Health

covid-testing-led-to-new-techniques-of-disease-diagnosis

Mon Mar 27 15:05:31 IST 2023

In March 2020, weeks before the World Health Organisation (WHO) declared Covid-19 a pandemic, its director-general Tedros Adhanom Ghebreyesus delivered a speech in which he emphasised the importance of testing:

...the most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate. You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don't know who is infected. We have a simple message for all countries: test, test, test.

The pandemic exposed critical shortcomings of existing diagnostic techniques. It revealed an urgent need for tests that are faster, simpler, cheaper and more scalable than existing methods, and just as accurate.

Three years on, the global face of diagnostics has changed. New techniques of disease diagnosis have been developed that can be applied to other emerging zoonotic pathogens such as disease X a hypothetical infectious disease that has the potential to develop into a pandemic.

As a molecular scientist with a keen interest in veterinary disease diagnostics, I have closely followed developments in the diagnostic space since the start of the pandemic. These emerging technologies, together with conventional tests, have the potential to overcome bottlenecks in the current diagnostic procedures.

By incorporating these tests into a country's healthcare system, clinicians and policy makers are better equipped to practise precision medicine and to react to potential outbreaks.

The first diagnostic tests for SARS-CoV-2 (the virus that causes Covid disease) used established molecular techniques such as reverse transcription polymerase reaction (RT-PCR). These techniques detect and identify organisms by amplifying their genetic material millions of times.

Running the tests however requires trained technicians and expensive equipment.

As the pandemic became more severe, other ways to test for the virus had to be developed. Substances and compounds needed to effectively run diagnostic tests were in short supply and many countries did not have the kinds of sophisticated laboratories needed for the existing tests. Low- and middle-income countries like those throughout the African continent had limited finances too and not enough trained specialists to handle the demand.

Isothermal amplification techniques helped to address the need. This is a simple process which rapidly and effectively amplifies DNA and RNA (genetic material) at constant temperature.

Immunological assays also helped. These tests can be used on-site or in the lab and are able to detect specific molecules such as antibodies and antigens. Antibodies are generated in a person's body when a foreign molecule (antigen) invades the body.

These cost-effective tests provide rapid results and can be used on a big scale even where resources are scarce.

The major challenge of these tests is that they are less accurate. Unlike molecular tests, which amplify the genetic material of the virus, immunological assays do not amplify their protein signal.

This makes them less sensitive. The risk is high that an infected person might incorrectly be told that they don't have the virus.

The global diagnostic community realised it was time to look at methods that were as accurate as conventional molecular tests but could be used outside laboratories and on a large scale.

Scientists needed a new generation of rapid, accurate, accessible and affordable diagnostic tests.

The National Institutes of Health in the US set up the Rapid Acceleration of Diagnostics programme (RADx) in 2020 to fund innovative point-of-care and home-based tests and to speed up the development, validation and commercialisation of these tests.

One particularly interesting change in this space is the use of CRISPR. The technology was previously known for its use in gene editing.

But now it has revolutionised diagnostics with the launch of SHERLOCK and DETECTR, two innovative CRISPR-based kits used for the detection of SARS-CoV-2.

These are particularly sensitive and specific and provide a visual colour readout using a commercially available paper dipstick, making them suitable for use as a point-of-care test.

The versatility of these techniques enables researches to apply the same principles to the detection of other infectious diseases too.

There have also been advances in using biosensors, nanotechnology, smartphone-based tests and wearable technologies for diagnostics.

Overall, in the past three years, the focus of disease testing has moved from simple detecting and understanding to incorporating speed, efficiency and portability of the tests.

While there is a lot to celebrate in the diagnostic space, problems remain. There are barriers in developing and disseminating tests, particularly in poorer countries. Fairer access to quality testing and improved data sharing between countries is needed to eliminate the inequity in diagnostics.

The lack of resources to deliver a robust regulatory system in low- and middle-income countries also poses a serious challenge.

Companies have less incentive to develop and commercialise products where there is weak regulation. Thus countries still depend on tests that are manufactured elsewhere.

As the world moves out of its pandemic response phase, it is likely that investment in diagnostics will fall. With a reduced need for tests, the economic return of investing in developing tests will diminish.

This is unfortunate as there are still so many healthcare challenges worldwide and unless disease surveillance is proactive, it won't be possible to predict where the next pandemic might emerge from.

