[Vol 30] Medi-Scene: Your Weekly Health News Update

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MediScene Magazine Vol 30

1. Russia becomes first nation to register coronavirus vaccine

Speaking on Tuesday at a government meeting, Russian President Vladimir Putin said that the vaccine has proven efficient during tests, offering a lasting immunity from the coronavirus. It has been registered for use and one of his daughters has already been inoculated. Russian authorities have said that medical workers, teachers and other risk groups will be the first to be inoculated. Russia is the first country to register a coronavirus vaccine. Many scientists in the country and abroad have been skeptical, however, questioning the decision to register the vaccine before Phase 3 trials that normally last for months and involve thousands of people.

2. New probiotic shows potential in treating type 2 diabetics

New research suggests that Pendulum Glucose Control, containing gut bacteria strains that are lacking in people with type 2 diabetes unobtrusively improves blood glucose levels. It contains the oligosaccharide-consuming Akkermansia muciniphila and Bifidobacterium infantis, the butyrate producers Anaerobutyricum hallii, Clostridium beijerinckii, and Clostridium butyricum, along with the “prebiotic” dietary fiber inulin. In the 12-week trial of people with type 2 diabetes who were already taking metformin, with or without a sulfonylurea, 23 were randomized to the product and 26 received placebo capsules. Participants in the active treatment arm had significantly reduced glucose levels after a 3-hour standard meal-tolerance test, by 36.1 mg/dL (P = .05), and average A1c reduction of 0.6 percentage points (P = .054) compared with those taking placebo.There were no major safety or tolerability issues, only transient gastrointestinal symptoms (nausea, diarrhea) lasting 3-5 days. No changes were seen in body weight, insulin sensitivity, or fasting blood glucose. Nanette I. Steinle, MD, an endocrinologist with expertise in nutrition who was not involved in the research, told an online medical news portal that, “To me it looks like the research was designed well and they didn’t overstate the results. I would say for folks with mild to modest blood glucose elevations, it could be helpful to augment a healthy lifestyle.” Lead author Orville Kolterman, MD, chief medical officer at Pendulum said, “The ones sold in stores are reconfigurations of food probiotics, which are primarily aerobic organisms, whereas the abnormalities in the microbiome associated with type 2 diabetes reside in anaerobic organisms, which are more difficult to manufacture. The fiber component, inulin, is important as well. This product may make the dietary management of type 2 diabetes more effective, in that you need both the fiber and the microbes to ferment the fiber and produce short-chain fatty acids that appear to be very important for many reasons.”

3. Know how development of osteoporosis can be affected by sleep duration

7-9 hours of sleep is recommended to adults over 18 years of age. A research by Chen and colleagues analysed the correlation between sleep, daytime nap duration, and osteoporosis. It was also explored if they varied by sex, menopause, and sleep quality. Longer sleep duration has been tied to increased risk of osteoporosis. The research was conducted on 8688 participants aged 40 years or above. In a study published in Scientific Reports, sleep durations of 7–8 hours/day, 9–10 hours/day, and >10 hours/day, and longer daytime naps were therefore linked with higher risks of having osteoporosis. Higher frequency and longer duration of daytime napping were reported to be associated with lower femoral bone mineral density (BMD) in elderly women. Shorter sleep duration, on the other hand, has also been linked with osteoporosis in postmenopausal women. A study published in the Journal of Bone and Mineral Research included 11,084 postmenopausal women from the Womens Health Initiative. Women with a sleep duration of ≤5 hours per night had significantly BMD compared to women who reported sleeping 7 hours per night. Wang et al noted that both short and long sleep duration were associated with a significantly increased risk of osteoporosis in middle-aged and elderly adults.

4. Weight gain remains a concern in HIV treatments

People living with HIV who put on extra pounds and develop metabolic syndrome or related disorders linked in part to certain antiretroviral agents remain a concern today, even as the drugs used to suppress HIV infection have evolved over the decades.  W.D. Francois Venter, PhD and Andrew Hill, PhD in a recent published commentary on the topic said, “Weight gain is clearly seen in studies of dolutegravir [DTG] or bictegravir [BTG] with TAF.” Jordan E. Lake, MD, an HIV specialist at the University of Texas Health Science Center at Houston commented on the same concern saying, “Excessive weight gain, defined as more than 10% over baseline, has recently been observed among people with HIV initiating or switching to regimens incorporating TAF, an INSTI, or both, particularly DTG are at even greater risk for excessive weight gain.” Anna Maria Geretti, MD, a professor of clinical infection, microbiology, and immunology at the University of Liverpool, England in an interview said, “In recent times, it has emerged that weight gain is more pronounced with the integrase inhibitor class of agents, especially dolutegravir and bictegravir, the so-called second-generation. The effect is more pronounced in women and people of non-White ethnicity, and is of concern because of the associated potential risk of metabolic syndrome, cardiovascular disease, etc.” Dr. Sokhela said during a press briefing at the conference that, “We believe that these results support the World Health Organization guidelines that reserve TAF for only patients with osteoporosis or impaired renal function. The risk for becoming obese continued to increase after 96 weeks. Dr. Venter, a professor and HIV researcher at University of the Witwatersrand, head of Ezintsha, and lead investigator of ADVANCE said, “All regimens are now brilliant at viral control. Finding the ones that don’t make patients obese or have other long-term side effects is now the priority. Clinicians and researchers have recently thought that combining TAF and an INSTI plus FTC or a similar NRTI would be the ultimate regimen to replace the non nucleoside reverse transcriptase inhibitors (NNRTIs) such as EFV, but now we have a major headache with unexpectedly high weight gains in some patients.Weight gains over 10 kg are unlikely to be acceptable in any circumstances, especially when starting body mass index is already borderline overweight.”

