Exercise Intensity in Asthma Therapy: Both Moderate and Vigorous Workouts Show Benefits in new research

Researchers have found that both moderate- and vigorous-intensity aerobic exercise can improve asthma outcomes, suggesting these exercise regimens as effective adjunct therapies for asthma management. A recent randomized controlled trial aimed to compare the effects of these different exercise intensities on asthma-related quality of life, asthma control, cardiorespiratory fitness, body composition, and inflammation. This study was published in The Journal Of Allergy and Clinical Immunology by Sarah R. and colleagues.

The therapeutic benefits of exercise in asthma care have led to calls for its integration into standard treatment protocols. However, the optimal exercise intensity for maximizing these benefits remains unclear. This study was designed to fill this gap by evaluating the differential impacts of moderate- and vigorous-intensity exercise on key asthma outcomes.

This 12-week randomized controlled trial involved 46 adults with asthma, divided into three groups:

  • Moderate-intensity exercise training (45 minutes, three times per week).

  • Vigorous-intensity exercise training (30 minutes, three times per week).

  • Control group (no specified exercise regimen).

Participants’ asthma-related quality of life (AQLQ), asthma control (ACQ), cardiorespiratory fitness, body composition, and markers of airway and systemic inflammation were assessed before and after the intervention.

  • Out of the initial 46 participants, 41 completed the study, achieving an 89% retention rate.

  • Significant clinical improvement [0.63 (0.33 to 0.93), p<0.001] relative to the control group.

  • Significant clinical improvement [-0.51 (-0.83 to -0.19), p=0.003] relative to the control group.

  • Reduction in sputum macrophage count [-1341 (-2491 to -191)×10^4/mL, p=0.024] and lymphocyte count [-114 (-220 to -8)×10^4/mL, p=0.036] relative to the control group.

  • Reduction in android fat mass was associated with improved AQLQ (rs=-0.341, p=0.030) and reduced sputum IL-6 (rs=0.422, p=0.013).

Vigorous-Intensity Exercise:

  • Statistically significant improvement [0.46 (0.14 to 0.80), p=0.007] relative to the control group, though not clinically significant.

  • Statistically significant improvement [-0.36 (-0.69 to -0.02), p=0.040] relative to the control group.

The study indicates that both moderate- and vigorous-intensity aerobic exercise can enhance clinical asthma outcomes. Moderate-intensity exercise demonstrated more substantial and clinically significant improvements in both asthma-related quality of life and asthma control, along with reductions in inflammatory markers. The vigorous-intensity exercise also showed beneficial effects, though to a lesser degree.

These findings support the incorporation of both moderate- and vigorous-intensity aerobic exercise into asthma care regimens. By providing patients with flexible exercise options, healthcare providers can tailor interventions to individual preferences and capabilities, potentially improving adherence and overall asthma management.

Reference:

Valkenborghs, S. R., Wood, L. G., Callister, R., Upham, J. W., Grainge, C. L., Anderson, S., Williams, L. M., McLoughlin, R. F., Williams, E. J., & Scott, H. A. (2024). Effects of moderate- versus vigorous-intensity exercise training on asthma outcomes in adults. The Journal of Allergy and Clinical Immunology in Practice. https://doi.org/10.1016/j.jaip.2024.06.015

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Popular weight loss drug Semaglutide linked to uncommon blinding condition, reveals JAMA study

Investigators at Mass Eye and Ear  have found in a new study have found that patients who were prescribed semaglutide for diabetes or weight loss had a higher risk of having a potentially blinding eye condition called nonarteritic anterior ischemic optic neuropathy (NAION) than similar patients who had not been prescribed these drugs.

Notably, the study found people with diabetes who had been prescribed semaglutide by their physician and then filled the prescription were more than four times more likely to be diagnosed with NAION. Those who were overweight or had obesity and prescribed this drug were more than seven times more likely to get the diagnosis.

The study has been published in JAMA Ophthalmology.

“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 Rizzo, the study’s corresponding author. “It is important to appreciate, however, that the increased risk relates to a disorder that is relatively uncommon.”

NAION is relatively rare, occurring up to 10 out of 100,000 people in the general population. NAION is the second-leading cause of optic nerve blindness (second only to glaucoma) and it is the most common cause of sudden optic nerve blindness. NAION is thought to be caused by reduced blood flow to the optic nerve head, with the consequence of permanent visual loss in one eye. According to Rizzo, the visual loss caused by NAION is painless and may progresses over many days before stabilizing, and there is relatively little potential for improvement. There are currently no effective treatments for NAION.

