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”.
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.
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
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 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.
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 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 faroutweighs 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.
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.
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.
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.
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 !
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.
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”
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
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.
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?
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 !
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.
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.
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.
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 !
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.
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
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.
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.
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 !
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.
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.
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 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 !
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.
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.
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
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.
If someone feels they are not having regular refreshing sleep, then it is bad news.
In a very large U.K. study, involving 487,728 people, the following question was asked: Do you have trouble falling asleep at night or do you wake up in the middle of the night?
About a quarter of people in study answered “never/rarely”; just under half answered “sometimes” and less than one-third reported “usually”.
The people in study were followed up for many years (mean follow-up time = 8.9 years)
The people who reported frequent sleep disturbances (“usually” category) were found to be at risk of dying early.
The risk was highest in those with both diabetes and frequent sleep disturbances.
It needs to be seen whether the sleep disturbance by itself led to early death or whether people who are going to die early have medical problems that cause them to have disturbed sleep !
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.
Yes, it is a possibility that a third booster dose of COVID vaccine would be offered later this year.
Vaccination has been tremendously successful so far. But it is too early to declare victory against the virus.
Data from Israel indicates that the current Pfizer vaccine, although still highly active, offers less protection against delta variant.
In June, the vaccine was found to be just 64 percent effective in preventing coronavirus infection whereas during May, when the delta strain was less prevalent, the vaccine was 94.3% effective.
So if more variants emerge, then vaccine boosters may be particularly needed for the vulnerable people.
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.
U.K. is on course to lift almost all COVID restrictions in mid July 2021.
A U.K. minister has said that “wearing masks” would become a personal choice.
Just because there is a choice, it does not mean it is always good for you.
Government decisions are often made not only with scientific facts but also with economic and political considerations. Compulsory masks may not be liked by a section of society and Government has to take that into account in a democratic society.
Personally electing to wear masks in crowded public places could be sensible for the following reasons.
– There is some debate about the extent of protection a person gets wearing masks following the Danish mask study. But no robust scientific study has shown significant harm from wearing masks. So it is better to be safe and wear masks even if the extent of protection is debatable.
– Infections are rising now and luckily, vaccines seem to have protected most people from getting severe COVID. But Vaccines are not 100% effective. Moreover, when infection rates go up further and society opens up more, there is a risk of variants emerging that may be partially vaccine resistant. So wearing masks may provide some protection.
– Not all people get poorly when they get COVID. But these people with COVID can still pass infection to other vulnerable family members and people who don’t have the protection from vaccines. So wearing a mask can stop people with mild COVID from spreading the infection to others.
– Some people do not want to wear masks because they think they are not at risk of death or hospitalisation. Remember, COVID related problems affect different people in different ways. Lot of people do recover from COVID without major problems. But some people do develop long-term symptoms from COVID. So it is better to wear masks for COVID 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 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.
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.
Yes, good masks may help to reduce infections that are spread by airborne particles.
But not all masks are the same.
Cloth masks were promoted during 2020 when the proper surgical masks were in short supply . The effectiveness of cloth masks are not well studied and they are of varying quality depending who made them and how well they were made.
Properly manufactured surgical masks are better than home made cloth masks. But how much protection they can offer is a matter of scientific debate. Surgical masks have been found to give some protection against other respiratory viruses in past. But a recent Danish study found no significant benefit against COVID among the general public.
The high quality FFP3 masks which filter most of the inhaled air is superior to normal surgical masks. A recent study from Cambridge found that Heath care workers who used FFP3 masks had better protection from COVID compared to normal surgical masks in the Hospital.
Overall, clean, well manufactured masks are likely to of some benefit to the public rather than wearing no masks at all. In the hospital setting, FFP3 masks seem to provide superior protection to Health care staff working with COVID patients.
And most importantly people have to understand that masks are not to be used alone. Masks got to be used along with protective measures such as social distancing and Hand-washing.
