Every year 33,000 people in 10 Indian cities die of air pollution related ilnesses

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 Every year 33,000 people in 10 Indian cities die of air pollution related ilnesses

At over 11,000 deaths per year, Delhi alone accounts for a third of those deaths, researchers report in an article in The Lancet Planetary Health

 

Air pollution kills more than 33000 people every year in ten Indian cities; with Delhi alone accounting for a third of those deaths, researchers have reported in The Lancet Planetary Health.

The study, by the Karolinska Institute analysed the association between PM2·5 exposure and approximately 3·6 million daily deaths in ten Indian cities between 2008 and 2019. It came to the conclusion that every year air pollution kills 2495 people I. ahmedabad, 2102 in Bangalore, 2870 in Chennai, 11964 in Delhi, 1597 in Hyderabad, 4678 in Kolkata, 5091 in Mumbai, 1367 in Pune, 59 in Shimla and 831 in Varanasi. The total death toll in these ten cities because of air pollution comes to 33627.

The researchers found a stronger effect of pollution in cities with relatively lower population. They wrote: “In addition, we observed stronger effects in lower polluted areas, such as Shimla and Bangalore, than higher polluted areas such as Delhi. This effect is probably related to the supralinear exposure–response curve, since Shimla and Bangalore had considerably lower concentrations. This sharp increase in risk at lower levels of exposure, which plateaus at higher levels, was reported by other studies in the region and studies in Europe.” They also wrote that the study was unique because there are no multi-city studies conducted in India and no global multi-city, multi-country analyses that featured Indian cities. 

This year’s State of the Global Air Report too had painted a dire picture. It said that air Pollution is now the second highest risk factor for death and accounted for 8.1 million deaths globally in 2021. It is also the second highest killer the world over of children under five years with 709,000 deaths in the age group being attributed to it.

 

New, once a month Alzheimer’s drug gets FDA approval, works in the early stages of the diseas

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New, once a month Alzheimer’s drug gets FDA approval, works in the early stages of the diseas

Eli Lilly’s Kisunla injection is expected to significantly lower treatment costs

A new drug that can significantly help Alzheimer’s patients in the early stages of the disease, has received approval of the Food and Drug Administration in the USA. 

Eli Lilly’s Kisunla which, the company claims is the first drug to target amyloid plaques that can be discontinued once these are gone, is expected to significantly lower treatment costs. he price of each vial of Kisunla is $695.65. It needs to be administered once a month. Amyloid is a substance produced in the body that can deposit in the brain in the form of plaques, aggravating dementia symptoms. 

“Alzheimer’s disease is a devastating disease for the person diagnosed and their loved ones,” said Teresa Buracchio, director of the Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research. “The trial data demonstrated, convincingly, that Kisunla reduces the rate of cognitive and functional decline in patients in the mild cognitive impairment and mild dementia stages of Alzheimer’s disease. Today’s approval is evidence of the FDA’s commitment to helping more safe and effective drugs to treat Alzheimer’s disease become available.” 

Alzheimer’s Disease which is one of the commonest forms of dementia, is a cause for grave concern for families because of the progressive nature of the disease and at an advances stage the all consuming memory loss that can make daily life of the patient completely dependent on the caregiver.

There has been research the world over on how to identify AD at an early stage with some theories suggesting that depression can be an early red flag. The new drug has raised hopes also of early treatment.

Eli Lilly said in a statement that among the overall population of participants, Kisunla reduced amyloid plaques on average by 61% at 6 months, 80% at 12 months, and 84% at 18 months compared to the start of the study. Kisunla can help the body remove the excessive buildup of amyloid plaques and slow the decline that may diminish people’s ability to remember new information, important dates, and appointments; plan and organize; make meals; use household appliances; manage finances; and be left alone, the company added.

