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Union Budget 2023-24: Govt needs to continue strengthening healthcare infrastructure; promote Make in India in pharma

Post author By Pragya sharma
Post date January 21, 2023
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The Union Budget 2023-24 is being presented at a time when the global economy is going through geo-political conflicts, rising inflation, and global recessionary inclinations.

Despite the uncertainties, the year 2023 holds a positive outlook for India’s pharmaceutical industry. The market has experienced significant growth during the past two decades, and pharma revenues worldwide totalled $1.42 trillion in 2021.
With the pandemic accentuating the significance of health and wellness, the Indian pharmaceutical industry is expecting expansion in the budget outlay and fund allocations in the upcoming Union Budget (2023-2024).

While the healthcare sector acquired a 16% hike in the budget allocation last year due to the pandemic crisis, the increase in the share of healthcare and pharma spending in the upcoming budget is imperative.

According to a recent EY FICCI report, as there has been a growing consensus over providing new innovative therapies to patients, the Indian pharmaceutical market is estimated to touch $130 billion in value by the end of 2030.
Meanwhile, the global market size of pharmaceutical products is estimated to cross over the $1 trillion mark in 2023. Thus, it is essential to allocate separate funds for R&D, formulation and API.

Additionally, it needs to put a deeper focus on quality manufacturing, and adoption of innovation and technology in terms of formulation manufacturing, diagnostics, packaging, medical devices among others.
The upcoming budget is also likely to focus on preventive healthcare, given the significant rise in non-communicable and lifestyle diseases in the country. Government incentives and grants for cost-intensive research are also anticipated.
Moreover, offering incentives to domestic API manufacturers and bringing about a reduction in GST and import duty on APIs is the need of the hour.

Further, given the increased reliance on imports towards medical equipment, incremental allocation towards manufacturing of healthcare equipment will help India become self-reliant. The government should come up with strategic plans to offer financial incentives to encourage the production of high-end medical devices in India.

Furthermore, the government may take measures to improve the ease of doing business in the pharmaceutical sector by simplifying the process and making it industry-friendly. Whilst the pandemic isn’t over yet, and its side effects long to stay here, the Union Budget (2023-2024) needs to continue focussing on strengthening the infrastructure of the healthcare sector and shift direction towards promoting Make in India pharmaceuticals for making India truly ‘Atmanirbhar’. We must become self-sufficient and competitive in KSMs and APIs to boost the growth of this sector.

The year 2022 saw several collaborations between the industry and academia, with both playing a pivotal role in helping the sector further strengthen its position in the global market. The same is expected in the coming year, along with the government and the industry partnering together for the greater good.
We must work together to ensure that Indian pharmacopoeia is acknowledged and appreciated worldwide. The government should make a roadmap and move forward so that more countries accept Indian pharmacopoeia.

The Pharmaceutical Inspection Cooperation Scheme (PICS) is bringing a great revolution in the GMP standards to establish the high quality in the drug product and thus India should become the member of PIC/S to raise its GMP standards as it is recognised as the ‘power house’ of pharmaceutical manufacturing. And for that, both regulators as well the industry need to upgrade themselves. To get PICS membership, our regulators, both at the central as well as at the state levels, need to undergo intense training programmes and our research laboratories need to be upgraded.

Similarly, at the industry level, pharma companies need to set up their facilities that comply with international regulatory requirements like the WHO GMP, US FDA among others.

A PICS membership reduces duplication of inspections, facilitates the industry in export, and provides huge market access among other benefits. As the industry expands its footprint across the world, it will need to continuously invest in upgrading manufacturing standards to keep its promise of being a high-quality, reliable supplier of medicines to the world.

The government has a role to play in terms of expanding the PLI scheme so that more local manufacturers can access incentives and support needed to play in the API sector, as well as formulations to cater to regulated export markets. Also, considering the rising need for robust intellectual property (IP) law and rights, we will need to work towards harmonising our regulatory requirements to global standards.

Similarly, at the industry level, pharma companies need to set up their facilities that comply with international regulatory requirements like the WHO GMP, US FDA among others.
A PICS membership reduces duplication of inspections, facilitates the industry in export, and provides huge market access among other benefits. As the industry expands its footprint across the world, it will need to continuously invest in upgrading manufacturing standards to keep its promise of being a high-quality, reliable supplier of medicines to the world.

Nonmelanoma skin cancer might be prevented with simple laser treatments: Study

Post author By Pragya sharma
Post date January 20, 2023
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According to new research, straightforward laser treatments to the skin may help to prevent the formation of these cancers. Basal cell carcinoma and squamous cell carcinoma, jointly known as keratinocyte carcinoma, are the most prevalent types of cancer identified in the United States.

New research indicates that simple laser treatments to the skin may help to prevent the development of basal cell carcinoma and squamous cell carcinoma, which are collectively known as keratinocyte carcinoma and are the most common types of cancer diagnosed in the United States. The work was conducted by a team of researchers from Massachusetts General Hospital, a founding member of Mass General Brigham. Published in Dermatologic Surgery, it reveals an easy-to-implement strategy to protect individuals’ skin health.

