How Repetitive Head injury leads to dementia in Football Players, reveals MRI study

In a groundbreaking study conducted between April 2021 and October 2022, researchers have uncovered alarming connections between repetitive head impacts (RHIs) in American football and an increased burden of white matter hyperintensity (WMH). They found that Fluid-attenuated inversion recovery (FLAIR) WMH in RHI-exposed individuals exhibits distinct risk factors and underlying pathologies when compared with asymptomatic unexposed men.

The study results were published in the journalNeurology.

Also Read: Risk of young onset dementia could be reduced through targeting health and lifestyle factors – study

Recent findings connect repetitive head impacts (RHIs) in American football to heightened white matter hyperintensity (WMH) burden. WMH may exhibit distinctive features in the context of RHI, extending beyond vascular risk and typical aging processes. Hence researchers conducted a study to assess the impact of repeated head injuries using encompassed biological markers like amyloid, tau, inflammation, axonal injury, neurodegeneration, and vascular health in former American football players.

Participants, as part of the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project, underwent clinical interviews, MRI scans, and lumbar punctures. Structural equation modeling assessed both direct and indirect effects between log-transformed total fluid-attenuated inversion recovery (FLAIR) lesion volumes (TLV) and various factors, including the revised Framingham stroke risk profile (rFSRP), MRI-derived metrics of cortical thickness and fractional anisotropy (FA), and cerebrospinal fluid (CSF) levels of amyloid β1–42, p-tau181, soluble triggering receptor expressed on myeloid cells 2 (sTREM2), and neurofilament light. Covariates considered in the analysis included age, race, education, body mass index, APOE ε4 carrier status, and evaluation site. Separate models were conducted for former football players and a control group of asymptomatic men not exposed to repetitive head impacts (RHI).

Findings:

  • In a cohort of 180 former football players (mean age = 57.2, 36% Black), elevated log-transformed total fluid-attenuated inversion recovery (FLAIR) lesion volumes (TLV) were directly linked to several factors.
  • These included a higher revised Framingham stroke risk profile (rFSRP) score (B = 0.26, 95% CI 0.07–0.40), increased p-tau181 (B = 0.17, 95% CI 0.01–0.43), diminished fractional anisotropy (FA) (B = −0.28, 95% CI −0.42 to −0.13), and reduced cortical thickness (B = −0.25, 95% CI −0.45 to −0.08).
  • Conversely, in a group of 60 asymptomatic unexposed men (mean age = 59.3, 40% Black), no direct effects on log(TLV) were observed.
  • This was evident in the negligible impact on rFSRP (B = −0.03, 95% CI −0.48 to 0.57), p-tau181 (B = −0.30, 95% CI −1.14 to 0.37), FA (B = −0.07, 95% CI −0.48 to 0.42), and cortical thickness (B = −0.28, 95% CI −0.64 to 0.10).
  • Comparatively, former football players exhibited notably stronger associations between log(TLV) and rFSRP (1,069% difference in estimates), p-tau181 (158%), and FA (287%) when contrasted with the unexposed men.
  • These findings underscore the distinct impact of repetitive head impacts in former football players, revealing significant correlations with various neurological markers compared to individuals without a history of such exposure.
Also Read: Modified Epley maneuver bests traditional approach for treating PC-benign paroxysmal positional vertigo

Risk factors and the biological relationships with white matter hyperintensity (WMH) vary significantly between former American football players and asymptomatic individuals without exposure to repetitive head impacts (RHI). Apart from considering vascular health, the former football players demonstrated more robust associations between WMH and factors like p-tau181 and diffusion tensor imaging indices, indicating a more profound connection to white matter integrity. These results suggest that fluid-attenuated inversion recovery (FLAIR) WMH in those exposed to repetitive head impacts may have unique risk factors and distinct underlying pathological mechanisms.

Further reading: Association of Vascular Risk Factors and CSF and Imaging Biomarkers With White Matter Hyperintensities in Former American Football Players. doi: https://doi.org/10.1212/WNL.00000000002080

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Low-Carbohydrate Diet helps in Weight Change

Low-carbohydrate diets (LCDs) are popular and gained considerable attention, as they hold the promise for promoting weight loss and improving metabolic health. LCDs, include diets such as ketogenic diets with only 5% to 10% of energy from carbohydrates, have led to favorable short-term weight changes.

A recent cohort study suggests LCDs that emphasized high-quality proteins, fats and carbohydrates from whole grains and other healthy plant-based foods were significantly associated with slower weight gain in the long term. In contrast, LCDs emphasizing animal-sourced proteins and fats or refined carbohydrates were associated with faster weight gain. This study is published JAMA Network.

