Does calcium in diet prevent fractures in elderly people ?

Yes.

A study published in British Medical Journal (BMJ) looked at 7195 permanent residents living in 60 residential aged-care facilities in Australia.

Over a two year period, they provided residents in half the facilities (30 facilities) with additional milk, yoghurt, and cheese. The residents in the remaining 30 facilities who served as controls had their usual menus.

The study found that the additional calcium in diet is beneficial.

Improving calcium and protein intakes reduced the risk of falls and fractures that commonly occur in aged care residents.

References: Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomised controlled trial
BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2364 (Published 21 October 2021)
Cite this as: BMJ 2021;375:n2364

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can cancer “finger prints” help to destroy them?

Potentially yes !

We still don’t know a lot about cancers, how they start, when they start and what keeps them going.

We already know that some of the changes seen more often in cancerous tissues than in normal tissues can help to devise anti-cancer treatments. Examples include Herceptin for Breast cancer, Olaparib for Ovarian cancer.

But there is a lot a do if we were to cure or control cancers.

A recently published study by the Cambridge team is quite exciting. It probably would lead to more similar studies and ultimately better and more effective cancer treatments.

The study analysed all the genetic material from cancers (“whole genome”) and found “genetic finger prints” in various cancers . Targeting these changes could help to diagnose and treat cancers more effectively.

A word of caution: it usually makes many years for the new discoveries to lead to better treatments. Clinical trials often take years to start, recruit and analyse results.

References

BBC. Cancer: Huge DNA analysis uncovers new clues. By Smitha Mundasad
Health reporter

Daily Telegraph. Mindblowing’ gene discovery brings tailor-made cancer treatment a step closer. Cambridge research reveals 58 new mutational signatures, raising hopes of a cancer care revolution based around personalised treatment By Laura Donnelly, HEALTH EDITOR 21 April 2022 • 7:00pm

Science Magazine AAAS. Andrea Degasperi et al. ‘Substitution mutational signatures in whole-genome–sequenced cancers in the UK population.’ SCIENCE • 22 Apr 2022 • Vol 376, Issue 6591 • DOI: 10.1126/science.abl9283

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light

Wearable Technology: are Physical activity and Fitness monitors useful ?

Once we come out of this COVID pandemic, everyone’s attention needs to be focused on the obesity pandemic.

During the COVID pandemic, lot of people started to focus on their physical fitness. People invested in Home Exercise equipment and in wearable technology such as Fitness monitors.

Even before this pandemic, lot of people have started using Fitness monitors.

Are they any good?

A recent study published in British Medical Journal (BMJ) looked the effectiveness of physical activity monitors.

The study authors looked at more than 120 trials involving more than 16 700 participants.

Most of studies they looked at were either European (31%) or North American (40%). Most of these studies included healthy participants (47%), although some included overweight participants (17%).

They found Fitness monitors are generally safe and help to increase physical activity.

Whether the Fitness monitors will help overweight people to lose weight permanently over long term needs further investigation.

References:

Effectiveness of physical activity monitors in adults: systematic review and meta-analysis. BMJ 2022; 376 doi: https://doi.org/10.1136/bmj-2021-068047 (Published 26 January 2022)Cite this as: BMJ 2022;376:e068047

Gov.UK. Physical activity: applying All Our Health
Office for Health Improvement & Disparities
Guidance. Physical activity: applying All Our Health. Updated 16 October 2019

Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007;298:2296-304. doi:10.1001/jama.298.19.2296 pmid:18029834.

Activity monitors for increasing physical activity in adult stroke survivors
Elizabeth A Lynch et al. Cochrane Database Syst Rev. 2018.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Another drug to fight severe COVID

More good news !

The new drug for COVID is called baricitinib.

The drug Baricitinib is not a brand new drug. It is normally used to treat a type of joint problem called rheumatoid arthritis. Now, this drug has been found to be very beneficial in patients suffering from severe COVID.

The drug was evaluated as part of the renowned RECOVERY trial.

RECOVERY ( Randomised Evaluation of Covid-19 Therapy) trial is led by investigators in U.K.

The trial found that Baricitinib reduces the risk of death by around one fifth in patients with severe covid-19.

On the other hand, Some bad news about a drug who was thought to be promising before. Questions have been raised about the actual benefit , if any, from a previously approved drug called Molnupiravir.

Overall, at present, we have lot more drugs to tackle COVID in addition to the Vaccines.

References

BMJ. Covid-19: Anti-inflammatory treatment baricitinib reduces deaths in patients admitted to hospital, finds trial
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o573 (Published 03 March 2022)
Cite this as: BMJ 2022;376:o573

BBC news. Another life-saving Covid drug identified
By Michelle Roberts
Digital health editor

Guardian. Arthritis drug could help save Covid patients – study
Rheumatoid arthritis drug baricitinib can reduce risk of death from severe Covid by about a fifth
Nicola Davis Science correspondent
@NicolaKSDavis
Thu 3 Mar 2022 18.07 GMT

Daily Mail. Arthritis drug cuts risk of severely-ill Covid patients dying by up to a fifth, major trial reveals. By Luke Andrews Health Reporter For Mailonline
15:00, 03 Mar 2022 , updated 16:42, 03 Mar 2022

BMJ. Molnupiravir’s authorisation was premature
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o443 (Published 03 March 2022)
Cite this as: BMJ 2022;376:o443

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can mild Covid affect the brain ?

Yes, according to an Oxford study.

The team investigated brain changes in 785 UK Biobank participants (aged 51–81).

The team compared Brain scans before COVID infection and Brain scans after infection.

They found that people with COVID subsequently had “brain shrinkage” and reduced “brain function” particularly relating to parts of brain dealing with emotions smell and long-term memory

It is not known whether these brain changes are temporary and reversible after a while or whether these changes are permanent.

References

Original paper in Nature for COVID brain. Douaud, G., Lee, S., Alfaro-Almagro, F. et al. SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature (2022). https://doi.org/10.1038/s41586-022-04569-5

Daily Telegraph. Covid may cause the brain to degenerate three times faster than normal
Study finds ‘significantly greater cognitive decline’ among people who have been infected with coronavirus

By Sarah Knapton, SCIENCE EDITOR
7 March 2022 • 4:46pm

BBC. Scans reveal how Covid may change the brain By Rebecca Morelle
Science Editor, BBC News

Bloomberg. Covid Can Shrink the Brain as Much as a Decade of Aging, Study Finds. By +Follow7 March 2022, 16:00 GMT

Daily Mail. ‘Covid brain’ IS real: Illness can cause regions of the brain to SHRINK and lead to cognitive decline, new study finds. By Bhvishya Patel For Mailonline
02:16, 08 Mar 2022 , updated 07:18, 08 Mar 2022

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, partic

Why did so many vaccinated people catch the omicron variant recently ?

Many people report that they have seen many of their friends and family and work colleagues have caught the COVID virus during the recent wave.

Why did so many vaccinated people catch the infection?

It’s because of two reasons. (1) the vaccines are not 100% effective and (2) there is substantial reduction in vaccines effectiveness over time.

A large U.K. study looked at vaccine effectiveness against symptomatic disease caused by the omicron and delta variants in England.

Frighteningly, No effect against the omicron variant was noted from 20 weeks after two Astra Zeneca vaccine doses, and the effectiveness of two Pfizer vaccine was only marginally better with 8.8% protection at 25 or more weeks after two Vaccine doses.

Vaccine effectiveness improved to about 65% protection at 2 to 4 weeks after a third Pfizer booster but this was not long lasting and the effectiveness decreased to about before decreasing to 44% at 10 or more weeks after Vaccination.

In summary, Vaccination with two doses of AstraZeneca or Pfizer vaccine provided limited protection against symptomatic disease caused by the omicron variant.

A third booster with Pfizer or Moderna vaccine substantially increased the protection, but even that protection gradually decreased over time.

This study, published in the Prestigious NEJM journal, was Funded by the U.K. Health Security Agency and hence highly reliable.

One has to hope that any new variants do not bypass the vaccine protection and cause much more severe disease than omicron!