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.
Yes, we should be cautious after the freedom day on July 19th and this is for the following reasons.
1. Vaccines are highly effective but they are NOT 100% effective.
2. Two doses are needed for full protection. Even though, more than two third of adults have had atleast one vaccine, only about half the U.K. population had double vaccination so far.
3. Vaccine Protection against New COVID variants may NOT be as good as it is now. For instance , vaccines are slightly less effective against the delta variant particularly after first dose.
4. Vaccine protection may decrease over time and Vaccines may not give the same level of protection as months pass by.
4. Being cautious now, may helps us to avoid lockdowns during Autumn and would help to save Christmas !
Public Health England. Press release Vaccines highly effective against hospitalisation from Delta variant New analysis by PHE shows for the first time that 2 doses of COVID-19 vaccines are highly effective against hospitalisation from the Delta (B.1.617.2) variant. Published 14 June 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 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.
Yes, even after having both the vaccines, there is still a small risk of dying from COVID-19
Why?
This is because the vaccines are not 100% effective.
People who had both the vaccines can still get COVID-19 infection. A unlucky few of those who get an infection can still die from COVID-19.
Recent reports indicate that about half of deaths in U.K. are in people who had at least one dose of COVID vaccine.
The good thing is that the overall number of deaths is VERY LOW compared to the high number of deaths at the peak of pandemic when vaccines were not available.
Vast majority of infections do still occur in the unvaccinated individuals. ( PHE document- page 13 & 14)
One has to hope that vaccines do NOT lose their effectiveness over time.
We have to hope that more new variants do NOT emerge as there is a possibility that Vaccines may be less effective against new variants emerging in future.
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.
Yes, the Kent variant who got a foothold in December was far more dangerous.
A recent study in BMJ reports that “the risk of hospital admission is higher” for people infected with the Kent variant compared with the original wild-type Wuhan variant of Coronavirus.
This higher severity seems to be specific to adults older than 30 years.
The current variant spreading in U.K. (delta a.k.a Indian variant) may not cause widespread havoc, like the Kent variant, due to the lock down and wide spread vaccination.
One has to hope that we do not get any variants that breaks the protective shield of COVID vaccines.
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.
It would be a shock for many to hear that “No amount of alcohol is absolutely safe”.
A team at Imperial College London analysed MRI scans of heart, brain and liver of people who drink alcohol. They found that higher alcohol consumption was related to smaller brain, weaker heart and fatty liver.
They reported that “there is no ‘safe threshold’ below which there were no toxic effects of alcohol.
Previously other studies have also reported that there is no safe limit for alcohol!
In 2018, a Lancet study reported that the risk of death and risk of cancers increased substantially with increasing levels of alcohol consumption; and there was no safe limit below which there was no risk.
The message is “Avoid alcohol”
If you can’t, then atleast drink as little as possible.
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.
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.
But the study also showed what we know already. Vaccination does not give 100% protection.
Everyone, in particular, health care staff need to continue with other COVID precautions such as masks, distancing and regular washing as advised by Government.
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.
Yes, people have died after having COVID-19 vaccines.
Recently, a BBC Radio Newcastle presenter, Lisa Shaw was reported to have died after the Astra Zeneca COVID vaccine. Her family is blaming the COVID vaccine for causing clots and ultimately her death.
In India, a Popular Tamil actor and comedian died within 48 hours of receiving a COVID vaccine. His vaccination was broadcast live on TV to encourage public uptake of vaccination but his unfortunate death after vaccination probably ended up causing vaccine hesitancy in some people.
A news article in BMJ reports that the “Pfizer-covid-19 vaccine is “likely” to have been responsible for at least 10 deaths of frail elderly people in nursing homes in Norway”.
But, the most important thing to remember is that deaths are rare after COVID-19 vaccines.
Yes, there are true distressing accounts of vaccine side effects. But what you do not hear is the benefit most people have from vaccines.