Nonablative fractional lasers (NAFL) deliver heat in a fractional manner that leaves it fully intact after treatment (unlike ablative fractional lasers that remove the top layer of skin), and they’re currently used to treat scars, sun-damaged skin, age spots, and more; however, their effectiveness for preventing skin damage is unknown.

To investigate, Mathew Avram, MD, JD, director of the Mass General Dermatology Laser & Cosmetic Center, and his colleagues studied patients who had been successfully treated for facial keratinocyte carcinoma in the past. Such patients have a 35% risk of experiencing a subsequent keratinocyte carcinoma within 3 years and a 50% risk within 5 years.

In the study, 43 patients received NAFL therapy and 52 served as controls and did not receive NAFL therapy. The rate of subsequent facial keratinocyte carcinoma development over an average follow-up of more than 6 years was 20.9% in NAFL-treated patients and 40.4% in controls, indicating that patients treated with NAFL had about half the risk.

When controlling for age, gender, and skin type, control patients were 2.65-times more likely to develop a new facial keratinocyte carcinoma than NAFL-treated patients. Also, among patients who developed a facial keratinocyte carcinoma, the time to development was significantly longer in patients treated with NAFL compared with untreated patients.

“These findings suggest that NAFL treatment may have an important role in protecting against subsequent keratinocyte carcinomas,” says Avram. “While the mechanism of NAFL’s protective effect is not completely understood, it is suspected that NAFL treatment reduces the overall burden of photo damaged keratinocytes and may promote a wound healing response, which gives healthy skin cells a selective advantage.”

Avram noted that additional studies are warranted to more critically assess the role of NAFL in skin cancer prevention, to reveal the duration of its protective effects, and to determine optimal treatment parameters. “Based on this research, it’s encouraged for patients to have nonablative laser treatments to help prevent skin cancer if they are at risk or notice abnormalities,” says Avram.

7 foods to consume in winter to avoid cold and cough

Post author By Pragya sharma
Post date January 17, 2023
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If you are falling ill frequently and feel low on energy all the time, you may need an immunity boost. Here are foods you must consume in winter season to avoid infections.

Cold and cough is a common symptom of many viral infections be it flu, Covid, RSV (respiratory syncytial virus) that are rampant in winter season. If you are falling ill frequently and feel low on energy all the time, you may need an immunity boost. Winter is a time of illnesses, but it is also a season of superfoods. Eating leafy green vegetables like mustard and spinach, seasonal fruits like amla and oranges can help improve your immunity and guard you against infections. While all we crave for during biting cold is some comfort food, we should instead add healthy ingredients to our meals.

“The ultimate goal for the cold and flu season? Trying not to get sick in the first place because prevention is the best way to protect yourself. Good nutrition – along with exercise and getting enough sleep – is the key to keeping your body fit to fight off germs,” says Nutritionist Lovneet Batra in her recent Instagram post.

She also lists some foods that one can eat to prevent cold and cough in the season.

Garlic

Garlic has natural antibacterial properties and a compound called allicin that helps in fighting off infections.

Turmeric milk

Golden milk is often used as a home remedy against colds. It can help build immunity. You can also add black pepper for instant action.

Tulsi

Tulsi does wonders by acting as a natural immune system booster while keeping infections at bay.

Almonds

Almonds are high in vitamin E, which fortifies the immune system. They also contain zinc, a mineral that has been beneficial during colds and coughs.

Amla

This seasonal fruit is rich in Vitamin C, which is known to have excellent immunity-boosting and antioxidant properties. Consuming Vitamin C regularly is associated with better performance of macrophages and other cells of the immune system.

Hospitalised patients’ infections may develop from their own bacteria: Study

Post author By Pragya sharma
Post date January 16, 2023
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Nearly 100,000 people die every year in U.S. hospitals of infections they develop after being admitted. But despite intense infection-control efforts, new strains of bacteria keep on emerging, seemingly out of nowhere, to sicken people in hospitals worldwide.

Hospitals have strict hygiene and sanitation protocols to protect patients from bacteria that rarely sicken healthy people but can be deadly for vulnerable patients already hospitalized with serious illnesses.

Nearly 100,000 people die every year in U.S. hospitals of infections they develop after being admitted. But despite intense infection-control efforts, new strains of bacteria keep on emerging, seemingly out of nowhere, to sicken people in hospitals worldwide.

Researchers at Washington University School of Medicine in St. Louis have found evidence pointing to an unexpected source of such bacteria: the hospitalized patients themselves. Studying mice, the researchers discovered that urinary tract infections (UTIs) can arise after sterile tubes, called catheters, are inserted into the urinary tract, even when no bacteria are detectable in the bladder beforehand. Such tubes are commonly used in hospitals to empty the bladders of people undergoing surgery. In the mice, inserting the tubes activated dormant Acinetobacter baumannii (A. baumannii)bacteria hidden in bladder cells, triggering them to emerge, multiply and cause UTIs, the researchers said.

The findings, published January 11 in Science Translational Medicine, suggest that screening patients for hidden reservoirs of dangerous bacteria could supplement infection-control efforts and help prevent deadly infections.