References

Daily Mail. US Omicron surge is close to reaching its peak with infections ‘coming down as fast as they went up as variant runs out of people to infect’: Deaths remain low, rising just 10% in two weeks as daily cases rise 184%. By Mansur Shaheen U.S. Deputy Health Editor For Dailymail.Com
14:53, 12 Jan 2022 , updated 22:18, 12 Jan 2022

NEJM. Covid-19 Vaccine Effectiveness against the Omicron (B.1.1.529) Variant.

Nature magazine. Iketani, S., Liu, L., Guo, Y. et al. Antibody evasion properties of SARS-CoV-2 Omicron sublineages. Nature (2022). https://doi.org/10.1038/s41586-022-04594-4 ( substantial loss in neutralizing activity against omicron variant)

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, partic

Are COVID vaccines less effective in people with low-immunity?

Yes, the COVID vaccines struggle to boost the immunity against COVID in people who have a defective or suppressed immune system.

A recent study published in BMJ looked at all relevant publications and confirms this. Cancer patients and patients who have received organ transplants are at risk of inadequate protection from the vaccines.

It is important that people who have low immunity get boosters as recommended by the guidelines ( third or fourth dose).

References

BMJ. Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj-2021-068632 (Published 02 March 2022)
Cite this as: BMJ 2022;376:e068632

U.K. govt. COVID-19 vaccination: a guide to booster vaccination for individuals aged 18 years and over and those aged 16 years and over who are at risk. Updated 2 February 2022.

NHS. Coronavirus (COVID-19) vaccine for people with a severely weakened immune system. Page last reviewed: 24 February 2022

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Is Diclofenac better than opioid drugs such as morphine, oxycontin, codeine, tramadol for knee arthritis pain ?

Yes.

Diclofenac is sometimes overlooked as a pain killer before people go on to stronger morphine-like prescription pain killers.

A study published in BMJ suggests that Diclofenac tablets take by mouth is effective for pain due to arthritis.

Overall, Diclofenac, taken by mouth, seem to be effective and generally safer than Opiod drugs. But caution is needed particularly in elderly people with multiple other medical problems.

Interestingly, Diclofenac Cream applied over the skin and Joints seem to be particularly effective for Knee arthritis pain.

Applying the cream also overcomes the problem of Diclofenac side effects, since very little of Diclofenac reaches other parts of the body.

The authors recommend Diclofenac Skin Cream as first line pharmacological treatment for knee osteoarthritis.

References

BMJ. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis
BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2321 (Published 12 October 2021)
Cite this as: BMJ 2021;375:n2321

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Are the brain surgeons more brainy than others ?

It is a common perception that brain surgeons are more brainy than the rest of general public.

It is also often quipped that rocket scientists are more smarter than general public

How true is it ?

A study published in British Medical Journal (BMJ) looked at the “smartness” of the rocket scientists and brain surgeons.

They assessed the “smartness” by using an online test. The study involved 600 aerospace engineers ( rocket scientists) and 148 neurosurgeons ( brain surgeons).

This online test known as “Cognitron’s Great British Intelligence Test” measured distinct aspects of cognition, spanning planning and reasoning, working memory, attention, and emotion processing abilities.

The brain surgeons had higher scores than the rocket scientists in semantic problem solving. The rocket scientists got higher scores in mental manipulation and attention.

With many other sections of the tests, the brain surgeons and rocket scientists did not do a lot better than the general population !

The study concludes that both neurosurgeons and aerospace engineers are unnecessarily placed on a pedestal with common phrases such as “It’s not rocket science” and “It’s not brain surgery”.

This study does NOT prove the experts do not know much more than general public.

The study does NOT mean that “social media rants” and “conspiracy theories” are somehow right !

Would you let a lay person operate on your brain ?

Technical and Scientific Expertise is still valuable !

References

“It’s not rocket science” and “It’s not brain surgery”—“It’s a walk in the park”: prospective comparative study
BMJ 2021; 375 doi: https://doi.org/10.1136/bmj-2021-067883 (Published 13 December 2021)
Cite this as: BMJ 2021;375:e067883

Guardian. Brain surgeons and rocket scientists no brighter than the rest of us, study finds
Data from 329 aerospace engineers and 72 neurosurgeons suggests they are not necessarily cleverer than general population.
Nicola Davis
@NicolaKSDavis
Mon 13 Dec 2021 23.30 GMT

BBC. Rocket scientists and brain surgeons aren’t necessarily more clever – study

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Does the use of Cosmetic and Deodorant Powder in Genital areas increase risk of Ovarian cancer ?

Some women apply powder to their private area, either through direct application or on underwear, sanitary napkins, diaphragms or tampons.

Some studies have previously raised the concern that this deodorant powder, particularly talc powder, can increase the risk of ovarian cancer.

A high quality study looked at the “Association of Powder Use in the Genital Area With Risk of Ovarian Cancer“.

The study findings are reassuring.

The study found no major significant association between use of powder in the genital area and ovarian cancer.

References

Association of Powder Use in the Genital Area With Risk of Ovarian Cancer. Katie M. O’Brien, PhD; Shelley S. Tworoger, PhD; Holly R. Harris, ScD; et al. JAMA. 2020;323(1):49-59. doi:10.1001/jama.2019.20079

Penninkilampi  R, Eslick  GD.  Perineal talc use and ovarian cancer: a systematic review and meta-analysis.  Epidemiology. 2018;29(1):41-49. doi:10.1097/EDE.0000000000000745

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Benefits of Vitamin D supplements and Omega 3 supplements

Most people assume that nutritional supplements are always beneficial. But it is not always the case.

Paradoxically, the people, who may need the supplements because they don’t have a healthy diet, are the often ones who do not take the supplements !

But people, who usually do not need various supplements, because they are health conscious and have a good healthy diet, are often the ones who take the supplements unnecessarily !

Sometimes Supplements can be harmful. Hence, the need for clinical trials to assess the benefits and risks of various supplements.

So it is interesting to read a trial in the British Medical Journal (BMJ) which looked at Vitamin D and marine derived omega 3 fatty acids supplements. The study looked the effect of these two supplements in preventing Autoimmune diseases.

Autoimmune disease is a type of disease where body’s own immune system misfires and causes inflammation in self-tissues.

Autoimmune diseases, are often chronic conditions and cause considerable misery.

The study published in BMJ looked at Autoimmune diseases, such as rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis, and inflammatory bowel disease, and all other new onset autoimmune diseases.

This well conducted study used a dummy pill and hence the results are usually expected to be quite reliable.

About 25 800 participants were enrolled in the study and were followed up for an average of about 5 years.

This large study from United States found that vitamin D and omega 3 fatty acid supplementation taken for five years reduces the risk of developing autoimmune diseases.

References: Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj-2021-066452 (Published 26 January 2022)
Cite this as: BMJ 2022;376:e066452. https://www.bmj.com/content/376/bmj-2021-066452

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Medical Negligence Jackpot

Modern Medicine is not without risks.

Practically all interventions or even non-interventions can cause harm. For example, a doctor simply encouraging a patient to drink more water or recommending bed rest can be harmful in certain medical circumstances.

Many medical harms ( side effects and complications) are certainly not due to significant clinical negligence.

But in the small minority where harm is due to clinical negligence ( albeit un-intentional ), getting compensation is not straightforward.

It is a shame that not everyone who suffers medical harm is able to seek compensation.

Patients usually have to prove medical negligence to get compensation and only a small fraction of people do have the time, money and drive to pursue a negligence claim through legal process. It seems like a jack-pot where a few win big amounts while others receive nothing.

A recent hotly debated case about a doctor who did not strongly recommend folic acid to a mother, has re-opened the discussion on no-fault compensation.

Read the articles in the BMJ and respond if you can.

References

S Sundar. “Wrongful conception” case: “Wrongful conception”: the case for no-fault compensation. BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o153 (Published 21 January 2022) Cite this as: BMJ 2022;376:o153. Free to access link: http://bmj.com/cgi/content/full/bmj.o153?ijkey=tVbj8XpptPFTQES&keytype=ref

Folic acid supplementation and the complexities of blame. BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o144 (Published 20 January 2022)Cite this as: BMJ 2022;376:o144

Papanikitas A, Spicer J, Hayhoe B. “Wrongful conception” ruling against UK general practitioner. BMJ2022;376:o79. doi:10.1136/bmj.o79 pmid:35031556. FREE Full TextGoogle Scholar

Dyer C. Show jumper wins case against mother’s GP for “wrongful conception” that resulted in her disability. BMJ2021;375:n2999. doi:10.1136/bmj.n2999. pmid:34862168. FREE Full TextGoogle Scholar

Toombes v Mitchell T. [2021] EWHC 3234. https://1f2ca7mxjow42e65q49871m1-wpengine.netdna-ssl.com/wp-content/uploads/2021/12/Toombes-v-Mitchell-Approved-Judgment.pdf.

