Can vitamins increase risk of cancer ?

Yes

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

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

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

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

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

Worryingly, the review also found that the following:

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

Vitamin C increases lung cancer incidence in women.

Vitamin E increases the risk of haemorrhagic strokes.

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

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

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

Does taking omega 3 fatty acids from plants improve health ?

Yes.

“Alpha linolenic acid (ALA) and linoleic acid is a essential polyunsaturated fatty acids commonly extracted from plants”

These fatty acids are found in “soybean, nuts, canola oils, flaxseed, and other plant foods”.

A recent study published in BMJ shows that these dietary fatty acids are good for overall health and reduces risk of death. The study found benefits in terms of reducing strokes and heart problems but paradoxically these fatty acids slightly increased the risk of death from cancer .

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

Reference: Dietary intake and biomarkers of alpha linolenic acid and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of cohort studies
BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2213 (Published 14 October 2021)
Cite this as: BMJ 2021;375:n2213

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

Does Drinking Coffee reduce the risk of getting prostate cancer ?

Yes

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

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

But a word of caution!

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

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

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

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

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

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

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

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

Can mild air pollution be deadly ?

Heavy Industrial air pollution can be harmful to health.

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

Yes !

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

City dwellers need to be careful !

References

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

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

COVID-19: Disease versus Vaccine

Two contrasting news about COVID vaccine and disease recently.

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

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

How to interpret this information?

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

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

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

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

What to do?

Ignore information that is not directly relevant to COVID vaccines.

Do NOT mix politics with Vaccines.

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

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

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

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

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

Live to post another day !

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

References

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

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

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

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

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

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

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

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

CDC. Vaccines for COVID-19.

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

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

Are mind numbing jobs associated with dementia ?

Yes.

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

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

The same principle seems to apply to the brain.

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

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

References

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

BBC. Dull jobs really do numb the mind

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

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

Health problems in middle age

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

This is very a depressing statistic.

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

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

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

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

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

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

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

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

References

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

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

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

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

Prostate Cancer U.K.: Support Groups.

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

Vaccine for the obesity pandemic !

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

The other pandemic is obesity !

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

The Vaccines promise to end the COVID-19 pandemic.

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

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

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

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

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

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

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

References

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

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

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

Do COVID vaccines cause heart inflammation?

Yes

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

But that does NOT mean Vaccines have to be avoided.

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

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

References

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

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

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

Would COVID Vaccination become mandatory for all adults ?

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

But it is not an impossible scenario in European countries.

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

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

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

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

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

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

References

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

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

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

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

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

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

No !

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

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

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

But the study also showed what we know already. Vaccination does not give 100% protection.

Everyone, in particular, health care staff need to continue with other COVID precautions such as masks, distancing and regular washing as advised by Government.

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

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

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

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

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

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

Does Hand Washing help to prevent COVID-19 ?

Yes,

But the extent to which Hand washing helps is uncertain.

Masks, Social distancing and Vaccination seem to be more highly important than Hand Washing.

Read the very good Guardian newspaper piece on the topic of hand washing.

References

Guardian: Q&A: Does handwashing stem the transmission of Covid-19?
James Tapper
Sun 14 Feb 2021 10.00 GMT

Daily Mail: So which Covid vaccines is Britain getting – and which one is the best? How two companies’ jabs are already being used, another is coming in March and two more could be approved within weeks. By Connor Boyd Assistant Health Editor For Mailonline
11:58, 29 Jan 2021 , updated 02:00, 30 Jan 2021

Daily Mail. Pfizer’s Covid vaccine COULD stop people spreading the virus as well as preventing serious illness, Israeli doctor claims after finding antibody levels surged after second dose. By Emily Webber and Sam Blanchard Deputy Health Editor For Mailonline
12:05, 19 Jan 2021 , updated 14:06, 19 Jan 2021

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

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

Obesity kills but is losing weight in old age also risky ?

Losing weight is a New year resolution for many people. There is no doubt that having a normal weight is healthy overall.

But there is always some degree of uncertainty with any health advice and this BMJ paper certainly gives “food for thought”.

Before you read further , you have understand that there are varying degrees of being overweight. BMI ( Body mass index) is the scientific way of looking at body weight issues and it is calculated using height and weight.

Based on BMI, people are usually classified into three groups:

(a) underweight and normal weight (BMI<25)

b) overweight (BMI 25.0-29.9)

(c) obese (BMI ≥30.0)

There is no doubt that obesity is bad for health. The BMJ paper not supringly found obesity in adulthood increased the risk death.

But, intriguingly, just being overweight only without being obese does NOT seem to have MAJOR impact on risk of death in adults.

Paradoxically, the study found that “weight loss from middle to late adulthood was associated with increased risk of death”

It is large well designed study but nevertheless results of observational studies need to be interpreted with caution.