Semaglutide found to be associated with higher risk of a form of blindnes

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Semaglutide found to be associated with higher risk of a form of blindnes

The popular weight loss drug was found to be associated with blindness caused by a problem in the optic nerve that supplies the eye

 

Popular weight loss drug semaglutide may be associated with a form of blindness, suggests a new study in JAMA Ophthalmology. 

The study found an association between use of the drug and a condition known as nonarteritic anterior ischemic optic neuropathy (NAION) in which the blood flow to an eye is reduced and there is a sudden and potentially complete loss of vision in that eye. There is no pain associated with the condition. 

“This study’s findings suggest an association between semaglutide and NAION. As this was an observational study, future study is required to assess causality,” researchers from Mass General Brigham wrote. Semaglutide, also marketed as Wegovy or Ozempic is normally used to treat Type II diabetes but has caught public imagination primarily as a weight loss drug. Over the short period during which the drug has been around, it has also been associated with many add-on benefits including protection against kidney diseases but this new revelation may cause some concern among semaglutide aficionados.

“The use of these drugs has exploded throughout industrialized countries and they have provided very significant benefits in many ways, but future discussions between a patient and their physician should include NAION as a potential risk,” said  Joseph Rizzo,  Joseph Rizzo, MD, director of the Neuro-Ophthalmology Service at Mass Eye and Ear and the Simmons Lessell Professor of Ophthalmology at Harvard Medical School. “It is important to appreciate, however, that the increased risk relates to a disorder that is relatively uncommon,” he added. He is the corresponding author of the study.

NAION is relatively rare, with an average incidence of about 10 cases out of 100,000 people in the general population. It is the second-leading cause of optic nerve blindness (second to glaucoma) and it is the most common cause of sudden optic nerve blindness. 

 

The antidepressants that make you gain the most weight, and one where the risk is the least

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The antidepressants that make you gain the most weight, and one where the risk is the least

Researchers have analysed the weight gain trends associated with drugs to treat depression and found that bupropion causes the least weight gain

 

That anti-depressants cause weight gain is well known but researchers from the Harvard T H Chan School of Public Health have now quantified the extent of weight loss commonly used medications can trigger. 

They have come to the conclusion that Escitalopram, paroxetine, and duloxetine were associated with 10% to 15% higher risk for gaining at least 5% of baseline weight, whereas bupropion was associated with 15% reduced risk. The findings were published in the Annals of Internal Medicine. Electronic health record (EHR) data from 2010 to 2019 across 8 U.S. health systems was used for the analysis. Escitalopram is marketed as Lexapro and Cipralex, paroxetine is marketed as Paxil and duloxetine is marketed as Cymbalta. Bupropion is marketed as Welllbutrin or Zyban.

“Small differences in mean weight change were found between 8 first-line antidepressants, with bupropion consistently showing the least weight gain, although adherence to medications over follow-up was low. Clinicians could consider potential weight gain when initiating antidepressant treatment,” the researchers wrote. A total of 1,83,000 US patients who had been put on these medicines for the first time, were followed for 24 months.

Recent research suggests that there are six different types of depression and treatment choices should be mindful of these categories.

Escitalopram is one of the most widely used antidepressants in India. “About half of the patients with diagnoses other than depression were prescribed antidepressants. SSRIs were the most common group and escitalopram was the most common medication used. Concomitant use of two antidepressants was infrequent. Hypnotic and sedatives were frequently prescribed along with antidepressants,” reads an analysis published in the Indian Journal of Medical Research in 2016.

SSRis are selective serotonin reuptake inhibitors – a class of antidepressants widely used the world over.

Pune battles Zika outbreak; this is why pregnant women need to be careful and condoms are a must

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Pune battles Zika outbreak; this is why pregnant women need to be careful and condoms are a must

Zika is a disease that can spread through mosquito bites; it is feared because of the effect it might have in an unborn child should a pregnant mother contract it

Pune has now reported its seventh case of Zika in a 45-year-old woman, sending alarm bells ringing in the Maharashtra city, particularly for pregnant women.