BMJ. What implications does the Toombes vs Mitchell case have for other healthcare professionals?
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o162 (Published 20 January 2022)
Cite this as: BMJ 2022;376:o162

Dollimore L. Spina bifida showjumper wins landmark legal case over her “wrongful conception”: Evie Toombes, 20, who sued her mother’s GP claiming she “should never have been born” could win millions in damages. Daily Mail 2021 Dec 1. https://www.dailymail.co.uk/news/article-10262911/Para-showjumper-sued-mothers-GP-claiming-never-born-wins-landmark-case.html

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Do statins cause muscle aches and pain ?

Yes, Statins can cause muscle aches and pains.

But the number of people getting it is very small and in vast majority of people, the symptoms are not serious.

Most importantly, the benefits of statins outweighs the risk of side effects.

That is the conclusion of a study published in BMJ medical journal.

References

BMJ. Associations between statins and adverse events in primary prevention of cardiovascular disease: systematic review with pairwise, network, and dose-response meta-analyses
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1537 (Published 15 July 2021)
Cite this as: BMJ 2021;374:n1537

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Low mood: Anti-depressants should not be the first choice for everyone

We live in a society where we look for quick fixes for everything.

For example, Fast-foods are immensely popular because we are all busy and we want quick fixes.

So it is not surprising that some people look at prescription medications as a quick fix for their low mood.

For some people, anti-depressants can be very helpful.

But a recent article suggests that anti-depressants should not be the first choice for everyone

Telegraph. Antidepressants might be largely ineffective, study suggests
By
Telegraph Reporters
21 December 2021 • 8:27am

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Poor Sleep and Heart attacks

A study reports that going to sleep 10pm is linked to lower risk of heart disease.

The study suggests that “Early or late bedtimes may result in individuals missing cues that help reset body clock each day”

The association with increased heart problems was stronger in females.

Even though going to bed early is very hard with globally interconnected mobile devices, it is important we all sleep well !

References

Guardian newspaper. Sleep at 10pm linked to lower risk of heart disease, study finds.
Nicola Davis Science correspondent
@NicolaKSDavis
Tue 9 Nov 2021 00.05 GMT

Accelerometer-derived sleep onset timing and cardiovascular disease incidence: a UK Biobank cohort study
Shahram Nikbakhtian, Angus B Reed, Bernard Dillon Obika, Davide Morelli, Adam C Cunningham, Mert Aral, David Plans
European Heart Journal – Digital Health, ztab088, https://doi.org/10.1093/ehjdh/ztab088
Published: 09 November 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can vitamins increase risk of cancer ?

Yes

Vitamins are absolutely essential nutrients and vitamin deficiency causes various illness.

But a high dose of vitamin, far too much than needed by the body, is also bad.

Everything in moderation is good. Even an abundance of a good thing is bad.

It is similar to food. Lack of food would cause starvation and even death in the extreme. But too much of food causes obesity and other health problems. Same principle applies to vitamins.

A Cochrane review looked at the ability of vitamins to prevent lung cancer. The review concluded that there is “no beneficial effect of supplements for the prevention of lung cancer and lung cancer mortality in healthy people”

Worryingly, the review also found that the following:

Vitamin A supplements increase lung cancer incidence and mortality in smokers or persons exposed to asbestos”.

Vitamin C increases lung cancer incidence in women.

Vitamin E increases the risk of haemorrhagic strokes.

So if you are having a healthy balanced diet, be careful with vitamin supplements.

Drugs for preventing lung cancer in healthy people
Marcela Cortés-Jofré et al. Cochrane Database Syst Rev. 2020.
Free PMC article

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

A new COVID variant !

A new variant of Coronavirus has emerged in Africa and it is causing significant concern.

The variant seems to have “changed its coat”. The scientists worry that these changes ( mutations) can make it more transmissible and potentially evade vaccines.

U.K government has put six African countries on the Red List. All flights from South Africa, Namibia, Zimbabwe, Botswana, Lesotho and Eswatini are being suspended now.

References

BBC news. Covid: New heavily mutated variant B.1.1.529 in South Africa raises concern. James Gallagher
Health and science correspondent.

BBC News. Covid: Africa travel restrictions over variant fear.

Guardian. South Africa to be put on England’s travel red list over new Covid variant.
Hannah Devlin, Ian Sample and Jessica Elgot
Thu 25 Nov 2021 21.22 GMT

Daily Mail. Scientists sound alarm over new ‘worst-ever’ super-mutant Covid variant that will make vaccines at least 40 per cent less effective as flights are BANNED from South Africa and five other African countries. By Tom Pyman and Connor Boyd Deputy Health Editor For Mail online
20:32, 25 Nov 2021 , updated 22:07, 25 Nov 2

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Anxiety and Irritable Bowel Syndrome (IBS)

IBS or Irritable bowel syndrome is a common condition. Lot of people with IBS also have Anxiety problems.

So it was not known whether anxiety by itself causes the IBS.

A recent study suggests Anxiety and IBS coexist due to genetic abnormalities. Anxiety by itself does not seem to lead to someone developing IBS.

This large U.K. study involving 53,400 cases and 433,201 controls suggests that genes that alter brain–gut interactions may be responsible for IBS.

On the other hand, the overall likelihood of an individual developing IBS due to genes passed down the family seems low.

So with IBS, lot of things about it continue to remain a mystery. How IBS starts and how it progresses is still mostly unknown. Hopefully, future research will clarify things.

BBC News. Anxiety link to irritable bowel syndrome seen in DNA – research
By Michelle Roberts
Health editor, BBC News online

University of Cambridge. Large-scale genetic study reveals new clues for the shared origins of irritable bowel syndrome and mental health disorders

Eijsbouts, C et al. Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders. Nature Genetics; 5 Nov 2021; DOI: 10.1038/s41588-021-00950-8

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can modified Infant formulas (breast milk substitutes) do harm ?

Yes.

Breastfeeding is best for mother and baby. But for various reasons, it is not possible to breast feed. So Infant formulas (breast milk substitutes) are widely used.

These infant formulas are often modified in the hope of making them equivalent to breast milk.

A recent study analysing data from multiple studies reports that modified infant formulas are not better.

The study worryingly suggests potential harm from infant formulas supplemented with long chain polyunsaturated fatty acids (LCPUFAs).

Mimicking nature doesn’t always work !

Reference

BMJ. Effect of nutritionally modified infant formula on academic performance: linkage of seven dormant randomised controlled trials to national education data
BMJ 2021; 375 doi: https://doi.org/10.1136/bmj-2021-065805 (Published 11 November 2021)
Cite this as: BMJ 2021;375:e065805

BMJ. Enriched formula milks and academic performance in later childhood
BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2661 (Published 11 November 2021)
Cite this as: BMJ 2021;375:n2661

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Two new anti-viral drugs for COVID

Two new viral drugs promise to reduce the health burden from COVID.

So far, Covid vaccines have played a pivotal role in reducing Cases, Hospitalisations and Deaths from Covid.

Two new drugs, one from Pfizer and another from Merck promise to provide a new way to fight the virus in vulnerable people.

The oral pills from Pfizer is called Paxlovid. Paxlovid is a combination of two drugs. One drug is a new antiviral drug developed by Pfizer and is called PF-07321332. Another drug is called ritonavir, and ritonavir is already being used to treat HIV/Aids.

The Merck drug is known by the brand name Lagevrio [chemical name is molnupiravir]. This drug is approved by U.K. regulators and is ready to be used in the NHS. The Pfizer drug is yet to be evaluated by authorities for approval.

