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8 chronic illnesses that are becoming common in post Covid-19 world

Post author By Pragya sharma
Post date April 6, 2023
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Chronic diseases like diabetes, heart disease, and cancer are on rise post pandemic. Here are 8 such illnesses you need to know about.

Covid-19 cases have been on rise in the past couple of weeks in India, but the virus is no longer perceived as a threat it earlier was. People have been largely reporting mild cases of Covid in the recent times, however, its long-term impact on people’s health remains unclear. The pandemic not only affected mental health as people lived in isolation from their loved ones and many grieved for their departed ones, it also impacted physical health as many studies discussed the virus’s impact on heart, lungs, kidneys and other body processes. The ongoing pandemic also acted as a roadblock to diagnosis and treatment of many existing diseases that could have been cured effectively otherwise. Another aspect of Covid-19 pandemic has been the sedentary lifestyle people became accustomed to. Many are still reeling with its impact as its endless side-effects continue to ail people.

Chronic diseases are those that last for at least one year or more and require ongoing medical attention. Be it diabetes, cancer heart disease, chronic kidney disease, they are the leading cause of death and disability all over the world. we asked experts about the chronic illnesses that are on rise post pandemic.

“If we look at the statistics, lifestyle diseases like diabetes, hypertension and cardiovascular diseases are on rise in the post- pandemic era. One may wonder why this is happening. During the pandemic era, the people were sitting at home doing Yoga, Pranayama and exercises. There was hardly any traffic on the roads. Now the roads are full, and so also the traffic jams people were on their nerves and cursing each other. Businesses are thriving and so also the competition that is the reason for increased BP in the population. People are having no time for exercise or yoga and eating unhealthy food, smoking, and drinking alcohol to reduce stress. In the nutshell, a ripe atmosphere for lifestyle diseases,” says Dr Pawan Kumar Goyal – Senior Consultant – Internal Medicine, Fortis Hospital Shalimar Bagh.

“Covid-19 not only affects lung but also harm kidneys, heart, and brain. Many psycho-social issues are also brought on by it. Heart attacks, paralysis, kidney illness, or a need for long-term oxygen are just a few of the less frequent but dangerous adverse effects. Cancer, high blood pressure, diabetes, asthma, and chronic obstructive pulmonary disease are among the main comorbidities with Covid-19. People of any age can get Covid-19 infection, but the elderly are most vulnerable. The pandemic significantly hampered the ability to diagnose, treat, and monitor chronic diseases. As a result, there are now more people suffering from chronic illnesses,” says Dr Parth Prajapati, MD – General Medicine, General Physician, Lybrate.

“The burden of non-communicable diseases has been on an alarming rise in India, accounting for 66% of deaths in 2019. The last three years brought to the fore the relationship COVID-19 and NCDs share, i.e., both exacerbating each other’s impact. NCDs that involve the cardio-renal-metabolic systems like diabetes, chronic kidney disease (CKD) and cardiovascular diseases are the top contributors to the rising healthcare burden. Moreover, cardiovascular diseases are the leading cause of death in our Indian population, accounting for over 1 out of all 4 deaths. Our national health policy aims to reduce the risk of premature deaths in India by 25%, by the year 2025,” says Dr. Shraddha Bhure, Medical Director, Boehringer Ingelheim India.

Here are chronic illnesses that have become common post Covid-19.

1. Psychological conditions

“Anxiety, depression, new or worsened problems with memory, concentration issues, worsened quality of life have become common post pandemic. The contributing factors have been stress, isolation, grief due to loss of near and dear ones and financial hardships,” says Dr Rajiva Gupta, Senior Consultant – Internal medicine at the CK Birla Hospital, Gurugram.

2. Cancer

“As Covid-19 targets multiple proteins involved in the pathophysiology, the infection may raise the risk of getting several cancers. A recent study described how the Covid-19 virus interacts with p53 and associated pathways, potentially leading to DNA and cell oxidative damage,” says Dr Prajapati.

3. Respiratory illnesses:

“Covid-19 may result in long term persistent cough, shortness of breath, tightness of the chest etc. These may deteriorate the quality of life of people with pre-existing respiratory conditions like Asthma or chronic obstructive pulmonary disease (COPD),” says Dr Gupta.

