Does Drinking Coffee reduce the risk of getting prostate cancer ?

October 17, 2021October 2, 2021

Yes

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

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

But a word of caution!

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

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

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

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

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

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

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

Is it safe to combine Flu Vaccines and COVID vaccines?

October 4, 2021October 2, 2021

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

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

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

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

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

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

References

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

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

ComFluCOV vaccine study

Study Summary slides

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

CDC. Combination Vaccines. Fewer shots, but same protection

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

New Pill for COVID

October 2, 2021October 2, 2021

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

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

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

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

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

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

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

References

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

Guardian. Covid antiviral pill halves hospitalisations and deaths.
Merck’s antiviral drug, molnupiravir.
Hannah Devlin Science correspondent
Fri 1 Oct 2021 15.56 BST

To Boost or not to boost ?

September 28, 2021September 28, 2021

U.K. has started offering booster vaccines.

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

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

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

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

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

References

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

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

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

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

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

Immunotherapy improves survival of patients with Advanced Cervical cancer

September 20, 2021September 19, 2021

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

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

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

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

This is likely to become the standard of care now.

References

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

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

September 19, 2021September 18, 2021

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

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

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

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

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

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

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

References

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

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

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

Galleri cancer test: an exciting new test for cancer

September 17, 2021September 16, 2021

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

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

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

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

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

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

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

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

References

Galleri™ Test

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

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

Traffic noise and dementia

September 13, 2021September 16, 2021

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

Possibly yes.

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

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

A word of caution though!

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

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

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

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

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

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

References

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

Dementia.org: The Connection Between Hearing Loss And Dementia

NHS blog. Keeping your ear to the ground on dementia

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

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

September 9, 2021September 12, 2021

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

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

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

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

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

References

BNF Ivermectin

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

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

eMC. Soolantra 10mg/g Cream

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

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

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

Ivermectin_Patient Information leaflet Download

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

September 7, 2021September 5, 2021

Should young teenagers have the COVID vaccine?

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

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

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

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

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

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

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

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

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

References

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

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

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

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

Gov.U.K. Guidance
Coronavirus (COVID-19): antibody testing
Updated 22 August 2021

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

Is Moderna COVID vaccine better than Pfizer Vaccine?

September 6, 2021August 31, 2021

Are all COVID Vaccines equally effective ?

Probably not.

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

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

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

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

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

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

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

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

References

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

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

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

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

Are booster vaccines the way out of this pandemic?

September 5, 2021September 4, 2021

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

Are teachers at higher risk of catching COVID ?

September 3, 2021September 2, 2021

No.

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

Most children in schools are not vaccinated against COVID.

Opening of schools in Scotland has recently increased COVID infections.

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

A recent study published in BMJ is reassuring.

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

References

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

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

COVID-19: Disease versus Vaccine

September 1, 2021August 30, 2021

Two contrasting news about COVID vaccine and disease recently.

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

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

How to interpret this information?

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

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

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

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

What to do?

Ignore information that is not directly relevant to COVID vaccines.

Do NOT mix politics with Vaccines.

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

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

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

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

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

Live to post another day !

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

References

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

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

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

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

Daily Record. Mum-of-three dies after suffering rare reaction to AstraZeneca vaccine
The 47-year-old developed blood clots on her brain – causing a catastrophic stroke – and her fiance Mark Tomlin has now spoken of the devastating impact her death has had on him and five-year-old son Orson.
By Dan Martin Kaitlin Easton
17:46, 27 JUN 2021

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

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

CDC. Vaccines for COVID-19.

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

Are mind numbing jobs associated with dementia ?

August 22, 2021August 21, 2021

Yes.

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

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

The same principle seems to apply to the brain.

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

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

References

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

BBC. Dull jobs really do numb the mind

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

Health problems in middle age

August 11, 2021August 3, 2021

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

This is very a depressing statistic.

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

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

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

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

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

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

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

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

References

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

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

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

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

Prostate Cancer U.K.: Support Groups.

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

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

August 8, 2021August 8, 2021

Yes.

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

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

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

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

Yes, they can.

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

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

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

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

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

A similar report was also published from USA recently.

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

References

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

CDC. How Vaccines work.

CDC. Diseases that Vaccines prevent.

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

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

Coffee and dementia: Good or bad ?

August 7, 2021August 7, 2021

Bad !

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

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

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

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

This study report is no different in that respect.

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

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

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

A 2021 negative report versus a 2017 positive report.

