Foetuses and placentas of pregnant women, especially those infected with COVID-19 at earlier points in the pandemic, were found to bear a greater risk of experiencing growth impairment or vascular lesions in organs and brain, according to a new research.
Foetuses and placentas of pregnant women, especially those infected with COVID-19 at earlier points in the pandemic, were found to bear a greater risk of experiencing growth impairment or vascular lesions in organs and brain, according to a new research.
According to the research, results demonstrate that the different strains of the virus that emerged during the pandemic led to varying degrees of damage, which was especially higher by those involving pre-Omicron variants. The detected placental lesions could potentially harm both development and health in some of the affected unborn children, the study said.
Using prenatal magnetic resonance imaging, a group of Medical University of Vienna, Austria, researchers examined the placentas and foetuses of women who tested positive for SARS-CoV-2 during pregnancy, the study said.
The research was published in the journal The Lancet Regional Health – Europe. While such damage occurs more infrequently and is less severe with the currently circulating Omicron sub-lineages, the study authors still advocate early detection measures for pregnant women who test positive for coronavirus.
Contrary to previous studies, in which SARS-CoV-2-related abnormalities were only identified postnatally and/or through histopathological procedures, the research team focused on prenatal imaging findings, the study said.
Using prenatal magnetic resonance imaging (MRI), 76 scans of placentas and foetuses of pregnant women were performed in the study: 38 following a confirmed SARS-CoV-2 infection (pre-Omicron or Omicron variants) and 38 in healthy control cases, the study said.
The study found that the placentas in both the pre-Omicron and the Omicron groups revealed abnormalities.
“Infections with pre-Omicron variants, such as Delta, led to significantly greater damage in the form of vascular events such as blood clots or bleeding than with the Omicron subvariants currently circulating through the population,” noted lead author Patric Kienast, outlining a key finding of the study.
The researchers attribute the varying extent of damage to the placenta caused by different virus strains to the fact that Omicron sub-lineages are less likely than their predecessors to result in severe cases, and to higher vaccination rates as the pandemic has progressed, the study said.
“In any case, our results showed that the two non-vaccinated study participants developed placental abnormalities following infection with SARS-CoV-2 Omicron, compared with just one out of six of the women who had received three doses of the vaccine,” confirmed senior author Gregor Kasprian.
Oxygen, nutrients and metabolic products are exchanged between mother and child in the placenta. Attached to the uterine wall, this organ forms such a strong barrier against the coronavirus that only 3 per cent or fewer of foetuses whose mothers test positive for SARS-CoV-2 are also infected, the study said.
But as the study shows, the placenta itself is not spared from complications caused by Covid-19. Subsequently, some unborn babies experience stunted growth or bleeding in the brain, the study said.
“This is why the placentas of pregnant women who have been infected with SARS-CoV-2 should be examined as soon as possible after testing positive using prenatal imaging techniques,” advised Daniela Prayer from Medical University of Vienna, citing the importance of scanning, particularly in the case of possible future coronavirus variants with mechanisms similar to Delta, for example.
By doing so, there is a chance to take measures to safeguard the health of the foetus in a worst case scenario, the study said.
Male and female hearts react differently to the stress hormone noradrenaline, according to a recent study published in Science Advances.
Male and female hearts react differently to the stress hormone noradrenaline, according to a recent study published in Science Advances. The research on mice may have ramifications for human heart conditions like arrhythmias and heart failure as well as how various sexes react to certain drugs.
The team built a new type of fluorescence imaging system that allows them to use light to see how a mouse heart responds to hormones and neurotransmitters in real-time. The mice were exposed to noradrenaline, also known as norepinephrine. Noradrenaline is both a neurotransmitter and hormone associated with the body’s “fight or flight” response.
The results reveal that male and female mouse hearts respond uniformly at first after exposure to noradrenaline. However, some areas of the female heart return to normal more quickly than the male heart, which produces differences in the heart’s electrical activity.
“The differences in electrical activity that we observed are called repolarization in the female hearts. Repolarization refers to how the heart resets between each heartbeat and is closely linked to some types of arrhythmias,” said Jessica L. Caldwell, first author of the study. Caldwell is a postdoctoral scholar in the UC Davis School of Medicine Department of Pharmacology.