References

Lagevrio 200 mg hard capsules. eMC SPC

Ritonavir Mylan 100 mg film coated tablets. eMC SPC

Wiki. Paxlovid.

Guardian. Pfizer Covid pill ‘can cut hospitalisations and deaths by nearly 90%’
Experimental antiviral pill taken at home is highly effective at preventing deaths, trial suggests

Ian Sample Science editor
@iansample
Fri 5 Nov 2021 14.10 GMT

Guardian. UK first to approve oral antiviral molnupiravir to treat Covid
Pill can be taken twice daily at home and priority will be given to elderly patients and those with health vulnerabilities

Ian Sample Science editor
@iansample
Thu 4 Nov 2021 12.38 GMT

Daily Mail. Daily Covid cases fall again… by a FIFTH: Infections drop 22% in a week to 34,029 while deaths and admissions creep up just 3% – as ONS finds third wave has ‘likely peaked’ and EU’s crisis starts to overtake UK. By Connor Boyd Deputy Health Editor For Mailonline
16:45, 05 Nov 2021 , updated 23:06, 05 Nov 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Does Drinking Coffee reduce the risk of getting prostate cancer ?

Yes

A study in the BMJ open journal reports that “Higher coffee consumption was significantly associated with a lower risk of prostate cancer”

The authors further report that “the risk of prostate cancer was reduced by nearly 1% for each extra one cup of coffee per day”

But a word of caution!

Almost every week there are newspaper reports of studies exploring associations between “various food/drink” with “various cancers/diseases” and some of them conflicting and confusing.

So conclusions of most individual studies relating to food and drink need to be taken with a dose of healthy scepticism.

Telegraph: Advanced prostate cancer sufferers less likely to die if they are heavy coffee drinkers, study finds
A single cup can reduce the chances of contracting the disease by as much as one per cent, researchers claim.

Chen X, Zhao Y, Tao Z, et al. Coffee consumption and risk of prostate cancer: a systematic review and meta-analysis BMJ Open 2021;11:e038902. doi: 10.1136/bmjopen-2020-038902

Jacobsen BK , Bjelke E , Kvåle G , et al . Coffee drinking, mortality, and cancer incidence: results from a Norwegian prospective study. J Natl Cancer Inst 1986;76:823–31.pmid:http://www.ncbi.nlm.nih.gov/pubmed/3457969

Nomura A , Heilbrun LK , Stemmermann GN . Prospective study of coffee consumption and the risk of cancer. J Natl Cancer Inst 1986;76:587–90.doi:10.1093/jnci/76.4.587 pmid:http://www.ncbi.nlm.nih.gov/pubmed/3457196

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Is it safe to combine Flu Vaccines and COVID vaccines?

Yes, according to a recent U.K. study which assessed the combination of Flu vaccines and COVID vaccines.

The well designed study found the combination to be safe. The study also found “the side effects of giving both vaccines together were generally well tolerated and acceptable”

There is a worry that Flu might cause severe problems this year compared to last year.

Everyone’s attention has been focused on COVID booster and many old people have not been thinking much about their yearly Flu shots.

It is important that elderly have the flu shots this year.

It is important to note that it is not unusual to combine vaccines. Lot of childhood vaccines are combined safely for many decades.

References

Guardian. Flu and Covid jabs safe to be given at same time, study finds

Safe for people to get flu and Covid jabs at same time, says study
Clinical trial finds reported side effects mainly mild to moderate.
ByNina Massey, PANick WoodMax Channon
00:15, 1 OCT 2021

ComFluCOV vaccine study

Study Summary slides

The Safety and Immunogenicity of Concomitant Administration of COVID-19 Vaccines (ChAdOx1 or BNT162b2) with Seasonal Influenza Vaccines in Adults: A Phase IV, Multicentre Randomised Controlled Trial with Blinding (ComFluCOV)

CDC. Combination Vaccines. Fewer shots, but same protection

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New Pill for COVID

A new antiviral pill for COVID is very promising. It may be used widely to control the infection in people suffering from early stages of illness.

But the pill does NOT seem to work very well in people with severe illness.

It is important to note that “Prevention is better than cure”. That’s why using COVID vaccines to prevent the disease in first place is a better option.

COVID Vaccines will continue to play the lead role in controlling the COVID pandemic.

The antiviral pill by the made by the company Merck is likely to become the first approved oral medication effective against coronavirus. But other companies, including Pfizer, are also developing new oral antiviral medications.

Dexamethasone and other steroid pills, which can help COVID illness, do NOT have direct antiviral activity.

Overall, this antiviral pill is another promising step towards complete normality.

References

BBC Covid antiviral pill can halve risk of hospitalisation
By Jim Reed
Health reporter

Guardian. Covid antiviral pill halves hospitalisations and deaths.
Merck’s antiviral drug, molnupiravir.

Hannah Devlin Science correspondent
Fri 1 Oct 2021 15.56 BST

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

To Boost or not to boost ?

U.K. has started offering booster vaccines.

People aged 50 years and over, health and social care workers and younger people at risk are being offered a booster dose of coronavirus (COVID-19) vaccine.

Firstly, it has to be pointed out that it is not uncommon to offer booster vaccines with various other viral illnesses.

Secondly, the Data from Israel does support a role for COVID booster vaccines.

On the other hand, some people feel the case for booster is overstated.

The decision by U.K. Govt seems to be a reasonable and pragmatic one considering that the rate of new COVID infections is still high.

References

Guardian Opinion
The message from Israel is clear: Covid booster shots should be standard
David O’Connor
Mon 27 Sep 2021 11.47 BST

NEJM. Protection of BNT162b2 Vaccine Booster against Covid-19 in Israel
Yinon M. Bar-On, M.Sc., Yair Goldberg, Ph.D., Micha Mandel, Ph.D., Omri Bodenheimer, M.Sc., et al.
September 15, 2021
DOI: 10.1056/NEJMoa2114255

U.K. Govt Guidance
COVID-19 vaccination: a guide to booster vaccination
Published 16 September 2021

BMJ. Editorials
Covid-19 vaccination: evidence of waning immunity is overstated
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2320 (Published 23 September 2021)
Cite this as: BMJ 2021;374:n2320

Daily Mail. UK’s daily Covid cases rise 5% in a week to 37,960 as hospital admissions and deaths continue to fall – amid fears FOURTH wave may have already began with cases starting to spill over from children to their parents. By Emily Craig Health Reporter For Mailonline and Luke Andrews Health Reporter For Mailonline
12:35, 27 Sep 2021 , updated 16:44, 27 Sep 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New treatment for Prostate cancer

At the recent ESMO congress, new data was presented showing that upfront treatment with Abiraterone helps patients liver longer.

Hormone injections plus Chemotherapy is standard of care for new diagnosed advanced prostate cancer ( doublet treatment).

A French trial ( PEACE 1) explored the use of Abiraterone in this setting. The investigators found that a “triplet treatment” of Abiraterone + Chemotherapy + Hormone injections would make people live substantially.

This is likely to become standard of care in near future.

Another U.K. trial ( STAMPEDE) assessed Abiraterone in the High risk but less advanced prostate cancer. The study found that adding Abiraterone to the other treatments can improve survival of prostate patients.

This again is likely to become standard of care.

References

Possible changes in the standard of care for metastatic and non-metastatic prostate cancer. 19 Sep 2021. ESMO Congress 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Immunotherapy improves survival of patients with Advanced Cervical cancer

Advanced Cervical cancer, that cannot be cured by surgery or radiotherpy, is usually treated with chemotherapy.

A study assessed the effectiveness of immunotherapy in combination with standard chemotherapy.

The results were presented at the ESMO (European Medical Oncology Conference) on 18th Sept 2021.

The combination of immunotherapy and chemotherapy is remarkably better and makes patients live longer.

This is likely to become the standard of care now.

References

Presidential Symposium 1 (ESMO Congress 2021). KEYNOTE-826 trial met its dual primary endpoints.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Risks and benefits of COVID vaccines in 12 to 15 year olds

Previously, the UK vaccine expert committee (JCVI) decided that would NOT advice COVID vaccines to healthy 12 to 15-year-olds because the “direct individual benefit” to their health was only marginal.

But the Chief Medical officers have decided the other way now. The UK Government is now offering 12-15 year olds COVID vaccination and believes that this is the way out of the pandemic.

