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.
U.K. Government vaccine minister announced over weekend that compulsory COVID vaccinations are being considered for NHS staff.
Majority of NHS staff believe in the vaccine and so it is not an issue for most NHS staff. But a small minority of staff are either sceptical or they have some other reasons why they were not able to have the vaccine.
Should those NHS staff be forced to have COVID-19 vaccines?
It is a tough question. Compulsory vaccines have caused huge backlash in past among the general population as well as among some in medical profession.
On the other hand, Vaccination against Hepatitis is already mandatory for NHS surgeons and this is not a new thing.
The vaccination of staff is not only for personal protection but also to prevent NHS staff spreading infection to vulnerable patients.
BMJ. COMPULSORY VACCINATION Association Medical Journal 1853; s3-1 doi: https://doi.org/10.1136/bmj.s3-1.10.224-a (Published 11 March 1853) Cite this as: Association Medical Journal 1853;s3-1:224
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.
A recent paper published in Lancet Psychiatry reports that at least 1 in 3 patients , who have recovered from severe COVID, have substantial neurological and psychiatric problems during the next six months .
This report is very worrying .
If study findings are confirmed by other studies, this would be yet another substantial reason to consider getting the vaccine as soon as it is offered.
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.
A recent study published in the esteemed Lancet Oncology Journal shows that the vaccine is well tolerated in patients having immunotherapy.
Unlike cancer chemotherapy, immunotherapy works differently. It works by releasing the in-built brakes holding down the immune system thereby boosting the body’s immune system against cancer.
There has been some theoretical concerns whether this might lead to COVID vaccine causing more side effects.
Reassuringly, the Vaccine side effects were NO different from those seen in people not having immunotherapy. The Vaccine also did NOT increase the immunotherapy side effects.
So the study is good news for tens of thousands of patients on immunotherapy and any cancer patient who has hesitated before, should seriously consider having the vaccine now
COVID infection could be very nasty in cancer patients and all evidence points to the benefits of vaccine far outweighing any risks from the Vaccine.
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.
BMJ News. Covid-19: Pfizer reports 100% vaccine efficacy in children aged 12 to 15 BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n881 (Published 01 April 2021) Cite this as: BMJ 2021;373:n881
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.
Many millions of people have now been vaccinated against COVID-19.
The COVID-19 vaccines are highly effective but the next important question is how long would the vaccines continue to protect.
Some vaccines for other viral diseases offer life long protection but others like flu vaccines need annual boosters. COVID-19 Studies are still ongoing.
A recently released Pfizer vaccine study data indicates that protection with Pfizer vaccine lasts for many months as a minimum. To be precise, so far, Pfizer vaccine was found to have 91% efficacy for up to six months. Ongoing studies would clarify whether booster vaccines are needed 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 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.
COVID-19 is not a self limiting illness particularly if you have been poorly enough to be hospitalised the first time around.
Even after recovering from a COVID-19 infection, many people remain at high risk of death.
A recent UK study published in the BMJ found that “ Nearly a third of people who have been in hospital before were readmitted after discharge for further treatment in the following four months”.
“And worryingly one in ten patients died during the follow up period after hospital discharge”.
The increase in risk was not confined to the elderly. So everyone still needs to be careful as the lockdown is being gradually eased.
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.
A recent study published in BMJ shows increase in heart and lung related deaths due to traffic pollution.
Reference:
BMJ. Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n534 (Published 24 March 2021) Cite this as: BMJ 2021;372:n534
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.
A Study published in British Medical Journal found that “A longer length of breastfeeding was associated with a reduced risk of cardiovascular disease”
The study also found that women who had certain pregnancy related complications were also at increased risk of heart disease in later life.
In addition, the study also found that taking contraceptive pills (combined pills) in younger age led to increased risk of heart disease and stroke in later life.
Awareness of these risks would help to take steps to reduce the risk from them.
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 the authors views are not in way intended to be a substitute for professional advice.
The new variant in UK, led to the second National Lockdown. Previously, it was reported that the new UK variant spreads more easily but it was NOT known whether it was more deadly.
Now, new evidence published in BMJ (British Medical Journal) indicates that the new UK variant of Coronavirus is more deadly and causes more deaths.
References for further information.
1.BMJ. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n579 (Published 10 March 2021) Cite this as: BMJ 2021;372:n579
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.
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.
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.
Nutritional supplements are often tried to prevent cancer. But well- designed rigorously conducted clinical trials have NOT shown any benefit in prevention of many cancers.
