August 2024

August 23,2024 The NHRC has taken suo motu cognisance of an explosion that killed at least 17 workers and injured several others at a private industrial unit in Andhra Pradesh’s Anakapalli district and directed the authorities to conduct a thorough investigation. A major fire and explosion ripped through a pharma unit on Wednesday. The damage could have been worse but fewer workers were in the plant when the accident occurred due to it being lunchtime. The death toll is expected to rise as search operations continue. The National Human Rights Commission (NHRC) in a statement on Friday expressed deep concern over the apparent violation of safety norms that led to the incident. The commission has issued notices to the Andhra Pradesh chief secretary and the director general of police, directing them to conduct a thorough investigation in the matter. The probe is expected to examine if the industrial unit adhered to all safety regulations and legal requirements and whether there was any negligence on the part of the authorities responsible for supervising the facility. The NHRC has mandated that a detailed report be submitted within two weeks. The report should include the status of the FIR filed in connection with the incident, the treatment being provided to the injured and the disbursement of compensation to the kin of those killed or injured. The commission has also sought information on any relief and rehabilitation efforts undertaken for the victims and the action taken against officials found responsible. The explosion sparked widespread concern, with State Disaster Response Force teams continuing its search for survivors. The cause of the explosion remains unclear and the authorities fear that more bodies may be trapped under the rubble. Source: Economic Times

August 24,2024 Brussels: The European Commission on Friday approved Moderna’s respiratory syncytial virus (RSV) vaccine for older adults — the first time the bloc has authorised an mRNA shot against a disease other than Covid-19. RSV is a highly contagious seasonal virus that can cause severe symptoms in infants and the elderly — one in 20 of whom contract it each year in Europe, according to the European Centre for Disease Prevention and Control (ECDC). In the European Union, Norway and United Kingdom, RSV leads to the hospitalisation of around 158,000 adults each year, as well as some 213,000 children under five, according to ECDC data. “Vaccination saves lives,” the EU’s commissioner for health and food safety, Stella Kyriakides, said in a statement announcing the approval of Moderna’s mResvia vaccine. “We are determined to ensure that everyone has access to the protection that they need against serious diseases.” The authorisation, which follows a similar step by the US Food and Drug Administration in May, is based on a positive assessment by the European Medicines Agency (EMA) in June. The EMA approved the use of mResvia for the prevention of lower respiratory tract disease (LRTD), which is caused by RSV, in adults of 60 and older. The EU had previously approved two vaccines for protecting against RSV, manufactured by Pfizer and GSK. GSK and Pfizer’s vaccines rely on traditional technology: introducing a pathogen component to the immune system to trigger a response. In contrast, Moderna’s vaccine utilises cutting-edge messenger RNA (mRNA) technology, instructing the body to produce a unique protein that stimulates an immune response, teaching it to defend against the infection. “This approval of the first mRNA vaccine against RSV clearly shows the importance of innovation when it comes to protecting the health of our citizens,” Kyriakides said. Stephane Bancel, Moderna’s chief executive, said the commission’s approval was “an important milestone for public health and highlights Moderna’s mRNA leadership.” Source: Pharma

August 21,2024 New Delhi: Addressing the rising prevalence of cervical cancer among adolescent girls, the World Health Organisation (WHO) has called on member countries in the South-East Asia region to intensify efforts to ensure all children receive life-saving vaccines. These vaccines, crucial for protecting adolescent girls from cervical cancer, are part of the childhood immunization program. “We should aim for a ‘big catch-up’ to vaccinate all zero-dose and partially vaccinated children, restore immunization progress lost during the pandemic, protect adolescent girls from cervical cancer, and accelerate efforts to eliminate Measles and Rubella from WHO South-East Asia by 2026,” stated Saima Wazed, Regional Director WHO South-East Asia, during the 15th Meeting of the WHO South-East Asia Regional Immunization Technical Advisory Group (SEAR-ITAG). Wazed emphasised, “The Region missed the target to eliminate measles and rubella by 2023. The WHO/UNICEF Estimates of National Immunization Coverage data released last month show slow progress and no meaningful change in childhood immunization coverage last year compared to 2022, with coverage yet to be restored to pre-pandemic 2019 levels. Nearly 2.7 million children in our Region did not receive any vaccines, and another 0.6 million children were partially vaccinated in 2023.” She further added, “We need locally impactful approaches and, most critically, enhanced political and social leadership as the foundation for the intensified actions needed to meet our Regional targets. The focus must be on tailored approaches, developed in consultation with affected communities.” The SEAR-ITAG is an annual meeting where experts, national immunization program managers, surveillance focal points, and partner agencies review immunization coverage progress. The group provides guidance on setting regional immunization priorities and offers technical support to Member States for strengthening routine immunization services. Source: Healthworld

