June 2024

June 12,2024 New Delhi: US based vaccine developer, Moderna announced the Phase III trial data for its COVID-19/influenza combination vaccine, mRNA-1083. The data suggest that the vaccine has potential to counter infectious diseases, says GlobalData, a data-analysis company. In the study the investigational combination mRNA vaccine generated statistically higher immune responses in comparison to the licensed comparator vaccines used in the randomised, observer-blind, active control study among 8,000 adults aged 50 years and older. Moderna in the trials reported that a single dose of mRNA-1083 met immunogenicity non-inferiority criteria versus the licensed comparator vaccines: Fluzone high-dose and Fluarix for influenza, and Spikevax for COVID-19, and has generated higher immune responses against the influenza strains including H1N1, H3N2, and B/Victoria, as well as SARS-CoV-2. The investigational combination vaccine displayed an acceptable safety and tolerability profile, with the most commonly reported adverse reactions being injection site pain, fatigue, myalgia, and headache. The development comes less than two weeks after Moderna’s FDA approval of the first mRNA respiratory syncytial virus (RSV) vaccine, mRESVIA, further demonstrating the potential of mRNA technology in combating infectious diseases. Commenting over it an expert Stephanie Kurdach, Infectious Disease Analyst, GlobalData said, “The development of a COVID-19/influenza combination vaccine could be advantageous to patients, as it would decrease the number of injections needed to provide sufficient protection against multiple respiratory illnesses. The development of a combination vaccine is strategic for pharmaceutical companies, as successful uptake of the vaccine can translate to significant market shares under multiple indications.” “If approved, Moderna’s COVID-19/influenza combination vaccine will be an important addition to the vaccines market. The positive Phase III data provides further validation of how mRNA technology is advancing the infectious diseases pipeline,” Kurdach added. Many experts have expressed positive opinions on the development of a COVID-19/influenza combination vaccine, as well as the advancement of vaccines for infectious diseases due to mRNA technology considering that mRNA vaccines require a shorter production time, have the potential to incorporate large numbers of antigens, and may therefore be more efficacious than traditional vaccines. Source: Pharma

June 13,2024 New Delhi: Children and foetuses exposed to hot and cold environments impact their brain’s white matter, responsible for connecting various brain regions and enabling communication, a new research has found. Researchers said that children are especially vulnerable to extreme environments as their bodies’ temperature regulation processes are still immature. They also found that early exposure could have lasting effects on the microstructure of white matter in the brain. These findings are published in the journal Nature Climate Change. “We know that the developing brain of foetuses and children is particularly susceptible to environmental exposures, and there is some preliminary evidence suggesting that exposure to cold and heat may affect mental well-being and cognitive performance in children and adolescents,” said lead researcher Monica Guxens, Barcelona Institute for Global Health (ISGlobal), Spain, and the study’s corresponding author. However, there is a lack of evidence with regards to how such exposure can bring about structural changes in the brain, Guxens said. The research team studied the exposure of close to 2,700 preteens to monthly temperatures from birth until they turned eight years old. They used magnetic resonance imaging (MRI) brain scans. The impacts of the exposure were measured between nine-12 years of age. For this, the researchers assessed the preteens’ white matter connectivity by measuring how water flowed and spread in their brains, or ‘mean diffusivity’. In more mature brains, water flows more in one direction than in all directions, showing lower mean diffusivity, the study said. The team found that exposure to colder-than-usual temperatures during pregnancy and the first year of life, and exposure to hotter-than-usual environments from birth until three years of age were linked with more mean diffusivity at preadolescence, pointing to a slower maturation of their white matter. “The fibres of the white matter are responsible for connecting the different areas of the brain, enabling communication between them. As the white matter develops, this communication becomes faster and more efficient,” said first author Laura Granes, a researcher at ISGlobal. “Our study is like a photograph at a particular moment in time and what we see in that image is that participants more exposed to cold and heat show differences in a parameter — the mean diffusivity — which is related to a lower level of maturation of the white matter,” said Granes. Previous studies have shown changes in mean diffusivity to be related with poorer cognitive function and mental health problems. Source: Healthworld