4. Hypertension:

“Increasing evidence indicates that the prevalence of hypertension among people has reached epidemic levels. According to a study in the journal Circulation, Covid pandemic has increased patients with high blood pressure among different age groups which is worrisome,” says Dr Prajapati.

5. Heart diseases

“The risk of cardiovascular or heart complications eg heart attack, stroke, irregularities of the heart rhythms, heart failure and blood clotting may have increased after Covid-19,” says Dr Gupta.

6. Diabetes

“Some Covid-19 survivors may develop newly diagnosed diabetes or other long-term health problems. High blood glucose, or blood sugar, causes this chronic illness,” says Dr Prajapati.

7. Asthma

“Inhaled oxygen typically has a more challenging time entering the bloodstream for persons with Covid-19. An inflammatory reaction can start when the immune system encounters a virus or other foreign substance. As a result, the muscles around the airways contract, and the airways narrow, swell, and produce more mucus. The subsequent mucus build-up causes related symptoms, such as coughing, chest aches, wheezing, etc,” says Dr Prajapati.

8. Chronic obstructive pulmonary disease (COPD)

The respiratory and lung symptoms of Covid-19 may be substantially more severe for people with COPD than those without COPD. Being diagnosed with COPD already increases your risk of developing pneumonia, which is true of Covid-19. You could experience worsening COPD symptoms in addition to the signs of Covid-19, which would make breathing extremely difficult and cause severe shortness of breath,” says Dr Prajapati.

How cancer cells migrate to the brain? Study reveals

Post author By Pragya sharma
Post date April 5, 2023
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Treating cancer that has spread to the brain is challenging as most drugs designed to combat metastasis are either ineffective against brain metastases.

Options for treatment are limited when cancer spreads to the brain. The majority of medications made to fight metastases either cannot penetrate the blood-brain barrier or are ineffective against brain metastases.

“Understanding how cancer cells thrive or fail in the brain niche could help us develop new treatments targeting these molecular processes,” said Sofia Merajver, M.D., Ph.D., the Greater Good Breast Cancer Research Professor at the University of Michigan Rogel Cancer Center.

Merajver and colleagues used two microfluidic chips to record cancer cell migration to the brain and examine what was occurring in the blood-brain niche in order to comprehend the molecular mechanisms that affect how cancer cells pass through the blood-brain barrier. The journal Advanced NanoBiomed Research publishes the findings.

Using breast cancer cell lines, they found that Dkk-1, a cytokine released by the astrocytes, triggers the cancer cells to migrate. Dkk-1 is known to play a role in in Wnt signaling, a key signaling pathway linked to cancer progression.

“Crosstalk between brain niche cells and cancer cells allows invading cancer cells to permeate the blood-brain barrier. Reducing Dkk-1 levels near invading tumor cells might disrupt this crosstalk and prevent brain metastases,” said corresponding author Christopher R. Oliver, Ph.D., a post-doctoral fellow in the Merajver Lab.

Health spend growth dips as Covid fades

Post author By Pragya sharma
Post date April 4, 2023
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Synopsis

As a proportion of GDP, health spending has declined post-pandemic, dropping from 1.23% in 2020-21 to 1.19% in FY23 and is expected to slip further in the coming year to 1.17%. The Centre’s health spending eased from 0.41% of GDP to 0.3% of GDP over this period.

The combined health expenditure of the Centre and 17 large states is expected to log 9.6% growth in 2023-24, down sharply from an average of 16.1% between 2020-21 and 2022-23.

As a proportion of GDP, health spending has declined post-pandemic, dropping from 1.23% in 2020-21 to 1.19% in FY23 and is expected to slip further in the coming year to 1.17%.

The Centre’s health spending eased from 0.41% of GDP to 0.3% of GDP over this period.

“The increase in expenditure on health has been very small. Adjusted for inflation, economic and population growth, the health budget has declined in India,” said Dr Chandrakant Lahariya, a public health expert.

These 17 states account for 80% of the country’s overall health expenditure. The analysis excludes Tamil Nadu, union territories and north-east states, except Assam.