“We know that there are sex differences in the risk for certain types of arrhythmias. The study reveals a new factor that may contribute to different arrhythmia susceptibility between men and women,” Caldwell said.
Heart disease is the leading cause of death for both men and women in the United States. It accounted for about 1 in every 4 male deaths and 1 in every 5 female deaths in 2020. Despite the impact on both sexes, cardiology research has largely been performed on male subjects.
In this study, the researchers were interested in looking at factors that may contribute to arrhythmias. Arrhythmias are a type of heart disorder where the electrical impulses that control heartbeats don’t function properly. They affect somewhere between 1.5% to 5% of the population.
The researchers had not planned to study sex-based responses, according to Crystal M. Ripplinger, senior author of the study. But the researchers started seeing a pattern of different reactions, which led them to realize the differences were sex-based.
Ripplinger, an electrical and biomedical engineer, is a professor in the Department of Pharmacology. When she started her lab at the UC Davis School of Medicine over a decade ago, she exclusively used male animals. That was the norm for most research at the time. But several years ago, she began including male and female animals in her studies.
“Sometimes the data between the two sexes is the same. But if the data start to show variation, the first thing we do is look at sex differences. Using both male and female mice has revealed clues into differences we would never have suspected. Researchers are realizing you can’t extrapolate to both sexes from only studying one,” Ripplinger said.
She notes that with the current study, it’s not clear what the differences in cAMP and electrical activity may mean. “The response in the female mice may be protective — or it may not. But simply documenting that there is a measurable difference in the response to a stress hormone is significant. We are hoping to learn more in future studies,” Ripplinger said.
Panic attacks can occur unexpectedly and have a significant impact on daily life. If you know someone who experiences frequent panic attacks, here are some tips to help them during an episode.
A panic attack is a sudden and unexpected episode of intense fear or anxiety that can lead to physical as well as emotional discomfort. One having panic attack may feel they are going to die or have a heart attack. However, one experiencing it does not realise at that time that it’s not actually life threatening. Panic attacks have certain triggers and research suggests that it is your body’s natural fight-or-flight response to danger. A racing heartbeat, sweating, trembling, difficulty breathing, stomach cramps, dizziness, nausea or choking sensation are the common symptoms of panic attacks. One must get to the root of their panic attack and get in touch with an expert as it can affect one’s quality of life severely.
While a person tends to lose control during a panic attack and feels that all the physical symptoms are real, their near and dear ones can help them deal with it with the help of certain tips. Nutritionist Lovneet Batra in her recent Instagram post offered useful suggestions to help someone who’s having a panic attack.
“Panic attacks are sudden, intense surges of fear, panic, or anxiety. They are often extremely overwhelming, and they have physical as well as emotional symptoms. Panic attacks can occur unexpectedly and have a significant impact on your daily life. Due to the extreme nature of the symptoms, it is important to understand how to react and help when someone undergoes a panic attack, as they may feel as if they are dying during an episode. However, if a person present around them is able to help them, they might feel a little better or understood. Certain strategies and methods can help alleviate panic, ease the situation, and even stop the symptoms from getting worse. Each one of us must know how to react and offer help in such situations,” says Lovneet Batra.
If you know someone who experiences panic attacks, guide them with things you can do (and avoid doing) to help them at the moment.
“Many people hesitate in helping someone facing panic attacks mostly because they don’t know what to do and they fear making the situation even worse,” says Batra.
She shared the three things that can be helpful in such situations:
Give them water
Water has calming effect. In fact, drinking cold water triggers parasympathetic nervous system to keep a person calm. What can also be helpful is physical contact with water. So, either, keeping a person’s hand or feet in water or giving them cold water to put on the face around the neck that can help easing the anxiety.
Ask if they need to sit
Help them find a comfortable chair. Let them sit as this can have a literal grounding effect that can be healing and that can be calming for their anxiety.
Use grounding technique
A grounding technique uses all five senses in calming a person. A very common grounding technique is 5-4-3-2-1 where you can ask a person to list five things they see, four things they can touch, three things they hear, two things they can smell and one thing they can taste. This in fact helps in focussing their thoughts in those questions and helps you release anxiety.
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.
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.
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.