Millions of people received vaccines so far with vast majority having no major side effects.
Consider this for context. Think about plane accidents. Millions of people travel by plane without any problems. If People fly safely and reach their destination, it is not headline news. People do not go around saying that they have traveled safely by plane and that they are alive !
But a aeroplane accident which happens rarely is front page news. It would be all over the 24 hour TV news channels across the world. Plane accidents are utterly and unimaginably devastating for those individuals and families involved. But the rare plane accidents do not make most other people avoid flying. The accidents do not mean that no one should travel by plane. The travel by planes has far more benefits than risks for majority of population.
Same with COVID vaccines. Serous Side effects are headline news even if they are very uncommon and rare. The available data indicate benefits are much greater than risks.
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.
Worries about vaccines are nothing new. Anti_vaccination groups were formed in 1860s when small pox vaccination was made compulsory. Even when small pox was causing untold devastation, some people were opposed to it.
The Vaccine hesitancy of 19th century is somewhat excusable. Some of the worries were real, and not much was known about the safety of small pox vaccine at that time. Lot of people were ill-informed and did not have access to good sources of information. They didn’t know the immense potential of the vaccination to eliminate distressing diseases.
Vaccines have now successfully eradicated small pox. Many other devastating infectious diseases such as polio have been controlled in many countries across the globe due to the vaccines.
Some of the vaccine hesitancy in west is because western people are not fully aware of the devastating power of infectious diseases (at least until COVID-19 came to the world in 2020).
Vaccine hesitancy is also sustained by “confirmation bias” . Confirmation bias is the tendency of human beings to seek information that confirms what they believe in. If you distrust vaccines, you go looking for information that confirms you beliefs and you disregard information that proves vaccines are hugely beneficial.
Some people wish for a 100% safe vaccine. But there is no such thing as completely risk free vaccine. It is true Vaccines can cause serious side effects. It is true that Vaccines can cause long term side effects. It is true that Vaccines can rarely cause life threatening side effects and even deaths.
It is normal to worry about side effects of vaccines. But the potential for side effects should not be the reason to decline vaccination.
One has to look at benefits as well as risks. Some people focus on everything bad that can happen as a result of vaccines.
COVID-19 vaccines had an unusually short development period. This is because of the pandemic. The available evidence indicate that the benefits of the vaccines are far greater than risks. It is true that there is no long term safety data. But in the middle of a pandemic, which has caused untold misery to millions, waiting for perfect long term data is not an option.
If you are sceptical about vaccines, please do focus on benefits as well as risks. Do not focus on risks only.
References
BMJ. Practice Pointer. Covid-19 vaccination hesitancy. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1138 (Published 20 May 2021) Cite this as: BMJ 2021;373:n1138
BMJ. News. Covid-19: Pfizer-BioNTech vaccine is “likely” responsible for deaths of some elderly patients, Norwegian review finds. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1372 (Published 27 May 2021) Cite this as: BMJ 2021;373:n1372
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.
There is concern whether PTSD is now over-diagnosed. There is a debate at the BMJ journal. Please do read my views and submit your views through the rapid response section.
References:
BMJ Head To Head. Is PTSD overdiagnosed? BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n787 (Published 05 May 2021) Cite this as: BMJ 2021;373:n787
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.
UK government wanted as manypeople have “some” degree of protection against the COVID-19 rather a only few people having “full” protection against COVID-19.
A recent paper published in BMJ validates the U.K. approach even though it was initially criticised by WHO ( world health organisation)..
Is it Luck or Foresight that U.K. Govt got it right? Probably both but more foresight than luck. Perhaps a cappuccino cup of foresight sprinkled with chocolate of luck.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
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.
But now comes the Variant from India. (the scientific name is B1.617.2 variant of concern).
The Indian variant appears to be more transmissible but no evidence yet that the Indian variant is inherently more deadly than the Kent variant.
Naturally, we are in a better place now than last year because of the vaccination.