Why hemp seed oil is the perfect summer skincare solution? Check out its amazing benefits

Post author By Pragya sharma
Post date April 3, 2023
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From combating dryness to sun damage, hemp seed oil is a must-have summer essential for combating all skin woes. Check out its amazing benefits.

With the arrival of summer, people tend to dress in lighter attire and spend more time outdoors. But the high temperature can be pretty harsh for the skin. Excessive sweating and humidity from the heat and sun exposure take a toll on the skin, leaving it dry, irritated, and prone to breakouts. Late March or early April is the perfect time to invest in sustainable and holistic summer-appropriate skincare for nourished and glowing skin. Hemp seed oil is a powerful ingredient that has taken the skincare industry by storm, especially in the clean and conscious beauty space.

It is a cold-pressed oil that is extracted from the seeds of the hemp (Vijaya) plant and is rich in essential fatty acids, including omega-3 and omega-6, antioxidants, vitamins, and minerals, which are important for healthy skin. Being natural and non-toxic, hemp is slowly gaining prominence as an effective remedy for skin woes.

2. Soothes sunburned skin

Sunburns are a common problem during the season, but hemp seed oil can help soothe the pain and inflammation associated with sunburned skin. Coupled with the oil’s moisturising properties that help in preventing peeling and flaking, the presence of gamma-linolenic acid (GLA) acts as a powerful anti-inflammatory and works to reduce redness and swelling of the skin. Further, the oil is efficacious in the treatment of various dermatological indications, such as psoriasis and eczema.

3. Helps to prevent breakouts

Perspiration during the summer months causes the skin to produce excess oil, leading to clogged pores and breakouts. This is especially true for people with oily and acne-prone skin. Using hemp seed oil is an excellent choice for people with this skin type, as it is non-comedogenic, meaning it won’t clog pores. In addition, its antibacterial properties aid in preventing the growth of acne-causing bacteria.

2. Soothes sunburned skin

3. Helps to prevent breakouts

“The many benefits and versatility of hemp seed oil make it a potent ingredient for summer skin care. Unlike other oils, it is light and non-greasy, making it a great choice for all skin types. Many hemp-based inventions are now available in the market, from oils and serums to creams and moisturisers. Incorporating them into your daily skincare routine can help you solve your skin woes and ensure healthy, radiant skin all summer long,” concludes Dr. Harshad.

Reduce HDL cholesterol to combat infertility: Study

Post author By Pragya sharma
Post date March 20, 2023
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The study demonstrates that by reducing the levels of HDL cholesterol, female infertility can be addressed.

By lowering high levels of circulating cholesterol with a bacterial protein, researchers at Houston Methodist demonstrated another link between high cholesterol and female infertility in sterile mice. One in five American women of reproductive age still cannot conceive after trying for a year, so this is an encouraging development.

“We are working with a protein, called serum opacity factor, with unique characteristics,” said Corina Rosales, PhD, assistant research professor of molecular biology in medicine with the Houston Methodist Research Institute and lead author on the study. “In our experiments, serum opacity factor lowered cholesterol levels by over 40 per cent in three hours. So, this protein is quite potent.”

The results are published in the American Society for Biochemistry and Molecular Biology’s Journal of Lipid Research.

While this protein’s primary function is to increase bacterial colonization, it also alters the structure of cholesterol-carrying high-density lipoproteins, or HDLs, making it easier for the liver to dispose of the excess cholesterol that’s preventing conception. The researchers also noted that serum opacity factor’s dramatic action on HDL could be leveraged as a potential alternative to statins, which are the current gold standard for lowering cholesterol in people with atherosclerosis.

HDL, known as the “good cholesterol,” carries excess cholesterol from different tissues to the liver for breakdown, thereby bringing down cholesterol levels. However, if there is HDL dysfunction, lipid metabolism gets altered, which could then be harmful, like its counterpart LDL, or low-density lipoprotein. Often called “bad cholesterol,” LDL carries cholesterol from the liver to other tissues, with high levels of it causing accumulation and diseases.

“Both HDLs and LDLs contain a mixture of free and esterified cholesterol, and free cholesterol is known to be toxic to many tissues,” said Henry J. Pownall, PhD, professor of biochemistry in medicine at the Houston Methodist Research Institute and corresponding author on the study. “So, any dysfunction in HDL could be a risk factor for several diseases, too.”

