plus cast (245) after 'manipulation' of their fracture. The average age of the participants was 60 years and 83 per cent were women.

"Surgical fixation with K-wires did not provide better wrist function at 12 months compared with a moulded cast, indicating that a cast is an acceptable first-line treatment following manipulation of a dorsally displaced fracture of the distal radius,” the authors wrote in the journal.

Both groups reported similar improvements in pain, wrist function, and quality of life at three, six, and 12 months after treatment.

However, one in eight patients who received a moulded cast required surgery within six weeks of their injury for loss of fracture position, compared with just one patient who was treated with pins.

Other complications were rare and similar across both groups.

Did You Know?

Long term use of acetaminophen (paracetamol) can increase systolic and diastolic blood pressure in people with hypertension, which could increase the risk of cardiovascular diseases like stroke and heart attack:

Circulation

First doses of an experimental HIV vaccine utilising Moderna’s mRNA technology that was used in the breakthrough Covid-19 vaccines have been administered to volunteers in a Phase 1 clinical trial:

Moderna

Paralysed man walks after spinal cord implant

THREE PATIENTS WHO were completely paralysed from waist down after spinal cord injuries were able to walk again with the help of targeted electrical stimulation to the spinal cord.

The men, between 29 and 41, can now stand, walk, and even swim, thanks to a nerve-stimulation device that has been surgically implanted to their spine and controlled by an artificial intelligence software on a touchscreen tablet.

They had a pacemaker implanted in the abdomen and electrodes placed underneath the vertebrae, directly on the spinal cord.

These implants can stimulate the region of the spinal cord that activates the trunk and leg muscles.

The electrodes were then paired with a new artificial intelligence software via a touchscreen tablet. The software is personalised to each patient's anatomy.

Two small remote controls were attached to a walker which was connected wirelessly to a tablet that forwards the signals to the pacemaker. It in turn relays the signals to the implanted spinal lead that stimulates specific neurons and facilitates a variety of movements.

“By controlling these implants, we can activate the spinal cord like the brain would do naturally to have the patient stand, walk, swim or ride a bike, for example,” the lead researcher explained.

“Our breakthrough here is the longer, wider implanted leads with electrodes arranged in a way that corresponds exactly to the spinal nerve roots. That gives us precise control over the neurons regulating specific muscles. Ultimately, it allows for greater selectivity and accuracy in controlling the motor sequences for a given activity.”

All the patients were able to move the very next day after their implants were activated.

“That’s thanks to the specific stimulation programmes we wrote for each type of activity. Patients can select the desired activity on the tablet, and the corresponding protocols are relayed to the pacemaker in the abdomen.”

The system was developed by Swiss researchers Grégoire Courtine and Jocelyne Bloch of the Swiss Federal Institute of Technology in Lausanne and their research was published in the journal Nature Medicine.

Antidepressants not for dementia patients

DEMENTIA PATIENTS are often prescribed the antidepressant mirtazapine to treat agitation. But a British study published in The Lancet suggests that the drug is not effective and might even increase the risk of death.

Dementia affects over 46 million people worldwide and is likely to double over the next 20 years.

Agitation is common in people with dementia. Dementia patients often display verbal and physical aggression which can be difficult for both the patients and their caregivers.

Since antipsychotics have been shown to increase mortality, dementia patients are often prescribed mirtazapine, an antidepressant.

To assess the safety and efficacy of the drug, the researchers recruited 204 people with probable or possible Alzheimer’s disease. Half the participants were prescribed mirtazapine, while the other half took a placebo.

At 12 weeks, patients in the mirtazapine group did not show less agitation than those in the control group. There were also more deaths in the mirtazapine group: seven patients in the mirtazapine group died by week 16 compared with just one in the control group.

“This finding implies a need to change the present practice of prescription of mirtazapine, and possibly other sedative antidepressants, for agitation in dementia,” the authors concluded.

Cognitive skills decline faster after heart attack

PEOPLE WHO SUFFER heart attack may experience faster declines in cognitive function.

To examine the short- and long-term impact of a heart attack on brain function, US researchers analysed data from 31,377 participants from six longitudinal studies between 1971 and 2017.

The average age of the participants was 60 when they took their first cognitive test, and 56 per cent were women.

None of the participants had a history of heart attack or a diagnosis of dementia at the onset. During a follow-up between five and 20 years (with a median of 6.4 years), 1,047 had a heart attack.

Participants who had a heart attack had significantly faster declines in memory, executive function, and global cognition in the years following the heart attack compared with those who did not have a heart attack.

They did not have a significant decline immediately after the heart attack.

It's important to know that cognitive decline is a possibility after a heart attack, so physicians are both managing patients' heart disease and looking for signs of dementia following a heart attack.

"We need to realise that what's going on in the heart and brain are related. Managing risk factors to prevent a heart attack is actually good for your brain as well," the study author said.

Did You Know?

Excess body fat is associated with a lower cognitive function such as slower thought processing speed and poor attention skills:

JAMA Network Open

Change your diet and add up to 13 years

MAKING DIETARY modifications can help you live up to 13 years longer.

Researchers at the University of Bergen have developed a model that is available online and is called the Food4HealthyLife calculator, which could help estimate how many years you could add to your lifespan by changing your diet.

The researchers used data from the Global Burden of Diseases study, a database that tracks 286 causes of death, 369 diseases and injuries, and 87 risk factors in 204 countries and territories, to build a model that estimates the effect on life expectancy from a range of dietary changes.

Unhealthy eating is linked to 11 million deaths and 255 million disability-adjusted life years globally each year.

A 20-year-old woman in the US could add just over 10 years to her life expectancy if she changes her diet from a typical western diet focused on red meat and processed food to an optimised diet that includes more legumes, whole grains, and nuts. A 20-year-old man could add 13 years to his life.

While gains in life expectancy from dietary changes were smaller for older people, it was still significant. By optimising diet, a 60-year-old could increase life expectancy by 8 years and an 80-year-old could gain 3.4 years.

Certain food groups showed a more robust association: the largest gains in lifespan were found from eating more legumes, whole grains, and nuts. Increased intake of fruits, vegetables, and fish was also beneficial. At the same time, reduced intake of red and processed meat, sugar-sweetened drinks, and refined grains were optimal.

Exercise reduced pain after breast cancer surgery

A STRUCTURED exercise programme soon after breast cancer surgery can help women regain mobility and ease arm and shoulder pain associated with the surgery, according to a study."We need to realise that what's going on in the heart and brain are related. Managing risk factors to prevent a heart attack is actually good for your brain as well," the study author said.

Shoulder and arm problems are common after non-reconstructive breast cancer surgeries, such as mastectomy. About a third of women experience restricted shoulder movement, chronic pain or swelling in the armpit area after surgery. This can delay recovery and impact the quality of life.

"We found robust evidence that early, structured, progressive exercise is safe and clinically effective for women at a higher risk of developing shoulder and upper limb problems after non-reconstructive breast surgery," said the study author.

For the study published in the BMJ, British researchers included 392 women, average age 58, undergoing non-reconstructive breast cancer surgery.

After the surgery, half the participants received usual care (information leaflets), while the other half received usual care plus a structured exercise programme that was led by physiotherapists and included stretching, strengthening, physical activity, and behavioral change techniques.

The exercise programme started 7 to 10 days after surgery, with two further appointments at one and three months.

One year after surgery, the women in the exercise group reported better upper limb function, lower pain intensity, fewer arm disabilities, and better health-related quality of life than those in the usual care group.

There were no differences in nerve pain, wound-related complications, surgical site infections, swelling, or other complications between the two groups.

The exercise programme was also cost-effective. Those in the exercise programme accrued lower costs per patient compared with usual care.

Did You Know?

After detecting carbon dioxide from our breath, mosquitoes fly towards specific colours, including red, orange, black, and cyan, and ignore other colours such as green, purple, blue, and white:

Nature Communications

Can chewing gums reduce preterm births?

CHEWING SUGARLESS gums can reduce the risk of premature births, according to a US study presented at a meeting of the Society for Maternal-Fetal Medicine.

Studies have shown that gum diseases can be linked to premature birth. Bacterial infections in the mouth can increase inflammation, which could lead to premature birth.

According to the World Health Organization, about 15 million babies are born too early (before 37 weeks of pregnancy) every year and about 1 million of them die due to related complications. And those who survive may face health challenges.

About 75 per cent of these deaths could be prevented with cost-effective interventions.

According to this study which was conducted over 10 years in Malawi, which has one of the highest rates of preterm delivery, chewing sugar-free gum with xylitol during pregnancy could be a simple and inexpensive intervention.

The study included 10,069 women who received education about oral health care and preterm birth prevention and care. Half of the women were also asked to chew xylitol gum for 10 minutes once or twice a day throughout their pregnancy.

There were fewer preterm births in the group that chewed the gum compared to the control group---12.6 per cent versus 16.5 per cent.

Also, women who used chewing gum had fewer babies with low birth weight, weighing 5.5 pounds or less (8.9 per cent vs. 12.9 per cent).

Chewing gum was also associated with improvement in maternal oral health.

eat-right-to-prevent-glaucoma

Sun Jan 30 12:19:37 IST 2022

THERE ARE USUALLY no warning signs for glaucoma. It develops so gradually that a person can lose about 40 per cent of vision without noticing. Once lost, it’s irreversible. But early treatment can often stop further damage and protect your vision.  

The only way to find out if you have glaucoma is with a comprehensive dilated eye exam.

According to the Glaucoma Research Foundation, your dietary habits can impact your risk of glaucoma.

Consuming fruits and veggies can protect against oxidative stress associated with damage to the optic nerve and other tissues of the eye in glaucoma.

A study that included 584 women showed that those who consumed three or more fruit or fruit juice servings per day were 79 per cent less likely to develop glaucoma compared with those who had less than one serving.

Fruits and vegetables are rich sources of vitamins A and C as well as the antioxidants lutein and zeaxanthin. Green leafy vegetables such as kale and spinach have been shown to reduce the risk of developing glaucoma.

Nuts and seeds, such as sunflower seeds, almond, hazelnuts and pistachios, are excellent sources of vitamin E which can keep cells healthy. It also protects them from free radical damage, which can break down the protective retinal tissues.

Eating fish such as salmon, tuna, sardines and halibut rich in omega-3 fatty acids have been shown to reduce glaucoma related pressure in the eye.

Chocolates, bananas, avocados, pumpkin seeds and black beans are other healthy food for eye health.

A study published in the British Journal of Ophthalmology showed that people who drank at least one cup of hot tea daily reduced their glaucoma risk by 74 per cent compared with those who did not.

People with glaucoma should avoid food that contribute to metabolic syndrome, obesity, blood pressure abnormalities, and diabetes which are all risk factors for primary open-angle glaucoma.

A lower intake of carbohydrates and calories are also beneficial.

Covid-19 may raise risk of diabetes in children

CHILDREN WHO HAD a diagnosis of Covid-19 have an increased risk for diabetes, according to researchers at the US Centers for Disease Control and Prevention (CDC).

People with diabetes are already known to have an increased risk for severe Covid-19. And diabetic people infected with SARS-CoV-2 experience worsening of diabetes symptoms.

Some studies have already reported that adults who have recovered from Covid-19 have an elevated risk of diabetes. The new report suggests that Covid-19 infection might also trigger newly diagnosed diabetes in children younger than 18.

The researchers analysed two insurance claim databases to calculate the number of new diabetes diagnoses made in children younger than 18, from March 2020 to June 2021. They compared new diabetes diagnosis in those who had Covid-19 with those who did not.

Both data sets showed that children with Covid-19 were more likely to receive a new diabetes diagnosis 30 days after infection than were those without the infection. One data set showed a 2.6-fold increase in new diabetes cases and the second data set showed a 31 per cent increase.

The study highlights the importance for doctors and parents to monitor children for signs and symptoms of diabetes which include increased thirst, frequent urination, unintentional weight loss, fatigue, stomach pain, nausea and vomiting.

Sedentary cancer survivors have worse outcomes

CANCER SURVIVORS who are not physically active and sit for longer periods are much more likely to die early from cancer or other causes.

For the study published in JAMA Oncology, researchers used data from 1,535 cancer survivors, aged 40 years or older.

During up to nine years of follow-up, 293 people died—114 from cancer, 41 from heart diseases and 138 from other causes.

More than half the participants did not engage in any leisure time physical activity and two-thirds typically sat for more than six hours a day.

More than a third of the participants did not exercise and also sat for more than six hours a day. Only about one-third got the recommended 150 hours of exercise a week.

Cancer survivors who did not meet the recommended 150 minutes per week of moderate-to-vigorous intensity leisure-time physical activity and sat longer than eight hours per day had the highest risk, more than a five-fold increase in the risk of death from all causes, both cancer and non-cancer.

On the other hand, being physically active was associated with lower risks of all-cause and cancer-specific mortality compared with inactivity and can reduce the negative impact of prolonged sitting.

Breastfeeding may reduce risk of heart disease, stroke

WOMEN WHO BREASTFEED have a lower risk of stroke and of developing and dying from heart disease.

Breastfeeding has already been linked to lower risks for breast cancer, ovarian cancer and type-2 diabetes.

The Austrian study published in the Journal of the American Heart Association used data for nearly 1.2 million women from eight studies conducted in different countries between 1986 and 2009. The average age of the women was 51.3 years at the start of the study.

As many as 82 per cent of the women reported having breastfed at some point in their life.

Women who breastfed for any length of time were less likely to develop heart disease, have a stroke or die from heart disease compared with women who had children but never breastfed.

They were 11 per cent less likely to develop cardiovascular disease events, 14 per cent less likely to develop coronary heart disease, 12 per cent less likely to have strokes and 17 per cent less likely to die from cardiovascular disease during 10 years of follow-up.

The benefits seemed to be even greater for those who breastfed for up to one year.

The World Health Organization has long recommended women breastfeed their babies exclusively for at least the first six months of life.

Did You Know?

Men who experience more relationship breakups and live alone longer have higher levels of inflammatory markers in their blood which can put them at risk for age-related diseases, such as cancer, heart disease and type-2 diabetes:
Journal of Epidemiology & Community Health

A study that reviewed the after-effects of Botox injections found that there was a 22 to 72 per cent drop in anxiety and anxiety-related disorders among people who got Botox injections for different reasons compared to patients who received other treatments for the same conditions:

Scientific Reports

Removing ovaries with hysterectomy before menopause raises death risk

WOMEN UNDER THE AGE of 50 who had their ovaries and fallopian tubes removed during a hysterectomy for non-cancerous reasons have an increased risk of death, according to a Canadian study published in the BMJ.

Surgical removal of the ovaries and fallopian tubes, a procedure known as bilateral salpingo-oophorectomy (BSO), is the most common major surgery performed on non-pregnant women worldwide, according to the Organization for Economic Cooperation and Development.

It is often offered to women undergoing hysterectomy to prevent future development of ovarian cancer.

More than two lakh women aged 30 to 70 years undergoing non-malignant hysterectomy were followed for an average of 12 years.

They were divided into four groups based on age at surgery: premenopausal (>45 years), menopausal transition (45-49 years), early menopausal (50-54 years) and late menopausal (<55 years).

Women under 50 who had undergone the surgery had an increased risk of death. But the same risk was not seen in women over 50.

The risk of death declined gradually as women approached menopause and was eliminated after the average age of menopause.

Premenopausal women go through “sudden menopause” because the surgery prematurely stops all ovarian hormone production, the researchers suggested. The loss of oestrogen may predispose women to serious health problems later in life.

Did You Know?

A study of 92,383 men and women who were followed for 28 years showed that those who consumed more than half a tablespoon of olive oil a day had a 19 per cent lower risk of dying from cardiovascular diseases, a 17 per cent lower risk of dying from cancer, a 29 per cent lower risk of dying from a neurodegenerative disease and an 18 per cent lower risk of dying from respiratory disease compared with those who don’t consume olive oil:
Journal of the American College of Cardiology

Gum disease linked to heart disease, mental illness

PEOPLE WITH GUM DISEASE are more likely to develop other chronic conditions including heart disease, diabetes, hypertension and mental disorders.

For the British study published in the journal BMJ Open, researchers compared the medical records of 64,379 patients with a history of periodontal disease, including gingivitis and periodontitis, with 2,51,161 people without the condition.

The average age of the cohort was 45 years, and 43 per cent were male.

During an average follow up of 3.4 years, people with gum disease were 37 per cent more likely to develop a mental health condition (depression and anxiety); 33 per cent more likely to develop an autoimmune disease (arthritis, type-1 diabetes, psoriasis); 26 per cent more likely to develop type-2 diabetes; 18 per cent more likely to develop cardiovascular disease (heart failure, stroke, vascular dementia; and 7 per cent more likely to develop a cardiometabolic disorder (high blood pressure).

Since poor oral health is extremely common, the study reinforces the importance of regular dental check-ups for “prevention, early identification and treatment of periodontal disease” and to reduce the burden of future chronic diseases.

eat-during-the-day-to-reduce-health-risks-linked-to-night-shift-work

Sun Dec 26 11:50:32 IST 2021

NIGHT-SHIFT WORKERS have an increased risk for obesity, diabetes and heart disease. A new US study published in the journal Science Advances suggests that eating during the daytime could be a simple intervention that can reduce the adverse metabolic effects linked to night-shift work.

The study included 19 healthy young men and women who were randomly assigned to a 14-day simulated night-work schedule with one of two eating plans: one group ate during the night-time which is typical among night-shift workers, and the other group ate during the daytime which aligns with their internal circadian rhythms.

The researchers found that eating during the night increased glucose levels by 6.4 per cent, a risk factor for diabetes. But those who restricted meals to the day did not see this spike in glucose levels.

Eating during the day can help night shift workers maintain internal circadian alignment and prevent glucose intolerance.

Anger may trigger stroke

LOSING YOUR TEMPER, getting emotionally upset and heavy physical exertion could trigger a stroke, according to the INTERSTROKE study published in the European Heart Journal.

Most studies on stroke focus on medium to long-term exposures, such as hypertension, obesity or smoking.

To explore the impact of acute exposure that could contribute to a stroke, the researchers looked at 13,462 cases of acute stroke, both ischaemic stroke and intracerebral haemorrhage, involving patients from 32 countries.

Among them, 9.2 per cent (1,233 participants) were angry or emotionally upset and 5.3 per cent (708 participants) engaged in heavy physical exertion within an hour of symptom onset.

The study found that one in 11 stroke survivors experienced a period of anger or were upset in the one hour leading up to it and one in 20 patients had engaged in heavy physical exertion.

Anger or emotional upset was linked to a 37 per cent increase in the risk of stroke for one hour after the episode. The risk was greater if the patient did not have a history of depression.

Heavy physical exertion was linked to a 62 per cent increase in the risk of intracerebral haemorrhage for an hour afterwards. The risk was greater for women and less for those with a normal BMI.

Elevated heart rate linked to a greater risk of dementia

YOUR RESTING HEART rate could be a predictor of future dementia risk.

According to a Swedish study published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, older adults with an elevated resting heart rate have an increased risk of dementia and faster cognitive decline.

Elevated resting heart rate is already known to increase the risk of several cardiovascular diseases such as ischaemic heart disease, atrial fibrillation, heart failure, and stroke, and these conditions are known risk factors for dementia as well.

To find out if the elevated resting heart rate is an independent risk factor for dementia, the researchers followed 2,147 people aged 60 and older. During 12 years of follow up, 289 people were diagnosed with dementia.

Individuals with a resting heart rate of 80 beats or more per minute had on average a 55 per cent greater risk of dementia than those with a heart rate of 60 to 69 beats per minute.

The association remained significant even after excluding participants with prevalent and incident cardiovascular diseases. The researchers added that resting heart rate could be used as a tool to identify people who are at an increased risk of dementia and intervene early to delay the onset of dementia.

Resting heart rate can be easily measured and can be lowered with exercise or medical treatment.

Did You Know?

Looking in the mirror encourages healthy behaviours in overweight and obese people. It reduces anxiety and body dissatisfaction and improves self-awareness which encourages them to choose healthier food and engage in exercise.

Journal of Clinical Nursing

Quit smoking before 45 to eliminate cancer risk

QUITTING SMOKING AT any age can reduce the risk of dying from lung and other tobacco-related cancers.

According to a US study published in JAMA Oncology, smokers who stop the habit before age 45 reduced their excess risk by 89 per cent.

The study involving more than 4,10,000 people examined the association between age at smoking initiation and cessation and cancer mortality at ages 25 to 79 years.

Smokers who gave up the habit before age 35 completely erased the risk.

Quitting at any age is beneficial. Those who quit between the ages of 45 and 54, reduced their excess risk by 78 per cent, and by 56 per cent if they quit between the ages of 55 and 64.

Equally important was the age at which smokers start the habit. Overall, smokers are three times more likely to die of cancer compared to non-smokers. The risk was four times greater for people who start smoking before age 10.

Among current smokers, smoking accounted for about 75 per cent of cancer deaths among those who started smoking before the age of 10 years, and 59 per cent of cancer deaths among those who started at age 21 years and older.

Surgery vs antibiotics for appendicitis

THE LARGEST STUDY comparing appendectomy and antibiotics for appendicitis, the Comparison of the Outcomes of Antibiotic Drugs and Appendectomy, or CODA trial, concluded that antibiotics can be the first-line of treatment for most patients with appendicitis.

Appendectomy has been the standard treatment for appendicitis for more than 120 years and is one of the most common emergency abdominal procedures. The findings of the trial give patients a safe alternative to surgical removal of the appendix.

As part of the trial, 1,552 patients with appendicitis from 25 hospitals across 14 American states were examined. They were randomly assigned to receive antibiotics or to undergo an appendectomy.

Around 70 per cent of the patients could avoid surgery the first three months after taking the antibiotics. While the proportion of patients who underwent surgery after initially taking antibiotics increased over time, just above 50 per cent of the patients could avoid the surgery up to four years.

Patients with an appendicolith, a small stone in the appendix—seen in about 25 per cent of cases of acute appendicitis—had a higher chance of appendectomy in the first 30 days.

The final results of the CODA Trial were published in the New England Journal of Medicine .

Did You Know?

Seniors who regularly did household chores such as washing dishes, dusting, ironing, cooking. vacuuming and mopping had a higher cognitive function, especially better memory and attention span, and stronger legs, which helps prevent falls.

BMJ Open

Viagra could help prevent Alzheimer’s disease

VIAGRA (SILDENAFIL), a drug commonly used to treat erectile dysfunction, could potentially help prevent Alzheimer’s disease, according to a US study published in the journal Nature Aging.

The research team from Cleveland Clinic analysed health insurance claims data of 7.23 million people to compare the prevalence of Alzheimer’s disease among sildenafil users and non-users.

They found that sildenafil users were 69 per cent less likely to develop Alzheimer’s disease than non-users after six years of follow-up.

“Notably, we found that sildenafil use reduced the likelihood of Alzheimer’s in individuals with coronary artery disease, hypertension and type 2 diabetes, all of which are comorbidities significantly associated with risk of the disease, as well as in those without,” the study author added.

In lab experiments with an Alzheimer’s patient-derived brain cell model using stem cells, the researchers also found that sildenafil increased brain cell growth and reduced tau protein accumulation in the brain, a hallmark of Alzheimer’s disease.

The researchers are planning a phase II randomised clinical trial to test the possibility of repurposing sildenafil as a treatment for Alzheimer's disease.

Is there an optimal bedtime?

ACCORDING TO A BRITISH study published in the European Heart Journal: Digital Health, going to sleep between 10pm and 11pm is associated with a lower risk of developing heart disease.

The study included 88,026 adults with an average age of 61 years. Their data on sleep and wake times were collected over a week using a wrist-worn accelerometer. The participants also provided information about their lifestyle and health.

Among them, 3,172 participants (3.6 per cent) developed cardiovascular disease during an average follow-up of 5.7 years.

The incidence of cardiovascular disease was lowest in those who went to sleep between 10pm and 10:59pm.

Those who went to sleep at midnight or later had a 25 per cent higher risk of cardiovascular disease. The risk was 12 per cent greater for those who went to bed between 11 to 11:59pm, and 24 per cent higher for those who hit the bed before 10pm.

The association between bedtimes and cardiovascular risk was stronger in women.

A chewing gum to fight Covid-19

RESEARCHERS AT THE University of Pennsylvania are developing a chewing gum that could reduce the spread of Covid-19 transmission.

The gum is laced with a plant-based protein known as ACE2 (angiotensin-converting enzyme 2) which can trap and neutralise SARS-CoV-2, the virus causing Covid-19, found in the saliva.

This gum can lower the viral load by neutralising the virus in the saliva, the primary site of viral replication, and possibly reduce transmission and infection.

The ACE2 protein was originally being studied to treat hypertension.

When saliva samples from Covid-19 patients were exposed to the gum with ACE2 protein, levels of viral RNA fell so dramatically that it was almost undetectable.

The researchers are working on obtaining approval for a clinical trial.

The study was published in the journal Molecular Therapy.

timing-of-exercise-matters

Sun Nov 28 13:08:13 IST 2021

IT IS ALREADY known that people with type 2 diabetes should exercise regularly. Now a US study published in the journal Diabetes Care suggests that timing of the exercise is also important for better fitness levels and cardiovascular health.

According to the study morning workouts can increase the risk of a heart attack in men with type 2 diabetes.

The study was based on 2,035 obese or overweight people with type 2 diabetes.

The participants wore accelerometer devices on their waists that measured the time and type of their physical activity, for a week. Men who performed moderate-to-vigorous exercise in the morning had the highest risks of developing coronary heart disease irrespective of the amount and intensity of weekly physical activity and cardiorespiratory fitness.

Men who were most active midday had lower cardiorespiratory fitness levels.

However, there was no association between specific activity timing and coronary heart disease risk or cardiorespiratory fitness in women.

Did You Know?

According to a survey of 2,004 Americans, men cry on average about four times a month compared to three times a month for women. That is 48 times a year for men and only 36 for women.

Vida Health

HPV vaccine cuts cervical cancer

THE HUMAN PAPILLOMAVIRUS (HPV) vaccine reduces cervical cancer by 87 per cent, confirms a British study published in the journal The Lancet.

Cervical cancer is the fourth most common cancer in women in the world, accounting for more than 3,00,000 deaths each year.

Nearly all cervical cancers are caused by HPV. The virus is also linked to other cancers including vaginal, vulval, anal, penile and some head and neck cancers. The vaccine is most effective when offered between the ages of 11 and 13, before girls become sexually active and are likely to get exposed to the virus.

The findings are based on an analysis of all cervical cancers diagnosed in England in women aged 20-64 between January 2006 and June 2019. The HPV vaccination programme started in England in 2008.

The risk of cervical cancer was 87 per cent lower among women who received the vaccine at ages 12 or 13, compared to unvaccinated women. It was 62 per cent lower in those who got the vaccine at ages 14-16 and 34 per cent lower in women who received the vaccine at ages 16-18.

Overall, the vaccination programme prevented about 450 cervical cancers and 17,200 pre-cancers during the nearly 13-year study period.

Early-onset hypertension linked to increased dementia risk

PEOPLE WHO ARE diagnosed with high blood pressure at an early age have smaller brain sizes and are more likely to develop dementia, according to new research published in the journal Hypertension.

The researchers analysed data from 2,70,904 participants in the UK Biobank. They compared the development of dementia in 1,24,053 people with high blood pressure and 1,24,053 matched adults who did not have high blood pressure.

During up to 14 years of follow up, 4,626 people developed some form of dementia. People diagnosed with high blood pressure between the ages of 35 and 44 had a 61 per cent increased risk of dementia compared to those who did not have high blood pressure.

The risk of vascular dementia was 45 per cent higher in the adults diagnosed with hypertension between ages 45-54, 69 per cent higher in those diagnosed between ages 35-44 and 80 per cent higher in those diagnosed before age 35 compared to those of the same age without high blood pressure.

However, no relationship was found between the age at hypertension diagnosis and the risk of Alzheimer’s disease.

To analyse related brain changes, they compared MRI measurements of brain volume between 11,399 people with high blood pressure and 11,399 participants who did not have high blood pressure.

In all age groups, the total brain volume, as well as the brain volume of several regions, were smaller in people diagnosed with high blood pressure compared to those who did not have high blood pressure. Those diagnosed before age 35 had the largest reductions in brain volume.

Did You Know?

Regularly engaging in nature-based activities can improve mood and positive emotions and decrease anxiety, even in people with pre-existing mental health problems.

SSM–Population Health

Radiation therapy risks revealed

WOMEN WHO RECEIVE radiation for breast cancer in their left breast have more than twice the risk of developing coronary artery disease compared to those who had radiation in their right breast.

The findings of the study published in the Journal of the American College of Cardiology: CardioOncology included 972 women, aged 55 years or younger, who received radiation for stage 1 or stage 2 breast cancer. All the women were free of cardiovascular diseases at the start of the study.

Overall, 10.5 per cent of the women who received left-sided radiation developed coronary artery disease compared with 5.8 per cent of women who received right-sided radiation, during 27 years of follow up.

Among women who were younger than 40, 5.9 per cent of those who received left-sided radiation developed heart disease, while there was no incidence of heart disease among those who received right-sided radiation therapy.

Among women aged 40-54 years, 18.7 per cent developed coronary artery disease after left-sided radiation therapy compared to 6.8 per cent after right-sided radiation therapy.

The incidence of heart disease among women given right-sided radiation was similar to those seen in women in general. When providing follow up care for breast cancer survivors, doctors should consider the laterality or side of their cancer.

Find your sleep ‘sweet spot’

FINDING YOUR SLEEP ‘sweet spot’ is crucial to stay mentally sharp and to keep cognitive performance stable as you age.

According to a US study published in the journal Brain, both short and long sleepers experience greater cognitive decline. Getting the right amount of sleep can reduce the risk of mental decline, even if you have early Alzheimer's disease.

Both poor sleep and Alzheimer's disease are associated with cognitive decline and poor sleep can hasten the progression of Alzheimer’s disease.

This study included 100 older adults whose average age was 75. The participants underwent a sleep study and were tested for early signs of Alzheimer’s disease.

Their cognitive function was assessed for an average of 4.5 years. Most of the participants (88) had no cognitive impairment, 11 had very mild impairment and one had mild impairment.

Overall, cognitive scores declined for those with less than 5.5 or more than 7.5 hours of self-reported sleep per night, even for those with early signs of Alzheimer’s disease.

But cognitive function stayed stable for those within a middle range of sleep time.

Did You Know?

Increasing intake of food rich in calcium and protein like milk, cheese and yoghurt can reduce the risk of fractures of any kind by 33 per cent, hip fractures by 46 per cent and fall by 11 per cent in older adults.

The BMJ

Feed eggs early to children

CHILDREN WHO ARE fed eggs before 12 months are less likely to develop egg allergies in the future.

The findings of the study presented at a meeting of the American College of Allergy, Asthma and Immunology (ACAAI) was based on an analysis of data from 2,237 parents who were surveyed about their children's eating habits and food allergies from birth to 6 years of age.

Among them, 0.6 per cent reported egg allergy in their children at one year, and 0.8 per cent reported egg allergy at 6 years.

Children who had not eaten eggs by 12 months and those who were fed fewer eggs at 5, 6, 7 and 10 months of age were much more likely to develop food allergies by age six, compared to those without food allergies.

Egg allergy is the second most common food allergy in the world. Early introduction of eggs during infancy, followed by consistent and frequent feedings, is protective against the development of egg allergy, the study author said.

New guidelines for cardiovascular health

NEW DIETARY GUIDELINES issued by the American Heart Association focuses on overall dietary patterns, rather than specific foods or nutrients. It encourages people to start healthy eating at an early age and to maintain a healthy diet throughout life.

Poor diet is strongly associated with an increased risk of cardiovascular disease and death.

The 10 dietary steps for a healthy heart include

(1) Balance calorie intake with physical activity to achieve and maintain a healthy body weight

(2) Eat plenty and a variety of fruits and vegetables

(3) Choose whole-grain foods over refined grain products

(4) Choose healthy sources of protein (mostly from plants like legumes and nuts); fish and seafood; low-fat or fat-free dairy products; and lean cuts of meat and avoid processed meat

(5) Choose healthy oils such as olive oil and sunflower oil, and avoid tropical oils such as palm oil and partially hydrogenated fats

(6) Choose minimally-processed foods instead of ultra-processed foods

(7) Limit the intake of beverages and foods with added sugars

(8) Choose and prepare foods with little or no salt

(9) Limit alcohol intake and if you do not drink alcohol, do not start

(10) Follow this guidance regardless of where food is prepared or consumed.

Best time for rehabilitation after a stroke

A NEW US STUDY published in the journal PNAS suggests that there is a critical period for rehabilitation after a stroke when recovery is the fastest.

Almost two-thirds of people who suffer a stroke do not regain complete mobility of their hands and arms which can severely limit their daily activities.

Studies in rodents have shown that there is a specific period after a stroke when networks of nerves adapt and reorganise, and the brain can learn and rewire very rapidly. Intensive motor training provided during this window can lead to nearly full recovery.

To find out if there is a similar window in humans, the researchers randomised 72 stroke patients into one of four groups. In addition to standard stroke rehabilitation therapy, participants in three groups received 20 extra hours of intensive motor skills therapy starting at 30 days after the stroke, two to three months after the stroke or six to seven months after the stroke. Participants in the control group received no extra rehabilitation therapy.

The participants’ arm and hand functions were assessed at different times before and after treatment. Those who received intensive therapy two to three months after the stroke showed the greatest improvement one year after the stroke. While participants in the 30-day group showed some improvement, those in the six- to seven-month group showed no significant improvement compared to the control group.

Did You Know?

Men with higher levels of the hormone testosterone are more likely to cheat and have more than one sexual partner at the same time.

The Journal of Sex Research

Bypass surgery vs stenting

BYPASS SURGERY IS slightly better than stenting to open blocked arteries for patients with severe coronary artery disease, finds a US study published in the New England Journal of Medicine.

But patients without complex disease fared better with stents. The findings will help guide doctors decide which treatment is best for individual patients.

The study included 1,500 patients in 24 countries, average age 65, who had three blocked coronary vessels. They were randomly assigned to either receive stents (757 patients) or undergo surgery (743 patients).

After one year, the incidence of major complications such as death, heart attack, stroke and the need for a repeat procedure was 10.6 per cent in the stent group and 6.9 per cent in the bypass group.