The message from this study is “do not gain excessive weight during early adulthood“. Losing the excessive weight later on might not undo the damage already done to the body.

References:

(1) Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study.

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l5584 (Published 16 October 2019) Cite this as: BMJ 2019;367:l5584

(2) Free NHS calculator for BMI ( Body mass index calculation) and advice regarding Body mass index.

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

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

Does smoking cause Body pain ?

Yes. Smoking can cause body pain and make you miserable.

Smoking is bad for various obvious reasons including the risk of developing of cancer. As smoking can make you miserable with pain, it’s time to make a new year resolution to stop smoking.

A large study done in UK shows that current and ex-smokers have a higher degree of bodily pain.

The study involved 223,537 people who were surveyed between 2009 and 2013 by the British Broadcasting Corporation (BBC) Lab UK Study.

As it is such a big study, the conclusions do need to be taken seriously.

Definitely another reason for quitting smoking this new year !

Reference:

Associations between smoking status and bodily pain in a cross-sectional survey of UK respondents. Addictive Behaviors 102:106229 · December 2019. DOI: 10.1016/j.addbeh.2019.106229

Smokers past and present ‘live in more pain’ – BBC News

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

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

Can a Vegan diet help weight loss?

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.

Can Pollution affect your heart?

Air pollution, particularly breathing toxic fumes whether it is from a cigarette or a diesel lorry is bad for the lungs.

Can pollution affect your heart as well ?

Yes, it can.

A large study involving more than 8 million people across 184 major cities in China studied the effect of pollution on heart diseases.

The study reports that “short term exposure to Pollutants in air is associated with increased risk of hospital admissions for major heart problems”.

May be everyone living or working close to major roads or high traffic areas should invest in a good mask !!!

Reference

Association between ambient fine particulate pollution and hospital admissions for cause specific cardiovascular disease: time series study in 184 major Chinese cities

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6572 (Published 30 December 2019)

Cite this as: BMJ 2019;367:l6572

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Is it worth stopping smoking after a diagnosis of lung cancer ?

Yes.

It is not too late to stop smoking even after a diagnosis of lung cancer.

A Study presented at the American Society of Clinical Oncology meeting earlier this year reports that ” No matter when smokers quit, their chance of survival increases following a lung cancer diagnosis”.

References

Quitting Smoking at Any Point, Even Close to a Lung Cancer Diagnosis, Improves Chances of Survival. Virtual scientific program of the 2020 American Society of Clinical Oncology (ASCO) Annual Meeting. 

https://www.asco.org/about-asco/press-center/news-releases/quitting-smoking-any-point-even-close-lung-cancer-diagnosis

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.

Is red meat bad for heart?

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

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.

Scientific evidence for a healthy diet and prevention of diabetes

Simple things in life can be the most difficult; For instance, Regular Exercise and a balanced Diet for a healthy life.

What constitutes a healthy diet is common knowledge. For example eating Whole grains, Fresh Fruit and Vegetables )

But what is accepted as common knowledge is not always backed up by robust scientific evidence .

So it is good to see two scientific papers in a recent issue of British Medical Journal with one paper exploring the role of fruit and vegetable consumption on type 2 diabetes and another paper exploring the role of whole grain foods on risk of type 2 diabetes.

1. One study found that Vitamin C and carotenoids have a protective effect against diabetes ( eg diet rich in citrus fruits, tomatoes , root vegetables such as carrots )

A word of caution to those rushing to buy vitamin supplements from the authors : “fruit and vegetable intake, rather than vitamin supplements, is potentially beneficial for the prevention of type 2 diabetes”.

2. Another study found that “whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, significantly reduced the risk of developing diabetes.

References

1. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries.

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2194 (Published 08 July 2020)

2. Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies .

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2206 (Published 08 July 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 publication 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.

Coronavirus re-infection and immunity

Many Viral infections give some sort of immunity to the person infected. For example, if a child has chicken pox, then the child develops immunity to further chicken pox. This immunity can even be life long for many children.

But some viral infections don’t result in significant immunity to further infection. For example, Flu and Common Cold viruses infections do not result in effective long immunity. That’s why flu vaccines are given yearly to vulnerable people.

It was hoped that a Coronavirus infection could result in at least some sort of long immunity to further infections.

A recent report of man who developed Coronavirus/ COVID-19 for the second time is worrying. If this is a widespread phenomenon and not an isolated case, then it has significant implications for the current pandemic.

Herd immunity, whereby many people are immune to further Coronavirus infection either through previous infection or Vaccination, was suggested as the way of ending the current pandemic.

This report, if confirmed to be true across significant sections of population, would indicate a much more longer duration of COVID-19 pandemic.