To study HDL dysfunction, the researchers worked with preclinical mouse models that had unnaturally high levels of HDL cholesterol circulating in their bloodstream. While this made them ideal for studying atherosclerosis, Rosales observed that these mice were also wholly sterile.

“Cholesterol is the backbone of all steroidal hormones, and an orchestra of hormones is needed to have a fertile animal,” Rosales said. “We know that the ovaries are studded with receptors for HDL, so the metabolism of HDL had to play a very important role in fertility for that reason.”

As predicted, when the researchers fed the sterile mice with a lipid-lowering drug, both LDL and HDL cholesterol levels were reduced, and the animals were temporarily rescued from infertility. Motivated by these results, they turned to the bacterial protein serum opacity factor, known to be highly selective for HDL.

“Serum opacity factor is known mainly in the context of bacterial strep infections where it serves as a virulence factor. But it was also discovered that this protein only reacts to HDL and not to LDL or other lipoproteins,” Rosales said. “We hypothesized that perhaps administering serum opacity factor to these mice might help restore their fertility, as well.”

For their next set of experiments, the team engineered an adeno-associated virus to deliver the gene for serum opacity factor to the mice lacking HDL receptors that had high blood cholesterol. When the gene was expressed and the bacterial protein was produced, the animals’ HDL cholesterol significantly lowered, and their fertility was restored.

Based on these promising preclinical results, the researchers next plan is to conduct a clinical study to investigate lipid levels in women undergoing treatments for idiopathic infertility, where the underlying causes are not fully known. If these patients have high HDL levels, then the researchers say serum opacity factor may be a line of future treatment.

COVID XBB 1.16 variant: Tracker finds high cases in India, know the symptoms

Post author By Pragya sharma
Post date March 17, 2023
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A new variant of COVID XBB, namely XBB 1.16 is in news currently for driving infection cases in the country. As per an international COVID tracking platform, the highest number of sequences of this sublineage have come from India followed by Brunei, the US and Singapore, media reports have said.The prevalence of this variant of COVID virus can lead to a fresh wave of infections, reports have predicted.

The COVID positivity rates in states like Maharashtra, Karnataka and Gujarat have increased. Maharashtra, from where this new variant is believed to have originated, reported 155 COVID positive cases in a single day along with two deaths. Telangana recorded more than 100 cases on Tuesday and Wednesday combinedly. In states like Rajasthan, Madhya Pradesh, Tamil Nadu, HimachalPradesh and J&K the positivity rate is between 5% and 10%.

So far, no different symptom related to the new circulating COVID variant has been reported.The classic symptoms of COVID which give a preliminary idea about the infection are headache, muscle pain, fatigue, sore throat, runny nose and cough.Apart from the classic signs people also experience abdominal pain and discomfort, and diarrhea.

“In India, XBB.1.16 is showing a high prevalence in the states of Maharashtra and Gujarat as per covSPECTRUM. XBB 1.16 has not descended from XBB.1.5 but both have descended from XBB and more recently XBB.1,” TOI has reported quoting a top expert from India’s genome sequencing network.”XBB is currently dominating in India, and the latest uptick in cases in the country could be a result of XBB 1.16 and perhaps XBB 1.5 but a few more sample runs would clear the picture,” the expert has told the media.

The new variant is circulating at a faster pace and is already seen as a threat. Going with the previous experience of dealing with the virus, mutants of COVID virus are smarter in escaping immunity and are contagious in nature. The Omicron variant, of which the XBB 1.16 is a sub-sub variant, is notorious for its high transmission rate. Since the later months of 2021, the Omicron variant has been circulating worldwide replacing the Delta variant.As of now less is known about the course of action of the variant is not known. The rate of hospitalisation which is a serious concern during a COVID wave is also unknown. Hence people need to be careful about their own safety and also take care of those who are in the vulnerable groups.

Avoid going outdoors when you have few symptoms of the infectionAvoid going near to those who have the symptoms of the infectionAvoid going to crowded places without wearing masksDo not touch the face, especially nose, mouth and eyes, without cleaning the handsDo not touch any exposed and unclean surfaceKeep kids and older people isolated when someone in the family or in the neighbourhood has COVID.Keep the indoor air circulating. Stale air indoors is a breeding ground for coronavirus.