But when the need for a repeat procedure was excluded from the analysis, the rates fell to 7.3 per cent and 5.2 per cent, respectively.

The risk of major bleeding, arrhythmia, acute kidney injury and rehospitalisation within 30 days was higher in the bypass surgery group.

The study also found that patients with less complex coronary artery disease did better with stents because they required fewer stents compared to those with complex diseases.

exercise-to-escape-cancer

Mon Oct 25 16:20:49 IST 2021

TWO NEW STUDIES are touting the importance of regular exercise to reduce cancer incidence and mortality.

The first study published in the International Journal of Behavioural Nutrition and Physical Activity has shown that strength training exercises like squats, rowing, planks, and weight training can reduce a person’s risk of dying from cancer by 14 per cent.

Specifically, muscle strengthening exercises were associated with a 26 per cent lower risk of developing kidney cancer.

However, combining resistance workouts with aerobic activities, such as walking, running, swimming and cycling, reduced the risk of cancer mortality by 28 per cent.

The findings are based on a review of 12 studies that followed nearly 1.3 million people for six to 25 years.

The second study from Australia has shown that exercise may help cancer patients fight off cancerous tumours.

When a person exercises a protein called myokines is secreted by the muscles into the blood. These myokines can suppress tumour growth and help the body fight off cancer cells.

The study, published in the journal Medicine and Science in Sports and Exercise, included 10 obese prostate cancer patients who participated in a regular exercise programme for 12 weeks. The patients provided blood samples before and after the exercise programme which the researchers applied directly on to living prostate cancer cells.

The levels of anti-cancer myokines increased in the three months of exercise. At the same time, there was significant suppression of the growth of prostate cancer cells as seen in the post-training blood.

While myokines may help slow down or stop cancer growth, they do not kill the cancer cells. Instead, they signal our immune cells to attack and kill the cancer cells, the researchers explained.

SIGNS IN THE EYES

ACCORDING TO a Chinese study published in the British Journal of Ophthalmology, people who suffer age-related eye diseases such as macular degeneration, cataract and diabetes-related eye disease have an increased risk of dementia.

It is well known that conditions such as diabetes, high blood pressure, heart disease, depression and stroke can increase the risk of dementia.

The researchers analysed data on 12,364 British adults aged 55-73. The participants were assessed between 2006 and 2010 and followed up until early 2021. Among them, 2,304 people developed dementia. The risk of dementia was 26 per cent higher in people with age-related macular degeneration, 11 per cent higher in those with cataracts, and 61 per cent higher in those with diabetes-related eye disease, compared with those who did not have vision problems at the start of the study.

However, glaucoma, another common eye ailment, did not increase the risk of dementia.

New recommendations

THE USE OF LOW DOSE aspirin to prevent a first heart attack or stroke in people who are at high risk for cardiovascular diseases is no longer recommended, says the US Preventive Services Task Force.

Heart disease and stroke are leading causes of morbidity and death, and low dose aspirin has been routinely prescribed to lower the risk.

The change in recommendation reflects new data showing that daily aspirin can potentially increase the risk of severe bleeding in the stomach, intestines, and brain which can be life-threatening. The risk of bleeding increases with age.

According to the latest guidelines, high-risk people aged 60 and older should not start taking aspirin for heart disease and stroke prevention because the risk of bleeding outweighs the benefits. High-risk people between the ages of 40 and 59 should take aspirin only if recommended by their doctor. For people in their 50s, the net benefit of aspirin use is limited. For people in their 40s, there might be some benefit.

The recommendation does not apply to people already taking aspirin for a previous heart attack or stroke. They should continue to do so unless advised otherwise by their clinician. When deciding whether patients should start taking aspirin to prevent a first heart attack or stroke, clinicians should consider age, heart disease risk, and bleeding risk, the task force said.

Did You Know?

The World Health Organization has approved the world’s first malaria vaccine called Mosquirix, which could save the lives of tens of thousands of children each year.

WHO

Good oral hygiene reduces the risk of severe Covid-19

PRACTISING GOOD ORAL hygiene may lower your risk of severe Covid-19 infection, especially if you have cardiovascular diseases, according to a study presented at a meeting of the American College of Cardiology and the Egyptian Society of Cardiology.

“Oral tissues could act as a reservoir for SARS-CoV-2, developing a high viral load in the oral cavity. Therefore, we recommended maintenance of oral health and improving oral hygiene measures, especially during Covid-19 infection," said the lead author of the study.

Previous research has shown that poor oral hygiene is linked to increased inflammation and heart disease. Covid-19 severity has also been linked to an inflammatory response.

Egyptian researchers assessed the oral health, severity of Covid-19 symptoms, C-reactive protein levels (an indicator of inflammation in the body) and duration of recovery in 86 heart disease patients with Covid-19.

Poor oral health was linked to more severe Covid-19 infection, delayed recovery and higher inflammation levels.

Did You Know?

People who sleep six to seven hours a night have the lowest risk of dying of a heart attack or stroke compared to those who sleep less or more.

Study presented at the American College of Cardiology’s Annual Meeting

New blood thinner may reduce blood clot risk

PATIENTS UNDERGOING orthopaedic surgery, such as knee replacement, are at a higher risk for blood clots and are advised to take daily anti-clotting medications after their procedure.

Findings of a new research published in the New England Journal of Medicine has shown that a single injection of an experimental blood thinner called Abelacimab may greatly reduce the risk for blood clots after surgery.

Abelacimab, developed by Anthos Therapeutics, could potentially be a game-changing treatment for people at risk of blood clots.

The researchers compared Abelacimab with another blood thinner called Enoxaparin in 412 patients undergoing knee replacement surgery.

Compared with enoxaparin, a single injection of Abelacimab reduced the risk of blood clots in the veins in the leg by 80 per cent for up to a month after surgery, without increasing the risk of bleeding which is a common side effect with blood thinners.

Abelacimab is an antibody that binds to both the inactive and activated forms of a clotting factor called factor XI, preventing its activation and activity, and halting clot formation, the researchers explained.

The researchers hope Abelacimab could be used in the treatment of other cardiovascular conditions such as "for prevention of stroke in patients with atrial fibrillation, for treatment of deep-vein thrombosis and pulmonary embolism, clots in the veins of the leg and clots in the lung, and in patients with cancer.”

Did You Know?

Increasing the amount of space between printed letters is a simple and effective method to increase the reading speed and accuracy of kids with dyslexia as well as those without. The extra-large letter spacing helped kids without dyslexia read 5 per cent faster and those with dyslexia read 13 per cent faster.

Research in Developmental Disabilities

Chewing gum to solve gut problems

ACCORDING TO A STUDY presented at the annual Perioperative and Critical Care Conference from the Society of Thoracic Surgeons, chewing gum could be a simple and inexpensive solution that could help cardiac surgery patients avoid postoperative digestive problems and recover faster.

Heart surgery patients may sometimes develop postoperative ileus, a condition that prevents normal muscle contractions in the intestines that leads to food buildup and potential blockage in the intestines. This can cause abdominal cramps, bloating, nausea, vomiting, constipation, and difficulty tolerating a normal diet and can slow the recovery process.

To analyse the benefits of chewing gum in cardiac surgery patients, the researchers asked 341 patients to chew one piece of sugarless gum three times a day for five to 10 minutes after their surgery. Rates of postoperative ileus were compared between this group and 496 patients who had similar cardiac surgeries but did not chew gum after their procedures.

Only two patients in the gum-chewing group had confirmed postoperative ileus, compared to 17 patients in the non-gum chewing group.

Chewing gum stimulates the digestive system by tricking it to believe that food is coming. This process is known as “sham feeding”, the researchers explained.

Screening to reduce stroke risk

SCREENING OLDER adults for atrial fibrillation (Afib), a heart rhythm disorder, could reduce the risk of stroke, severe bleeding and death, according to a Swedish study published in the journal The Lancet.

Atrial fibrillation, or irregular heartbeat, is associated with a five-fold increased risk of ischemic stroke. With early detection, patients can be started on anticoagulant therapy which can reduce the risk of stroke and mortality.

The study included about 28,000 people aged 75 and 76 who were randomly invited to join either a screening (13,979) or a control group (13,996). Only half of those invited to the screening group participated. They completed a health questionnaire and underwent an electrocardiogram.

Those without Afib were asked to take home the ECG device and record their heart rhythm twice daily for two weeks. If the patients detected irregular heart rhythms, they were referred to a cardiologist and started on oral anticoagulants.

During six to nine years of follow-up, the incidence of stroke, severe bleeding and death were slightly lower in the screening group compared to the control group (31.9 per cent vs 33 per cent).

The researchers point out that only half of those invited to screening participated and the benefits could have been more pronounced had more people done the screening.

Bedtime is a bad time for exercise

WORKING OUT CLOSE to your bedtime can negatively impact your sleep quality. For the study published in the journal Sleep Medicine Reviews, Canadian researchers analysed data from 15 published studies, that included 194 participants, to examine how a single session of intense workout can affect young and middle-aged healthy adults and their sleep. They also looked at the fitness level of the participants, the duration of the exercise and how different types of exercise influence sleep.

Exercising in the early evening was optimal for sleep quality. High-intensity exercise that ended two hours before bedtime was associated with better sleep onset and improved sleep duration, especially when performed by sedentary people.

Exercising 30 to 60 minutes appeared to be the most beneficial for sleep onset and sleep duration. Of different types of exercise, cycling had the most sleep benefits. It helped with sleep onset and deep sleep.

On the other hand, people who ended their exercise less than two hours before bedtime had poor sleep quality. They took longer to fall asleep and stay asleep.

Keeping a consistent exercise schedule is also important since exercising at different times of the evening could cause sleep disturbances.

Sleep hygiene strategies such as taking a shower after exercise and avoiding eating heavy meals or drinking a lot of water before going to bed would also promote good sleep quality.

Did You Know?

Women who get more sunlight in their first trimester have a ten per cent lower risk of developing problems with their placenta that can lead to premature birth and baby loss compared to those exposed to the lowest levels.

Frontiers in Reproductive Health

Screens of danger

SPENDING TOO much time on digital smart devices can impair our eyes and vision.

A study published in The Lancet Digital Health has found a link between screen time and a higher risk and severity of myopia, or short-sightedness, in children and young adults.

For the study, researchers from Singapore, Australia, China and the UK analysed more than 3,000 studies that included children and young adults aged between three months and 33 years.

High levels of smart device screen time were associated with about a 30 per cent greater risk of near-sightedness. When the usage of smartphones and tablets was combined with excessive computer use, the risk increased to around 80 per cent.

The study authors estimate that about half the population in the world will have myopia by 2050. Spending less time outdoors and more time engaged in near-vision activities are two major driving factors that “could lead to an increase in the global burden of myopia and its complications, such as irreversible vision loss,” the study concluded.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

time-matters

Mon Sep 27 12:13:45 IST 2021

A US STUDY PUBLISHED in the Annals of Surgical Oncology finds that breast cancer patient survival improves when the time from diagnosis to treatment conclusion is limited.

The findings were based on 28,284 newly diagnosed patients with stage I to III breast cancer who received all three treatment modalities—surgery, chemotherapy and radiation.

The median age of the study patients at the time of diagnosis was 53.8 years. Among them, 28.6 per cent of the patients had stage I cancer, 44.4 per cent had stage II, and 27.0 per cent had stage III breast cancer. The patients were followed for an average of 5.8 years.

Completing all three treatment options within 38 weeks from diagnosis was associated with improved survival.

Patients who did not complete their treatments within 38 weeks had lower overall survival. The five-year overall survival rate in those who completed treatment within 38 weeks was 89.8 per cent compared to 83.3 per cent in those whose treatment extended beyond 38 weeks.

20,772 patients had surgery first, followed by chemotherapy and radiation therapy, whereas 7,512 patients had chemotherapy first, followed by surgery and radiation therapy.

More patients who underwent neoadjuvant chemotherapy first experienced longer delays than patients who underwent surgery first.

Gum disease tied to heart disease

GUM DISEASE (periodontitis) can increase the risk of cardiovascular disease and the risk increases with the severity of the gum disease.

The risk is especially greater among heart attack survivors, concludes a Swedish study presented at the meeting of the European Society of Cardiology.

The Swedish researchers had previously found that gum disease was much more common in first-time heart attack patients compared to a group of healthy people of the same age and sex.

The new study examined whether gum disease was associated with an increased risk of new heart problems in both heart attack survivors as well as the healthy group.

The study included 1,587 participants with an average age of 62 years. Dental examinations showed that 985 did not have gum disease, 489 had moderate periodontitis and 113 had severe periodontitis.

During an average follow up of 6.2 years, there were 205 incidences of cardiovascular events and death.

Participants with gum disease were 49 per cent more likely to die of any cause, have a nonfatal heart attack or stroke, or to develop severe heart failure. The risk increased with the severity of the gum disease.

Mediterranean diet could help men with erectile dysfunction

A MEDITERRANEAN DIET is known to improve heart and brain health. A new Greek study presented at the European Society of Cardiology's annual meeting suggests it could also reduce the risk of erectile dysfunction.

The Mediterranean diet focuses on fruits, vegetables, whole grains, fish and olive oil, modest consumption of dairy products and poultry, and limiting red meat.

The study included 250 men, average age 56 years, with high blood pressure and erectile dysfunction.

The participants underwent different tests to see if their dietary habits were linked with fitness, testosterone levels, blood flow, arterial stiffness, and erectile performance.

Men with a higher Mediterranean diet score had healthier arteries, better blood flow throughout the body, higher testosterone levels, better erectile performance, and better exercise capacity.

Those who were more physically fit did even better on all these metrics.

Did You Know?

When is a person with Covid-19 most contagious? Two days before and three days after they develop symptoms.

JAMA Internal Medicine

Night-shift workers, beware

PEOPLE WHO WORK night shifts have an increased risk of developing atrial fibrillation (AFib), a heart rhythm disorder, as well as coronary heart disease.

The study published in the European Heart Journal was based on 2,83,657 people in the UK Biobank database.

During an average follow-up of over ten years, 5,777 people developed Afib.

Those who worked night shifts on a usual or permanent basis had a 12 per cent increased risk of AFib compared to people who only worked during the day.

The risk was 18 per cent higher after ten or more years for those who worked a night shift for their entire life and 22 per cent higher for those who worked an average of three to eight night shifts a month for ten years or more.

Working night shifts also increased the risk of coronary heart disease by 22 per cent to 37 per cent compared to daytime work.

Women had a greater risk of AFib than men. Women who worked night shifts for more than ten years had a 64 per cent increased risk compared to day workers.

However, night shift workers who exercised regularly had a lower risk of atrial fibrillation compared to night shift workers who did not.

Cast or brace?

ACCORDING TO A BRITISH study published in the BMJ, using a functional brace is just as effective as a traditional cast for treating broken ankles.

Ankle fractures have traditionally been treated with a cast, which provides maximum support to bones during healing. But this rigid immobilisation can cause stiff joints and weakened muscles. Removable braces can address these issues and allow patients to perform leg exercises and keep their leg clean.

The four-year trial included 669 patients with an ankle fracture. They were randomly assigned to receive either a cast (334 patients) or removable brace (335 patients).

Those who got the brace were asked to take the boot off three times a day and perform ankle strengthening exercises.

After four months, the participants answered questions about functionality and pain when walking, climbing stairs, running, jumping and squatting; any swelling or stiffness; and the use of supports and activities.

Their answers were combined into a score called the Olerud Molander Ankle Score and the researchers compared the scores for both groups.

There was no statistically significant difference in the scores of the two groups.

Did You Know?

High-risk patients with mild to moderate Covid-19 who were treated with two monoclonal antibodies—combination of casirivimab and imdevimab—had a 60 per cent to 70 per cent lower risk of hospitalisation than untreated patients. Of those who were hospitalised, rates of ICU admission and death were low.

EClinicalMedicine

Delay retirement for delaying dementia

ACCORDING TO A SCOTTISH study published in the journal SSM Population Health, delaying retirement may help you retain your cognitive function longer.

To study the impact of postponing retirement to age 67 on later-life cognitive function, the researchers used data on 20,469 Americans aged 55 to 75 years.

About 45 per cent of the participants were retired, while the remaining were in full- or part-time work.

The study found a 30–34 per cent reduction in cognitive decline among men and women who remained employed compared to those who retired younger than age 67.

The protective benefits of working longer applied to both men and women and people of all ethnic groups, regardless of their educational and occupational attainment and health. But the greatest benefit was seen in the highest educated.

According to the study authors, the protective effect can be attributed to a “slowed rate of cognitive decline” rather than a “boost in cognitive function.”

Biological block

ACCORDING TO A BRITISH study published in Acta Obstetricia et Gynecologica Scandinavica, the chances of fathering a child tend to decline for men after age 50, irrespective of the mother’s age.

The study was based on couples undergoing fertility treatments. The researchers reviewed 4,833 in-vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycles, involving 4,271 men.

Among them, 1974 cycles (40.8 per cent) resulted in a live birth.

The probability of a live birth was 33 per cent lower for men older than 50 years of age compared to younger men.

Delaying parenthood is becoming more common for both men and women throughout the world.

Previous studies have shown that increasing paternal age can increase the risk of adverse pregnancy outcomes such as increased odds of gestational diabetes in the mother as well as child outcomes such as preterm birth, neonatal seizures and several neuropsychiatric disorders.

Older men may also have poorer semen quality: decrease in total sperm numbers and sperm concentration, reduction in motility and sperm DNA fragmentation.

Some medications may raise blood pressure

IF YOU HAVE HIGH blood pressure, you may want to check all the medications that you are taking with your doctor.

A review of data from 27,599 adults found that one in five of them were taking medications that could raise their blood pressure.

About half of the study participants had hypertension. Among them, 19 per cent of them were taking a medication that can raise blood pressure and 4 per cent were taking more than one.

Women and older adults were more likely to use a blood pressure-raising medication. The three most used classes of medication were antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs) that include ibuprofen and naproxen and oral steroids prescribed for conditions such as gout, lupus or rheumatoid arthritis. Other medications included antipsychotics, certain oral contraceptives and popular decongestants.

The researchers suggest that, in some cases, instead of treating high blood pressure with more medications, it would be wiser to lower blood pressure by deprescribing or prescribing other classes of medications to treat the same condition that has less impact on blood pressure.

The findings of the study were presented at the American College of Cardiology’s Annual Scientific Session.

Did You Know?

People who consume flavonoid-rich food such as berries, apples, pears and wine regularly have lower blood pressure which could reduce the risk of stroke and heart disease.

Hypertension

Step to a healthy life

TAKING 7,000 steps a day can help you live longer.

According to a study published in JAMA Network Open, people who took about 7,000 steps a day had a 50 per cent to 70 per cent lower risk of dying of all causes when compared with people who took fewer steps each day.

The study was based on 2,110 participants aged 38 to 50. They were divided into three groups based on their daily step count: low (less than 7,000), moderate (7,000-9,999) and high (more than 10,000).

During an average follow up of about 11 years, 72 of the participants died—most commonly from cancer or cardiovascular disease. Walking faster and step intensity, or the number of steps per minute, also did not reduce the risk of dying.

There was a difference in longevity benefits among men and women. Compared with the low step group, moderate/high step rate was associated with a 58 per cent and 72 per cent reduced risk of mortality in men and women, respectively.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

walk-stroke-survivors

Fri Aug 27 15:09:40 IST 2021

JUST HALF AN HOUR of walking, or similar activities, every day can reduce the risk of death from any cause in stroke survivors.

The Canadian study published in the journal Neurology included 895 stroke survivors with an average age of 72 and 97,805 people, average age 63, who had never had a stroke.

The participants answered questions about their daily physical activity. Around 25 per cent of the stroke survivors and 6 per cent of the people who had never had a stroke died of any cause during an average follow up of 4.5 years. In the stroke group, 15 per cent of the people who exercised at least the equivalent of three to four hours of walking each week died compared to 33 per cent of those who did not exercise that much. In the group of people who did not suffer a stroke, 4 per cent of those who exercised that amount died, compared to 8 per cent of those who did not.

Stroke survivors who engaged in three or four hours of activities like walking or gardening, two to three hours of bike riding, or an equal amount of other physical activities, per week, had a 54 per cent reduced risk of death from any cause. The risk of death was reduced by 80 per cent for stroke survivors under the age of 75 who met the minimum level of physical activity.

Cancer survivors age faster

CANCER SURVIVORS are more likely to experience accelerated ageing and functional decline than those without a history of cancer, according to a study published in the Journal of the American Geriatrics Society.

There is growing evidence that cancer and its treatment may adversely affect ageing-related processes.

The researchers evaluated the functional status, including grip strength and gait speed of 1,728 men and women, above the age of 22. Among them, 359 reported a history of cancer.

Overall, those who survived cancer were 1.42 times more likely to have a weaker gripping strength.

Cancer survivors who were older than 65 years had 1.61 greater odds of slow gait speed than those with no cancer history. They also had lower physical performance scores.

Cancer survivors also experienced faster declines in grip strength and gait speed as they grew older.

Did You Know?

Wearable fitness trackers like Fitbit and smartwatches are highly effective in helping overweight and obese people lose weight, lower their BMI and reduce their risk of related illnesses such as cancer, type 2 diabetes, cholesterol and heart disease.

British Journal of Sports Medicine

Non-surgical treatment for arthritis

A MINIMALLY INVASIVE, non-surgical treatment effectively reduces pain and improves function in patients suffering from knee arthritis, according to findings of a study presented at the Society of Interventional Radiology’s Scientific Meeting.

Genicular artery embolisation (GAE) provides immediate and lasting pain relief by reducing inflammation in the knee for people with moderate to severe knee pain. The study included 40 patients between the ages of 40 and 80 who were not eligible for total knee replacement and did not benefit from other treatment options.

Under localised sedation, a catheter was inserted through a tiny incision in the hip and tiny particles were delivered into the arteries in the knee to reduce blood flow in the joint and thereby decrease painful inflammation in the knee.

The patients saw benefits within three days of the procedure. Average pain scores decreased from eight out of 10 before the procedure to three out of 10 within the first week. About 70 per cent of patients reported more than 50 per cent reduction in pain scores at the one-year follow up.

Did You Know?

People who sleep six to seven hours a night have the lowest risk of dying of a heart attack or stroke compared to those who sleep less or more.

Study presented at the American College of Cardiology’s Annual Meeting

Sugary sign

PEOPLE WHO ARE diagnosed with diabetes at a younger age have a greater risk of developing dementia later in life, according to a French study published in the Journal of the American Medical Association.

The findings were based on 10,095 diabetes free adults who were between the ages of 35 and 55 at the outset, in the 1980s. Over 30 years of follow up, 1,710 people developed type 2 diabetes and 639 people were diagnosed with dementia.

Overall, each five-year earlier onset of diabetes was associated with a 24 per cent increased risk of dementia.

Compared to participants without diabetes at age 70, those who had been diagnosed with type 2 diabetes five years earlier or less had a 11 per cent increased risk for dementia.

The risk rose substantially as the years lived with diabetes increased: those who were diagnosed six to 10 years earlier had a 49 per cent increased risk of later dementia, and those diagnosed more than 10 years earlier had more than double the risk.

Dementia risk was particularly high among diabetes patients who also suffered a stroke and had other cardiovascular diseases.

Did You Know?

An analysis of studies that included 1.8 million women of all reproductive ages who underwent fertility treatment and were followed for an average of 27 years found that using ovarian stimulating drugs did not increase their risk of developing breast cancer.

Fertility and Sterility

Less popular, but safer

BOTH ANGIOTENSIN-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are recommended first-line treatments for high blood pressure. But doctors tend to favor ACE inhibitors as they have been around longer and tend to be cheaper than ARBs. While both classes of medications are equally effective in improving cardiovascular outcomes, the less popular type causes slightly fewer side effects, finds a US study published in the journal Hypertension.

To compare the safety and efficacy of ACE inhibitors and ARBs, the researchers analysed the medical records of nearly 3 million patients who were starting treatment for high blood pressure with either an ACE inhibitor or an ARB.

The vast majority of patients (2.3 million) were started on ACE inhibitors. Only about 6,74,000 patients were prescribed an ARB.

The researchers looked for four cardiovascular events, heart attack, heart failure, stroke, and sudden cardiac death, and 51 side effects in patients once they started the medications.

There were no significant differences between the two types of drugs in reducing the risk of major cardiovascular events. But patients taking ACE inhibitors had an increased risk of developing chronic cough and angioedema (swelling under the skin, often in the face). They also had a slightly higher risk of pancreatitis and gastrointestinal bleeding.

Intermittent fasting: Is it effective?

INTERMITTENT FASTING is widely popular among people trying to lose weight. But does it live up to the hype?

A British study published in the journal Science Translational Medicine finds that intermittent fasting is not a magic bullet when compared with other standard diets that focus on reducing overall calorie intake.

As part of the study, 36 healthy volunteers were allocated into one of three groups: Group 1 fasted on alternate days and on non-fast days they ate 50 per cent more than usual; group 2 reduced their calorie intake across all meals every day by 25 per cent (traditional dieting strategy); and group 3 fasted on alternate days like group 1 but ate 100 per cent more than usual on their non-fast day.

Groups 1 and 2 reduced their overall calorie intake by 500-1,000 calories during the three-week study period. Even though group 3 fasted, they did not reduce their overall calorie intake.

At the end of the study period, participants in group 2 lost more weight than those in groups 1 and 3, even though the calorie intake of groups 1 and 2 was identical.

High risk phase

The risk for a recurrent heart attack is highest in the first two weeks after the first heart attack, concludes a US study published in the Journal of the American Heart Association.

To analyse the chances for a second heart attack within 90 days of being discharged from hospital after the first one, the researchers looked at data from 6,626 admissions for heart attack at Cleveland Clinic.

Among them, 168 patients suffered a second heart attack within 90 days of discharge. The average patient age was 65 years and 37 per cent were women.

Patients who were medically managed had a higher chance of a recurrent heart attack than patients who were revascularised. Stent-related events and progression in coronary artery disease accounted for most recurrent heart attacks.

The overall risk for a recurrent heart attack was only about 2.5 per cent. But nearly 50 per cent of these patients died within five years from any cause compared with 22 per cent of the patients who did not suffer a second heart attack.

Did You Know?

A Canadian study has found that patients cared for by female physicians had lower in-hospital mortality rates than those cared for by male doctors.

JAMA Health Forum

Colourful food reduce cognitive decline

PEOPLE WHO CONSUME at least half a serving a day of food high in flavonoids such as berries, citrus fruits, peppers, pears, bananas, celery and apples have a 20 per cent lower risk of cognitive decline, according to a US study published in the journal Neurology.

Naturally occurring compounds found in colorful fruits and vegetables, flavonoids are rich in antioxidants which play a huge role in preserving brain health.

The researchers looked at the flavonoid intake and self-reported cognitive decline of 49,493 women, average age 48, and 27,842 men, average age 51. The participants were followed for over 20 years.

People who consumed the most flavonoids had about 600mg daily, while those who ate the least had about 150 mg. Those who consumed the most flavonoids had a 20 per cent lower risk of cognitive decline than those who ate the least.

Anthocyanins, another type of flavonoid found in blueberries, blackberries and cherries, were associated with a 24 per cent reduced risk of cognitive decline.

Magnets in smart devices may affect pacemakers

THE US FOOD and Drug Administration has issued warnings that magnets in some cellphones and smartwatches can cause pacemakers and other implanted medical devices to malfunction.

High field strength magnets found in many newer electronic devices such as cell phones and smart watches can cause some implants to switch to “magnet mode”. This might affect the normal functioning of the medical devices until the magnet is moved away from the medical device.

Many medical devices have a “magnet mode” that can be activated during medical procedures, such as MRI scans. This is done by placing a high field strength magnet near the implanted device. Removing the magnetic field after the procedure restores normal functioning of the medical device.

The FDA advised patients with implanted medical devices to take the following precautions: keep consumer electronics, such as cell phones and smart watches, six inches away from implanted medical devices; do not carry consumer electronics in a pocket over the medical device; check your device using your home monitoring system, if you have one.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

exercise-to-fight-memory-loss

Thu Jul 22 18:22:16 IST 2021

REGULAR AEROBIC exercise can slow memory loss and cognitive decline in people living with Alzheimer’s disease. The study published in the Journal of Alzheimer's Disease included 96 older adults living with mild to moderate Alzheimer’s dementia.

The participants were randomly assigned to either cycling on a stationary bike or stretching intervention for six months, and they were followed for another six months.

The researchers used the Alzheimer’s Disease Assessment Scale-Cognition (ADAS-Cog) to assess cognition at baseline, three, six, nine and 12 months.

“Our primary finding indicates that a six-month aerobic exercise intervention significantly reduced the decline in global cognition in comparison to Alzheimer’s disease dementia’s natural course of decline,” said the study author.

The study supports the use of “exercise as an additional therapy for Alzheimer’s disease.”

Bone marrow cell injections could help stroke patients

TREATING STROKE patients with an injection of their own bone marrow cells may lead to a reduction in brain injury and enhance recovery.

About 90 per cent of patients who suffer an ischaemic stroke suffer weakness or paralysis to one side of the body caused by injuries to the corticospinal tract (CST) which is the main white matter connection in the brain that carries movement-related information to the spinal cord, the lead researcher explained.

The findings of the clinical trial published in the journal Stem Cells Translational Medicine were based on 37 patients aged 18 to 80. All the patients received standard stroke treatment and follow-up rehabilitation; 17 patients who suffered the most severe strokes also received bone marrow cell injections.

As expected after a stroke, MRI scans of each patient at three months showed a decrease in the integrity of their CST. However, scans taken 12 months after the stroke showed an improvement in the CST of the 17 patients who received injections, even though their stroke was more severe. On the other hand, the CST of those who did not receive the injections showed ongoing and continuing microstructural injury and axonal degeneration.

Did You know?

Working 55 hours or more a week can increase the risk of stroke by 35 per cent and death from heart disease by 17 per cent compared with a normal working week of 35 to 40 hours.

WHO

Suffering in silence

HEARING IMPAIRMENT can accelerate decline in physical function as people grow older and put them at an increased risk for mobility limitations, according to a study published in JAMA Network Open.

The researchers used data from 2,956 older adults, average age 79 years. Among them, 33 per cent had normal hearing, 40 per cent had mild hearing impairment, 23 per cent had moderate hearing impairment and 4 per cent had severe hearing impairment.

Those with hearing impairment had poorer physical function, bad walking endurance, slower gait speed and poorer balance compared to those with normal hearing.

Over the study period (close to nine years), participants with hearing impairment had a faster decline in physical function compared with those with normal hearing.

Since hearing impairment is a treatable condition and affects nearly two-thirds of adults older than 70 years, prompt and appropriate interventions can “slow the decline of physical function associated with ageing,” the study concluded.

Did You know?

Listening to sedative music before bedtime can help older adults struggling with insomnia sleep better.

Journal of the American Geriatrics Society

Danger from antibiotic overuse

OVERUSE OF ANTIBIOTICS can increase the risk of colon cancer, especially in people under 50.

While junk food, sugary drinks, obesity and alcohol are the main drivers for this rise, the study found that unnecessary use of antibiotics, especially in children and young adults, could also be a reason.

For the study presented at the ESMO World Congress on Gastrointestinal Cancer 2021, the researchers compared data from 8,000 people with colon and rectal cancer, with people without the disease.

Antibiotic use was associated with an increased risk of colon cancer across all ages. But the risk was highest among people younger than 50 years who had a nearly 50 per cent increased risk, compared to 9 per cent in people over 50 years.

Antibiotic use was linked to cancers in the colon's right side in younger people. The use of quinolones and sulfonamides/trimethoprim, antibiotics used to treat a wide range of infections, were associated with these cancers.

Covid-19 vaccines are safe in pregnancy

A US STUDY PUBLISHED in the journal Obstetrics and Gynecology has found that Covid-19 vaccines do not damage the placenta and are safe for pregnant women.

The researchers examined placenta from 84 vaccinated women and 116 unvaccinated women after delivery. There was no evidence of any injury to the placenta.

The researchers also looked for abnormal blood flow between the mother and foetus, and problems with foetal blood flow, which had been previously reported in pregnant patients who had tested positive for Covid.

The rate of these injuries was similar among both the vaccinated and unvaccinated patients.

An earlier study published by the same team showed that pregnant women make Covid-19 antibodies after vaccination and transfer them to their foetuses.

Did You know?

Your risk of heart disease more than doubles if your spouse has experienced a cardiovascular event such as a heart attack or stroke, or has undergone procedures to open or bypass blocked arteries.

Study presented at the American College of Cardiology’s 70th Annual Scientific Session

Loneliness shortens lifespan

LONELINESS IS ALREADY known to cause depression and other mental health issues. A new study from Singapore, published in the Journal of the American Geriatrics Society, finds loneliness in old age can negatively impact quality of life and shorten your lifespan.

The study included 3,449 participants who were interviewed three times between 2009 and 2015.

People who were lonely sometimes or most of the time at age 60 die three to five years earlier than their peers who were never lonely. Similarly, people who were lonely at age 70 and 80 have a life expectancy that was three to four years shorter or two to three years shorter, respectively. People who were lonely also spent less of their remaining life in good health or staying active.

Multiple benefits found

BLOOD PRESSURE-lowering medication can lower the risk of serious cardiovascular issues such as strokes, heart failure and heart attacks even in adults with normal blood pressure, according to a study published in The Lancet.

The researchers examined data from 3,44,716 adults, average age 65 years, from 48 randomised trials.

The participants were divided into two groups: Those with a prior diagnosis of cardiovascular disease (1,57,728 participants) and those without (1,86,988 participants).

Each group was further divided into seven subgroups based on their systolic blood pressure. About 20 per cent of those who had a prior cardiovascular disease and 8 per cent of those who had never had cardiovascular disease had normal or high-normal systolic blood pressure at the onset.

Over an average follow up of four years, 42,324 participants had at least one major cardiovascular event, including heart attack, stroke, heart failure, or death from cardiovascular disease.

Each 5mmHg reduction in systolic blood pressure lowered the risk of developing major cardiovascular disease by around 10 per cent, stroke by 13 per cent, heart failure by 13 per cent, ischaemic heart disease by 8 per cent, and death from cardiovascular disease by 5 per cent.