June 13,2024 Chennai: Apollo Hospitals has identified a much-needed intervention in fatty liver diagnosis in India. Out of over 50,000 people (53,946), who underwent comprehensive preventive health checks at Apollo Hospitals, 33 per cent were diagnosed with fatty liver. However, among those with fatty liver, only one in three had their liver enzymes elevated, indicating that diagnosis interventions in our healthcare systems need to go beyond just relying on blood tests for early detection and reversal of such conditions in all individuals. Currently, the diagnosis of fatty liver disease mainly relies on a combination of patient history, physical examination, and blood tests, including liver enzyme levels and markers of liver function. Imaging studies, such as ultrasound and fibro scan, can help visualise the liver and detect fat accumulation, even in cases where liver enzyme levels may not show any significant deviation. Despite this, ultrasound is not always the first choice due to accessibility and perceived necessity based on initial non-imaging assessments. MASLD increases mortality related to liver diseases and cardiovascular, and oncological complications. Commenting on this, Dr N Murugan, Senior Consultant Hepatologist & Liver Transplant Physician, Apollo Hospitals, Chennai, said, “The lack of timely diagnosis of fatty liver disease (FLD) is a growing concern. Particularly metabolic dysfunction-associated steatotic liver disease (MASLD), caused by factors other than excessive alcohol use, is increasingly prevalent in India due to rising rates of obesity, diabetes, and metabolic syndrome. Despite its growing incidence, FLD often goes undiagnosed because it’s largely asymptomatic in early stages and would not necessarily reflect through a LFT blood test.” “Early and accurate detection through imaging techniques like ultrasound could lead to timely interventions, lifestyle modifications, and treatment plans that could significantly improve patient outcomes. Therefore, I urge healthcare professionals to consider adopting ultrasound as a more routine diagnostic tool for fatty liver disease and using its benefits are more widely utilised to enhance patient care,” added Dr Akash Roy, Senior Hepatologist, Apollo Hospitals, Kolkata. Weight reduction is known to be one of the ways to reverse fatty liver in its early stages. Even a 5 per cent to 10 per cent reduction in body weight can significantly reduce liver fat and inflammation. Dr Sathya Sriram, CEO, Preventive Health, Apollo Hospitals, said, “We have also advocated for integrating ultrasound as a safe and critical component of health checks, recognising its significant clinical benefits for true preventive care. We hope more and more healthcare providers start utilising imaging for enhancing patient care, especially in early detection of fatty liver disease.” Fatty liver disease is related to obesity and diabetes, all of which indicate metabolic dysfunction. Consuming excessive carbs raises insulin levels, and chronic high insulin levels lead to insulin resistance. This disrupts metabolism and converts excess glucose into fatty acids, which are stored in the liver. FLD can be classified into two main types: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD/MASLD). MASLD can further progress to non-alcoholic steatohepatitis (NASH/MASH), which involves liver inflammation and damage and can eventually lead to fibrosis, cirrhosis, or liver cancer. Source: Healthworld

June 13,2024 New Delhi: After witnessing the horrors, devastation, and large-scale human suffering caused by a once-in-a-generation global pandemic, it seemed like things were getting back on track and the Indian healthcare ecosystem is in recovery mode. However, the recent bird flu cases in India serve as a reminder of the persistent threat posed by zoonotic disease developments. From the episodes of Nipah virus outbreaks to the recent bird flu cases underscore the need for robust surveillance and preventive measures to manage zoonotic diseases effectively, informed experts. Last week the World Health Organisation (WHO) confirmed the first ever death of a human being due to bird flu in Mexico, while in India the issue started hitting the headlines after the world health body confirmed the second-ever case in the country and the first since 2019 of a human infection attributed to the avian influenza A (H9N2) virus, commonly referred to as bird flu, in a four-year-old child from West Bengal. Understanding the gravitas of the problem and to dissect its overlooked aspects ET HealthWorld spoke to several experts Providing the basic description of the problem Dr Mohan Kumar Singh, Senior Consultant Internal Medicine, Marengo Asia Hospital, Gurugram said, “So far we know that H9N2 is a subtype of avian influenza virus, commonly found in birds. While it primarily infects birds, it can occasionally infect humans, including children. This is the second such case in our country, as confirmed by WHO. The virus can spread through two different ways: direct contact with infected animals or indirect contact with polluted settings and environment.” On being asked about the prevention and precautions from the disease Dr Singh suggested, “To prevent H9N2 infection, it is essential to limit exposure to live poultry and bird markets since these types of environments can act as hotspots for viral transmission. Maintaining good hygiene by washing