The ministry of health has now issued an advisory to states asking for screening of pregnant women in affected areas for Zika virus infection. The advisory also asked state administrations to monitor the growth of the fetus of expecting mothers who have tested positive for Zika and follow the central government guidelines for subsequent action.

Zika is a disease that can spread through mosquito bites; instances of sexual transmisison have also been reported. But it is feared because of the effect it might have in an unborn child should a pregnant mother contract it. 

Here’s all you need to know about Zika.

How does Zika spread?

Zika is a viral infection that spreads mostly through mosquito bites. However for a limited period of time – that is when the virus is still circulating in body fluids, an infected person can also spread it through unprotected sex. This includes vaginal, anal and oral sex and also sharing of sex toys, says the Centers for Disease Control (CDC). The period over which a person is infective can vary with gender but is about three months for men and two months for women. The virus survives longer in semen. Hence it is advisable to use protection when Zika virus is in circulation. And at all other times.

What are the symptoms of Zika?

The common symptoms of Zika are fever, rash, headache, body ache and muscle pain. The severity of symptoms though may vary from person to person. Some may only have mild symptoms while others may become very ill. However sometimes a Zika infection may lead to a complicated neurological problem called Guillain Barre’ Syndrome.

How is Zika treated?

There is neither a vaccine nor any specific anti viral for the Zika virus. Treatment is mostly symptomatic such as fever control and pain management. People who have Zika also need to be tested for dengue and Chikungunya as the same mosquito spreads all three diseases. Till dengue is ruled out drugs that can cause bleeding need to be avoided.

What is Congenital Zika Syndrome?

When a pregnant woman contracts Zika, she can pass the disease on to her unborn child. Such a child may be born with congenital defects such as microencephaly (brain smaller than normal), hearing an eye defects and movement problems. All the symptoms together are referred to as Congenital Zika Syndrome. According to the World Health Organisation: “The risk of congenital malformations following infection in pregnancy remains unknown; an estimated 5–15% of infants born to women infected with Zika virus during pregnancy have evidence of Zika-related complications. Congenital malformations occur following both symptomatic and asymptomatic infection. Zika infection in pregnancy can also cause complications such as fetal loss, stillbirth and preterm birth.  

(This post has been edited reflect a later development – the government of India advisory on Zika).

First ever clinical treatment guidelines for tobacco cessation in adults unveiled by WHO

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First ever clinical treatment guidelines for tobacco cessation in adults unveiled by WHO

Over 60% of the world’s 1.25 billion tobacco users – more than 750 million people – wish to quit, says the World Health Organisation

The World Health Organisation has released the first ever clinical treatment guidelines for tobacco cessation in adults; 750 million who want to quit, according to its own estimates. The recommendations are relevant for all adults seeking to quit various tobacco products, including cigarettes, waterpipes, smokeless tobacco products, cigars, roll-your-own tobacco, and heated tobacco products (HTPs).

There are 1.25 billion tobacco users across the world. WHO estimates that about 60% of them – 750 million – want to quit. Of the people who want to quit, 75% do not know how to do so as they have no access to cessation services.

“This guideline marks a crucial milestone in our global battle against these dangerous products,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “It empowers countries with the essential tools to effectively support individuals in quitting tobacco and alleviate the global burden of tobacco-related diseases.”

WHO recommends varenicline, Nicotine Replacement Therapy (NRT), bupropion, and cytisine as effective treatments for tobacco cessation. The global body recommends a comprehensive set of tobacco cessation interventions, including behavioural support delivered by health-care providers, digital cessation interventions and pharmacological treatments in a first guideline on tobacco cessation.

“This guideline marks a crucial milestone in our global battle against these dangerous products,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “It empowers countries with the essential tools to effectively support individuals in quitting tobacco and alleviate the global burden of tobacco-related diseases.”

Over 60% of the world’s 1.25 billion tobacco users – more than 750 million people – wish to quit, yet 70% lack access to effective cessation services. This gap exists due to challenges faced by health systems, including resource limitations.