“You could sterilize the whole hospital, and you would still have new strains of A. baumannii popping up,” said co-senior author Mario Feldman, PhD, a professor of molecular microbiology. “Cleaning is just not enough, and nobody really knows why. This study shows that patients may be unwittingly carrying the bacteria into the hospital themselves, and that has implications for infection control. If someone has a planned surgery and is going to be catheterized, we could try to determine whether the patient is carrying the bacteria and cure that person of it before the surgery. Ideally, that would reduce the chances of developing one of these life-threatening infections.”

Feldman and Hultgren — along with co-first authors Jennie E. Hazen, a graduate student, and Gisela Di Venanzio, PhD, an instructor in molecular microbiology — investigated whether A. baumannii can hide inside cells like E. coli can. They studied mice with UTIs caused by A. baumannii. They used mice with weakened immune systems because, like people, healthy mice can fight off A. baumannii.

Once the infections had resolved and no bacteria were detected in the mice’s urine for two months, the researchers inserted catheters into the mice’s urinary tracts with a sterile technique. Within 24 hours, about half of the mice developed UTIs caused by the same strain of A. baumannii as the initial infection.

“The bacteria must have been there all along, hiding inside bladder cells until the catheter was introduced,” Hultgren said. “Catheterization induces inflammation, and inflammation causes the reservoir to activate, and the infection blooms.”

Since A. baumannii rarely causes symptoms in otherwise healthy people, many people who carry the bacteria may never know they’re infected, the researchers said. As part of this study, the researchers searched the scientific literature and discovered that about 2 pc of healthy people carry A. baumannii in their urine.

“I wouldn’t put much weight on the precise percentage, but I think we can say with certainty that some percentage of the population is walking around with A. baumannii,” Feldman said.

“As long as they’re basically healthy, it doesn’t cause any problems, but once they’re hospitalized, it’s a different matter. This changes how we think about infection control. We can start considering how to check if patients already have Acinetobacter before they receive certain types of treatment; how we can get rid of it; and if other bacteria that cause deadly outbreaks in hospitals, such as Klebsiella, hide in the body in the same way. That’s what we’re working on figuring out now.”

Is it flu or Covid-19? Experts on how to differentiate between the symptoms

Post author By Pragya sharma
Post date January 14, 2023
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Flu and Covid-19, both being respiratory illnesses, have a lot in common in terms of symptoms and way of transmission. Here’s how you can know the difference between their symptoms.

Flu and Covid-19, both being respiratory illnesses, have a lot in common in terms of symptoms like fever, cough, sore throat, difficulty breathing, and how they are transmitted – through cough, sneeze or touching an infected object. So, you may not initially know if you are suffering from flu or Covid-19. The best way to know for sure is to get tested without delay. The primary difference between the two is that the flu and Covid-19 are caused by difference viruses. Covid-19 is caused by the SARS-CoV-2, while influenza viruses are responsible for flu. Flu may cause severe symptoms in elderly while Covid-19 can lead to severe disease even in those who are not in vulnerable group. Covid can infect a greater number of people than flu and the symptom onset is slightly slower. Good thing is there is a vaccine for both the infections and one must get their shots to prevent these infections.

We spoke to experts on difference between flu and Covid-19 symptoms and here’s what they said.

“The flu and Covid-19 are both respiratory illnesses, but they are caused by different viruses. Symptoms of the flu and Covid-19 can be similar, such as fever, cough, and fatigue, but there are some key differences. The flu typically causes more severe symptoms in the elderly and people with underlying health conditions, whereas Covid-19 can cause severe illness in people of all ages,” says Dr Shalini Joshi, Senior Consultant-Internal Medicine, Fortis Hospital Bannerghatta Road, Bangalore.

Different viruses

“Covid-19 and flu (Influenza) are contagious illnesses of the respiratory tract. They differ from each other in several aspects. These are caused by two different viruses, i.e., SARS CoV-2 and influenza virus, respectively,” says Dr Rohit Kumar Garg, Consultant, Department of Infectious Diseases, Amrita Hospital, Faridabad.

Loss of taste or smell

Dr Joshi says Covid-19 can cause loss of taste or smell, which is not a symptom of the flu.

“Although symptoms such as fever, cough, sore throat, body aches, headache, fatigue, vomiting, diarrhoea etc. are usual and common to both, COVID patients may also experience loss of smell, loss of taste,” says Dr Garg.

Symptom onset

“The time period from viral exposure to symptoms onset is shorter for flu (1-4 days) and somewhat longer for Covid (2–14 days). The exposed person starts spreading the SARS CoV-2 virus 2–3 days before symptoms onset, whereas in the flu, patients start spreading 1 day before symptoms,” says Dr Garg.

Which is more contagious?

“Patients remain infective for a longer duration after Covid than flu. SARS CoV-2 virus is more contagious than flu virus, i.e., it can infect many patients at a time, whereas only 1-2 patients at a time in case of flu,” says Dr Garg.

Symptoms and complications in Covid-19

“A Covid patient may also experience the formation of clot in blood vessels and cytokine release syndrome, in addition to other complications such as pneumonia, respiratory failure, multi-organ dysfunction, or sepsis etc. A Covid patient may experience symptoms such as cough, fatigue, shortness of breath, a high pulse rate, poor appetite, etc. for a long time after recovery from an acute illness,” says Dr Garg, adding, “SARS CoV-2 virus can cause serious complications even in healthy individuals, unlike the flu, which cause serious complications usually in patients with comorbid conditions.”