References:

1. BBC news: Covid reinfection: Man gets Covid twice and second hit ‘more severe’
By James Gallagher
Health and science correspondent

2. Lancet Infectious diseases. Genomic evidence for reinfection with SARS-CoV-2: a case study. Richard L Tillett, PhD, Joel R Sevinsky, PhD, Paul D Hartley, PhD, Heather Kerwin, MPH, Natalie Crawford, MD, Andrew Gorzalski, PhD, et al.
Published:October 12, 2020. DOI: https://doi.org/10.1016/S1473-3099(20)30764-7

3. Lancet Infectious diseases. What reinfections mean for COVID-19. Akiko Iwasaki
Published:October 12, 2020. DOI:https://doi.org/10.1016/S1473-3099(20)30783-0Edridge AWD

4. Edridge AWD, Kaczorowska et al.Seasonal coronavirus protective immunity is short-lasting.Nat Med. 2020; (published online Sept 14.)https://doi.org/10.1038/s41591-020-1083-1View in Article

5. Tillett RL et al. Genomic evidence for reinfection with SARS-CoV-2: a case study.Lancet Infect Dis. 2020; (published online Oct 12.)https://doi.org/10.1016/S1473-3099(20)30764-7View in Article

6. To KK-W et al. COVID-19 re-infection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole genome sequencing.Clin Infect Dis. 2020; (published online Aug 25.)https://doi.org/10.1093/cid/ciaa1275View in Article

7. Van Elslande J et al.Symptomatic SARS-CoV-2 reinfection by a phylogenetically distinct strain.Clin Infect Dis. 2020; (published online Sept 5.)https://doi.org/10.1093/cid/ciaa1330View in Article

8. Prado-Vivar B et al.COVID-19 re-infection by a phylogenetically distinct SARS-CoV-2 variant, first confirmed event in South America.SSRN. 2020; (published online Sept 8.) (preprint)https://doi.org/10.2139/ssrn.3686174View in Article

9. Dearlove B et al. A SARS-CoV-2 vaccine candidate would likely match all currently circulating variants.Proc Natl Acad Sci USA. 2020; 117: 23652-23662View in Article

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.

Which is better for COVID-19 protection : face masks or face shields.

Various type of masks are used by public for protection against COVID-19.

Some wear cloth masks. Some use medical disposable masks. Some wear face shields particularly those working in shops.

Are they all the same?.

No

Recent evidence indicates that standard light-blue disposable surgical masks are the most effective at containing the Cornovirus.

Face shields were found to be failing when compared with standard ( triple layer) medical grade masks.

References

1. Face shields ineffective at trapping aerosols, says Japanese supercomputer. Guardian Newspaper. Justin McCurry in Tokyo. Tue 22 Sep 2020 07.19 BST. https://www.theguardian.com/world/2020/sep/22/face-shields-ineffective-trapping-aerosols-japanese-supercomputer-coronavirus

2. Do cloth masks work? Supercomputer Fugaku says yes.World’s fastest computer calculates that nonwoven fabric is best. YUKI MISUMI, Nikkei staff writer. August 25, 2020 00:34 JST. https://asia.nikkei.com/Business/Technology/Do-cloth-masks-work-Supercomputer-Fugaku-says-yes

3. Visualizing droplet dispersal for face shields and masks with exhalation valves. Physics of Fluids 32, 091701 (2020); https://doi.org/10.1063/5.0022968

4. Visualizing the effectiveness of face masks in obstructing respiratory jets. Siddhartha Verma, Manhar Dhanak, and John Frankenfield. https://aip.scitation.org/doi/10.1063/5.0022968
Phys Fluids (1994). 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.

Do soft drinks increase the risk of an early death?

Yes.

Soft drinks do increase risk of an early death.

In a large study involving 451 743 individuals from 10 countries in Europe, the regular consumption of soft drinks increased the risk of death.

The increased risk was seen with both sugared drinks as well as artificially sweetened drinks. Worryingly the hazard from artificially sweetened drinks seems higher.

The take home message: drink more water !

References

1. JAMA . Association Between Soft Drink Consumption and Mortality in 10 European Countries. JAMA Intern Med. Published online September 3, 2019. doi:10.1001/jamainternmed.2019.2478.

2. Daily Mail. Just TWO glasses of diet drinks each day may raise the risk of an early death, reveals study by the World Health Organisation.

3. The Guardian. Soft drinks, including sugar-free, linked to increased risk of early death.

COVID-19 risk assessment of NHS members : is it an opportunity missed?

The National Health Service had recently embarked on a Risk assessment exercise of its staff to assess the Vulnerability of individual members to Coronavirus infection ( COVID-19).

The exercise is being done with good intentions. Given the unprecedented situation of the pandemic and lack of concrete data , the exercise seemed to have steered away from firm “one size fits all” type of recommendations.