The beneficial effects of the antihypertensive drugs were similar whether the participants had cardiovascular disease at the start or not, and regardless of their blood pressure at study entry. The relative reductions in risk were proportional to the intensity of blood pressure-lowering.

Did You know?

Ovarian stimulation drugs commonly used during fertility treatments do not increase a woman’s risk of breast cancer.

Fertility and Sterility

New viable option

A COMMON INTRAUTERINE device (levonorgestrel IUD) could be a viable option for women who have early endometrial cancer or a precancerous condition, according to an Australian study published in the journal Gynecologic Oncology.

The standard treatment for early-stage endometrial cancer is total hysterectomy, the study author explained.

While safe and effective, surgery may not be an option for some patients—those who are young and would like to preserve their fertility and have children, and women who are quite obese and have other serious medical issues such as heart, kidney or lung disease.

The FEMME study, a phase II randomised clinical trial, included 165 patients with an average age of 53 years.

Among them, 82 per cent of women who had a precursor to endometrial cancer called endometrial hyperplasia with atypia and 52 per cent of women with endometrial cancer responded completely to the treatment. They had a “complete pathological response”. There was no sign of cancer in biopsy after six months.

Importantly, the trial also showed that with weight loss, the new treatment was more successful with a 67 per cent response rate, and side effects were less.

adopt-a-healthy-lifestyle-to-beat-dementia

Fri Jun 25 17:46:22 IST 2021

HAVING A PARENT or sibling with dementia can increase a person’s future risk of dementia by nearly 75 per cent compared to someone without a family history.

According to a study presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Conference 2021, following a healthy lifestyle can lower dementia risk even among people who have an increased risk due to family history.

The study included 3,02,239 participants aged 50 to 73 years, who completed a baseline physical examination at the start of the study. None of the adults had dementia. They answered questions about family history and lifestyle behaviours.

The participants got one point for each of six healthy lifestyle behaviours they followed, including: eating a healthy diet with more fruits and vegetables, and less processed meat and refined grains; getting at least 150 minutes of moderate-to-vigorous physical activity a week; sleeping six to nine hours each night; drinking alcohol in moderation; not smoking; and not being obese.

Over eight years of follow up, 1,698 participants developed dementia.

Those with a family history of dementia had about a 70 per cent increased risk of dementia compared to those without. But the risk of dementia was reduced with the number of healthy lifestyle behaviours followed.

Those who followed all six healthy lifestyle behaviours cut their risk of dementia by nearly half compared to those who followed two or fewer healthy behaviours.

Do sleep medicines work?

NEARLY 40 PER CENT of people who start taking sleep medications continue to take them for years. While prescription sleep medications may work for short durations, new research published in the journal BMJ Open finds that long term use of these drugs does not provide better sleep quality. The researchers compared 238 women who took medications for sleep problems with 447 women who had sleeping problems but did not take any medication.

The medications included benzodiazepines, Z-drugs which include zolpidem, zaleplon and eszopiclone, as well as other drugs used to treat anxiety and depression. At the start of the study, all the participants reported sleep problems, such as difficulty falling asleep, staying asleep or waking up too early.

After a year or two, women who took sleep medications did not report better sleep quality or sleep duration than those who did not take any medications.

Sleep medications have side effects including daytime sleepiness.

OCD triples a person’s risk of stroke

PEOPLE WHO SUFFER from obsessive compulsive disorder, commonly known as OCD, are over three times more likely to suffer a stroke than those without the condition.

For the study published in the journal Stroke, Taiwanese researchers compared stroke risk between 28,064 adults with OCD and 28,064 adults who did not have OCD for up to 11 years.

Men and women with OCD were more than three times as likely to suffer an ischaemic stroke (caused by a blood clot) compared to adults who did not have OCD. The risk was greatest among adults aged 60 and older.

OCD was an independent risk factor for ischaemic stroke even after accounting for other risk factors that can increase stroke risk, including obesity, heart disease , smoking, hypertension, high cholesterol and type 2 diabetes . Medications used to treat OCD did not appear to increase the risk of stroke.

Did You Know?

Continuous skin-to-skin contact with mothers immediately after delivery (immediate Kangaroo Mother Care) can reduce mortality by 25 per cent in babies with a very low birth weight.

The New England Journal of Medicine

Check heart condition with thumb-palm test

A SIMPLE THUMB-PALM test can be used to identify people who are at a higher risk of having a hidden ascending aortic aneurysm, which could be fatal.

An aortic aneurysm is an abnormal bulge in the aorta, the largest artery that carries blood from the heart to your body. Aortic aneurysms are often hard to detect in advance, before it ruptures and becomes fatal.

The test involves flexing the thumb as far as possible across the palm. People whose “thumb crosses beyond the far edge of the flat palm”may have a hidden aneurysm.

“Being able to move the thumb in that way is an indication that a patient’s long bones are excessive, and their joints are lax—possible signs of connective tissue disease throughout the body, including the aorta.”

The test was conducted in 305 patients undergoing cardiac surgery for a variety of disorders, including aortic aneurysms.

While the majority of aneurysm patients did not manifest a positive thumb-palm sign, those who did have a positive sign were extremely likely to have an ascending aneurysm.

The study was published in the American Journal of Cardiology.

Pill of hope

ASTRAZENECA’S DRUG Olaparib (sold under brand name Lynparza) reduced the risk of relapse and death in breast cancer patients with BRCA1 or BRCA2 mutations, according to findings published in the New England Journal of Medicine.

The OlympiA phase III trial included 1,836 women and men with early-stage breast cancers who had been treated with standard care therapies, such as surgery, chemotherapy, hormone therapy, or radiation therapy.

About 82 per cent of the patients had triple-negative breast cancer.

They were randomly assigned to take either 300mg of Olaparib or a placebo twice a day for a year. After three years, 86 per cent of patients who took the pill were alive without cancer recurrence compared to 77 per cent in the placebo group.

The drug reduced the risk of cancer recurrence or death by 42 per cent compared to the placebo.

Common side effects included nausea, anemia, fatigue and lower white blood cell counts.

The drug is already used to treat breast cancers that have spread throughout the body and for treating certain cancers of the ovaries, prostate, and pancreas.

Did You Know?

Just one glass of wine, beer or any other alcoholic beverage can double the risk of suffering an episode of atrial fibrillation within the next four hours. The risk was threefold for people having two or more drinks in one sitting.

Study presented at the American College of Cardiology’s 70th annual scientific session

Good news for Parkinson’s patients

THE BENEFITS of deep brain stimulation (DBS) last for more than 15 years for patients with Parkinson’s disease, according to a French study published in the journal Neurology.

Most of the symptoms of Parkinson’s disease are due to the gradual loss of a chemical in the brain called dopamine. Patients with Parkinson's disease often take the drug levodopa which can temporarily restore dopamine and help relieve symptoms which affect their speech, walking and balance.

But the levels of dopamine can fluctuate through the day, leading to dyskinesia, a side effect of levodopa that can cause involuntary movements such as wriggling, twitching, swaying or head bobbing.

In deep brain stimulation, electrodes are placed in specific areas of the brain and are connected to a stimulator device that is placed under the skin of the chest. Similar to a heart pacemaker, the neurostimulator uses electrical pulses to regulate brain activity and control Parkinson's symptoms such as tremor, slowing down of movement, stiffness, and walking problems.

The findings of the study were based on 51 patients who had the device implanted for an average of 17 years. The average age of diagnosis of Parkinson’s disease was 40 and for device implantation was 51.

The researchers compared data from before the implant, at one year, and beyond 15 years after surgery. The amount of time participants experienced dyskinesia was reduced by 75 per cent after the device was implanted.

The use of medications to control dopamine levels was reduced by 51 per cent, and the amount of time when medication was no longer working well dropped by 59 per cent.

Alcohol consumption can lower chances of pregnancy

WOMEN SHOULD limit alcohol consumption if they are planning to get pregnant, suggests a US study published in the journal Human Reproduction that examined the link between alcohol intake and the chances of conceiving during a single menstrual cycle.

The researchers followed 413 women aged 19 to 41 years for a maximum of 19 menstrual cycles.

Heavy drinking during any phase of the menstrual cycle was significantly associated with reduced chances of conception. Both moderate (three to six drinks per week) and heavy (greater than six drinks per week) drinking during the luteal phase—the last two weeks of the menstrual cycle before bleeding would start and when the process of implantation occurs—was associated with a 44 per cent reduction in the odds of conceiving, compared to abstaining from alcohol.

Heavy drinking during the ovulatory phase of the cycle was associated with a 61 per cent reduced odds of becoming pregnant.

Each extra day of binge drinking (four or more drinks on a single day) was associated with a 19 per cent reduction in the odds of conceiving during the luteal phase and a 41 per cent reduction during the ovulatory phase.

Did You Know?

Adolescents and young adults with Covid-19 can suffer from symptoms of chronic fatigue syndrome—such as extreme fatigue and light headedness—months after their infection, even if their infection was mild.

Frontiers in Medicine

Sit less to keep the pounds away

WHAT IS THE secret to keep the pounds from creeping back after losing weight? Sit less and move more.

The study published in the journal Obesity included 4,305 people who had lost weight and kept off at least 9.1 kg for 3.3 years.

The researchers compared their sitting habits with a group of people who were obese and remained obese during the study period.

Those who kept their weight off sat for three fewer hours each day. They spent one hour less per day sitting at a computer, playing video games or watching TV. They also burned significantly more calories per week in physical activity.

“Finding ways to sit less and move more is part of the successful package of tools for weight management. Engage in planned physical activity, and also pay attention and interrupt any extended periods of sitting,”said the study author.

Alternative antidepressant

NITROUS OXIDE, the anesthetic drug commonly known as laughing gas, might be a safe and effective alternative to treating people suffering from severe depression.

The findings of a phase 2 clinical trial published in the journal Science Translational Medicine showed that symptoms of depression improved rapidly and significantly after just one treatment session and the benefits lasted several weeks.

The study included 24 patients aged 18 to 75 who did not respond to standard treatments.

All the patients received three treatments about a month apart. In the first session, patients were exposed to an hour of 50 per cent nitrous oxide and 50 per cent oxygen inhalation treatment; the second session included 25 per cent nitrous oxide; and the third session involved breathing only oxygen, with no nitrous oxide.

Out of the 20 people who completed all three treatment sessions and follow-up exams, 55 per cent experienced significant improvement in at least half their depressive symptoms and 40 per cent were no longer clinically depressed.

sleep-duration-matters

Thu May 27 20:04:58 IST 2021

PEOPLE WHO sleep six hours or less each night in their 50s and 60s are more likely to develop dementia when they are older.

For the British study published in the journal Nature Communications, the researchers followed 7,959 British adults for about 25 years.

The participants reported their sleep durations six times while they were between ages 35 and 55, and then again between the ages of 63 and 86. Among them, 521 participants developed dementia at an average age of 77.

Those who consistently slept six hours or less per night were about 30 per cent more likely to be diagnosed with dementia, compared to people who regularly slept seven hours per night.

No association was seen between sleeping for eight or more hours and dementia risk.

Exercise can minimise migraine triggers

JUST TWO-AND-A-half hours of exercise a week can reduce migraine triggers, such as stress, depression and sleep problems.

But more than 60 per cent of the people with migraine do not get enough exercise, according to a study presented at the American Academy of Neurology's Annual Meeting.

The study included 4,647 people who completed a questionnaire about their migraine characteristics, sleep, depression, stress, anxiety, and the amount of moderate to vigorous exercise they got each week.

About 75 per cent of the participants had 15 or more migraines a month, while the others had 14 or fewer. People who got less than two-and-a-half hours of moderate to vigorous exercise per week had increased rates of depression, anxiety and sleep problems.

Among people who did not exercise, 47 per cent had depression, 39 per cent had anxiety, and 77 per cent had sleep problems. Among people who exercised the most, only 25 per cent had depression, 28 per cent had anxiety, and 61 per cent had sleep problems.

People who exercised also had fewer migraines. In the no exercise group, 5 per cent had low headache frequency (zero to four headache days per month) and 48 per cent had high headache frequency (25 or more headache days per month). In the high exercise group, 10 per cent had low headache frequency and 28 per cent had high headache frequency.

Wake up to your favourite song

DO YOU WAKE UP GROGGY? You must be experiencing sleep inertia, a feeling of grogginess and lack of alertness.

Sleep inertia can last from 30 minutes up to four hours and can adversely affect our memory, decision-making and reaction time.

According to Australian researchers, setting up your favourite song as your alarm is a simple tactic that can help you wake up more alert.

To find out if waking up to music is effective, the researchers designed a special app to allow participants to wake up to different alarm sounds on their smartphone.

Once awake, they had to immediately perform a game-like task that assessed their state of alertness. The task was to touch their mobile phone screen as quickly as possible when the colour of a shape changed.

“Melodic alarm sounds resulted in participants having faster and more accurate responses, compared with a control group who woke up using classic alarm sounds without melody,” the researchers said.

The study was published in the Journal of Sleep Disorders & Therapy.

Did You Know?

A study that analysed the air quality in indoor spaces showed that in-flight aircraft cabins had the lowest levels of tiny aerosol particles, while restaurants had the highest particle levels, followed by stores, vehicles, homes and offices.

Indoor Air

An effective alternative

CRYOABLATION, OR freezing tumours, could be an effective alternative to surgery for women over 60 years with low-risk breast cancers.

“The non-invasive procedure is fast, painless and can be delivered under local anesthesia in a doctor’s office. Recovery time is minimal and cosmetic outcomes are excellent with little loss of breast tissue and no scarring,” said the study author.

In the treatment, the tumour is exposed to extreme cold to destroy it. The ICE3 clinical trial included 194 patients, aged 60 years or older, with low-risk, early-stage breast cancer. A nitrogen chilled probe was inserted through the skin directly into the tumour site, under localised anaesthesia. Freezing temperatures targeted the tumour and destroyed it. The treatment lasted 20 to 40 minutes. No serious side effects or complications were reported.

Twenty-seven patients also received radiation, 148 patients were further treated with endocrine therapy and one patient underwent chemotherapy.

Only four patients (2 per cent) had cancer recurrence during an average follow-up of nearly three years.

Compared to a lumpectomy or mastectomy, cryoablation preserves breast volume and minimises infection risk, the study author added.

The findings were presented at a meeting of the American Society of Breast Surgeons.

Did You Know?

People with abdominal obesity and excess belly fat have an increased risk of cardiovascular disease, even if they are not overweight.

Circulation

Tasty poison

EATING OUT FREQUENTLY could shorten your lifespan.

According to a study published in the Journal of the Academy of Nutrition and Dietetics, eating too much restaurant food is significantly associated with increased risk of all-cause mortality, as well as cancer and cardiovascular mortality.

Meals that are not home-cooked tend to be higher in energy density, fat, salt and refined sugars, all of which can increase the risk of obesity, diabetes and other chronic diseases.

The researchers analysed data from the US National Health and Nutritional Examination Survey 1999-2014:

35,084 adults aged 20 years or older answered questions about their dietary habits, including the frequency of eating meals prepared away from home. The researchers then analysed death records through December 2015.

There were 2,781 deaths during follow up, including 511 deaths from cardiovascular disease and 638 deaths from cancer.

Compared to people who ate less than one meal per week away from home, people who ate two or more meals per day away from home were 49 per cent more likely to die of any cause. They also had a 67 per cent increased risk of dying of cancer, and an 18 per cent greater risk of dying of cardiovascular diseases.

Common Alzheimer's drug linked to slower cognitive decline

PATIENTS WITH ALZHEIMER’S disease are often prescribed a class of drugs called cholinesterase inhibitors, which include galantamine, donepezil and rivastigmine.

But do they actually work to slow cognitive decline? A Swedish study published in the journal Neurology finds that these drugs show “persisting cognitive benefits and reduced mortality for up to five years after diagnosis.”

When a person develops Alzheimer's disease, several chemical neurotransmitters in the brain change, thus inhibiting the ability of the neurons to communicate with each other. One such neurotransmitter is acetylcholine, which plays a crucial role in cognitive functions such as memory, attention and concentration.

The researchers followed 11,652 patients treated with cholinesterase inhibitors within three months of the dementia diagnosis, and a matched control group of 5,826 untreated patients for a period of five years.

Among them, 255 patients developed severe dementia, and 6,055 patients died during the follow-up.

Those who were treated with cholinesterase inhibitors had slower cognitive decline over five years. They also had a 27 per cent lower mortality compared with the controls.

Did You Know?

Listening to the sounds of nature, like birds singing, waves lapping, and rain falling, can improve health, decrease pain, improve mood, lower stress and annoyance, and enhance cognitive performance.

Proceedings of the National Academy of Sciences

Borderline hypertension: When to start the treatment

ACCORDING TO A NEW scientific statement from the American Heart Association, published in its journal Hypertension, if lifestyle changes do not lower blood pressure within six months in people with borderline, or stage-1 high blood pressure, doctors should consider prescribing medication.

People with stage-1 high blood pressure have a systolic pressure (top number) of 130-139 or a diastolic pressure (bottom number) of 80-89. They have a low risk for heart attack or stroke within 10 years, meaning less than 10 per cent.

The statement updates the 2017 American College of Cardiology and American Heart Association’s blood pressure management guidelines, which recommend people with stage-1 hypertension to first try to lower their blood pressure with healthy lifestyle changes.

The recommended healthy behaviour to lower blood pressure includes maintaining ideal body weight, exercising, limiting sodium intake, enhancing potassium intake, limiting alcohol and not smoking. Also recommended is following Dietary Approaches to Stop Hypertension (DASH) diet, which includes fruits and vegetables, low-fat dairy products, and less saturated and total fat.

Personalised cancer vaccine shows promise

A PERSONALISED CANCER vaccine is showing promise against different cancers, including lung and bladder cancers that have a high risk of recurrence.

Researchers at the Icahn School of Medicine at Mount Sinai, New York, developed the vaccine, known as PGV-001. The vaccine was well tolerated with no safety concerns in phase 1 clinical trial, and showed potential benefits.

The personalised cancer vaccine was developed by sequencing each patient's tumour and germ-line DNA and tumour RNA. The patient's tumour-specific target was also identified to help predict whether the patient's immune system would recognise the vaccine's targets.

Following their surgery and any standard-of-care treatment, 13 patients received 10 doses of the vaccine over a six-month period: six had head and neck cancer, three had multiple myeloma, two had lung cancer, one had breast cancer and one had bladder cancer. The patients had at least a 30 per cent chance of disease recurrence.

After an average follow-up of 925 days, four patients had no evidence of cancer, four received subsequent lines of therapy, four passed away, and one patient quit the trial. The vaccine was well tolerated. About a third of patients developed minor injection-site reactions.

The findings were presented at the American Association for Cancer Research Annual Meeting 2021.

Did You Know?

Pregnant women who drink as little as half a cup of coffee a day on average may give birth to smaller babies than pregnant women who avoided caffeinated beverages.

JAMA Network Open

Covid-19 updates

GENDER APPEARS to play a significant role in the risk of death and severity of disease for Covid patients who are obese, according to a study published in the European Journal of Clinical Microbiology & Infectious Diseases.

US researchers analysed data from 3,530 Covid-19 patients who were hospitalised.

Overall, compared to patients with a normal weight, moderately obese Covid-19 patients were 44 per cent more likely to die, and those who were severely obese were nearly twice as likely to die.

While the risk for severe pneumonia, need for a ventilator and death all rose for men who were either moderately or severely obese, in women, those risks rose only for those who were severely obese.

A US study published in JAMA Network Open has found that the risk of mother-to-newborn transmission of Covid-19 is extremely low, but preterm delivery is more likely in infected mothers.

The study looked at 255 babies born to mothers with a recent positive SARS-CoV-2 test result.

Of the 88.2 per cent of babies who were tested for Covid-19, only 2.2 per cent had a positive result.

But worsening Covid-19 illness in the mothers accounted for 73.9 per cent of preterm births. Premature birth can increase the risk of several complications, including respiratory distress, chronic health problems and developmental disabilities.

twin-birth-rates-on-the-rise

Fri Apr 23 20:42:57 IST 2021

TWIN BIRTH RATES are soaring worldwide, according to a global overview published in the journal Human Reproduction.

The researchers analysed data on twin births from 165 countries between 2010 and 2015. They also looked at data from 112 countries between 1980 and 1985.

Since the 1980s, twin births have increased by more than 30 per cent, from 9 to 12 per 1,000 deliveries. Globally, about 1.6 million twins are born each year and one in every 42 babies born is a twin.

A big reason for this rise is the increase in medically assisted reproduction, including in vitro fertilisation, ovarian stimulation and artificial insemination.

Another reason is that women are delaying childbearing. The possibility of having twins increases with the mother’s age. Increased use of contraception and lower fertility overall could also play a role.

The absolute number of twin deliveries has increased everywhere except in South America. There was a 32 per cent increase in twin birthrate in Asia, and 71 per cent increase in North America. In both periods, Africa had the highest twin birth rates. Nearly 80 per cent of all twin deliveries in the world now take place in Asia and Africa.

Short-course antibiotics work well for common infections

ACCORDING TO NEW recommendations from the American College of Physicians, shorter courses of antibiotics work as effectively as the traditional 10 days or more courses, for some of the most common bacterial infections.

The recommendation addressed conditions such as bronchitis, pneumonia, skin infections (cellulitis) and urinary tract infection (UTI).

Antibiotic treatment duration should be limited to five days when managing patients with chronic obstructive pulmonary disease (COPD) and acute uncomplicated bronchitis who have clinical signs of a bacterial infection.

Patients with uncomplicated pneumonia should be treated with antibiotics for a minimum of five days. Longer treatment should be based on clinical symptoms.

UTIs can be treated with short-course antibiotics: nitrofurantoin for five days, or trimethoprim-sulfamethoxazole for three days, or fosfomycin as a single dose.

Patients with uncomplicated cellulitis can be treated with five to six days of an antibiotic that covers streptococci, a common cause of these infections.

Even though the guidelines focused on four common conditions, shorter courses could also work for other less serious infections.

But people with diabetes or compromised immune systems may still need longer courses.

Covid-vaccine safe for pregnant women

ACCORDING TO A US study published in the American Journal of Obstetrics and Gynecology, pregnant women who were vaccinated for Covid-19 had a strong immune response after vaccination and they transferred protective antibodies to the baby as well.

The researchers analysed blood samples of 27 pregnant women—who had received either the Pfizer or Moderna vaccine in their third trimester—and the umbilical cord blood of their newborns. The women had a robust immune response after vaccination, suggesting that the vaccines will protect them from Covid-19. The study also found that a longer period between vaccination and delivery was associated with a greater transfer of Covid-19 antibodies to the baby.

Only three babies in the study did not have antibodies at birth. Their mothers received their first vaccine less than three weeks before giving birth.

Survivors’ struggle

ABOUT A THIRD of Covid-19 survivors go on to develop a neurological or psychiatric diagnosis within six months of infection with the SARS-CoV-2 virus. The risk was greatest for those who were hospitalised and critically ill.

For the study published in The Lancet Psychiatry, researchers from the University of Oxford analysed electronic health records of 2,36,379 Covid-19 patients. They looked at 14 neurological and mental health disorders.

Overall, 34 per cent of patients were diagnosed with a neurological or mental health disorder following Covid-19 infection. For 13 per cent of the patients, it was their first neurological or psychiatric diagnosis.

The most commonly diagnosed disorders were anxiety (17 per cent), mood disorders (14 per cent), substance misuse disorders (7 per cent) and insomnia (5 per cent).

The risk of neurological disorders was lower—0.6 per cent for brain haemorrhage, 2.1 per cent for ischaemic stroke, and 0.7 per cent for dementia.

Exercise for improved heart health

AS MEN GROW OLDER, their testosterone levels slowly start to decline. And, often they turn to testosterone supplements.

According to an Australian study published in the journal Hypertension, while testosterone supplements can boost levels of the male sex hormone, these supplements do not improve cardiovascular health. Instead, exercise is the best way to boost arterial function and improve cardiovascular health, and prevent heart attack and stroke.

To analyse the impact of testosterone therapy and exercise on the ageing heart, the researchers recruited 78 men, aged 50 to 70 without a history of heart disease.

None of the men was on testosterone therapy and their testosterone levels ranged from low to normal.

After an initial analysis of their arterial function, the men were randomly assigned to one of four groups: aerobic and strength training exercise two to three times per week plus testosterone therapy; testosterone therapy without exercise; placebo supplements without exercise; and placebo supplements with exercise.

Testosterone levels rose in 62 per cent of men who took the supplements. But, testosterone supplements without exercise did not improve arterial function at all.

On the other hand, exercise alone boosted arterial function as well as men's natural testosterone levels.

Arterial function improved by 28 per cent among those who exercised without taking testosterone therapy compared to 19 per cent among those who exercised and took the supplements.

Did You Know?

Fast eaters tend to eat more and are more likely to gain weight and become obese.

Clinical Obesity

Dental cavities linked to stroke risk

ACCORDING TO A US study presented at the American Stroke Association's virtual International Stroke Conference, dental cavities could significantly increase the risk of stroke caused by bleeding in the brain, which can be deadly.

For the study, the researchers followed 6,506 people without stroke for 30 years. They focused on the link between cavities and intracerebral stroke, which occurs when a blood vessel in the brain bursts and causes bleeding inside the brain.

Among them, 1,227 (19 per cent) participants developed dental cavities.

For those who developed cavities, the risk of stroke was only slightly higher in the first 15 years. But their risk increased significantly in the next 15 years. Those with cavities had a 4.5 times higher risk of a stroke from brain bleed than those without cavities, in the second half of the study period, even after accounting for age, gender, race and high blood pressure.

New hope for women in early menopause

AN EXPERIMENTAL TREATMENT may help restore fertility in women who go through early menopause.

A woman’s ability to become pregnant typically ends with menopause. But according to a study published in the journal Menopause, administering platelet-rich plasma and gonadotropins near the ovarian follicles may restore ovarian function.

An estimated 12 per cent of women experience early menopause, when ovarian function ceases at or before age 45. As more women are delaying motherhood to pursue their careers, their hope of conceiving ends with early menopause.

This pilot study included 12 early menopausal women whose ovaries were injected with platelet-rich plasma and gonadotropins. Following treatment, 11 women started to menstruate again, and one became pregnant.

Pen and paper, or tablet?

FOR LEARNING AND MEMORISATION, paper and pen are better than tablets and other digital devices, according to a Japanese study published in the Frontiers in Behavioral Neuroscience.

Taking notes on paper is associated with more brain activity, and can help us remember information better than when taking notes on a tablet or smartphone. Those who take notes on paper are also 25 per cent faster than those who use digital devices.

The study was based on 48 volunteers aged 18 to 29 years who were divided into three groups based on memory skills, preference for digital or analog methods, gender, age and other factors.

The participants read a fictional conversation between characters discussing their future, including 14 different class times, assignment due dates and personal appointments.

The volunteers then recorded this schedule using either a notebook and pen, a digital tablet with a stylus, or a smartphone with touch-screen keyboard.

After an hour, the participants answered questions about the schedule. While answering the questions, the researchers measured the neuronal activity in specific brain areas based on increased blood flow using an fMRI scanner.

Participants who used pen and paper completed the task in about 11 minutes compared to 14 minutes for the tablet users and 16 minutes for the smartphone users. They also scored better than the digital device users on simple test questions.

Furthermore, volunteers who used paper had significantly more brain activity in areas associated with language, and imaginary visualisation, as well as in the hippocampus, an area associated with memory and navigation.

The activation of the hippocampus suggests that analog methods contain richer spatial details that can be recalled and navigated in the mind’s eye, said the researchers.

Did You Know?

People who work more than 55 hours a week after a heart attack are twice as likely to suffer a second heart attack compared with those who work 35 to 40 hours a week.

Journal of the American College of Cardiology

Once-a-week insulin shots are effective

AN EXPERIMENTAL once-a-week insulin injection has shown to be safe and effective at controlling blood sugar in patients with type 2 diabetes. Phase 2 clinical trials of the new drug called Basal Insulin Fc (BIF) was just as effective as the standard once-a-day Basal Insulin degludec.

The 32-week trial included 399 patients who had type 2 diabetes. The patients were randomly assigned to once-a-week injections of BIF at one of two different doses or the standard once-daily injections of insulin degludec.

Long-term blood glucose control as measured by haemoglobin A1c was similar for patients taking the weekly shots and for those taking the daily shots. The participants had an average A1c of 8.1 per cent at the start of the study. At the end of the study, patients on BIF had an average improvement in A1c of 0.6 per cent compared to 0.7 per cent for those on insulin degludec.

Moreover, the risk of hypoglycaemia, or dangerously low blood sugar, was significantly lower in patients taking BIF compared to insulin degludec.

Did You Know?

Eating your breakfast before 8.30am may reduce your risk for developing type 2 diabetes.

Study presented at the Endocrine Society's annual meeting

Is breastfeeding safe for Covid-infected mothers?

ACCORDING TO A STUDY published in the journal mBio, Covid-19 infected breastfeeding mothers do not transfer the SARS-CoV-2 virus through their breast milk. Furthermore, the study found that Covid-19 antibodies appear to pass from mother to child through breastmilk.

The researchers analysed 37 milk samples from 18 Covid-positive women. None of the samples showed any signs of carrying the coronavirus. However, nearly two-thirds did contain two types of Covid-19 antibodies.

“These results support recommendations to continue breastfeeding during mild-to-moderate maternal Covid-19 illness as milk likely provides specific immunologic benefits to infants,” the study concluded.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

suicide-inducing-media

Fri Mar 26 15:33:19 IST 2021

GIRLS WHO SPENT too much time on social media have an increased risk for suicide.

For the study published in the Journal of Youth and Adolescence, the researchers tracked social media habits and suicide risk among 500 teenage boys and girls for 10 years. The participants were 14 years on average at the start of the study.

Girls who started using social media for at least two to three hours a day at age 13 and then increased their use over time had the highest risk for suicide risk in emerging adulthood.

However, no such pattern was seen among boys.

“Research shows that girls and women, in general, are very relationally attuned and sensitive to interpersonal stressors, and social media is all about relationships,” said the study author.

Thirteen-year-olds may not be developmentally ready to handle the darker side of social media such as cyberbullying, fear of missing out and constant comparisons, she explained.

Benefits of clinical breast examination

BREAST CANCERS are often detected in advanced stages in low and middle-income countries, and death from breast cancer is steadily rising, while breast cancer mortality is decreasing in developed countries.

Led by Dr Indraneel Mittra from the Tata Memorial Hospital, Mumbai, a new study sought to compare the effectiveness of screening by clinical breast examination in earlier diagnosis and reduced mortality, with no screening.

The study published in The BMJ was based on medical records of 1,51, 538 women aged 35 to 64, with no history of breast cancer, living in slum areas. The women were randomly assigned to 10 screening and 10 control groups, and were followed for 20 years.

The women in the screening group (75,360) received four screening rounds of clinical breast examination conducted by trained female primary health workers and cancer awareness information every two years, followed by five rounds of active surveillance every two years.

The women in the control group (76,178) received one round of cancer awareness followed by eight rounds of active surveillance every two years.

Breast cancer was detected at an earlier age in the screening group than in the control group. Among women who developed breast cancer, there was a significant reduction in the proportion of women with more advanced disease in the screening group compared to the control group (37 per cent vs 47 per cent).

Breast cancer mortality was 15 per cent lower in the screening group across all ages. However, among women aged 50 and older, there was a 30 per cent reduction in breast cancer mortality.

A 5 per cent reduction in all-cause mortality was also seen in the screening group.

Prediabetes is a predictor

PEOPLE WITH PREDIABETES may have an increased risk of cognitive decline and vascular dementia, according to a British study published in the journal Diabetes, Obesity and Metabolism.

People with prediabetes have blood sugar levels that are higher than normal, but not high enough to be diagnosed with type 2 diabetes. They have an increased risk of developing diabetes.

The researchers analysed data from 5,00,000 people aged 58 years on average. They were divided into five groups based on their blood sugar levels: low-normal, normal, prediabetes, undiagnosed diabetes and diabetes.

People with prediabetes were 42 per cent more likely to experience cognitive decline over an average of four years and were 54 per cent more likely to develop vascular dementia over an average of eight years compared to people with normal blood sugar levels. However, prediabetes was not associated with an increased risk of Alzheimer's disease.

MRI scans showed that prediabetes was associated with having lesions on the brain and a slightly smaller hippocampus—both associated with age-related cognitive decline.

Exercise regularly to survive a heart attack

PEOPLE WHO EXERCISE regularly are more likely to survive a heart attack, according to a study published in the European Journal of Preventive Cardiology.

To study the impact of an active versus sedentary lifestyle on the risk of death after a heart attack, the researchers used data from 28,140 patients who suffered a heart attack.

Based on their weekly level of physical activity, the participants were categorised as sedentary, low, moderate, or high.

Among them, 4,976 (17.7 per cent) patients died within 28 days of their heart attack. Of these, 3,101 (62.3 per cent) died instantly.

Overall, patients who were physically active had a lower risk of death instantly and within 28 days. Patients with high levels of leisure-time physical activity had a 45 per cent lower risk of immediate death and a 28 per cent lower risk of death within 28 days of a heart attack compared to sedentary patients.

The risk of immediate death was 33 per cent lower for those who had engaged in moderate levels of activity. At 28 days, they had a 36 per cent lower risk of death.

Chronic heartburn linked to oesophageal and laryngeal cancers

PEOPLE WITH GASTROESOPHAGEAL reflux disease (GERD), or chronic heartburn, may have an increased risk of developing cancers of the oesophagus or larynx, according to a US study published in the journal Cancer.

The findings were based on 4,90,605 US adults aged 50 to 71 at the outset. About a quarter of the participants had GERD.

Over about 16 years of follow up, there were 931 cases of oesophageal adenocarcinoma, 876 cases of laryngeal cancer and 301 cases of oesophageal squamous cell carcinoma.

Overall, people with GERD were about twice as likely to develop one of the three cancers compared to people without GERD, after accounting for smoking, alcohol intake and gender.

Chronic exposure of the oesophagus to gastric acid and other digestive enzymes can damage the oesophageal tissue, which could potentially lead to cancer.

Did You Know?

Older adults who get five or fewer hours of sleep per night have twice the risk of developing dementia or dying of all causes.

Aging

Eat five servings of fruits and veggies

FIVE SERVINGS OF FRUITS and vegetables a day can help you live longer. Two servings of fruit and three servings of vegetables a day is the optimal balance.

