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‘Kid’s waist size can predict disease risk’ DELHI: The waist size of your child can predict if he or she is likely to suffer from any metabolic disorder. This has been found in a multi-centre cross-sectional study done by the International Diabetes Federation. It was conducted on 10,842 children in Delhi, Chennai, Kolkata, Pune and Raipur.

Dr Archana Dayal Arya, paediatric endocrinologist at Sir Ganga Ram Hospital, New Delhi, and co-author of the study, said Metabolic Syndrome (MS) in children has been defined as the presence of high triglyceride levels in blood, low HDL cholesterol (good cholesterol), increased fasting blood glucose levels, high systolic blood pressure and waist circumference > 75th percentile. It results in increased risk of hypertension, type 2 diabetes mellitus, and atherosclerosis cardiovascular disease.

“It is shocking to see children as young as six years old with diseases like hypertension, diabetes mellitus and abnormalities in the lipid profile,” the doctor said.

The study found that the risk factor for Indian children for developing MS was at 70th waist circumference (WC) percentile, which is significantly lower than international proposed WC cutoff of 90th percentile.

Dr Anuradha Khadilkar, consultant paediatrician in Jehangir Hospital, Pune and corresponding author of the study, said primary or essential hypertension, commonly seen in adults, is becoming common in children, who are obese or overweight.

The study, which will be published in the forthcoming issue of the Journal of Paediatrics, found that 3.3 per cent or 358 children out of a total sample size of 10,842 were hypertensive.


Diseases can be cured if diagnosed early 600 million people worldwide have some kind of kidney ailment and chronic kidney diseases are predicted to increase by 17 per cent over the next decade if not detected early, said a nephrologist in Mumbai on Thursday.
Speaking on the occasion of World Kidney Day, Vivekanand Jha, Executive Director, George Institute for Global Health, India said chronic kidney diseases are considered to be a global health problem but many cases go undiagnosed as people ignore the symptoms of the disease in the early stages.
“In kidney diseases if detected early and treated properly, the deterioration in kidney functioning can be slowed or even stopped,” Jha said.
“Though it is an undeniable fact that chronic kidney disease prevalence rises with age and exceeds 40-50 per cent amongst elders, people should visit doctors at least twice a month for a check up,” said Jha, who is also the secretary of the Indian Society of Nephrology.
“Early detection and prevention will lead not only to improved outcomes, better quality of life, but huge cost-savings on treatment,” said Jha.
Early stage kidney disease is not being identified and diagnosed as early and often as is necessary. Patients are frequently told not to worry until kidney damage has progressed to near failure. Furthermore, patients do not have the necessary education or resources to manage their own risk factors and lifestyle to prevent initial kidney damage and progression of the disease.
Primary care practitioners will know which tests to order and how to recognise early-stage kidney disease, which will increase the total number of diagnoses of kidney disease. In addition, primary care practitioners have the knowledge and tools to treat early-stage kidney disease in order to slow its progression, and refer their patients to nephrologists when they need more specialised care.

Astrocal Update: Sunshine reduces BP and cuts risk of heart attack and stroke

A new study has revealed that exposing skin to sunlight may help to reduce blood pressure and thus cut the risk of heart attack and stroke.

Research carried out at the Universities of Southampton and Edinburgh showed that sunlight alters levels of the small messenger molecule, nitric oxide (NO) in the skin and blood, reducing blood pressure.

Martin Feelisch, Professor of Experimental Medicine and Integrative Biology at the University of Southampton, said: “NO along with its breakdown products, known to be abundant in skin, is involved in the regulation of blood pressure. When exposed to sunlight, small amounts of NO are transferred from the skin to the circulation, lowering blood vessel tone; as blood pressure drops, so does the risk of heart attack and stroke.

While limiting sunlight exposure is important to prevent skin cancer, the authors of the study, including Dr Richard Weller of the University of Edinburgh, suggested that minimising exposure may be disadvantageous by increasing the risk of prevalent conditions related to cardiovascular disease.

The results suggested that UVA exposure dilates blood vessels, significantly lowers blood pressure, and alters NO metabolite levels in the circulation, without changing vitamin D levels.

Further experiments indicated that pre-formed stores of NO in the upper skin layers are involved in mediating these effects.

The study was published in the Journal of Investigative Dermatology.

HIV prevalence rate comes down in Kerala

From being a death sentence, HIV/AIDS has now evolved as a chronic yet manageable disease, with early and effective treatment utilising anti-retroviral drugs.

Thus, even as the State continues to focus on the goal of preventing new HIV infections in the general population, the major challenge in the coming years would be ensuring continued care and support services for those who are surviving with the infection.