Given the uncertainties with the currently available data on various forms of protection ( from simple surgical masks to shielding) , the exercise could have been a starting point for an nationwide intervention study .

An opportunity seems to have been missed and if there is a second wave, NHS might regret not learning from the first wave.

Please do add your opinion at the rapid response section of the BMJ.

References

1. Covid-19 risk assessment in BAME staff

Covid-19 risk assessment: a futile metaphorical strip search

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3251 (Published 26 August 2020)

Cite this as: BMJ 2020;370:m3251

2. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2743 (Published 15 July 2020)

Cite this as: BMJ 2020;370:m2743

3. Complete protection from covid-19 is possible for health workers

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2641 (Published 07 July 2020)

Cite this as: BMJ 2020;370:m2641

4. Two metres or one: what is the evidence for physical distancing in covid-19?

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3223 (Published 25 August 2020)

Cite this as: BMJ 2020;370:m3223

Can Coffee cause abortion ?

Yes, it can .

Coffee can harm pregnancy. Coffee can cause miscarriage, stillbirth, lower birth weight, and preterm birth.

Hence various guidelines do advise reduction in coffee consumption during pregnancy.

A recent study in BMJ group journal goes further and suggests avoiding coffee altogether during pregnancy.

There are caveats but those who want to be very cautious should consider avoiding coffee during pregnancy just like one avoids alcohol during pregnancy.

References

1. Guardian Newspaper. No safe level of coffee drinking for pregnant women, study says.

2. BMJ Evidence-Based Medicine. Jack James RT al. Reykjavik University

3. Independent newspaper. No safe level of caffeine consumption for pregnant women and would-be mothers, study suggests

4. World Health Organization. Restricting caffeine intake during pregnancy.

5. UK. Food Standards Agency. Assessment of caffeine consumption, altered caffeine metabolism and pregnancy outcome.

5. NICE. National Institute for Health and Care Excellence. New recommended drinking guidelines welcomed by NICE.

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.

If you survive the Coronavirus, Can you get Coronavirus infection again ?

Yes, you can get infection again.

Last month, we had studies reporting that the immunity to Coronavirus fades quickly after recovering from an infection. The scientists have warned that re-infection is a risk.

Now, we have a case in Hong Kong where a patient seem to have been unlucky to get the infection again. It is a worrying report and suggests that coronavirus is going to be with us for a long time.

The only reassuring fact is that patient was free of symptoms during second infection. One has to hope that all re-infections are mild !

References

1. Sundar.blog. CAN YOU GET CORONAVIRUS INFECTION MORE THAN ONCE?

2. BBC. Hong Kong reports ‘first case’ of virus reinfection.

3. Clinical Infectious Diseases : report on twitter.

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 publication 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.

Can you catch Coronavirus infection from Soft drink cans, Sandwich wrapper and Amazon Parcels?

Yes. Possible but chances are very small according to reports.

If someone sneezed or coughed near a parcel or food package and you touch it within a few hours, it is possible to get Coronavirus infection from parcels and packages.

But, in practice, most parcels and food packaging seem safe and no conclusive real world evidence has been published so far to indicate that packages spread infection widely.

In experimental conditions, Coronavirus has been shown to survive for upto 72 hours. The virus is “more stable on plastic and stainless steel than on copper and cardboard”.

In laboratory conditions “On copper, no viable SARS-CoV-2 virus was measured after 4 hours . On cardboard, no viable SARS-CoV-2 virus was measured after 24 hours”.

In the artificial conditions of the lab “The longest viability of viruses was on stainless steel and plastic; the estimated median half-life of SARS-CoV-2 virus was approximately 5.6 hours on stainless steel and 6.8 hours on plastic”.

Solution: If you are worried , and if possible, you can try leaving parcels for 24hrs before touching them with bare hands. Alternatively, try wearing disposable gloves to remove packaging.

References

1.NEJM. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. April 16, 2020. N Engl J Med 2020; 382:1564-1567. DOI: 10.1056/NEJMc2004973

2. BBC. Coronavirus: What are the risks of catching it from food packaging?

3. CDC. How It Spreads.

Is Honey a better treatment for coughs and colds ?

Possibly yes, in some cases of viral infections , according to a paper published a BMJ group journal ( BMJ Evidence Based Medicine) .

The paper has been widely quoted in various newspapers today.

The BMJ group journal authors report: “Honey was superior to usual care for the improvement of symptoms of upper respiratory tract infections.

It provides a widely available and cheap alternative to antibiotics…….but further high quality, placebo controlled trials are needed.”

A word of caution: Honey has high sugar content. Diabetics need to be careful. People will allergies need to take care. Of course bacterial infections need antibiotics particularly in old and vulnerable!

References

1. BMJ Evidence Based Medicine. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis .

Abuelgasim H, Albury C, Lee J Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis BMJ Evidence-Based Medicine Published Online First: 18 August 2020. doi: 10.1136/bmjebm-2020-111336.