Selenium was suggested as a preventative supplement for skin cancer.
A clinical trial compared Selenium against placebo in United States. The results were disappointing.
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.
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.
Vast majority of people are desperate to have vaccination and some people are even queue jumping. So this issue is of relevance to some people only and that too when vaccines are freely available to all.
If you are a plumber, who may be visiting the homes of Vulnerable people or a Care Home worker looking after very elderly people, it may be justifiable to say ‘no jab, no job’.
Balancing individual Liberty versus the benefit of others would be a legal minefield particularly when existing workers are concerned.
Furthermore, there are still lot of things we do not know how vaccines. We do not know how long they will protect somebody. We do not know whether all vaccines have similar efficacy. We do not know about the extent to which vaccines would be effective against any variants.
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.
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.
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.
The study presented at the ASCO ( American Society of Clinical Oncology) virtual scientific symposium in 2020,
“The VITamin D and OmegA-3 TriaL (VITAL) was a high quality study. The study randomly assigned patients to Vitamin D3 supplements and/or omega-3 fatty acid supplements and/or both or placebo in 25,871 men and women.
The study found that “vitamin D supplementation decreased risk of developing advanced cancers by 17% compared with placebo ”
“Omega-3 supplementation did not reduce the incidence of advanced cancer.”
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.
A large study in BMJ reports that high intake of cereals is associated with higher risk of Blood pressure and Heart diseases.
High intake of white bread, pasta/noodles were also as bad as breakfast cereals because of the refined grains.
Intake of whole grains and whole grain porridges. did not affect the health outcomes.
Interestingly, white rice did not affect the health outcomes either.
Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.m4948 (Published 03 February 2021) Cite this as: BMJ 2021;372:m4948
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.
If all the vaccines now in use continue to be safe and highly effective in real world population, then it is only a matter of months before the pandemic comes to an end and normal life returns in 2021 !
Vaccines work by tricking the body into thinking that there is a real infection and hence the body produces antibodies. So this study indirectly indicates the protection from vaccines will also last longer and yet another reason to be hopeful about the end of pandemic in 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 authors views are not in way intended to be a substitute for professional advice.
More good news on the vaccine front in the fight against the coronavirus.
Two new vaccines have reported positive results.
The NOVAVAX vaccine is first Vaccine to report efficacy against the new variants. It is 95.6% effective against the original strain of coronavirus.
NOVAVAX is 86% effective at protecting against the new UK variant, which is very reassuring. But the Vaccine is only, 60% effective against South African variant of the virus. The efficacy against Brazilian variant is unknown.
The Janssen vaccine, produced by the US giant Johnson & Johnson, is a single-dose vaccine and has proved 66% effective against Covid-19. The vaccine was just 57% effective in the South African part of the trial.
The reduction in efficacy of both vaccines against new variants is a bit worrying and indicates that if further new variants emerge in future, existing vaccines could be less effective and vaccines would need to be updated.
The Janssen vaccine uses a common cold virus and uses a approach similar to the Oxford Astra Zeneca Vaccine.
Novavax vaccine differs from existing vaccines and it uses a artificially produced COVID-19 spike protein, which is then assembled into nanoparticles to make them look like coronavirus.
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.
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.
Read the excellent article in BMJ and contribute your views through the rapid response section of BMJ
Reference
Too little, too late: social media companies’ failure to tackle vaccine misinformation poses a real threat BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n26 (Published 21 January 2021) Cite this as: BMJ 2021;372:n26
Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.
You don’t need to be exposed to an infected person who is coughing, sneezing and spluttering to get the infection.
Merely talking to an infected person can make you catch the coronavirus infection particularly if you are very close to the person with infection and not wearing a mask in an indoor setting with poor ventilation.
Guardian. Talking can spread Covid as much as coughing, says research. Tiny aerosols of the virus emitted when speaking linger in air for longer than larger droplets from a cough. Nicola Davis Science correspondent @NicolaKSDavis Wed 20 Jan 2021 00.01 GMT
Journal Proceedings of the Royal Society A. Evolution of spray and aerosol from respiratory releases: theoretical estimates for insight on viral transmission. P. M. de Oliveira , L. C. C. Mesquita , S. Gkantonas , A. Giusti and E. Mastorakos. Published:20 January 2021. https://doi.org/10.1098/rspa.2020.0584
Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.
Dr S Sundar 