“Kerala’s HIV prevalence rate has further come down, from last year’s 0.19 per cent to 0.12 per cent this year. The total estimated number of those living with HIV in the State is 25,090. We have achieved almost zero transmission of the infection from mother to child; the infection among those groups considered to be high-risk is also coming down because of our intensive programmes. But high-risk behaviour of those in the general population has been resulting in new infections,” a senior official working in the area of HIV/AIDS said.

“Our focus will soon shift exclusively to the issues faced by those living with HIV because the anti-retroviral therapy (ART) has made it possible for them to live normal lives.

“When the State began offering free ART in 2004, the strategy had been to start treatment when the CD4 count reached 200. (CD4 is the cell count indicating the stage of HIV infection when drugs should be started). In the last two years, we raised the CD 4 cut-off to 350 and soon it will be made 500. This means that we are offering treatment very early to HIV +ve

persons,” said M. Prasannakumar, former head of the technical support unit for the Kerala State AIDS Control Society.

Early ART is now a major strategy to prevent new infections in the community because the transmission potential of the virus when a person is on ART is very low, he said.

According to KSACS, HIV prevalence rates among targeted high-risk groups have been coming down steadily, especially among the injecting drug users (IDU) and female sex workers.

“The IDU group has been a concern, but we have now started oral opiod substitution therapy in over 10 government hospitals and the infectio

n rate amongst the group is coming down. Influx of migrant workers — we have some 25 lakh in the State — could be a concern but we can also seek relief in the fact that they are all from the low-prevalence States of West Bengal, Assam, and Orissa,” Dr. Prasannakumar said.

But the euphoria over the State’s successes should not result in complacence in the health system because new infections have not totally disappeared in the

State, warns Ajithkumar, Professor of Dermatology, Thrissur Medical College.

Experts: Obesity not a single disease, more likely a combination of diseases

mid section view of a man sitting on a bench in a parkA growing number of experts are now classifying obesity as a compilation of diseases, rather than a single disease.

In June, the American Medical Association announced it would recognize obesity as a disease rather than a “major public health problem.” The change in classification has led more experts to look at obesity in a different way.

Some experts believe the term obesity is now more similar to the term cancer in that cancer covers numerous conditions when abnormal cells divide uncontrollably. Like cancer, obesity is not a single disease but can be several diseases tied together by the symptom of excess body fat.

Nikhil Dhurandhar, a researcher and vice president of the Obesity Society, found that the presence of certain viral antibodies in the bloodstream of humans could be linked to increased body weight. Although Dhurandhar does not believe obesity is infectious in nature, he believes the discovery of the “fat bug” could be a breakthrough in how people perceive obesity and how it is treated. Dhurandhar says that traditional methods to help obesity, such as diet and exercise, might not be the best option for everyone.

“What good does a starvation diet do if obesity is caused by a virus?” he asked on “Good Morning America.” “We’ve focused almost all our resources on the so-called ‘Big Two’ of diet and exercise for more than 50 years and it hasn’t helped. We will have to move beyond ‘eat less and move more’ if we want to make progress.”

Scientists have identified at least 84 potential contributors to obesity, ranging from biological to psychological to environmental.

According to the Centers for Disease Control and Prevention, more than one-third of U.S. adults and 17 percent of children and teens are obese. In 2008, medical costs associated with obesity were estimated to be $147 billion, or $1,429 higher than medical costs for people of normal weight.

A study conducted by scientists at the University of Michigan in Ann Arbor found that how people believe obesity is caused could affect their own waistlines. People who believed obesity was caused solely from lack of exercise were more likely to weigh more than those who blamed a poor diet or genetics.

“Across multiple studies, we found the first evidence that people generally have two different lay theories about what causes obesity, and that these beliefs impact people’s actual likelihood of being overweight,” wrote the study authors, led by Brent McFerran, a marketing professor and social psychologist at the University of Michigan in Ann Arbor.

Christopher Ochner, director of research development and administration at the Mount Sinai School of Medicine in New York, told “Good Morning America” that the reasons for weight gain vary greatly for each individual and the precise formula for energy balance through diet and exercise is nearly impossible to determine.

According to a recently released report, Utah tied with Montana as the seventh least obese state in the nation. The report, “F as in Fat: How Obesity Threatens America’s Future”, showed Utah’s obesity rates increased from 23.8 percent in 2011 to 24.3 percent in 2012.

Utah was ranked No. 1 in the country for the lowest rate of childhood obesity, with 11.6 percent of obese 10- to 17-year-olds.

Doctor performs angioplasty in 16 minutes!