“It’s crucial to take the appropriate precautions to protect yourself and others from both viruses, the best way to prevent both is to get vaccinated, and practice good hygiene, such as washing your hands frequently and avoiding close contact with sick people. Flu (Influenza) is caused by a virus and most people recover on their own but it can lead to serious problems in high-risk patients. Therefore, we recommend yearly Influenza vaccination for elderly people, people living with chronic health diseases like diabetes, liver and kidney issues or weak immune systems. Consultation with a doctor is advised because the symptoms are quite similar. It is important to conduct appropriate tests for diagnosis and early treatment should be started by the health care professionals,” says Dr Shalini Joshi.

“There are specific antiviral treatments and vaccines for SARS CoV-2 and influenza viruses. Despite these differences, the key preventive strategies, i.e., social distancing, use of face masks, cough etiquettes, hand cleanliness, and vaccination, remain the same for both due to similarity in mode of transmission and route of infection, as well as the availability of effective vaccines against both of them, says Dr Rohit Kumar Garg.

Diabetes: 5 best and worst fruits for managing blood sugar

Post author By Pragya sharma
Post date January 10, 2023
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Some fruits are good for people with diabetes, while others are not. However, every fruit has its own benefits and should be consumed on a regular basis. Experts on best and worst fruits for managing your blood sugar levels.

People who are diagnosed with diabetes often hesitate in adding fruits to their daily diet fearing they could raise their blood sugar levels being sweet in taste. However, their fear is only partly true. Fruits are a storehouse of fibre, vitamins, antioxidants and all the essential nutrients that are important in maintaining gut health, immunity and overall health. But at the same time, they also have a type of sugar called fructose that is naturally present in fruits. In fact, studies claim that consumption of fruits regularly can cut risk of diabetes. This doesn’t mean though that people with diabetes can fill their plate with all sorts of fruits and consume them multiple times a day without fear of sugar spikes. There are certain fruits that are high in GI (glycaemic index) while some are low GI which means they are broken down slowly and raise blood sugar only gradually over a period of time. Once you know which fruits are more suitable for your blood sugar levels, you can consume them in the quantities recommended by your diabetologist. Even fruits with high GI can be consumed but in smaller quantities.

“Some fruits are good for people with diabetes, while others are not. However, every fruit has its own benefits and should be consumed on a regular basis, weekly, or seasonal basis. Like many other foods, fruit can make your blood sugar go up. Your HbA1c, or average blood sugar level, can also go up if you experience frequent spikes in your blood sugar. Despite the well-established health benefits of eating fresh fruits, the sugar content of fruits has raised questions about its effect on glucose levels and their suitability for people with diabetes,” says Dr V. Mohan – Chairman and Chief Diabetologist- Dr Mohan’s Diabetes Specialities Centre.

THE RIGHT QUANTITY OF FRUITS FOR PEOPLE WITH DIABETES

“There is nothing like the best and worst fruits for diabetics. Diabetics can eat all the fruits, but for the fruits with a higher glycaemic index, the portion size of those fruits needs to be controlled. Where the difficulty occurs is when fruits with a higher glycaemic index are ingested in excess. Therefore, if you have diabetes, you should consume 150–200 g of fruit every day. But if your sugar levels are higher, this quantity drops to 100 to 150 grams a day. The quantities of higher-glycaemic fruits can be around 100 grams. So, portion control is key when it comes to fruits,” says Dr Charu Dua, Chief Clinical Nutritionist, Amrita Hospital, Faridabad, on fruits for diabetes.

Dr Dua, however, adds that it is important that diabetic patients do not combine fruits with the main meals like breakfast, lunch, and dinner, because usually our food is rich in carbohydrates and fruits are the source of carbohydrates.

“It’s a good idea to have a fruit between meals, and it’s crucial to pair fruits with protein. So, if you combine fruits with nuts in the mid-morning, the absorption rate of carbohydrates converted into glucose and absorption are going to slow down. The easiest and healthiest alternative is to combine fruits with a protein, almonds, or one teaspoon of seeds. It’s also a good idea to pop and top it with cucumbers and tomatoes. However, adding nuts, such as peanuts or occasionally paneer, will delay the body’s absorption of glucose and prevent a surge in blood sugar after eating fruit,” says Dr Dua.

It’s important to keep in mind that if you have diabetes, you should eat fruits, chew them properly, and stay away from fruit juices because they are quickly absorbed and can raise your blood glucose levels. Consuming the fruit will also give you fibres, which assist in managing and regulating your blood sugar levels. So, have fruits and nuts in mid-morning time.

BEST FRUITS FOR PEOPLE WITH DIABETES

As per Dr Mohan, the best five recommended fruits for people with diabetes are apple, guava, orange, papaya and melons. He also explains why these fruits are good for managing the metabolic disorder.

