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.

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.

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.

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.

Should you elect to wear masks when restrictions are lifted ?

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.

References

1. BBC news. Covid-19: Masks will become personal choice, says Robert Jenrick
By Emma Harrison & Kathryn Snowdon
BBC News

2. Bloomberg. Face Masks in England to Become ‘Matter of Personal Choice’
By Andrew Atkinson
4 July 2021, 09:47 BST
Updated on 4 July 2021, 11:14 BST

3. Daily Mail. SAJID JAVID: The economic arguments for opening up Britain are well known. But, for me, the health case is equally compelling. By Sajid Javid For The Mail On Sunday 22:02, 03 Jul 2021 , updated 23:13, 03 Jul 2021

4. BBC news. Covid-19 in the UK: How many coronavirus cases are there in my area?
By The Visual and Data Journalism Team
BBC News

5. Daily Mail. Face masks do NOT protect the wearer from coronavirus, but will stop them from infecting other people, Danish study finds. By Mary Kekatos Senior Health Reporter For Dailymail.com and Reuters
15:26, 18 Nov 2020 , updated 18:02, 20 Nov 2020

6. BMJ. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4919 (Published 23 December 2020)
Cite this as: BMJ 2020;371:m4919

7. NICE. COVID-19 rapid guideline: managing the long-term effects of COVID-19
NICE guideline [NG188] Published: 18 December 2020

8. Coronavirus: When can we stop wearing face masks or coverings?
By Michelle Roberts
Health editor, BBC News online

9. Science. Implications of defective immune responses in SARS-CoV-2 vaccinated organ transplant recipients. Peter S. Heeger, Christian P. Larsen, Dorry L. Segev

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.

Do face masks prevent COVID illness ?

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.

References

CLOTH MASKS

BMJ. Covid-19: What is the evidence for cloth masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1422 (Published 07 April 2020)
Cite this as: BMJ 2020;369:m1422

DANISH STUDY- SURGICAL MASKS

Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial
Henning Bundgaard et al. Ann Intern Med. 2021 Mar.

BMJ. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4919 (Published 23 December 2020)
Cite this as: BMJ 2020;371:m4919

BMJ. The curious case of the Danish mask study
BMJ 2020; 371
doi: https://doi.org/10.1136/bmj.m4586 (Published 26 November 2020)
Cite this as: BMJ 2020;371:m4586

Daily Mail. Face masks do NOT protect the wearer from coronavirus, but will stop them from infecting other people, Danish study finds. By Mary Kekatos Senior Health Reporter For Dailymail.com and Reuters
15:26, 18 Nov 2020 , updated 18:02, 20 Nov 2020

Spectator (magazine) https://www.spectator.co.uk/article/do-masks-stop-the-spread-of-covid-19-

Full fact.org. Danish study on mask efficacy only tells us half the story. 24 NOVEMBER 2020

Forbes. Lead Researcher Behind Controversial Danish Study Says You Should Still Wear A Mask
Leah Rosenbaum. Forbes Staff 18 Nov 2020. Critics of mask-wearing policies used a Danishstudy on mask-wearing to bolster their claims such policies are ineffective, but scientists, including those involved with the study, disagree.

JAMA Insights
February 10, 2021
Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2
John T. Brooks, MD1; Jay C. Butler, MD1
Author Affiliations
JAMA. 2021;325(10):998-999. doi:10.1001/jama.2021.1505

CAMBRIDGE REPORT ON HIGH QUALITY MASKS

BMJ. Covid-19: Upgrading to FFP3 respirators cuts infection risk, research finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1663 (Published 29 June 2021)
Cite this as: BMJ 2021;373:n1663. https://www.bmj.com/content/373/bmj.n1663

BBC news. Covid: Masks upgrade cuts infection risk, research finds
By David Shukman
Science editor

Guardian. Cambridge hospital’s mask upgrade appears to eliminate Covid risk to staff
Hospital infection study shows use of FFP3 respirators at Addenbrooke’s ‘may have cut ward-based infection to zero’
Nicola Davis and Denis Campbell
Tue 29 Jun 2021 10.49 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 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.

Are many NHS staff reluctant to have COVID-19 vaccines?

No !

Vast majority of health care workers already had the COVID vaccine. Only a small minority have vaccine hestitancy.

A recent study found that about 90% of staff had at least one dose of the vaccine within 2 months of vaccine roll out. That is very impressive.

This study ( published in Lancet Journal) found that vaccines are very effective in reducing infections.

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.

Reference: COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study. Published:April 23, 2021 DOI: https://doi.org/10.1016/S0140-6736(21)00790-X

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. approach to vaccination proven to be the right one. Is it Luck or Foresight?

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.

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.

Guardian. No data to support UK delay of vaccines’ second dose, says WHO.
Sarah Boseley Health editor
Tue 5 Jan 2021 19.48 GMT

Daily Mail. UK should feel ‘vindicated’ over its ‘brave’ decision to delay second doses of Covid vaccines, World Health Organization official says. By Sam Blanchard Deputy Health Editor For Mailonline. 13:29, 08 Feb 2021 , updated 15:03, 08 Feb 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 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.

What has ‘Public health’ ever done for us ?

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.

Read my letter in BMJ and make your views known at the BMJ rapid response section.

Sundar S. Public health needs to go back to basics, not rely on nudge theory.

Toll-free link:
http://bmj.com/cgi/content/full/bmj.n1153?ijkey=CUQNozGH9yJeK57&keytype=ref

References:

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.