hands frequently, especially after handling birds or their environments, is crucial. Wearing protective gear, such as gloves and masks, when working with birds can reduce direct contact with potential viral sources. Furthermore, getting the yearly flu shot can provide some cross-protection against H9N2, even if there isn’t a specialized vaccination for it.” Talking about its management the expert suggested, “Antiviral drugs like zanamivir (Relenza) or oseltamivir (Tamiflu) must be used as soon as possible if you are infected in order to lessen the frequency and severity of your symptoms. Supportive care is equally important, focusing on staying well-hydrated, getting a good amount of rest, and using fever reducers to manage symptoms effectively. Seek immediate medical attention, in case of breathing difficulties as it may require hospitalisation.” Voicing his stance on the problem another expert Dr Nasiruddin G, Consultant-Internal Medicine, Fortis Hospital, said,” The WHO confirmed a 4-year-old in India tested positive for H9N2 bird flu, the second such case in the country. This strain typically causes mild illness, but this child did require hospitalisation. The infection likely occurred through contact with poultry, as the child had no reported close contacts with other cases. H9N2 rarely spreads between people, but health officials monitor these cases because flu viruses can mutate.” “As a precaution, people in India, especially those around poultry farms, should practice good hygiene, avoid close contact with sick birds, and cook poultry products thoroughly,” Dr Nasiruddin added. Dr Praveen Gupta, Principal Director and Chief of Neurology, Fortis Hospital voiced similar views and urged for extensive monitoring at various hotspots. He said, “The recent report of a bird flu case in India is alarming and necessitates immediate action. Forest officials and wildlife personnel must adopt stringent safety protocols, such as wearing gloves and protective gear when handling dead birds.” “Alongside, there should be an increase in monitoring and preventive measures to swiftly identify and contain new cases. This includes setting up checkpoints for wildlife health, increasing testing in areas with previous outbreaks, and educating the public about the signs of bird flu and the importance of avoiding contact with wild birds. Proactive steps in surveillance and hygiene can help to mitigate the spread of this potentially dangerous virus.” Dr Gupta added. Commenting over the potential diagnostic strategies to detect the rare disease Dr Manish Mannan, HOD – Paediatrics and Neonatology, Paras Health, Gurugram said,” Diagnosing H9N2 requires a combination of clinical suspicion and laboratory testing. If a child presents with symptoms suggestive of bird flu and has a history of bird exposure, a respiratory sample (swab or wash) will be collected and tested for the specific influenza virus strain. Early diagnosis is crucial for prompt treatment and isolation to prevent further spread. Adding to the management aspect Dr Mannan said, “The infection primarily involves supportive care to manage symptoms like fever and dehydration. Antiviral medications are typically used to shorten the illness duration and reduce the risk of complications. In severe cases, additional supportive measures like oxygen therapy or respiratory assistance might be needed. Sharing her opinion on how to mitigate the risk in the initial stages Dr Neha Rastogi Panda, Consultant-Infectious Diseases, Fortis Gurugram suggested to, “Ensure that poultry reaches an internal temperature of 165°F (74°C) to kill any virus; avoid live bird markets: If possible, opt for poultry from reputable sources.” Mentioning that the disease is mild in humans, and treatment is similar to that of other influenza viruses, including antiviral medications like Tamiflu, Dr Sushila Kataria, Senior Director, Internal Medicine, Medanta,said, “H9N2 bird flu is a type of influenza A virus primarily found in birds. Human transmission is possible due to the same, usually occurring through close contact with infected birds. This includes individuals handling poultry, such as those working in hatcheries, who are at a higher risk of infection. H9N2 bird flu is not highly transmissible and does not have the potential to become a pandemic, as its R0 (basic reproduction number) is very low. Therefore, there is no cause for widespread concern. But, people with comorbid conditions, children, and the elderly with low immunity are more susceptible to infections and should take extra precautions. By adhering