The momentum created by the Covid pandemic offers an opportunity and should be used to build on the things that worked well in the diagnostic industry and to improve on the things that didn't.

(The Conversation: By Angelika Loots,Postdoctoral Fellow, University of Pretoria)

healthcare-and-medical-education-the-indian-way

Sat Mar 25 19:54:31 IST 2023

All Faith Spiritual Master, Sri Sathya Sai Baba is remembered the most for inspiring his followers to give; give free food to the hungry, free quality healthcare to the needy and free education to all with love, seeing God in one’s fellowmen. Baba always said that after his time, his students and devotees would continue the good work; and that is happening.

When Baba exited the physical in 2011, a then barely thirty-year old Madhusudan Naidu, a double gold medallist from Baba’s University in Puttaparthi, an MBA and ex-banker, was inspired by Baba from the beyond to carry on and eventually lead a mission under the banner of the Sri Sathya Sai Loka Seva Group of Institutions. He followed his heart selflessly and fearlessly, despite endless trouble from many quarters who considered him an upstart! Baba was known all through life as the ’Man of Miracles’. In hindsight, this posthumous mission in the verticals of nutrition, education and healthcare qualifies to be the greatest miracle of all.

On the healthcare front, the continuing mission began with healthcare focussed on children; tertiary care to battle congenital heart disease, the commonest birth defect in children, and primary care to battle the scourge of malnutrition. On the tertiary care front, in 2011, C. Sreenivas, an alumnus of the first batch of Baba’s students who helped set up the legendary tertiary care hospitals in Puttaparthi and Whitefield in Bangalore, was commanded by Baba, through Madhusudan, to set up a free heart hospital for children in the heartland of India - in Raipur, in backward Chhattisgarh. Today, it has expanded into a global chain of dedicated Sri Sathya Sai Sanjeevani paediatric cardiac hospitals with footprints from Fiji in the South Pacific to India and Sri Lanka; from Nigeria in Africa, all the way to Mississippi, the poorest state of the USA. To date, 25,000 plus children have had their hearts mended- totally free of cost, literally getting a Gift of Life.

As for primary care, India is home to one third of the world’s stunted children and half of the world’s wasted children; and 70 per cent of them are in rural areas. In 2012, Sadguru, inwardly guided by Baba, launched a free of cost nutritious, fresh ‘Breakfast Seva’ for rural government school children, who invariably came to school only for the free mid-day meal. What began as a small experiment on fifty school children in the Bangalore rural district by a bunch of dedicated IT techies who volunteered to sacrifice sleep and set out on their two-wheelers at the crack of dawn, with a cook in tow, to a tumbledown school in Doddabelle, today has grown into an 'Annapoorna' mission, which serves a nutritious breakfast to over a million children every single day. In rural north-east India, where access to healthcare is a challenge, a primary healthcare-on-wheels initiative named Aarogya Vahini, primarily to battle the NCD epidemic, has been growing by leaps and bounds!

Touched by the plight of malnourished, under-weight, young pregnant women of the global South, in 2017, Sadguru launched a 'Divine Mother and Child Health Programme' globally, with the emphasis on nutrition. World over, devotees took up the challenge and antenatal care clinics for under-served communities got under way with the focus on nutrition. An amazing protein and micro-nutrient supplement, ‘SaiSure’, for free distribution to pregnant women, toddlers and school children was also developed. Its impact? Improved haemoglobin and weight among young mothers; and improved attendance, academic performance and health indices among school children. School teachers are delighted; for they can now teach children who are hungry for knowledge rather than for food.

On the secondary care front, multi-speciality secondary care hospitals were begun in rural Nigeria and Sathya Sai Grama in India. In 2022, on the tenth Anniversary of Sathya Sai Sanjeevani hospitals, in a bid to reverse the unacceptable maternal and infant mortality rates in rural India by promoting institutional deliveries, Sanjeevani Mamatwa hospitals (maternity hospitals) were launched, the first being in the Bastar tribal belt of Chhattisgarh. Eventually, one such facility is to come up in every district of India. Connected to these hospitals, several small Sai Swasthya rural health centres were launched in 2022-23 on a hub and spokes, rent/lease model to further coverage of healthcare delivery. They offer diagnostic facilities and primary care through tele-medicine at the taluk level. Beginning with Karnataka state, Sai Swasthya will eventually cover all of India. All services are provided totally free of cost to the beneficiaries; and at every level of this amazing rural healthcare mission, Sadguru had adopted Baba’s Sarkar-Samaj-Sanstha model of working harmoniously with the government and the civil society.

