[Vol 40] Medi-Scene: Your Weekly Health Update

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MediScene Vol 401. Mental Health Now To Be A Part Of Post-Covid Care

In the light of the rising complaints of mental health issues surfacing at the post-Covid care clinics, the state public health department has revised its approach to address this aspect even when a patient is being treated for the virus. Guidelines will be shortly issued across the state for sussing out the mental health condition of patients undergoing treatment for Covid-19 and start tackling them involving relevant experts. The guidelines will also be for attending to the mental health of healthcare staff whose job puts them under severe stress and psychological pressure, informed officials. Speaking on the change of tact, Dr Archana Patil, director of health services, Maharashtra, explained, “The guidelines have now been made more comprehensive. Earlier we addressed these issues only at the post-Covid clinics but now the guidelines will be for taking it up parallelly with the treatment of the virus. In fact, mental health plays a vital role in the recovery of a patient and the guidelines will lay down protocols for screening tests, counselling and treatment.” With the new guidelines yet to arrive, Dr Sanjeev Wavare, assistant health chief of Pune Municipal Corporation said, “As of now we have mental health experts at our post-Covid clinics, where we see issues of stress, anxiety and depression come up in Covid-19 patients. However, a more timely intervention would certainly be helpful. Even the kin of patients should seek help as soon as they notice behavioural changes in the patient.”

2. Mediterranean Diet Reduces Diabetes Risk: New Study

A new study published online talks about the known reduction in the risk of type 2 diabetes associated with adoption of the Mediterranean diet. While a reduction in BMI may be somewhat obvious, other mechanisms include beneficial effects on insulin resistance, lipoprotein metabolism, and inflammation. Senior author Samia Mora, MD, of the Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, in Boston, Massachusetts said, “It is striking to see in these US women how strong the long-term antidiabetic properties of a Mediterranean-type dietary pattern are. While it was known that the Mediterranean diet has many health benefits in particular on metabolism and inflammation, it was not previously known which of these biological pathways may be contributing to the lower risk of diabetes and to what magnitude. Our findings support the idea that by improving their diet, people can improve their future risk of type 2 diabetes, particularly if they are overweight or have obesity. And it’s important to note that many of these changes don’t happen right away. While metabolism can change over a short period of time, our study indicates that there are longer term changes happening that may provide protection over decades.” The Mediterranean diet, with an emphasis on healthy olive oil as the predominant source of oil, favors fruits, vegetables, legumes, nuts, and seeds, fish and dairy products, while limiting intake of red and processed meats as well as sweets. To investigate the precise mechanisms that underlie the prevention of diabetes, lead author Shafqat Ahmad, PhD, also at Harvard, and colleagues examined data from 25,317 healthy women participating in the Women’s Health Study who had baseline assessments between September 1992 and May 1995. They were a mean age of 52.9 years at baseline. Over the course of the study, 2307 participants developed type 2 diabetes. Those who had the highest self-reported adherence to the Mediterranean diet at baseline, had as much as a 30% lower risk of developing type 2 diabetes after multivariate adjustments compared to those with a lower Mediterranean diet score.

3. Turmeric Capsules Help Reduce Knee Arthritis Pain

A new clinical study suggests that people with knee osteoarthritis who take daily turmeric capsules feel less pain in the knee joint than their peers who don’t take this supplement. Researchers randomly assigned patients with symptomatic knee osteoarthritis to take two capsules of turmeric capsules (n=36) or placebo (n=34) daily for 12 weeks. At the end of the study period, turmeric improved knee pain on a visual analog scale (VAS) by -9.1 mm (95% CI, -17.8 to -0.4 mm) compared with placebo, but did not alter effusion-synovitis volume on magnetic resonance imaging. Senior study author Dr Benny Eathakkttu Antony of the Menzies Institute for Medical Research at the University of Tasmania in Hobart, Australia in an interview said, “The moderate effect we found in our trial from a short-term study is reassuring for turmeric as a treatment option. However, there are no long-term studies that explored the efficacy and safety of turmeric extracts for the treatment of osteoarthritis. There are no disease-modifying drugs approved to treat knee osteoarthritis, Antony and colleagues note in the Annals of Internal Medicine. Other pain relievers including acetaminophen and nonsteroidal anti-inflammatory drugs have only mild to moderate effects and are associated with adverse events, the researchers point out. Dr Antony further added, “Turmeric extracts are generally considered as safe in moderate doses usually seen in the over-the-counter medication. Curcumin, the most active constituent of turmeric, is generally classified ‘generally recognized as safe’ by the U.S. FDA as a food supplement.” Romy Lauche, deputy director of research at the National Centre for Naturopathic Medicine at Southern Cross University in East Lismore, NSW, Australia said, “Supplements and herbal products are one of many options that some patients may prefer over pharmacological therapies, and to some extent the treatment choice for knee osteoarthritis may come down to individual patient preferences. Supplements as well as pain medication may be able to support individuals with their osteoarthritis, for example by reducing their pain and helping them to be physically active again. However, which supplement or medication works is very individual, and patients may need to test different approaches to find the best management strategy before considering invasive treatments such as joint replacement surgery.”