“The immense struggle that people face when trying to quit smoking cannot be overstated. We need to deeply appreciate the strength it takes and the suffering endured by individuals and their loved ones to overcome this addiction,” said Dr Rüdiger Krech, Director of Health Promotion at WHO. ”These guidelines are designed to help communities and governments provide the best possible support and assistance for those on this challenging journey.”

 

Popping multivitamin pills won’t make you live longer, may even increase mortality risk

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Popping multivitamin pills won’t make you live longer, may even increase mortality risk

Researchers from the National Institute of Health followed 400,000 healthy U.S. adults for two decades found people who use multivitamins have a 4% higher mortality risk

Researchers from the National Institutes of Health in the United States of America, after following 400,000 healthy U.S. adults for 20 years have come to the conclusion that multivitamin pills do not lower mortality risk. They have reported their findings in JAMA Network Open.

In fact, the study found that people who use multivitamins have a 4% higher mortality risk compared to people who do not use it. 

The NIH in its press release about the study wrote: “Because the study population was so large and included lengthy follow-up and extensive information on demographics and lifestyle factors, the researchers were able to mitigate the effects of possible biases that may have influenced the findings of other studies. For example, people who use multivitamins may have healthier lifestyles in general, and sicker patients may be more likely to increase their use of multivitamins.

The analysis showed that people who took daily multivitamins did not have a lower risk of death from any cause than people who took no multivitamins. There were also no differences in mortality from cancer, heart disease, or cerebrovascular diseases. The results were adjusted for factors such as race and ethnicity, education, and diet quality.”

The researchers estimated that in the US about one in three people use multivitamin pills. Similar data about India is not available but there has, in recent times, been an increase in the use of multivitamin pills in India, particularly in urban centres. According to some estimates, the Indian dietary supplement market (which also includes vitamins) is pegged at Rs 157.4 billion. 

 

Climate change is linked to a global surge in dengue cases including in Americas, Europe

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Climate change is linked to a global surge in dengue cases including in Americas, Europe

An estimated 9 million cases have been reported across the world till date; WHO says not all countries are reporting all cases

The Centers for Disease Control and Prevention (CDC) has recently issued an alert for a dengue outbreak in the United States. It’s counterpart in Europe the European Centers for Disease Control and Prevention has also issued a similar warning. The World Health Organisation last month said that over 90 countries have known active dengue transmission in 2024, not all of which have been captured in formal reporting.

The dengue surge in many parts of the world alongside the unprecedented heat wave in some others – including India – have now begun to raise climate change alarm bells. WHO, while laying out the reasons for the global surge in cases of the disease that spreads through the bite of mosquitoes said: “…early start and longer duration of dengue transmission seasons in endemic areas; changing distribution and increasing abundance of the vectors (Aedes aegypti and Aedes albopictus); consequences of climate change and periodic weather phenomena (El Nino and La Nina events) leading to heavy precipitation, humidity, and rising temperatures favouring vector reproduction and virus transmission; changes in the circulating serotypes within a country affecting population immunity…” are among the culprits.

The role of rising temperatures in the dengue surge in the Americas was also acknowledged by the CDC in its recent alert when it wrote: “Dengue transmission peaks during the warmer and wetter months in many tropical and subtropical regions. Dengue cases are likely to increase as global temperatures increase. Higher temperatures can expand the range of the mosquitoes that spread dengue, as well as affect other factors that facilitate virus transmission like faster viral amplification in the mosquito, increased vector survival, and changes in reproduction and biting rates. U.S. summer travel often overlaps with the months of increased dengue activity in many countries. Epidemics in the Americas region increase travel-associated cases and limited local transmission in the continental United States.”

That mosquitos breed better and faster in warmer temperatures is a well known fact. However with the disease spreading to geographies not considered endemic for dengue may now require different strategies. Ending neglected tropical diseases like dengue is one of the sustainable development goals and the deadline of 2030 is fast approaching. 