5. Hypertension in patients who have history of stroke is often untreated

A new study of hypertension treatment trends, published in JAMA Neurology, found that unchecked high blood pressure along with considerable lack of treatment of the condition were widespread in individuals with a history of both hypertension and stroke. Daniel Santos, MD, and Mandip S. Dhamoon, MD, DrPH, of the Icahn School of Medicine at Mount Sinai, New York wrote, “To our knowledge, the present study is the first to analyze and report national antihypertensive medication trends exclusively among individuals with a history of stroke in the United States.” The researchers examined more than a decade of data from the National Health and Nutrition Examination Survey (NHANES). The cross-sectional survey is conducted in 2-year cycles; the authors analyzed the results from 2005 to 2016 and uncovered a total of 4,971,136 eligible individuals with a history of both stroke and hypertension. The mean age of the study population was 67.1 (95% confidence interval, 66.1-68.1), and 2,790,518 (56.1%) were women. Their mean blood pressure was 134/68 mm Hg (95% CI, 133/67–136/69), and the average number of antihypertensive medications they were taking was 1.8 (95% CI, 1.7-1.9). Of the 4,971,136 analyzed individuals, 4,721,409 (95%) were aware of their hypertension diagnosis yet more than 10% of that group had not previously been prescribed an antihypertensive medication. Louis Caplan, MD, of Harvard Medical School and Beth Israel Deaconess Medical Center, both in Boston, said in an interview that, “All the studies that have ever been done show that hypertension is inadequately treated. One of the reasons is that it can be hard to get some of the patients to seek treatment, particularly Black Americans. Also, a lot of the medicines to treat high blood pressure have side effects, so many patients don’t want to take the pills. Treating hypertension really requires continued surveillance. It’s not one visit where the doctor gives you a pill. It’s taking the pill, following your blood pressure, and seeing if it works. If it doesn’t, then maybe you change the dose, get another pill, and are followed once again. That doesn’t happen as often as it should. Be evaluated more seriously. Even as home blood pressure kits and monitoring become increasingly available, many doctors are still going by a casual blood pressure test in the office, which doesn’t tell you how serious the problem is. There needs to be more use of technology and more conditioning of patients to monitor their own blood pressure as a guide, and then we go from there.”

6. Patients who are asymptomatic, don’t need hospitalization: Govt

With an increasing number of Covid-19 cases, the government said a large number of cases detected were asymptomatic and did not require hospitalization. Such cases could be in isolation and monitored and states did not need to be overawed by rising positive cases as long as they vigorously implemented testing, containment and tracking strategies.  Health secretary Rajesh Bhushan said, “Neither the Union or state governments should be overawed by the number of positive people per day, we advise home isolation (for asymptomatic cases) under medical care and control, where on a daily basis health parameters are monitored physically or telephonically.” He restated that less than 1% of active cases were on ventilators, less than 3% on oxygen and less than 4% in ICU. Commenting further Rajesh Bhushan said, “Our joint monitoring group is seized with this issue and will provide a guidance note soon. With a consistent and sustained increase in recoveries, the gap between recovered patients and active Covid-19 cases has reached nearly 950,000. India’s test, track and treat strategy is showing the desired result — the gap between percentage of recoveries and percentage of active cases of Covid-19 is growing every day.” The recovery rate of Covid-19 cases has improved to nearly 70% while the fatality rate is now a shade below 2%. India has conducted 2.5 crore tests, reaching the record of more than 7 lakh tests in a single day. 

Reference link

  1. https://health.economictimes.indiatimes.com/news/pharma/russia-registers-virus-vaccine-putins-daughter-inoculates/77486390
  2. https://www.medscape.com/viewarticle/934976
  3. https://www.emedinexus.com/post/17499/
  4. https://www.medscape.com/viewarticle/935345
  5. https://www.medscape.com/viewarticle/935516
  6. https://health.economictimes.indiatimes.com/news/policy/asymptomatic-cases-dont-need-hospitalisation-govt/77495881

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