For the study published in the journal Circulation, US researchers analysed data from about 2 million people from 29 countries.

Eating about five servings of fruits and vegetables daily was associated with the lowest risk of death.

Compared to participants who had two servings of fruit and vegetables per day, those who had five servings a day had a 13 per cent lower risk of death from all causes; a 12 per cent lower risk of death from cardiovascular disease, including heart disease and stroke; a 10 per cent lower risk of death from cancer; and a 35 per cent lower risk of death from respiratory disease, such as chronic obstructive pulmonary disease.

Eating about two servings of fruits and three servings of vegetables per day was associated with the lowest mortality.

However, eating more than five servings a day did not provide any additional benefits.

Did You Know?

Having more than seven servings of refined grains per day was associated with a 27 per cent greater risk for early death, 33 per cent greater risk for heart disease and 47 per cent greater risk for stroke.

The BMJ

Eyes carry signs

ACCORDING TO A STUDY presented at the American Stroke Association’s International Stroke Conference 2021, people with the eye disease retinopathy have an increased risk of stroke, dementia and early death.

The study included 5,543 adults with an average age of 56 years who were followed for nearly 10 years. The participants provided their medical history and had retinal scans to look for signs of retinopathy; 696 participants had retinopathy, 289 had stroke, and 597 had dementia.

Compared to participants without retinopathy, those with retinopathy were more than twice as likely to have had a stroke and almost 70 per cent more likely to have dementia.

They were also more likely to die during the follow up. The risk of death increased one to three times depending on the severity of retinopathy.

The increased risk remained even after accounting for age and vascular risk factors such as diabetes and high blood pressure.

BCG vaccination may protect babies from other infectious diseases

THE TUBERCULOSIS VACCINE, Bacillus Calmette-Guérin (BCG), could also protect newborns from a number of other common infections, such as upper respiratory tract infections, chest infections and diarrhoea, according to a British study published in the journal The Lancet Infectious Diseases.

The study included 560 healthy newborns in Uganda who were randomly assigned to receive BCG at birth or at six weeks of age and were followed up for 10 weeks.

The researchers took blood samples from all the infants to examine their immune system.

At six weeks, infection rates from any disease were 25 per cent lower in the group who received the vaccine at birth compared to the delayed vaccination group. Infants who were especially vulnerable, such as low birth-weight babies, and boys, appeared to be protected the most. The vaccine protected against mild, moderate and severe types of infections.

After the delayed vaccination group received BCG at six weeks, there was no difference in the rates of infection between the two groups, suggesting that the infants in the delayed group quickly “caught up” once they received the vaccine.

About a million babies die each year of common infections. Vaccinating all babies on the day of birth with BCG could reduce neonatal infections and death, especially in countries with high rates of infectious disease, potentially saving thousands of lives, the research team noted.

Did You Know?

Women who were diagnosed with type 1 diabetes before they started having periods have a shorter reproductive lifespan and are at risk for premature ovarian ageing. They start menstruating later and enter menopause earlier.

Menopause

Covid-19 updates

A FRENCH STUDY of 2,796 hospitalised diabetic Covid-19 patients, published in the journal Diabetologia, found that 21 per cent of patients died within 28 days of admission, while 50 per cent were discharged.

Patients who regularly took insulin, indicating more advanced diabetes, had a 44 per cent higher risk of death than those not treated with insulin.

An asymptomatic Covid-19 person can infect others by simply talking. Japanese researchers report in the journal Physics of Fluids that the virus can spread through small aerosol droplets in their exhaled breath.

The researchers recommend wearing both a mask and a face shield when providing services to customers in face-to-face customer service settings, such as in hair salons, medical exam rooms, or long-term care facilities.

Being overweight is the second greatest predictor, after old age, of hospitalisation and higher risk of death from Covid-19.

According to researchers from the World Obesity Federation, nearly 90 per cent or 2.2 million of the 2.5 million Covid-19 deaths reported by the end of February 2021 have taken place in countries such as the United Kingdom, Italy and United States, where over half the population is classified as overweight.

People who are obese should be prioritised for Covid-19 vaccines and testing, according to the researchers.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

night-sign

Wed Feb 24 17:00:55 IST 2021

HIGHER BLOOD PRESSURE at night compared to this day can increase the risk of Alzheimer’s disease in older men.

Blood pressure varies over 24 hours and is typically lower at nighttime. But in some people, this pattern is reversed, and they have higher blood pressure at night, which is called reverse dipping.

Nighttime is also important for human brain health and blood pressure is one of the risk factors for Alzheimer's and other types of dementia.

For the study published in the journal Hypertension, the researchers used data from 997 Swedish men, who were followed for a maximum of 24 years. The men were in their early seventies at the start of the study.

There were 286 cases of dementia during the study period.

Men with reverse dipping had a 1.64 times greater risk of dementia, especially Alzheimer’s disease, compared to those with normal dipping.

An afternoon nap helps the brain

A CHINESE STUDY published in the journal General Psychiatry suggests that afternoon nap may improve mental agility.

The study was based on 2,214 healthy adults aged at least 60 years. Among them, 1,534 took regular afternoon naps, while 680 did not. The participants in both groups averaged 6.5 hours of nighttime sleep.

Those who took regular afternoon naps had a better cognitive function and scored higher than those who did not take naps, especially on locational awareness, verbal fluency and memory.

Sleep regulates the body’s immune response and regular naps may help reduce inflammation.

Extra pounds may help

ACCORDING TO A US STUDY published in the journal Annals of Epidemiology, people who enter adulthood with a normal weight and go on to become overweight, but not obese, as they grow older, tend to live the longest.

The researchers analysed data on 4,576 people and 3,753 of their children, from age 31 to 80. The participants in the older generation were followed from 1948 through 2010. Their children were followed from 1971 to 2014.

Almost all the members of the older generation had died by the end of the study, which helped the researchers understand better the link between BMI and mortality.

Across both generations, those who started at a normal weight at age 31 and moved on to become overweight later in the life lived the longest. Those who stayed at a normal weight throughout their life had the second-longest lifespan.

Those who started as obese and continued to gain weight had the shortest lifespan.

Did You Know?

Mindfulness-based stress reduction (MBSR) therapy can help men control their anger and reduce intimate partner violence, including sexual, physical, psychological or emotional violence.

BMC Psychiatry

Insulin may not need refrigeration

INSULIN VIALS can be stored without refrigeration for four weeks, even in hot weather.

The current pharmaceutical protocol requires insulin vials to be stored between 2° and 8 °C until opened, and then at 25 °C for 4 weeks. This is not always viable in poor, tropical regions and refugee camps where people may not have refrigerators and the temperature can get very hot.

So, people with diabetes often have to go to a hospital every day to get their insulin injections, which could make it difficult for them to go to work.

Researchers from Doctors Without Borders and the University of Geneva tested insulin storage in real conditions ranging from 25 °C to 37 °C for four weeks, the time it typically takes to use a vial of insulin.

The findings published in the journal PLOS ONE showed that the structural integrity and stability of insulin stored in fluctuating temperatures were the same as those stored in cold temperatures, with no impact on efficacy. Insulin stored at fluctuating temperatures as well as those kept in cold storage lost no more than one per cent in potency. Pharmaceutical regulation allows a loss of up to five per cent.

High-risk patients

COVID-19 PATIENTS who have gum disease are nine times more likely to die. They also have a higher risk of needing ventilators and being admitted to intensive care units.

For the study published in the Journal of Clinical Periodontology, researchers examined the health records of 568 patients diagnosed with Covid-19.

Of the 258 patients who had periodontitis, a severe form of gum disease, 33 experienced Covid-19 complications compared to only seven of the 310 patients without periodontitis.

Covid-19 patients with gum disease were 8.81 times more likely to die compared to those without gum disease. They were also 3.54 times more likely to be admitted to intensive care units and 4.57 more likely to need ventilators.

Overall, patients with gum disease were 3.67 times more likely to suffer from severe Covid-19 complications.

Gum disease can be a sign of inflammation and systemic inflammation is also a symptom of Covid-19.

New hope for weight loss

A new weight-loss drug could be a game-changer for people who struggle with obesity.

The drug, semaglutide, was almost twice as effective as the current medications in helping people lose weight, according to a study published in the New England Journal of Medicine.

The weekly injectable 2.4 milligram dose of semaglutide works by reducing hunger and calorie intake.

The 68-week study included 1,961 overweight or obese adults from 16 countries.

The participants started with an average weight of 230 lb and a body mass index of 38 kg/m2.

Participants who got semaglutide shots had an average weight loss of 14.9 per cent compared to 2.4 per cent for the placebo group.

Semaglutide proved to be about 1.5 to two times more effective than other weight-loss drugs, which helps people lose between 6 to 11 per cent of their body weight.

One-third of the participants lost 20 per cent (46 lb) of their body weight, which is comparable to what those who have undergone weight-loss (bariatric) surgery lose.

Participants treated with semaglutide also reported better physical functioning, like walking faster and climbing stairs with less pain. They also saw improvements in their blood pressure, cholesterol and blood glucose control.

Did You Know?

Wearing tight-fitting masks that prevent leakage from the mask’s edges by double masking, or wearing a cloth mask over a medical mask, and knotting the ear loops and then tucking in and flattening the extra material close to the face, can cut Covid-19 transmission by 95 per cent.

Morbidity and Mortality Weekly Report

Harm from hand sanitisers

WIDESPREAD use of hand sanitisers to prevent the spread of Covid-19 may be causing eye injuries among children, according to a French study published in JAMA Ophthalmology.

The injury is often caused by accidentally spraying the liquid into the eye or rubbing the eyes before the sanitiser has fully evaporated.

Exposure to small amounts of hand sanitisers is not worrisome. But if large amounts of hand sanitiser get into the eye, it can lead to more severe complications such as keratitis (inflammation of the cornea) or corneal abrasions (scratch on the surface of the eye).

The researchers reviewed data collected by the French Poison Control Centers and a paediatric ophthalmology hospital in Paris on accidental eye injuries and emergency calls related to exposure to hand sanitiser among children under 18 in 2019 and 2020.

Cases related to eye injuries increased sevenfold from April to August in 2020 compared to the same period in 2019.

Did You Know?

Women who drink coffee during pregnancy are more likely to have kids with behavioural problems, including attention difficulties and hyperactivity.

Neuropharmacology

Prediabetes is a predictor

PEOPLE WITH PREDIABETES have an increased risk of heart attack and stroke. A person with prediabetes has blood sugar levels that are higher than normal but below the levels required for a diagnosis of diabetes.

According to a study published in the Journal of the American Heart Association, people who reverse their prediabetes can lower their risk of heart attack, stroke and death from any cause.

The Chinese study included 14,231 participants, average age 58 years, without cardiovascular disease. The participants’ blood sugar was checked in 2006, and again in 2008.

From 2006 to 2008, about 45 per cent of the participants reverted from prediabetes to normal blood sugar; about 42 per cent stayed the same, and 13 per cent progressed to diabetes.

During an average follow up of about nine years, there were 713 cases of stroke, 180 cases of myocardial infarction and 941cases of all‐cause mortality.

Participants who reverted to normal blood sugar from prediabetes had a 38 per cent lower risk of heart attack, a 28 per cent lower risk of ischaemic stroke and an 18 per cent lower risk of dying of any cause compared to those who progressed to diabetes.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

covid-19-updates

Fri Jan 29 14:16:31 IST 2021

PATIENTS WITH ACUTE heart failure may be nearly twice as likely to die if they get Covid-19, according to the study published in the journal ESC Heart Failure. The study highlights the need for heart failure patients to take all the necessary precautions to avoid getting Covid-19 as well as prioritising them for vaccination.

Diabetic patients who take a class of drugs known as sodium-glucose co-transporter 2 inhibitors have an increased risk for a potentially fatal complication called diabetic ketoacidosis if they contract Covid-19, according to a study published in the journal AACE Clinical Case Reports. The study authors recommend avoiding these medications during SARS-CoV-2 infection.

PRESSURE PERIL

EVEN SLIGHTLY ELEVATED blood pressure in middle and older age can accelerate memory loss and cognitive problems, according to a Brazilian study published in the journal Hypertension.

The researchers analysed blood pressure and cognitive health information of 7,063 adults whose average age was about 59 years at the start of the study. Cognitive function rapidly declined for participants regardless of whether hypertension started in middle age or older age. The faster declines were evident even in participants with prehypertension, a condition of slightly elevated blood pressure, and even if they had high blood pressure only for a short duration.

Those with uncontrolled hypertension showed a faster decline in memory and cognitive function compared to adults who controlled their blood pressure with medication.

The good news: effectively treating high blood pressure with medication and lifestyle changes at any age reduced or prevented this acceleration.

SLEEP WELL FOR A SAFE HEART

PEOPLE WHO HAVE healthy sleep habits are less likely to suffer from heart failure.

To examine the relationship between healthy sleep habits and heart failure, the researchers analysed data on 4,08,802 adults aged 37 to 73. Each participant was given a “healthy sleep score” of 0 to 5 based on five healthy sleep practices: sleeping seven to eight hours per night, not snoring, no frequent insomnia, no excessive daytime sleepiness, and rising in the morning.

There were 5,221 cases of heart failure during a median follow-up of 10 years. Participants with the healthiest sleep patterns (score of 5) had a 42 per cent lower risk of heart failure compared to people with an unhealthy sleep pattern, even after accounting for other risk factors such as diabetes, hypertension, smoking and alcohol use, and genetic variations.

The risk of heart failure was also independently associated with each sleep habit: 8 per cent lower in early risers; 12 per cent lower in those who slept 7 to 8 hours daily; 17 per cent lower in those who did not have frequent insomnia; and 34 per cent lower in those reporting no daytime sleepiness.

FIVE-STEP FIGHT

FOLLOWING A FIVE-STEP lifestyle plan can considerably ease the symptoms of gastroesophageal reflux disease (GERD), also known as chronic heartburn, and reduce, or even eliminate, the need for medications in people suffering from the condition.

The five-step diet and lifestyle factors include avoiding smoking, maintaining a healthy weight, exercising regularly, eating healthy, and limiting coffee, tea and sodas to two cups daily.

The study published in the journal JAMA Internal Medicine included data from almost 43,000 women aged 42 to 62 who answered questions about heartburn symptoms from 2005 to 2017.

Those who adhered to all five factors reduced GERD symptoms by 37 per cent. The more factors they adhered to, the lower their risk of symptoms. Following the guidelines also reduced symptoms in women taking common heartburn medications.

TEST YOUR HEART HEALTH

IF YOU CAN climb four flights of stairs in less than a minute, your heart is in good shape. But if it takes you more than one-and-a-half minutes to ascend four flights of stairs, your health is suboptimal, and it would be a good idea to consult a doctor, says a study presented at the meeting of the European Society of Cardiology.

The study included 165 patients who had been referred for exercise testing. All of them had known or suspected coronary artery disease.

The participants first walked or ran on a treadmill, the intensity gradually increasing and continuing until they became exhausted. Their exercise capacity was measured as metabolic equivalents (METs), which has been linked to mortality rate.

After resting for 15 to 20 minutes, the patients were asked to climb four flights of stairs (60 stairs) at a fast pace without stopping, but also without running. The researchers then compared the patients’ METs achieved during exercise testing and the time it took for them to climb four flights of stairs.

Those who climbed the stairs in less than 40–45 seconds achieved more than nine METs. Ten METs during an exercise test is linked with a low mortality rate (1 per cent or less per year, or 10 per cent in 10 years).

However, those who took 1.5 minutes or longer to climb the stairs achieved less than eight METs, which translates to a mortality rate of 2–4 per cent per year, or 30 per cent in 10 years.

Did You Know?

Just one alcoholic drink (120ml glass of wine, 330ml of beer or 40ml of spirits) a day was linked to a 16 per cent increased risk of atrial fibrillation.

European Heart Journal

DO MULTIVITAMINS REALLY MAKE YOU HEALTHY?

THE HEALTH BENEFITS of multivitamins may all be in the mind of the users. However, a US study published in the journal BMJ Open did not find any clinically measurable health benefits when people who took multivitamins without known vitamin or mineral deficiencies were compared to non-users.

The researchers analysed data on 21,603 adults; 4,933 of the participants regularly took multivitamin/mineral supplements, while 16,670 respondents did not.

Multivitamin users considered themselves healthier than nonusers. They self-reported 30 per cent better overall health than nonusers. But there was no difference between those who did and did not take the supplements in the history of 10 chronic conditions like hypertension, diabetes, asthma and arthritis; the presence of 19 common health conditions, including infections, memory loss, neurological and musculoskeletal problems; severity of current psychological distress and rates of needing help with daily activities.

YOUNG, WILD AND LONELY

SURPRISING RESULTS OF a study, published in the Journal of Clinical Psychiatry, has found that young adults in the 20s are the loneliest, while people in the 60s are the least lonely.

The findings were based on a survey of 2,843 participants, aged 20 to 69 years, from across the United States, in 2019.

Levels of loneliness were highest in the 20s, followed by the mid-40s, and lowest in the 60s.

People in the 20s usually face high stress while trying to establish a career and find a life partner.

“A lot of people in this decade are also constantly comparing themselves on social media and are concerned about how many likes and followers they have. The lower level of self-efficacy may lead to greater loneliness,” says the study author.

Lower levels of empathy and compassion, smaller social circles, lack of a spouse or a partner, and sleep problems were predictors of loneliness across all age groups. On the contrary, compassion appeared to reduce the level of loneliness at all ages.

Did You Know?

For every hour of a delay from the onset of heart attack symptoms to an artery-clearing procedure called angioplasty, the risk of death or hospitalisation for heart failure within a year rose 11 per cent.

Circulation: Cardiovascular Intervention

AGE MYTH BURSTS

AGE MAY NOT be a factor in the success of vasectomy reversal.

A US study published in the journal Urology finds that men over 50 who undergo a vasectomy reversal procedure have the same rate of pregnancy with their partners as those under 50.

For the study, the researchers analysed the results of vasectomy reversal in 2,777 men over 50 and 353 men under 50. All the procedures were performed by the same surgeon.

The partners of 33.4 per cent of the younger group and 26.1 per cent of the older group got pregnant after the procedure.

The odds of successful pregnancy were higher when the woman was under 35 and/or the man had the vasectomy less than 10 years ago, and lower if the man was smoking.

According to the researchers, one reason why older men were usually not as successful as younger men in reaching pregnancy was because older men tend to have older female partners.

Did You Know?

Participants given a cocoa drink enriched with flavanols performed 11 per cent faster on cognitive tasks than when drinking a non-flavanol enriched-drink.

Scientific reports

FAN THERAPY FOR HELP

MANY ADVANCED CANCER patients suffer from dyspnea or shortness of breath.

Blowing air from a fan into the face of patients with advanced cancer was more effective in easing breathlessness than other pharmacologic interventions, according to a US study published in the journal JAMA Oncology.

The conclusion was drawn from a review of 29 clinical trials involving 2,423 adults with advanced cancer who suffered from breathlessness.

Nonpharmacological interventions that helped ease breathlessness in hospitalised patients included fan therapy and bi-level ventilation (air pressure delivered through a face mask covering the mouth and nose). Both therapies provided relief lasting from a few minutes to a few hours.

For outpatients, acupressure and reflexology, as well as interventions that combined activity and rehabilitation with behavioural, psychosocial and integrative medicine provided relief lasting for a few weeks to months.

On the contrary, medications such as opioids and anti-anxiety drugs had limited impact in improving breathlessness and can cause side effects such as drowsiness and constipation.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

covid-19-updates

Sat Dec 26 12:04:40 IST 2020

PATIENTS WITH COVID-19 are more likely to develop psychiatric disorders. And, having a psychiatric disorder can increase the risk of getting Covid-19.

One in five Covid-survivors received a diagnosis of anxiety, depression, or insomnia within three months of testing positive for SARS-CoV-2. People with a pre-existing psychiatric diagnosis were 65 per cent more likely to be diagnosed with Covid-19 than those without. The findings were published in The Lancet Psychiatry.

The WHO is not recommending the use of the antiviral drug remdesivir for patients with Covid-19 because the drug has not shown any effective impact on survival, the need for ventilation or time to clinical improvement. The WHO guideline on drugs for Covid-19 was published in The BMJ.

According to a study published in Science Advances the best way to limit transmission (apart from wearing a mask) while travelling in a taxi or other ride-sharing modes of commute is to keep all four windows down and have the passenger sit in the back on the opposite side from the driver.

An Archives of Disease in Childhood study suggests that healthier blood vessels and a stronger immune system are likely the factors that protect children from severe Covid-19.

CHEAP DIAGNOSIS

THE FIRST BLOOD test that can help diagnose Alzheimer’s disease goes on sale in the US, even though it has not received approval from the US Food and Drug Administration.

Developed by C2N Diagnostics, the PrecivityAD™ test measures the concentrations of two types of amyloid particles as well as the presence of apolipoprotein E isoforms in the blood. The results are then combined with other data such as a person’s age to determine their risk of having amyloid buildup in the brain, which is a hallmark of Alzheimer’s disease.

The blood test report includes a score that shows a low, intermediate or high probability of having amyloid plaques in the brain.

The blood test is intended only for people 60 or older suffering from thinking and memory problems.

According to the company, in a study of 686 patients, aged 60 and older, with cognitive impairment or dementia, the blood test correctly identified brain amyloid plaque buildup in 86 per cent of the patients when the results were compared with PET scans.

The best method to diagnose Alzheimer’s is a PET scan which can be very costly. The blood test is cheap and non-invasive and can be easily accessible.

MEAL TIMINGS MATTER

ACCORDING TO A STUDY presented at the American Heart Association's Scientific Sessions conference, inconsistent meal times can negatively impact your cardiovascular health.

Greater meal time inconsistency is associated with higher body mass index, waist circumference, blood pressure and fasting glucose.

The findings were based on a study of 116 women aged 20 to 64. The women recorded their meal timings and diet for a week using an electronic food diary.

The researchers looked at day-to-day changes in eating timing, duration of the eating period, evening eating and differences in eating patterns on weekdays versus weekends.

Each one hour increase in the difference between first meal time on weekdays compared to weekends was associated with higher body mass index, diastolic blood pressure and systolic blood pressure.

Each one hour increase in the difference between weekdays vs weekend nightly fasting duration was associated with higher body mass index, fasting glucose and systolic blood pressure. Greater inconsistency in nighttime eating was associated with higher waist circumference.

WORLD'S NO 1 KILLER

CARDIOVASCULAR DISEASES, especially ischaemic heart disease and stroke, are the leading cause of death worldwide, accounting for one-third of all deaths globally in 2019, according to review published in the Journal of the American College of Cardiology.

The review was based on data from The Global Burden of Diseases, Injuries, and Risk Factors Study 2019, which examined all “available population-level data sources on incidence, prevalence, case fatality, mortality and health risks to estimate measures of population health for 204 countries and territories”.

Cardiovascular disease cases nearly doubled from 271 million in 1990 to 523 million in 2019. The number of cardiovascular disease deaths also steadily increased from 12.1 million in 1990 to 18.6 million in 2019.

Most of the cardiovascular disease deaths were from ischaemic heart disease and stroke.

In 2019, 9.6 million men and 8.9 million women died from cardiovascular diseases. More than 6 million of these deaths occurred in people between the ages of 30 and 70.

The number of years lived with heart disease-related disability doubled to 34.4 million in 2019 from 17.7 million in 1990.

NOT FIT FOR CHILDREN

GIVING CHILDREN ANTIBIOTICS before age two can increase their risk of several chronic conditions, including asthma, hay fever, food allergies, eczema, celiac disease, obesity and attention deficit hyperactivity disorder.

For the study published in the journal Mayo Clinic Proceedings, the researchers followed 14,572 children born between 2003 and 2011, for nearly eight years.

Among them, 70 per cent were given at least one antibiotic prescription during their first two years, with most receiving multiple antibiotics.

The association varied with the gender, and number, type and timing of antibiotic exposure. The risk was greatest when babies were exposed to antibiotics within the first six months. The risk increased when kids were exposed to several courses of antibiotics.

The risk also differed with different antibiotics. Use of cephalosporins was associated with the highest risk for multiple health conditions.

Girls exposed to antibiotics were more susceptible to eczema and celiac disease, while boys were more susceptible to obesity.

Early exposure to antibiotics could alter the baby’s microbiome during critical developmental periods which can have long-term health consequences.

DID YOU KNOW?

Regular participation in organised sports could help reduce behavioural problems in young boys with development delays.

The Journal of Pediatrics

VULNERABLE STAGES

WHILE ALCOHOL CONSUMPTION can be harmful throughout a person’s life, Australian and British researchers have identified three life stages when the brain is most susceptible to the damaging effects of alcohol.

The negative effects of alcohol are most prominent during gestation (from conception to birth), later adolescence (15-19 years), and older adulthood (over 65 years)—three periods when the brain is going through dynamic changes.

Heavy alcohol use during pregnancy can cause foetal alcohol spectrum disorder, which can lead to reductions in brain volume and cognitive impairment. Even low or moderate alcohol consumption is associated with poorer psychological and behavioral outcomes in offspring.

Binge-drinking in adolescence is associated with reduced brain volume, poorer white matter development (critical for efficient brain functioning), and a range of cognitive functioning issues.

In older people, alcohol use is one of the strongest modifiable risk factors for all types of dementia, especially early onset, compared with other known risk factors such as high blood pressure and smoking.

Even moderate drinking can lead to significant brain shrinkage in midlife. The study was published in The BMJ.

DID YOU KNOW?

Eating tree nuts, such as almonds, hazelnuts and walnuts, daily can improve sperm quality.

Andrology

THE END OF INSULIN SHOTS?

A GROUNDBREAKING procedure could help people with type 2 diabetes stop insulin therapy.

Researchers from the Netherlands used the minimally-invasive procedure—Duodenal Mucosal Resurfacing—which rejuvenates the lining of the duodenum, in combination with daily doses of a class of diabetes medication called glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and lifestyle counselling.

During DMR, an endoscope is used to resurface, or ablate, the lining of the duodenum, the first part of the small intestine that is connected to the stomach.

The preliminary study included 16 patients who underwent DMR. The participants had type 2 diabetes for an average of 11 years and had been on insulin for about three years.

Six months after the procedure, 75 per cent of the patients no longer needed insulin. At 12 months, their average A1C levels (average blood glucose levels over three months) fell to 6.7.

The average body mass index of patients who responded to the treatment fell from 29.8 to 25.5 after 12 months. The percentage of fat in their liver also dropped from 8.1 per cent to 4.6 per cent at six months.

Patients who still needed insulin after the procedure were able to reduce their insulin dose by more than half—from 35 units per day at the start of the study to 17 units per day at 12 months.

DID YOU KNOW?

Long-term androgen deprivation therapy was associated with an almost four-fold increased risk of cardiovascular mortality and reduced cardiorespiratory fitness in prostate cancer patients with high risk of cardiovascular disease.

JACC: CardioOncology

DELAYED FERTILITY AFTER STOPPING CONTRACEPTION

HOW LONG WILL it take for fertility to return after women stop using contraceptives?

To find out, researchers examined data from 17,954 Danish and American women. The women provided information about their contraceptive history, as well as personal, medical, and lifestyle information, at the start of the study and then answered follow-up questionnaires every two months for up to 12 months or until they became pregnant.

The most commonly used method of contraception was oral contraceptives, followed by barrier methods and natural methods. About 13 per cent of the women used long-acting reversible contraceptive methods, such as IUDs and injectable contraceptives.

Almost 56 per cent of women conceived within six menstrual cycles of stopping contraceptives, and 77 per cent within twelve cycles. Return to fertility varied depending on the contraceptive method used. Women who used injectable contraceptives had the longest delay in return of normal fertility (five to eight cycles), followed by users of patch contraceptives (four cycles), users of oral contraceptives and vaginal rings (three cycles), and users of hormonal and copper intrauterine devices and implant contraceptives (two cycles).

The study was published in The BMJ.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

chili-pepper-is-a-life-saver

Tue Nov 24 15:34:23 IST 2020

ACCORDING TO A study presented at the American Heart Association’s Scientific Sessions 2020, people who regularly include chili peppers in their diet have a significantly reduced risk of death from cardiovascular disease, cancer and other causes.

Previous studies have shown that capsaicin, an active component in chili peppers that makes them spicy, has anti-inflammatory, antioxidant, anticancer and blood-glucose regulating properties.

Researchers at the Cleveland Clinic in the US analysed four large studies that included health and dietary records of more than 5,70,000 people in the United States, Italy, China and Iran. They compared the health outcomes of those who consumed chili peppers with those who rarely or never did.

People who ate chili peppers had a 26 per cent reduction in death from cardiovascular diseases; a 23 per cent reduction in cancer-related deaths; and a 25 per cent reduction in death from all illnesses, compared to people who rarely or never ate chili peppers.

DELAYING TREATMENT IS DANGEROUS

DELAYING CANCER TREATMENT by just four weeks can increase the risk of dying from it by about 10 per cent, according to a study published in The BMJ. The risk of death increases the longer the treatment is delayed.

As part of the study, Canadian and UK researchers looked at the impact of delaying treatments such as surgery, chemotherapy or radiotherapy on a person’s mortality risk for seven types of cancer—bladder, breast, colon, rectum, lung, cervix, and head and neck. Together, these cancers account for 44 per cent of all cancers globally.

The researchers examined 34 studies involving more than 1.2 million patients. A month’s delay across all forms of cancer treatment was associated with a 6 per cent to 13 per cent higher risk of death.

For surgery, there was a 6 to 8 per cent increase in the risk of death for every month treatment was delayed.

There was a 9 per cent increased risk of death if radiotherapy was delayed for head and neck cancer, and delay in follow up chemotherapy for colorectal cancer increased the risk of death by 13 per cent.

Delays of up to eight and 12 weeks increased the risk of death further. An eight-week delay in breast cancer surgery increased the risk of death by 17 per cent, and a 12-week delay increased the risk by 26 per cent.

NOCTURNAL BLOOD PRESSURE, AN INDICATOR

CHANGES IN NIGHTTIME blood pressure could increase the risk of heart disease and stroke, according to a Japanese study published in the journal Circulation.

The study included 6,359 Japanese adults, average age 69. About three quarters of the participants were on blood pressure lowering medications, but none had a symptomatic cardiovascular disease at the start of the study.

The participants had 20 daytime and seven nighttime ambulatory blood pressure readings. During a mean follow up of 4.5 years, there were a total of 306 cardiovascular events, including 119 strokes, 99 diagnoses of coronary artery disease and 88 diagnoses of heart failure.

The researchers analysed the occurrence and timing of heart events in relation to blood pressure variations.

When nighttime systolic blood pressure increased by 20mmHg compared to daytime systolic reading, the risk of heart disease and stroke increased by 18 per cent and the risk of heart failure increased by 25 per cent.

Participants who had higher blood pressure readings at night, but normal readings during the day, had a 48 per cent greater overall cardiovascular disease risk and more than twice the risk of heart failure.

DID YOU KNOW?

After one member in a household becomes sick with Covid-19, about 53 per cent of others living in the same home also become infected.

US CDC’s Morbidity and Mortality Weekly Report

SCREEN EARLY

ADULTS SHOULD START getting screened for colorectal cancer at the age of 45, according to new recommendations by the US Preventive Services Task Force.

The current guidelines recommend adults aged 50 to 75 be regularly screened for colorectal cancer.

“We have epidemiologic data that the risks of colorectal cancer are increasing before age 50, particularly in the 45- to 49-year-old age group,” said task force member Dr Michael Barry.

But people with an increased risk, such as those with a family history of colon cancer, a hereditary predisposition to the disease, or those who suffer from inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis, should have screening even earlier.

FOOD FOR YOUR HEART

FOLLOWING A DIET rich in anti-inflammatory food, such as fruits, vegetables and whole grains, can lower your risk of heart disease and stroke, says a study published in the Journal of the American College of Cardiology.

To analyse the effects of pro- and anti-inflammatory diets on cardiovascular disease risk, Harvard researchers followed more than 2,10,000 women and men for up to 32 years.

The participants, who were free of cardiovascular disease and cancer at the start of the study, provided dietary information every four years. There were 15,837 cardiovascular disease cases, including 9,794 coronary heart disease cases and 6,174 strokes during the study period.

Those who ate the most pro-inflammatory diets had a 46 per cent greater risk of heart disease and a 28 per cent greater risk of stroke than those who had the most anti-inflammatory diets.

Food with anti-inflammatory properties include green leafy vegetables, yellow vegetables, whole grains, fruits, tea and coffee. On the other hand, foods such as refined grains, red meat, processed meat and sugary beverages promote chronic inflammation.

DID YOU KNOW?

Children who spend more time in extracurricular activities, like sports and the arts, and less than two hours in recreational screen-based activities [will] have better mental health, and lower levels of anxiety and depressive symptoms.

Preventive Medicine

WORKING WOMEN EXPERIENCE SLOWER MEMORY DECLINE

WOMEN WHO WORKED for pay in early adulthood and middle age may have slower memory decline later in life compared to women who did not work outside the home, according to a new study published in the journal Neurology.

The link remained regardless of whether a woman was married, single or had children. To analyse the link of work-family experiences between 16 and 50 years, and memory decline after 55 years, the researchers followed 6,189 women with an average age of 57 for about 12 years. The women took memory tests every two years.

Between the ages of 55 and 60, memory scores were similar for all women. But after age 60, the average rate of decline on the memory test scores was slower for women who worked for pay.

Overall, after adjusting for factors such as age, education and socioeconomic status, rate of memory decline was 50 per cent greater among women who did not work for pay after having children than among working mothers.

WORK REMOTELY, STAY SAFE

WORKING IN AN office or school setting, instead of remotely, could double your risk of testing positive for SARS-CoV-2, the virus that causes Covid-19, according to research published in the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

To compare the impact of remote working and working in an office on SARS-CoV-2 infection, the researchers interviewed 314 adults who had taken a Covid-19 test in July.

Those who tested positive for Covid-19 were almost twice as likely to report regularly going to an office or school setting in the two weeks before illness onset, compared with those who tested negative. This was true even among those working in a profession outside of the critical infrastructure, including health care and factory settings.

DID YOU KNOW?

A person whose husband or wife is admitted to the ICU has an increased risk of suffering a cardiovascular event, such as chest pain, heart attack, stroke, irregular heart rhythm, heart failure or pulmonary embolism, within a month of the ICU admission.