Such an ambitious, huge, selfless-service-oriented, model health care mission, with the aim of reaching the unreached, serving the unserved and literally doing the un-done, requires a truly inspired team of doctors, nurses, paramedics and so on, who would be ready to serve in rural areas. The million-dollar question posed by the intelligentsia to Sadguru was- “All your ideas are noble; but how are you going to get such dedicated doctors, nurses and paramedics who will be happy to work in rural areas?”

In 2021, Sadguru Madhusudan Sai declared the impossible, that medical education, which hitherto, has been mainly the preserve of the well-heeled, would be de-commoditised and de-commercialised, that he would establish a world class residential private Medical College in rural Sathya Sai Grama, which would give totally free of cost medical education preferably to rural students who today make up only a paltry 5 per cent of medical students. Sadguru says it is unrealistic to expect urban students to be happy to make a life amid cows and buffaloes, though exceptions may be there. The key is to train rural students in a rural milieu, by a faculty that cares for rural patients to generate inspired young doctors ready to serve the rural. Only then can we move from the current one doctor for 11,000 plus population in rural India, to the WHO recommendation of one doctor for 1,000 population.

Rural roots, gratitude for a world-class but free medical education, a purpose and passion imbibed from an inspired faculty will be the drivers of a generation of healthcare professionals devoted to rural healthcare. A truly dedicated faculty is in place and in February 2023, the NMC after inspection has given permission to admit 100 medical students in July 2023. Post graduate DNB courses in the basic clinical disciplines have also received approval, for all the infrastructure is miraculously in place.

Infrastructure-wise, in 2021, the Sri Sathya Sai Sarla Memorial Hospital in Sathya Sai Grama, which was the only dedicated COVID-19 Hospital in the district with 150 oxygenated beds, was first upgraded into a 360 bedded multi-speciality teaching hospital. ‘Rogi Narayana Hari’ (patient is God) is the ethos of the hospital; and competence, compassion and totally free of cost sum up the culture of the hospital. Naturally, patient numbers are going through the roof with over 1,200 villagers attending the OPD every day. The Rs 350 crore Dr C. Rajeshwari academic block, with state-of-the-art facilities, is the newest addition. Under the aegis of the Sri Sathya Sai University for Human Excellence, the Sri Madhusudan Sai Institute of Medical Sciences and Research, as christened by devoted fellow human beings, is ready to admit the first batch of 100 medical students into its pre-clinical wing with on-campus hostels, this academic year. Work on an additional 400 bedded facility, to be ready before the first batch reaches the clinical years, is under way.

Aspiring students need to pass the NEET exam. They will also need to pass an aptitude test that assesses their suitability for rural service. Students from low-income rural domicile families will get preference; they have to live on campus and follow the discipline of residential learning. Boarding, lodging, medical education- everything will be given to them free with great love; but they will need to sign a contract to work in rural areas for as many years as they studied free of any cost; ie, 5 years. Those who jump this bond will be required to pay back all the expenses incurred to make them doctors.

Sadguru’s experiment with the general education wing of the mission has proved the astounding power of gratitude. Nearly all of the graduating batches of the Sri Sathya Sai University for Human Excellence, which imparts higher education totally free of cost, have opted to join the mission and serve; to give back to society, the gift of free values-based education with love, that they received. Sadguru is therefore confident that if the right kind of rural students are given the right training, they would in turn become inspired doctors who would serve in the rural healthcare mission.

What is the math of the money needed? Indian regulations necessitate admitting 100 medical students a year for a five-year course at a minimum 460 bedded hospital facility. In short it means providing free education, boarding and lodging for a total of 500 medical students and offering free quality treatment to around 500 inpatients at any point in time. Private colleges charge both the students and patients; and make good the cost of education, hospital treatment and of course, profit. In a free set up such as this, with subsidies on drugs, consumables, etc, from all stake holders, as well as stringent controls on expenses and admin-costs, the cost of educating one medical student and running one free hospital bed for a year, can be brought down to around 50 lakh rupees, reckoned the team after brainstorming with experts. Five hundred kind-hearted individuals or groups coming up with fifty lakhs each a year, can keep the medical college going. One word from Sadguru - and his team in Sathya Sai Grama and devotees the world over chipped in. Corporates through CSR funds, high net worth individuals, ordinary devotees, and the Indian diaspora abroad have come forward to create the infrastructure, sponsor scholarships for students as well as support hospital beds. The Heart2Heart Foundation led by legendary cricketer Sunil Gavaskar who has been an Ambassador for the Sanjeevani Child Heart hospitals, is a major fund raiser.