The associations of low-carbohydrate diets (LCDs) with long-term weight management remains unclear, and the source and quality of macronutrients within LCDs are less explored.

To prospectively examine associations between changes in LCD indices and weight change among US adults.

Researchers designed a prospective cohort study included initially healthy participants at baseline from the Nurses’ Health Study (NHS; 1986-2010), Nurses’ Health Study II (NHSII; 1991-2015), and Health Professionals Follow-up Study (HPFS; 1986-2018). Data analysis was performed between November 2022 and April 2023. Five LCD indices were examined: (1) a total LCD (TLCD) emphasizing overall lower carbohydrate intake; (2) an animal-based LCD (ALCD) that emphasized animal-sourced protein and fat; (3) a vegetable-based LCD (VLCD) that emphasized plant-sourced protein and fat; (4) a healthy LCD (HLCD) emphasizing less refined carbohydrates, more plant protein, and healthy fat; and (5) an unhealthy LCD (ULCD) emphasizing less healthful carbohydrates, more animal protein, and unhealthy fat. The outcome of interest was 4-year changes in self-reported body weight.

The key findings of the study are

  • A total of 123 332 participants (mean [SD] age, 45.0 [9.7] years; 103 320 [83.8%] female) were included in this study. The median carbohydrate intake (as a percentage of energy) of the highest quintiles of TLCD score at baseline ranged from 38.3% in HPFS to 40.9% in NHSII.
  • Mean weight gain over 4-year intervals among participants varied from 0.8 kg in the HPFS to 1.8 kg in the NHSII. After adjusting for demographics and baseline and concomitant changes of selected lifestyle factors, each 1-SD increase in TLCD score was associated with 0.06 (95% CI, 0.04-0.08) kg more weight gain over the 4-year periods.
  • Similarly, participants gained 0.13 (95% CI, 0.11 to 0.14) kg per each 1-SD increase in ALCD score and 0.39 (95% CI, 0.37 to 0.40) kg per each 1-SD change in ULCD score. In contrast, each 1-SD increase in VLCD score was associated with 0.03 (95% CI, 0.01 to 0.04) kg less weight gain, and each 1-SD increase in HLCD score was associated with 0.36 (95% CI, 0.35 to 0.38) kg less weight gain.
  • The associations were more pronounced among obese individuals (per 1-SD increase in HLCD score: BMI ≥30, 0.88 [95% CI, 0.80, 0.97] kg less weight gain; BMI <25, 0.23 [95% CI, 0.20, 0.26] kg less weight gain; P for interaction < .001).

Researchers concluded that “These findings suggest that the quality of LCDs may play a critical role in modulating long-term weight change. Only LCDs that emphasized high-quality protein, fat, and carbohydrates from whole grains and other plant-based foods were associated with less weight gain.”

Reference: Liu B, Hu Y, Rai SK, Wang M, Hu FB, Sun Q. Low-Carbohydrate Diet Macronutrient Quality and Weight Change. JAMA Netw Open. 2023;6(12):e2349552. doi:10.1001/jamanetworkopen.2023.49552.

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Biological E Gets CDSCO Panel Nod to study safety of XBB 1.5-RBD Subunit Covid-19 Vaccine in 5-80 years old

New Delhi: The drug major Biological E has got the go-ahead from the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) to conduct the Phase-III clinical trial of the SARS-CoV-2 (Covid-19) Vaccine (Variant XBB.1.5)

This came after Biological E presented the Phase –III Clinical trial protocol titled “ A prospective single-blind randomized Phase-III comparative study to evaluate immunogenicity and safety of Biological E’s XBB 1.5-RBD subunit Covid-19 vaccine in 5-80 years old Individuals.”

The COVID-19 Omicron subvariant XBB.1.5 has become more prevalent due to a potent combination of mutations that facilitate its transmission, even among individuals who have already been vaccinated or infected.

The COVID-19 Omicron strain has undergone several subvariants’ mutations. It was BA.1 at first, and subsequently the Omicron subvariant of BA.5. After a while, it transformed into BQ.1.1 and BQ.1.

Next, there is XBB.1.5, sometimes known as the Kraken, which is a subvariant of BA.2 Omicron. It belongs to the XBB family of variants, which became identified a few months ago and attracted the attention of virologists due to the fact that it has more mutations that escape immunity than other variants that have been observed so far. It is thought that a mutation in the XBB.1.5 subvariant facilitates the virus’s ability to bind to cells and increase its transmissibility.

Symptoms with XBB.1.5 appear to be similar to the earlier Omicron subvariants. Those can range from typical cold symptoms such as cough and congestion to shortness of breath and low oxygen levels that require emergency medical attention.