Circulation

KEEP YOUR WINDOWS UP WHILE DRIVING

DRIVING WITH THE windows down can increase the risk of air pollution exposure by 80 per cent, according to a UK study published in the Science of The Total Environment.

As part of the study, the researchers analysed air pollution exposure levels for commuters in ten cities around the world. They looked at air pollution exposure levels inside vehicles during different times of the day and with different types of car ventilation—when the drivers used recirculation systems, fans and simply opened the windows.

No matter the city and the car model, the highest exposure was when drivers kept the windows open, followed by fan-on and recirculation.

Exposure was much lower when driving during off peak hours. Exposure was 91 per cent less when driving with windows open during off peak hours compared to morning peak hours and 40 per cent less compared to evening peak hours.

Those who used the recirculation system were exposed to about 80 per cent less harmful particles than those who kept the car windows open.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

mask-will-not-cause-oxygen-levels-to-drop

Fri Oct 23 19:20:51 IST 2020

Wearing a face mask, though uncomfortable, does not cause overexposure to carbon dioxide, even in people with severe lung diseases, according to a study published in the Annals of the American Thoracic Society. The researchers examined whether wearing a face mask had any effect on gas exchange—changes in oxygen or carbon dioxide levels—in 15 healthy physicians and 15 military veterans with severe chronic obstructive pulmonary disease, or COPD. The volunteers participated in a quick paced six-minute walk test wearing surgical masks. Oxygen and carbon dioxide levels were measured before and after the walking test. There were no major changes in gas exchange measurements in either group up to 30 minutes after taking the walking test. According to the study authors, the discomfort people feel while wearing masks can be attributed to “neurological reactions [increased afferent impulses—impulses that travel from sensory organs/receptors to the central nervous system—from the highly thermosensitive area of the face covered by the mask or from the increased temperature of the inspired air] or associated psychological phenomena such as anxiety, claustrophobia or affective responses to perceived difficulty in breathing.”

Seasonal strike

Flu-like illness can trigger heart attacks and strokes, according to a US study published in the Journal of the American Heart Association. Heart attack, stroke and influenza occur at higher rates during the winter months.

To examine the correlation among the three health conditions, the researchers analysed data from patients who were hospitalised for either a stroke, heart attack or influenza-like illness from 2004 to 2015 in New York. While the risk of heart attack increased immediately after a flu-like illness, there was a time lag of 30 days in the risk of stroke.

“We found that if someone is going to have a heart attack, it is going to occur within seven days of the flu-like illness, during the acute phase. With stroke, we see an increased risk seven to 15 days after, similar to heart attacks. But with stroke, there is an additional higher-risk period after 30 days,” the lead researcher said. The study also found that the rates of influenza-like illness and the rates of subsequent heart attacks and strokes after flu-like illness were lower in the years when the flu vaccine was highly effective.

The arm squeezes to save

The first line of treatment for patients who suffer a stroke is administration of a clot-busting drug called tissue plasminogen activator (tPA) to break up the blood clots.

A new Chinese study published in the journal Neurology finds that combining clot-busting drugs with a therapy called remote ischaemic post-conditioning could improve outcomes for stroke patients. Remote ischaemic post-conditioning involves using blood pressure cuffs to squeeze the arms which repeatedly stops and restores blood flow, and the oxygen it carries.

The study included 68 patients, average age 65, who were treated with the clot-busting medication (tPA) within four-and-a-half hours of suffering an ischaemic stroke, when blood flow to a part of the brain is blocked by a clot.

Half of the patients were also randomly assigned to receive remote ischaemic post-conditioning therapy. For an average of 11 days, twice a day they wore blood pressure cuffs on both arms for 40 minutes, with alternating cycles of inflation for five minutes and deflation for three minutes.

Seventy-two per cent of the patients who received the therapy (23 of 32 people) had a favorable recovery, compared to 50 per cent (17 of 34 people) who did not receive the therapy.

Fly safe

A review published in the Journal of Travel Medicine provides simple guidelines to help pregnant women reduce the risk of blood clots during flights.

Air travel can increase the risk of venous thromboembolism (VTE), or blood clots. About 1,50,000 cases of travel-related VTE are diagnosed annually. While the risk of VTE is highest in the first week after travel, it can remain high for up to eight weeks after a long-distance flight.

The risk is even greater for pregnant and postpartum women who fly long distance, especially if they have other risk factors such as obesity, prior history of blood clots, family history, recent surgery, or inherited conditions that promote blood clots. The risk remains high up to 12 weeks after childbirth,

For pregnant women without any risk factors, the study recommends non-medical measures such as frequent walks around the cabin, stretching the legs and calf muscles, drinking plenty of water, wearing loose, comfortable clothing and minimising baggage under the seat.

For pregnant women with risk factors, graduated compression stockings can be used. High risk women can also consult their doctor about the use of injectable blood thinners.

Honey remedy

Honey is often touted as a home remedy for upper respiratory tract infections like cold, cough, sore throat and congestion. A review of 14 studies involving 1,761 participants of varying ages, published in the BMJ Evidence-Based Medicine, has shown that honey may indeed be more beneficial than traditional medicines, such as antihistamines, expectorants, cough suppressants, and painkillers, for treating upper respiratory tract symptoms, especially in reducing the frequency and severity of coughing. Antibiotics are often prescribed for upper respiratory tract infections. But as most of the upper respiratory tract infections are caused by viruses, antibiotics are “both ineffective and inappropriate.” And overuse of antibiotics can cause antimicrobial resistance Honey is a safe and cheap alternative to treat upper respiratory tract symptoms, said the researchers. It is widely available, and does not have any side effects. Honey, however, should not be given to babies under one year of age because it carries a risk for infant botulism.

Survival instinct

SARS-CoV-2, the virus that causes Covid-19, can survive on human skin for about nine hours, compared to the influenza A virus, which remained viable for about two hours, according to a Japanese study published in the journal Clinical Infectious Diseases.

The researchers compared the survival times of the two viruses by applying samples of the coronavirus and influenza viruses to human skin collected from autopsy specimens about 24 hours after death.

The coronavirus survived on the human skin for 9.04 hours, compared with 1.82 hours for the influenza A virus. The good news is that both viruses can be completely inactivated within 15 seconds by using a hand sanitizer that contained 80 per cent ethanol.

Early indicator

A woman’s reproductive health could be a window to her risk for future health problems. A US study published in The BMJ suggests that women’s menstrual cycle could be a predictor of early death risk (before age 70).

The researchers used data from 79,505 premenopausal women (average age 38 years) without a history of cardiovascular disease, cancer, or diabetes. During the follow up of 24 years, 1,975 premature deaths were reported, including 894 from cancer and 172 from cardiovascular disease. Women who reported consistently irregular and long menstrual cycles during adolescence and adulthood had a greater risk of early death, especially from cardiovascular diseases. The risk was even greater for women who smoked.

Another study from the UK published in The BMJ also found that a woman’s reproductive health can affect her risk of heart disease and stroke later in life.

The researchers reviewed 32 studies with an average follow-up period of seven to 10 years. Several factors, including early menarche, use of combined oral contraceptives, polycystic ovary syndrome, pre-eclampsia, gestational diabetes (diabetes during pregnancy), pre-term birth, low birth weight, miscarriage, stillbirth and early menopause were associated with up to a two-fold risk of cardiovascular diseases. Pre-eclampsia was associated with a four-fold risk of heart failure.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

slow-murder

Fri Mar 06 15:12:48 IST 2020

Women who experience domestic abuse are more likely to develop cardiometabolic diseases such as heart disease, stroke and type 2 diabetes. They also have a higher risk of all-cause mortality.

For the study published in the Journal of the American Heart Association, the researchers compared the medical records of 18,547 women who had experienced domestic abuse with 72,231 women matched by age and lifestyle factors who did not have such an experience recorded.

Women who had been exposed to domestic abuse were 31 per cent more likely to develop cardiovascular disease, especially coronary artery disease and stroke, and 51 per cent more likely to develop type 2 diabetes. In addition, they also had a 44 per cent increased risk of all-cause mortality.

Women exposed to domestic abuse are more likely to have adverse lifestyle factors such as poor diet, smoking and excessive alcohol use as well as chronic stress, all of which could partly explain the increased health risks. “Clinicians should be made aware of the disproportionally increased risk and encouraged to manage modifiable risk factors actively in this group,” the study concluded.

Time your knee replacement

According to a US study published in the Journal of Bone and Joint Surgery, timing is crucial for knee replacement surgery. A study of 8,002 participants who had or were at risk of knee osteoarthritis found that 91 per cent of them waited too long before surgery, while 25 per cent underwent surgery without needing it.

People who wait too long may not regain function and mobility as much as someone who gets the procedure done at the appropriate time. “When people wait too long, two things happen,” the study author said. “The osteoarthritis causes deterioration of their function. Some of them wouldn’t be able to straighten their legs, affecting their walking and mobility.”

On the other hand, getting the surgery too early may yield limited benefits while exposing the patient to increased risk of major surgery-associated complications. These patients may also need a second surgery later, which is much more complicated and has poorer outcomes.

Degree of pain, joint function, age and radiographic assessment should be used to figure out the ideal time to have knee replacement surgery.

Did You Know?

Active, adult men who could perform more than 40 push-ups in one attempt had a 96 per cent reduced risk of major cardiovascular events over the next 10 years compared with those who were able to do fewer than 10 push-ups.

—JAMA Network Open

Fish oil for fertility

Taking fish oil supplements, which are high in omega-3 fatty acids, may improve sperm count and quality in young men, according to a Danish study published in JAMA Network Open.

The study included 1,679 healthy Danish men, aged 18 and 19, taking a compulsory medical examination for military service. Ninety-eight of them reported taking fish oil supplements in the previous three months. Those who took fish oil supplements for at least 60 days during the previous three months had a higher sperm count than others. They also had higher semen volume, greater proportion of normal sperm cells, larger testicular size and improved levels of male hormones.

The study did not find any association between taking other daily supplements, such as multivitamins, and measures of testicular function. Previous studies have shown that fish oil supplements can improve semen quality among men with infertility. The current study shows that it improved semen quality and reproductive hormone levels among healthy men as well.

The fish oil supplements also had a dose-response effect. Those who took the supplements for more than 60 days had better testicular function that those who took them less often.

BP rises earlier, faster in women

Women's blood vessels age at a faster rate than men's. Blood pressure starts to increase at a younger age in women and continues to rise at a faster rate, than men.

For the study published in JAMA Cardiology, the researchers analysed nearly 1,45,000 blood pressure measurements collected from 32,833 people (54 per cent women) aged 5 to 98, over a period of 43 years.

Women showed signs of high blood pressure in their 20s compared with men and it continued to rise at a steeper rate throughout life. High blood pressure is a strong risk factor of cardiovascular diseases such as heart attack, stroke and heart failure. The study suggests that the biological and physiological processes that lead to cardiac events start earlier in women.

“Our data showed that rates of accelerating blood pressure elevation were significantly higher in women than men, starting earlier in life,” the author of the study said. “This means that if we define the hypertension threshold the exact same way, a 30-year-old woman with high blood pressure is probably at higher risk for cardiovascular disease than a man with high blood pressure at the same age.”

Praise for performance

Students focus more and behave better in class when teachers praise good behaviour rather than reprimand bad behaviour, according to a study published in Educational Psychology.

For the study, the researchers observed 2,536 students (aged 5 to 12 years) in 151 classes in 19 elementary schools for three years. Half of the classes observed followed a behavioural intervention programme, where students were told about the behaviour expected in class and commended for doing so. The other half of the classes followed typical classroom management practices.

The more teachers praised, the more attentive students were in class. The students listened to the teacher and focused on tasks up to 30 per cent more when teachers praised them more than they reprimanded them. “Even if teachers praised as much as they reprimanded, students' on-task behaviour reached 60 per cent,” the study author said. “Everyone values being praised and recognised for their endeavours. It is a huge part of nurturing children's self-esteem and confidence. If teachers are praising students for good behaviour, it stands to reason that this behaviour will increase, and learning will improve.”

Suicidal thoughts start young

Children as young as nine and 10 can have suicidal thoughts, according to a study published in JAMA Network Open.

The study included 11,814 children aged nine and 10 and their caregivers. Around 2.4 to 6.2 per cent of the children reported having suicidal thoughts, from wishing they were dead to planning but not executing a suicide attempt.

Around 1.3 per cent said they had tried to commit suicide, while 9.1 per cent reported non-suicidal self-injury. Boys were more likely than girls to have suicidal thoughts and commit non-suicidal self-injury. But this trend reverses as they grow older.

The study also found that family conflict and lack of parental monitoring are significant predictors of suicidal thoughts. Caregivers were mostly oblivious to their children having such thoughts. In more than 75 per cent of cases where children reported suicidal thoughts or behaviour, the caregivers were unaware of the child’s experience.

Usually people do not ask young kids if they have suicidal thoughts. But the author of the study said, “If you have kids who are distressed in some way, you should be asking about this. You can help identify kids who might be in trouble.”

Burnout linked to A-Fib

People who constantly feel stressed, irritated and exhausted may have burnout syndrome, or vital exhaustion. According to a US study published in the European Journal of Preventive Cardiology, burnout can increase the risk of irregular heartbeat known as atrial fibrillation, or A-Fib, which can lead to heart attack and stroke.

The researchers surveyed 11,445 people, with an average age of 57, who were free of A-Fib. They were monitored for signs of burnout and followed for 25 years. Burnout “is typically caused by prolonged and profound stress at work or home” and “differs from depression, which is characterised by low mood, guilt and poor self-esteem”.

There were 2,220 new cases of A-Fib during the study period. Those with the highest levels of burnout were 20 per cent more likely to develop A-Fib compared to those with little or no evidence of burnout.

“Vital exhaustion is associated with increased inflammation and heightened activation of the body’s physiologic stress response,” the author of the study explained. “When these two things are chronically triggered that can have serious and damaging effects on the heart tissue, which could then eventually lead to the development of this arrhythmia.”

Did You Know?

Getting two-and-a-half to five hours of moderate exercise or one-and-a-quarter to two-and-a-half hours of vigorous exercise per week can significantly lower the risk for seven cancer types, including colon, breast, endometrial, kidney, multiple myeloma, liver, and non-Hodgkin lymphoma.

—Journal of Clinical Oncology

New tool for post-stroke recovery

A new, non-invasive wearable magnetic brain stimulator could boost recovery and improve motor function in stroke survivors. The study presented at the American Stroke Association’s International Stroke Conference showed that the device improved brain activity in areas damaged by the stroke.

Thirty ischemic stroke survivors at least three months post-stroke, who had weakness on one side of their body, were included in the clinical trial. Half of the patients used a new wearable, multifocal, transcranial, rotating, permanent magnet stimulator for 40 minutes per session, for a total of 20 sessions over four weeks. The device, which is worn like a swim cap, has multiple magnetic microstimulators attached to it.

The remaining patients had a placebo treatment. The researchers analysed brain activity before, immediately after and one month after treatment. The device significantly increased brain activity—nearly nine times more than the placebo. There was also some improvement in motor function. The treatment was well tolerated, without any device-related complications.

If confirmed in larger clinical trials, “this technology would be the first proven treatment for recovery of motor function after chronic ischemic stroke”, the lead researcher said.

Did You Know?

Older adults who regularly consume food (like green leafy vegetables, apples, pears and tea) that are good sources of a type of antioxidants called flavonols have a 48 per cent decreased risk of developing Alzheimer's disease.

—Neurology

A brainy solution

Brain stents are safe and effective in cutting the odds of a recurrent stroke and death in patients who suffer a stroke due to intracranial atherosclerotic disease, or cholesterol-clogged brain arteries.

The study presented at the American Stroke Association's International Stroke Conference analysed data on recurrent stroke or death in 152 stroke survivors and found that the risk of a repeat stroke was about 50 per cent lower in patients who had received a brain stent.

“After a year, there was a low risk of recurrent stroke or death in these patients compared to what we would expect historically. About 9 per cent or so of the patients had a recurrent event, compared with what we would expect to be closer to 20 per cent,” the study author said, adding that stenting could provide an alternative to stroke survivors when medical therapy and other treatments have been unsuccessful.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

magic-therapy

Mon Feb 10 14:49:55 IST 2020

A single dose of psilocybin—a compound found in magic mushrooms—along with psychotherapy, may improve the emotional well-being of cancer patients for up to five years, says a new study. Psilocybin is chemically similar to the neurotransmitter serotonin, that is involved in different neural functions controlling perception and mood. The compound can produce profound effects on subjective experience by mimicking the effects of serotonin.

As part of the study, 29 cancer patients were given psilocybin-assisted therapy at NYU Grossman School of Medicine in 2016. Researchers found that the treatment produced immediate relief in conditions of anxiety and depression in patients. Six months later, they found that 60 to 80 per cent patients continued with significant reduction in depression and increased quality of life.

Now, after a follow up of five years, 70 per cent patients reported that the therapy has brought long-term positive life changes. Although the exact working of psilocybin is not fully understood, researchers have the opinion that the drug makes the brain more receptive to newer ideas and thought patterns.

However, the researchers warn against any attempt to self-medicate using psilocybin.

Bank of emotions

According to a study by the IMT School for Advanced Studies Lucca, Italy, the entire set of our emotions is topographically represented in a 3cm area of the brain’s cortex.

To investigate how distinct components of emotional states are processed by the brain, the researchers asked a group of 15 volunteers to express and rate their emotions while watching the Hollywood movie Forrest Gump.

The volunteers reported their “emotional ratings” to each scene on a scale from 1 to 100. Their answers were then compared to those of 15 other persons who had watched the same movie during a functional magnetic resonance imaging (fMRI) study in Germany. The researchers found that the activation of bundles of nerves at two lobes in the brain, called temporo-parietal regions, had a connection with the emotional state of the subjects.

The intensity of emotional experiences were represented by smooth transitions of electrical activity in temporo-parietal areas of the brain. The researchers made the conclusion that the unique spatial arrangements and shapes formed by the nerve bundles in distinct parts of the cortex allows the brain to map a variety of emotional states within a single patch of this region.

Did You Know?

Smoking marijuana carries many of the same cardiovascular health hazards as smoking tobacco.

Journal of the American College of Cardiology

Exercise, to stay alert

Twenty minutes of exercise has the same effect on your working memory as a cup of coffee, according to a new study published in Nature Scientific Reports. Caffeine in coffee can fire up the grey cells in the morning. But caffeine is a psychoactive substance and its regular consumption can cause withdrawal symptoms like headache, fatigue, anxiety and difficulty in concentrating.

To compare the effects of caffeine and exercise on working memory, the researchers used something called an n-back test, which is similar to a card game. The participants were randomly allotted into a caffeine group or exercise group. They were presented with a list of items, and were asked to spot the repeats. In the first part of the study, both caffeine consumers and non-caffeine consumers underwent the n-back tasks prior to and after exercise and caffeine administration. The second part of the study focused on caffeine withdrawal. Here, the coffee drinkers took the tests after 12 hours of caffeine deprivation.

The results revealed that the improvements in the participants’ working memory were similar after spending 20 minutes on a treadmill and consuming a single serving of caffeine. The study found that exercise can help with caffeine withdrawal symptoms, too.

Reset yourself, fight diabetes

Reset your internal circadian clock to fight diabetes. The circadian clock allows organisms to adjust to changes related to geophysical time. Most of the cells in the body comprise molecular clocks. They regulate and synchronise metabolic functions to a 24-hour cycle.

As part of the study, researchers at the University of Geneva (UNIGE) and at the University Hospitals of Geneva (HUG), Switzerland, compared pancreatic cells of type 2 diabetic patients with that of healthy people. Bioluminescence-fluorescence time-lapse microscopy, a technology that allows tracking the molecular clock activity, was employed as part of the study.

They found that pancreatic islet cells derived from the type 2 diabetic human donors exhibit both reduced amplitudes of circadian oscillations and poor synchronisation capacity. It was found that with the disruption of the circadian clock, hormone secretion had no longer been coordinated. However, when researchers reset the disrupted cellular clocks using a clock modulator extracted from a lemon peel, they found that insulin levels improved.

The study is published in the Proceedings of the National Academy of Sciences.

Vegetarian diet to prevent UTI

Those following a vegetarian diet have a lower risk of developing a urinary tract infection than those who eat meat, according to a Taiwanese study published in the journal Scientific Reports. The study analysed the responses on diet, smoking, drinking, physical activity and medical conditions by more than 9,700 participants. None of the participants previously had a UTI.

During the study period of nine years, 217 of the 3,257 vegetarian participants developed UTI, compared with 444 of the 6,467 non-vegetarians. A vegetarian diet was linked to a 16 per cent lower risk of developing UTI, compared with meat eating, after taking into account factors such as age, sex, lifestyle and health conditions.

The researchers say that this may be because meat, particularly pork and poultry, is known to contain the strains of E-coli bacteria that cause UTIs. By avoiding a meat-based diet, people decrease their exposure to these bacteria, reducing levels in the bowel and hence lowering the risk they will reach the urethra. However, the study did not consider factors like history of UTIs, the frequency with which participants had sex or the method of contraception.

High protein risk

High-protein diets increase the risk of cardiovascular problems, according to a new study published in the journal Nature Metabolism. As part of the study, a few mice received a diet that was high in fat and proteins, whereas others received a high-fat diet with low-protein content. To see if the high protein level has an effect on cardiovascular health, the amount of protein received by the mice in the high-fat, high-protein diet was tripled (keeping the fat constant).

Researchers found that the build-up of arterial plaque was more than 30 per cent in mice that were in the high-fat, high protein-diet compared to those in the high-fat, low-protein diet. The excess amount of plaque in the arteries could accumulate on an artery wall. In time, the plaque could break off, and cause a blood clot. If the clot is large enough, it will block blood flow through the coronary artery and result in a heart attack.

Did You Know?

Young-onset Parkinson’s disease, defined by onset at less than 50 years, accounts for approximately 10 per cent of all Parkinson’s disease cases.

Nature Medicine

Quit today, fight back

According to a new study published in the journal Nature, human lungs can produce new healthy cells and can replace some of the tobacco-damaged and cancer-prone cells, if a person quits smoking. The researchers examined lung biopsies of 16 people including current smokers, former smokers and never smokers.

The results revealed that despite not being cancerous, more than 9 out of every 10 lung cells in current smokers had up to 10,000 extra genetic mutations compared with non-smokers. These mutations happened because of the chemicals in tobacco smoke. More than a quarter of these damaged cells had at least one cancer-driver mutation, too. In those who quit smoking, it was found that many of these damaged cells had been replaced by healthy ones just like those in non-smokers. About 40 per cent of the lung cells in ex-smokers was found to be healthy—four times more than current smokers.

The study revealed that these healthy lung cells could repair the lining of the airways in ex-smokers and help protect them against lung cancer. However, smoking also causes damage deeper in the lungs that can lead to emphysema—a chronic lung disease. This damage is not reversible, even after stopping smoking.

Root of addiction

Exercise addiction is more common among people with an eating disorder, says a study published in the journal Eating and Weight Disorders. As part of the study, researchers compared exercise addiction in people with and without the characteristics of an eating disorder. Data of 2,140 participants across nine different studies was examined.

Those with exercise addiction are driven primarily by a desire to control body weight, shape and composition. They often make their food choices solely based on exercise. This is the first time the risk factor connecting unhealthy relationship with food and exercise addiction is being calculated. The results revealed that people displaying characteristics of an eating disorder are 3.7 times more likely to suffer from addiction to exercise than people displaying no indication of an eating disorder. It is well known that those with eating disorders are more likely to display addictive personality and obsessive-compulsive behaviours.

Did You Know?

Dimensional psychopathology (including depression, anxiety, impulsive behaviour) in children is negatively correlated with sleep duration.

Molecular Psychiatry

Soy solution to health

A new Japanese study suggests that people who have higher consumption of fermented soy have a reduced mortality risk. In Asian countries, especially Japan, several types of soy products are widely consumed, such as natto, miso, and tofu. The study published in the British Medical Journal is based on the dietary habits, lifestyle, and health status of 42,750 men and 50,165 women aged 45-74 years. The subjects were followed for nearly 15 years.

People who ate natto (soybeans fermented with Bacillus subtilis) had a lower risk of cardiovascular mortality. The researchers found that a higher intake of fermented soy was associated with 10 per cent lower risk of all-cause mortality. However, total soy product intake did not impact all-cause mortality.

Fermented soy products are rich in fibre, potassium and bioactive components than their non-fermented counterparts. Apparently, scientists could not prove any association between soy intake and cancer-related mortality.

COMPILED BY: NIRMAL JOVIAL

green-tea-for-longevity

Fri Jan 24 15:21:08 IST 2020

PEOPLE WHO drink green tea at least three times a week may live longer and suffer a lower risk of cardiovascular disease, according to a Chinese study published in the European Journal of Preventive Cardiology.

As part of study, 1,00,902 adults free of heart attack, stroke, or cancer were followed for a median of 7.3 years.

Habitual tea drinkers (three or more times a week) had a 20 per cent lower risk of heart attack and stroke, 22 per cent lower risk of dying from heart disease and stroke, and 15 per cent lower risk of dying from all causes compared to non-habitual tea drinkers (less than three times a week).

An analysis of a subset of 14,081 participants found that habitual tea drinkers had a 39 per cent lower risk of heart disease and stroke, 56 per cent lower risk of fatal heart disease and stroke, and 29 per cent lower risk of all-cause mortality compared to never or non-habitual tea drinkers.

Abstain from alcohol to ease a-fib

GIVING UP alcohol can reduce the symptoms of atrial fibrillation (a-fib), or irregular heart rhythm. Previous studies have shown that the incidence of a-fib increases by 8 per cent for every one standard drink. The researchers wanted to see if abstinence or alcohol reduction can reduce a-fib episodes and time to recurrence. The Australian study published in The New England Journal of Medicine included 140 adults, average age 63, who suffered from a-fib and consumed 10 or more standard drinks per week. All the participants were moderate drinkers.

Half of them were randomly assigned to abstain from alcohol for six months, while the other half (the control group) were allowed to drink as usual.

While about two-thirds of the abstinence group gave up alcohol completely, the other third still consumed two or fewer drinks per week.

A-fib episodes were much lower in the abstinence group compared to the control group. While 73 per cent of the patients in the control group had an a-fib episode during the study period, only 53 per cent of the patients in the abstinence group had an episode.

Patients who abstained from alcohol also saw significant reduction in weight and blood pressure.

Stroke signal

According to a study published in the journal Stroke, patients who suffer a stroke for the first time have a considerably increased risk of major heart problems, even if they do not have any preexisting heart condition.

The study included 93,627 men and women without known heart diseases. Among them, 21,931 (12,421 women and 9,510 men) had suffered an ischaemic stroke for the first time.

The risk of a major cardiac event such as a heart attack, coronary artery disease, heart failure or cardiovascular death was significantly higher in both men and women after suffering a first time stroke compared to those who did not have a stroke.

The risk was highest within 30 days of suffering a stroke: 25 times higher in women and 23 times higher in men.

The risk decreased with time, but still remained significant. Between 31 and 90 days, the risk was nearly 5 times higher for women and 4 times higher for men. Both men and women still had twice the risk of a major cardiac event between 91 and up to 365 days.

The risk was higher even in patients without underlying heart diseases and risk factors such as hypertension, diabetes and smoking.

Did You Know?

Running a marathon for the first time was associated with reduced blood pressure and arterial stiffness equivalent to a four-year reduction in vascular age.

Journal of the American College of Cardiology

98.6 F no longer the normal body temperature

THE AVERAGE HUMAN body temperature is falling.

The average human body temperature was set at 98.6 Fahrenheit in 1851.

But according to Stanford researchers that is no longer correct.

For the study published in eLife researchers analysed more than 6,77,423 body temperature measurements from three datasets: 23,710 readings from 1862 to 1930; 15,301 readings from 1971 to 1975; and 1,50,280 readings from 2007 to 2017.

The body temperature of men born in the 2000s is on average 1.06 F lower than that of men born in the early 1800s. Likewise, the body temperature of women born in the 2000s is on average 0.58 F lower than that of women born in the 1890s.

The mean body temperature is 1.6 per cent lower than the 1800s. The average body temperature today is about 97.5 F.

Another recent study found that the average body temperature of 25,000 Britons was 97.9 F.

The researchers are not fully sure about the reason for this downward trend. One possible explanation could be the reduction in metabolic rate (the amount of energy people use) brought about by a population-wide decline in inflammation which could be the result of economic development, improved standard of living, advancement in dental and medical care, and the consistent indoor temperatures maintained by modern heating and air conditioning.

Low dose, better results

TREATING MEN with half the typical amount of chemotherapy can prevent testicular cancer recurrence, according to a study published in the journal European Urology.

Testicular cancer is the most common cancer affecting young men in their twenties and thirties. Men who undergo chemotherapy may suffer serious side effects such as hearing loss, hair loss, infections and infertility. Cutting the amount of chemotherapy in half can reduce the risk of these side effects that can have lifelong consequences.

The study included nearly 250 men with early-stage testicular cancer that had a high risk of recurrence after surgery.

Patients are currently offered two cycles of chemotherapy after surgery.

The patients in the study were given one three-week cycle of a chemotherapy known as BEP.

The researchers compared cancer recurrence rates within two years of treatment among those treated with one cycle and patients who were given two cycles.

Only three men (1.3 per cent) who received one cycle saw their testicular cancer return. This was identical to the rates seen in previous studies of patients who had received two cycles of the chemotherapy.

41 per cent of the men who received one cycle of chemotherapy had one or more serious side effects during treatment, such as an increased risk of infection, sepsis or vomiting. But only 2.6 per cent had long-term side effects such as damage to their hearing.

Natural stress busters

FEELING STRESSED at work? Keeping an indoor plant on your desk could be the solution.

According to a Japanese study published in the journal HortTechnology, just gazing at indoor plants can relieve stress at work and improve your mental health.

To scientifically analyse the degree of psychological and physiological impact of indoor plants at the workplace, the researchers recruited 63 office workers at an electric company and conducted the experiment in a real office setting, instead of a traditional lab setting.

The experiment had two phases: a control period without plants in the office and an intervention period when the participants had a small plant placed near the PC monitor on their desk.

The participants were asked to take a three-minute rest when they felt tired at work. The researchers recorded pulse rates and measured psychological stress of the participants using the state-trait anxiety inventory before and after placing a plant on the desk.

The participants had a significantly lower pulse rate after a three-minute rest with interaction with their desk plant. Anxiety decreased significantly from the control period (without plants) to the intervention period. The results were similar for employees of different age groups and with different plant selections.

Add extra years to your life

A HEALTHY lifestyle in middle age can add 10 extra years—free of chronic diseases—for women and 7 for men.

The Harvard study published in The BMJ analysed 34 years of data from 73,196 women and 28 years of data from 38,366 men.

Each participant was given a healthy lifestyle score ranging from 0 to 5 (5 being the healthiest) based on five lifestyle factors: at least 30 minutes per day of moderate to vigorous physical activity; never smoking; healthy weight; good quality diet; and moderate alcohol intake (one serving per day for women and up to two for men).

Women who followed four or five of these healthy habits at age 50 lived about 34.4 more years free of diabetes, cardiovascular diseases, and cancer, compared to 23.7 healthy years among women who followed none of these healthy habits.

Men who followed four or five healthy habits at age 50 lived 31.1 more years free of these chronic diseases compared to 23.5 years among men who practiced none. Men who smoked heavily, and obese men and women had the lowest disease-free life expectancy.

Did You Know?

Listening to music while exercising not only makes exercise more enjoyable but it can actually make it more productive and less tiresome, enhance physical performance, and improve physiological efficiency.

Psychological Bulletin

Dietary danger

BREAST CANCER patients who take certain dietary supplements during chemotherapy may be at an increased risk of disease recurrence and death, according to a US study published in the Journal of Clinical Oncology.

Dietary supplements known as antioxidants, as well as iron, vitamin B12, and omega-3 fatty acids may interfere with the ability of chemotherapy to kill cancer cells.

The study included 1,134 patients who provided information about their supplement use at the outset and during treatment, and were followed for six years. Among them, 18 per cent used at least one antioxidant daily, while 44 per cent took multivitamins.

Patients who reported taking any antioxidant, including vitamins A, C, E and carotenoids and Coenzyme Q10, both before and during chemotherapy were 41 per cent more likely to have their breast cancer return and 40 per cent more likely to die during follow-up compared to patients who did not take these supplements.

Patients taking B12 were 83 per cent more likely to experience a recurrence and had twice the risk of mortality. Patients taking omega-3 fatty acids before and during chemo had a 67 per cent higher risk of recurrence and those taking iron supplements were 91 per cent more likely to experience a recurrence.

Did You Know?

Working 49 or more hours each week was linked to a 66 per cent greater risk of developing sustained hypertension and a 70 per cent greater risk of having masked or hidden hypertension, a type that can go undetected.

Hypertension

AI to save

A NEW ARTIFICIAL intelligence (AI) system developed by Google was able to accurately detect breast cancer using mammograms and outperformed radiologists in reducing errors, according to a study published in the journal Nature.

Breast cancer affects about one in eight women globally. Mammograms are widely used to screen for breast cancer. But according to the American Cancer Society, radiologists miss about one in five cases of breast cancer (false negative) which can result in delayed detection and treatment. Also, half of all women who undergo screening for a 10-year period will get a false positive report, where cancer is wrongly suspected, which can lead to unnecessary treatments such as invasive biopsies and breast tissue removal.

The AI model can reduce such errors while accurately detecting cancer.

Researchers from the US and UK first trained an AI model to identify breast cancers on tens of thousands of mammograms, which had been previously interpreted by radiologists.

They then tested the model against a new set of 25,856 new mammograms from the UK and 3,097 in the US. The results were compared with those gathered from six radiologists in an independent study.

The AI system could detect cancers as accurately as the radiologists. But it outperformed the radiologists in reducing errors. False positives were reduced by 5.7 per cent in the US group and by 1.2 per cent in the UK group, and false negatives were reduced by 9.4 per cent in the US group, and by 2.7 per cent in the UK group.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

dyeing-issue

Fri Jan 10 15:02:26 IST 2020

WOMEN WHO use permanent hair dyes and chemical hair straighteners have an increased risk of developing breast cancer, and the risk increases with more frequent use.