Sadguru points out that the Universe conspires to help when selfless service is done with selfless love. The past decade is proof of that; for with nothing but fearlessness and a readiness to serve with selfless love, led by Sadguru Sri Madhusudan Sai, the Sri Sathya Sai Loka Seva Group today serves 1.2 million school children free breakfast, gives values based quality residential education across 27 school campuses and a university with three campuses to around 5,000 students. In India alone, 412,000 plus patients have benefited through the healthcare mission while globally, thousands of children have got a new lease of life through heart surgery; and all this has been done TOTALLY FREE OF COST FOR THE BENEFICIARIES concerned.

On March 25, Prime Minister Narendra Modi inaugurated the one of its kind rural Medical College—Sri Madhusudan Sai Institute of Medical Sciences and Research—in the hamlet of Sathya Sai Grama, in Chikkaballapura district of Karnataka in the presence of its founder Sadguru Sri Madhusudan Sai. The prime minister was accompanied by the chief minister of the state, Basavaraj Bommai and health minister Dr K. Sudhakar. Also present were the Chancellor of the Sri Sathya Sai University for Human Excellence, Sri Narasimhamurthy, and the head of the global healthcare mission, Dr C. Sreenivas. Dr Sreenivas, who welcomed the prime minister and the gathering, recounted how his late mother, Dr C. Rajeshwari, in whose memory the new academic block is named, relinquished her practice abroad to start the free General Hospital in then rural Whitefield on Sri Sathya Sai Baba’s command in the seventies.

The chief minister lauded the humanitarian projects undertaken in the state by Sadguru with amazing efficiency and compassion. Sadguru, whose vision and grace power this initiative, stated that medical education that empowered dedicated rural youth was the need of the hour globally. A video of the free service rendered by the organisation in the verticals of nutrition, education and healthcare globally was screened. Food, education and healthcare had always been given free in ancient Bharat. This free medical college was one more step in reviving that culture.

The prime minister pointed out that only a concerted effort by all citizens and all sections of society could make the vision of Amrit Kal happen, and in that regard, he deeply appreciated the work of Sadguru Madhusudan Sai and the team which were in sync with the nation’s objectives.

That this gathering in rural India included devotees from over fifteen countries, and that the live proceedings were being watched in over fifty countries, all of whom had selflessly contributed to the success of this unique mission of free medical education for rural youth, only underscored the truth of the ancient motto of Bharat - ‘Vasudhaiva Kutumbakam’(one world, one family).

dr.hiramalini.seshadri@gmail.com

natural-immune-system-may-hold-key-to-reducinig-reliance-on-anti

Sat Mar 25 12:08:28 IST 2023

A new study suggests that the body's natural process of removing old and damaged cell parts could be used to treat infections like tuberculosis (TB), reducing the need for antibiotics.

Researchers at the Francis Crick Institute, UK, found that disabling a self-destruction mechanism called autophagy in human immune cells allowed TB bacteria to replicate more, causing mass cell death.

Their study is published in Nature Microbiology.

According to the study, from induced pluripotent stem cells, a kind of specialist stem cells and are able to become any cell type in the body, the scientists engineered macrophages, or human immune cells.

Following this, they disabled these macrophages from performing autophagy using genome editing tools.

The cells were then infected with Mycobacterium tuberculosis, bacteria causing TB. The scientists found that the infection took hold, replicating more within the edited macrophages and causing mass host-cell death.

The results evidence the role of autophagy in controlling infections like TB.

This pathway, if strengthened, could make existing antibiotic drugs more effective or present an alternative to drugs where bacteria have evolved resistance, the study said.

"As immunotherapies have harnessed the immune system to fight cancer, boosting this immune defence with a host-directed therapy, could be a valuable new tool in the fight against infections, particularly those becoming resistant to antibiotics," said Max Gutierrez, head of the Host-Pathogen Interactions in Tuberculosis Laboratory at the Crick.