XBB 1.16 scare has arised amid scare around the H3N2 influenza virus which has claimed 7 lives in the country so far.H3N2 is a seasonal influenza virus caused by the viruses which are part of the viral family Orthomyxoviridae. Health experts have said that H3N2 virus does not affect the lungs and is mild in nature except for older people and those with comorbidities.COVID led to global pandemic and nationwide shut down in 2020. While things have returned to normalcy health experts are constantly warning people to stay safe from the viral infection. COVID also poses another risk of complications which are combinedly referred to as long COVID.

Morality risk for people with dementia rises after hurricane exposure

Post author By Pragya sharma
Post date March 15, 2023
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It is observed that with disruption in normal routine, such as access to caregiving, changes in living environment, loss in access to medications, and change in daily routines, the mortality risk for dementia patients see a significant rise.

Prior hurricane studies have found general increases in fatality, but nothing is known about how death may differ among older adults living with dementia.

Their increased risk could be due to disruption of normal routine, such as access to caregiving, changes in living environment, loss in access to medications, and change in daily routines, said study first author Sue Anne Bell, assistant professor at the U-M School of Nursing.

The analysis focused on risk for mortality among people with dementia, rather than actual increases in mortality. The findings don’t give a precise number of deaths due to hurricane effects.

Bell and colleagues examined counties in U.S. states affected by Hurricanes Irma, Harvey and Florence in the year before and after the storm. There were 54,340 deaths among the study population of 346,171.

Key findings include:

Risk of mortality was highest in those aged 85 and older, with a 9% increase in risk of death compared to adults over 85 without dementia. Older adults who are enrolled in both Medicare and Medicaid had an 11% increased risk for mortality. Among people with dementia who moved a year after the storm, the risks for mortality remained whether they moved or not. The percentage of mortality attributed to exposure among people with dementia ranged from 10.9% for Harvey to 6.2% for Irma. Mortality peaked 3-6 months after hurricanes Irma and Harvey, suggesting the increase in mortality was due to factors other than the immediate harms of the storm, such as lack of health care access and changes in normal routines. Why the impact on dementia patients matters

The Population Reference Bureau estimates that more than 7 million people aged 65 or older had dementia in 2020, Bell said. If current demographic and health trends continue, more than 9 million Americans could have dementia by 2030 and nearly 12 million by 2040. As climate change worsens, disasters will increase along with the numbers of people with dementia.

“The important message is that older adults with dementia have unique needs, most notably that during a disaster, they are almost entirely dependent on caregivers due to their lack of awareness of the crisis,” Bell said. “I think if anything, there is new attention to the needs of older adults during a disaster, and this study is one of an emerging body of evidence that is working to better support the needs of older adults before, during and after disasters.

Next steps in disaster research and dementia

“There is so much more that needs to be studied here that could help inform us about being ready for disasters,” Bell said. “Studying how caregivers have prepared, whether people evacuated, what type of response capabilities their community had–would potentially influence the impact of the disaster on this group of older adults.”

Bell hopes these findings raise awareness about the special needs of people living with dementia during disasters and call for an integrated approach to preparedness and response that includes local, state and federal responders, healthcare regulators, and policy makers.

Diabetes management plan: Understanding medications, diet and exercise

Post author By Pragya sharma
Post date March 14, 2023
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Diabetes management is a life-long intervention and positive health outcomes hugely depend on your commitment, engagement and participation in your own healthcare management. Here’s all you need to know about medications, diet and exercise for diabetics.

Type 2 diabetes still remains undoubtedly a lifestyle malady, the result of abundance, poor food choices, lack of awareness, little need for self control, obesity, reducing need for physical toil for daily living, a curse of human advancement and industrialisation. However, this very scientific advancement is now also paving the way for diabetes cure and urging humankind to unlearn and relearn a lifestyle that can fight this diabetes pandemic.

The discovery of diabetes remission in 2017 is one such scientific marvel that will be looked back upon by humankind as one of the life changing discoveries of the century. This has now led us to rethink the predominant drug-based approach to diabetes and instead bring in strong life-style based interventions as the first step in diabetes management.

