[Vol 19] Medi-Scene: Your Weekly Health News Update

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MediScene Magazine Vol19

1. Coronavirus update: Cases cross 1.5 lakh while fresh cases dip to 5.5k

On Tuesday, 26th India had reported 1,47,758 coronavirus cases while the death toll from the pandemic was 4,345. On the other hand, the number of people who had recovered from the virus had risen to 64,239. The number of cases dipped to 5,502 on Tuesday, which has been the lowest number since six consecutive days. With a surge in cases, Mumbai was among the world’s four cities – Moscow, Sao Paulo and New York. Six states that were worst-hit by the Covid-19 epidemic – Maharashtra, Tamil Nadu, Gujarat, Delhi, Rajasthan and Madhya Pradesh recorded a drop in cases as compared to the previous day. In some states, the count rose. Bihar recorded 231 new cases, Assam 95 and Kerala 67, the latter being the highest single-day number for the state. The surge in cases was high in the hill states as well, with J&K reporting 91, Uttarakhand 44 and Himachal 24 fresh infections. Gujarat recorded 27 more Covid-related deaths in the past 24 hours, taking the state’s death toll to 915. The state has second highest deaths in the country after Maharashtra which has recorded 1,792 mortalities.

2. Covid-19 recovery rate improved to 41.61% compared to 11.4%: Govt

India has been observing successful lockdowns since March and it has helped in drastically improving its Covid-19 recovery rate and reducing the case fatality rate, the government claimed. Presenting statistics on India’s Covid-19 management, the ministry of health and family welfare said that India’s recovery rate improved to 41.61% on May 26, in the fourth stage of the lockdown, from 7.1% on March 25, when the lockdown started, and 11.42% on April 15 when the second lockdown was imposed. Joint secretary Lav Aggarwal in an interview said, “Our fatality rate is among the lowest in the world. India has one of the lowest number of cases reported per lakh of population in the world.”

3. Eli Lilly drug approved for thyroid, lung cancers driven by a genetic mutation: FDA

The Food and Drug Administration on 8th May 2020, gave a nod to a drug to treat lung and thyroid cancers driven by a specific genetic mutation that Eli Lilly and Co acquired with its 2019 purchase of Loxo Oncology. The drug is called selpercatinib, which works against cancers driven mutations of a gene known as RET, is part of a trend of treating cancer based on a patient’s genetics rather than where in the body the disease originated. RET mutations occur in about 2% of lung cancers, 10% to 20% of papillary thyroid cancers. The drug is invented to hinder the mutated RET enzyme that drives cancer by triggering uncontrolled cancer cell growth. In clinical trials, it performed equally impressively regardless of where the cancer was located.

4. Schizophrenia patients may face problems due to lockdown

Schizophrenia is a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behaviour, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation. Mental health issues have been on a rise since the lockdown. Psychiatrists now think that people who suffer from Schizophrenia  may face more problems. The country is suffering a massive mental health crisis due to unemployment, alcohol abuse, economic hardship, domestic violence and related issues, all of which are leading causes of developing schizophrenia. Biswa Ranjan Mishra, an additional professor in the department of psychiatry, AIIMS Bhubaneswar commented on the same issue and said, “Though the patients take medicines in time, sometimes their symptoms of illness fluctuate over time and they need to visit a psychiatrist. Many patients could not visit their doctors due to lockdown. We had started telepsychiatry consultation for our patients. Though we were managing to talk to the patients, some of them were not getting medicines in their area. If the people don’t get quality sleep, get irritated a lot, suspect people very often, show abnormal behaviour and mutter, they need doctor consultation.” Lagnajit Dash, neuropsychiatrist in SUM Hospital in an interview said, “There is a risk of worsening or relapse in persons with existing mental illness because of financial issues, jobless and lockdown difficulties. People with this disorder become very confused and they cannot understand much of the world around them. They become suspicious and often hold false beliefs which may lead to them harming others or harming themselves including suicide.”