June 01,2024 New Delhi: Amid a global rise in metabolic disorders such as gut health issues, heart diseases, and obesity, organic jaggery is gaining significant recognition for its exceptional health benefits in both Indian and international markets. India’s jaggery market is projected to expand at a Compound Annual Growth Rate (CAGR) of 12.31 per cent from 2024 to 2032, with the market size reaching INR 63.51 1 billion in 2023. Clinical Dietitian and Diabetes Educator Ms. Kanikka Malhotra says, “Jaggery’s appeal goes beyond its delicious taste. Unlike refined sugar, which is stripped of its nutrients during processing, jaggery retains a wealth of antioxidants. These antioxidants help combat free radicals in the body, potentially reducing the risk of chronic diseases like cancer and heart disease.” Malhotra further highlights jaggery’s potential for digestive health and asserts, “Jaggery is a natural source of minerals like potassium, magnesium, and iron. These minerals may play a role in aiding digestion and preventing constipation. Additionally, the presence of potassium in jaggery may help regulate blood pressure, potentially contributing to better heart health However, Malhotra emphasises moderation as key, stating, “Remember, jaggery is still a form of sugar. It’s best to consume it in moderation and limit your overall intake of added sugars. Jaggery offers a natural sweetness with a potential health boost, making it a compelling option for those seeking a more balanced approach to their diet.” With obesity affecting 1 in 8 people globally2, according to a World Health Organisation report, metabolic disorders like obesity, diabetes, and high blood pressure are widespread. Incorporating jaggery into diets offers a hopeful solution. Mukesh Singh, Founder and Director of Jivamrit Agro Organic Foods, says, “Given the health benefits and growing demand for organic jaggery, our goal is to make organic food products, including jaggery, affordable and accessible to everyone. This will help people include these healthy options in their diet, supporting their efforts to stay fit and prevent metabolic diseases.” Singh adds further, “Jivamrit’s organic jaggery is naturally processed from specially grown sugarcane and is rich in essential vitamins and minerals. It helps reduce water retention, boosts metabolism, and supports weight loss. Recognising the needs of health-conscious consumers, Jivamrit has introduced both organic jaggery and jaggery powder.” Globally, the Netherlands is the top jaggery exporter, followed by the United States, Germany, Malaysia, and Slovakia3. Organic jaggery’s health benefits are gaining worldwide acceptance. Organic jaggery is gaining global acceptance due to its significant health benefits. By providing naturally processed jaggery, Jivamrit aims to contribute to a healthier nation, ensuring that consumers have access to a nutritious alternative to refined sugar. Source: Healthworld

June 02,2024 Washington DC: Scaling back treatment for three kinds of cancer can make life easier for patients without compromising outcomes, doctors reported at the world’s largest cancer conference. It’s part of a long-term trend toward studying whether doing less – less surgery, less chemotherapy or less radiation – can help patients live longer and feel better. The latest studies involved ovarian and esophageal cancer and Hodgkin lymphoma. Thirty years ago, cancer research was about doing more, not less. In one sobering example, women with advanced breast cancer were pushed to the brink of death with massive doses of chemotherapy and bone marrow transplants. The approach didn’t work any better than chemotherapy and patients suffered. Now, in a quest to optimize cancer care, researchers are asking: “Do we need all that treatment that we have used in the past?” It’s a question, “that should be asked over and over again,” said Dr. Tatjana Kolevska, medical director for the Kaiser Permanente National Cancer Excellence Program, who was not involved in the new research. Often, doing less works because of improved drugs. “The good news is that cancer treatment is not only becoming more effective, it’s becoming easier to tolerate and associated with less short-term and long-term complications,” said Dr. William G. Nelson of Johns Hopkins School of Medicine, who was also not involved in the new research. Studies demonstrating the trend were discussed over the weekend at an American Society of Clinical Oncology conference in Chicago. Here are the highlights: French researchers found that it’s safe to avoid removing lymph nodes that appear healthy during surgery for advanced ovarian cancer. The study compared the results for 379 patients – half had their lymph nodes removed and half did not. After nine years, there was no difference in how long the patients lived and those with less-extreme surgery had fewer complications, such as the need for blood transfusions. The research was funded by the National Institute of Cancer in France. This German study looked at 438 people with a type of cancer of the esophagus that can be treated with surgery. Half received a common treatment plan that included chemotherapy and surgery on the esophagus, the tube that carries food from the throat to the stomach. Half got another approach that includes radiation too. Both techniques are considered standard. Which one patients get can depend on where they get treatment. After three years, 57% of those who got chemo and surgery were alive, compared to 51% of those who got chemo, surgery and radiation. The German Research Foundation funded the study. A comparison of two chemotherapy regimens for advanced Hodgkin lymphoma found the less intensive treatment was more effective for the blood cancer and caused fewer side effects. After four years, the less harsh chemo kept the disease in check in 94% of people, compared to 91% of those who had the more intense treatment. The trial included 1,482 people in nine countries – Germany, Austria, Switzerland, the Netherlands, Denmark, Sweden, Norway, Australia and New Zealand – and was funded by Takeda Oncology, the maker of one of the drugs used in the gentler chemo that was studied. The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The is solely responsible for all content. Source: Healthworld