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

But there are no easy answers.

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

References

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

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

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

When will the COVID Virus go away?

August 3, 2021August 3, 2021

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

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

August 2, 2021August 2, 2021

COVID vaccines lose some efficacy over time.

How much ?

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

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

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

References

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

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

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

Why COVID Vaccine boosters may be necessary during winter ?

August 1, 2021July 31, 2021

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

Why?

Two reasons.

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

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

References

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

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

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

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

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

Vaccine for the obesity pandemic !

July 25, 2021July 25, 2021

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

Do COVID vaccines cause heart inflammation?

July 23, 2021July 22, 2021

Yes

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

But that does NOT mean Vaccines have to be avoided.

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

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

References

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

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

A new blood test for cancer

July 19, 2021July 13, 2021

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

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

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

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

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

A word of caution though.

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

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

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

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

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

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

REFERENCES

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

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

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

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

NHS. Should I have a PSA test?

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

Would COVID Vaccination become mandatory for all adults ?

July 13, 2021July 13, 2021

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

But it is not an impossible scenario in European countries.

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

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

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

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

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

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

References

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

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

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

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

Would we be having a third dose of COVID-19 Vaccine as a Booster ?

July 6, 2021July 6, 2021

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.

References

Ministry data said to show Pfizer shot blocks majority of serious Delta cases. Figures reportedly indicate vaccine less effective against contagion from variant, but hospitalizations remain low; officials said weighing use of Moderna for 2nd dose for over 18s. By AMY SPIRO
Today, 10:23 am

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.

Should you elect to wear masks when restrictions are lifted ?

July 5, 2021July 4, 2021

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.

Is Aspirin useful for COVID-19 ?

July 4, 2021July 3, 2021

Many drugs, which are commonly used for other diseases, have been tried in COVID

Aspirin was also tested and it was NOT helpful

Covid-19: Aspirin does not improve survival for patients admitted to hospital, trial reports
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1475 (Published 08 June 2021)
Cite this as: BMJ 2021;373:n1475

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 ?

July 3, 2021July 4, 2021

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.

Should we continue to wear masks and be cautious in public places after July 19th ?

June 29, 2021June 29, 2021

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 !

Of course, some people may feel strongly against any compulsory restrictions and hence it should not be made compulsory.

People, who are comfortable at being cautious, can try to wear masks and practice as much social distancing as possible in public places.

References

BBC News. Covid-19: End of England’s Covid rules still set for 19 July
By Hazel Shearing
BBC News

Daily Mail. Freedom Day ‘will see virtually ALL Covid curbs axed’: Ministers prepare full unlocking on July 19 with masks, social distancing and work from home advice dropped to save shattered businesses – but date will NOT be brought forward. By James Tapsfield, Political Editor For Mailonline
08:29, 23 Jun 2021 , updated 14:52, 23 Jun 2021

Daily Mail. Now Jacob Rees-Mogg joins the calls to DITCH masks as soon as restrictions are lifted: Three Cabinet members break ranks to urge PM to ditch face coverings amid calls for clarity. By Jack Maidment, Deputy Political Editor For Mailonline and James Tapsfield Political Editor For Mailonline
17:40, 24 Jun 2021 , updated 19:56, 24 Jun 2021

Guardian. Vaccines are not magic bullets – we’ll still have to take precautions
Zania Stamataki
To make the most of England’s vaccination rollout we may need to keep wearing masks even after restrictions are lifted
Dr Zania Sta. Tue 22 Jun 2021 06.00 BST

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

Public Health England (page 39).
Investigation of SARS-CoV-2 variants of concern: technical briefings
Technical briefing documents on novel SARS-CoV-2 variants.
Last updated
25 June 2021

European Centre for Disease Prevention and Control. Immune responses and immunity to SARS-CoV-2.
(last update 18 May 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.

Have People died after COVID-19 vaccines ?

May 30, 2021May 29, 2021

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.

So think carefully before you refuse a vaccine.

References

Guardian. Lisa Shaw death: BBC presenter had blood clots after AstraZeneca jab, family says
(Radio Newcastle broadcaster had severe headaches a week after vaccine and fell seriously ill days later, relatives say).
Lisa Shaw
Lucy Campbell
Thu 27 May 2021 18.36 BST

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

BMJ. Research. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1088 (Published 13 May 2021)
Cite this as: BMJ 2021;373:n1088

BMJ. News. Covid-19: Risk of cerebral blood clots from disease is 10 times that from vaccination, study finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1005 (Published 16 April 2021)
Cite this as: BMJ 2021;373:n1005

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.