The team also validated their results using macrophages isolated from blood samples, confirming the importance of autophagy in human defences.

"TB is a great example of where targeting our own immune defences could be really effective, because it takes a very long course of different antibiotic treatments to effectively remove the infection.

"Anything that can be done to more effectively remove bacteria, could also make a huge difference to the cost and accessibility of treatments," Beren Aylan, co-first author and PhD student at the Crick.

The team is now planning to screen for drug compounds that could boost autophagy in a targeted way.

March 24 is World TB Day.

(With inputs from PTI)

hormonal-birth-control-pills-linked-with-small-breast-cancer-ris

Thu Mar 23 17:10:42 IST 2023

Use of all hormonal contraceptives is associated with a small increase in the risk of breast cancer, according to a new study.

The research, published in the journal PLOS Medicine, found a relative increase of 20 to 30 per cent in breast cancer risk associated with both combined and progestogen-only contraceptives, whatever the mode of delivery.

The resaerchers at the University of Oxford, UK, and colleagues found that a 15-year absolute excess incidence is at most 265 cases per 100,000 users.

Use of combined oral contraceptives, containing both estrogen and progestogen hormones, has previously been associated with a small increase in breast cancer risk but there is limited data about the effect of progestogen-only contraceptives, the resaerchers said.

However, the use of progestogen-only contraceptives has increased substantially in recent years, with almost as many prescriptions in England for oral progestogen-only contraceptives as for combined oral contraceptives in 2020, they said.

The researchers analysed data from a UK primary care database, the Clinical Practice Research Datalink (CPRD), on 9,498 women under the age of 50 with invasive breast cancer diagnosed in 19962017, as well as data on 18,171 closely matched controls.

On average, 44 per cent of women with breast cancer and 39 per cent of matched controls had a hormonal contraceptive prescription, with about half the prescriptions being for progestogen-only preparations.

With five years use of either oral combined or progestogen-only contraceptives, the associated 15-year absolute excess incidence of breast cancer was estimated at 8 cases per 100,000 hormonal contraceptive users at age 1620 years and 265 cases per 100,000 users at age 3539 years.

The odds of breast cancer were similarly and significantly raised, regardless of whether the contraceptive used was a combined (estrogen and progestogen) oral preparation, a progestogen-only oral preparation, an injected progestogen, or a progestogen releasing intra-uterine device.

These results were combined with those from previous studies from high income countries, which included women from a wider age range.

"These findings suggest that current or recent use of all types of progestogen-only contraceptives is associated with a slight increase in breast cancer risk, similar to that associated with use of combined oral contraceptives," said Kirstin Pirie of University of Oxford.

"Given that the underlying risk of breast cancer increases with advancing age, the absolute excess risk associated with use of either type of oral contraceptive will be smaller in women who use it at younger rather than at older ages," Pirie said.

However, the resaerchers said these excess risks must be viewed in the context of the well-established benefits of contraceptive use in women's reproductive years.

how-bad-is-vaping-and-should-it-be-banned-

Wed Mar 22 15:10:01 IST 2023

Vaping regularly makes headlines, with some campaigning to make e-cigarettes more available to help smokers quit, while others are keen to see vaping products banned, citing dangers, especially for teens.

So just how dangerous is it? We have undertaken an evidence check of vaping research. This included more than 100 sources on tobacco harm reduction, vaping prevalence and health effects, and what other countries are doing in response. Here's what we found.

How does vaping compare to smoking?

Smoking is harmful. It's the leading preventable cause of death in Australia. It causes 13% of all deaths, including from lung, mouth, throat and bladder cancer, emphysema, heart attack and stroke, to name just a few. People who smoke regularly and don't quit lose about ten years of life compared with non-smokers.

Nicotine, a mild stimulant, is the active ingredient in both cigarettes and nicotine vaping products. It's addictive but isn't the cause of cancer or the other diseases related to smoking.

Ideally, people wouldn't be addicted to nicotine, but having a safe supply without the deadly chemicals, for instance by using nicotine patches or gum, is safer than smoking. Making these other sources available is known as harm reduction.

Vaping is not risk-free, but several detailed reviews of the evidence plus a consensus of experts have all estimated it's at least 95% safer to vape nicotine than to smoke tobacco. The risk of cancer from vaping, for example, has been estimated at less than 1%.