June 04,2024 New Delhi : Healthcare has been a major canvassing point in the Lok Sabha election 2024. As the counting continues for the General Lok Sabha Elections, the BJP-led National Democratic Alliance (NDA) is seeking to form a government that will give Prime Minister Narendra Modi a third term. With far fewer numbers, whether the Modi government will be able to fulfil the hefty promises made for the next five years remains to be seen. As Indians depend heavily on private services, the National Health Policy (NHP) 2017, which promises to increase public health spending to 2.5 per cent of GDP, is long overdue. So the question remains: will affordable healthcare services for Indian citizens be just an election doldrum or will it see real-time development? Will Modi 3.0 make any difference by increasing public expenditure on healthcare to the desired level in India? Analysts and experts in the healthcare segment voice the sector’s expectations. Speaking to ETHealthworld, Dr Girdhar Gyani, Director General, Association of Healthcare Providers (AHPI), said, “Healthcare has become an election agenda. New government will have to increase allocation to 2.5 per cent of GDP. It has to include the underprivileged population within the scope of Ayushman Bharat. It will have to incentivise the private sector to open tertiary care hospitals in tier III towns.” Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AiMeD) said, “We expect the new government to boost manufacturing of medical devices and bring in a predictable tariff regime that makes manufacturing viable without being overly protectionist and instead focuses on monitoring and regulations of labelled prices of medical devices as that’s what is charged to consuming patients and they are currently being taken for a ride with artificially inflated prices.” “We want to encourage fair marketing based on quality and value, not on pushing products with high-profit margins. For a while now, we’ve been asking for rules that stop companies from artificially raising prices on medical device labels. This practice hurts honest manufacturers and marketing companies. Instead, we want fair competition based on the real value of the products, not inflated prices,” added Nath. He also stated that a separate regulatory framework for medical devices will ensure patient safety and quick access to affordable innovative options while keeping manufacturers disciplined and acting responsibly. Dr Praveen Gupta, Principal Director & Chief of Neurology, Fortis Hospital, stated that the impact of a UPA (United Progressive Alliance) or NDA (National Democratic Alliance) win in Lok Sabha polls on the healthcare market can vary based on the policies and priorities of the winning party. “NDA manifesto promises aim to put healthcare accessibility and quality in the front seat. Firstly, by providing sanitary pads at Rs 1, there’s a focus on improving women’s healthcare. Secondly, initiatives will target the prevention and reduction of ailments like anaemia, breast cancer, cervical cancer, and osteoporosis, with a specific goal to eliminate cervical cancer,” said Dr Gupta. “Ayushman Bharat will be expanded to cover non-EWS and SC/ST senior citizens, and regular Ayush camps will offer elders holistic healthcare rooted in traditional practices. The manifesto also promises to eradicate malnutrition among tribal children, and provide comprehensive healthcare in tribal areas, including combating sickle cell anaemia,” he added. Dr Aashish Chaudhry, Managing Director, Aakash Healthcare, said, “Our healthcare infrastructure has undergone significant improvements. The government’s proactive approach has brought healthcare needs to the forefront. However, this journey is far from over. As we look ahead, I expect the National Democratic Alliance (NDA) government to continue prioritizing healthcare for the next five years. Continued priority-healthcare must remain a central focus. We need sustained efforts to strengthen our healthcare system, enhance medical facilities, and ensure access to quality care for all citizens.” Stressing upon Public-Private Partnership (PPP), Dr Chaudhry said, “To accelerate progress, the government should foster a conducive environment for private players. Collaborations between public and private sectors can lead to innovative solutions, increased capacity, and better outcomes. Infrastructure Boost -Investments in healthcare infrastructure—such as hospitals, clinics, and research centers—are crucial. Upgrading existing facilities and building new ones will enhance our preparedness for future health crises.” He also added that the new government should focus on curative measures that are vital, and preventive healthcare deserves equal attention. Promoting healthy lifestyles, vaccination drives, and early disease detection can significantly improve overall well-being. Adding to it Dr Gupta said the NDA has started several initiatives, like Ayushman Bharat, for the benefit of the people, and hopefully, the new government, either the NDA or INDIA will continue. Health has been and should be an important focus for all governments. Source: Healthworld