This is a very finely balanced decision. Decision seem to have been made on “public health grounds” rather than “individual” benefit.

In England, children aged 12 to 15 will be offered one dose of the Pfizer and BioNTech vaccine ( one dose instead of the usual two doses so as to minimise risks).

Lot of Vaccines offered for many other childhood illnesses have much greater benefit than COVID vaccines.

A nice article in Guardian by a Paediatrician discusses the benefits and risks of COVID vaccines in the 12 to 15 year olds. Boys seem to be more at risk of Heart side effects compared to Girls.

It would be difficult decision for lot of parents with healthy children.

References

Guardian. As a paediatrician, I believe it’s right to vaccinate young people aged 12 to 15
Russell Viner
There are no simple solutions to Covid, but children themselves will, on balance, benefit from being vaccinated. Russell Viner is a paediatrician and professor at the UCL Great Ormond Street Institute of Child Health
Tue 14 Sep 2021 14.31 BST

BMJ. Covid-19: Vaccinating children will help end pandemic, says minister
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2254 (Published 14 September 2021)
Cite this as: BMJ 2021;374:n2254

Daily Mail. It makes you think…’ Holly Willoughby finds herself conflicted about son Harry, 12, getting the COVID-19 vaccine as she’s caught between debating doctors on This Morning. By Andrew Bullock For Mailonline
13:19, 14 Sep 2021 , updated 14:28, 14 Sep 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

How many people get long-COVID?

Immediately after a COVID infection, people can be very sick and in some people, hospitalisation and death can occur.

Even after recovering from a COVID infection, some people can have fatigue, breathlessness, muscle ache, brain fog and other symptoms which can persist for many months. This persistence of symptoms is known as long COVID.

Previously, it was feared that a high percentage of people may go on to develop long COVID. A previous estimate suggested that as many as 1 in 10 people may develop long COVID.

Now , an ONS survey suggests that far less people may develop longer COVID. It is mow estimated that 1 in 40 people may have long COVID after recovering from a COVID infection.

References

BBC news. Long Covid less common than feared – ONS study.

BMJ. Long covid clinics should be run as research hubs. BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1996 (Published 20 August 2021)
Cite this as: BMJ 2021;374:n1996

BMJ rapid response. S Sundar. Loss of smell due to COVID-19 presents a rare opportunity for a natural experiment to study the obesity pandemic. 20 August 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light

Galleri cancer test: an exciting new test for cancer

Galleri test is a new type of blood test for cancer. The test promises to revolutionise cancer diagnosis.

Trials have started in UK to see how well the test works in real world.

Within a few years, we should be able to see early results.

Just because a cancer can be diagnosed early, it does not automatically mean that it will make patients live longer.

Let’s say, a person is diagnosed with a serious cancer at age of 60 yrs and dies of cancer at age of 65 yrs.

Any test that detects the cancer early ( before the age of 60) should make this person live longer than 65 years.

If the test , for example, detects the cancer at the age of 55 instead of 60, but the person still dies of cancer at 65, then it is a worthless test.

Hopefully, the trial will thoroughly analyse the outcome to see whether the test is of overall benefit.

References

Galleri™ Test

NHS launches world first trial for new cancer test. 13 September 2021

BBC news. Galleri cancer test: What is it and who can get it? 13 Sept 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Traffic noise and dementia

Can the noisy traffic outside your home increase your risk of getting dementia ?

Possibly yes.

A study from Denmark looked at “exposure to road traffic and railway noise” and “risk of dementia” in later life.

They found “traffic noise” is associated with risk of dementia.

A word of caution though!

This study does NOT conclusively prove that noise caused dementia. In science, association does not prove causation.

It is known that some people with hearing loss are more likely to develop dementia in later life.

It is possible that people with hearing loss were NOT bothered with traffic noise and carried on living in places with traffic noise.

On the other hand, people with good hearing were bothered by traffic noise and moved away from areas with traffic noise to live in a quieter area with less traffic noise.

This natural human behaviour could have affected the results of this study from Denmark

So, it may appear, at first glance, that traffic noise caused dementia. But deeper examination shows that the results of Denmark study are not conclusive and more confirmatory studies are needed.

References

Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1954 (Published 09 September 2021)Cite this as: BMJ 2021;374:n1954

Dementia.org: The Connection Between Hearing Loss And Dementia

NHS blog. Keeping your ear to the ground on dementia

Hearing loss and the connection to Alzheimer’s disease, dementia
By American Heart Association News.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Ivermectin for COVID-19 : what’s the evidence?

Ivermectin tablets are used in human beings to treat a disease called onchocerciasis (river blindness) and various infections caused by parasites. It is also sometimes used for “difficult-to-treat’ scabies. Ivermectin is also used as skin cream for certain skin conditions.

Ivermectin tablets are used in veterinary medicine to treat various parasitic infections.

There is genuine scientific interest in evaluating Ivermectin as a COVID treatment. But the evidence is not good enough for widespread use outside the clinical trials.

Unfortunately, there is widespread promotion of ivermectin in certain countries and there is a significant risk that people may be harmed by this promotion. (Side effects: Ivermectin data sheet).

That’s why the FDA and European regulators have advised against the use of Ivermectin outside clinical trials.

References

BNF Ivermectin

BBC news. Ivermectin: Oklahoma doctor warns against using drug for Covid treatment

Ivermectin for preventing and treating COVID-19
Maria Popp et al. Cochrane Database Syst Rev. 2021.

eMC. Soolantra 10mg/g Cream

NICE. Difficult-to-treat scabies: oral ivermectin
Evidence summary [ESUOM29] Published: 18 March 2014

EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials

FDA. Why You Should Not Use Ivermectin to Treat or Prevent COVID-19.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

COVID vaccination of 12-15 year olds: benefits vs risks

Should young teenagers have the COVID vaccine?

At present, this is a difficult question to give a straightforward answer.

For most of “middle to old age” people, the benefits of COVID vaccines are far greater than potential side effects from vaccines.

On the other hand, in case of 12-15 year olds, the benefits are marginally better than risks and individual circumstances need to be taken into account.

UK’s vaccine advisory body is called JCVI. ( Joint Committee on Vaccination and Immunisation ).

JCVI on Friday declined to recommend universal vaccination of all 12-15 year olds. This is because the chances of children becoming seriously ill from COVID-19 is very small. This needs to be balanced against a tiny risk of myocarditis, or inflammation of the heart in young people due to the vaccines. It is a matter of weighing up disease versus vaccine.

But, this does not mean COVID vaccines are not being given to 12-15 year olds.

USA, France, Italy, Israel and Ireland are offering vaccines to this group.

In U.K., vulnerable children with heart and lung problems, blood disorders, diabetes and various other diseases are eligible for the COVID vaccine. Children living with extremely vulnerable adults are also eligible.

Parents with healthy 12-15 year olds have a difficult choice to make in the coming weeks.

References

BMJ news. Covid-19: JCVI opts not to recommend universal vaccination of 12-15 year olds
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2180 (Published 03 September 2021)
Cite this as: BMJ 2021;374:n2180

BBC news. Covid: What do parents think about vaccinating children?
By Jennifer Meierhans & Kris Bramwell
BBC News

BBC news. Scientists not backing Covid jabs for 12 to 15-year-olds
By Philippa Roxby and Nick Triggle
BBC News

BBC news. Why vaccinating all teens is a difficult decision
By Philippa Roxby
Health reporter

Gov.U.K. Guidance
Coronavirus (COVID-19): antibody testing

Updated 22 August 2021

NHS. Antibody testing to check if you’ve had coronavirus (COVID-19)

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Is Moderna COVID vaccine better than Pfizer Vaccine?

Are all COVID Vaccines equally effective ?

Probably not.

But until recently there has been hardly any direct clinical studies comparing different vaccines.

A recent study conducted in Belgium compared the Moderna and Pfizer COVID vaccines.

The study looked at antibody responses following vaccination in Health care workers. Antibody levels were measured prior to vaccination as well as 6 to 10 weeks after the second dose.

Higher antibody levels were observed in people vaccinated with Moderna vaccine compared with those vaccinated with Pfizer vaccine.