– Firstly, these fruits are naturally low in fat, calories and sodium. Additionally, the majority of them are loaded with nutrients that we frequently fail to get enough of. Folate, Vitamin C, potassium, and dietary fibre are few examples of such nutrients.

– Potassium, which helps maintain healthy blood pressure, is abundant in these fruits.

– Vitamin C, which is essential for tissue growth and repair, wound healing, and maintaining healthy teeth and gums, is abundant in guava and citrus fruits.

– We get folate—a group of naturally occurring B vitamins known as B9—from citrus fruits, apple, melons, papaya which aid in the production of red blood cells.

“Whole fruits, not juice, give us a feeling of fullness with fewer calories. They also contain dietary fibre, which helps us digest food and maintain healthy bowel movements and lowers blood cholesterol and the risk of heart disease. So, please take whole fruit instead on fruit juices,” says Dr Mohan.

WORST FRUITS FOR PEOPLE WITH DIABETES

Five fruits that are to be eaten less frequently or in smaller quantities are mango, jack fruits, banana, chickoo, grapes according to Dr Mohan. He also explains why.

“These fruits usually increase the blood glucose level and to avoid spikes in blood sugar, people with diabetes must closely monitor their sugar intake,” says Dr Mohan, adding that it depends on how much fruit one eats.

“It is fine, if you take one or two slices or small quantities of these restricted fruits as sugar levels can rise if they are consumed in large quantities. We see several patients with uncontrolled diabetes after taking large quantities of these fruits every season. Hence, you can limit your consumption of these fruits to one or two slices, so that you can still enjoy these fruits. If you want to lower your blood glucose levels, take these fruits in the intervals between meals. You can also limit your consumption of cereals like rice and chapatis in lunch and dinner,” says Dr Mohan.

Dr Mohan says every person with diabetes has a different response to fruits and it’s imperative to check the impact of fruits on blood sugar levels.

“Please do check your blood sugar levels to see if these fruits have an effect on your blood sugar levels. If you want to add fruits, use a continuous glucose monitor sensor, you can easily see which fruits affect your glucose levels and which do not,” says the expert.

“All people with diabetes do not respond in a similar manner with respect to fruits. The body is able to tolerate the intake of fruits if your glucose level (diabetes)is under good control. In those with poor control, blood glucose levels tend to increase further with fruits,” concludes Dr Mohan.

Child’s weight has little effect on mood, behavioural disorders: Study

Post author By Pragya sharma
Post date January 9, 2023
No Comments on Child’s weight has little effect on mood, behavioural disorders: Study

Children with obesity are more likely to be diagnosed with depression, anxiety, or attention-deficit hyperactivity disorder (ADHD). But the nature of the relationship between obesity and these mental health conditions is not clear. Obesity might contribute to mental health symptoms, or vice versa.

According to a new study, childhood BMI is unlikely to have a significant impact on children’s mood or behavioural disorders.

The results suggest that some previous studies, which have shown a strong link between childhood obesity and mental health, may not have fully accounted for family genetics and environmental factors.

Children with obesity are more likely to be diagnosed with depression, anxiety, or attention-deficit hyperactivity disorder (ADHD). But the nature of the relationship between obesity and these mental health conditions is not clear. Obesity might contribute to mental health symptoms, or vice versa. Alternatively, a child’s environment might contribute to both obesity and mood and behavioural disorders.

“We need to better understand the relationship between childhood obesity and mental health,” says lead author Amanda Hughes, Senior Research Associate in Epidemiology at Bristol Medical School, University of Bristol, UK. “This requires teasing apart the contributions of child and parent genetics and the environmental factors affecting the whole family.”

Hughes and colleagues examined genetic and mental health data from 41,000 eight-year-old children and their parents from the Norwegian Mother, Father, and Child Cohort Study and Medical Birth Registry of Norway. They assessed the relationship between children’s body mass index (BMI) — a ratio of weight and height — and symptoms of depression, anxiety and ADHD. To help separate the effects of the children’s genetics from the influence of other factors that affect the whole family, they also accounted for parental genetics and BMI.

The analysis found a minimal effect of a child’s own BMI on their anxiety symptoms. There was also conflicting evidence about whether a child’s BMI influenced their depressive or ADHD symptoms. This suggests that policies aiming to reduce childhood obesity are unlikely to have a big impact on the prevalence of these conditions. “At least for this age group, the impact of a child’s own BMI appears small. For older children and adolescents, it could be more important,” says Neil Davies, Professor at University College London, UK.

When they looked at the effect of the parents’ BMI on the children’s mental health, the team found little evidence that the parents’ BMI affected children’s ADHD or anxiety symptoms. The data suggested that having a mother with a higher BMI might be linked with depressive symptoms in children, but there was little evidence of any link between the child’s mental health and the father’s BMI.

“Overall, the influence of a parent’s BMI on a child’s mental health seems to be limited. As a result, interventions to reduce parents’ BMIs are unlikely to have widespread benefits to children’s mental health,” says Alexandra Havdahl, Research Professor at the Norwegian Institute of Public Health, Norway. Havdahl is a co-senior author of the study alongside Neil Davies and Laura Howe, Professor of Epidemiology and Medical Statistics at Bristol Medical School.