Dr. Sanjay RajdevIt’s time for Dr Sanjay Rajdev, consultant cardiologist, and the SevenHills hospital, where he is consultant, to celebrate as they have successfully managed to enter their names in the Limca Book Of Records for doing an angioplasty on Rajendra Varma, 46, in a record time of 16 minutes! (Also read: Bioabsorbable stents – the future of angioplasty)

Varma’s surgery took place sometime in December last year but the confirmation from the Limca Book Of Records came through last week.

The international standard for door-to-balloon time in angioplasty is 90 minutes or less. That’s the time recorded from the moment a patient enters the hospital until the balloon is inflated and blood flow is restored (the blockage is removed).

Doctors at SevenHills managed to complete this process in 16 minutes.

‘Varma was known to us and the time we took for finishing the formalities for angioplasty was the least. Mostly the time goes in clearing logistic issues like making the patient understand the procedure, take his/relatives’ consent and treatment cost,’ said Dr Rajdev.

Dr Rajdev said that in Varma’s case logistic issues were averted and the team of doctors managed to do door-to-balloon in 16 minutes. ‘He came to us with chest pain in the night. We did an ECG (which checks for problems with the heart’s electrical activity and is used to distinguish whether the heart attack is the result of a blockage that needs to be opened as soon as possible)

‘With the ECG result in hand and after taking some measures, which showed abnormality and signs that he had a massive attack, a message was sent and our cardiac catherisation team was mobilised. Then we spoke to Varma who immediately gave his consent,’ said Dr Rajdev. According to the doctors, one of Varma’s main arteries had 100 per cent blockage and two stents were used in dissolving the blockage.

Experts said that every second counts for patients receiving angioplasty — a lifesaving procedure followed for the most serious types of heart attacks. ‘There is growing evidence to show that doctors can shave off ‘door-to-balloon’ time and lower a patient’s risk of death and lessen serious damage done to the heart muscle,’ said Dr Ajay Chaurasiya, cardiologist at BYL Nair Hospital.

Right from the time the first symptoms of heart attack appear to the time he reaches the hospital is pre-hospitalisation time. Dr Prafulla Kerkar, head of the cardiology department at KEM hospital said that ‘in India it takes 300 minutes for a heart attack patient to reach hospital, which is twice the time taken in western countries.

We need to cut this pre-hospitalisation delay with more competent centres and increasing the awareness on heart attacks.’

New malaria vaccine shows promise in clinical trials

VaccineA new malaria vaccine, which is being developed in the US, has shown promising results in early stage clinical trials, scientists say. Researchers found that high doses of the vaccine protected 12 out of 15 patients from the disease. The vaccine involves injecting live but weakened malaria-causing parasites directly into patients to trigger immunity.

“We were excited and thrilled by the result, but it is important that we repeat it, extend it and do it in larger numbers,” said lead author Dr Robert Seder, from the Vaccine Research Center at the National Institutes of Health, in Maryland. Previous research has found that exposure to mosquitoes treated with radiation can protect against malaria. But studies have shown that it takes more than 1,000 bites from the insects over time to build up a high level of immunity.

A US biotech company called Sanaria took lab-grown mosquitoes, irradiated them and then extracted the malaria-causing parasite (Plasmodium falciparum), all under the sterile conditions. These living but weakened parasites are then counted and placed in vials, where they can then be injected directly into a patient’s bloodstream. This vaccine candidate is called PfSPZ.

To carry out the Phase-1 clinical trial, the researchers looked at a group of 57 volunteers, none of whom had had malaria before. Of these, 40 received different doses of the vaccine, while 17 did not. They were then all exposed to the malaria-carrying mosquitoes, ‘BBC News’ reported. The researchers found that for the participants not given any vaccine, and those given low doses, almost all became infected with malaria.

However, for the small group given the highest dosage, only three of the 15 patients became infected after exposure to malaria. “Based on the history, we knew dose was important because you needed 1,000 mosquito bites to get protection – this validates that,” Seder said. “It allows us in future studies to increase the dose and alter the schedule of the vaccine to further optimise it. The next critical questions will be whether the vaccine is durable over a long period of time and can the vaccine protect against other strains of malaria,” he said. The results were published in the journal Science.

Bad dental hygiene linked to Alzheimer’s

DentureA study of brain samples from deceased dementia patients found that they contained unusually high levels of Porphyromonas gingivalis, a type of bacteria which causes gum disease.

Although the bacteria live in the mouth, they can enter the bloodstream during eating, chewing, tooth brushing or dental surgery, and potentially reach the brain, experts explained.

Inflammation caused by gum disease-related bacteria has already been linked to various health problems including diabetes, heart disease and stroke.

Their arrival in the brain could prompt the immune system to release chemicals which kill brain cells, resulting in the type of changes seen in the brains of Alzheimer’s patients and causing symptoms like memory loss and confusion, experts said.