These reviews looked at the known dangerous chemicals in cigarettes, and found there were very few and in very small quantities in nicotine vapes. So the argument that we won't see major health effects for a few more decades is causing more alarm than is necessary.

Is everyone' vaping these days?

Some are concerned about the use of vaping products by teens, but currently available statistics show very few teens vape regularly. Depending on the study, between 9.6% and 32% of 14-17-year-olds have tried vaping at some point in their lives.

But less than 2% of 14-17-year-olds say they have used vapes in the past year. This number doubled between 2016 and 2019, but is still much lower than the rates of teen smoking (3.2%) and teen alcohol use (32%).

It's the same pattern we see with drugs other than alcohol: a proportion of people try them but only a very small proportion of those go on to use regularly or for a long time. Nearly 60% of people who try vaping only use once or twice.

Smoking rates in Australia have declined from 24% in 1991 to 11% in 2019 because we have introduced a number of very successful measures such as restricting sales and where people can smoke, putting up prices, introducing plain packaging, and improving education and access to treatment programs.

But it's getting harder to encourage the remaining smokers to quit with the methods that have worked in the past. Those still smoking tend to be older, more socially disadvantaged, or have mental health problems.

Should we ban vapes?

So we have a bit of a dilemma. Vaping is much safer than smoking, so it would be helpful for adults to have access to it as an alternative to cigarettes. That means we need to make them more available and accessible.

But ideally we don't want teens who don't already smoke to start regular vaping. This has led some to call for a crackdown on vaping.

superbug-fungus-cases-rose-dramatically-during-pandemic

Wed Mar 22 12:25:31 IST 2023

US cases of a dangerous fungus tripled over just three years, and more than half of states have now reported it, according to a new study.

The COVID-19 pandemic likely drove part of the increase, researchers at the Centers for Disease Control and Prevention wrote in the paper published Monday by Annals of Internal Medicine.

Hospital workers were strained by coronavirus patients, and that likely shifted their focus away from disinfecting some other kinds of germs, they said.

The fungus, Candida auris, is a form of yeast that is usually not harmful to healthy people but can be a deadly risk to fragile hospital and nursing home patients.

It spreads easily and can infect wounds, ears and the bloodstream.

Some strains are so-called superbugs that are resistant to all three classes of antibiotic drugs used to treat fungal infections.

It was first identified in Japan in 2009 and has been seen in more and more countries. The first U.S. case occurred in 2013, but it was not reported until 2016.

That year, US health officials reported 53 cases.

The new study founds cases have continued to shoot up, rising to 476 in 2019, to 756 in 2020, and then to 1,471 in 2021. Doctors have also detected the fungus on the skin of thousands of other patients, making them a transmission risk to others.

Many of the first U.S. cases were infections that had been imported from abroad, but now most infections are spread within the US., the authors noted.

(AP)

public-surveillance-crucial-as-covid-cases-increase

Tue Mar 21 19:52:46 IST 2023

It might be time to mask up. At a time when H3N2 influenza virus is spreading with Covid-like symptoms, doctors suggest making surveillance and covid-appropriate behaviour mandatory, and stressed on the need to step up testing, as well as identifying genomic surveillance.

“Symptomatic people should self-isolate themselves, irrespective of whether it is Covid or any other flu,” says Dr Sandeep Budhiraja, Group Medical Director at Max Healthcare. “People should wear masks in crowded places. Social distancing, regular sanitisation and following coughing and sneezing etiquettes go a long way. Also, those who have not yet taken their third dose of Covid vaccine should do that.”

With the rapid rise in Covid and influenza cases, doctors are worried about a huge patient surge. They advocate pro-active surveillance at the earliest. Last year was challenging for medical practitioners who treated Covid patients. Many lost their lives.

Dr Milan Dhariwal from North Bengal Medical College and Hospital in Darjeeling, suggests that “The government must declare mandatory use of masks in hospitals, airports, railway stations and other crowded places, along with rapid Covid test at international airports.”

Dr Minesh Mehta, senior physician and critical care specialist at Shalby Multi-speciality Hospitals, Ahmedabad, stresses on “increasing the number of hospital beds, ensuring adequate supplies of PPE, intensifying testing and contact-tracing efforts.” He also advocates providing financial and mental health support to healthcare professionals, and prioritising distribution of vaccines to high-risk populations.”