4. Postmenopausal Women With Sedentary Lifestyle At Higher Risk Of Heart Diseases

Based on data from more than 80,000 postmenopausal women, The more time older women spent sitting or lying down, the more likely their risk of hospitalization for heart failure. Michael J. LaMonte, PhD, MPH, of the State University of New York at Buffalo, and colleagues in a study published in Circulation: Heart Failure wrote, “The 2018 Physical Activity Guidelines show evidence of the impact of physical activity on reducing heart failure risk, but the association between activity, sedentary behavior (SB) and heart failure (HF) in older women in particular has not been well studied. Given the high prevalence of prolonged sedentary time among U.S. adults aged 65 and older, among whom HF burden is substantial, understanding the role SB has in HF development is relevant to future HF prevention strategies.” Researchers identified 80,982 women aged 50-79 years who were enrolled in the Women’s Health Initiative Observational Study, had no known HF, and could walk at least one block unassisted. The average follow-up period was 9 years, and a total of 1,402 women were hospitalized for heart failure during the period of time they were observed. The time spent sedentary (combined sitting or lying down) was divided into tertiles of 6.5 hours or less, 6.6-9.5 hours, and more than 9.5 hours. Time spent sitting was divided into tertiles of 4.5 hours or less; 4.6-8.5 hours; and more than 8.5 hours. The trends remained significant after controlling for comorbidities including MI and coronary revascularization, and the associations were similar among categories of women with additional HF risk factors, including body mass index, diabetes, hypertension, and coronary heart disease. Researchers concluded, “Results of this study underscore the need for effective strategies to reduce daily SB time, in addition to increasing recreational physical activity, as part of population efforts for HF prevention.” Dr LaMonte further added, “However, our study clearly shows that we also need to increase efforts to reduce daily sedentary time and encourage adults to frequently interrupt their sedentary time. This does not necessarily require an extended bout of physical activity; it might simply be standing up for 5 minutes or standing and moving one’s feet in place. We do not have sufficient evidence on the best approach to recommend for interrupting sedentary time. However, accumulating data suggest that habitual activities such as steps taken during household and other activities of daily living are an important aspect of cardiovascular disease prevention and healthy aging.”

5. Age Doesn’t Influence Weight Loss in Those With Morbid Obesity

Older adults should be recommended for hospital-based lifestyle interventions to reduce weight, say UK investigators after finding there was no difference in weight loss between older and younger individuals in their program for those with morbid obesity. Thomas M. Barber, PhD, and colleagues looked back at nearly 250 randomly selected adults who attended their obesity service over an 11-year period. Barber, of University Hospitals Coventry and Warwickshire, UK, in a news release from his institution said, “Age should be no barrier to lifestyle management of obesity. Rather than putting up barriers to older people accessing weight loss programs, we should be proactively facilitating that process. To do otherwise would risk further and unnecessary neglect of older people through societal ageist misconceptions. Furthermore, age per se should not contribute towards clinical decisions regarding the implementation of lifestyle management of older people.” Jason Halford, PhD, a professor of biological psychology and health behavior said, “The fear is that older patients are perceived not to respond” to lifestyle interventions to control obesity, “and that’s clearly a fallacy, according to this study. The findings are strengthened by the fact that these are real-world data, “and so it will inform clinical practice. And one of the “more interesting” findings was that [type 2] diabetes was “more prevalent” in the older group “but they’re still losing weight. Traditionally it’s been thought that people with type 2 diabetes find it more difficult to lose weight because you’re trying to manage two conditions.”

Reference link:

  1. https://health.economictimes.indiatimes.com/news/diagnostics/post-covid-care-to-now-involve-mental-health/79483467
  2. https://www.medscape.com/viewarticle/941649
  3. https://www.medscape.com/viewarticle/937384
  4. https://www.medscape.com/viewarticle/941592
  5. https://www.medscape.com/viewarticle/941682

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