The impetus for the study occurred in the late summer of 2023 when Rizzo, a resident (study co-author Seyedeh Maryam Zekavat, MD, PhD) and other Mass Eye and Ear neuro-ophthalmologists noticed a disturbing trend — three patients in their practice had been diagnosed with vision loss from this relatively uncommon optic nerve disease in just one week. The physicians observed all three were taking semaglutide.

This anecdotal recognition led the Mass Eye and Ear research team to run a backward-looking analysis of their patient population to see if they could identify a link between this disease and these drugs, which had been surging in popularity.

Semaglutide was developed to treat type 2 diabetes. The drug encourages weight loss, and its use has snowballed since its launch as Ozempic for diabetes in 2017. The drug was also approved for weight management, branded as Wegovy, and released in 2021.

The researchers analyzed the records of more than 17,000 Mass Eye and Ear patients treated over the six years since Ozempic was released and divided the patients in those who were diagnosed with either diabetes or overweight/ obesity. The researchers compared patients who had received prescriptions for semaglutide compared to those taking other diabetes or weight loss drugs. Then, they analyzed the rate of NAION diagnoses in the groups, which revealed the significant risk increases.

There are several limitations to the study. Mass Eye and Ear sees an unusually high number of people with rare eye diseases, the study population is majority white, and the number of NAION cases seen over the six-year study period is relatively small. With small case numbers, statistics can change quickly, Rizzo noted. The researchers also couldn’t determine if the patients actually took their medication or if they started and then stopped taking semaglutide at some point and how this might have impacted their risk.

Importantly, the study does not prove causality, and the researchers don’t know why or how this association exists, and why there was a difference reported in diabetic and overweight groups.

“Our findings should be viewed as being significant but tentative, as future studies are needed to examine these questions in a much larger and more diverse population,” Rizzo said. “This is information we did not have before and it should be included in discussions between patients and their doctors, especially if patients have other known optic nerve problems like glaucoma or if there is preexisting significant visual loss from other causes.”

Reference:

Hathaway JT, Shah MP, Hathaway DB, et al. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide. JAMA Ophthalmol. Published online July 03, 2024. doi:10.1001/jamaophthalmol.2024.2296.

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Kerala doctor loses Rs 7.65 crore in stock market investment scam, 3 arrested

Alappuzha: In another shocking cyber fraud case, a Cherthala-based doctor was allegedly duped Rs 7.65 crore in a stock market investment scam. As a result, the police managed to capture three fraudsters in this connection.

According to the police, the three arrested fraudsters are alleged to be part of a large interstate racket. Although the doctor lost a whooping amount in crores, the police have recovered Rs 35 lakh from the arrested accused. 

The alleged fraud started when the doctor started receiving messages from what seemed to be two genuine investment companies. The fraudsters pretending to be authorities of these companies were able to manipulate him and extract the money when the doctor responded to text messages after being intrigued by the possibility of earning high profits.

Also read- Ayurveda Doctor Loses Rs 7 Lakh In Trading Scam, Falls Prey To Mukesh Ambani’s Deepfake Video

To earn the trust of the victim, the fraudsters offered thorough tutorials on the investment procedure, also answering all his questions and creating a convincing illusion of legitimacy. After being convinced by the fraudsters, the doctor was asked to deposit investment money into five different accounts. To maintain the illusion of legitimacy, they sent periodic messages claiming profits had been credited to his account making the doctor believe in the scheme. 

Speaking to Onmanorama, a police official said ”The fraudsters began calling the victim posing as authorities from the said firms. They took classes for him detailing how to make the investments and how it would bring huge profits. They cleared all his doubts and convinced him that the deal was authentic.”

”The complainant never doubted these messages nor did he check the veracity of these messages. That was a mistake. Instead, he trusted them to be true and made more such ‘investments.’ The final transaction he made was for Rs 50 lakh before he eventually realised that he had been duped. The transactions were done to five accounts, two of which – Petro Logistics and Modern – were traced to Kozhikode.” said the official.

”We utilised the data from the National Cybercrime Reporting Portal (NCRP). We identified the five different accounts to which he transferred money. Two of them were registered in the name of two women in Kozhikode. Our investigation revealed that one of the women’s son-in-law and two of his friends were operating these accounts,” the official said.

“The other accounts were traced to Gujarat and other parts of north India. Rs 35 lakh was recovered of the Rs 50 lakh from the arrested. The arrested will be produced before the court along with the retrieved money. State police will take up the case for further inquiry and track down the other members involved in the racket,” added the official. 