2. Guardian Newspaper:

3. Daily Mail.

4. BBC paper review .

5. Evening Express

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 publication 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.

Is weight loss a sign of cancer?

If you have been dieting and exercising to shed excess weight, then you can celebrate your success in achieving your goal.

But some poorly lose weight unintentionally . This type of weight loss that occurs without intention might be of concern in some people.

A recent article in BMJ advocates screening for cancer in some patients if they have weight loss and other symptoms in their chest and abdomen.

Male smokers over the age of 50 are one of the high risk groups !

Don’t ignore weight loss !

References

Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2651 (Published 13 August 2020)

Cite this as: BMJ 2020;370:m2651

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 publication 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.

Can a Protein rich diet lead to a longer life ?

Yes, a protein rich diet can lead a longer life and reduce risk deaths due to heart diseases.

Before you rush to relish your burger or steak , please note the evidence for beneficial effect is very much in favour of plant proteins than animal proteins.

So Befriend your Beans !

And Love your Lentils !

Reference

Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2412 (Published 22 July 2020)

Cite this as: BMJ 2020;370:m2412

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 publication 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.

Can you get Coronavirus infection more than once?

If you are one of the unlucky ones to have already been infected with Coronavirus infection but recovered from it, can you become unlucky again and get another Coronavirus infection later this year ?

Unfortunately, the answer is a YES.

Some Viral infections can sometimes lead to life long immunity. For example, most people who had chicken pox as a child tend to have lifelong immunity and it would be uncommon to get chicken pox again. (except in some circumstances).

But infection with ‘Coronavirus causing COVID-19’ doesn’t seem led to long lasting immunity or resistance to a second Coronavirus infection.

A Newspaper report on a study by a team from King’s College London suggests that susceptibility to a second infection may occur as short as 3 months in some patients. This because the level of antibodies produced by the immune system after first infection start to fade away within a few months in some patients.

If confirmed, this is probably one of the most worrying news during this pandemic.

This study result could also affect Vaccine development and how frequently it may need to be administered.

References

Guardian Newspaper: Coronavirus outbreak. Immunity to Covid-19 could be lost in months, UK study suggests. Ian Sample. Science editor. @iansample. Sun 12 Jul 2020 17.31 BST

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 publication 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.

Can Coronavirus linger in air, and cause COVID-19 by spreading through air ?

Normally many flu-like viruses spread by direct or close contact.

Because Virus containing droplets are heavier than air, scientifically it is thought that when someone coughs or sneezes, virus particles quickly fall to ground or surrounding objects.(“like a brick or stone falling to ground“).

But a group of scientists and WHO have raised the possibility that coronavirus can stay in air for longer periods, float around and cause more infections. (“float like a balloon“). This is called air-borne transmission.

What does it mean?

If confirmed– this means “closed spaces” are high risk even if you maintain 2 metre distance from an infected person. AVOID CLOSED SPACES.

As many people in UK do not wear masks in public places, there is a high chance of second wave of infections in the coming weeks as lock down is eased. WEAR A MASK.

It also means avoiding non-essential visitors to hospitals so that visitors cannot catch the infection or pass the infection to vulnerable patients. AVOID NON-ESSENTIAL VISITORS AT HOSPITALS.

If air borne transmission is confirmed, it is also bad news for the coming winter.

If Coronavirus is still in community and not eliminated by winter, air-borne transmission is likely to result in further wave of infections.

This is because Winter means more closed spaces and more chance of infection !!!!!!

STAY SAFE

References

1. Daily Mail Newspaper. Group of 239 scientists demand that WHO admit coronavirus is AIRBORNE -meaning the public should wear masks indoors and AC units should be fitted with filters .By Ariel Zilber For Dailymail.com and Reuters and Associated Press. 17:44, 05 Jul 2020 , updated 08:14, 06 Jul 2020

2. Guardian Newspaper. WHO underplaying risk of airborne spread of Covid-19, say scientists. Open letter says there is emerging evidence of potential for aerosol transmission. Hannah Devlin. Science correspondent. @hannahdev

3. Guardian Newspaper. Coronavirus outbreak Global report: WHO says ‘evidence emerging’ of airborne coronavirus spread. Martin Farrer and agencies.

4. BBC News. Coronavirus: WHO rethinking how Covid-19 spreads in air.

5. It is Time to Address Airborne Transmission of COVID-19. Lidia Morawska, Donald K Milton. Clinical Infectious Diseases, ciaa939, https://doi.org/10.1093/cid/ciaa939. Published: 06 July 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 publication 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.

Can Vitamin D prevent respiratory infections such as COVID-19 ?

No conclusive evidence yet.

Some studies suggest a protective effect but two recent “official” reviews in UK has concluded the following.