Future research is needed to see how these differences affect the general population.

Both Moderna and Pfizer vaccines are based on same technology (mRNA based vaccines).

If significant differences exist between between vaccines of same technology, then it is likely that differences would exist between vaccines of different technology (eg Pfizer vs Astra Zeneca).

The public health authorities would need to decide whether booster vaccinations should be done with a different vaccine.

References

Bloomberg. Moderna Creates Twice as Many Antibodies as Pfizer, Study Shows
By Jason Gale
31 August 2021, 03:54 BST

JAMA Research Letter
August 30, 2021
Comparison of SARS-CoV-2 Antibody Response Following Vaccination With BNT162b2 and mRNA-1273
Deborah Steensels, PharmD, PhD1; Noella Pierlet, MSc1; Joris Penders, MD, PhD1; et al . JAMA. Published online August 30, 2021. doi:10.1001/jama.2021.15125

(mRNA-1273 is Moderna Vaccine and BNT162b2 is Pfizer vaccine).

Daily Mail. ALL over-50s will get Covid booster shots by autumn: People who got AstraZeneca ‘are set to be offered a Pfizer jab’ in new vaccine drive because it is more effective against Indian variant. By Katie Feehan For Mailonline and Glen Owen for The Mail on Sunday
10:12, 01 Aug 2021 , updated 18:02, 01 Aug 2021

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Are booster vaccines the way out of this pandemic?

Vaccination promised a straightforward way out of the pandemic. Protection from TWO doses of vaccine initially promised to end the pandemic.

Israel led the way in mass vaccination. Infection rates plummeted and life seemed to be returning to normal.

But infection rates then started rising in Israel and Israel was forced to use booster vaccines for high risk population.

It is now hoped that the THIRD booster vaccines would provide a way of keeping COVID infections at a manageable level.

Only time will tell whether this strategy would be successful!

References

BBC Covid: What Israel tells us about the way out of the pandemic
By Rachel Schraer
Health reporter

Sky News. COVID-19: Scientists say vaccines could control pandemic … After two doses of Pfizer, there was a 70% reduction in all cases and a 90% drop in symptomatic cases, new data shows. Friday 23 April 2021 09:08, UK

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can mild air pollution be deadly ?

Heavy Industrial air pollution can be harmful to health.

Can even a mild level of air pollution be harmful to health?

Yes !

A study published in BMJ reports that “outdoor air pollution is associated with increased risk of death even at low pollution levels below the current European and North American standards and WHO guideline values”.

City dwellers need to be careful !

References

BMJ Research
Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1904 (Published 02 September 2021)
Cite this as: BMJ 2021;374:n1904

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Are teachers at higher risk of catching COVID ?

No.

Generally, Children are known to spread viral infections easily among themselves due to close contact in confined environments.

Most children in schools are not vaccinated against COVID.

Opening of schools in Scotland has recently increased COVID infections.

So there is an understandable worry that teachers may get more COVID infections.

A recent study published in BMJ is reassuring.

Compared to other adults, teachers were NOT found to be at increased risk of severe COVID or at increased risk of hospital admission with COVID-19

References

BMJ Research.
Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021: population based case-control study
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2060 (Published 02 September 2021)
Cite this as: BMJ 2021;374:n2060

BBC News. Covid in Scotland: Return of schools ‘fuelling’ record case numbers

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Bladder radiotherpy

Bladder cancer can be cured by Radiotherpy.

Bladder cancer surgery is a very tough operation and not everyone is medically fit to undergo the procedure.

Radiotherapy is an excellent alternative treatment to bladder surgery.

A potentially curative course of radiotherpy typically involves daily Radiotherpy given for many weeks. Typically in U.K, the radiotherpy is given either over 4 weeks or 6.5 weeks.

The 4-week course of Radiotherpy has been recently reported to be better by eminent U.K. oncologists in a paper published in the highly esteemed Lancet Oncology.

We had some reservations and our views were published in the American Journal specialising in Radiotherpy.

References

Macmillan. Bladder Radiotherpy.

A Choudhury, N Porta, E Hall, et al.
Hypofractionated radiotherapy in locally advanced bladder cancer: An individual patient data meta-analysis of the BC2001 and BCON trials
Lancet Oncol, 22 (2021), pp. 246-255.

Radiation Dose and Fractionation for Bladder Cancer. In Regard to Dinh et al. Santhanam Sundar MRCP, FRCR
Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
Paul Symonds MD, FRCR
University of Leicester, Leicester, United Kingdom

Share Link:
https://authors.elsevier.com/a/1dfje1Hx528Si2 ( link expires link October 19, 2021 )

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

COVID-19: Disease versus Vaccine

Two contrasting news about COVID vaccine and disease recently.

First, a New Zealand woman dies after COVID vaccine. Death was attributed to heart inflammation caused by the vaccine.

Second, a 40 year vaccine-sceptic dies of COVID disease and sadly, leaves behind a pregnant wife.

How to interpret this information?

Remember everyday life is full of risks. Almost nothing is risk free. People balance risks and benefits everyday for most things in life. The same approach should be used for COVID vaccines.

It is understandable that some people are worried about side effects of vaccines. These concerns are REAL There is still lot unknown about long term efficacy and side effects of COVID vaccines.

If you are worried about vaccines and yet to have the vaccine, do note that the available evidence indicates that it is in your interests to have the vaccine.

If you are a vaccine sceptic, do NOT believe everything that is said on social media. Sometimes people put wrong information on social media. Sometimes people post information that is out of context.

What to do?

Ignore information that is not directly relevant to COVID vaccines.

Do NOT mix politics with Vaccines.

Beware that social media can make you paranoid about COVID vaccines.

Read official information. Available scientific evidence now indicates that the benefits of COVID-19 vaccine far outweighs the risks for vast majority of adults.

In particular, if you are above 50 years, do consider having the vaccine as a matter of urgency without further delay.

This is because in England, the Schools and Universities are going to open this month. Data from Scotland shows that COVID cases will spike after schools and Universities open.

Be selfish and do what is right for you and your family. Do not worry about “loss of face” on social media because you have changed your mind about vaccines.

Live to post another day !

Stay safe and be careful even after vaccination. No vaccine give you 100% protection.

References

BBC News. New Zealand woman dies after receiving Pfizer vaccine.

BBC News. Staffordshire Covid sceptic Marcus Birks dies in hospital.

Daily Mail. BBC presenter Lisa Shaw, 44, died due to incredibly rare blood clot complications caused by AstraZeneca covid vaccine three weeks after she had first jab, coroner rules. By Katie Weston and Joe Davies For Mailonline.
11:29, 26 Aug 2021 , updated 13:46, 26 Aug 2021

Daily Mail. Hillsong member, 34, who tweeted ‘got 99 problems but a vax ain’t one’ dies after month-long battle with COVID-19 and final ‘pray for me’ message. By Emily Crane For Dailymail.com
14:17, 23 Jul 2021 , updated 18:41, 23 Jul 2021

Daily Record. Mum-of-three dies after suffering rare reaction to AstraZeneca vaccine
The 47-year-old developed blood clots on her brain – causing a catastrophic stroke – and her fiance Mark Tomlin has now spoken of the devastating impact her death has had on him and five-year-old son Orson.

By Dan Martin Kaitlin Easton
17:46, 27 JUN 2021

MHRA. COVID-19 vaccines: updates for August 2021.

GOV. UK Coronavirus: how to stay safe and help prevent the spread . Last updated
27 August 2021

CDC. Vaccines for COVID-19.

BBC News. Covid in Scotland: Return of schools ‘fuelling’ record case numbers

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Cereals and Sausages, Chips and Candies, increase risk of Inflammatory bowel disease.

Inflammatory bowel disease (IBD), is life long bowel disease. It consists of two types of diseases. One is called Crohn’s disease and another is called ulcerative colitis.

Crohn’s disease is a type of bowel disease which causes inflammation of the whole digestive tract from mouth to the end of back passage.

Ulcerative Colitis is a bowel disease which causes inflammation of the large bowel and back passage only.

What exactly causes Crohn’s disease or Ulcerative colitis is not fully understood.

A recent study in BMJ reports that high intake of ultra-processed increases risk of inflammatory bowel disease.