June 06,2024 Washington: A man’s death in Mexico was caused by a strain of bird flu called H5N2 that has never before been found in a human, the World Health Organisation said Wednesday. The WHO said it wasn’t clear how the man became infected, although H5N2 has been reported in poultry in Mexico. There are numerous types of bird flu. H5N2 is not the same strain that has infected multiple dairy cow herds in the U.S. That strain is called H5N1 and three farmworkers have gotten mild infections. Other bird flu varieties have killed people across the world in previous years, including 18 people in China during an outbreak of H5N6 in 2021, according to a timeline of bird flu outbreaks from the U.S. Centers for Disease Control and Prevention. Mexican health officials alerted the WHO that a 59-year-old man who died in a Mexico City hospital had the virus despite no known exposure to poultry or other animals. According to family members, the WHO release said, the patient had been bedridden for unrelated reasons before developing a fever, shortness of breath and diarrhea on April 17. Mexico’s public health department said in a statement that he had underlying ailments, including chronic kidney failure, diabetes and high blood pressure. Hospital care was sought on April 24 and the man died the same day. Initial tests showed an unidentified type of flu that subsequent weeks of lab testing confirmed was H5N2. The WHO said the risk to people in Mexico is low, and that no further human cases have been discovered so far despite testing people who came in contact with the deceased at home and in the hospital. There had been three poultry outbreaks of H5N2 in nearby parts of Mexico in March but authorities haven’t been able to find a connection. Mexican officials also are monitoring birds near a shallow lake on the outskirts of Mexico City. Whenever bird flu circulates in poultry, there is a risk that people in close contact with flocks can become infected. Health authorities are closely watching for any signs that the viruses are evolving to spread easily from person to person, and experts are concerned as more mammal species contract bird flu viruses. Source: Healthworld

June 08,2024 Barcelona: The fact that individuals with type 2 diabetes have elevated fasting glucose levels is among the most perplexing factors for them. This is due to the fact that in these insulin-resistant individuals, the liver produces glucose, a process that still raises many unanswered issues for scientists. The most significant developments in our knowledge of this mechanism are now presented in a review paper that was published in the journal Trends in Endocrinology & Metabolism. In the battle against type 2 diabetes mellitus, which the World Health Organization (WHO) lists as one of the pandemics of the twenty-first century, it also aids in the discovery of novel therapeutic targets. The UB Institute of Biomedicine (IBUB), the Sant Joan de Deu Research Institute (IRSJD), the Faculty of Pharmacy and Food Sciences at the University of Barcelona, the Centre for Biomedical Research Network on Diabetes and Associated Metabolic Diseases (CIBERDEM), and Professor Manuel Vazquez-Carrera are the study’s leaders. Experts Emma Barroso, Javier Jurado-Aguilar, and Xavier Palomer (UB-IBUB-IRJSJD-CIBERDEM) as well as Professor Walter Wahli from the University of Lausanne (Switzerland) are involved in the work. Type 2 diabetes mellitus is an increasingly common chronic disease that results in high levels of circulating glucose — the cellular energy fuel — due to a deficient insulin response in the body. It can cause severe organ damage and is estimated to be under-diagnosed in a high percentage of the affected population worldwide. In patients, the glucose synthesis pathway in the liver (gluconeogenesis) is hyperactivated, a process that can be controlled by drugs such as metformin. “Recently, new factors involved in the control of hepatic gluconeogenesis have been identified. For example, a study by our group revealed that growth differentiation factor (GDF15) reduces the levels of proteins involved in hepatic gluconeogenesis”, says Professor Manuel Vazquez-Carrera, from the UB’s Department of Pharmacology, Toxicology and Therapeutic Chemistry. To make progress in the fight against this pathology, it will also be necessary to further study pathways such as TGF-b, which is involved in the progression of metabolic dysfunction-associated fatty liver disease (MASLD), a very prevalent pathology that often coexists with type 2 diabetes mellitus. “TGF-b plays a very relevant role in the progression of liver fibrosis and has become one of the most important factors that may contribute to increased hepatic gluconeogenesis and, therefore, to type 2 diabetes mellitus. Therefore, studying the involvement of the TGF-b pathway in the regulation of hepatic gluconeogenesis could help to achieve better glycaemic control”, stresses Vazquez-Carrera. However, acting on a single factor to improve the regulation of gluconeogenesis does not seem to be a sufficient therapeutic strategy