(1). “The available evidence does not support vitamin D supplementation to prevent acute respiratory tract infections in the general UK population”.

(2). “There is currently no evidence to support vitamin D supplements reducing the risk or severity of covid-19″.

References

NICE. Covid 19 rapid evidence summary: vitamin D for covid-19 evidence summary. 29 June 2020. http://www.nice.org.uk/advice/es28/chapter/Key-messages.

Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017;356:i6583. doi:10.1136/bmj.i6583 pmid:28202713

Evidence does not support vitamin D for reducing respiratory infections, reviews conclude. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2629 (Published 30 June 2020). Cite this as: BMJ 2020;369:m2629

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 publication 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.

Can Vitamin K help fight Coronavirus?

Possible but like every other observational study, take it with pinch of salt.

Further evidence from well conducted trials are needed before it can be recommended as a COVID treatment.

In mean time, it’s better to stick to natural sources of vitamin such as those mentioned in the newspaper article ( spinach, broccoli, green vegetables, blueberries, all types of fruit and vegetables).

Guardian Newspaper: Vitamin K could help fight coronavirus, study suggests

Scientists in Netherlands explore possible link between deficiency and Covid-19 deaths

Daniel Boffey. Fri 5 Jun 2020 14.50 BST

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 publication 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.

Does Eating Eggs lead to Heart problems?

No, Eating Eggs in moderation is not associated with increased Heart problems.

Heart diseases are one of major killers in Men and Women. In the past, Cholesterol was exclusively blamed for most of the Heart problems. Nowadays, such a simplistic view has been abandoned. We now know that Heart diseases are due to a complex set of poor diet and life style.

Previously Eggs which have lot of dietary cholesterol have been subject to lot of bad press.

A recent pooled analysis of good quality data shows that ” moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations.”

So like everything else with regards to diet , moderation is the way to go !

Reference

Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m513 (Published 04 March 2020)

Cite this as: BMJ 2020;368:m513

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Is Chloroquine useful in treatment of Corona Virus?

Chloroquine and the related drug Hydroxy-Chloroquine are drugs commonly used to prevent and treat Malaria infections; and treat some Joint conditions.

During the initial stages of COVID-19 pandemic, there were some reports of Chloroquine being useful in treating Corona Virus.

A Chinese trial published in British Medical Journal BMJ now reports that ” Administration of hydroxychloroquine did not result in …. any meaningful antiviral benefits… compared to standard of care alone in patients admitted to hospital with mainly persistent mild to moderate covid-19

Chloroquine was not only useless but it had significant side effects in a minority. So Chloroquine or Hydroxy-Chloroquine should not be used routinely outside a clinical trial setting.

References

1. Hydroxychloroquine (HCQ). Wiki. https://en.m.wikipedia.org/wiki/Hydroxychloroquine

2. BMJ. Chloroquine and hydroxychloroquine in covid-19. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1432 (Published 08 April 2020)

3. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1849 (Published 14 May 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 publication 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.

Face Masks: Should Public wear face masks because of Corona Virus pandemic ?

Should Public wear face masks because of Corona Virus pandemic ?

Yes.

In some of the Asian Countries there has been universal acceptance of face masks even before Corona Virus pandemic. Hence, it is not surprising that there is wide spread use of face masks during this pandemic .

In USA, after initial hesitation, CDC now recommends use of cloth face masks by public.

In Germany, many states have made face masks compulsory.

In UK, there has been no official recommendation about widespread use of face masks.

With so many unknowns, it is prudent to follow the advice published in British Medical Journal : WEAR A MASK !!

References

1. USA CDC. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

2 Germany: BBC news. Coronavirus: Germany’s states make face masks compulsory. 22 April 2020. https://www.bbc.co.uk/news/world-europe-52382196

3. TIME Magazine. https://time.com/5815251/should-you-wear-a-mask-coronavirus/

4. BMJ paper. Analysis. Face masks for the public during the covid-19 crisis. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1435 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1435

5. BMJ editorial. Editorial. Covid-19: should the public wear face masks?. Editorials. Covid-19: should the public wear face masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1442 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1442

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

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 publication 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 expressed are not substitute for professional advice.

Does air pollution in cities make your jogging and walking less beneficial ?

Yes, air pollution is now being recognised as an important cause of death in major cities and towns.

So avoid major roads and very busy streets.

Any benefit you might accrue from exercise can be wiped out by heavy air pollution if you are jogging on a heavily congested road.

References

1. Telegraph: Pollution wipes out the benefits of exercise, study suggests

2. BMJ . Air pollution. Short term exposure to fine particulate matter and hospital admission risks and costs in the Medicare population: time stratified, case crossover study

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6258 (Published 27 November 2019)

3. Telegraph. Does exercising in pollution do you more harm than good?

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Blaming the tools

Tools

Any one from any trade would be expected to use the tools of the trade appropriately.