Also read- Bhopal Doctor Swindled Out Of Rs 1.5 Crore By Hospital Employee

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Drug Safety Alert: Indian Pharmacopoeia Commission Flags ADR Linked To amlodipine and acetazolamide

New Delhi: The Indian Pharmacopoeia Commission (IPC), through its recently issued drug safety alert for the month of June, has revealed adverse drug reactions linked with amlodipine and acetazolamide.

In accordance with the drug safety alert, amlodipine causes lichenoid keratosis, which is an inflammatory reaction arising in a regressing existing solar lentigo or seborrhoeic keratosis.

In connection with the above, the Indian Pharmacopoeia Commission (IPC) has cautioned healthcare professionals to diligently monitor the potential occurrence of adverse drug reactions (ADRs) when administering amlodipine and acetazolamide.

Furthermore, the alert stated that acetazolamide, a medication used to treat glaucoma, epilepsy, acute mountain sickness, periodic paralysis, idiopathic intracranial hypertension, heart failure, and to alkalinize urine, may lead to choroidal effusion or choroidal detachment.

This came after a preliminary analysis of adverse drug reactions (ADRs) from the Pharmacovigilance Programme of India (PvPI) database.

Amlodipine is a calcium channel blocker used to treat hypertension and angina. In line with the drug safety alert, amlodipine is used to reduce fatal coronary heart disease, non-fatal myocardial infarction, and to reduce the risk of stroke. Furthermore, it added that amlodipine is indicated to reduce the risk of coronary revascularization procedures and the need for hospitalization due to angina in patients with coronary artery diseases.

On the other hand, acetazolamide is a carbonic anhydrase inhibitor used to treat edema from heart failure or medications, certain types of epilepsy, and glaucoma. The anticonvulsant activity of acetazolamide may depend on a direct inhibition of carbonic anhydrase in the CNS, which decreases carbon dioxide tension in the pulmonary alveoli, thus increasing arterial oxygen tension. The diuretic effect depends on the inhibition of carbonic anhydrase, causing a reduction in the availability of hydrogen ions for active transport in the renal tubule lumen. This leads to alkaline urine and an increase in the excretion of bicarbonate, sodium, potassium, and water.

As per the drug safety alert, acetazolamide is indicated as an adjunct in the treatment of chronic open-angle glaucoma, secondary glaucoma, and as part of the preoperative treatment of acute-angle closure glaucoma.

Following the preliminary analysis of adverse drug reactions (ADRs) from the PvPI database, it is reported that amlodipine can cause lichenoid keratosis, also known as, keratosis lichenoides chronica, a condition where, usually, a solitary brown lesion turns red and becomes itchy. These lesions usually appear in an area that is exposed to the sun. They generally appear most on the forearms, hands, or chests of middle-aged white women.

Additionally, preliminary research on adverse drug reactions (ADRs) from the PvPI database indicates that acetazolamide may lead to choroidal effusion or choroidal detachment. Choroidal detachment is a detachment of the choroid from the underlying sclera due to the accumulation of fluid in the suprachoroidal space, generally due to increased intraocular pressure (IOP).

Now, as per the issued drug safety alert, the following suspected drug is associated with the ADRs, as given below:

S. No.

Suspected Drugs

Indications

Adverse Drug Reactions

1

Acetazolamide

As an adjunct in the treatment of chronic open-angle glaucoma; secondary glaucoma; as part of preoperative treatment of acute-angle closure glaucoma.

Choroidal effusion or Choroidal detachment

2

Amlodipine
  • To reduce fatal coronary heart disease and non-fatal myocardial infarction, and to reduce the risk of stroke.
  • To reduce the risk of coronary revascularization procedures and the need for hospitalization due to angina in patients with coronary artery diseases

Lichenoid Keratosis

In light of the above, the Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, has advised healthcare professionals, patients, and consumers to closely monitor the possibility of the above ADRs associated with the use of the above suspected drugs.

Further, the safety alert added, “If such reaction is encountered, please report to the NCC-PvPI, IPC, by filling of Suspected Adverse Drug Reactions Reporting Form/Medicines Side Effect Reporting Form for Consumer (http://www.ipc.gov.in), through Android Mobile App “ADR PvPI App” and PvPIHelpline No. 1800-180-3024 (toll-free).”