“Our results suggest that interventions designed to reduce child obesity are unlikely to make big improvements in child mental health. On the other hand, policies which target social and environmental factors linked to higher body weights, and which target poor child mental health directly, may be more beneficial,” Hughes concludes.

Early intervention effective in treating neurodevelopmental disorders: Study

Post author By Pragya sharma
Post date January 5, 2023
1 Comment on Early intervention effective in treating neurodevelopmental disorders: Study

The results suggest that critical period plasticity in the amygdala is increased and may be shifted to earlier developmental time-points. This could cause a ‘maladaptive’ form of plasticity and yet one that can be treated with therapeutic intervention at key developmental time points.

A new study suggests that therapeutic interventions to treat neurodevelopmental disorders may be more effective if done during the early stages of brain development.

“In order to stop the progression of neurodevelopmental disorders, it is important to identify how and when brain circuits are changing during development. Our study identifies when circuits are altered in addition to how brain circuits are corrected,” said the study’s senior author Molly Huntsman, PhD, associate professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences located on the University of Colorado Anschutz Medical Campus.

The study, published in The Journal of Neuroscience, looks at Fragile X Syndrome (FXS), a pervasive neurodevelopmental disorder and a common cause of intellectual disability, autism and anxiety disorders.

“Currently, there are no approved or effective therapies targeting specific pathophysiology underlying the clinical manifestations of FXS,” Huntsman said, adding, “We’re hoping to provide answers for when and how to treat FXS to help with therapeutic options eventually.”

The CU Skaggs School of Pharmacy researchers identified potential causal circuit-level changes during a critical period of brain development susceptible to therapeutic intervention. They focused on the amygdala — the brain region where fear and anxiety are processed.

Using a mouse model of FXS, they identified a critical period of increased circuit plasticity occurring in early brain development. They showed that fear-learning emerges in the brain during these periods of increased plasticity. At the same time, they demonstrated that early intervention ameliorates it.

The results suggest that critical period plasticity in the amygdala is increased and may be shifted to earlier developmental time-points. This could cause a ‘maladaptive’ form of plasticity and yet one that can be treated with therapeutic intervention at key developmental time points.

Age at the time of treatment, the study said, is important because early pharmacological intervention was shown as effective in reducing fear-learning in the mouse model.

“This is highly significant and addresses a critical barrier for understanding how circuits develop in a mouse model of autism and intellectual disability and even more important, for therapeutic intervention-directed treatment options,” Huntsman said.

Ischemic Heart Disease: Causes, risk factors, symptoms, diagnosis, treatment of coronary heart disease

Post author By Pragya sharma
Post date January 4, 2023
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Ischemic cardiac diseases reduces the heart’s ability to pump blood which might lead to heart attacks, or irregular heart rhythm and heart failure as well. Here’s all you need to know about its causes, risk factors, different symptoms in men and women, diagnosis and treatment.

A partial or total blockage of the arteries pumping the heart muscle with blood results in ischemic heart disease, a health condition that is sometimes also referred to as coronary heart disease. If the coronary arteries were thought of as a network of tubes, then as they progressively become blocked, the blood that is flowing through them, in this situation, is prevented from properly reaching its destination, the heart.

The prevalence of ischemic heart disease is currently decreasing in developed countries due to improved treatments and healthier lifestyles; but the same is increasing in developing countries. In either case, ischemic heart disease remains the leading cause of death among adults in both developing and developed countries.

Causes:

A significant population in both developed and developing nations are affected by ischemic heart disease, which is a prevalent condition. In an interview with HT Lifestyle, Dr Yogendra Singh, Associate Director at Max Super Speciality Hospital’s Department of Cardiology in Dehradun, explained, “Ischemic heart diseases occur when blood flow to the heart decreases, which prevents the heart which is a muscle from receiving enough oxygen. Ischemic cardiac diseases reduces the heart’s ability to pump blood which might lead to heart attacks, or irregular heart rhythm and heart failure as well. The decrease in blood flow is a result of blockage in the heart’s arteries. Under this condition, the treatment usually is to improve the blood flow in arteries by simultaneously reducing the blockage.”

Dr MM Yusuf, Consultant Cardiac Surgeon at Apollo Hospital in Chennai’s Greams Road, elaborated, “Ischemic Heart Disease (IHD) denotes, narrowing or blockage in the blood vessels over the heart, (Coronary arteries). These vessels supply blood to the heart muscles and enable good function. There are 3 blood vessels, 2 on the left and 1 on the right side of the heart. Triple vessel or multivessel coronary artery disease indicates disease in all these 3 vessels. These narrowing or blockages are caused by fat deposits within the blood vessel, which reduces blood supply to the heart muscle. This can lead to angina (chest pain), breathing difficulty or heart attack which can lead to death.”

Risk factors and symptoms:

Dr Yugal Kishore Mishra, Head of Cardiac Sciences and Chief Cardiovascular Surgeon at Manipal Hospital in Delhi’s Dwarka, revealed, “The risk of this condition rises with age and is common in the elderly. In terms of men and women, men are more likely to have ischemic heart disease as compared to women. According to various studies, men and women who are 65 to 94 years old are twice as likely to have coronary heart disease than those who are 35 to 64 years old. The most common symptom of ischemic heart disease in men is myocardial infarction (heart attack), while the most common symptom in women is angina pectoris.”