Vaccine Hesitancy

May 29, 2021May 29, 2021

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.

Should chemotherapy be used before radiotherpy for bladder cancer?

May 24, 2021May 23, 2021

Yes, chemotherapy given before surgery or radiotherapy for invasive bladder cancer improves cure rates and survival rates.

But there is also strong U.K. data to show that Chemotherapy given along with Radiotherapy is useful because it makes radiotherapy work better .

Should chemotherapy be given before radiotherapy and then followed by more chemotherapy along with radiotherapy ?

There is lot of scientific debate on this question and well known U.K. experts are favouring this “double chemo” approach in-spite of inconclusive new data published in the European Urology journal.

The NICE guidelines on bladder cancer also favours this approach of “double” chemotherapy ( before as well as along radiotherapy).

It is a question that ideally needs to addressed in clinical trials .

Read my views expressed in a letter published in the Journal European Urology

Reference: Re: Syed A. Hussain,
Nuria Porta, Emma Hall, et al. Outcomes in Patients with Muscle-invasive Bladder Cancer Treated with Neoadjuvant Chemotherapy
Followed by (Chemo)radiotherapy in the BC2001 Trial. Eur Urol 2021;79:307–15

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.

How effective are the COVID vaccines against the new Indian variant?

May 23, 2021May 23, 2021

Everyone in U.K. hoped that we have turned the corner with this pandemic after the recent spike in infection from the Kent Variant,

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?

Lab testing shows that the current vaccines can be still effective against the Indian variant but may not be highly effective as it is against the Kent/U.K. variant.

PHE data shows that after two doses, Pfizer vaccine is 88% effective against Indian variant compared to 93% effectiveness against the Kent strain.

After two doses, AstraZeneca jab is 60% effective against Indian variant compared to 66% effectiveness against the Kent variant.

But after the first dose, both vaccines were only 33% effective against Indian variant compared to around 50% efficacy against the Kent strain.

The vaccine protection is better with two doses of vaccine and that’s why the Govt is speeding up second vaccine dose in affected areas.

Fingers crossed, hope this strategy works !

References

BMJ. Covid-19: Caution urged while lockdown eases in England because of vaccine success
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1203 (Published 11 May 2021)
Cite this as: BMJ 2021;373:n1203

BMJ News Covid-19: UK cases of variant from India rise by 160% in a week
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1315 (Published 21 May 2021)
Cite this as: BMJ 2021;373:n1315

U.K. Govt. Most vulnerable offered second dose of COVID-19 vaccine earlier to help protect against variants. From: Department of Health and Social Care. Published 14 May 2021

Telegraph: Two doses of AstraZeneca vaccine provide over 80 per cent protection against Indian variant, PHE study finds.

Guardian. India Covid variant: is it a threat to the UK’s reopening plans?
Ian Sample Science editor
@iansample
Fri 14 May 2021 11.19 BST

Daily Mail. UK is in a ‘very good position’ against Covid variants as Pfizer says there is NO proof current jab needs updating to fight mutant strains. By Luke Andrews Health Reporter For Mailonline
16:30, 10 May 2021 , updated 18:12, 10 May 2021

Daily Mail. How deadly is India’s Covid variant and is it REALLY behind explosion of cases? Scientists say ‘perfect storm’ fuelled nation’s crisis and mutant strain just had a ‘head-start’ – as study shows vaccines DO work against it. By Connor Boyd Assistant Health Editor For Mailonline
16:26, 27 Apr 2021 , updated 08:17, 28 Apr 2021

Collier, DA et al. SARS-CoV-2 B.1.1.7 sensitivity to mRNA vaccine-elicited antibodies. Nature; 11 March 2021; DOI: 10.1038/s41586-021-03412-7

BBC. What is the India Covid variant and will vaccines work?
Soutik Biswas
India correspondent

BBC. Covid: Increasing confidence jabs work against Indian variant
By Doug Faulkner
BBC News

ONS. Coronavirus (COVID-19) Infection Survey, UK: 21 May 2021 (“early signs of a potential increase in the week ending 15 May 2021”)

BBC. Covid: Pfizer and AstraZeneca jabs effective against Indian variant – study
By Dulcie Lee
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 views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Can Mistletoe control cancer?