Also Read: Meropenem linked to Acute Generalized Exanthematous Pustulosis, IPC Drug Safety Alert

To view the official notice, click the link below:

https://medicaldialogues.in/pdf_upload/drugsafetyalertsjune2024-243084.pdf

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Re-NEET unreasonable, harsh for honest hardworking students! 56 successful candidates move Supreme Court to Stop NTA from cancelling NEET 2024

New Delhi: Amid the ongoing controversy over the alleged irregularities in NEET 2024 conduct this year, another petition has been filed before the Supreme Court wherein over 50 successful Gujarat-based NEET candidates, including several who have been ranked first, have opposed the re-neet and cancelling the results of the NEET-UG 2024 examination. Through the plea, the candidates have moved the apex court seeking a direction to restrain the Centre and the National Testing Agency (NTA) from cancelling the controversy-ridden exam.

According to a recent report by PTI, the candidates have sought a direction from the top court to the Union Education Ministry to probe, identify and take strict action against students and others who indulged in unfair practices like paper leak and impersonation in the NEET-UG exam conducted on May 5 this year.

The fresh plea by 56 students through lawyer Devendra Singh has been filed days before a top court bench headed by Chief Justice DY Chandrachud is scheduled to hear as many as 26 petitions seeking reliefs including re-test and probe into the conduct of the examination plagued by allegations of malpractices.

Also Read:Supreme Court to hear NEET petitions on July 8

“The Hon’ble court may further direct the respondents (Centre and the NTA) not to re-conduct NEET-UG … as that would not only be unreasonable and harsh for the honest and hardworking students but also would lead to the infringement of the Right to Education and therefore violative of Article 14 (right to equality) of the Constitution,” the plea said, quotes PTI.

The plea sought a direction to the Centre and the NTA to identify and punish the examinees who adopted unfair means, identify the centres and take appropriate action where any “compromise to the established guidelines for NEET-UG 2024 examinations has been done.”

The Petitioners are young students around 17-18 years of age, and to achieve their dream of becoming a doctor, they have given their 100 per cent and have cleared the exam after consistent hard work of more than 3-4 years, it said.

However, the continuous coverage of news regarding the cancellation of the exam and possibility of a re-test for all is creating mental pressure and causing unnecessary stress, it said.

If the re-test happens as a result of “hype created due to the misleading coverage by media”, the honest successful students will have to face hardship, it added.

Singla, the lead petitioner, ranked 778 in the merit list of NEET-UG 2024, the plea said, adding, “He has always been an outstanding student who in class 12th has topped in his school with 96.60%. It is further stated that amongst the other co-petitioners, there are students who have scored even the 1st Rank…”.

According to the cause list for July 8 uploaded on the apex court’s website, the batch of 26 petitions would come up for hearing before a bench comprising Chief Justice D Y Chandrachud and Justices J B Pardiwala and Manoj Misra.

NEET Controversy

This year’s NEET UG 2024 exam was mired in controversies after a paper leak scam came to light. Medical Dialogues had earlier reported that around 13 people, including four examinees and their family members, were arrested in Bihar for their alleged involvement in the paper leak of the NEET-UG exam. Patna police sources had previously claimed that the NEET-UG question papers along with their answers were provided to around 20 aspirants a day before the date of the exam i.e. May 5, 2024.

Then, the Economic Offences Unit (EOU) of Bihar Police, which took over the investigation, revealed that the brokers involved in the NEET paper leak scam took between Rs 30 lakh to Rs 50 lakh from each of the medical aspirants in exchange for giving them the question paper of the NEET UG 2024 question paper ahead of the examination.

Multiple pleas have been filed before the High Courts and the Supreme Court seeking an investigation into the alleged paper leak scam. Some of the pleas demanded the scrapping of the NEET UG 2024 exam and holding a retest.

Meanwhile, during the case proceedings, NTA earlier decided to withdraw the grace marks awarded to 1563 candidates and hold an optional retest for those candidates. Those who did not opt for the retest were allowed to retain their original marks, without the grace marks.

The matter is now being investigated by the Central Bureau of Investigation (CBI). Central Government on June 22, 2024, handed over the charge of investigating in the alleged irregularities in the NEET UG 2024 examination to the Central Bureau of Investigation (CBI).

“Certain cases of alleged irregularities / cheating / impersonation / malpractices have been reported. For transparency on the conduct of the examination process, the Ministry of Education, Government of India after a review has decided to entrust the matter to the Central Bureau of Investigation (CBI) for a comprehensive investigation,” the Ministry of Education stated in a release.

Earlier, while considering the NEET-related pleas, the Supreme Court had refused to defer the counselling/seat allotment process scheduled to commence on July 6. However, the bench had orally observed that the admissions would be subject to the final outcome of the petitions and if the exams were set aside, the counselling would get invalidated consequentially.