Talking about the common risk factors for ischemic heart disease, Dr MM Yusuf blamed diabetes, high blood pressure, high cholesterol, smoking and family history of IHD.

Diagnosis:

According to Dr Yogendra Singh, it is advised to consult a doctor for advice if one experiences persistent or severe chest pain. He said, “An ischemic cardiac condition can be diagnosed with the help of an ECG, stress test, echocardiogram, coronary angiography, and cardiac CT scan, which will show which artery or arteries are afflicted. Your doctor might advise drugs, surgery, or a combination of the two depending on the seriousness of your disease. Consume a balanced diet low in saturated fat, cholesterol and sodium to help treat coronary artery disease and reduce your risk of problems. Additionally, you’ll receive advice on how to exercise safely given your condition. Don’t think of lifestyle adjustments as temporary remedies. Instead, resolve to create lasting healthy behaviours.”

Treatment for Ischemic Heart Disease

Dr Yugal Kishore Mishra shared, “Increasing blood flow to the heart muscle is part of the treatment for ischemia heart disease. Treatment options include prescription drugs, an angioplasty procedure to unblock clogged arteries, or bypass surgery. The treatment of ischemic heart disease, there are a number of treatments in each class. To control any ischemic episodes, using medication is sometimes the best course of action. In other circumstances, when dealing with a more serious issue or if medication is not enough, it is recommended to unblock the artery.”

He added, “Sometimes, there can be numerous lesions or blocked coronary arteries that make angioplasty a challenge so in such cases a heart bypass surgery can be the best option to open up the blocked arteries of the heart. A robotic assisted bypass surgery of heart is considered to be the best option for heart disease. Robotic heart surgery is performed through very small chest incisions. Surgeons can perform open-heart surgery without as much trauma as they can with minimally invasive procedures using robot-controlled tools and microscopic instruments. In order to prevent a recurrence of angina or an infarction, this can be supported by long-term treatment (heart attack). To lower the risk of heart disease, a mix of lifestyle modifications and medication therapy is prescribed.”

As per Dr Yogendra Singh, treatment options include:

Medications
Angioplasty
Bypass Surgery

Explaining the process, he said, “A long, thin tube (catheter) is placed into the blocked area of your artery during coronary angioplasty. The artery is widened by inserting a wire carrying a tiny balloon there and inflating it. To keep the artery open, a tiny coil of wire mesh called a stent is typically employed. Drug eluting stents are safe and effective. This procedure can be performed radially from the groin to the thigh or from the wrist. As a result of it being easier, more accurate and less painful than the femoral technique, radial angioplasty is gaining more popularity.”

He added, “Contrarily, a coronary artery bypass surgery involves the creation of a graft that allows blood to move around a blocked or constricting coronary artery using a vascular from another region of your body. This kind of open-heart surgery is typically only performed on patients with several narrowed coronary arteries.”

Dr MM Yusuf suggested, “Sensible eating, regular exercise and good lifestyle would prevent IHD. Ischemic Heart Disease is widely prevalent in India. Patients with risk factors should have regular health checks and follow preventive measures, while patients with IHD should seek medical help early and take appropriate treatment. The outcomes of treatment are extremely good with minimally invasive treatment procedures hence, patients need not be worried and keep away from getting appropriate treatment.”

He recommended, “Patients affected with IHD can be treated depending on the severity of the coronary artery stenosis (narrowing / blockage). Minimal stenosis can be managed with medications and lifestyle modifications. Significant stenosis in 1 or 2 vessels can be treated with angioplasty and stent insertion. Much more severe and multiple blockages especially in diabetics or patients with reduced heart function is best treated by Coronary Artery Bypass Graft (CABG) surgery. Use of Internal Mammary Artery in CABG has the best long-term outcome.”

Traditionally, CABG was performed by splitting open the chest bone and patients would take 3 to 6 months to recover depending on their age and other co-morbid conditions. Dr MM Yusuf revealed, “Over the past decade minimally invasive cardiac surgery with the use of surgical robot (Robotic assist CABG) has significantly reduced the trauma and recovery in treating patients requiring CABG surgery. Patients undergoing robotic assisted CABG stay in hospital for 2 to 4 days and recover to full normal activity within 2 to 3 weeks. Over the years, CABG had been performed with the use of cardiopulmonary bypass (CPB) and cardioplegic arrest. With the advent of self-retaining coronary stabilizers and intracoronary shunts, CABG is being performed in many centers without the use of CPB-Off Pump CABG (OPCABG).”

He added, “However, conventional CABG has its own limitations in terms of being invasive and associated with morbidity. Stroke, bleeding, wound infections, arrhythmias, prolonged ICU stay and hospital stay has been the known common complications of conventional CABG. Minimally Invasive Direct Coronary Artery Bypass Surgery (MIDCAB) is gaining increasing popularity in recent years owing to its technique and lesser incidence of complications associated with conventional CABG and OPCABG surgery.”