However, as XBB.1.5 continues to spread, the signs and symptoms of COVID-19 may seem different than what was seen earlier in the pandemic with Alpha or Delta variants. Symptoms such as the temporary loss of taste and smell can still happen in some instances, but it has become less common with the Omicron variant and subvariants.

Other symptoms may include fever, chills, fatigue, muscle or body aches, sore throat, nausea or vomiting, and diarrhea. Symptoms can last between five to seven days but vary from person to person.

At the recent SEC meeting for Covid 19 held on 7th December 2023, the expert panel reviewed the Phase –III Clinical trial protocol presented by Biological E titled “ A prospective single-blind randomized Phase-III comparative study to evaluate immunogenicity and safety of Biological E’s XBB 1.5-RBD subunit Covid-19 vaccine in 5-80 years old Individuals.”

The expert panel noted that permission in CT-23 was already granted to the firm for the SARS-CoV-2 vaccine containing the Receptor Binding Domain (RBD) of SARS-CoV-2 gene (CORBEVAX) in the age group of ≥5 to <12 years, ≥ 12 years and ≥ 18 years old individuals.

After detailed deliberation, the committee recommended a grant of permission to conduct the Phase-III clinical trial as per the protocol presented by the firm.

Also Read: Modify phase III clinical trial protocol: CDSCO panel tells Akum Pharma on antidiabetic FDC

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Zydus Healthcare gets Rs 284.58 crore income tax demand notice

Zydus Lifesciences on Tuesday said its arm Zydus Healthcare Ltd has been served an income tax notice demand of Rs 284.58 crore for the assessment year 2023-2024.

Zydus Healthcare Ltd (ZHL), a wholly-owned subsidiary, has received an intimation under section 143(1) of the Income Tax Act, 1961 (IT Act), determining demand of Rs 284.58 crore, Zydus Lifesciences said in a regulatory filing.

For more details, check out the link given below:

Zydus Healthcare Gets Rs 284.58 Crore Income Tax Demand Notice

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Govt doctors in Haryana observe daylong strike, OPD services hit at some hospitals

Government doctors in Haryana observed a strike on Wednesday in support of their various demands, impacting outpatient department (OPD) services at some hospitals.

The strike was observed on a call given by the Haryana Civil Medical Services Association (HCMS).

For more news & updates, check out the link given below:

https://medicaldialogues.in/

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JJ Hospital 780 resident doctors on indefinite strike from today

A total of 780 resident doctors at JJ Hospital in Mumbai have initiated an indefinite strike in solidarity with the 21 resident doctors from the dermatology department who have been on mass leave for the past two weeks. The strike is a response to alleged mental harassment and inadequate patient care attributed to the head of the dermatology department, resulting in six deaths this year. The Maharashtra Association of Resident Doctors (MARD) had previously demanded action against the dermatology head, citing mental harassment and mismanagement of patient care.

For more news & updates, check out the link given below:

https://medicaldialogues.in/

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CISF seizes medicines worth Rs 80 lakh at IGI airport, two held

Two international passengers were apprehended for allegedly carrying medicines worth Rs 80 lakh at IGI Airport in New Delhi, an official statement issued by the Central Industrial Security Force (CISF) said on Tuesday.

According to CISF, the two persons identified as Md Raihan Fazal and Azeem Khan were planning to go to Kabul via Dubai on a flight.

For more details, check out the link given below:

2 International Passengers Held For Allegedly Carrying Medicines Worth Rs 80 Lakh At IGI Airport

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SR Post Vacancies: Walk In Interview At GB Pant Hospital Delhi In Various Specialties, View Details Here

New Delhi: Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER) has notified vacancies for the Senior Resident post on an ad hoc basis in this medical institute.

The Institution has a unique recognition by the Medical Council of India and the University Grants Commission as an independent post-graduate College affiliated with Delhi University. the Foundation stone of Govind Ballabh Pant Hospital was laid in October 1961 and was commissioned by the then Prime Minister late Pt. Jawaharlal Nehru on 30th April 1964. From a very humble beginning with 229 beds, it has expanded to currently over 700 beds (714 beds). Today it is an internationally recognized tertiary care institution for Heart, Brain Gastrointestinal, and Psychiatric disorders. It offers super specialty treatment to about 3 lac patients in the OPD and almost 15,000 patients in General and Private wards yearly.

GIPMER Vacancy Details:

Total no of vacancies: 34

The vacancies are in the Departments of Neurology, Biochemistry, and Anaesthesiology.

The Walk-In-Interview date is 29th December 2023.