India, meanwhile is just entering its peak dengue season with monsoon kicking in in most parts of the country and the capital New Delhi having seen an unprecedented deluge in its first pre monsoon shower after a record breaking hot summer, both instances also being linked to climate change in many quarters.

ICMR ready to transfer rapid TB detection technology to the private sector, handhold them

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ICMR ready to transfer rapid TB detection technology to the private sector, handhold them

The technology developed by the ICMR- Regional Medical Research Centre, North East, Dibrugarh cuts down test time

Indian Council of Medical Research is ready to transfer technology for a rapid TB test based on gene editing. The test cuts down the time for a confirmatory TB test from a few days to a few hours. The technology has been developed by the ICMR- Regional Medical Research Centre, North East, Dibrugarh.

ICMR has invited expressions of interest from the private sector for to undertake further development, manufacture, sell, and commercialization of a CRISPR Cas based TB detection system. CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) is a section of the bacterial genome that is often used to invade host organisms and damage their cellular mechanisms. In the laboratory it is used for the purposes of gene editing. The technology in question is designed to detect the presence of Mycobacterium tuberculosis which is the causative organism for tuberculosis.

In its notice inviting EOIs, ICMR has said: “Conventional diagnostic techniques for TB commonly rely on culture (which requires 42 days to confirm as TB negative), microscopy, and nucleic acid-based methods. These are time-consuming and may require sophisticated equipment. Additionally, some molecular diagnostic methods, while offering improved sensitivity, may lack the desired specificity or face challenges associated with cost and ease of handling. Considering the above problems, the CRISPR-Cas12a-based molecular diagnostic system ‘GlowTBPCRKit’ coupled with an amplification step (using thermal cycler) and the ‘RapidGlow device’ provides a promising solution.”

India has the highest tuberculosis burden in the world and has committed to eliminate the disease by 2025, five years ahead of the global deadline of 2030. The healthcare system is still struggling to recover from the setback that happened to the TB control initiative because of the COVID19 lockdown.

Plant-based meat alternatives may protect the heart, say Canadian researchers

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Plant-based meat alternatives may protect the heart, say Canadian researchers

Long-term randomised controlled trials and prospective cohort studies that evaluate myocardial infarction, stroke incidence essential 

 

Plant based meat alternatives may have some attributes that protect the heart, Canadian researchers have reported in a recent review published in the Canadian Journal of Cardiology. 

But, they have also flagged that long term trials and studies that evaluate incidence of cardiovascular events such as stroke and myocardial infarction in people who have been on such diets for long, are needed for more definitive conclusions. Plant-based meat alternatives (PBMAs) are foods that taste like meat but contain ingredients such as soy, pea, wheat and certain kinds of fungi.

“Overall, the nutritional profiles of PBMAs vary considerably but generally align with recommendations for improving cardiovascular health; compared with meat, PBMAs are usually lower in saturated fat and higher in polyunsaturated fat and dietary fibre. Some dietary trials that have replaced meat with PBMAs have reported improvements in CVD risk factors, including total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B-100, and body weight. No currently available evidence suggests that the concerning aspects of PMBAs (eg, food processing and high sodium content) negate the potential cardiovascular benefits. We conclude that replacing meat with PBMAs may be cardioprotective,” wrote the researchers from the University of British Columbia.

The researchers also wrote that most PBMAs are ultra-processed foods (UPFs): foods produced primarily from substances extracted from whole food sources (eg, sugar, salt, oil, protein) or synthesized in a laboratory (eg, flavour enhancers, food colouring, etc). For this reason, the potential health implications of PBMAs have been questioned by the public and health professionals. Health risks of ultraprocessed foods are currently being widely discussed. A recent 30-year study that looked at all cause mortality in subjects consuming ultraprocessed foods finds higher mortality links and not just related to cancer and cardiovascular diseases.

 

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