August 22,2024 New Delhi: An ICMR-led study, which estimated risk of adults in India developing heart disease over a 10-year period, found that those unemployed were at a significantly higher risk, followed by those having high blood sugar levels. Researchers analysed nearly 4,500 adults aged 40-69 years, about half of whom were younger (40-49 years old). Data was collected using surveys and questionnaires, including those developed by the World Health Organisation (WHO), such as for gauging one’s physical activity levels. Among the study group, about 85 per cent were at a very low-to-low chance of developing cardiovascular diseases, while about 14.5 per cent and one per cent were at a moderate and high-to-very high chance of developing these conditions, respectively, they found. Twice as many men as women had a higher than 10 per cent risk of developing heart disease over 10 years, the researchers, including those from the Indian Council of Medical Research (ICMR) – National Centre for Disease Informatics and Research, Bengaluru, found. A very low-to-low chance meant less than 10 per cent risk of experiencing heart-related diseases, while moderate and high-to-very high chance indicated 10-20 per cent and over 20 per cent likelihood, respectively, according to the study published in the Indian Journal of Medical Research. Among the participants having high blood sugar levels, women had an 85 per cent increased risk of getting heart conditions over 10 years, while men were at a 77 per cent higher risk, the researchers estimated. They also said that among the participants who were obese, women and men had a 71 per cent and a 55 per cent higher chance of developing heart conditions, respectively, compared to those who were not obese. The researchers also found that the participants living in urban areas were at a higher risk of heart diseases, with 17.5 per cent having more than 10 per cent risk, compared to 13.8 per cent of those living in rural places. About two-thirds of the study group was from rural backgrounds. Further, urban women participants had an 86 per cent higher probability of having elevated 10-year CVD risk than rural women participants, the authors said. However, the researchers found that the unemployed participants were at a significantly higher risk of cardiovascular diseases compared to the employed ones or homemakers. “While 87-88 per cent of the latter two groups had a low risk of (cardiovascular diseases), only 54 per cent of the unemployed population had a low risk,” the authors wrote. They said that previous studies assessing cardiovascular disease risk in India were conducted using geographically localised samples and, therefore, a national estimate was missing. This study was the first one to estimate risk in India using the non-laboratory-based WHO charts, the team said. Source: Healthworld

August 22,2024 New Delhi: The recent confirmation of the first Mpox (Monkeypox) case in Pakistan, the virus, once confined to Central Africa, is now perilously close to India. Experts warn that ignoring these early signs could lead to a significant health crisis and are urging for immediate and comprehensive preparedness to prevent another pandemic. India, still recovering from the devastating impact of the COVID-19 pandemic, cannot afford complacency. With Mpox cases emerging in neighboring regions, experts are calling for swift preventive measures to avert a potential health crisis. Dr Prashant Sinha, Head of Emergency at PSRI Hospital, said, “Mpox is highly transmissible through close human contact, particularly during intimate interactions or through sexual fluids. This includes actions like touching, hugging, kissing, or sharing utensils or clothing with an infected person. Additionally, the virus can spread through contact with contaminated materials like bedding, towels, or surfaces exposed to the virus. We must be vigilant, especially with individuals who have a history of travel to African nations.” Highlighting about the role of vaccines for Mpox prevention, Dr Pranjit Bhowmik, Chairman of Asian Hospital, said, “While the JYNNEOS vaccine, recommended for Mpox prevention, is currently unavailable in India, vaccination remains the best protection, particularly for high-risk groups. In its absence, we must focus on other preventive measures like avoiding contact with wild animals, practicing good hygiene, and wearing protective gear when dealing with potentially infected individuals.” Emphasising the neurological risks posed by Mpox, Dr Praveen Gupta, Principal Director & Chief of Neurology at Fortis Hospital, said, “Mpox can affect brain function, with headaches being just one symptom. The virus can cause inflammation in brain tissues, leading to serious conditions like encephalitis. Vigilance is crucial, especially in patients presenting with neurological symptoms, to ensure timely intervention. A multidisciplinary approach is necessary for managing the disease.” So far this year, around 1,100 deaths have been reported due to Mpox in the Democratic Republic of Congo. While the virus was initially confined to Central Africa, cases have now been reported in other regions, including Sweden and Pakistan. This development prompted the World Health Organization to declare the outbreak a global health emergency, the highest level of alert under international health law. Source: Healthworld