The new findings, by researchers from the University of Central Lancashire (UCLan), back up a previous study by US researchers which showed that failing to brush your teeth at least daily significantly increases the risk of dementia

Dr Sim Singhrao, one of the authors of the study published in the Journal of Alzheimer’s Disease, said: “We are working on the theory that when the brain is repeatedly exposed to bacteria and/or their debris from our gums, subsequent immune responses may lead to nerve cell death and possibly memory loss.

“Thus, continued visits to dental hygiene professionals throughout one’s life may be more important than currently envisaged with inferences for health outside of the mouth only.”

Prof StJohn Crean, dean of the school of medicine and dentistry at UCLan, added: “Our hypothesis is that this is a chronic assault. It is not happening overnight, it is a build-up over years.

“But all we have shown so far is that bacteria from the gum region get into the brain. We haven’t proven that they cause Alzheimer’s disease.”

The researchers studied brain tissue from ten deceased dementia patients, and compared them against samples from ten patients who died without dementia.

Significant signs of the gum disease virus were found in the dementia patients’ brains but not the controls, the researchers reported.

Previous studies had linked dementia to other bacteria and viruses, such as the Herpes simplex virus type 1, but the new study is the first to identify Porphyromonas gingivalis in the brains of dementia patients.

Dr Simon Ridley, of Alzheimer’s Research UK, said: “We don’t know whether the presence of these bacteria in the brain contributes to the disease and further research will be needed to investigate this.

“We know that there are likely to be many risk factors for Alzheimer’s and we need to investigate these in more detail to help develop new preventions or treatments.”

Heart disease number one killer of Indians

HeartHeart disease has emerged as the number one killer among Indians, a new survey has revealed.

According to a recent study by the Registrar General of India (RGI) and the Indian Council of Medical Research (ICMR), about 25 percent of deaths in the age group of 25- 69 years occur because of heart diseases.

If all age groups are included, heart diseases account for about 19 percent of all deaths. It is the leading cause of death among males as well as females and in all regions of India, the study found.

India, with more than 1.2 billion people, is estimated to account for 60 percent of heart disease patients worldwide. According to the World Health Organization, heart related disorders will kill almost 20 million people by 2015, and they are exceptionally prevalent in the Indian sub-continent. Half of all heart attacks in this population occur under the age of 50 years and 25 percent under the age of 40.

It is estimated that India will have over 1.6 million strokes per year by 2015, resulting in disabilities on one third of them. The need is urgent.

It is in this context that the American Association of Physicians of Indian Origin (AAPI) has launched educational “Networks” of renowned thought leaders in the areas of Cardiology, Diabetes, and Stroke to foster high quality medical education of physicians of Asian Indian origin in the US.

Widest study highlights risks from MERS virus

MERS VirusParis: The broadest probe yet into the deadly MERS virus which erupted in Saudi Arabia last year says older patients, men, and people with underlying medical conditions are those particularly at risk.

Saudi and British scientists, reporting in The Lancet on Friday, looked at symptoms and disease progression among 47 people, 36 of them men, admitted to Saudi hospitals with Middle East Respiratory Syndrome (MERS).

The vast majority of the patients had fever, coughing and shortness of breath, and a minority experienced diarrhoea, vomiting and other gastrointestinal symptoms.

Such characteristics are shared with MERS` coronavirus cousin, Severe Acute Respiratory Syndrome (SARS), which triggered a global health scare a decade ago, they wrote. The two viruses also have the same incubation period.

But, according to the investigators, there are important differences between the two viruses.

Unlike SARS, MERS is likelier to cause a fast-track progression to respiratory failure, taking five days less than SARS.

In addition, SARS affected people were relatively healthy and young, whereas MERS seems to target older patients and those with a chronic medical condition.

Out of the 47 cases, 45 were already being treated for diabetes, high blood pressure, heart or kidney disease and other disorders, according to the new study.

Statistically, MERS also appears to be deadlier. Twenty-eight out of the 47 patients died, a case-fatality rate of 60 percent, compared with only 1-2 percent for SARS.

“This high mortality rate with MERS is probably spurious due to the fact that we are only picking up severe cases and missing a significant number of milder or asymptomatic cases,” cautioned Professor Ziad Memish, Saudi Arabia`s deputy health minister, who led the research.

The kingdom accounts for 38 of the 45 fatalities recorded in nine countries, and 67 of the total 90 cases. Other cases have been recorded in Jordan, Qatar and the United Arab Emirates, Tunisia, Britain, France and Italy.

Key aspects of the virus, notably how it spreads and whether it has a “reservoir” among wild animals, remain unclear.

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