Another precautionary step that experts suggest is involving fewer people at weddings and congregations. Last year, several states had restricted the number of wedding guests to 20, or at the most 100.

The worry is more this year, because till last year, it was only Covid, but today, we have H3N2 and swine flu hitting people. Covid is also returning with several variants. "It's time to accept the Covid-appropriate behaviour as almost a permanent way of life, including social distancing, masking, washing hands and maintaining good civic behaviour,” says Dr Tarun Sahni, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospitals.

He adds, “Surveillance at public places epidemiologically on a random basis can help to get an idea how the disease and strains are spreading.”

right-to-health-bill-protest--police-use-water-cannons-to-disper

Tue Mar 21 16:15:04 IST 2023

Police used water cannons to disperse private doctors protesting against the Right to Health Bill as they tried to march towards the state assembly, where it was scheduled to be discussed on Tuesday.

The Right to Health bill, listed for discussion and passage in the Assembly, seeks to give the residents of the state the right to avail free healthcare services from hospitals and clinics, including private establishments.

Doctors who run private clinics have been agitating against the bill claiming that it will increase "bureaucratic interference" over them.

The protesting doctors, who gathered at the statue circle, were stopped by police as they tried to move towards the Assembly complex.

When the doctors tried to cross the barricades, police used water cannons and mild force to stop them.

The doctors raised slogans against the state government and demanded the withdrawal of the bill.

After staging a protest at the statue circle on Monday, a delegation of five doctors met the health minister in the Assembly and demanded the withdrawal of the bill.

The doctors were waiting for a response from the government but there was no development following which the private doctors started moving towards the Assembly on Tuesday.

Heavy deployment of the police force, including horse-mounted policemen, is also there at the statue circle.

The agitation is carried out by the Sanyukt Sangharsh Samiti, members of the Private Hospitals and Nursing Home Society and the United Private Clinics and Hospitals of Rajasthan.

They are the doctors who run their private hospitals and nursing homes.

The doctors have claimed that the bill will the condition of the private hospitals will become like that of government-run hospitals.

They further claimed that the doctor-patient relationship will be affected, district and state level committees will harass private doctors and the quality of treatment in private hospitals will be affected.

long-covid-infection-linked-with-risk-of--face-blindness---study

Tue Mar 21 15:58:33 IST 2023

Prolonged symptoms of COVID-19 may be associated with difficulty recognising faces, a little-known condition called face blindness, and navigational problems, according to a study.

Previous studies have shown that COVID-19 can cause a range of neurological problems, including the loss of smell and taste, and impairments in attention, memory, speech, and language, known as "brain fog".

The latest research, published in the journal Cortex, is the first to report prosopagnosia, or face blindness, following symptoms consistent with COVID-19.

The condition that can make people fail to recognise familiar faces, has been estimated to affect between 2 and 2.5 per cent of people in the world.

The researchers assessed the case of Annie, a 28-year-old customer service representative and part-time portrait artist in the US, who was diagnosed with COVID-19 in March 2020 and suffered a symptom relapse two months later.

"When I first met Annie, she told me that she was unable to recognise the faces of her family," said Marie-Luise Kieseler, a graduate student at Dartmouth College in the US, adding Annie now relies on voices to recognise people.

Annie also experienced navigational deficits after having COVID-19. She has had difficulty remembering where particular sections in her grocery store are and relies on Google maps and its pin function to remember where she parks her car.

The combination of prosopagnosia and navigational deficits that Annie had is something that caught our attention because the two deficits often go hand in hand after somebody either has had brain damage or developmental deficits, said study senior author Brad Duchaine, a professor at Dartmouth.

"That co-occurrence is probably due to the two abilities depending on neighbouring brain regions in the temporal lobe," Duchaine said in a statement.

Dr. Vinit Suri, Senior Consultant, Neurology, Indraprastha Apollo Hospitals, New Delhi noted that the exact mechanisms by which long Covid may cause face blindness are not yet fully understood, but there are several possible explanations.

"Firstly, long Covid can cause a range of neurological symptoms which may affect the brain regions responsible for face recognition, causing difficulty in processing visual information and recognising familiar faces," Suri told PTI.