Diabetes is one of the major global concerns, which is now turning into an epidemic with more than 463 million adults affected by diabetes and it has nearly quadrupled in the past two decades, growing from 4.7% to 8.5%. This challenging illness is affecting an increasing number of adults and is now more prevalent in young people where according to experts, it is sharply rising in rural and urban India so, there is an immediate need to pay attention to the growing concerns about the health threats posed by this and prioritise preventive care.

In an interview with HT Lifestyle, Dr Hema Venkataraman, Consultant Endocrinologist at NHS UK and Medical Advisor, shared, “With the advent of new wonder drugs for diabetes and obesity (eg Munjaro, Semaglutide), the pharma industry in diabetes care is also entering a new era. These new drugs bring unparalleled weight loss and induce a drug induced diabetes remission of sorts. It is well known that the average Indian with diabetes does not meet the required physical activity levels necessary for optimal health (150 min of aerobic activity / week), with over 50% deemed to be inactive as per the ICMR-Indiab-5 report.”

She insisted, “Just like the idea of “diet” should pave the way for “healthy food choices”, so must “exercise” pave the way for “active living”. Our society will have to come full circle from ditching the bicycle for the car and now ditching the car for the bicycle (only this one will have some gears!).”

According to Vilasini Bhaskaran, Specialist Registered Dietitian at NHS UK and Head of Nutrition and Dietetics at Practo in India, there is no one single prescriptive dietary approach to diabetes management as “one-size” doesn’t fit all and nutrition therapy should be aimed at catering to the individual needs of patients. She recomended, “It is high-time we ditch the diet mentality and re-tune our overall approach and behavior towards eating. The ideal way to control blood sugars long term is through intuitive, healthy eating, focusing on food choices, balance, moderation, textures and consistency. A healthy meal plate should consist of vegetables or salad (1/2 plate), proteins (1/4 plate) and carbohydrates (1/4 plate) in recommended portions. Restrict eating out/ takeaways to once a fortnight as they contain a lot of calories and saturated fat even in smaller portions and this could make you put on extra pounds.”

The health expert added, “It is ‘OK’ to include sweets occasionally in smaller portions and choose ‘sugar-free’ alternatives where possible. Non-nutritive artificial sweeteners such as aspartame, stevia, acesulfame and saccharin don’t increase blood glucose and can be safely used as part of a healthy diet. Avoid foods labeled as ‘suitable for diabetics’ as these products have no special health benefits and they are often high in calories, may contain hidden ingredients that can still increase your blood glucose levels and may have a laxative effect!”

Vilasini Bhaskaran advised, “People with diabetes need to be extra careful with alcohol as it significantly increases the risk of hypoglycemia (low blood sugar levels) and adds to calories. Recommended allowance is <14 units (around 6 medium {175ml} glasses of wine) per week spread throughout the week with 2-3 alcohol-free days/ week. Remember, diabetes management is a life-long intervention and positive health outcomes hugely depend on your commitment, engagement and participation in your own healthcare management.”

Be on alert, closely monitor H3N2 influenza situation, Union Health Minister tells states

Post author By Pragya sharma
Post date March 11, 2023
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Synopsis

In a tweet, Mandaviya said, “Held a meeting to review rising cases of #H3N2 Influenza virus in the country. Advisory issued to states to be on the alert and closely monitor the situation. Government of India is working with states and extending support for public health measures to address the situation.”

As India recorded its first two deaths due to seasonal influenza subtype H3N2, one each from Karnataka and Haryana, Union Health Minister Mansukh Mandaviya on Friday asked states to be on alert and closely monitor the situation in view of “rising” cases. From January 2 to March 5, 451 cases of H3N2 have been reported in the country, according to data shared by the health ministry.

“It can be seen that Influenza H3N2 is the predominant subtype among the samples testing positive for influenza, since the beginning of this year,” it said.

In a tweet, Mandaviya said, “Held a meeting to review rising cases of #H3N2 Influenza virus in the country. Advisory issued to states to be on the alert and closely monitor the situation. Government of India is working with states and extending support for public health measures to address the situation.”