But there is some evidence that spontaneous changes (mutations) in the B.1.617.2 variant virus may make it partially resistant to antibodies produced by vaccines.
So how effective are the current vaccines against this Variant from India?
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.
UK government wanted as many people have “some” degree of protection against the COVID-19 rather a only few people having “full” protection against COVID-19.
Some people have now been offered two vaccines but still there are many people who were yet to have the second dose. They would be wondering how effective a single dose of the vaccine is. How much protection they have now.
With Pfizer vaccine, vaccine effectiveness reached 61% after 4 to 5 weeks of the first dose.
With AstraZeneca vaccine, vaccine effectiveness reached 73% after 5 weeks of first dose.
This data is very reassuring
But the data also stresses the importance of having the second dose for further protection.
Please do make a note that (a) vaccines do take a few weeks to be become effective after the first dose (b) no vaccine is 100% effective and (c) we also do not know how long this protection from vaccine will last.
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 the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
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.
Advanced Cervical cancer which has come back after surgery or radiotherpy is usually treated with chemotherapy.
There is a new immunotherapy treatment option for all advanced cervical cancer patients now .
At the European Society of Medical Oncology (ESMO 2021) virtual conference, an international team of investigators, presented trial data regarding this new immunotherapy drug called cemiplimab.
One group of patients in the trial received the immunotherapy drug cemiplimab every 3 wks and another group of patients received intravenous chemo (pemetrexed, vinorelbine, gemcitabine, irinotecan or topotecan).
Cemiplimab significantly improved survival of patients and was better than chemotherapy.
This new immunotherapy drug cemiplimab is already being used for skin cancers and vulval skin cancers. Very soon, it would be used in cervical cancer patients.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
How effective is a single dose of Pfizer Vaccine in cancer patients?
Single dose is not very effective in cancer patients.
An UK study has now been peer reviewed and published in the esteemed Lancet oncology journal. The study showed inadequate protection after first dose.
More than half of the cancer patients receiving a single dose of the Pfizer COVID-19 vaccine have been left with little protection against the virus.
Two doses are critical and the second booster ideally need to be given on time at 21days.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
The vaccination rates are rapidly going up and understandably many people are hoping for some sort of normality very soon.
But a new variant has been detected across the country. The scientists are worried about this new variant of coronavirus- called India variant. This variant can derail government plans in UK.
The current vaccines seem to offer somewhat less protection against this new variant . If this variant takes a strong foothold in UK , then we have to wait a bit longer for normality.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
Yes, there is a risk of serious harm from “unauthorised” COVID treatments that are not officially authorised by competent regulatory authorities such as MHRA in UK or FDA in USA.
India is going to a rough patch. People with COVID are desperate for treatment. There is shortage of oxygen which is a commonly used treatment.
Apart from oxygen for respiratory support, only Two treatments have been proven to be of significant help in COVID-19 pneumonia. (1) Steroids (2) An arthritis drug called Tocilizumab
Many antivirals drugs have not shown any meaningful benefit. Various other drugs are still in trials.
It is rapidly evolving area and the BMJ has a COVID guideline which is being frequently updated during this pandemic.
This is significant risk of harm from drugs which are NOT properly assessed in clinical trials.
Anecdotally there has been lot of sudden deaths in India. Lot of unproven treatments such as Azithromycin, ivermectin, antivirals agents,chloroquine, and other agents widely used in india.
Although there is no definitive proof, One cannot help wondering whether poor outcome in at least some Indian patients is related to combinations of unproven drugs that are used widely in unregulated private healthcare sector.
BMJ. Drug treatments for covid-19: living systematic review and network meta-analysis BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2980 (Published 30 July 2020) Cite this as: BMJ 2020;370:m2980
BMJ. A living WHO guideline on drugs for covid-19 BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379 (Published 04 September 2020).
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
An apple a day might not keep the doctor away. But a good public health team can keep the doctors away for many people!