For the study published in the International Journal of Cancer, researchers analysed data from 46,709 women, aged 35 to 74 years. Among them, 55 per cent reported using permanent dyes in the year prior to enrolling in the study. During a median follow-up of eight years, 2,794 participants developed breast cancer.

Women who regularly used permanent hair dyes were 9 per cent more likely to develop breast cancer than women who did not use hair dyes. The study did not find an increased risk of breast cancer with the use of semi-permanent or temporary dyes.

Women who used chemical hair straighteners had an 18 per cent higher risk of breast cancer compared to those who did not use these products.

Brush for heart

PEOPLE WHO brush their teeth regularly have a lower risk of heart issues such as atrial fibrillation and heart failure, according to a South Korean study published in the European Journal of Preventive Cardiology.

The study included 1,61,286 participants, aged 40 to 79, without a history of atrial fibrillation or heart failure. The participants had a routine medical examination at the start of the study and provided information about their lifestyle, oral health, and oral hygiene habits.

During an average follow-up of 10.5 years, 4,911 participants developed atrial fibrillation and 7,971 developed heart failure.

Those who brushed their teeth three or more times a day had a 10 per cent lower risk of atrial fibrillation and a 12 per cent lower risk of heart failure.

Getting regular professional dental cleanings was also linked to a 7 per cent lower risk of heart failure. But missing 22 or more teeth was linked to a 32 per cent higher risk of heart failure.

The reduced risk was independent of factors such as age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, and hypertension.

Did You Know?

Eating chilli peppers at least four times a week was associated with a 23 per cent lower risk of all-cause mortality and a 34 per cent lower risk of dying of cardiovascular diseases compared to never or rarely eating them.

Journal of the American College of Cardiology

For your baby’s safety

INDUCING LABOUR at 41 weeks is associated with a lower risk of new-born death compared with waiting until 42 weeks, according to a Swedish study published in The BMJ.

Health risks to the mother and baby starts to increase as the pregnancy continues beyond 40 weeks. About 14 per cent of stillbirths worldwide are associated with prolonged pregnancy. The researchers wanted to compare the risks and health outcomes of induction after 41 weeks with 42 gestational weeks.

For the study, 2,760 pregnant women—average age 31—with uncomplicated, low-risk single pregnancy were randomly assigned to receive induction at either 41 full weeks (1,381 women) or at 42 full weeks (1,379 women).

There was no significant difference between the two groups in terms of most health measures including pneumonia, sepsis, low oxygen levels, breathing problems, birth weight, convulsions and admission to an intensive care unit for the baby and complications such as caesarean delivery, vaginal birth with instruments, prolonged labour, epidural anaesthesia, wound infection and haemorrhage for the mother.

However, a significant difference was found when considering infant mortality. While there were no deaths in the group that was induced after 41 full gestational weeks, there were five stillbirths and one neonatal death among the women who waited until week 42.

Healthy window

EATING WITHIN a 10-hour window and fasting for 14 hours can help people with metabolic syndrome reduce weight, abdominal fat, blood pressure and cholesterol.

Metabolic syndrome refers to a cluster of conditions, such as obesity, excess abdominal fat, high blood pressure, high blood sugar and abnormal cholesterol or triglycerides, which can increase the risk of heart disease, stroke and type 2 diabetes.

For the study published in Cell Metabolism, 19 participants diagnosed with metabolic syndrome were asked to restrict their eating to within a window of 10 hours or less a day over a period of 12 weeks. The participants logged when and what they ate on an app created by the lab. Among them, 84 per cent were on some type of medication for one or more conditions, such as high cholesterol or high blood pressure.

Even though the participants could eat what they wanted, they consumed about 8.6 per cent fewer calories, probably due to the limited eating window.

At the end of 12 weeks, the participants lost weight, reduced abdominal fat, lowered blood pressure and cholesterol and had more stable blood sugar and insulin levels. They also reported better sleep and more energy, and many of the participants were able to have their medications lowered or stopped.

No escape from risk

EVEN LIGHT to moderate alcohol consumption can increase the risk of cancer. For the study published in the journal Cancer, researchers compared clinical data on 63,232 cancer patients with 63,232 matched controls. The participants provided information about their average daily consumption of alcohol and the duration of drinking.

One standardised drink was considered equivalent to 500ml of beer, 180ml of wine, or 60ml of whiskey.

The overall cancer risk was lowest at zero alcohol consumption. There was an almost linear association between cancer risk and alcohol consumption. Those who drank two or fewer drinks per day had an elevated cancer risk regardless of how long they had consumed alcohol.

After controlling for smoking, hypertension, diabetes, obesity and other factors, consuming one drink per day for 10 years or two drinks per day for five years was associated with a five percent increased risk of cancer.

The relative risk of having any cancer increased by 54 per cent for those who consumed two drinks a day for 40 years, compared to teetotallers.

Did You Know?

Heavy smoking can affect facial attractiveness, increase wrinkling and accelerate facial ageing.

PLOS Genetics

Danger of sleeping too much

SLEEPING NINE hours or more a night and taking long afternoon naps can increase your risk of stroke, according to a Chinese study published in the journal Neurology.

The researchers followed 31,750 healthy people—average age 62—for six years. Among them, 24 per cent reported sleeping for at least nine hours each night and 8 per cent reported taking naps for longer than 90 minutes.

During the follow up, 1,557 participants reported suffering a stroke. Those who slept for nine or more hours per night had a 23 per cent greater risk of stroke than those who regularly slept seven to eight hours each night.

Taking afternoon naps for more than 90 minutes a day was associated with a 25 per cent increased risk of stroke compared with napping for 30 minutes or less.

People who slept more than nine hours and napped more than 90 minutes per day had an 85 per cent higher risk of stroke.

People who reported poor sleep quality had a 29 per cent increased risk of stroke than those who reported good sleep quality. Those who slept more than nine hours per night and had poor sleep quality had an 82 per cent increased risk of stroke.

Lose weight, prevent cancer

BEING OVERWEIGHT or obese is a known risk factor for breast cancer. According to the American Cancer Society, postmenopausal women who are overweight or obese have up to two times higher risk of breast cancer.

A new study published in the Journal of the National Cancer Institute suggests that losing weight can reduce a woman’s risk of developing breast cancer. The more weight a woman loses, the lower her risk of breast cancer.

To find out if losing weight in middle or later adulthood can reduce breast cancer risk, the researchers analysed data from 1,80,885 women aged 50 and older, who were cancer-free at the start of the study.

Their weight was assessed three times over a decade; 6,930 women developed breast cancer during follow-up.

Women with sustained weight loss had a lower risk of breast cancer. Compared to women whose weight remained stable, those who lost 2kg to 4.5kg had an 18 per cent lower risk of breast cancer. The risk was 25 per cent lower for women who lost 4.5kg to 9kg, and 32 per cent lower for women who lost 9kg or more.

Even women who lost 9kg or more, but gained some of it back, had a lower risk of breast cancer compared with those whose weight remained stable.

Birth season and heart health

ACCORDING TO A study published in the BMJ, women born during spring and summer months, especially March-July, are more likely to die from cardiovascular diseases.

The study included 1,16, 911 women aged 30 to 55.

During 38 years of follow-up, 43,248 participants died; 8,360 deaths were from cardiovascular causes.

While no significant association was seen between birth month, birth season, and overall mortality, women born in the spring and summer were more likely to die of heart disease than those born in autumn and winter.

People born in April had the highest cardiovascular mortality, while those born in December had the lowest. Those born in December had an 18 per cent lower risk of cardiovascular disease mortality compared to those born in April.

While the exact reason for these differences are not clear, the researchers think seasonal fluctuations in diet, air pollution levels, and availability of sunlight before birth and in early life could be contributing factors.

Did You Know?

Grandparents who care for grandchildren scored lower on loneliness and social isolation, and had a larger social network than those who did not care for grandchildren.

BMJ Open

Musicians, beware of tinnitus

MUSICIANS ARE constantly exposed to loud noise which puts them at a higher risk of developing tinnitus.

People with tinnitus hear ringing, buzzing, hissing or whistling sounds when there are no external sounds.

For the study published in the journal Trends in Hearing, researchers used data from 23,000 people to compare tinnitus rates and hearing problems in people working in noisy jobs such as construction, agriculture and music to people working in quiet jobs such as finance.

People working in all genres of music industry (even classical music), including musicians, music directors and production staff, are nearly twice as likely to develop tinnitus as those working in quieter industries.

The length of safe noise exposure is reduced by half for every three decibels increase in noise intensity—that would be four hours of daily exposure for 88 decibels of noise, two hours for 91 decibels, and so forth.

“Most amplified concerts exceed 100 decibels, meaning that musicians should not be exposed to that level of noise for more than 15 minutes without proper hearing protection,” said the study author.

Prescribed less, more effective

ANTI-HYPERTENSIVE drugs inhibitors, the most widely prescribed first-line blood pressure medication, is less effective and has more side effects than thiazide diuretics, another class of medication that is prescribed less often.

As per the American College of Cardiology and American Heart Association guidelines, patients with high blood pressure can be started on any drug from five different classes of medications: ACE inhibitors; thiazide diuretics; angiotensin II receptor blockers (ARBs); dihydropyridine calcium channel blockers and non-dihydropyridine calcium channel blockers.

To find out the safety and effectives of these medications, the researchers tracked data on nearly five million patients from four countries—Germany, Japan, South Korea and the United States.

All the patients had been started on treatment for high blood pressure with a single drug: 48 per cent of the patients were started on an ACE inhibitor compared with 17 per cent of patients who were first prescribed thiazide diuretics.

Compared to those who had been prescribed ACE inhibitors, patients who were started on thiazide diuretics had 15 per cent fewer heart attacks, strokes and hospitalisations for heart failure, as well as fewer side effects.

According to the researchers, about 3,100 major cardiovascular events among the patients who first took ACE inhibitors could have been prevented if they had been started on thiazide diuretics.

Non-dihydropyridine calcium channel blockers were also less effective than all the other four first-line classes of blood pressure drugs.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

run-to-live-longer

Fri Dec 06 15:39:06 IST 2019

ACCORDING TO AN Australian study published in the ‌‌British‌ ‌Journal‌ ‌of‌ ‌Sports‌ ‌Medicine, running on a regular basis for as little as 50 minutes a week is associated with a significantly lower risk of death from all causes, especially cardiovascular diseases and cancer.

The researchers reviewed 14 studies involving 2,32,149 people whose health had been tracked for between 5.5 and 35 years; 25,951 participants died during the study period.

Compared to people who did not run at all, those who ran had 27 per cent lower risk of death from all causes, 30 per cent lower risk of death from cardiovascular diseases and 23 per cent lower risk of death from cancer. The benefits were seen in both men and women and among those who ran only once a week, or even less frequently.

Duration, frequency and intensity did not seem to matter much. Even people who ran for less than ‌50‌ ‌minutes‌ ‌a week ‌and‌ ‌at‌ ‌a‌ ‌speed‌ ‌below‌ ‌9.7‌km ‌per ‌hour tend to live longer. The study did not find greater benefits with higher amounts of running.

Testosterone therapy linked to blood clots

TAKING TESTOSTERONE supplements can double a man's risk of suffering venous thromboembolism (VTE), a potentially deadly medical condition which causes blood clots to form in the veins.

Testosterone therapy is already known to increase a man's risk of heart attack and stroke. Millions of men who do not suffer from hypogonadism (a condition in which the body does not produce enough testosterone) take testosterone supplements to combat common symptoms of ageing such as weight gain and sexual disfunction.

For the study published in JAMA Internal Medicine, the researchers analysed the use of testosterone in 39,622 men, aged 18 to 99 years, who had venous thromboembolism. Among them, 7.8 per cent had been diagnosed with hypogonadism.

Men without hypogonadism had a 2.3 times increased risk of developing a deep vein clot within six months of taking the hormone. The risk was two times greater in men diagnosed with hypogonadism. The risk was even greater in middle-aged men than in seniors.

Men under 65 who did not have hypogonadism had about three times greater risk compared to men 65 years and older, whose risk was only about 1.5 times greater.

Herbal remedies are risky

CANCER PATIENTS who take herbal products such as garlic, ginger and turmeric could be doing more harm than good as these products can interfere with their treatment and affect wound healing.

Cancer patients often turn to complementary therapies even though there is no scientific evidence for their efficacy. Skin lesions that appear when the cancer has spread are often difficult to treat effectively. The pain and the smell caused by these lesions often push patients to try different herbal products and creams that can actually cause harm.

The ingredients in many of these products can delay wound healing and interfere with systemic anti-cancer treatments such as hormone therapy or chemotherapy.

Products such as garlic, ginger, ginkgo, ginseng, hawthorn, horse chestnut and turmeric can slow down blood-clotting, causing the wound to take longer to heal and cause more scarring.

The study author urges patients to try complementary therapies such as mindfulness, acupuncture, Reiki and yoga to alleviate psychological distress. The study was presented at the Advanced Breast Cancer Fifth International Consensus Conference.

Late eating is harmful

EATING LATE IN the evening is not good for women’s cardiovascular health. Women who consumed most of their daily calories later in the evening had a greater risk for cardiovascular disease, according to a study presented at the American Heart Association’s Scientific Sessions 2019.

The study included 112 women, average age 33, whose heart health was assessed at the start of the study and 12 months later.

Most women ate some food after 6pm, but those who consumed a higher proportion of their daily calories after this time had poorer heart health. They were more likely to have higher blood pressure, higher body mass index and poorer long-term control of blood sugar. Heart health deteriorated with every 1 per cent increase in calories consumed after 6pm.

Did You Know?

A person's risk of atrial fibrillation, or irregular heart beat that can lead to stroke, heart failure and other heart related complications, increases by about 3 per cent for every one inch increase in height over the average height of 5 feet and 7 inches.

American Heart Association’s 2019 Scientific Sessions

Fit to return to work?

HOW FAST A stroke survivor can walk could determine whether they are ready to go back to work, according to a study published in the journal Stroke.

About 25 per cent of patients who suffer a stroke are younger than 65 years old and about 44 per cent may not be able to return to work mostly because of walking difficulties.

The researchers compared mobility in 46 stroke survivors, aged 18 to 65, with 15 people who did not have a stroke. The participants took a walking test to see how far and how fast they could walk in three minutes.

A walking speed of more than three feet per second was identified as the threshold that predicts whether a stroke survivor can return to work.

Among the 23 per cent of study participants who went back to work, 90 per cent walked faster than three feet per second, almost six feet per second. But those who did not return to work walked only about 2.5 feet per second.

Benefits of angioplasty limited

ANGIOPLASTY AND BYPASS surgery may not provide any added benefits over medications and lifestyle changes in preventing an array of major cardiovascular events in patients with severe but stable heart disease, according to the findings of a major international clinical trial presented at the American Heart Association meeting.

The trial was conducted at 320 sites in 37 countries and included 5,179 patients with moderate to severe but stable ischaemia—a condition in which blood flow to the heart is reduced due to clogged arteries. About 50 per cent of patients had severe ischaemia, 33 per cent had moderate, and 12 per cent had mild.

All the participants received medications such as aspirin, blood pressure medications and cholesterol-lowering drugs and lifestyle advice. But half were also randomly assigned to undergo either angioplasty or a bypass surgery.

Overall, the risk of major cardiovascular events like heart-related death, heart attack, hospitalisation with unstable angina (chest pain), heart failure or cardiac arrest was similar for patients in both groups. Invasive procedures were not better than conservative therapy at reducing adverse heart events.

However, invasive treatments provided better symptom relief and quality of life in patients who had severe and frequent chest pain. But they did not lower their odds of death or heart related problems.

The findings, however, do not apply to heart patients with blockages in the left main coronary artery and those suffering a heart attack. In such cases the procedures do save lives.

Supercooling can preserve donor organs longer

A NEW SUPERCOOLING technique can triple the time that donor organs can be stored before transplantation. Once removed, human livers can be currently preserved for only about nine hours—stored at 4 degrees Celsius—before the tissues become damaged, making the organ unusable for transplantation. This short time frame makes it very difficult to get the organs to compatible patients, especially if they live far away.

Organs can survive longer in freezing temperatures, but it causes ice crystals to form within the organs' cells which damages the tissues and the organ would be unviable.

The new supercooling method allows the organ to be preserved in -6 degrees Celsius without freezing and causing damage to the tissues for up to 27 hours, giving doctors and patients a much longer time to work with.

The technique was developed by scientists at Harvard Medical School and Massachusetts General Hospital. The findings are published in the journal Nature Biotechnology.

Did You Know?

An international survey found kindness tops qualities that we look for in a life-partner.

Journal of Personality

Spot depression in kids

ACCORDING TO A US survey, two-thirds of parents find it difficult to distinguish between their teen’s normal mood swings and signs of depression.

The researchers surveyed 819 parents with at least one child in middle school, junior high, or high school. They found that 40 per cent of parents could not differentiate between normal ups and down and depression symptoms; 30 per cent said their kids are good at hiding feelings. Other hindrances include not talking about feelings with their kids, not spending enough time with their kids and not being aware of the signs of depression.

But children are familiar with depression and suicide. One in four parents said their child knows a peer with depression and one in 10 knew a peer who committed suicide.

Since rates of teen suicide are steadily rising, it is paramount to recognise depression in youth. Parents should look out for signs of depression in kids, which include sadness, isolation, anger, irritability and acting out.

Not worth the wait

ACCORDING TO A study presented at the American College of Surgeons annual meeting, delaying a gallbladder removal operation can increase the odds of complications, longer hospital stays and hospital readmissions.

Gallstones that form in the gallbladder can lead to serious inflammation and infection. The study was based on nearly 50,000 patients who had either a laparoscopy or open abdominal surgery for gall bladder attack.

The patients were divided into three groups based on the time from admission to surgery: 12,968 patients had their gallbladders removed within 24 hours of admission; 26,758 patients had the surgery between 24 and 72 hours after admission and 9,594 patients had the surgery 72 hours or more after admission.

Delaying the operation three days or more after admission increased the likelihood of requiring an open operation versus a laparoscopic procedure by 28 per cent.

The risk of complications also increased with delayed surgery. The risk of sepsis increased by nearly 50 per cent, venous thrombus embolism by over 80 per cent, and surgical site infection by 20 per cent when surgery was done 72 hours or more from admission compared to within 24 hours.

Moreover, patients who had the surgery within 24 hours of admission were able to go home the day after the operation, while patients who had the procedure after 72 hours had to stay in the hospital for about five days.

Did You Know?

Listening to music can relieve the cardiac stress induced by driving in heavy traffic.

Complementary Therapies in Medicine

Exercise more as you grow old

ACCORDING TO A South Korean study published in the European Heart Journal, older adults should increase or maintain their exercise levels to prevent heart disease and stroke, even if they have disabilities and chronic health conditions such as diabetes and hypertension.

The study included more than 1.1 million people aged 60 and older without cardiovascular diseases at the start of the study. Among them, 47 per cent were men. The participants had two health screenings between 2009 and 2012, and they were followed until the end of 2016.

About two-thirds of the participants were physically inactive during both screening periods. Women were more likely to be inactive.

While 22 per cent of inactive people increased their physical activity by the time of the second screening, 54 per cent of those who had been active became inactive by the time of the second screening.

During the follow-up period, 1,14,856 cases of heart disease or stroke occurred. Those who were inactive at the start and became moderately or vigorously active three to four times a week by the second screening had an 11 per cent reduced risk of cardiovascular problems. Those who increased their activity from one or two times a week to five or more times a week had a 10 per cent reduced risk.

At the same time, those who were moderately or vigorously active more than five times a week at the first screening and then became inactive had a 27 per cent increased risk of cardiovascular issues.

Even people with disabilities and chronic conditions lowered their risk with increased activity. The risk was 16 per cent lower for those with disabilities, and 4 to 7 per cent lower for those with type 2 diabetes, high blood pressure or high cholesterol.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

adulthood-will-be-good

Tue Nov 12 14:44:03 IST 2019

EVEN THOUGH PREMATURE babies have an increased risk of several health issues, including heart, lung and neuropsychiatric disorders, and premature mortality, a US study published in the Journal of the American Medical Association has found that most premature babies grow up to be healthy adults.

The researchers analysed the health data of more than 2.5 million Swedes born between 1973 and 1997, and followed them through 2015 (ages 18 to 43 years). Among them, 1,49,065 were born preterm (gestational age less than 37 weeks); 48.6 per cent were female.

About 55 per cent of those born premature had no serious chronic physical or mental health issues by early adulthood, compared with 63 per cent of those born full-term. But only 22.3 per cent of babies born extremely preterm (22 to 27 weeks) were alive without any major health conditions in adulthood.

The odds of disease-free survival improved as the gestation period increased; 48.5 per cent of preterm babies (28 to 33 weeks) and 58 per cent of late preterm babies (34 to 36 weeks) were alive and generally healthy by early adulthood.

The results were similar for both men and women.

Toothache? Antibiotics not necessary

ANTIBIOTICS ARE NOT necessary for most toothaches, according to new guidelines issued by the American Dental Association.

The advisory committee reviewed studies on the benefits and harms of using antibiotics for the treatment of various tooth problems and concluded that the medications may actually cause significant harm with limited benefit.

Antibiotics may not be effective in treating most toothaches. Instead, they can cause serious side effects, and overuse can result in antibiotic resistance.

Patients should not be prescribed antibiotics for most cases of dental pain, even though most doctors do. Instead, they should get dental treatment and, if necessary, take pain medications such as acetaminophen or ibuprofen.

Most dental infections can be managed with dental treatments such as pulpotomy, pulpectomy, and nonsurgical root canal treatment. Antibiotics should only be used if dental treatment is not immediately available and the patient has other signs and symptoms such as fever or swollen lymph nodes.

Did You Know?

A diet rich in plant-based food is associated with a reduced risk of prostate cancer, while a high consumption of dairy products is associated with an increased risk of prostate cancer.

The Journal of the American Osteopathic Association

Be aware and beware

MALE BREAST CANCER is very rare. Only less than 1 per cent of all breast cancers occur in men. But according to a US study published in JAMA Oncology, men are more likely to die after a breast cancer diagnosis than women, across all stages of the disease.

The researchers analysed 11 years of data from the national cancer database to compare death rates among 1.8 million female patients (average age 59.9 years) and 16,025 male patients (average age 63.3 years).

Overall, the five-year mortality rate for men was 19 per cent higher than for women. The higher death rate remained even after accounting for clinical characteristics, such as types and stage of breast tumours, age at diagnosis, treatments received and access to care, which combined with under-treatment accounted for 63.3 per cent of the gender-related mortality disparity.

The disparity could be attributed to possible distinct cancer biology, according to the study authors. Lack of adequate treatment, late diagnosis, treatment compliance issues and an unhealthy lifestyle could be contributing factors as well.

Painful days

CAN WEATHER conditions affect pain?

Humid, windy days can worsen pain for people suffering from chronic conditions such as arthritis, fibromyalgia, migraine and neuropathic pain, according to a British study published in the journal NPJ Digital Medicine.

The study included 2,658 people across the United Kingdom. The participants used a smartphone app to record daily pain symptoms over 15 months and the local weather was determined using the location data on the smartphone’s GPS.

The majority of participants suffered from arthritis. The researchers analysed about six months’ data.

People with chronic pain were 20 per cent more likely to suffer from pain on humid and windy days with low atmospheric pressure.

Humid days were the worst, whereas dry days were least likely to be painful. Rainfall also did not affect pain.

Even though it is widely believed, the study did not find an association between temperature and pain. Cold days did not aggravate pain, but cold days that were also damp and windy did.

Exercise before or after breakfast?

EXERCISE BEFORE breakfast to reap the most health benefits.

According to a study published in the Journal of Clinical Endocrinology and Metabolism, people who exercise before breakfast burn more fat and have a better control over blood sugar levels, which can lower their risk of type 2 diabetes and cardiovascular disease.

To find out how exercise timing affect muscle fat stores and insulin response, the researchers divided 30 overweight or obese men to one of three groups: eat breakfast before exercise, eat breakfast after exercise and make no lifestyle changes.

Those who exercised before breakfast burned twice the fat as those who exercised after breakfast.

When people exercise after having fasted overnight, they have lower insulin levels and they use more of the fat from their fat tissue and muscles as fuel. While eating after exercise did not have any effect on weight loss, it significantly improved their overall health. The muscles of those who exercised before breakfast responded better to insulin, keeping their blood sugar levels under control and thus reducing the risk for diabetes and heart disease.

Did You Know?

Parents and toddlers are more engaged with each other and have a more shared experience when reading from a print book. But an e-book tends to create conflict because both parents and kids try to control the tablet.

JAMA Pediatrics

Bedtime, the best time

ACCORDING TO A STUDY published in the European Heart Journal, taking blood pressure medications at bedtime rather than in the morning can reduce your risk of cardiovascular events such as heart attack, stroke and heart failure and death from such events by nearly half.

To analyse the impact of antihypertensive medication timing on the risk of cardiovascular events, the researchers randomly assigned 19,084 adults (10,614 men and 8,470 women) with hypertension to take all their the blood pressure pills either in the morning or at bedtime.

The participants wore 48-hour ambulatory blood pressure monitoring devices that tracked their blood pressure, at least once a year. During an average follow-up of six years, 1,752 participants experienced a cardiovascular event: 521 cases of heart failure; 345 strokes; 302 coronary revascularisation (procedures to open clogged arteries); 274 heart attacks, and 310 deaths from a cardiovascular event.

Taking the pills at bedtime reduced the risk of death due to heart or blood vessel conditions by 66 per cent, stroke by 49 per cent; heart attack by 44 per cent, heart failure by 42 per cent, and coronary revascularisation by 40 per cent.

The overall reduction in risk for cardiovascular-related death was 45 per cent.

People with mental illness die early

PEOPLE WHO SUFFER from mental disorders have a shorter lifespan than the general population. For the study published in The Lancet, the researchers analysed data form 7.4 million Danish adults.

The researchers classified mental disorders into 10 groups and causes of death into 11 groups. The aim of the study was to analyse age specific and gender specific mortality risk for each type of disorder, as well as specific causes of death such as cancer, diabetes and suicide.

Across all ages, the risk of early death was higher for people with mental disorders. Men had a greater death risk than women. The average life expectancy was 10 years shorter for men and seven years shorter for women after a diagnosis of mental disorder compared to a person of the same age.

Men and women with mood disorders died about 7.9 and 6.2 years earlier than a person of the same age, respectively. Apart from an increased risk of death due to suicide, people with mental disorders also had an increased risk of death from other medical conditions such as cancer, heart disease, respiratory diseases and diabetes.

This could be due to diagnostic overshadowing, meaning, while getting help for mental disorders, a person’s symptoms for other physical ailments may be attributed to his mental illness.

Early surgery saves

DUCTAL CARCINOMA in situ (DCIS) is the earliest stage of breast cancer. Abnormal cells form inside the milk duct of the breast at this stage. DCIS is noninvasive, but when the cancerous cells spread beyond the milk duct, it becomes invasive. If left untreated, 30 to 50 per cent of women with DCIS will get invasive cancer.

Treatment for DCIS include surgery and radiotherapy, along with endocrine therapy.

According to a US study published in the Annals of Surgical Oncology, women who delay surgery for DCIS may have a higher risk of invasive ductal carcinoma and a slightly lower survival outcome.

The study included 123,947 women with DCIS and 16,668 women with invasive ductal carcinoma. The overall survival and risk of progression to invasive cancer were compared during five time intervals between diagnosis and surgery: less than 30 days, 31-60 days, 61-90 days, 91-120 days, or 121-365 days.

Five-year survival for all patients was 95.8 per cent, with an average time from diagnosis to surgery of 38 days. But with each increase in diagnosis to surgery interval, the risk of death increased by 7.4 per cent. Delaying surgery also predicted progression to invasive cancer.

Paracetamol peril

WOMEN WHO TAKE acetaminophen (paracetamol) during pregnancy are more likely to have a child with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), according to a study published in JAMA Psychiatry.

Acetaminophen is widely used by pregnant women for aches and is generally thought to be safe. Previous studies based on maternal self-report on the use of acetaminophen during pregnancy have suggested a connection between acetaminophen and ADHD and autism in children.

The current analysis was based on 996 babies and their mothers.

Acetaminophen has been shown to cross the placenta and reach the baby. The researchers measured the amount of acetaminophen and two of its byproducts in each umbilical cord blood sample.

By the time the children were an average of about ten years, 257 had been diagnosed with ADHD, 66 with ASD, and 42 with both ADHD and ASD, 304 with other development disorders and 327 did not have any disabilities.

Children whose cord blood contained the highest levels of acetaminophen metabolites were 2.86 times more likely to have been diagnosed with ADHD and 3.62 times more likely to have an ASD diagnosis than those with the lowest levels.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

planning-to-conceive-avoid-alcohol

Fri Nov 01 15:25:43 IST 2019

ACCORDING TO A Chinese study published in the European Journal of Preventive Cardiology, parental alcohol consumption in the months before conception can increase the risk of congenital heart disease in their babies.

The researchers analysed 55 studies that included 41,747 babies with congenital heart disease and 2,97,587 without. The risk of congenital heart diseases gradually rose as parental alcohol consumption increased. Babies had a 44 per cent increased risk of congenital heart disease if fathers drank alcohol three months before conception, compared with babies whose fathers abstained. If mothers drank three months prior to conception and during the first trimester, babies had a 16 per cent higher risk of congenital heart defects.

Five or more drinks per sitting was linked to a 52 per cent higher likelihood of having a baby with birth defects for men. It was 16 per cent for women.

Forcing will not help

CHILDREN WHO ARE forced to diet or lose weight by their parents are more likely to be obese as adults and suffer from eating disorders. The study published in the Journal of Adolescent Health was based on 1,116 adolescents (61 per cent girls) who completed surveys in 1998-1999.

Follow-up surveys were completed every five years from 2003 to 2016. More than 40 per cent of women and 27 per cent of men said their mothers had encouraged them to diet to stay slim. About 20 per cent of women and 18 per cent of men had received similar messages from their fathers.

Parental pressure to lose weight was associated with poor health, unhealthy weight-related behaviours and lower psychosocial wellbeing in young adulthood. Girls and boys who had been pressured to diet had a 49 per cent and 13 per cent higher odds of being obese as adults, respectively, compared to those who did not face any parental pressure.

The likelihood of being obese was 29 per cent higher for girls whose parents resorted to extreme weight control behaviours and 12 per cent greater for boys. Girls had a 17 per cent higher risk for binge eating. The risk was 39 per cent greater for boys.

Tone matters

WANT TO GET your teenager to listen to you? Talk to them in a warm, supportive voice.

According to a British study published in the journal Developmental Psychology, teenagers are less likely to listen to their mothers when spoken in a controlling tone of voice.

The study examined how 1,000 teens would respond to their mothers when receiving instructions in different tones. The mothers used either a controlling, supportive, or neutral tone of voice.

Teens were more likely to engage and respond positively to instructions that conveyed a sense of encouragement and support for self-expression and choice.

Speaking in a controlling tone elicited a range of negative emotions and less feelings of closeness.

“If parents want conversations with their teens to have the most benefit, it is important to remember to use supportive tone of voice. It is easy for parents to forget, especially if they are feeling stressed, tired or pressured themselves,” said the study author.

Radiation after surgery, not a must

RADIATION THERAPY right after surgery may not be necessary for men with prostate cancer, according to a study presented at the European Society for Medical Oncology meeting.

To find out whether the benefits of radiotherapy after surgery outweigh the side effects, the researchers enrolled 1,396 patients after surgery for prostate cancer. They were randomly assigned to either radiotherapy right after surgery or to an observation-only group that received radiotherapy only if the disease recurred.

The study did not find any difference in disease recurrence at five years between those who had radiotherapy shortly after surgery and those who had radiotherapy later, if the cancer came back.

Eighty five per cent of the men in the radiotherapy group were cancer-free five years after their surgery compared to 88 per cent in the standard care group.

Omitting or delaying radiotherapy can help many men avoid the side-effects of radiotherapy such as urinary incontinence and narrowing of the urethra, which can make urination difficult.

Did You Know?

A single child is not more self-centered or narcissistic than children with siblings.

Social Psychological and Personality Science

Sleep at least six hours

MIDDLE-AGED adults with high blood pressure, type 2 diabetes, heart disease or stroke, who sleep less than six hours a day, could be at an increased risk for cancer and early death.

For the study published in the Journal of the American Heart Association, researchers analysed data from 1,654 adults, aged 20 to 74 years old. More than half of the participants were women. Of the 512 people who died during 20 years of follow up, one-third died of heart disease or stroke and one-fourth died due to cancer.

People with high blood pressure or diabetes who slept less than six hours had twice the risk of dying from heart disease or stroke compared to those who slept for more hours.

People with a history of heart disease or stroke who slept less than six hours had three times the increased risk of dying from cancer. These associations remained even after accounting for sex, age, race, smoking, obesity, or other physical or mental health conditions.

Exercise helps, in all ages

ACCORDING TO A French study published in the Canadian Journal of Cardiology, regular exercise will benefit all patients with cardiovascular disease regardless of their age.

Older patients are especially at a higher risk for complications and accelerated physical de-conditioning after a cardiovascular event. But often they are not referred to cardiac rehabilitation programmes.

The study was based on 733 patients who participated in a 25-session cardiac rehabilitation programme. They were divided into three subgroups by age: under 65, between 65 and 80, and 80 and older.

Exercise benefited all patients regardless of their age.

“We found a few weeks of exercise training not only significantly improved exercise capacity but also decreased anxiety and depression. Patients with the greatest physical impairments at baseline benefited the most from exercise,” said the study author.

Did You Know?

Your personality as a teen could predict your risk of dementia: those who were calm and mature as teens had a 10 per cent reduced risk of dementia in their 70s.

JAMA Psychiatry

More harm than good

CORTICOSTEROID injections are often given to patients with osteoarthritis to reduce pain and inflammation.

But according to a US study published in the journal Radiology, these steroid shots can accelerate osteoarthritis progression and joint destruction. The study was based on 459 patients who had one to three corticosteroid injections for hip or knee arthritis in 2018.

Eight per cent of the patients suffered complications: 26 patients had a quick progression of their arthritis; three patients suffered rapid joint destruction, including bone loss; four had stress fractures; and three had complications from osteonecrosis, where bone tissue dies. The complications were detected, on average, seven months after the corticosteroid injection.