Ultra-processed food means processed meat, cold breakfast cereal, various types of sauce, soft drinks, refined sweetened foods (eg, candy, chocolate, jam, jelly, brownies, pudding), chips, ice cream, commercially prepared pastries, biscuits, fruit drinks, sweetened foods and soft drinks.

References

Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1554 (Published 15 July 2021)
Cite this as: BMJ 2021;374:n1554

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Are mind numbing jobs associated with dementia ?

Yes.

It’s the principle of “use it or lose it”.

Body muscle strength can be lost quickly if it is not used. That’s why many people try to go to Gym and exercise regularly.

The same principle seems to apply to the brain.

People who are using their brain regularly with stimulating jobs are better off than people who are doing mind numbing jobs when it comes to dementia later in life.

So if your are not using your brain that much in your job, perhaps you need a “brain Gym” outside your work !

References

BMJ Research: Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1804 (Published 19 August 2021)
Cite this as: BMJ 2021;374:n1804. https://www.bmj.com/content/374/bmj.n1804

BBC. Dull jobs really do numb the mind

Daily Mail. A boring job really CAN make you brain dead: Lack of stimulation ‘affects memory and concentration later in life’

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Health problems in middle age

A recent British study reports that nearly a third of middle-aged adults have at least two Health issues.

This is very a depressing statistic.

Lot of people seem to suffering from high blood pressure, mental ill-health and back problems.

It’s important that people take time to look after themselves even if work and life in general is stressful.

It is also important to note that COVID affects people with underlying health issues much more badly.

On the other hand, middle aged people who have health issues should not despair. They are not an exception and think of themselves as very unlucky.

They can see that lots of other people are also suffering. They should get on with their lives and make it better.

This may sound a bit odd at first glance. But some people do find it reassuring to know that lots of other people are also suffering with same health issues.

For example, Some of prostate cancers patients are relieved when they learn that hundreds of thousands of people are out there, living for many years, after a cancer diagnosis. They are not alone.

Cancer Research U.K. website says this: “An estimated 280,500 men who had been diagnosed with prostate cancer between 1991 and 2010 were alive in the UK at the end of 2010”

References

BBC news. Chronic health issues for third in late 40s – study

BMJ. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study
BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1985 (Published 22 May 2020)
Cite this as: BMJ 2020;369:m1985

Cancer Research U.K. Prostate cancer incidence statistics ( prevalence)

Macmillan Cancer Support and National Cancer Registration and Analysis Service. Cancer Prevalence UK Data Tables(link is external). London: NCRAS; 2015.

Prostate Cancer U.K.: Support Groups.

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Can Vaccinated people spread the disease to others if they get a COVID infection?

Yes.

Normally Vaccines that are highly effective (for various other diseases) prevent most vaccinated people from getting the infection completely.

But that does not seem to be the case with COVID vaccines.

The COVID vaccines are highly successful in preventing severe COVID, hospitalisations and deaths. But they seem to be a bit less effective in preventing people from catching mild COVID infections.

So if a vaccinated person gets a mild COVID infection, can they pass it onto others?

Yes, they can.

This is an important fact for people with vulnerable family members and friends.

If you have mild symptoms, do get tested and be extremely careful when you are with your vulnerable family members ( elderly parents, grandparents etc).

You can pass COVID to them even if you do not have much symptoms.

As vaccines lose some effectiveness over a period of time, do NOT assume that double vaccination would protect your vulnerable family members.

A recent Public Health England report indicates that both vaccinated and unvaccinated people with COVID infection are equally infectious and capable of spreading to others.

A similar report was also published from USA recently.

The end is not in sight yet. Be careful when you are with vulnerable family members !

References

Nature. COVID vaccines slash viral spread – but Delta is an unknown.
Smriti Mallapaty

CDC. How Vaccines work.

CDC. Diseases that Vaccines prevent.

U.K. Public Health England. SARS-CoV-2 variants of concern and variants under investigation in England: technical briefing 20. Ref: PHE publications gateway number: GOV-9220. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1009243/Technical_Briefing_20.pdf

USA. BMJ. Covid-19: Delta infections threaten herd immunity vaccine strategyBMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1933 (Published 02 August 2021)Cite this as: BMJ 2021;374:n1933

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Coffee and dementia: Good or bad ?

Bad !

According to a recent large study which analysed ‘habitual coffee consumption in 398,646 UK Biobank participants aged 37–73 years’.

The study found that “High coffee consumption was associated with smaller total brain volumes and increased odds of dementia”.

In particular, consumption of >6 cups/day was associated with 53% higher odds of dementia compared to consumption of 1–2 cups/day.

A word of caution applies to all ‘food and disease’ association reports. Almost every week there are newspaper reports of studies exploring associations between “various food/drink” with “various diseases”. Some of them are conflicting and confusing with a positive study followed by a negative study !

This study report is no different in that respect.

A previous review published in 2017 concluded that ‘Drinking Coffee was often associated with Health benefits than harm for a range of health outcomes’.

The 2017 review in particular concluded that ‘Coffee consumption reduced risk of Alzheimer’s disease’.

So how to make sense of these two conflicting study reports ?

A 2021 negative report versus a 2017 positive report.

One can look for quality of studies, pedigree of authors and further confirmatory studies .

But there are no easy answers.

Everything in moderation is perhaps the most sensible thing when it comes to Food and Drink.

References

High coffee consumption, brain volume and risk of dementia and stroke. Nutritional Neuroscience.
An International Journal on Nutrition, Diet and Nervous System. Published online: 24 Jun 2021
https://doi.org/10.1080/1028415X.2021.1945858

BMJ Minerva.
Calcification in arteries . . . and other stories
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1901 (Published 05 August 2021)
Cite this as: BMJ 2021;374:n1901

BMJ. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes
BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5024 (Published 22 November 2017)
Cite this as: BMJ 2017;359:j5024

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

When will the COVID Virus go away?

The bad news is that it looks like that the virus is NOT going away any time soon.

COVID Vaccination has been tremendously successful in preventing people from getting severe disease.

A couple of months back, it was hoped that “Herd immunity” (Wide spread protection) caused by Vaccination would make the virus go away.

But recent news from Massachusetts, USA indicates that Vaccination is NOT going to produce herd immunity and make the virus go away.

Lot of Vaccinated people do get infected and the only good news is that “the vaccines offer strong protection against severe disease”

China fights to contain a new outbreak in Wuhan now. There is a possibility of further outbreaks elsewhere as well. That can create favourable conditions for new variants to emerge .

So don’t be surprised if new variants emerge in winter and COVID is still the headline news early next year !

References

BMJ. Covid-19: Delta infections threaten herd immunity vaccine strategy
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1933 (Published 02 August 2021)
Cite this as: BMJ 2021;374:n1933

BBC news. 3Aug 2021. Wuhan: Chinese city to test entire population after virus resurfaces
By Yvette Tan

BBC. Covid: ‘Israel may be reaching herd immunity’
By Rachel Schraer
Health reporter
Published14 April

BMJ News
Covid-19: What new variants are emerging and how are they being investigated?
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n158 (Published 18 January 2021)
Cite this as: BMJ 2021;372:n158

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Pfizer COVID Vaccine: How much efficacy is lost every month?

COVID vaccines lose some efficacy over time.

How much ?

Pfizer vaccine has been reported to lose, on average, about 3% efficacy every month.

An updated trial report of the Pfizer vaccine says that “ Pfizer vaccine efficacy decreased from 96% to about 84% over 4 months.

The results of this study certainly indicates that booster vaccines are needed for the winter months to prevent another wave of deaths.

References

BMJ News. Covid-19: Pfizer vaccine’s efficacy declined from 96% to 84% four months after second dose, company reports
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1920 (Published 30 July 2021)Cite this as: BMJ 2021;374:n1920

BMJ News. Covid-19: Millions could be offered booster vaccinations from September
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1686 (Published 02 July 2021)
Cite this as: BMJ 2021;374:n1686

Thomas SJ, Moreira ED Jr., Kitchin N, et al. Six month safety and efficacy of the BNT162b2 mRNA covid-19 vaccine.medRxiv2021 [Preprint].

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Why COVID Vaccine boosters may be necessary during winter ?