August 24,2024 New Delhi: A study has found a two-way relationship between complications due to diabetes, such as heart attack and stroke, and mental health conditions, like anxiety and depression – having any of the problems from the former group increased the risk of one from the latter , and the other way round. Researchers said that the two-way link could also be “less direct” as both — diabetes complications and mental health conditions — shared multiple risk factors, including obesity and problems in controlling blood sugar levels, which increase the chances of developing both sets of disorders. “Most likely, a combination of direct and indirect effects and shared risk factors drive the association we are seeing,” Maya Watanabe, a biostatistician at the Harvard University’s School of Public Health, US, and first author of the study published in the journal Diabetes Care, said. “Diabetes care providers may be able to simultaneously prevent the risk of multiple complications by providing interventions to treat these shared risk factors,” Watanabe said. For the study, the researchers examined insurance claims made from 2001 to 2018 data from over five lakh people with type 1 or type 2 diabetes and more than 3.5 lakh people without diabetes. The authors found that people having a chronic diabetes complication had a two-fold or three-fold higher risk of developing a mental health condition, while those having mental health disorders were found to be up to 2.5 times more likely to experience sustained diabetes complications. “We found a consistent bidirectional association between chronic diabetes complications and mental health disorders across the life span, highlighting the important relationship between (both sets of conditions). Prevention and treatment of either comorbidity may help reduce the risk of developing the other,” the authors wrote. Further, “in those (of) age less than 60 years, individuals with type 1 diabetes were more likely to have chronic diabetes complications, whereas individuals with type 2 diabetes were more likely to have mental health disorders,” they wrote. A possible reason for this bi-directional relationship may be that having a diabetes complication or a mental health condition has direct effects on developing the other disorder, the researchers said. “For instance, a stroke causes detrimental effects on the brain, which may directly lead to depression,” senior author Brian Callaghan, a professor of neurology at the University of Michigan, US, said. “And having a mental health condition and diabetes may affect a person’s self-management of their condition — like poor glycemic control or not taking medications — which, in turn, may increase their risk of diabetes complications,” Callaghan said. Source: Healthworld

August 23,2024 New Delhi: The United Doctors Front Association (UDFA) has suspended the nationwide strike, protesting the Kolkata rape and murder of trainee doctor, following a Supreme Court’s directive on Thursday. “In response to the Supreme Court’s proactive and reassuring directives, UDFA has resolved to suspend the ongoing nationwide strike. This decision is rooted in our unwavering commitment to patient care and our confidence in the judiciary’s ability to address the pressing concerns of the medical fraternity,” a UDFA release said on Thursday. The UDFA expressed gratitude to the top court for recognising the gravity of our concerns and taking swift action. The UDFA also emphasised the urgent need for the establishment of a Central Protection Act (CPA) to provide comprehensive legal safeguards for healthcare professionals. “UDFA remains vigilant and committed to advocating for this critical legislation, which is essential for the long-term security of medical practitioners in India,” the release mentioned. On August 22, the Supreme Court directed the Union Ministry of Health and Family Welfare to engage with the Chief Secretaries and Directors General of Police across all states and Union Territories. The directive includes an unequivocal mandate for state governments and Union Territories to establish and enforce minimum safety standards in all medical institutions. The apex court has assured that no adverse action will be taken against doctors who have participated in protests prior to this ruling. It has also instructed the installation of CCTV cameras and call distress systems in medical establishments. The court also affirmed UDFA’s role as a key stakeholder in the ongoing National Task Force discussions. The apex court has imposed stringent timelines for action. The Union Health Ministry, along with state authorities, is required to complete consultations within one week, followed by prompt implementation within the subsequent two weeks. A bench led by Chief Justice of India DY Chandrachud and also comprising Justices JB Pardiwala and Manoj Mishra passed these directions while hearing the suo motu petition that it initiated in the wake of the rape and murder of a trainee doctor at state-run RG Kar Medical College and Hospital in Kolkata, West Bengal on August 9. Earlier, doctors of the Ram Manohar Lohia Hospital, All India Institutes of Medical Sciences, Indira Gandhi Hospital and several other hospitals ended their strike following the apex court directive. Source: Healthworld

August 23,2024 Jakarta: An Indonesian court ordered two local companies to pay up to 60 million rupiah ($3,850) to each family whose children died of an acute kidney injury or were seriously injured after consuming toxic cough syrup. More than 200 children in Indonesia died of the injury and about 120 more survived, some of whom lived with disabilities which led to financial hardships for their parents. Indonesian courts have cited lax oversight by pharmaceutical companies, including local drugmakers and some suppliers, as well as the country’s food and drugs agency (BPOM), in hearings into the poisonings. In late 2022, more than 20 families launched a civil suit against the agency, the health ministry, and several companies. Judges at the Central Jakarta court found a drugmaker and a supplier, Afi Farma and CV Samudera Chemical, at fault in the poisonings, according to a ruling released late on Thursday. The health ministry and the BPOM were cleared of wrongdoing. The court ordered the companies to pay the parents who brought the suit compensation of 50 million rupiah for children who died and 60 million rupiah for children who were injured. Parents had asked for 3.4 billion rupiah for each child that died, and 2.2 billion rupiah for survivors. Indonesia’s 2023 gross domestic product per capita was nearly $5,000, data from the country’s Statistics Bureau shows. Source: Healthworld