Tweaking the tools unnecessarily or blaming the tools if things do not pan out as planned is generally frowned upon .

Same with medical professionals !

Please contribute your thoughts at BMJ rapid response page.

Interpreting test results: dont blame the tools

Access the article at: http://bmj.com/cgi/content/full/bmj.m1162

Toll-free link:
http://bmj.com/cgi/content/full/bmj.m1162?ijkey=sZarWS4YlJf9NS0&keytype=ref

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Plain English Medical Letters to Patients

Writing letters to patients in plain English without medical jargon is a gift that only a few doctors possess.

Personalising complex medical terminology in a letter dictated over a few minutes is NOT an inherent skill possessed by many doctors including those who are native English speakers.

Dictating Plain English medical letters would take considerable time and effort – particularly if letters are going to succinctly summarise everything from a medical consultation.

In UK, with regards to Cancer, we are lucky to have cancer charities who do a good job of providing information in plain English ( E.g Cancer Research UK, Macmillan Cancer Support, Prostate Cancer UK).

Cancer Patients in UK also have the support of Cancer Nurse Specialists ( CNS ) who do a fantastic job of guiding patients through their cancer journey and clarify all medical jargon to patients.

Other specialities might not have the resources that are available to cancer patients. But, on the whole, Clinic Time slots are precious. Many UK specialists have long waiting lists.

So if further time and effort is to be expended in busy clinics for dictating plain English Letters – in addition to the usual Medical letters to GP – good clinical evidence is needed to demonstrate that separate plain English letters do benefit patients in a meaningful way.

Please do read the BMJ article and put forward your views in the rapid response section.

Access the article at: http://bmj.com/cgi/content/full/bmj.m949

Toll-free link:
http://bmj.com/cgi/content/full/bmj.m949?ijkey=nxJ9CdIVHKZW1Jd&keytype=ref

Disclaimer:

The views expressed here are my personal views and do not represent the views of any other professional organisation I am associated with…

Do omega 3 supplements provide protection from Stroke and Heart diseases?

It is a common belief that omega 3 fatty acids provide protection from strokes and heart attacks, and improve overall health.

A review from the esteemed Cochrane collaboration pours cold water on this belief.

The review concludes that omega 3 provides ” little or no meaningful effect on the risk of death from any cause”.

They conclude that “omega 3 supplements probably makes little or no difference to risk of cardiovascular events, coronary heart deaths, coronary heart disease events, stroke or heart irregularities”.

The review did find “moderate evidence that ALA, found in plant oils (such as rapeseed or canola oil) and nuts (particularly walnuts) may be slightly protective of some diseases of the heart and circulation”.

However, the effect was very small. They estimated that “143 people would need to increase their ALA intake to prevent one person developing arrhythmia”.

They also estimated that “One thousand people would need to increase their ALA intake to prevent one person dying of coronary heart disease or experiencing a cardiovascular event”.

Overall the review finds that overall “omega 3 provides little if any benefit at all”.

References

New Cochrane health evidence challenges belief that omega 3 supplements reduce risk of heart disease, stroke or death.

Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No.: CD003177. https://www.cochrane.org/CD003177/VASC_omega-3-intake-cardiovascular-disease

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Walking is good exercise

New year. January. First month of a New year – it’s the time of year many people take a look at their lifestyle and vow to eat better, exercise better and live better.

Many people consider Gym or Health Club membership.

But Exercise doesn’t need to cost a lot. Being active, doesn’t need to be regimented.

Simply walking anywhere is good compared to no exercise at all. Walking in the Park or Quiet streets has lot of benefits.

Good article in BBC on the benefits of walking.

A word of caution though !

Avoid Walking or Jogging near busy roads so that the benefits of walking are not negated by pollution.

Reference

1. BBC. 8 reasons why we should all walk more. BBC.

2. Guardian. Traffic fumes in city streets ‘largely wipe out exercise benefits for over-60s’.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Is whole milk harmful ?

In years gone by , many viewed milk as a wholesome healthy food. Government encouraged consumption of milk by providing free milk.

But in recent years, milk is viewed with suspicion.

Vegans shun milk and diary products.

Perhaps the Vegans got it right all along at least as far as whole milk is concerned.

A very large study involving 168 153 women and 49 602 men was published recently in British Medical Journal. The study found that whole milk intake is associated with increased risk of death from heart problems and from some cancers such as lung cancer, ovarian cancer, and prostate cancer.

Interestingly “Cheese and yogurt intake was NOT associated with increased risk of death”.

The risk was also less with “skimmed or low fat milk”.