Public health is about prevention and promotion of health in the society.
Public health is largely responsible for the significant improvements in life expectancy over the last 150 years.
Providing people with clean drinking water, removal of rubbish from houses and streets, good sewage system, and vaccination has saved many millions of lives over the years.
The recent smoking ban in work-places, public places and indoor venues is a modern example of public health activity.
The one area where public health has not been hugely successful is obesity. It may be because of the reliance on nudging the individual to change rather than dealing with underlying structural problems.
BMJ. Lifestyle and socioeconomic group on health Public health needs to go back to basics, not rely on nudge theory BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1153 (Published 06 May 2021) Cite this as: BMJ 2021;373:n1153
BMJ. Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2161 (Published 08 June 2010) Cite this as: BMJ 2010;340:c2161
BMJ. Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n604 (Published 14 April 2021) Cite this as: BMJ 2021;373:n604
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
BMJ. News Analysis. Covid-19: Is the UK heading towards mandatory vaccination of healthcare workers? BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1056 (Published 21 April 2021) Cite this as: BMJ 2021;373:n1056
BMJ News. Covid-19: Italy makes vaccination mandatory for healthcare workers BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n905 (Published 06 April 2021) Cite this as: BMJ 2021;373:n905
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
COVID-19 is still raging like wild fire in various parts of world particularly in India now.
But, in U.K, it does look like the “beginning of the end” for the COVID pandemic. Vaccines seem to have greatly aided this end.
On Tuesday, UK reported 1,946 new infections and only four deaths within 28 days of a positive test.
So unless there is a new variant which overcomes the protective shield of the Vaccines, there may be no more lockdowns and life may go back to some sort of normality.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
In the indoor settings, wearing masks can help to reduce the risk of getting COVID-19 infection.
But in the outdoor setting, masks may not be very helpful as the risk of getting COVID-19 infection from others, in outdoor settings, is considerably smaller.
Apart from infection prevention, I can see some additional benefits for voluntarily wearing masks in the streets.
The streets of major cities have significant air-pollution. So facial masks can help to reduce inhalation of toxic chemicals.
More and more surveillance street-cameras are now deploying facial-recognition software to deter criminals. But the cameras may also track movements of ordinary law-abiding people for marketing and advertising reasons. So face-masks may also be helpful to those with privacy concerns.
Read the article and submit your views through BMJ rapid response section.
BMJ . Coronavirus Transmission Should masks be worn outdoors? BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1036 (Published 28 April 2021) Cite this as: BMJ 2021;373:n1036
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
Combination therapy with Hormone therapy and Radiotherapy is used with curative intent for treatment of prostate cancer.
There is some debate which treatment should be started first. At present, the hormone therapy is started first and radiotherpy is started second at a later date.
This is because many previous clinical trials, which found beneficial effects for the combination therapy, involved starting hormones first.
One advantage of starting hormone therapy immediately and delaying the start date of radiotherpy is that hormone therapy shrinks the size of prostate before radiotherpy . This greatly helps when image-guided Radiotherpy is planned later on.
A group of high Calibre researchers and authors from Canada and USA have published paper arguing in favour of radiotherpy starting first and starting hormones afterwards.
Some of the authors behind this paper in Journal of Clinical oncology have previously published seminal, practice changing, papers in field of prostate cancer.
My personal view, is that we have to wait for confirmatory evidence before changing the current practice.
I have to resort to the megaphone of a provocative headline grabbing title so that oncologists won’t uncritically accept the conclusion of the paper
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
CPR or cardiopulmonary resuscitation is a medical procedure that is often misunderstood. It causes lot of anguish and distress to patients and family unnecessarily.
It is sometimes colloquially known as “kiss of life” as “mouth to mouth resuscitation” was previously used in pre-COVID era along with “chest compressions”.