Ageing indicator

SLOW WALKING could be a sign of accelerated physical and biological ageing, according to a US study published in JAMA Network Open. The study included nearly 1,000 people born between 1972 and 1973 in Dunedin, New Zealand. They underwent frequent tests that assessed vision, hearing, neuropsychology, musculoskeletal health, respiratory and cardiovascular health, social and lifestyle habits, mental health, reproductive and sexual health, physical and grip strength, and facial ageing from birth to age 45.

At age 45, slow walkers showed more signs of ageing. They had lower total brain volume and cortical thickness, reduced brain surface area and higher incidence of white matter hyperintensities, which is associated with cognitive decline and dementia. Their lungs, teeth and immune systems were in worse shape than fast walkers. They also looked older to a panel of eight screeners who were asked to guess each participant’s facial age from a photograph.

Irregular periods? Be cautious

WOMEN WHO consistently had irregular periods or extra-long menstrual cycles had an increased risk of death during twenty years of follow up.

The study presented at the American Society for Reproductive Medicine meeting analysed data on 93,775 women without a history of cardiovascular disease, cancer or diabetes.

The participants provided information about the usual length and regularity of their cycles. The women were followed from 1991 to 2013, during which time 1,679 people died including 828 from cancer and 166 from cardiovascular disease.

Women who consistently had irregular periods between the ages of 14 and 17 were 21 per cent more likely to die from any cause during the study than women with regular periods. The risk was 34 per cent higher for women who had irregular periods from 18 to 22. A similar association was seen in women with irregular menstrual cycles from ages 28 to 48.

Women who had longer cycles (more than 32 days) were also more likely to die from any cause during the study, than women whose cycles lasted 26 to 31 days.

CONTRIBUTOR SHYLA JOVITHA ABRAHAM

healthy-drinks-healthy-kids

Fri Oct 04 16:59:57 IST 2019

What children drink in early childhood can impact their health and determine their choices throughout life. With so many products in the market, it can be confusing for parents.

Four key national health and nutrition organisations in the US have come together to issue a comprehensive guideline for beverage consumption for children from birth to age five. Here are the highlights:

0-6 months: Babies need only breast milk or infant formula.

6-12 months: In addition to breast milk or formula, babies can be given few sips of water once they are started on solid foods. Fruit juice should be avoided. Even 100 per cent fruit juice does not provide any nutritional benefits compared to whole fruit.

1-2 years: Introduce cow’s milk (whole) and add more water to your child's diet. Small amounts of 100 per cent fruit juice can be given. But small pieces of whole fruit is healthier.

2-5 years: Continue with milk and water, but switch to skim or low-fat milk. Stick to small amounts of 100 per cent fruit juice.

The committee does not recommend plant-based milk products, such as soy, almond, rice and oats, unless the child is allergic to cow’s milk or is lactose intolerant. Plant-based milk products lack essential nutrients such as vitamin D and calcium. Any drink with caffeine as well as all flavoured milk and all sugary beverages should be avoided.

Naps are good for heart

Taking naps could be good for your heart health. According to a Swiss study published in the journal Heart, adults who took a daytime nap once or twice a week had a lower risk of cardiovascular events, including heart attack, stroke and heart failure.

The study included 3,462 Swiss adults aged 35 to 75, who provided information about their sleep habits, and were followed for 5.3 years. More than half of the participants had not napped during the previous week of the study. And 155 fatal and non-fatal cardiovascular events occurred during the follow up.

Those who napped occasionally were almost 50 per cent less likely to suffer a heart attack, stroke or heart failure compared to those who did not nap at all.

No association was seen with more frequent napping or duration of napping. Occasional naps could relieve stress due to inadequate nighttime sleep and promote cardiovascular health.

Did you know?

People who drink tea regularly have better organised brain regions, suggesting that habitual tea drinking can protect against age-related decline in brain structure and cognitive function.

Aging

Breast cancer screening for men

Men at high risk of breast cancer may benefit from mammography screening, according to a US study published in the journal Radiology. Though rare, breast cancer is often deadly in men because it is often diagnosed at a more advanced stage.

To analyse how breast imaging affects disease outcomes, the researchers examined the records of 1,869 men, aged between 18 and 96, who underwent mammography, over a 12-year period. Of the 2,304 breast lesions detected during screening, 149 were biopsied. Of those, 41 (27.5 per cent) were malignant.

The study found that mammography was more effective at detecting cancer in high risk men than in women with average risk of breast cancer. For every 1,000 exams in high risk men, 18 had breast cancer. But the detection rate was 3 to 5 for every 1,000 exams in average risk women.

Men who already had breast cancer had an 84 times greater risk of getting it again. Men with a first degree relative, such as a sister or mother, with breast cancer had a three times greater risk of getting the disease.

Reverse-balding cap

Engineers at the University of Wisconsin, USA, have developed a low-cost, noninvasive device that can regrow hair. The electric patch can be discreetly worn under a baseball cap. It is powered by the movement of the wearer. It gathers energy from a person’s day-to-day movements and then transmits low-frequency electric pulses to the scalp, which causes dormant follicles to reactivate hair production.

The device is most suitable for people who have recently lost hair and is not effective for people who have been bald for several years. It only reactivates hair follicles that are dormant and does not cause new hair follicles to grow on smooth skin.

The device does not have any side effects. Since the electric pulses are so low, they will not penetrate beyond the very outermost layers of the scalp. When tested on mice, the device was as effective as baldness medicines. The researchers are starting human testing soon. The findings are detailed in the journal ACS Nano.

Height and diabetes

Taller people have a lower risk of developing type 2 diabetes, finds a German study published in the journal Diabetologia. The study included 2,500 adults who were part of a larger study that comprised 26,437 people aged between 35 and 65.

About 800 of these participants developed type 2 diabetes during seven years of follow up. Every 10 centimeter (4-inch) increase in a person's height was associated with a 41 per cent lower risk of developing type 2 diabetes for men and a 33 per cent lower risk for women.

So how does height influence diabetes risk? According to the researchers, shorter people may have higher levels of liver fat. They are also more likely to have other cardio-metabolic risk factors such as higher blood pressure, cholesterol and inflammation.

Interventions to reduce liver fat may help reduce the risk of diabetes in shorter people, the study authors suggested.

Did you know?

Taking a hot bath or shower in water of 40-42.5°C for about 90 minutes before bedtime can significantly improve sleep quality and help you fall asleep faster.

Sleep Medicine Reviews

Empty-stomach decisions

People should avoid making important decisions on an empty stomach, according to a Scottish study published in the Psychonomic Bulletin & Review. Fifty participants were offered three different types of rewards (food, money and music downloads) twice—once they had eaten normally and once after they had fasted for 10 hours.

They had the option to receive a small reward immediately or wait for a bigger one later. People preferred the smaller rewards rather than larger ones that would arrive later even for choices unrelated to food. When offered a reward now or the choice to double that reward later, most were willing to wait for 35 days to double the reward, but when hungry this dropped to only 3 days.

The study suggest: “A reluctance to defer gratification may carry over into other kinds of decisions. It is important that people know that hunger might affect their preferences in ways they don't necessarily predict.”

Aided by hearing aids

Using hearing aids soon after a diagnosis of hearing loss can lower the risk of dementia, depression or anxiety, and fall-related injuries. The cost and stigma often deter most people with a diagnosis of hearing loss from get hearing aids.

To find out how hearing devices can lower those risks, US researchers analysed data from 1,14,862 people 66 years and older with hearing loss. They looked at the health records of the participants from one year before their diagnosis to three years afterward.

Only 12 per cent of those with a diagnosis of hearing loss actually get the devices. Men were more likely to get a hearing aid than women (13.3 per cent vs 11.3 per cent).

Those who wore a hearing aid reduced the relative risk of being diagnosed with dementia by 18 per cent. They also had an 11 per cent lower risk of being diagnosed with depression or anxiety and a 13 per cent lower risk of being treated for fall-related injuries. The findings were published in the Journal of American Geriatrics Society.

Did you know?

One person dies from suicide every 40 seconds. It is the second leading cause of death among young people aged 15-29, after road injury.

WHO

Killer silent strokes

Silent (covert) strokes are common in seniors after an elective, non-cardiac surgery, which can double their risk of cognitive decline within a year. While an overt stroke causes symptoms such as weakness or speech problems, a covert stroke does not have any symptoms and can be seen only on brain scans.

Canadian researchers looked at the incidence and impact of silent strokes in 1,114 seniors from 12 centres around the world. All the patients had an MRI scan within nine days of their surgery. The study found that a covert stroke is more common than overt strokes in people aged 65 or older who have major, non-cardiac surgery.

One in 14 people had a silent stroke, suggesting that about three million seniors globally suffer a covert stroke after surgery each year.

The researchers found that those who had a silent stroke after surgery were more likely to experience cognitive decline, perioperative delirium, overt stroke or transient ischemic attack. The findings were published in The Lancet.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

optimists-live-longer

Tue Sep 10 15:20:39 IST 2019

People who are optimistic are more likely to live to age 85 or older. The conclusion comes from a study published in PNAS that included 69,744 women who were followed for 10 years and 1,429 men who were followed for 30 years.

The participants completed surveys that assessed their level of optimism and health habits such as diet, smoking and alcohol use.

The most optimistic men and women lived, on average, 11 to 15 per cent longer than the least optimistic participants. They were also 50 to 70 per cent more likely to live to the age of 85.

The results remained even after accounting for age, education, chronic diseases, depression, alcohol use, exercise and diet.

The researchers provide possible explanations: optimistic people may have healthier habits like exercising and not smoking which could increase lifespan. They also may be able to regulate emotions better and recover from stressors more effectively.

Haemoglobin levels linked to dementia

According to a Dutch study published in the journal Neurology, people who have either low or high levels of haemoglobin may have a higher risk of developing dementia, including Alzheimer’s, as they get older.

The study included 12,305 people without dementia (average age 65). Haemoglobin levels were measured at the start of the study and the participants were divided into five groups based on that. Among them, 745 participants (6 per cent) had anaemia.

During an average follow up of 12 years, 1,520 people developed dementia, including 1,194 with Alzheimer’s disease. People with anaemia were 41 per cent more likely to develop Alzheimer’s disease and 34 per cent more likely to develop any type of dementia.

People with high levels of haemoglobin also had a higher risk of dementia. Those with the highest haemoglobin levels were 20 per cent more likely to develop dementia than those with levels in the middle. Similarly, those with the lowest haemoglobin levels were 29 per cent more likely to develop dementia than those with levels in the middle.

The results remained the same even after accounting for other risk factors of dementia, including smoking, high blood pressure, high cholesterol and alcohol intake.

Open all blockages

Opening all the clogged arteries with stents after a heart attack is significantly better than opening only the one blockage that caused the heart attack, according to a major clinical trial published in The New England Journal of Medicine.

Nearly half of all heart attack patients have more clogged arteries than the one that caused their heart attack. Doctors usually open only the one artery responsible for the heart attack, leaving the other blockages to be treated with medication alone. The international study included 4,041 patients treated at 140 hospitals in 31 countries.

Opening all the blockages reduced the risk of the patient's risk of dying or having a recurrent heart attack by 26 per cent. All the patients had the blocked artery that caused the heart attack opened. Half of them were assigned to a second procedure to have other blocked arteries opened.

Over a median follow up of three years, 7.8 per cent of the patients who had all their blockages opened suffered a second heart attack or cardiovascular death compared to 10.5 per cent of those who had only the artery that caused the first heart attack opened.

Risk remains

Smoking is a leading cause of cardiovascular diseases such as heart attack, stroke and cardiovascular death. Quitting can significantly reduce the risk. But it could take 10 to 15 years after quitting for the risk to be similar to that of someone who never smoked, according to a study published in the Journal of the American Medical Association.

To find out the risk of cardiovascular diseases after smoking cessation, the researchers followed 8,770 adults with a mean age of 42 years for an average of 26 years. Among them, 2,371 were heavy smokers, smoking at least one pack of cigarettes daily for 20 years.

There were 2,435 cardiovascular events during the study period. Of these, 1,095 were among heavy smokers.

Quitting smoking reduced the risk of cardiovascular events by 39 per cent within five years for former heavy smokers compared with current smokers. But their risk remained significantly higher for at least 10 to 15 years and possibly for 25 years after quitting compared to never-smokers.

Did you know?

Practising mindfulness meditation can help adults with mild cognitive impairment enhance their cognitive reserve.

Journal of Alzheimer's Disease

Polypill solution

A low cost polypill that contains four drugs could effectively reduce the risk of heart attack and stroke by more than half.

The study, published in The Lancet, included 6,841 people aged 55 years or over living in northern Iran. Nearly half the participants were women.

Among them, 3,421 participants were asked to take a daily polypill, while 3,417 participants were given advice on a heart-healthy lifestyle. The polypill contained aspirin, a cholesterol-lowering statin and two blood pressure medications.

During five years of follow up, 301 participants in the lifestyle advice group suffered a cardiovascular event, compared to only 202 participants in the polypill group.

Those taking the polypill had a 34 per cent lower risk of major heart events, including heart attack, stroke, heart failure, acute coronary syndrome, procedures to reopen clogged arteries and heart related mortality, compared with those who received only lifestyle advice.

The risk was 40 per cent lower among people without a history of heart disease, and up to 57 per cent lower in people who took the medication as recommended.

The benefits and side effects were similar in both men and women.

The best companion

Dog owners have better heart health, according to a US study published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes.

To study the impact of pet ownership, specifically dog ownership, on cardiovascular health and risk factors, the researchers recruited 1,769 adults aged 25 to 64 years without a history of cardiovascular diseases from the Czech Republic.

Pet owners, in general, were more likely to eat a healthy diet, be physically active, and have ideal blood glucose levels and higher levels of HDL (good) cholesterol. Regardless of their age, sex and education level, the greatest heart benefits were seen in dog owners.

The cardiovascular benefits could be explained by the simple fact that dogs keep their owners physically active, which could also explain the lower blood sugar levels. On average, 67 per cent of dog owners met the recommended exercise goals compared to 48 per cent of people without pets and 55 per cent of other pet owners.

Dogs also promote better mental health by providing companionship and emotional comfort. They reduce stress and relieve feelings of loneliness.

Did you know?

The US Food and Drug Administration is warning consumers that Hyland's homeopathic teething tablets contain inconsistent amounts of belladonna, a toxic substance, that can cause unnecessary risk to infants and children.

Eat more plant protein

People who eat more plant proteins like nuts, soy, legumes and beans tend to live longer, according to a Japanese study published in JAMA Internal Medicine.

To analyse the association between dietary protein intake and the risk of death, the researchers followed 70,696 healthy people, average age of about 55, for about 20 years.

Among them, 12,381 people died during the study period: 5,055 deaths from cancer; 3,025 from cardiovascular disease; 1,528 from heart disease; and 1,198 from cerebrovascular disease.

Participants whose diet had the most plant protein had a 13 per cent lower risk of all-cause mortality and a 16 per cent lower risk of cardiovascular mortality compared to those who consumed the least plant protein.

Substituting just 3 per cent of red meat with plant protein was associated with a 34 per cent lower risk of all-cause mortality, a 39 per cent lower risk of cancer related mortality, and a 42 per cent lower risk of cardiovascular mortality.

Substituting just 4 per cent of processed meat with plant protein was associated with 46 per cent lower risk of dying from all causes and 50 per cent lower risk of dying from cancer. No association was seen between intake of animal protein and mortality outcomes.

Avoid alcohol during pregnancy

No level of alcohol is safe during pregnancy. Even small amounts can increase the risk of miscarriages.

More than half of women drink alcohol in the early stages of pregnancy before they realise they are pregnant. Alcohol-related adverse pregnancy outcomes, like foetal alcohol syndrome, are often thought to be related to heavy consumption.

But according to the current study published in Alcoholism: Clinical and Experimental Research, consuming even small amounts of alcohol during pregnancy can increase the risk of miscarriages by 19 per cent.

Among women who have less than five drinks a week, each additional drink per week during pregnancy was associated with a 6 per cent increase in miscarriage risk.

The findings were based on 24 studies that included more than 2,31,808 pregnant women.

Did you know?

A comparison of healthiness of packaged food and beverages among different countries showed that India and China had the worst Health Star Rating.

Obesity Reviews

Abusers at home

As their physical and intellectual capabilities start to wane, senior citizens often become victims of scams and abuse. But who is the most likely perpetrator?

According to a study published in the Journal of Applied Gerontology, in majority of cases the perpetrator is a family member and not a stranger. The findings are based on an analysis of 1,939 calls made to the National Center on Elder Abuse (NCEA) resource line which was created to help people seeking information on how to identify or report elder abuse.

Among them, 42.2 per cent of the calls reported some form of abuse, with 54.9 involving financial abuse; 23 per cent of the calls reported multiple abuse types and 18.2 per cent alleged multiple abusers. A family member was the alleged perpetrator in nearly 48 per cent of the calls.

Financial abuse was the most common type of abuse perpetrated by family members (61.8 per cent), followed by emotional abuse (35 per cent), neglect (20.1 per cent), physical abuse (12 per cent) and sexual abuse (0.3 per cent).

More than one type of abuse was reported in more than 32 per cent of the calls alleging abuse by a family member.

Cancer and antibiotic response

According to a US study published in the journal Gut, antibiotic exposure can increase the risk of colon cancer.

For the study, the researchers compared the medical records of 19,726 colon cancer patients and 9,254 rectal cancer patients with 1,37,077 people matched for age and sex, who did not develop these cancers. Nearly six out of 10 of all study participants had been prescribed more than one class of antibiotics.

Even a single course of antibiotic use can slightly increase the risk of colon cancer, and the risk increased with prolonged usage.

Those who were on antibiotics for a total of 15 to 30 days had an 8 per cent greater risk of colon cancer compared to those who had not taken any antibiotics. The risk was 15 per cent greater with 30 or more days of total antibiotic exposure.

On the other hand, antibiotic use was linked to a small decrease in the risk of rectal cancer. This could be due to differences in the impact of antibiotics on the gut bacteria.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

is-jogging-the-best-way-to-lose-weight

Tue Aug 20 11:36:41 IST 2019

Are you doomed to become overweight if you are genetically prone to obesity? A Chinese study published in the journal PLOS Genetics has identified six exercises that can help people with obesity genes to avoid weight gain.

The study included 18,424 adults aged 30 to 70 who provided information about their workout regimen. The researchers looked for genetic markers of obesity and examined the impact of 18 types of exercise on several measures of obesity, including body mass index, body fat percentage, waist circumference, hip circumference and waist-to-hip ratio.

Overall, people who exercised regularly had a lower BMI, even if they were genetically prone to obesity, compared to those who did not engage in regular exercise. Jogging topped the list in helping people avoid obesity. Regular jogging was associated with a lower BMI, lower body fat percentage and a smaller hip circumference.

Mountain climbing, walking, exercise walking, international standard dancing, and a longer practice of yoga also help reduce the genetic effects of obesity. But the study also found that exercises such as cycling, stretching, swimming and qigong were not effective in keeping weight in check.

Blood pressure control to prevent second stroke

One in four stroke survivors will suffer a recurrent stroke. But intensive blood pressure control can reduce the risk of recurrence, finds a Japanese study published in JAMA Neurology.

The trial included 1,263 people, average age of 67.2 years, who had suffered a stroke within three years before the start of the study. Half of the participants were randomly assigned to standard blood pressure control (less than 140/90mmHg), while the other half were assigned to intensive blood pressure control (less than 120/80mmHg). The mean baseline blood pressure was 145/84mmHg. During a mean follow up of 3.9 years, the average blood pressure was 133/78mmHg in the standard group and 127/77mmHg in the intensive group. Ninety-one people suffered a second stroke, but the risk was lower in the intensive group.

When the study results were combined with the findings of three similar studies, intensive blood pressure control was associated with a 22 per cent lower risk of a second stroke. A healthy diet, maintaining a healthy weight, exercising regularly, reducing stress and reducing salt intake are other factors that can help reduce the risk of a second stroke.

Eat plant-based food for a healthy heart

People who follow a mostly plant-based diet have a lower risk of cardiovascular diseases, such as heart attack and stroke, cardiovascular disease mortality, and all-cause mortality, according to a US study published in the Journal of the American Heart Association.

The researchers followed 12,168 middle-aged US adults for nearly 30 years. None of the participants had cardiovascular disease at the start of the study. Of the subjects, 5,436 participants died during the study period, including 1,565 deaths from cardiovascular disease. There were 4,381 incidents of cardiovascular diseases.

People who ate the most plant-based foods had a 16 per cent lower risk of heart attacks, stroke, heart failure and other heart conditions; a 32 per cent lower risk of dying from a cardiovascular disease; and a 25 per cent lower risk of dying from any cause compared to those who ate mostly animal-based foods.

Did You Know?

People who have a parent, sibling, or child with blood cancer have an increased risk for the malignancy. People with a relative diagnosed at a young age or with multiple affected relatives are especially at risk.

Blood

Blood test to detect Alzheimer’s

A blood test to spot Alzheimer’ disease even before symptoms appear could soon be a reality. Harmful clumps of the amyloid beta protein, associated with Alzheimer's, begin to accumulate in the brain about 20 years before people actually show symptoms of the disease such as memory loss and confusion, the researchers said.

By measuring the levels of the protein in blood, it would be possible to predict with 88 per cent accuracy whether the protein has accumulated in the brain as well. People with early Alzheimer’s brain changes can be identified with 94 per cent accuracy when the blood test is combined with age and the presence of the genetic variant APOE4—two major Alzheimer’s risk factors.

The study, published in the journal Neurology, included 158 adults over 50 without any cognitive or memory problems. The blood test could be even more beneficial once more treatments are available for Alzheimer’s disease. It would help to identify at-risk patients early and start treatment and prevent disease progression. The immediate advantage of the blood test is identifying people who have signs of the disease and enrolling them for clinical trials evaluating the efficacy of drugs to prevent Alzheimer’s.

Did You Know?

Smokers have nearly triple the risk of dying from cardiovascular disease and double the risk of a heart attack, a stroke or heart failure compared to nonsmokers. Quitting at any age reduces the risk, and quitting by age 45 can eliminate about 90 per cent of the cardiovascular risks linked to smoking.

BMC Medicine

Don't stop statins in old age

Discontinuing statins (drugs that reduce levels of fat in the blood) in old age can increase the risk of cardiovascular events, finds a French study published in the European Heart Journal.

It has been proven that statin therapy can help control cholesterol levels and prevent cardiovascular problems. But can statins prevent cardiovascular events in healthy, older adults? To find out, the researchers examined the medical records of 1,20,173 participants, aged 75 or older, without any history of cardiovascular disease. The participants had been taking statins regularly for two years prior to the start of the study. During an average follow up of 2.4 years, 17,204 people (14.3 per cent) stopped taking statins for at least three consecutive months. Of that, 5,396 people had to be admitted to hospital for cardiovascular issues. Those who discontinued their statins were 33 per cent more likely to experience a cardiovascular event, had a 46 per cent increased risk of a coronary event and a 26 per cent increased risk of a blood vessel problem, such as stroke.

Sling treatment for shoulder fractures

Nondisplaced shoulder fractures are usually treated by resting the shoulder in a sling for two to three weeks, followed by physical therapy. But for displaced shoulder fractures, the typical treatment is surgery in which the bones are rejoined with plates or metal screws.

But according to a European study published in the journal PLOS Medicine, treatment with a sling is as good as surgery for displaced shoulder fractures as well. The study included 88 patients over 60 who suffered a displaced shoulder fracture. Half of them had surgery, while the other half only had the arm supported by a sling. All patients underwent rehabilitation and were monitored for two years.

There was no significant difference between the two treatments. The patients who underwent surgery did not have better shoulder function, less pain or better quality of life than those who had the sling treatment. In that context, the study author suggested that treatment with a sling should be preferred as patients thereby avoid surgery-related complications.

Stay socially connected

People who are socially active in their 50s and 60s may have a lower risk of developing dementia, according to a British study published in the journal PLOS Medicine.

The researchers followed 10,228 adults aged 35 to 55 for 28 years. The participants provided information about the frequency of social contact with non-cohabiting relatives and friends and took cognitive tests several times during the study period.

The medical records of the participants were analysed for a diagnosis of dementia.

More frequent social connection was associated with a lower dementia risk. This association was linked to social contact with friends rather than relatives. People in their 60s who interacted with friends nearly every day had a 12 per cent lower risk of developing dementia than people who saw a couple of friends every few months.

Similar association was seen with social contact at ages 50 and 70. More frequent social contact in middle age was also associated with better cognitive function during follow-up.

Procedure to delay menopause by 20 years

Women can delay menopause by up to 20 years with a new 30-minute surgical procedure, claim doctors at ProFaM (Protecting Fertility and Menopause) in Birmingham, England.

The procedure involves having a piece of ovarian tissue removed using keyhole surgery. The tissue is then cryogenically frozen. As the woman gets closer to menopause, the tissue will be thawed and transplanted back into the armpit, which hopefully will restore their younger hormones and delay menopause. A similar procedure is already available to protect the fertility of young women and girls before undergoing cancer treatment.

The procedure to delay menopause has been performed on nine British women ranging from 22 to 36. The long term effects will be known only several decades later. The doctors hope that delaying menopause could help women stave off common menopausal symptoms such as low sex drive, anxiety, difficulty sleeping, hot flushes, night sweats and other health problems such as heart disease and osteoporosis that are brought on by menopause.

The surgical procedure was launched by Professor Simon Fishel, the fertility expert who pioneered IVF.

Osteoarthritis may increase heart disease risk

Two studies have linked osteoarthritis to an increased risk of heart disease. According to one study published in the journal Arthritis & Rheumatology, taking nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of cardiovascular disease in osteoarthritis patients. NSAIDs such as ibuprofen and naproxen are the most common medication to manage pain and inflammation associated with osteoarthritis.

For the study, the researchers matched 7,743 osteoarthritis patients with 23,229 people without the disease. Overall, osteoarthritis patients had a 23 per cent higher risk of developing cardiovascular disease. They had a 42 per cent higher risk of congestive heart failure; a 17 per cent greater risk of ischemic heart disease; and a 14 per cent greater risk of stroke. Taking NSAIDS accounted for nearly 41 per cent of the increased risk of cardiovascular diseases.

Another study published in the journal Osteoarthritis and Cartilage followed 4,69,177 Swedish people, aged 45 to 84, for up to 11 years. The researchers looked for cause-specific mortality among the 34,699 people who had osteoarthritis. Most cases were not linked to specific causes of death. But people with knee or hip osteoarthritis had a 19 per cent increased risk of dying from chronic heart diseases, and the risk increased with the duration of the disease.

Did You Know?

Pregnant women who change residence during the first trimester have a 37 per cent greater risk of having a baby with low birthweight and a 42 per cent heightened risk of premature birth compared with women who do not move during this period.

Journal of Epidemiology & Community Health

Track blood pressure with a selfie

Monitoring your blood pressure could be as easy as taking a selfie video, according to findings of a new research published in the journal Circulation: Cardiovascular Imaging.

The new smartphone-based technology, developed by researchers at the University of Toronto, uses transdermal optical imaging, which measures blood pressure based on facial blood flow changes. Ambient light penetrates the skin’s outer layer allowing optical sensors in smartphones to capture blood flow patterns. Transdermal optical imaging models use these patterns to predict blood pressure.

The researchers tested the technology on 1,328 Canadian and Chinese adults with normal blood pressure and then compared the values measured using the videos to readings taken using a traditional device. The imaging technology was about 95 per cent accurate in predicting systolic blood pressure and about 96 per cent accurate in predicting diastolic blood pressure with pulse pressure.

But several issues need to be resolved before the technique can be used widely. The study was conducted in a controlled environment with fixed lighting. The researchers need to make the system work in a normal home setting. Also, the study did not include people with extremely dark or fair skin tones and people with high or low blood pressure.

Mortality risk high post noncardiac surgery

Patients undergoing noncardiac surgery are more likely to die during recovery than during the surgery.

The study, published in the Canadian Medical Association Journal, included 40,004 patients aged 45 or above undergoing noncardiac surgery at 28 hospitals in 14 countries across North and South America, Asia, Europe, Africa and Australia.

Of them, 715 patients (1.8 per cent) died within 30 days of the surgery. Major bleeding, injury to the heart muscle and severe infection (sepsis) accounted for 45 per cent of the deaths.

Only five patients (0.7 per cent) died in the operating room compared to 500 patients (69.9 per cent) who died in the hospital and 210 patients (29.4%) who died after they were discharged from the hospital. “Given that most deaths in adults undergoing non-cardiac surgery occur not in the operating room but afterwards, efforts to improve postsurgical care has substantial potential to reduce mortality,” the study author said.

According to the study, nearly 100 million adults aged 45 or older, worldwide, undergo noncardiac surgery every year and about 1.8 million people die of complications within 30 days.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

a-salaried-job-helps

Fri Aug 02 16:34:02 IST 2019

Women who have salaried jobs experience slower decline in memory, which may reduce their risk of dementia and Alzheimer’s later in life.

For the US study presented at the Alzheimer’s Association International Conference, the researchers followed 6,836 women born between 1935 and 1956.

The women, who were in their 50s at the start of the study, provided information about their parental and marital status and employment history. They had memory assessment tests, which included memorising a series of words and recalling them later, every two years for about 20 years.

The group included working married mothers, working single mothers, stay-at-home married mothers and stay-at-home single mothers.

Some level of cognitive decline was seen in most women after the age of 60, which is natural. But memory declined at a faster rate in women who did not engage in paid work.

Married mothers who did not work had a 61 per cent faster memory decline compared to married mothers who had paying jobs.

Single mothers without paid work saw the fastest decline. Their memory declined 83 per cent faster compared to married mothers who worked.

Cancerous heartbreak

Broken heart syndrome is not just a trigger for heart events. According to an international study published in the Journal of the American Heart Association, one in six people with broken heart syndrome also had cancer. What is more, they were more likely to die within five years after the syndrome began.

Broken heart syndrome occurs when the heart’s main pumping chamber temporarily enlarges and does not pump properly. It can be triggered by emotional situations such as the death of a loved one, or by a surgery or physical trauma.

Of the 1,604 patients with broken heart syndrome included in the study, 267 patients had cancer. The average age was 69.5 years, and 87.6 per cent were women. The most common type of cancer was breast cancer. Other affected areas included the gastrointestinal system, respiratory tract, internal sex organs, and the skin.

Cancer patients were more likely to have physical triggers and less likely to have emotional triggers.

Blind about women's issue

Blindness in general, and blindness caused by cataracts in particular, are considerably higher among Indian women compared to Indian men. But women are less likely to have their cataracts corrected with surgery, finds an Indian study published in the British Journal of Ophthalmology.

To analyse the gender-related differences in blindness, cataract blindness and cataract surgery in India, the researchers reviewed 22 studies.

The age of the study participants ranged from 61 to 70.

Blindness was more prevalent among women (5.68 per cent) than in men (4.17 per cent).

Women were 35 per cent more likely to be blind and 69 per cent more likely to be cataract blind than men. But women were 27 per cent less likely to get cataract surgery compared to men.

Around 35 per cent of the prevalence of blindness and 33 per cent of the prevalence of cataract blindness in women can be attributed to their gender alone.

The researchers highlight several possible explanations for the gender difference in the prevalence of blindness in India.

Longer life expectancy and biological predisposition to age-related illnesses can only partly explain the gender differences.

Access to surgery could be a major contributing factor. Having less control over household income, inability to travel outside their village to access care, and lack of education or awareness make surgical correction less likely.

Pressure parameter

A study published in the New England Journal of Medicine shows that the diastolic blood pressure is also an important indicator of cardiovascular events.

The researchers reviewed more than 36 million blood pressure readings from 1.3 million people for the study.

According to new guidelines issued by the American College of Cardiology, a reading of 130/80 mmHg is considered as high blood pressure which is lower than the traditional threshold of 140/90 mmHg. A reading of 120/80 mmHg is considered normal.

Over eight years of follow up, more than 44,000 patients had a heart attack or stroke. The study found that while systolic blood pressure was a stronger predictor of heart attack and stroke, diastolic blood pressure also increased the risk.

On average, the risk of cardiovascular events rose by about 18 per cent with increase in each unit of systolic pressure above 140. Similarly, the risk increased by 6 per cent with increase in each unit of diastolic blood pressure above 90.

Did You Know?

Cognitively normal older adults with high levels of amyloid-ß protein, linked to Alzheimer's disease, in their brains can slow any mental decline if they socialise regularly.

American Journal of Geriatric Psychiatry

Age is not just a number

Foot morphology, or the shape of our feet, changes and foot deformities increase as we grow older. But older adults often wear ill-fitting shoes that can affect their balance and gait, and increase the risk of falls and fracture.

To find out the effects of footwear on comfort, mobility and quality of life among adults aged 65 and older, Dutch researchers reviewed 57 studies.

According to them, safe and comfortable footwear for older adults should include proper anatomical fit, a well-fitting toe box, a low heel height, a broad enough heel, a firm insole and midsole, an outsole with sufficient tread and width, a bevelled heel and shoe nose, a firm heel counter with snug fit, and an easy and effective closing mechanism.

The researchers found that when older adults were provided with properly fitted shoes, they experienced less pain, and higher quality of life related to foot health and general health.

Sugary cause for cancer

People who drink a lot of sugary drinks, including soda and juice, have an increased risk for various cancers, especially breast cancer.

The French study published in The BMJ included 101,257 healthy adults (21 per cent men and 79 per cent women) with an average age of 42 years.

Participants answered questions about their daily intake of 3,300 different foods and beverages. Men, on average, drank more sugary drinks than women.

During nine years of follow up, 2,193 cases of cancer were diagnosed. The average age at diagnosis was 59 years.

Drinking 100ml of sugary drinks each day was associated with an 18 per cent increased risk of overall cancer and a 22 per cent increased risk of breast cancer, even after accounting for well known risk factors for cancer, such as age, sex, education, family history, smoking and physical activity.

All sugary drinks, including 100 per cent fruit juice were associated with a higher risk of overall cancer. However, artificially sweetened beverages were not associated with a risk of cancer.

Did You Know?

Genetic factors account for 80 per cent of autism spectrum disorders. Environmental causes are responsible for the remaining 20 per cent. Maternal factors such as a mother's diet and weight, and mode or timing of delivery were almost nonexistent.