May 17, 2021May 1, 2021

Photo by Pixabay on Pexels.com

No, there is no good clinical evidence to show that Mistletoe therapy improves life expectancy or quality of life of cancer patients.

Laboratory studies have indicated that Mistletoe might have some clinical activity. But activity seen in lab setting is not good enough for using it in actual patients.

The popularity of mistletoe extracts continues unabated despite their unproven efficacy in oncology.

The clinical evidence does not support use of Mistletoe as a standard therapy for cancer.

Mistletoe is best used as Christmas decoration only !

References:

1. Mistletoe and cancer: controversies and perspectives. Patrick J Mansky. Semin Oncol. 2002 Dec.

2. Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem. Peter Fritz et al. Anticancer Res. 2018 Mar.

3. Molecular mechanisms of mistletoe plant extract-induced apoptosis in acute lymphoblastic leukemia in vivo and in vitro. Georg Seifert et al. Cancer Lett. 2008.

4. From ill-defined extracts to the immunomodulatory lectin: will there be a reason for oncological application of mistletoe?H J Gabius et al. Planta Med. 1994 Feb.

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.

New treatment for Cervical cancer

May 15, 2021May 16, 2021

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.

Reference

ESMO 2022 Virtual Plenary Resources:
RANDOMISED PHASE III TRIAL DATA ON THE EFFICACY AND SAFETY OF CEMIPLIMAB AS OPPOSED TO CHEMOTHERAPY IN PATIENTS WITH PROGRESSIVE ADVANCED CERVICAL CANCER. Presenter: Krishnansu S. Tewari, USA; Discussant: Mansoor Mirza, Denmark;

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 ?

May 7, 2021May 7, 2021

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.

Does breast feeding the baby protect the mother from heart diseases in later life ?

March 15, 2021January 4, 2021

Yes, it can.

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.

References

Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3502 (Published 07 October 2020). Cite this as: BMJ 2020;371:m3502. https://www.bmj.com/content/371/bmj.m3502

Selenium can be harmful for Skin cancer patients

March 1, 2021January 4, 2021

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.

Selenium supplementation was found to be ineffective at preventing Skin cancers.

To make matters worse, Selenium was found to Harmful and increased the the risk of getting some skin cancers such as squamous cell carcinoma.

Selenium Supplementation and Secondary Prevention of Nonmelanoma Skin Cancer in a Randomized Trial. Anna J. Duffield-Lillico, Elizabeth H. Slate, Mary E. Reid, Bruce W. Turnbull, Patricia A. Wilkins, Gerald F. Combs, Jr., H. Kim Park, Earl G. Gross, Gloria F. Graham, M. Suzanne Stratton … Show moreJNCI: Journal of the National Cancer Institute, Volume 95, Issue 19, 1 October 2003, Pages 1477–1481, https://doi.org/10.1093/jnci/djg061

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.

Vitamin D reduces risk of advanced cancer in normal-weight individuals.

February 8, 2021January 29, 2021

“An ounce of prevention better than a pound of cure” is certainly true when it comes to cancer prevention.

Vitamin D, the “sunshine” vitamin has been proven to reduce risk of advanced cancers an large American study.

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.”

Reference:

Vitamin D Reduces Incidence of Advanced Cancers in Normal-Weight Individuals. ASCO Annual Meeting 2020.

Anything potentially good from this COVID-19 pandemic?

January 15, 2021January 15, 2021

It might seem foolish to ask the question “Anything good from this COVID-19 pandemic?” when so many people across the world has been so badly affected by the coronavirus pandemic.

There is some truth in the proverb that “every dark cloud has a silver lining” and no matter how bad the current pandemic is now, human spirit and endeavour would get something positive out of it.

One possible good thing that has come out of the pandemic is the “mRNA technology”.

Of the three vaccines so far, two of them the Pfizer vaccine and the Moderna vaccine are based on RNA technology.

The successful use of RNA technology for Coronavirus Vaccines would hopefully enable the versatile RNA technology to be further developed and successfully used a cancer treatment in near future.

Further clinical trials in cancer patients would be done to provide proof of their potential.

References:

Bloomberg. Technology & Ideas. mRNA Vaccines Could Vanquish Covid Today, Cancer Tomorrow.
The best news about the mRNA shots from BioNTech and Moderna is that the same technique could also defeat many other diseases.

MSKCC. In a Twist, Scientists Find Cancer Drivers Hiding in RNA, Not DNA.