to adequately control the disease. “It would be important to be able to design combination therapies that could consider the different factors involved to improve the approach to type 2 diabetes mellitus”, Vazquez-Carrera says. “Today there are several molecules — TGF-b, TOX3, TOX4, etc. — that could be considered therapeutic targets for designing future strategies to improve patients’ well-being. Their efficacy and safety will determine their therapeutic success. We cannot lose sight of the fact that controlling the overactivation of hepatic gluconeogenesis in type 2 diabetes mellitus has an additional difficulty: it is a key pathway for making glucose available in fasting situations, it is finely modulated by numerous factors and this makes regulation difficult”, he adds. Interestingly, other factors involved in the control of gluconeogenesis have also been identified in patients hospitalised with COVID-19 who showed high glucose levels. “Hyperglycaemia was very prevalent in patients hospitalised with COVID-19, which seems to be related to the ability of SARS-CoV-2 to induce the activity of proteins involved in hepatic gluconeogenesis”, the expert notes. The mechanisms of action of metformin, the most commonly prescribed drug for the treatment of type 2 diabetes, which reduces hepatic gluconeogenesis, are still not fully understood. It has now been discovered that the drug decreases gluconeogenesis via inhibition of complex IV of the mitochondrial electron transport chain. This is a mechanism independent of the classical effects known until now through activation of the AMPK protein, a sensor of the cell’s energy metabolism. “Inhibition of mitochondrial complex IV activity by metformin — not complex I as previously thought — reduces the availability of substrates required for hepatic glucose synthesis”, says Vazquez-Carrera. In addition, metformin can also reduce gluconeogenesis through its effects on the gut, leading to changes that ultimately attenuate hepatic glucose production in the liver. “Thus, metformin increases glucose uptake and utilisation in the gut, and generates metabolites capable of inhibiting gluconeogenesis when they reach the liver via the portal vein. Finally, metformin also stimulates the secretion of GLP-1 in the intestine, a hepatic gluconeogenesis inhibitory peptide that contributes to its anti-diabetic effect”, he explained. (ANI) Source: Healthworld

June 03,2024 New Delhi: Delhi’s Karkardooma Court dismissed the bail plea of Dr Akash, who has been arrested in connection with the New Born Baby Care hospital fire case. In this case, eight babies have died so far. It was argued that Dr Akash was a trainee at the hospital. He was neither an employee nor in a supervisory capacity. Chief Metropolitan Magistrate Vidhi Gupta Anand dismissed the bail plea of Dr Akash after hearing submissions of defence counsel and an additional public prosecutor (APP). Advocate Naveen Kumar Singh, counsel for Dr Akash argued that he (Akash) is neither an employee, nor in a supervisory capacity. There is no appointment letter. He is a Bachelor of Ayurvedic Medicine and Surgery (BAMS). In January 2024, he joined the hospital as a trainee, the counsel added. It was also submitted that Akash was assisting the nursing staff. Dr Naveen Khichi does the treatment. The accused never treated any patients or gave any prescriptions. It is an old hospital. He is 26 years old; can he be given a supervisory capacity? defence counsel asked. He (Akash) was just following the instructions of the doctor and the nursing staff. He is 26 years old. How can he be in a supervisory role? It is the start of his career, he enrolled in 2023, the defence counsel added. It has also been submitted that it is an accident. This fire started on the second floor by a short circuit. Death happened due to suffocation, not burns. In this way, how can he be responsible for all this? The defence counsel also submitted that there is a lack of procedure. His career will be spoiled if he is kept in jail, accused is from a poor family; he is not influential, the counsel said. He further stated that the fire started on the second floor with the cylinder used for patient treatment. Before the arrival of police and fire staff, they rescued seven babies. There is a discrepancy between the dates of arrest May 26 and 27. Prosecution opposed his bail application. Additional public prosecutor (APP) argued that allegations are serious. The offence is punishable with life imprisonment. It is triable by court of session. This case should be transferred to court of session. The investigation was at initial stage, APP argued. It also submitted that accused was not a trainee. He was overall in charge in the night. He fled from the hospital. General public informed about the incidents. He did not inform the police or fire department; instead, he called Dr Naveen Khichi. Delhi Police also said that a dead body was also kept in ICU prior to this incident. High Court is also seized of the matter. It is also stated that one more baby has died. Total 8 babies have died so far. Defence counsel submitted in rebuttal that police have inquired into the cause of fire. What is his role in the fire? He (accused) saved 7 babies, the defence counsel said. Source: Healthworld