Is Diclofenac better than opioid drugs such as morphine, oxycontin, codeine, tramadol for knee arthritis pain ?

Yes.

Diclofenac is sometimes overlooked as a pain killer before people go on to stronger morphine-like prescription pain killers.

A study published in BMJ suggests that Diclofenac tablets take by mouth is effective for pain due to arthritis.

Overall, Diclofenac, taken by mouth, seem to be effective and generally safer than Opiod drugs. But caution is needed particularly in elderly people with multiple other medical problems.

Interestingly, Diclofenac Cream applied over the skin and Joints seem to be particularly effective for Knee arthritis pain.

Applying the cream also overcomes the problem of Diclofenac side effects, since very little of Diclofenac reaches other parts of the body.

The authors recommend Diclofenac Skin Cream as first line pharmacological treatment for knee osteoarthritis.

References

BMJ. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis
BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2321 (Published 12 October 2021)
Cite this as: BMJ 2021;375:n2321

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.

Have People died after COVID-19 vaccines ?

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.

Are COVID-19 vaccines safe in Children ?

Yes, Israel has vaccinated vulnerable children and there have been NO reports of unusual or unexpected reactions.

Pfizer has just released positive results of a study which looked at safety and efficacy of the Vaccine in 12 to 15 year olds.

Pfizer-BioNTech covid-19 vaccine has shown 100% efficacy against SARS-CoV-2 in 12 to 15 year olds.

The Vaccine reassuringly was well tolerated, and the side effects were no different from those observed in the group aged 16 to 25.

What about much more younger children?

A vaccine trial in the children aged 6 months to 11 years has been started recently and results should be available later this year.

References

SKY news. Wednesday 31 March 2021 14:35, UK

The Guardian. Wed 31 Mar 2021 14.20 BST

BMJ News. Covid-19: Pfizer reports 100% vaccine efficacy in children aged 12 to 15
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n881 (Published 01 April 2021)
Cite this as: BMJ 2021;373:n881

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

How long does it take for taste sensation to recover after Radiotherpy to Head and Neck region ?

Curative Radiotherpy to Tongue, Mouth , Throat and other parts of head and Neck can lead to dry mouth, sticky saliva, difficulty in swallowing solid foods, and loss of taste sensation.

Loss of taste sensation affects food intake and affects quality of life.

A group from Tel Aviv studied the effect of radiotherapy on taste sensation in head and neck cancer patients.

They found that “taste recovery started to occur 1 month after treatment completion

References:

The effect of radiotherapy on taste sensation in head and neck cancer patients – a prospective study. Michal Asif et al. Radiat Oncol. 2020. Radiat Oncol. 2020 Jun 5;15(1):144. doi: 10.1186/s13014-020-01578-4. Authors: Michal Asif, Assaf Moore, Noam Yarom, Aron Popovtzer.

Oral complications at 6 months after radiation therapy for head and neck cancer. R V Lalla et al. Oral Dis. 2017 Nov. Oral Dis. 2017 Nov;23(8):1134-1143. doi: 10.1111/odi.12710. Epub 2017 Aug 3.

Prospective assessment of taste impairment and nausea during radiotherapy for head and neck cancer. Stefania Martini et al. Med Oncol. 2019 Apr 9;36(5):44. doi: 10.1007/s12032-019-1269-x.

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.

Why are some people falsely sceptical of COVID Vaccines?

Disclaimer: A personal view point !

“Vaccines hesitancy” is a problem in some sections of society.

A significant minority of people have an unhealthy scepticism about all vaccines in general fuelled by misinformation on social media. Some people in western world, who haven’t seen the horrors that can be wrecked by infectious diseases, have an ill-informed view about all Vaccines.

Vaccines have played a significant role in protection against various deadly infections diseases in the past century. The infectious diseases of childhood have become less prevalent even in developing countries now. But there is a risk of Vaccine Hesitancy spreading to these third world developing countries .