Jerusalem Post Health & Science. Israeli scientists use mRNA COVID-19 vaccine technology to fight cancer. By MAAYAN JAFFE-HOFFMAN NOVEMBER 24, 2020 20:08

Where can I find official detailed information about the three COVID vaccines (Pfizer, Astra Zeneca and Moderna)

January 12, 2021January 23, 2021

You might have read information about the COVID vaccines on various news outlets and social media messages.

If you want complete summary information about vaccines approved by the regulatory authorities, click on the links below.

Two types of information leaflets accompany all licensed medicines.
– One is meant for health professionals and has lot of clinical information. (called SPC)
– The other is meant for patients and public and provides a summary of facts using lay terms.(called PIL).

The leaflets provide information about all common side effects observed in the trials.

Oxford Astra Zeneca: Professionals Version .

Oxford Astra Zeneca: Patient Version

Pfizer. Professionals Version

Pfizer. Patient Version

Moderna. Professionals Version

Moderna. Patient Version

FDA USA: Pfizer-BioNTech COVID-19 vaccine prescribing informationexternal

FDA USA: Moderna COVID-19 vaccine prescribing informationexternal

The above links reproduced below with longer titles and date of publication.

Please note when new significant information comes to light, the company and regulatory authorities are likely to update the information leaflets.

Oxford Vaccine : Information for Healthcare Professionals on COVID-19 Vaccine AstraZeneca
Updated 7 January 2021.

Oxford Vaccine: MHRA. Information for UK recipients on COVID 19 Vaccine AstraZeneca
Updated 7 January 2021.

Pfizer Vaccine. MHRA. Information for Healthcare Professionals on Pfizer/BioNTech COVID-19 vaccine
Updated 31 December 2020

Pfizer Vaccine. MHRA. Information for UK recipients on Pfizer/BioNTech COVID-19 vaccine
Updated 31 December 2020

Moderna. MHRA. Information for Healthcare Professionals on COVID-19 Vaccine Moderna
Updated 8 January 2021.

Moderna. MHRA. Information for UK recipients on COVID-19 Vaccine Moderna
Updated 8 January 2021.

A third Vaccine approved for protection against COVID-19 Coronavirus infection

January 10, 2021January 9, 2021

Pfizer Vaccine and Astra Zeneca/Oxford Vaccine were approved last month by the UK regulatory authorities.

Now the regulatory authorities have approved a third vaccine. The third vaccine from Moderna along with two other vaccines should help to bring the pandemic to an end.

The Moderna vaccine is a new technology like the Pfizer Vaccine. (based on mRNA technology).

Like the two vaccines, the short term data for Moderna vaccine is very encouraging.

Over long term, one hopes that the protective effect of all the three vaccines is long lasting and that they remain effective against any new variants of coronavirus that might emerge in the coming months.

Overall, there is certainly ‘light at end of the tunnel’ and the world can emerge out of this horrific pandemic in a short period.

BBC. Moderna becomes third Covid vaccine approved in the UK
By Michelle Roberts
Health editor, BBC News online

BBC.Covid-19: Pfizer/BioNTech vaccine judged safe for use in UK
By Michelle Roberts
Health editor, BBC News online
Published2 December 2020

BBC. Covid-19: Oxford-AstraZeneca vaccine approved for use in UK
By James Gallagher and Nick Triggle
BBC News
Published30 December 2020

MHRA. Oxford University/AstraZeneca COVID-19 vaccine approved.

MHRA. Moderna vaccine becomes third COVID-19 vaccine approved by UK regulator.

MHRA. UK medicines regulator gives approval for first UK COVID-19 vaccine.

Can a Vegan diet help weight loss?

January 1, 2021December 27, 2020

Yes, Vegan diet can help weight loss.

Lot of diets promoted by Magazines, Social Media Influencers and Celebrities do not have strong scientific evidence in favour of them.

A scientifically sound trial published by the medical journal JAMA ( Journal of American Medical Association) recently, found the Vegan Diet helped weight loss and promoted Good metabolism.

The trial involving 244 participants found that over 16 weeks, body weight decreased on average by 5.9 kg in those having a Vegan Diet. That’s very impressive!

References: Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults: A Randomized Clinical Trial
Hana Kahleova et al. JAMA Netw Open. 2020.

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.

New oral medication approved for Prostate Cancer

December 30, 2020December 29, 2020

Advanced Prostate cancer can be successfully controlled for many years by hormone therapy.