"Secondly, Covid-19 can cause inflammation and damage to the blood vessels, which can lead to reduced blood flow to the brain. This can cause brain damage and cognitive impairments, including face blindness," he added.

The research team conducted a series of tests with Annie to evaluate her problems with face recognition and determine whether she also has difficulties with other perceptual or cognitive abilities.

In one test, Annie was sequentially presented with 60 images of celebrity faces and was asked to name them. Annie correctly identified 29 per cent of the 48 celebrities whom she was familiar with as compared to most people, who can correctly identify 84 per cent of familiar celebrities.

The second test was a doppelganger test. Annie was shown a celebrity's name and then presented with images of two faces: the face of a celebrity and that of someone similar, and was then asked to identify which face was the famous person.

She identified the celebrity in 69 per cent of the 58 trials, as compared to 87 per cent in the control group.

"Our results from the test with unfamiliar faces show that it wasn't just that Annie couldn't recall the name or biographical information of a famous person that she was familiar with, but she really has trouble learning new identities," said Kieseler.

The research team also obtained self-reported data from 54 individuals who had long COVID with symptoms for 12 weeks or more, and 32 persons who had reported that they had fully recovered from COVID-19.

Most respondents with long COVID reported that their cognitive and perceptual abilities had decreased since they had COVID.

"It was not just a small concentration of really impaired cases but a broad majority of people in the long COVID group reported noticeable difficulties doing things that they were able to do before contracting COVID-19 without any problems," Kieseler said.

"Our study highlights the sorts of perceptual problems with face recognition and navigation that can be caused by COVID-19 -- it is something that people should be aware of, especially physicians and other health care professionals, Duchaine added.

Dr. Atul Prasad, Principal Director & HOD Neurology, BLK-Max Super Speciality Hospital, New Delhi said this is the first report of long COVID causing prosopagnosia.

"The more we study the virus, the more we realise how much damage it can cause during acute infection and now after infection has settled," Prasad told PTI.

Suri noted that that not all people with long Covid will develop face blindness, and the severity and duration of symptoms can vary widely.

"Further research is needed to better understand the relationship between long Covid and face blindness and to develop effective treatments and interventions for those affected," he added.

35--indians-unhappy-due-to-negative-emotions-post-pandemic

Tue Mar 21 11:25:26 IST 2023

A recent study conducted by consulting firm HappyPlus has found that negative emotions, such as stress, anger, sadness, and worry, have increased among Indians post-COVID-19 pandemic.

According to 'The State of Happiness 2023' report, 35% of the respondents stated that they have felt such emotions compared to 33% in 2022. The survey also found that positive emotions among Indians have dropped to 67% from 70% in the year-ago period. The study was conducted based on responses from 14,000 people from across 36 states and union territories.

The top five reasons for negative emotions were financial issues, workplace pressure, societal norms, loneliness and isolation, and uncertainties after the COVID-19 pandemic. The report further stated that the student population has seen the highest rise in negative experiences and was impacted the most in the overall outcome.

"People below 18 years and above 60 years are experiencing anger or sadness higher than any other age group in India. It also found 5 out of 10 reported as unhappy persons in comparison to 2 out of 10 in the previous year," HappyPlus Senior Director and Research Head Shyamasree Chakrabarty said.

Relationship issues and work life have pulled down the scores along with the lack of social support in India, she said, adding "these points need to be addressed soon".

The report said 20 per cent of Indian people are suffering in 2023 compared to 12 per cent in 2021, while 63 per cent of people are struggling as against 49 per cent in the previous year. On the other hand, only 17 per cent of Indians feel that they are thriving compared to 39 per cent last year.

Though people started coming back to normal life in 2022 after recovering from pandemic-induced restrictions, their struggle has increased as the rise in the number of job loss cases or continuous fear of 'job losses' added insecurities in life, the study opined.

"Global economic scenario and constant glooming news of global recession have its share in the rise of stress and unhappiness. Indians are also struggling from a silent pandemic -- loneliness and isolation. Loneliness has been recognised as one of the major public health concerns across generations," it added.

HappyPlus founder and CEO Ashish Ambasta said individual happiness has a direct influence on mental and physical health, which lead to distress and slow down economic, social and environmental growth.

Every year, the UN publishes the 'World Happiness Report' and helps examine the effects of happiness and life satisfaction in nations and communities. As per the 2022 report, India's rank was 136 out of 146 countries.