He explained, “Conventional CABG uses median sternotomy. In contrast, MIDCAB is performed using anterolateral thoracotomy in the 4th or 5th intercostal space using a 5-7 cm incision. Thorax is entered through this incision. LIMA is harvested either under direct vision or using Robotic assistance or thoracoscope camera. Bypass Grafting is then performed under direct vision with the aid of MICS instruments – MICS retractor system, MICS stabilizer (Octopus Nuvo) and Heart positioner (Starfish NS). Intracoronary shunts and mister blower are used to keep the field bloodless. The notable advantages of MIDCAB surgery are decrease in incidence of post operative complications such as stroke, decrease in ICU stay & hospital stay, lesser blood product transfusion, lesser wound infection, quick recovery and better cosmoses. The disadvantages being longer learning curve and limited working space.”

Talking about Minimally Invasive Hybrid Coronary Artery Revascularization (MIHCR), he said, “Minimally Invasive Hybrid Coronary artery Revascularization (MIHCR) combines the benefits of PCI and OPCABG surgery. This involves IMA grafting to one or two major coronary arteries, usually the left coronaries through a left mini thoracotomy, followed by the stenting of the non-LAD vessels. MIHCR provides the advantages of reduced incidence of MACCE in the immediate post operative period with best long term outcome. This less invasive procedure minimizes the incidence of known complications of off pump coronary artery bypass surgery and hastens the recovery. Another added advantage with MIHCR is that the patency of IMA can be assessed while undergoing PCI to non- bypassed vessel. This provides an opportunity for the graft to be revised in case of need while the patient is still in hospital.”

He concluded, “Due to these advantages it is emerging as the method of choice among the younger population as it enables faster return to routine activities and also among the older group as it is less invasive and reduces post-operative complications.

There is a growing interest in MIHCR, although conventional open techniques remain more popular, a study to assess the early outcomes of MIHCR in our population is opted here.

Booster dose of Covid-19 increases resilience of antibody response: Study

Post author By Pragya sharma
Post date January 3, 2023
No Comments on Booster dose of Covid-19 increases resilience of antibody response: Study

The most recent study explains how Pfizer and Moderna mRNA boosters affect our Covid-19 antibodies’ ability to remain over time. The researchers found that all patients, including those who had recovered from a Covid-19 infection, developed more robust antibodies in response to a booster.

Recent research from the University of Virginia School of Medicine discussed the benefits of a Covid-19 booster vaccine dose. The most recent study clarifies how Pfizer and Moderna mRNA boosters influence the persistence of our Covid-19 antibodies. According to the researchers, a booster produced more durable antibodies in all individuals, including those who had recovered from a Covid-19 infection.

The researchers have published their latest findings in the scientific journal Annals of Allergy, Asthma & Immunology. “These results fit with other recent reports and indicate that booster shots enhance the durability of vaccine-elicited antibodies,” said senior researcher Jeffrey Wilson, MD, PhD, of UVA Health’s Division of Asthma, Allergy and Immunology.

Tracking Covid-19 antibodies: Wilson and his collaborators looked at antibody levels following a booster in 117 UVA employee volunteers and compared those results with the levels seen in 228 volunteers after their primary vaccination series. Antibody levels one week to 31 days after the primary series and booster were similar, but the boosted antibodies stuck around longer regardless of whether the person had had Covid-19.

“Our initial thought was that that booster would lead to higher antibody levels than the primary vaccine series, but that was not what we found,” said researcher Samuel Ailsworth, the first author of a new scientific paper outlining the findings. “Instead, we found that the booster led to longer-lasting antibodies.”

Antibody levels naturally decline over time after an infection or after vaccination, but higher levels are thought to be more protective. Thus, longer-lasting antibodies would be expected to provide more sustained immunity against severe Covid-19.

The researchers found that the antibodies generated by the Moderna booster proved longer lasting than those generated by the Pfizer booster. Moderna’s antibody levels exceeded Pfizer’s out to five months, the end of the study period. Although the findings were statistically significant, Wilson notes that both mRNA vaccine boosters provide enhanced and fairly similar levels of protection against Covid-19 in recently published large epidemiologic studies. Because the frequency of Covid-19 infections in the community was relatively high when the boosters were being given, the authors also studied the effect of COVID-19 infection on antibody levels. The findings suggest that the “enhanced antibody durability observed after booster vaccination was not explained by hybrid immunity,” the researchers report in their paper.

The new results are the latest from Wilson’s team tracking the antibody response to the Covid-19 vaccines over time. The researchers previously found that after the primary vaccination series the antibodies generated by Pfizer’s Covid-19 vaccine rose more slowly and declined more quickly than those generated by the Moderna vaccine. That study also found that older recipients of the Pfizer vaccine generated fewer antibodies than did younger recipients – but this wasn’t the case for Moderna, where age did not appear to be a factor.

In the latest results, younger booster recipients initially generated more antibodies than did older recipients, but this difference disappeared with time. Wilson notes that this study adds to the accumulating evidence that boosters are important in protecting the community from Covid-19. “Although only about half of the U.S. population that is eligible for a booster has received one, it is increasingly clear that boosters enhance the protection that is conferred by the primary series mRNA vaccines alone,” he said.