CPR may involve “electric shocks to heart” when needed if machines are available. CPR in hospital may involve “tubes pushed down the throat” to enable air get into lungs. CPR almost always involves someone “pressing hard on the chest repeatedly with both hands” so as to help air get into lungs.
Overall, it can appear a bit brutal but it can be a life saver. That’s why the work places, train stations, airports and some public parks have the automatic defibrillators.
CPR is a wonderful medical first aid, which, delivered promptly, can save lives. It is highly successful in previously fit people with a sudden cardio respiratory arrest due to a “reversible or treatable” illness.
Television serials and Hollywood movies often portray CPR as a highly successful procedure.
But, unfortunately, in routine hospital practice, the success rates are low.
In particular, success rates are very low in “terminally ill” cancer patients and in frail patients with “multiple irreversible medical conditions”.
Because many people believe CPR is hugely successful in “everyone”, patients and families understandably get very upset when the medical team talk about “do not attempt resuscitation (DNAR)“.
When CPR is NOT used appropriately, it prevents peaceful death and stops terminally ill patients from gently fading away surrounded by their loved ones.
In cancer patients, when cancer treatments are not working, death occurs after the body has been overwhelmed by cancer. Trying to re-start the heart and lungs after the organs have stopped working due to cancer is often futile. More importantly, CPR can make death more traumatic for patients and family.
Other than educating people about benefits and limitations of CPR, there is no easy way to make this misconception about resuscitation go away.
Read my BMJ letter on this topic and contribute your views on the rapid response section of BMJ.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
In USA, about 5800 “breakthrough” COVID-19 infections has been reported so far among the roughly 77 million people who had been fully vaccinated. That’s less than 0.008% cases.
A much more smaller minority among this minority group had serious infections. Among the 5800 cases, 396 patients were admitted to hospital and 74 patients died from COVID-19. That’s less than 0.0001% deaths.
1. BMJ News. Covid-19: Infections fell by 65% after first dose of AstraZeneca or Pfizer vaccine, data show BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1068 (Published 23 April 2021) Cite this as: BMJ 2021;373:n1068
2. BMJ news. Covid-19: US reports low rate of new infections in people already vaccinated BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1000 (Published 16 April 2021) Cite this as: BMJ 2021;373:n1000
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.
If someone has recovered from a COVID-19 infection, they would have some protection against getting another COVID-19 infection.
But, even if someone has recovered very well from a previous infection, vaccination is necessary because there is still a significant risk of getting COVID-19 infection again.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.
Like everything else in medicine, risks and benefits needs to be assessed in each individual case.
For instance, a doctor won’t give toxic treatments for a self limiting flu. But, on the other hand, a doctor will try toxic chemotherapy to control advanced lung cancer.
No vaccine or medicine is ever going to be 100% safe.
For that matter, Life is full of risks. Getting out of bed can be risky. Not getting out of bed everyday is also risky.
Older adults who are at high of COVID related death and COVID related complications should have the vaccine during this pandemic and not worry too much about rare serious side effects.
But young adults, who are a low risk, can avoid Astra Zeneca vaccine based on the available data, if alternatives are available.
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 previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.
Vitamins and Minerals are absolutely essential nutrients for a Healthy body and a Healthy mind. Anyone not eating a healthy balanced should look what nutrients they might be missing.
But on the other hand, taking too much of vitamins and minerals, when they are not needed, could be harmful to the body.
There is widespread use of dietary supplements during cancer treatment, in the hope they can reduce side effects but many do not think about the disadvantages.
An American study of Breast cancer patients undergoing Chemotherapy looked at the effect of taking dietary supplements such as anti-oxidants, iron, vitamin B12, and omega-3 fatty acids.
Breast cancer patients who took the dietary supplements during chemotherapy were found be harmed by them. They had a higher chance of cancer coming back compared to people who did not take these supplements. The supplements also increased risk of death in those the supplements.
Beware supplements when used improperly, can be harmful.
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 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 is likely to 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.
Dr S Sundar 