JAMA Psychiatry

Can dementia be prevented?

According to a British study published in the Journal of the American Medical Association, following a healthy lifestyle can lower your risk of dementia even if you have a high genetic risk.

The study included 196,383 adults, aged 60 and older, without dementia at the onset.

Based on their genetic predisposition, the participants were grouped as high, intermediate and low genetic risk for dementia. They were also grouped on the basis of favourable, intermediate and unfavourable lifestyles they follow.

There were 1,769 cases of dementia during eight years of follow-up. Both genetic risk and healthy lifestyle were independently associated with risk of dementia.

The risk of dementia was 32 per cent lower in people with a high genetic risk if they had followed a healthy lifestyle, compared to those who had an unhealthy lifestyle. Participants with high genetic risk and an unhealthy lifestyle were almost three times more likely to develop dementia, compared to those with a low genetic risk and healthy lifestyle.

Early indicators

People with high blood pressure or high cholesterol before age 40 are at an increased risk for cardiovascular diseases later in life.

The study published in the Journal of the American College of Cardiology included data from six studies involving 36,030 participants aged 18 to 84.

The researchers looked at the association between blood pressure readings and cholesterol levels during early adulthood (18 to 39 years) and later adulthood (above 40), and subsequent risks of coronary heart disease, heart failure and stroke.

During 17 years of follow up, 4,570 people had coronary heart disease, 5,119 had heart failure and 2,862 people suffered a stroke.

People whose LDL (bad) cholesterol was 100mg/dL and up before age 40 had a 64 per cent higher risk of coronary heart disease compared to people with low LDL levels in early adulthood.

Young adults with a systolic blood pressure (top number) reading above 130 had a 37 per cent elevated risk for heart failure later in life compared with someone with a reading under 120. And those with a diastolic blood pressure (bottom number) reading above 80 had a 21 per cent greater risk compared to someone with a reading under 80.

Did You Know?

Having access to a garden, or being able to see green spaces from your home can reduce cravings for alcohol, cigarettes, and unhealthy food.

Health & Place

Every minute matters

Starting treatment for stroke patients 15 minutes sooner can save lives and prevent long term disability, according to a study published in JAMA.

To analyse patient outcomes based on their 'door-to-puncture' time—the interval from their arrival at the hospital to the time their treatment began—the researchers reviewed data for 6,756 patients who suffered ischaemic strokes and were treated with endovascular reperfusion therapy. The average age of the patients was 69.5 years, and 51.2 per cent were women.

For every 1,000 patients whose time to treatment was 15 minutes sooner, 15 fewer died or required hospice care after discharge from the hospital, 17 more were able to walk out of the hospital without support and 22 more could care for themselves after leaving the hospital.

The study found that the median time from arrival at the hospital to the start of treatment was 1 hour 27 minutes, and the median time from the start of stroke symptoms to treatment was 3 hours 50 minutes.

The study also found that treatment initiation tends to be delayed in hospitals that treat less than 30 stroke patients each year and at hospitals that are not certified as comprehensive stroke centres.

Microvascular risk

Microvascular disease, or small vessel disease, can increase the risk of leg amputations, irrespective of its location in the body.

For the study published in the journal Circulation, the researchers looked at the risk of amputation among 125,674 veterans with microvascular disease, peripheral artery disease (PAD) or both.

PAD is a narrowing of the arteries typically found in the legs. Left untreated, PAD can lead to gangrene and amputation.

There were a total of 1,185 amputations during an average of nine years of follow up.

Those with microvascular disease had a 3.7 times greater risk of lower limb amputation, and accounted for 18 per cent of all amputations.

Those with PAD had a 13.9 times greater risk of lower limb amputation and accounted for 22 per cent of all amputations.

Participants with both microvascular disease and PAD had a 23-fold increased risk of lower limb amputation and accounted for 45 per cent of all amputations.

Did You Know?

You are more likely to meet your weekly exercise goals if you exercise at the same time every day.

Obesity

Small cut, big impact

Cutting just 300 calories from your daily diet can significantly improve cardio-metabolic risk factors, and reduce the risk of cardiovascular diseases and related deaths.

The study published in the journal The Lancet Diabetes & Endocrinology included 218 healthy, non-obese adults aged 21 to 50.

Among them, 143 participants were assigned to a calorie-restricted diet. They had to reduce their daily calorie intake by 25 per cent for two years, while the remaining participants continued their usual diet.

The ability to cut calories varied among the participants in the calorie-restricted group. The average calorie reduction was about 12 per cent over two years.

Even with 12 per cent calorie retraction, which equals about 300 calories, they lost 10 per cent of their body weight, 71 per cent of which was fat.

They also had lower levels of a biomarker that indicates chronic inflammation, which has been linked to heart disease, cancer and cognitive decline.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

nature-the-best-healer

Sat Jul 20 15:48:05 IST 2019

Spending just two hours a week in nature may promote physical and mental well-being, according to a British study published in the journal Scientific Reports.

The study was based on a survey of nearly 20,000 people in England who were asked to rate their general health and well-being, and also answered questions about their engagement with nature during the previous week, including parks, beaches, countryside and other natural settings.

People who spent two to three hours per week in nature were 59 per cent more likely to report good health and 23 per cent more likely to report high well-being, compared to participants without any nature contact.

The positive association peaked at 300 minutes per week, beyond which there was no further gain. The benefits were seen across different groups of people, men and women, old and young, different occupational and ethnic groups, and those living in both rich and poor areas.

Even people with long-term illnesses or disabilities reported better health and well-being if they spent two hours in nature. And the benefits were seen if the nature visits were done in one long stretch or several short visits in a week.

The majority of nature visits in the study took place within just two miles of home.

Shape matters

Your cardiovascular disease risk may depend on your body shape.

According to a US study published in the European Heart Journal, post-menopausal women who are apple-shaped have a greater risk of cardiovascular diseases, even if they are of normal weight, while pear-shaped women have a considerably lower risk.

To analyse if fat distribution impacted heart disease risk, the researchers followed 2,683 women with normal body mass index for nearly 18 years. None of the participants had cardiovascular disease at the start of the study. During the study period, 291 new cases occurred.

Women who stored most fat round their middle (apple shaped) had almost twice the risk of heart disease and stroke compared to women with the least fat stored around their middle. On the other hand, the risk was 40 per cent lower in women who stored the most fat in their legs (pear-shaped).

Women who had the highest percentage of fat around their middle and the lowest percentage of leg fat had more than three times greater risk compared to women with the least body fat and the most leg fat.

Stroke-triggering infections

Infections, especially urinary tract infections, may put you at risk of suffering a stroke.

For the study published in the journal Stroke, the researchers looked at the medical records of more than 190,000 people who had been treated for a stroke to see if they had been hospitalised for infections, including skin, urinary tract, septicaemia, abdominal and respiratory, at seven, 14, 30, 60, 90, and 120 days prior to the stroke occurrence.

Every type of infection increased the risk of ischaemic stroke, a type of stroke caused by blocked blood vessels in the brain. But UTIs showed the strongest link. Patients were more than three times as likely to suffer an ischaemic stroke within 30 days of an UTI. The risk was over five times greater in the week following an infection.

UTI, blood infection and respiratory infection increased the risk for intra-cerebral haemorrhage, which is caused by a ruptured blood vessel in the brain. Respiratory infection also increased the likelihood of subarachnoid haemorrhage, caused by bleeds in the inner lining of the brain.

Anticholinergic drugs and dementia risk

A commonly prescribed class of drugs has been shown to increase the risk of dementia. According to a British study published in the journal JAMA Internal Medicine, patients aged 55 and older who took anticholinergic medication daily for three years or more, had a 50 per cent increased risk of dementia.

Anticholinergic drugs work by blocking acetylcholine, a chemical that transmits messages in the nervous system. They are prescribed for a variety of health conditions, including chronic obstructive pulmonary disease, bladder conditions, depression, allergies, gastrointestinal disorders and Parkinson’s disease.

The researchers compared the medical records of 58,769 patients with dementia and 225,574 patients without dementia. All the patients were 55 and older.

The increased risk of dementia was especially seen in patients who took anticholinergic drugs for depression, Parkinson’s, bladder problems and epilepsy, and in people aged below 80, suggesting that “anticholinergic drugs should be prescribed with caution in middle-aged and older people”.

Risky treatment

Patients who receive radioactive iodine (RAI) treatment for hyperthyroidism have an increased long-term risk of cancer death from solid tumours, especially breast cancer. RAI is one of three commonly prescribed treatments for hyperthyroidism. The other two are anti-thyroid drugs and surgery.

The US study published in JAMA Internal Medicine included nearly 19,000 people with hyperthyroidism (mainly Graves’ disease) who received the radiation treatment between 1946 and 1964. None of them had cancer at the start of the study.

The researchers estimated radiation doses that each organ or tissue was exposed to as part of the treatment. While most of the radiation is absorbed by the thyroid gland, other organs like the breast and stomach are also exposed during treatment.

There was a dose-response relationship between the radiation dose absorbed by an organ and the risk of death from cancer at that site, especially for solid tumours in men and women, and for breast cancer in women.

Every 100 milligram of dose was associated with a 12 per cent increased risk of breast cancer death and 5 per cent greater risk of death from other solid cancers.

According to the study, for every 1,000 patients (average age 40) treated with RAI, there would be an additional 19 to 32 radiation-related solid cancer deaths.

Did You Know?

The risk of stillbirth increases with every week that a pregnancy continues beyond 37 weeks, which is considered full term. The risk increased by 87 per cent for deliveries at 42 weeks compared to 41 weeks of gestation.

PLOS Medicine

For timely detection

Prostate cancer often grows slowly and most men with a diagnosis do not require treatment. But the current prostate-specific antigen (PSA) blood tests cannot predict which tumours will become aggressive, making it hard for doctors to decide which men need further treatment.

About 75 per cent of men with a high PSA test result do not have prostate cancer when they have a biopsy. On the other hand, PSA test fails to spot cancer in about 15 per cent of men with prostate cancer.

Prostate urine risk (PUR), the new urine test, can predict which patients will require treatment, five years earlier than the current tests. PUR looks for genetic markers to make a more accurate diagnosis.

The researchers hope the new test would help low-risk patients on active surveillance avoid unnecessary and repeated biopsies.

The findings were published in the journal BJU International.

Yogurt to fight colon cancer

Eating yoghurt may lower the risk of colon cancer in men.

The study published in the journal Gut was based on 32,606 men and 55,743 women.

All of them had a colonoscopy between 1986 and 2012. During the study, 5,811 men and 8,116 women developed polyps or adenomas, which are abnormal growths that have the potential to turn cancerous.

Men who ate two or more servings of yoghurt a week were 19 per cent less likely to develop conventional adenomas compared with men who did not eat any yoghurt. They were also 26 per cent less likely to develop the kind of adenomas that have the highest potential to become cancerous.

However, the study did not find any link between yoghurt consumption and adenoma risk in women.

So how does yoghurt help fight cancer? According to the researchers, yoghurt may promote the growth of healthy bacteria in our gut. Two common probiotics found in yoghurt, lactobacillus bulgaricus and streptococcus thermophilus, may reduce acids and cancer-causing chemicals in the colon. Yoghurt may also reduce inflammation, which reduces cancer risk.

Did You Know?

Using LASER antiretroviral therapy followed by gene editing, US researchers have successfully eliminated HIV from infected animals’ genome for the first time.

Nature Communications

Can cervical cancer be eradicated?

A global review of the impact of HPV vaccinations has shown significant reductions in human papillomavirus infections, genital warts and precancerous lesions that can lead to cervical cancer.

The HPV vaccine, offered to girls and boys, protects against the HPV strains—HPV 16 and 18—that cause 70 per cent of cervical cancers. It also provides protection against 90 per cent of the strains that cause genital warts.

For the study published in The Lancet, researchers reviewed 65 studies that included data collected over eight years from more than 60 million people in 14 countries.

Compared to rates before vaccination, HPV 16 and 18 dropped by 83 per cent in girls aged 13 to 19 years, and by 66 per cent among women aged 20 to 24, five to eight years after vaccination initiation. In addition, there was a 54 per cent reduction in three other types of HPV—31, 33 and 45—in teen girls.

Precancerous cervical lesions went down by 31 per cent in women aged 20 to 24 and 51 per cent in teen girls.

Cases of genital warts went down by 67 per cent in girls aged 15 to 19, 48 per cent in boys aged 15 to 19, 54 per cent in women aged 20 to 24, 32 per cent in men aged 20 to 24, and 31 per cent in women aged 25 to 29 years.

For your sexual health

Regular nut consumption can improve erectile and sexual function in healthy men.

Lifestyle factors, including smoking, excessive alcohol consumption, lack of physical activity, psychological stress, and unhealthy diets can negatively impact erectile and sexual function.

For the Spanish study published in the journal Nutrients, researchers assigned 83 healthy men, aged 18 to 35, to one of two groups. Men in the nut group were asked to add 60g raw mixed nuts (hazelnuts, almonds, and walnuts) daily to their usual western-style diet for 14 weeks, while those in the control group followed their usual western-style diet without any nuts.

The nut intervention group reported significant increase in the orgasmic function and sexual desire at the end of the study period compared to the control group.

“Our study suggests that compliance with a healthy diet supplemented with mixed nuts may help improve erectile function and sexual desire,” the study concluded.

Hidden recovery signals

There is no clear way for doctors to predict which patients will recover from coma after a brain injury. Neurological examinations and other tests that are currently used by doctors to estimate the likelihood of recovery are often inaccurate.

According to a study published in the New England Journal of Medicine, some patients in coma may show signs of hidden consciousness that are detectable with EEGs just days after injury and those patients are more likely to get better.

The study was based on 104 unresponsive adult patients who had suffered a sudden brain injury due to internal bleeding, trauma, or oxygen deprivation. They were unable to talk and did not respond to commands to move.

The researchers used EEG to scan the brain waves of the patients as they were asked many times to open and close their hands or stop opening and closing their hands. Using an algorithm, the brain waves were then analysed to see if there were different patterns of activity, suggesting that the patients could differentiate between the two commands even though they could not act on it.

Fifteen per cent of the patients had brain activity patterns suggesting hidden consciousness within four days of the injury. Among them, 50 per cent were able to follow verbal commands before being discharged from hospital compared to 26 per cent of those without such brain activity.

A year later, 44 per cent of patients with the brain activity patterns were able to function independently for eight hours daily, compared with only 14 per cent of those without such brain activity.

Did You Know?

About 81 per cent of antibiotics prescribed by dentists before dental procedures to prevent infections are unnecessary.

JAMA Network Open

Beware, workaholics

People who regularly work long hours have a higher risk of stroke, especially if they do so for ten years or more, according to a French study published in the journal Stroke.

The study defined long hours as working more than ten hours for at least 50 days a year.

The risk was similar for both men and women, but greatest for people younger than 50. The study included 143,592 participants, 29 per cent of whom reported working long hours and 10 per cent reported working long hours for a decade or more.

Among them, 1,224 had suffered a stroke.

Working long hours was associated with a 29 per cent greater risk of stroke. The risk was 45 per cent greater for those who worked long hours for ten years or more.

Part-time workers and those who suffered a stroke before working long hours were excluded from the study.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

preventive-dose-daily

Tue Jun 25 17:33:26 IST 2019

New guidelines issued by the US Preventive Services Task Force is recommending all healthy people at high risk of HIV infection take a daily pre-exposure prophylaxis (PrEP) pill. PrEP is a combination of two HIV medicines—tenofovir and emtricitabine.

According the US Centers for Disease Control and Prevention, taking PrEP pill daily can reduce the risk of getting HIV from sex by more than 90 per cent. Combining PrEP with condoms can reduce the risk of infection even further. PrEP can also reduce the risk of HIV infection in people who inject drugs by more than 70 per cent.

PrEP is highly effective in preventing HIV if used as prescribed. It is much less effective in people who do not take it consistently.

Side effects are mild and include some kidney and gastrointestinal issues. The new recommendations are published in the Journal of the American Medical Association

Additional defence

A landmark clinical trial has shown that a common diabetes drug—canagliflozin—may also reduce the risks of kidney failure and cardiovascular events, including heart failure, in patients with diabetes and kidney disease.

The study published in the New England Journal of Medicine included 4,401 patients with diabetes and chronic kidney disease from 34 countries. Half of the participants were given canagliflozin, while the other half received a placebo. All the participants received treatment for kidney disease.

People who took canagliflozin had a 30 per cent reduced risk of developing kidney failure, a 30 per cent lower risk of dying from either kidney failure or cardiovascular disease, a 39 per cent lower risk of heart failure, and a 20 per cent reduced risk of major cardiovascular outcomes, including heart attack, stroke and cardiovascular death.

Stents for elderly, too

Percutaneous coronary intervention (PCI), also known as angioplasty with stent, is a non-surgical procedure that unlocks arteries that have been narrowed by plaque buildup. The blocked arteries can lead to a heart attack. PCI is safe, effective and improves overall survival, and is widely used in younger heart-attack patients.

But what about older patients?

To find out if PCIs work in older adults, researchers analysed medical records of nearly 470,000 older patients admitted to US hospitals who faced their first heart attack.

They grouped patients aged 75 to 79 years as 'young-old', 80 to 84 as 'middle-old' and 85 and older as 'old-old'.

Though the use of PCI has been steadily increasing among all age groups, 'old-old' patients were the least likely to receive the lifesaving procedure.

PCI was performed in 38 per cent of young-old patients compared to 33 per cent of middle-olds and 20 per cent of old-olds.

Overall death was 5 per cent lower among the young-olds in the PCI group compared to those who did not get the procedure. The reduction in death with PCI was 49 per cent and 42 per cent lower among the middle-olds and old-olds, respectively.

The findings were published in the American Heart Association journal Circulation: Cardiovascular Interventions.

DID YOU KNOW

Pregnant women who take benzodiazepines, a class of drugs prescribed for anxiety, seizures and insomnia that include Xanax and Valium, are nearly twice as likely to suffer miscarriages.
JAMA Psychiatry

Count your steps

According to a US study published in the JAMA Internal Medicine, taking as few as 4,400 steps per day was significantly associated with a lower risk of death and the benefits seemed to taper off at around 7,500 steps per day, which is much less than the 10,000 steps touted by many wearable devices.

For the study, 16,741 women, average age 72 years, wore an accelerometer that counted steps and measured stepping intensity for seven consecutive days.

During an average follow-up of over four years, 504 women died. Among them, 275 of them were in the bottom 25 per cent of steps walked, an average of 2,700 per day.

The study found a close association between daily step count and mortality risk. Women who took about 4,400 steps per day had a 41 per cent lower risk compared to those who walked 2,700 steps per day. The risk of death steadily declined with more steps taken, but levelled off at around 7,500 steps per day.

Rehab after big fight

Advances in cancer screening, detection and treatment have significantly improved the survival odds of cancer patients.

But cancer survivors are 1.3 to 3.6 times more likely to die from cardiovascular causes and 1.7 to 18.5 times more likely to develop diabetes, high blood pressure, high cholesterol or other risk factors for heart disease than someone without a cancer history.

Cancer treatments can damage the heart and survivors may also have to grapple with weight gain or loss of fitness.

A new scientific statement from the American Heart Association published in the journal Circulation, aims to draw attention to the importance of adopting a cardiac rehab plan for cancer survivors—cardio-oncology rehabilitation—similar to the one used for heart attack survivors.

The aim of the programme is to identify cancer survivors at risk of heart disease and provide exercise training, nutritional guidance, information about management of weight, blood pressure, cholesterol and diabetes. It also includes counselling to reduce stress and anxiety. The programme can help people regain some of the cardiorespiratory fitness lost during cancer treatment and improve their muscular strength and quality of life.

DID YOU KNOW

Men who wear moustaches have a 16 times lower risk of developing actinic keratosis (a pre-cancerous lesion) on the lower lip that can increase the risk of a cancer called squamous cell carcinoma.
Journal of the American Academy of Dermatology

Sign of serious problems

Fainting during pregnancy is often considered normal and benign.

But according to a Canadian study published in the Journal of the American Heart Association, fainting spells during the first semester could be a sign of health concerns for both the mother and baby.

The researchers reviewed the birth records of 481,930 babies and the medical records of their mothers for one year after delivery.

About one per cent of the mothers experienced fainting spells. Among them, 32 per cent of those were during the first trimester, 44.1 per cent during the second trimester and 23.6 per cent during the third trimester.

The risk of preterm birth was higher among women who fainted during the first trimester. Children born to mothers who had fainted multiple times were more likely to have congenital anomalies.

Women who fainted during pregnancy had higher rates of cardiac arrhythmia and further fainting episodes after delivery.

DID YOU KNOW

Increasing the reach of treatment for high blood pressure to 70 per cent of the world’s population could save the lives of 39.4 million people; reducing sodium intake by 30 per cent could prevent another 40 million deaths; and eliminating trans fat could prevent an additional 14.8 million deaths.Circulation

Are PPIs safe?

Long term use of popular heartburn drugs can increase the risk of premature death from cardiovascular disease, chronic kidney disease and upper gastrointestinal cancer.

Popular proton pump inhibitors (PPIs), which include drugs such as omeprazole, lansoprazole, pantoprazole, rabeprazole, esomeprazole and dexlansoprazole, are often prescribed for heartburn, ulcers and acid reflux.

For the study published in The BMJ, researchers studied the medical records of 157,625 people who were prescribed PPIs and 56,842 people taking another class of heartburn drugs known as H2 blockers.

PPI users had a 17 per cent increased risk of death compared with the H2 blocker users. PPI use was specifically associated with deaths from cardiovascular disease, chronic kidney disease and upper gastrointestinal cancer.

The risk increased with the duration of PPI use and even when the drugs were taken at low doses. More than half of the people were taking PPIs without any medical indication and death rates were highest among them.

Ultra-processed menace

Two studies published in The BMJ have found a strong association between eating ultra-processed foods and an increased risk of cardiovascular diseases and early death.

For the first study, 105,159 adults with an average age of 43 years completed six 24-hour dietary questionnaires that measured the intake of 3,300 different food items that were grouped based on the degree of processing. They were followed for an average of 5.2 years.

For every 10 per cent increase in the amount of ultra-processed foods the participants consumed, the risk of cardiovascular disease increased by 12 per cent, coronary heart disease by 13 per cent and cerebrovascular disease by 11 per cent.

On the other hand, the risk of all these diseases were significantly lower in those who consumed more unprocessed or minimally-processed foods.

In the second study, 19,899 adults with an average age of 38 years completed a food questionnaire of 136 items. Among them, 335 died during an average of ten years of follow-up.

Those who consumed more than four servings of ultra-processed foods per day had a 62 per cent higher risk of all-cause mortality compared with those who ate less than two servings per day.

For each additional daily serving of ultra-processed food, mortality risk increased by 18 per cent.

Advanced combination

Adding a newer drug, Ribociclib, which is taken as a tablet, to the standard hormone treatment can improve the odds of survival by about 30 per cent in younger women with advanced breast cancer.

Ribociclib belongs to a class of drugs called CDK4/6 inhibitors. They work by targeting cancerous cells and blocking their ability to multiply.

The findings of the current study included 672 women, aged 25 to 58, with advanced breast cancer, who were premenopausal or going through menopause. All had cancer that was hormone receptor-positive, but lack a protein called HER2.

Half of the patients were randomly assigned to take Ribociclib in cycles of three weeks on the drug and one week off, while the other half took placebo tablets.

All the women received standard hormonal therapy and drugs to stop the production of the hormone oestrogen.

Among them, 70 per cent of patients on hormone therapy plus Ribociclib were still alive three and half years later compared with only 46 per cent of those on hormone therapy alone.

The drug is less toxic than chemotherapy. Possible side effects include fatigue, nausea, diarrhoea and constipation, and a drop in certain white blood cells that help fight infections.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

sleep-mantra

Sat Jun 15 18:27:30 IST 2019

Sleep problems in teenagers can be easily reversed by limiting evening exposure to blue light-emitting devices such as phones, tablets and computers.

Too much evening exposure to the blue light emitted from screens can affect the body’s circadian rhythm and the production of the sleep hormone melatonin, disrupting the quality of sleep.

Chronic sleep deprivation can cause fatigue and poor concentration as well as increase the risk of obesity, diabetes and heart disease.

The Dutch study presented at the European Society of Endocrinology annual meeting found a simple fix to the problem.

The researchers assessed the sleep patterns of 25 frequent users of phones in two settings: wear orange-tinted glasses that block blue light when using devices before bed time for a week and abstain from usage in the evening for a week.

Both methods were equally effective. Just one week of limiting exposure to blue-light emitting devices in the evening improved sleep quality of the participants and reduced symptoms of fatigue, lack of concentration and bad mood.

To deal with dementia

The World Health Organization has issued new guidelines to reduce the risk of cognitive decline and dementia.

Dementia affects about 50 million people globally, with nearly 10 million new cases added every year. The number of people with dementia is expected to triple to 152 million in the next 30 years, and the cost of caring for dementia patients is expected to rise to $2 trillion by 2030.

While age is the most important risk factor for cognitive decline, according to the report, "Dementia is not a natural or inevitable consequence of ageing”.

The guidelines provide evidence-based recommendations to prevent or delay the onset and progression of cognitive decline and dementia.

Getting regular exercise topped the list followed by nonsmoking, non-drinking healthy diet, controlling weight, and maintaining healthy blood pressure, cholesterol and blood sugar levels.

Vitamins and supplements did not appear to offer protection, nor did social activity and cognitive training and interventions.

There was also insufficient evidence to recommend antidepressants or hearing aids to reduce the risk of dementia. Nevertheless, being socially engaged, treating depression and managing hearing loss are important for good health and wellbeing.

Fast walkers live long

According to a British study published in the Mayo Clinic Proceedings, people who habitually walk faster tend to live longer regardless of their body weight or waist circumference.

Walking pace is an important marker of cardiorespiratory fitness and overall health.

To analyse the link between physical fitness—assessed by walking pace and handgrip strength—and life expectancy, the researchers used data from 474,919 participants with an average age of 58 years.

Among them, 12,823 people died over a median follow-up of seven years.

Participants with faster walking pace had longer life expectancies, ranging from 86 to 87 years in women and 85 to 86 years in men, across all weight groups.

On the other hand, participants with slow walking pace had shorter life expectancies. Slow walkers with a BMI less than 20 kg/m2 had an average of 72 years for women and 64 years for men.

A similar pattern of results was found for waist circumference measurements as well.

Early indicator

Diabetes is a strong predictor of deadly liver diseases, including cirrhosis and cancer, finds a British study published in the journal BMC Medicine.

The researchers looked at the medical records of 18 million adults and identified 136,703 patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).

NAFLD is the most common liver disease in the world and is closely linked to obesity and type 2 diabetes. Even though NAFLD is a benign condition, about one in six people with the condition will go on to develop NASH, a more aggressive disease, which can lead to liver injury, cirrhosis, liver failure and even cancer.

Each NAFLD patient was matched with 100 controls without the disease to see who would develop liver cirrhosis and liver cancer over time.

Patients with NAFLD/NASH were more likely to have type 2 diabetes, hypertension and obesity than matched controls.

NAFLD/NASH patients who had type 2 diabetes were more than twice as likely to develop aggressive liver disease, suggesting that diabetes could be a good predictor of liver disease progression.

NAFLD/NASH patients were almost five times more likely to be diagnosed with cirrhosis and more than three and a half times more likely to be diagnosed with liver cancer.

In the zone of a second stroke

Smoking is already known to increase the risk of numerous cancers and cardiovascular events such as heart attack and stroke.

According to a Chinese study published in the Journal of the American Heart Association, smokers who do not quit after an initial stroke are more likely to suffer a second stroke.

The study included 3,069 patients who suffered a first stroke. Among them, 48 per cent were current smokers, 8.6 per cent were former smokers and 43.4 per cent were nonsmokers; 61.6 per cent of the current smokers quit smoking after the initial stroke.

During the study period, 9.5 per cent of the patients suffered a second stroke.

Compared to nonsmokers, the risk for a recurrent stroke was 93 per cent higher in persistent smokers, 31 per cent higher in those who quit smoking after the initial stroke and 16 per cent higher in former smokers.

The risk of a repeat stroke increased with the number of daily cigarettes smoked. Those who smoked up to 20 cigarettes daily were 68 per cent more likely to suffer a second stroke, while the risk was almost three times greater for those who smoked more than 40 cigarettes a day.

Bipolar disorder increases Parkinson’s risk

Patients suffering from bipolar disorder are seven times more likely to develop Parkinson's disease, according to a Taiwanese study published in the journal Neurology.

The researchers compared the medical records of 56,340 patients diagnosed with bipolar disorder between 2001 and 2009 with 225,360 matched controls without bipolar disorder. People in both groups did not have a history of Parkinson’s disease.

Both groups were followed until the end of 2011.

During the study, 372 people with bipolar disorder developed Parkinson's disease, compared to 222 of those without the disorder.

People with bipolar disorder developed Parkinson's disease at a younger age—64 years old at diagnosis compared to 73 years old for those without the disorder.

Patients who were hospitalised more often for bipolar disorder were more likely to develop Parkinson's disease. Those who were hospitalised one to two times per year were four times more likely to develop Parkinson's disease than those who were hospitalised less than once per year. The risk was six times greater for those who were hospitalised more than two times per year.

Did You Know

Weighing yourself daily can help you maintain or even lose weight. Seeing weight increase can motivate behavioural changes like exercising more and watching your diet.

Obesity

Don’t fat-shame children

Teasing children about their weight may lead to more weight and fat gain, according to a US study published in the journal Pediatric Obesity.

The study included 110 kids with an average age of 12 years at the start of the study. They were either overweight, or at risk of being overweight because their parents were overweight or obese.

They completed a brief questionnaire on whether they had been teased about their weight. They were then followed for 15 years.

Children who were teased about their weight had a 33 per cent increase in their body mass index each year compared with children who had not been teased. They also had a 91 per cent greater gain in fat mass (an additional 0.65 kg) per year.

According to the study authors, kids who are teased about their weight are more likely to engage in unhealthy behaviours, such as binge eating and avoiding exercise. The stress of being teased may also stimulate the release of the stress hormone cortisol, which may lead to weight gain.

Did You Know

Older adults who regularly play word and number puzzles such as crosswords and Sudoku have sharper brains and perform better on a range of cognitive tasks assessing memory, attention and reasoning.

International Journal of Geriatric Psychiatry

Diabetes linked to several cancers

People with type 2 diabetes have an increased risk for several cancers.

According to a Chinese study published in the Journal of Diabetes, diabetes can increase the risk for 11 types of cancer in men and 13 types of cancer in women.

The researchers identified 410,191 adults with type 2 diabetes from July 2013 to December 2016.

None of them had cancer at the start of the study. They were followed until December 2017.

Among them, 8,485 of the participants were diagnosed with cancer during the follow up period.

Men and women with diabetes had a 34 per cent and 62 per cent elevated risk of cancer compared to men and women without diabetes, respectively.

For men, the greatest risk was for prostate cancer; the risk was 86 per cent greater. They also had a higher risk for leukaemia, skin cancer, thyroid cancer, lymphoma, kidney cancer, liver cancer, pancreatic cancer, lung cancer, colorectal cancer, and stomach cancer.

For women with diabetes, the highest risk was for nasopharynx cancer. They also had a higher risk for liver cancer, oesophageal cancer, thyroid cancer, lung cancer, pancreatic cancer, lymphoma, uterine cancer, colorectal cancer, leukaemia, breast cancer, cervical cancer, and stomach cancer.

The study found a lower risk for oesophageal cancer and gallbladder cancer for men and women with diabetes, respectively.

Diet matters

Unhealthy diets accounted for 5.2 per cent of all new cancer cases among adults 20 and older in the US in 2015, according to a study published in JNCI Cancer Spectrum.

This is similar to the rates of cancer cases associated with alcohol consumption, which is 4 to 6 per cent. In comparison, being obese accounts for 7 to 8 per cent of the cancer cases and physical inactivity is associated with 2 to 3 per cent.

The researchers identified seven dietary factors that could increase the risk of cancer. Low whole-grain intake accounted for the largest proportion of new cancer cases, followed by low dairy intake, high intake of processed meat and red meat, low fruit and vegetable intake and high intake of sugary beverages.

The largest number of cancer cases associated with poor diet was for colorectal cancer, followed by cancer of the mouth, pharynx, and larynx, uterine cancer, post-menopausal breast cancer, kidney cancer, stomach cancer and liver cancer.

Middle-aged men had the highest proportion of diet-related cancers compared to other age and gender groups.

Did You Know

Drinking 32 ounces of energy drink in an hour can cause abnormal electrical activity in the heart and increase blood pressure.

Journal of the American Heart Association

For mothers' wellness

Giving a single dose of antibiotics soon after delivery to women who undergo assisted vaginal birth could halve the rate of maternal infections and reduce the need for antibiotics later.

Pregnancy-related infections after assisted vaginal delivery are a major cause of death and serious illness, affecting about one in five women worldwide.

For the study published in The Lancet, 3,427 women were randomly assigned to receive either a single dose of intravenous amoxicillin with clavulanic acid or a saline placebo about three hours after delivery.

Among them, 19 per cent of those who received the placebo developed an infection after childbirth, compared with only 11 per cent of those in the antibiotic group. The rates of sepsis, a more serious infection, were 56 per cent lower in women who received the antibiotics than those who received the placebo.

Women who received the antibiotics also had lower rates of perineal infection, perineal pain, burst stitches and problems feeding babies as a result of pain. They also had a better recovery after childbirth.

A single dose of antibiotic given prophylactically also reduced the overall use of antibiotics for post-delivery infections by 17 per cent.

Delayed fatherhood has consequences

Men who delay fatherhood may be putting the health of their partners and children at risk, according to US study published in the journal Maturitas.

To evaluate the effect of parental age on fertility, pregnancy and the health of children, the researchers reviewed 40 years of research.

Men aged 45 and older can have decreased fertility. Their partners are at a greater risk for increased pregnancy complications such as gestational diabetes, preeclampsia and preterm birth. Infants born to older fathers have a higher risk of premature birth, late still birth, low birth weight, higher incidence of newborn seizures and birth defects such as congenital heart disease and cleft palate.

As they get older, these children have an increased risk for cancers, psychiatric and cognitive disorders, and autism.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM