[Vol 14] Medi-Scene: Your Weekly Health News Update

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MediScene Vol 14

1. Coronavirus update: Number of cases cross 20,000. Death toll more than 600

India is the 17th country across the globe to record 20,000 cases of coronavirus. There were a total of 49 death cases on Tuesday, taking the toll to 645. Maharashtra, West Bengal and Rajasthan recorded their highest single-day rise in infections. The total number of cases was at 20,083 as on Tuesday, and as per reports collected from all states, the covid-19 active cases had risen by 1493 in a day, which is the second highest since 1613 cases that were recorded on Sunday. 1/3rd of new cases were recorded in Maharashtra, which was at 552, out of which 419 cases and 12 deaths alone were from Mumbai. Gujrat reported 239 new cases followed by 159 cases in Rajasthan and 53 cases in West Bengal. Gujarat, which has emerged as the biggest Covid hotspot after Maharashtra, crossed the 2,000-mark in number of cases and overtook Delhi to claim the second spot in the country. The number of Covid-19 deaths has also risen to 640 with 45 deaths being reported from various states. With 71 new cases reported in the state on Tuesday, Madhya Pradesh’s Covid-19 count rose to 1,553 but a sharp downward slope in the curve over the past few days has helped it drop from third rank in the country to sixth. 

2. Goa becomes the first Indian state to be Covid-free

Goa has been successful in flattening the Covid-19 curve. It has not reported a single case since April 3 and all seven patients, out of which six had a travel history, while one was related to one of the patients have now recovered. In spite of this, the state has decided to be on high alert because it’s neighboring states – Karnataka and Maharashtra, both have recorded a large number of coronavirus cases. Belagavi on the other hand has been declared as covid-19 hotspot and that becomes a worrying case for Goa as it is an important link for Goa to procure most of its vegetable and fruit supply. There are also fears that Goa could find itself on the back foot again with almost 8,000 seafarers now preparing to return to the state.

3. Around 69% of COVID cases were asymptomatic: ICMR

The Indian Council of Medical Research (ICMR) on Tuesday revealed that the number of Covid-19 tests that delivered positive results in India show that 69% of active positive cases were asymptomatic, whereas 31% were symptomatic representing a ratio of 1:2. ICMR head of epidemiology and communicable diseases Dr R R Gangakhedkar in an interview said, “There is only one study that suggests there are 80% cases. Secondly in case of asymptomatic, where the symptoms are not very clear, the chances of the patient coming and reporting the case too becomes low. I am now saying for the first time that if we look at the number of tests done, so far 31% belong to the symptomatic category and the rest 69% would fall under asymptomatic, we can say that for every single case detected there would be about two cases that may be termed as asymptomatic.” Lav Agarwal, joint secretary in the health ministry, said “We are working with a pre-emptive approach while working on community surveillance. If we find a so-called asymptomatic case in a field with high risk or direct contact, then we collect even that sample for testing. In that case, when a person has even mild symptoms, the test is positive. This way we can timely identify and reduce mortality.”  According to WHO, the pre-symptomatic period is the incubation interval for Covid-19. This period can last up five to six days on an average but can also lead up to 14 days. During this period, some infected persons can be contagious. A truly asymptomatic case is a confirmed case in a person infected with Covid-19 who does not develop symptoms.

4. COVID-19 patient recovers well post plasma therapy

A 49-year-old man in Delhi was tested COVID-19 positive on April 4th and was shifted to Max Hospital in Saket. When he was admitted, he showed moderate symptoms of fever and respiratory issues. His condition had worsened during the next few days and soon required external oxygen to maintain saturation. He also developed pneumonia with Type I respiratory failure and had to be put on ventilator support on April 8. Seeing his condition, his family members requested for plasma therapy to be administered to him – a first of its kind treatment modality that was used for this disease in India. The family arranged a donor who had recovered from the infection three weeks ago and again tested COVID-19 negative at the time of donation along with other standard tests to rule out other infections. After receiving the treatment on 14th April, the patient showed progressive improvement and by the fourth day, he was weaned off ventilator support on the morning of April 18. Dr Sandeep Budhiraja, Group Medical Director, Max Healthcare and Senior Director, Institute of Internal Medicine, commented on the success of the first case administered under plasma therapy and said “We are delighted that the therapy worked well in his case, opening a new treatment opportunity during these challenging times, but we also understand that plasma therapy is no magic bullet. During the patient’s treatment at Max Hospital, other standard treatment protocols were followed. We can say that plasma therapy could have worked as a catalyst in speeding up his recovery. We cannot attribute 100 per cent recovery to plasma therapy only. In a country like India, a therapy of such kind has a good potential to help COVID-19 patients, who have disease severity, which fits into moderate to severe categories. The government regulations should work towards making it more accessible for hospitals. One donor can donate 400 ml of plasma which can save two lives, as 200 ml is sufficient to treat one patient.”

5. Sleep deprivation linked to hormonal changes

In a recent interview Dr Mahavir M Modi, Modi Clinic, Pune spoke about the consequences of sleep deprivation and how it is associated with changes in body. Commenting on the major health issues caused by sleep deprivation, he said, “We all need to take at least eight hours of sleep, but we are all taking maybe six hours of sleep. Almost 30- 35% of Indian population has been sleeping only for six hours. The consequences of sleep deprivation are most likely because of the hormonal changes. There is an increase in the levels of ghrelin and decrease in the level of leptin, so it makes you feel more hungry. These patients keep on eating more and more, and that is the reason that they gain weight. Obesity is the first important consequence of sleep deprivation. These patients are also more prone because of the insulin-resistance to diabetes. Therefore, diabetes and weight gain are very closely related to sleep deprivation and then definitely cardiovascular morbidity, hypertension and ischemic heart diseases are also playing a key role in this.” Hormonal changes is one major area of worry for those who do not sleep well as it disrupts the basic metabolic functions and rates. He further added, “In the initial part of the sleep, the growth hormone has the maximum number of releases. Even in females, prolactin levels are basically released during sleep, so if somebody is sleep deprived, then the prolactin levels are going to be less.Cortisol hormone again depends on the sleep because they’re released in the latter part of the sleep and most importantly, what we see commonly is thyroid. Basically, the patients who are sleep deprived have more release of TSH. Due to this, they’re more prone to the hypothyroid diseases. Growth hormone, prolactin, thyroid as well as cortisol, all are basically related with the hormonal changes during sleep.”

6. ADHD in children can be reduced with healthy lifestyle

In a recent study that was first of its kind, more than 3000 fifth-grade students in Nova Scotia, Canada, showed that those who met at least seven of nine healthy lifestyle recommendations had a substantially lower incidence of ADHD compared to their counterparts who only met between one and three of the criteria. Senior investigator Dr. Paul Veugelers, PhD, School of Public Health, University of Alberta, Edmonton, Canada commented on the investigation and said, “The evidence is there to show that the association between lifestyle and physical health exists. Now it seems that these same recommendations also protect children from developing ADHD. The more factors they comply with, the less likely they are to develop ADHD. To date, no other study has really considered all these lifestyle factors simultaneously.” The incidence of ADHD affects approximately 1 in 8 boys and 1 in 18 girls. Globally, approximations show that more than 100 million children and teenagers have an ADHD diagnosis. According to researchers, increasing rates of the disorder run have been linked to deteriorating lifestyle choices. Poor diet, physical inactivity, bad sleeping habits, and sedentary behavior have all been associated with ADHD.  Dr. Paul Veugelers further added, “My research interest has always been how the lifestyles of children affect health. At first I only considered physical health, but in recent years it’s become apparent that lifestyle affects mental health as well.So originally I did not intend to look at ADHD, but because of the associations that kept coming up, I decided this needs further investigation and this study is one of the products of that further investigation.” 

Reference links:

  1. https://health.economictimes.indiatimes.com/news/industry/india-17th-nation-to-hit-20000-covid-19-cases-death-toll-crosses-600/75283427
  2. https://health.economictimes.indiatimes.com/news/industry/goa-is-covid-free-and-on-the-guard/75248736
  3. https://health.economictimes.indiatimes.com/news/industry/69-of-cases-found-positive-were-asymptomatic-icmr/75284013
  4. https://health.economictimes.indiatimes.com/news/industry/covid-19-patient-recovers-well-post-administration-of-plasma-therapy/75268699
  5. https://health.economictimes.indiatimes.com/news/industry/sleep-deprivation-impacts-various-diseases-and-hormonal-changes-dr-mahavir-m-modi/72269405
  6. https://www.medscape.com/viewarticle/929207

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