Until now, the hormone therapy, which is widely used widely used, involved either hormone injections or hormone implants.

The FDA in USA has recently approved a new novel oral medication for prostate cancer. It acts quickly and has been proven to be highly active. It is taken as a daily oral medication. It is reasonably well tolerated.

It is not known when the medication would be approved in UK and Europe.

References

(1) NEJM. Oral Relugolix for Androgen-Deprivation Therapy in Advanced Prostate Cancer

(2) FDA approval. FDA approves relugolix for advanced prostate cancer.

(3) Information about Relugolix. FDA: HIGHLIGHTS OF PRESCRIBING INFORMATION. and FULL PRESCRIBING INFORMATION.

Is the new variant of Coronavirus more dangerous?

December 20, 2020December 29, 2020

Yes and No

The new mutant is more dangerous because it is more easily transmissible from person to person. The new variant is now spreading very rapidly in London and South East of England.

But, so far, the new variant has NOT been found to be more deadly than the original version. The new variant does NOT seem to have substantially increased the risk of hospitalisation and death anymore than the original version of coronavirus.

Emergence of this new mutant (called variant VUI-202012/01 fall) is a certainly a worrying development in this pandemic.

The mutations has made the new strain 70 per cent more transmissible but scientists do not expect these mutations to reduce the effectiveness of vaccines.

Tests are being carried out to confirm that the existing vaccines would still have a high degree of protective affect.

It is an evolving area and we have to hope that the new variant doesn’t make things worse than they are now !

Covid-19: New coronavirus variant is identified in UK. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4857 (Published 16 December 2020)
Cite this as: BMJ 2020;371:m4857

Should a patient avoid a surgeon on the surgeons’ birthday?

December 19, 2020December 22, 2020

If you are going to have an emergency surgery, it may be worthwhile asking your surgeon whether it is their birthday on that day.

If you accept the findings of a recent study at face value, one should weigh up the pros and cons of seeking a different surgeon if one is available or request your surgeon to be extra careful.

An intriguing paper published in BMJ recently suggests so. The study looked at the outcome of Medicare patients who underwent emergency surgery in USA. It is a very large study in which 980876 procedures performed by 47489 surgeons were analyzed. Hence the study findings do need to be taken very seriously.

The study found that patients operated by surgeons on the surgeons’ birthday had a higher risk of death.

The study provocatively suggests, without any direct proof, that surgeons were possibly distracted on their birthdays and in their rush to go to their birthday celebration, they might have done “botched emergency surgeries” by not concentrating properly during surgery and by not providing good post-operative care.

The findings are entirely plausible from behavioural psychology point of view and the study authors seem to have done a thorough statistical analysis of various factors that could have spuriously affected the death rates.

Nevertheless, there remains a distinct possibility that the study findings are spurious. For instance, the scientific community is aware of the fact that if “any data is tortured enough”, the dataset will cough up spurious and unexpected results.

Apart from data dredging , one has to take findings from observational studies with a “pinch of salt”. That’s why we often see conflicting results about Nutrition published in Newspapers all the time.

Genuine Surgical errors can sometimes lead to death but much more commonly surgical errors can often lead to increase in rate of surgical complications. It is a bit of stretch for the study to suggest that surgeons all over the country are doing “ technically poor surgeries” everyday if that day happens to be their birthday and they are doing it in such a way to cause deaths without causing any surgical complications.

We don’t know whether the study inadvertently looked at male surgeons working on weekends at rural non-teaching hospitals as these factors could have a bearing on death rates.

Sad life events can adversely affect the work performance of any human being. But happy people are more productive at work. So the conclusion by the study that a happy event, such as a birthday, can adversely affect a surgeon’s performance deserves more scrutiny in a well designed study.

Read the full paper at BMJ website and share your views at the BMJ rapid response section.

References.(1). BMJ. Patient mortality after surgery on the surgeon’s birthday: observational study. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4381 (Published 10 December 2020)
Cite this as: BMJ 2020;371:m4381

(2) Conflicting healthy eating advice leaving public ‘clueless’, poll suggests. Rob Knight
Tuesday 16 July 2019 14:56

(3). Does Employee Happiness have an Impact on Productivity?. Saïd Business School WP 2019-13

Is red meat bad for heart?

December 6, 2020December 3, 2020

Yes, red meat can increase the risk of developing heart disease.

A large study involving more than 43,000 men conducted at USA shows that “Red meat increased the risk of developing heart disease “.