Vaccine boosters may be offered to adults, particularly vulnerable adults, during this winter.

Why?

Two reasons.

1. The amount of protective antibodies produced by a person’s body after vaccination seem to fall after a few months. This may mean that that some protection is lost and that some vaccinated people may become more vulnerable to COVID infection during the winter wave. A booster would benefit.

2. The COVID vaccines may also have reduced protection against new variants. A booster using an updated vaccine may give better protection.

References

Guardian. Vaccines and immunisation.
UK scientists back Covid boosters as study finds post-jab falls in antibodies
Exclusive: Waning antibody levels are possible warning sign of lower protection in months after vaccination.
Ian Sample Science editor
@iansample
Thu 22 Jul 2021 12.45 BST

Guardian. Rates of double-jabbed people in hospital will grow – but that does not mean Covid vaccines are failing.
Ian Sample Science editor
@iansample
Thu 22 Jul 2021 16.34 BST

Daily Mail. Pfizer says booster shot of its COVID-19 vaccine extends protection and is being updated to target Indian ‘Delta’ variant. By Mary Kekatos Acting U.S. Health Editor For Dailymail.Com
22:23, 08 Jul 2021 , updated 23:32, 08 Jul 2021

Daily Mail. Are these the numbers scaring Boris? Study shows 29% of the 42 people who have died after catching the new strain had BOTH vaccinations as cases soar another 40%. By James Robinson for MailOnline
14:08, 13 Jun 2021 , updated 12:22, 14 Jun 2021

How long does covid-19 immunity last?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1605 (Published 30 June 2021)
Cite this as: BMJ 2021;373:n1605

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Vaccine for the obesity pandemic !

As the world battles the COVID-19 pandemic , there is another pandemic that been going on for decades without any end in sight.

The other pandemic is obesity !

Obesity has caused far more deaths than the COVID-19 pandemic.

The Vaccines promise to end the COVID-19 pandemic.

Wouldn’t it be wonderful if a vaccine can sort the obesity pandemic ? It does not need to be rhetorical question or wishful thinking.

An article in Science magazine reports an association between obesity and a type of body immune cell called macrophages. This raises the possibility of using immunotherapy for obesity.

There is also another tantalising possibility. Behaviours, emotions and eating wrong type of food are often blamed for obesity. What if the entire scientific thinking about obesity is wrong?

In the past, another widespread condition used to be blamed on wrong food and stress. Stomach ulcers used to be very common and very distressing. Modern stressful life, emotions and wrong type of food were universally blamed for stomach ulcers. Then an Australian team proved stomach ulcers were due to an infection. Now stomach ulcers are routinely treated by antibiotics!

Obesity is common among the disadvantaged people in society. All types of infections are common in disadvantaged people. So it is not beyond the realms of plausiblity to hypothesise (suggest) that obesity could be caused by an infectious agent that affects food intake in some way, by possibly affecting sense of taste or smell of smell or feeling of fullness after eating (satiety).

If an infectious agent (e.g bacteria, virus or prion) is indeed found to be responsible for development of obesity, then the vaccines would provide a very easy way to prevent obesity.

Please note: The science magazine article on immunotherapy is based on excellent, high quality scientific work. But the possibility of an infection being responsible for obesity is merely a scientific hypothesis or scientific suggestion. It is based on a personal hunch. It is NOT based on any direct high quality scientific data at this stage !

References

Science Magazine. An anti-obesity immunotherapy? https://science.sciencemag.org/content/373/6550/24

BBC. Over a million hospital admissions for obesity
By Sophie Hutchinson
BBC News

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Do COVID vaccines cause heart inflammation?

Yes

COVID Vaccines have caused heart inflammation in a small minority of people.

But that does NOT mean Vaccines have to be avoided.

The benefits of vaccines are far higher than risk of side effects for vast majority of adult population.

People have not stopped traveling by car because of risk of road accidents. This is because benefits considerably outweigh the risks !

References

BBC news. Heart inflammation link to Pfizer and Moderna jabs
By James Gallagher
Health and science correspondent

BMJ. News Analysis.
Covid-19: Should we be worried about reports of myocarditis and pericarditis after mRNA vaccines?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1635 (Published 24 June 2021)
Cite this as: BMJ 2021;373:n1635

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

A new blood test for cancer

Cancer cells can float in a person’s blood. But finding them, in the past, used to be like “looking for a needle in a haystack”.

But new smart technology promises to detect these cancer cells easily and much early before a person develops symptoms. Detection of cancer cells at an early stage may be helpful for some patients.

A recently published study in the journal “Annals of Oncology” reports exciting results.

A Californian company called Grail has developed a blood test which seems to have a high degree of accuracy for detection of multiple cancers.

Times newspaper reports that “The NHS will begin a pilot scheme of the test with 140,000 people this year. If that is successful it will be used for millions of patients by 2025”

A word of caution though.

Just because something could be diagnosed early does not always mean that it is a good thing.

The most important thing is whether the early diagnosis can lead to better cure rates and a better quality of life.

If a test detects a cancer early but has no meaningful effect on quantity or quality of life, then it is not a good thing.

For example. Up to 80% of men have prostate cancer which can now be detected by a simple blood test called PSA. There is a good reason why we are NOT using the simple PSA test in every 80 year old.

Most 80 year old men die WITH prostate cancer rather than DUE to prostate cancer.

So why diagnose a cancer that is not causing symptoms if it is not going to make person live longer !

REFERENCES

Times. New blood test, created by Californian company Grail, detects cancers among over-50s. Kat Lay, Health Editor. Friday June 25 2021, 12.01am, The Times.

Clinical validation of a targeted methylation-based multi-cancer early detection test using an independent validation set. E A Klein et al. Ann Oncol. 2021.

Guardian. Blood test that finds 50 types of cancer is accurate enough to be rolled out.
Diagnostic tool being piloted by NHS England shows ‘impressive results’ in spotting tumours in early stages
Blood tests’ development could help the NHS further.
Nadeem Badshah and agency
Fri 25 Jun 2021 06.00 BST

Daily Mail. NHS trials ‘holy grail’ blood test that can spot 50 kinds of cancer: Ground-breaking check that can accurately detect two thirds of deadly cancers early in healthy people could save thousands of lives a year. By Victoria Allen Science Correspondent For The Daily Mail
00:00, 25 Jun 2021 , updated 10:04, 25 Jun 2021

NHS. Should I have a PSA test?

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Would COVID Vaccination become mandatory for all adults ?

It is unlikely to become mandatory in most western countries. It almost certainly would not become mandatory in USA, where Vaccination seems to become tangled with highly divisive politics.

But it is not an impossible scenario in European countries.

It is possible that more countries would follow the example of Turkmenistan, which has a policy of “no jab, no job”

Also, it does not have to a direct government policy.

If the governments change the law to allow businesses to demand vaccination proof, then indirectly vaccination becomes mandatory for most people.

Private Businesses and Travel industry may decide to make vaccination mandatory for their employees and customers so as to avoid further disruption to their business.

In countries, such as Israel and U.K., where there is already high uptake of vaccination, a change in Law may not be needed at present.

But if the present surge in infections continue, and variants emerge, Governments may change their approach.

References

BMJ. Covid-19: Turkmenistan becomes first country to make vaccination mandatory for all adults
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1766 (Published 12 July 2021)
Cite this as: BMJ 2021;374:n1766

Daily Mail. Get ready for Covid jab passports at busy pubs that don’t do enough to tackle infections, warns Boris Johnson. By Daniel Martin Policy Editor For The Daily Mail
23:54, 12 Jul 2021 , updated 01:47, 13 Jul 2021

Daily Mail. Pingdemic pandemonium! Chaos at airports and on the railways as key workers are ordered to go into self-isolation by controversial app. By David Churchill, Transport Correspondent For The Daily Mail
23:51, 12 Jul 2021 , updated 23:59, 12 Jul 2021

Daily Mail. It IS full steam ahead on freedom day: Boris Johnson puts faith in the public’s common sense on July 19 – even though some doctors and scientists want to delay it. By Glen Owen and Anna Mikhailova For The Mail On Sunday
22:00, 10 Jul 2021 , updated 01:52, 11 Jul 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.