That is not to say that all vaccines are free of side effects. Lot of people do have mild side effects after any vaccination. But very serious side effects are rare.

The concerns of people with Vaccine Hesitancy particularly relating to COVID Vaccine is genuine. The COVID vaccines have been rapidly developed and there are no long term efficacy or toxicity data. Because it is a global emergency, countries are forced to begin COVID vaccination based on the available excellent short term efficacy and safety data. Only time can tell whether the Governments got it right over long term.

But there is no evidence to suggest secrecy or conspiracy surrounding development of various vaccines including COVID vaccines. For instance, two reports of severe allergies due to COVID vaccine was immediately brought to the attention of everyone by Regulatory authorities in UK.

It is now reported that Norway is investigating deaths after coronavirus vaccination in very frail elderly people. Any adverse report on vaccines will be investigated and made public.

Rare individual stories of serious side effects is understandably shocking. It is human nature not to risk when one personally feels well at a particular point in time.

It is very important to remember that life is full of risks. People make decisions every day based on benefits versus risks ( eg driving a car). People need to understand that the benefits from most vaccines against infections diseases significantly outweighs the risks of various vaccine side effects. While a handful have serious side effects, many millions do benefit from the all vaccines.

“Vaccines hesitancy” is also not helped Historic mistrust of government in sections of population which regrettably can make things difficult in terms of achieving good vaccine coverage at population level.

If you have concerns about vaccines –

“Do read information about Vaccines with an open mind and pay attention to high quality population level studies assessing risks versus benefits and ignore individual unsubstantiated stories”.

“Do speak to your doctor about your concerns with an open mind”.

“Do NOT always seek information that affirms your views and Worries. Do seek reliable information that challenges your views on vaccines before you make your choice”.

References

JAMA Insights Clinical Update
January 21, 2021
Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine
Tom Shimabukuro, MD, MPH, MBA1; Narayan Nair, MD2
Author Affiliations
JAMA. Published online January 21, 2021. doi:10.1001/jama.2021.0600

BMJ. Covid-19: Norway investigates 23 deaths in frail elderly patients after vaccination
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n149 (Published 15 January 2021)
Cite this as: BMJ 2021;372:n149.

Guillain-Barré syndrome after vaccination in United States: data from the Centers for Disease Control and Prevention/Food and Drug Administration Vaccine Adverse Event Reporting System (1990-2005)
Nizar Souayah et al. J Clin Neuromuscul Dis. 2009 Sep.

The Atlantic. Anti-vaxxers Think This Is Their Moment. Society’s well-being depends on how well public-health officials and average internet users combat misinformation. DECEMBER 20, 2020
Renée DiResta.
Technical research manager at the Stanford Internet Observatory.

Countering Vaccine Hesitancy. Kathryn M. Edwards, Jesse M. Hackell and THE COMMITTEE ON INFECTIOUS DISEASES, THE COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE
Pediatrics September 2016, 138 (3) e20162146; DOI: https://doi.org/10.1542/peds.2016-2146

Guardian. Covid vaccine: 72% of black people unlikely to have jab, UK survey finds.
Linda Geddes
Sat 16 Jan 2021 07.00 GMT

Lazarus JV, Ratzan SC, Palayew A, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med 2020 doi: 10.1038/s41591-020-1124-9

BBC. Royal Marsden’s leading cancer expert Martin Gore dies.
Published 11 January 2019

Times. Cancer pioneer Martin Gore’s sudden death from routine jab.
David Brown
Friday January 11 2019, 12.01am, The Times

The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations
Emilie Karafillakis et al. Vaccine. 2017.

BMJ. The rush to create a covid-19 vaccine may do more harm than good. BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3209 (Published 18 August 2020)Cite this as: BMJ 2020;370:m3209

MHRA: Confirmation of guidance to vaccination centres on managing allergic reactions following COVID-19 vaccination with the Pfizer/BioNTech vaccine

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

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not 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.

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

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.

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.