References

1. Government Cheap Milk Scheme. Br Med J 1940; 2 doi: https://doi.org/10.1136/bmj.2.4170.806-b (Published 07 December 1940)

2. Vegetarian diets. BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b2507 (Published 08 July 2009)

3. Associations of dairy intake with risk of mortality in women and men: three prospective cohort studies. BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6204 (Published 27 November 2019). Cite this as: BMJ 2019;367:l6204

Futile antibiotic treatments

Infections are normally highly treatable with antibiotics.

But when someone is dying , the body’s immune system gets weaker. Hence infections quite often occur as part of the dying process.

Treating these infections are often futile. But human nature is inclined to “fight and survive” by all means. So quite often powerful antibiotics are used to treat these infections in dying patients.

There is an ethical argument against futile treatments.

There is also the risk of antibiotic resistance in general population if antibiotics are used inappropriately.

Submit your views at BMJ journal website (rapid response section).

References

Access the article at: http://bmj.com/cgi/content/full/bmj.l6706

Toll-free link:

http://bmj.com/cgi/content/full/bmj.l6706?ijkey=ZXN1zz6QXpPz8np&keytype=ref

Can long working hours kill you?

Yes, it can.

It has been well established by systemic review that working long hours can lead to excessive heart attacks. ( ref 1).

A recent French study indicates that working long hours can lead to increased risk of stroke ( Long hours defined as more than 10 hours on at least 50 days per year in this study) (ref 2).

So look after yourself and don’t push yourself too hard !

References

1. Long Working Hours and Coronary Heart Disease: A Systematic Review and Meta-Analysis .

2. Long working hours ‘linked to stroke risk’ BBC News.

Can weather affect joint pain?

Yes, weather can affect joint pain.

A study involving 2500 people conducted by University of Manchester study showed that “people with arthritis feel more pain on humid days”

The study reports that “Damp and windy days with low pressure can increase risk of experiencing more pain than normal”

Cold, damp days also made pain worse but interestingly pain was not made by temperature alone”.

Other studies in the past have also found a “significant correlation between humidity and pain“.

References

BBC News. People ‘more likely to feel pain on humid days’.

Does rheumatoid arthritis disease activity correlate with weather conditions?

The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis.

“Think Positive “ and live longer !

People with sunny disposition seems to live longer.

Having a positive outlook on life seems to protect heart.

Is it a case of “chicken vs egg” in that what came first. Do healthy people have a optimistic outlook and pessimistic people have lot of social, personal and health problems. Do life problems make people pessimistic or being optimistic makes one do better?

Researchers have adjusted the data for confounding factors. Evidence so far is very intriguing.

And the next question is – can one learn to be optimistic, change personality and have beneficial health effects. We don’t know at present.

References

1. Guardian. Optimists have lower risk of heart problems and early death.

2. Guardian. Optimism may hold secret to longer life, study suggests.

3. The association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA)

4. JAMA. Association of Optimism With Cardiovascular Events and All-Cause Mortality

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Crowdfunding expensive stem cell therapies

Crowd fund metaphor

If you have come across a desperate request to crowdfund an expensive stem cell therapy, read this well researched BBC article before you contribute.

Hope is a powerful driver particularly when someone is facing immense difficulties in life. Human beings have a natural inclination to fight against all odds and it seems to be inbuilt in our DNA and psyche.

But not all promising treatments do help desperate people searching for a cure.

Reference.

BBC news. The unwarranted hype of stem cell therapies. By Jules Montague. 21 August 2019

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Dietary advice: take it with a pinch of salt

Official dietary advice as well as various “Diets” promoted by various celebrities tend to be very prescriptive. They often give the impression that the evidence behind everything they promote is very clear cut.

But truth is far more murkier ( I might say more “mish mash “).

A new study analysis of old data comes to a different conclusion about “red meat”. This is in fact not surprising as the evidence for various Dietary guidelines and “Diets” are not usually robust and watertight and involves lot of assumptions.

What is the take home message:

Eat “everything you like” in moderation and try to make it as balanced as possible with substitutes for things you avoid !!

Avoid processed food as much as possible and eat fresh.

Don’t be surprised if the next two studies on this topic reach three different conclusions.

References

1. BBC news. Is red meat back on the menu?

2. New York Times. Eat Less Red Meat, Scientists Said. Now Some Believe That Was Bad Advice.

3. The original study article from Annals of Internal Medicine. Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium.

4. Daily Mail. You DON’T need to cut out red meat: Scientists say official advice on eating less beef, pork and lamb is based on bad evidence and having it four times a week poses ‘NO cancer risk’ 

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Veliparib : Another new drug for treatment of Ovarian Cancer

Veliparib trial data has certainly brought more options to the table in treatment of advanced Ovarian cancer.

Trial data presented at ESMO congress at Barcelona shows that first line therapy with Veliparib is beneficial.

Acknowledgement: Copyright of Slides: Authors and ESMO

References

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.