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.
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.”
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.”
Long covid is defined as symptoms persisting or new symptoms appearing more than four weeks after initial infection. A new study reveals that most Long Covid symptoms that developed after a mild coronavirus infection lingered for several months but returned to normal within a year.
The effects of long Covid tend to resolve within a year of mild infection, with vaccinated people at lower risk of breathing difficulties compared with unvaccinated people, according to a study.
Researchers examined the health records of almost 2 million people in Israel who tested for Covid-19 over a 19-month period. Over 70 long Covid conditions were analyzed within a group of infected and matched uninfected members. They also compared conditions in vaccinated versus unvaccinated people.
Their study published in the BMJ medical journal found most symptoms that developed after a mild infection lingered for several months, but returned to normal within a year.
“The long Covid phenomenon has been feared and discussed since the beginning of the pandemic,” the researchers wrote. “This nationwide dataset of patients with mild Covid-19 suggests that mild disease does not lead to serious or chronic long term morbidity.”
Previous studies have indicated that vaccination tends to lead to milder cases of Covid infection and long Covid.
Long covid is defined as symptoms persisting or new symptoms appearing more than four weeks after initial infection. An estimated 1.5 million people in the UK, or 2.4% of the population, were suffering from long Covid symptoms in March. These include fatigue, shortness of breath, loss of smell, loss of taste and difficulty concentrating.
Some of the limitations of the study include incomplete measurement within the medical records, meaning the data might not fully reflect diagnoses and outcomes reported, according to the researchers.
“The general message that symptoms improve over time is encouraging,” said Peter Openshaw, professor of experimental medicine at Imperial College London, who was not part of the research team. “The study adds to the evidence that outcomes are improved by vaccination, even if vaccines don’t prevent viral transmission very well.”
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.
Many post Covid patients who mistakenly believe their rapid heartbeat is due to anxiety could be suffering from POTS. Know all the symptoms of the disorder.
Do you experience dizziness, fatigue or rapid heart beat while getting up from the bed or a chair after prolonged sitting? You could be suffering from Postural orthostatic tachycardia syndrome (POTS), a condition that causes the heart to beat faster than usual. Our autonomic nervous system or the part of the nervous system that controls muscles of internal organs such as heart, blood vessels, lungs, stomach, and intestines is usually tasked with maintaining a healthy balance between heart rate and blood pressure to keep the blood flowing at a regular pace. In POTS, however, this function gets disrupted. Many post Covid patients who may mistakenly believe their rapid heartbeat is due to anxiety could be suffering from POTS.
WHAT IS POTS
“When you move from laying down or sitting to standing up, POTS, a disorder that causes your heart to beat more quickly than usual, can occur,” says Dr. Rajiv Dang, Senior Director and HOD – Internal Medicine and Medical Director, Max Hospital Gurugram.
SYMPTOMS OF POTS
– Dizziness or lightheadedness after prolonged standing or sitting
– Fainting
– heart palpitations
– fatigue or exhaustion
– Feeling anxious
– Excessive sweating
– Headache
– Shortness of breath
POTS symptoms can worsen on hot days, doing strenuous activities or during menstruation.
HOW POTS IS A LONG COVID MANIFESTATIOn
“We have what is basically one of the manifestations of long Covid syndrome, Postural Orthostatic Tachycardia Syndrome. People visit the doctor with mild palpitations and a lot of patients feel that it is anxiety but it may not be anxiety. It may be a symptom of the long Covid called POTS, the palpitations and so on, but it may remain for two months, six months or maybe more but it settles over a period of time. You may treat each patient differently according to their symptoms,” says Dr Vasant Nagvekar, co-director of infectious disease at Sir HN Reliance Foundation Hospital.
No matter what posture your body is in, your autonomic nervous system normally maintains a healthy balance between your heart rate and blood pressure to keep your blood flowing at a regular pace.
“If you have POTS, your body is unable to balance the reaction of your heart rate and blood vessel constriction (squeezing). This signifies that your body is unable to maintain a constant and stable blood pressure level,” says Dr Dang.
“There is no hard evidence of the connection between Covid and POTS but we have witnessed that post Covid patients come with this issue and it could be an effect of long Covid,” says Dr Nagvekar.