The ministry is also tracking and keeping a close watch on morbidity and mortality due to the H3N2 subtype of the seasonal influenza, according to an official statement.

“Young children and old age persons with comorbidities are the most vulnerable groups in context of seasonal influenza. So far, Karnataka and Haryana have confirmed one death each from H3N2 influenza,” the ministry said.

In an advisory issued by the Indian Council of Medical Research (ICMR) last week, it urged people to wash hands with soap and water if symptomatic, wear masks and avoid crowded places, and cover mouth and nose while sneezing and coughing.

The apex health research body also advised people to take plenty of liquids, avoid touching eyes and nose, and take paracetamol for fever and bodyache.

Among the dont’s, it has urged people not to shake hands or use other contact greetings, spit in public, not to take antibiotics or other medicines without consulting doctor and eat together sitting close to others.

Indian scientists identify better drug treatment for severe scrub typhus

Post author By Pragya sharma
Post date March 10, 2023
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Synopsis

The study, published in the New England Journal of Medicine (NEJM), shows that treating patients with a combination of intravenous antibiotics doxycycline and azithromycin is more effective than the current monotherapy of using either drug alone.

A team of Indian scientists has identified a significantly more effective treatment for severe scrub typhus – a life-threatening bacterial infection that kills thousands of people every year. The study, published in the New England Journal of Medicine (NEJM), shows that treating patients with a combination of intravenous antibiotics doxycycline and azithromycin is more effective than the current monotherapy of using either drug alone.

Using data from the Intravenous Treatment for Scrub Typhus (INTREST) clinical trial, researchers from several Indian institutes compared the efficacy and safety of three 7-day intravenous antibiotic treatments (doxycycline, azithromycin, or a combination of both) in patients with severe scrub typhus.

They found that combination therapy was superior to therapy with intravenous doxycycline or azithromycin alone. Patients who were treated with combination antibiotics had fewer complications from the infection on day 7.

The poor outcome, defined as a composite of death, persistent complications or prolonged fever was reduced by nearly one-third, to 33 per cent for combination therapy versus 47 per cent for doxycycline and 48 per cent for azithromycin, according to the researchers.

INTREST is the largest ever randomised controlled trial on the treatment of scrub typhus, and the only one on the treatment of severe scrub typhus.

“Combination therapy with intravenous doxycycline and azithromycin is a better, more effective way to treat severe scrub typhus than monotherapies of either drug by itself,” said INTREST study lead author Professor George M Varghese, from Christian Medical College (CMC) in Vellore, Tamil Nadu.

“This new evidence will change treatment guidelines, leading to swifter recovery and potentially saving thousands of lives of people with scrub typhus in the future,” Varghese said in a statement.

A life-threatening infection caused by the bacteria Orientia tsutsugamushi, scrub typhus is transmitted to humans by bites from tiny infected mites.

Scrub typhus is a major public health threat in India, other South Asian countries and around the tropics and kills an estimated 10 per cent of the approximately one million people infected by it every year.

Scrub typhus typically presents as fever that may be associated with headache, cough, shortness of breath, and brain symptoms like confusion and disorientation.

One-third of patients develop severe disease that affects multiple organs in the body and leads to lethally low blood pressures.

Death rates in severe diseases can reach up to 70 per cent without treatment and 24 per cent with treatment.

Researchers do not know for certain why a combination of doxycycline and azithromycin should be more clinically effective in the treatment of severe scrub typhus than either of the drugs alone.

The study found that when both azithromycin and doxycycline were administered together to patients with severe scrub typhus, the bacteria were cleared away quicker and patients improved faster.

This could be because doxycycline and azithromycin stop the bacteria from producing proteins through different, but complementary, mechanisms, the researchers said.

As a consequence the combination of the two drugs may have reduced bacterial growth and multiplication, leading to quicker control of bacterial growth and more rapid resolution of symptoms, they said.

The team at CMC Vellore collaborated with researchers at Mahidol Oxford Tropical Medicine Research Unit, Thailand, and Wellcome Trust Thailand Asia and Africa Programme for the study.

PGI Chandigarh, IGMC Shimla, PGIMS Rohtak, JIPMER Pondicherry, CMC Vellore, SVIMS Tirupati and KMC Manipal were the seven participating centres across India.