5. High risk of cardiovascular disease risk linked to social isolation

In a study done recently, it concluded that social isolation is responsible for increasing the risk of a cardiovascular event by more than 40%. Janine Gronewold, PhD, University Hospital in Essen, Germany, in a press briefing said, “These results are especially important in the current times of social isolation during the coronavirus crisis.” Study has shown that loneliness or lack of contact with close friends and family can affect physical health. The paper presented at the sixth Congress of the European Academy of Neurology (EAN) 2020 and researchers analyzed data from 4139 participants, ranging in age from 45 to 75 years. The randomly selected study group was representative of an industrial rural area of Germany. One part of the study measured information on three types of social support: instrumental (getting help with everyday activities such as buying food), emotional (provided with comfort), and financial (receiving monetary assistance when needed). Of the total, 501 participants reported a lack of instrumental support, 659 a lack of emotional support, and 907 a lack of financial support. Other part of the study concentrated on cardiovascular risk factors, health behaviors, depression, and socioeconomic factors. Janine Gronewold commented further on that and said, “Social relationships protect us from cardiovascular events and mortality, not only via good mood, healthy behavior, and lower cardiovascular risk profile. They seem to have a direct effect on these outcomes. The new results are worrying and are particularly important during the current COVID-19 pandemic, as social contact has been restricted in many areas.”

6. Diabetics are at 50%  higher risk of critical outcome due to Covid-19

Lockdown has inflicted a lot of challenges to the chronic patients, Dr. V Mohan, Chairman & Managing Director, Dr. Mohan’s Diabetes Specialities Centre, Director and Chief of Diabetes Research, Madras Diabetes Research Foundation, in one of his interviews sheds light on this. Commenting on how COVID-19 impacted the care of diabetes in India he said, “The lockdown situation due to COVID-19 has created a distress among the people with diabetes and other chronic diseases about the availability of essential medicines. However, several pharmaceutical industries have worked to ensure uninterrupted supply of medicines. Medical Council of India has recently updated the telemedicine guidelines in India to support delivery of care keeping in mind the social distancing norms and safety of HCPs. This can be successfully utilised especially in treating diabetes, as the physician can interact, take history and analyse the self-monitored blood glucose charts (SMBG) of the patient and give advice, reducing the number of hospital visits. The risk of a fatal outcome from COVID-19 is up to 50% higher in people with diabetes than in those who do not have diabetes. It is very important to maintain a good glycaemic control as it has been shown to boost the innate immune system. Most of the physicians may consider reviewing the prescription over continuing current therapy or intensifying them, in order to achieve a good glycaemic control. Insulin is considered to be a safe choice under such circumstances as it remains the sole therapy for people with type 1 diabetes mellitus, and a superior alternative in people with type 2 diabetes mellitus having poor glycaemic control. However, with the rise in price in insulin analogues, it is a big challenge for patients to access insulin especially during the current financial crisis. In such a scenario, it is a welcome move by Novo Nordisk India to reduce the price of Ryzodeg (IDegAsp), a premix insulin in India by 30% to support patients.”

7. Combo of Hydroxychloroquine-azithromycin could be fatal: Study

On Monday 25th May 2020, the World Health Organization suspended testing hydroxychloroquine in COVID-19 patients due to safety concerns. According to a study, hydroxychloroquine and azithromycin, which have been proposed for treatment of COVID-19 patients, are a potentially lethal combination, and may have a serious impact on the cardiovascular system. The researchers from Vanderbilt University and Stanford University in the US, carried out an observational, retrospective meta-analysis of a WHO database encompassing over 21 million adverse event case reports. The report was published in the journal Circulation, compared cardiovascular adverse-drug-reactions (CV-ADRs) in patients who received hydroxychloroquine, azithromycin, or the combination of both medications with all other cardiovascular medications in the database. They found that 76,822 adverse event reports were associated with hydroxychloroquine alone, and in 28.4% of those cases (21,808), the drug was suspected to be associated with the adverse event. The researchers said 607 adverse event reports were associated with the combination of both medications.

Reference links:

  1. https://health.economictimes.indiatimes.com/news/industry/indias-covid-count-set-to-cross-1-5-lakh-fresh-cases-dip-to-5-5k/76021861
  2. https://health.economictimes.indiatimes.com/news/industry/covid-19-recovery-rate-at-41-61-as-compared-to-11-4-on-april-15-govt/76033710
  3. https://health.economictimes.indiatimes.com/news/pharma/fda-approves-eli-lilly-drug-for-thyroid-lung-cancers-driven-by-a-genetic-mutation/75643498
  4. https://health.economictimes.indiatimes.com/news/diagnostics/problems-of-schizophrenia-patients-may-increase-due-to-lockdown/75969170
  5. https://www.medscape.com/viewarticle/931047
  6. https://health.economictimes.indiatimes.com/news/industry/the-risk-of-a-fatal-outcome-from-covid-19-is-up-to-50-higher-in-people-with-diabetes-dr-v-mohan/76009347
  7. https://health.economictimes.indiatimes.com/news/pharma/hydroxychloroquine-azithromycin-combo-may-be-potentially-lethal-study/76000845

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