The Top Court had also expressed its concern over the alleged discrepancies in the NEET UG 2024 exam. The Court had noted that even ‘0.001& negligence’ in conducting the NEET-UG 2024 exams would be looked into with all seriousness considering the immense labor put in by the candidates for the prestigious examination.

Recently two candidates Kritika Garg and Priyanjali Garg approached the Apex Court opposing the proposal to cancel the NEET exam and hold a retest. Hailing from Meerut, these candidates secured Rs 705 and 690 marks respectively.

Approaching the Apex Court bench, they argued that students who have prepared for years should not be put to the trouble of appearing in the exam again. These applicants further contended that holding a retest for the NEET UG 2024 exam would not only be “unfair” to most students but would also cause hardship to their families.

Also Read: Scrapping NEET 2024 for Mischief of a Few would be Unjust: 2 Candidates File Application before Supreme Court

NEET-UG retest result

The Centre and the NTA had, on June 13, told the court that they had cancelled the grace marks awarded to 1,563 candidates. They were given the option to either take a re-test or forgo the compensatory marks awarded for loss of time.

The NTA announced the revised rank list on Monday after issuing the results of the re-test held on June 23.

A total of 67 students had scored a perfect 720, unprecedented in the NTA’s history, with six from a Haryana centre figuring in the list, raising suspicions about irregularities in the examination held on May 5. It has been alleged that grace marks contributed to 67 students sharing the top rank.

The number of candidates sharing the top rank in the NEET-UG reduced to 61 from 67 as the NTA announced the revised results on Monday.

Also Read:NEET paper leak update: CBI arrests private school owner in Godhra for allegedly taking Rs 10 lakh from at least 27 candidates each

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New exam date for NEET PG 2024 to be released this week, says NBE: Report

New Delhi: Despite the assurances and assumptions that the new date for the NEET-PG 2024 would be announced by Tuesday or Wednesday, no announcement has come either from the side of the Union Health Ministry, National Board of Examinations (NBE) or the National Medical Commission (NMC).

Amid this confusion among the doctors who will be appearing in the Postgraduate medical entrance test, a senior official from the NBE told Indian Express on July 2 that the new exam date for the National Eligibility-and-Entrance Test for postgraduate courses (NEET PG) 2024 will be released this week.

For more information, click on the link below:

New NEET PG 2024 Exam Date By This Week, Says NBE: Report


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Kerala Govt to release special guidelines for amoebic meningoencephalitis

In response to recent incidents of two deaths and one hospitalization due to amoebic meningoencephalitis in Kerala over the past two months, Kerala Health Minister Veena George chaired a significant meeting of the health department.

It has been decided that special guidelines will be released for the state regarding amoebic meningoencephalitis. Instructions have been given to strengthen awareness. The amoeba enters the brain through rare openings in the thin membrane that separates the nose from the brain or through a hole in the eardrum and causes meningoencephalitis. Therefore, children with pus in their ears should not bathe in ponds, stagnant water, etc. The minister requested to seek treatment immediately if symptoms are seen.

For more information, click on the link below:

Amoebic Meningoencephalitis: Kerala Govt To Issue Special Guidelines

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Restrictions imposed on private practice by government doctors during duty hours in Assam

o curb the private practice of government doctors, the Medical Education and Research Department of the Assam Government has issued a directive prohibiting government doctors from practising at private hospitals and nursing homes during their duty hours.

Addressing the Health & Family Welfare Department, Dr Siddharth Singh IAS Commissioner & Secretary to the Government of Assam’s Medical Education & Research Department issued an order which stated, “Director of Health Services, Assam may be instructed accordingly to instruct all Private Health Institutions registered under the Clinical Establishment Act to ensure that no government doctor should practice in their establishment during duty hours.”

For more information, click on the link below:

Private Practice During Duty Hours: Assam Govt Imposes Restrictions On Govt Doctors

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UK issues guidelines for use of stem cell-based embryo models in research

Stem cell-based embryo models (SCBEMs) are three-dimensional biological structures that mimic aspects of early human embryo development. They can be created in the lab from stem cells, and can provide new insights into critical stages of early human development that are normally inaccessible to researchers.

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An innovative test to diagnose Chagas disease in newborns

An innovative test that combines a DNA extraction system inspired by a modified 3D printer (PrintrLab) with loop-mediated isothermal molecular amplification (LAMP) could be used to detect T. cruzi infection—responsible for Chagas disease—in newborns.

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