In contrast , plant proteins such as nuts and lentils reduced the risk of developing heart disease.

References: Red meat intake and risk of coronary heart disease among US men: prospective cohort study.
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4141 (Published 02 December 2020)
Cite this as: BMJ 2020;371:m4141

Is this the beginning of the end for COVID-19 ?

November 23, 2020November 24, 2020

The superstitious might say “don’t jinx it by calling the end early”……..

So the answer is “may be”.

The good news from two Vaccine trials indicates that this might be “beginning of the end” for COVID-19.

Two recent press reports give rise to lot of optimism to the population that is getting weary with the lockdown. It is good to have a ray of hope among all the doom and gloom.

The covid-19 vaccine (mRNA-1273) from US biotech company Moderna was found to be 94.5% effective.

Another mRNA vaccine developed by Pfizer and BioNTech was reported to be 90% effective.

Now the caveats…. these are interim trial results and the trial results have not been subject to scrutiny by the wider scientific community as the full results are yet to be published.

Clinical Trials usually recruit motivated people without too many other medical problems. So one has to hope that these interim trial results can be replicated in the wider elderly population with lot of medical problems.

Update: Now a third Vaccine, the “Oxford Vaccine” has been found to be 90% effective when given as “a half and then full” schedule.

Update: summary so far at BMJ website.

Let’s hope that all the vaccines are very safe and highly effective when used in the real world population.

References: (1). Covid-19: Vaccine candidate may be more than 90% effective, interim results indicate. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4347 (Published 09 November 2020). Cite this as: BMJ 2020;371:m4347.

(2). Covid-19: Moderna vaccine is nearly 95% effective, trial involving high risk and elderly people shows. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4471 (Published 17 November 2020). Cite this as: BMJ 2020;371:m4471

(3). Covid-19: Oxford vaccine is up to 90% effective, interim analysis indicates
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4564 (Published 23 November 2020)
Cite this as: BMJ 2020;371:m4564

Covid-19: What do we know about the late stage vaccine candidates?. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4576 (Published 24 November 2020)
Cite this as: BMJ 2020;371:m4576

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.

Cancer treatment delays during the pandemic

November 18, 2020November 22, 2020

The Staff at National Health Service in UK are doing an admirable job during the pandemic. In the particular, the frontline staff (“patient-facing”) are showing great courage in face of great difficulties and are primarily driven by altruism.

But the pressures of pandemic means many routine scans and hospital clinic appointments have been cancelled particularly during the first wave. There is a great worry about delayed diagnosis of cancer and delayed treatment of cancer.

A paper in BMJ reports that cancer patients survival can be significantly compromised.

But, as with everything else in life, things are not always what they look like at first impression. Even things that are logical and common sense at first glance do not turn out to be simple and clear.

Firstly, delays and cancellations of scans paradoxically could have psychologically benefited some cancer patients . This might seem counterintuitive or even an outrageous statement.

But there are some cancers which are being over diagnosed. A Cancer diagnosis does not always mean a death sentence. Some cancers do not cause problems for a long time or never in the life time of a person. These cancers do not need to be diagnosed promptly. Not being diagnosed with these cancers prevents the psychological burden of a cancer diagnosis. This “over diagnosis” would be expectedly less during pandemic.

Secondly, treatment delays could be caused by a cancer that is advanced and the need for time consuming additional investigations and procedures. Sometimes delays are caused by patients needing to see many medical specialists for the treatment. So it’s the aggressive cancer and the complex patient care that would cause the delay and is responsible for poor outcome rather than the delay by itself.

Read the BMJ article and make your views known.

Mortality due to cancer treatment delay: systematic review and meta-analysis
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4087 (Published 04 November 2020)
Cite this as: BMJ 2020;371:m4087

Overdiagnosis in Cancer
H. Gilbert Welch, William C. Black
JNCI: Journal of the National Cancer Institute, Volume 102, Issue 9, 5 May 2010, Pages 605–613, https://doi.org/10.1093/jnci/djq099

Disparities in head and neck cancer: assessing delay in treatment initiation
Urjeet A Patel et al. Laryngoscope. 2012 Aug.

Khorana AA, Tullio K, Elson P, Pennell NA, Grobmyer SR, Kalady MF, et al. (2019) . Time to initial cancer treatment in the United States and association with survival over time: An observational study. PLoS ONE 14(4): e0215108. doi:10.1371/journal.pone.0215108