August 24,2024 New Delhi: Mohsin Khan (32), best known for his role in Yeh Rishta Kya Kehlata Hai, in a recent interview shared that he had a mild heart attack last year. It was due to fatty liver. “While it might seem surprising, incidences of heart attack among younger individuals is becoming increasingly common. Traditionally, heart attacks were associated with older age groups, but recent trends show a worrying rise in cardiovascular events among people in their 30s and 40s,” says Dr Niranjan Hiremath, Adjunct Professor and Senior Consultant Cardiovascular and Aortic Surgeon, and Surgical Lead of the Apollo Aortic Program. “Fatty liver ho gaya tha, toh last year I had a mild heart attack. Aur bahut jyada badh gaya tha. I was admitted for sometime. Phir ilaaj wagera hua. 2-3 hospital change kiye humne. But it is now controlled,” Mohsin said during a chat with a portal. ‘NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS UNRELATED TO ALCOHOL INTAKE’ “Nonalcoholic fatty liver disease (NAFLD) is characterised by fat accumulation in the liver unrelated to alcohol consumption. It’s often linked to poor dietary choices, lack of physical activity, obesity, and metabolic syndrome, which includes conditions such as high blood pressure, insulin resistance and abnormal cholesterol levels,” explains Dr Niranjan Hiremath. ‘NAFLD IS OFTEN SILENT, WITH MANY UNAWARE OF IT UNTIL IT ADVANCES TO SERIOUS STAGES’ Doctors inform that the symptoms of NAFLD often go unnoticed with most individuals not knowing that they have it until it progresses to severe stages. Dr Niranjan Hiremath says, “People in their 30s are increasingly experiencing heart attacks, and fatty liver disease can indeed be a contributing factor. NAFLD plays a critical role in this. The liver, when overloaded with fat, can lead to metabolic disturbances such as elevated cholesterol levels and insulin resistance. These disturbances are key contributors to the development of atherosclerosis, a condition where plaque builds up in the arteries, eventually leading to heart attacks. The condition is often silent, with many people unaware of it until it advances to more serious stages. However, its impact on cardiovascular health is profound. The metabolic derangements caused by fatty liver disease create an environment conducive to heart disease, making younger individuals, who may otherwise appear healthy, susceptible to heart attacks.” ‘INDIANS ARE GENETICALLY PREDISPOSED TO DEVELOPING VISCERAL OBESITY’ “Indians, due to their genetic makeup, are more prone to developing visceral obesity. This means that even if an individual is only slightly overweight, they may have more fat deposited in their visceral organs compared to under the skin. This difference in fat distribution is one reason why heart disease is more common in India compared to western countries, highlighting the link between fatty liver, heart disease, and blockages,” says Dr Manish Bansal, Senior Director, Clinical & Preventive Cardiology, Cardiac Care, Medanta, Gurgaon. ‘FATTY LIVER ITSELF DOESN’T DIRECTLY CAUSE HEART ATTACKS’ “Fatty liver itself doesn’t directly cause heart attacks. While fatty liver, particularly in its early stages (grade one or even grade two), is quite common and generally not linked to heart attacks, certain underlying conditions can lead to both. These include obesity, excessive alcohol consumption, and smoking. However, a fatty liver in isolation, especially in its early stages, has no direct relation to heart attacks,” says Dr Ravi Prakash, Senior Consultant, Cardiology, PSRI Hospital, Delhi. Source: Healthworld

August 22,2024 Sydney: If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and it’s believed he was straining very hard to poo, which then led to a fatal heart attack. We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many. But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack. This includes a recent study led by Australian researchers involving data from thousands of people. Are constipation and heart attacks linked? Large population studies show constipation is linked to an increased risk of heart attacks. For example, an Australian study involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age. A Danish study of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes. It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital. These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated. How about this new study? The recent international study led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population. The researchers analysed data from the UK Biobank, a database of health-related information from about half a million people in the United Kingdom. The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation. People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation. The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34 per cent increased risk of a major heart event compared to those with just hypertension. The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations. A Japanese study looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day. How might constipation cause a heart attack? Chronic constipation can lead to straining when passing a stool. This can result in laboured breathing and can lead to a rise in blood pressure. In one Japanese study including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people. One theory is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels. As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease doubles when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure). The systolic blood pressure rise with straining in passing a stool has been reported to be as high as 70 mmgHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks. Some people with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing. This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure. Another intriguing avenue of research examines the imbalance in gut bacteria in people with constipation. This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack. This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease. What can we do about this? Constipation affects around 19 per cent of the global population aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health. Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease. Source: Healthworld