For more details about Qualifications, Age, Pay Allowance, and much more, click on the given link:
https://medicaljob.in/jobs.php?post_type=&job_tags=GB+Pant+Hospital&location=&job_sector=all

How to Apply For Eligible Candidates:-

1. Appointment will be subject to Medical fitness and verification of Certificate(s) of educational qualification/age/caste/DMC registration.

2. The vacancies are likely to vary and may be filled in phases.

3. Panel of wait listed candidates will be prepared separately.

4. No TA/DA will be paid for appearing in the aforesaid interview.

5. The appointment and services of selected SR’s will be governed under the Residency Scheme.

6. In case, interview cannot be completed on the scheduled date/duration the same shall be conducted on the following working day.

7. No correspondence or personal inquiries shall be entertained.

8. Bring all original documents along with their self-attested photocopies on the scheduled date of Interview & on the date of joining to the post.

9. The Candidates are advised to check the Institute website regularly for any/further updation in the matter.

10. FEES PAYABLE:- Rs. 300/-(Non-Refundable) in the form of a Cash/Demand Draft issued by a nationalized bank in favor of MEDICAL SUPERINTENDENT, G.B. PA VT HOSPITAL, PAYABLE At New Delhi, The eligible candidate can deposit the fee(in Cash) to the Cashier at Accounts Branch of this Institute, GIPMER.

JURISDICTION OF DISPUTE: In case of any Legal dispute, the jurisdiction of the Court will the Delhi/New Delhi only.

• Note: – The application form is available at the Institute’s website gbpant.delhigovt.nic.in.

Also Read:Job Alert: Senior Lecturer Post At UPSC In GMCH, Chandigarh

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Lupin bags USFDA nod for Loteprednol Etabonate Ophthalmic Suspension

Mumbai: Global pharma major Lupin Limited has announced
that the Company has received approval from the United States Food and Drug Administration (U.S. FDA) for its
Abbreviated New Drug Application for Loteprednol Etabonate Ophthalmic Suspension, 0.2%, to market
a generic equivalent to the reference listed drug (RLD) Alrex Ophthalmic Suspension, 0.2%, of Bausch
& Lomb Inc.

The product will be manufactured at Lupin’s Pithampur facility in India.


Loteprednol Etabonate Ophthalmic Suspension, 0.2%, is indicated for the temporary relief of the signs
and symptoms of seasonal allergic conjunctivitis.

Loteprednol Etabonate Ophthalmic Suspension, 0.2% (RLD Alrex), had estimated annual sales of USD
29.1 million in the U.S. (IQVIA MAT October 2023).

Read also: Lupin to buy established products portfolio in Europe, Canada from Sanofi for Rs 91 crore

Lupin is an innovation-led transnational pharmaceutical company headquartered in Mumbai, India. The
Company develops and commercializes a wide range of branded and generic formulations, biotechnology
products, and APIs in over 100 markets in the U.S., India, South Africa, and across the Asia Pacific (APAC), Latin
America (LATAM), Europe, and Middle East regions.
The Company specializes in the cardiovascular, anti-diabetic, and respiratory segments and has
a significant presence in the anti-infective, gastro-intestinal (GI), central nervous system (CNS), and women’s
health areas. The company
invested 7.9% of its revenue in research and development in FY23.
Lupin has 15 manufacturing sites, 7 research centers.

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COVID JN.1 variant: Himachal health dept issues advisory to district units

Hamirpur: Following the detection of COVID-19 variant JN.1 in the country, Himachal Pradesh’s health department has issued an advisory to the chief medical officers in the state to test patients with COVID-like symptoms and take necessary precautions, officials said.

People with symptoms of cold, fever or cough are advised to take a COVID test, Una CMO Dr Sanjeev Kumar said on Tuesday. He also urged people to wear masks.

Also Read:COVID subvariant JN.1: AIIMS Delhi advises not to panic, need to remain alert

In cases of respiratory diseases like influensa, cough, cold, sore throat, runny nose, headache and fever, all patients should get an RT-PCR test done immediately, doctors said.

India has recorded 69 cases of COVID JN.1 variant, as per official sources.

Medical Dialogues team had earlier reported that after a surge in the cases of the new COVID subvariant JN.1, doctors from the All India Institute of Medical Sciences (AIIMS) have advised people to not panic but rather remain alert and vigilant. “People are getting infected by the new sub-variant of COVID-JN.1 in many states of the country. The symptoms of the patients are mild. Therefore, there is no need to panic but the need to remain alert,” Doctor Neeraj Nischal said.

Doctor Nischal, who is an Additional Professor in the Department of Medicine at AIIMS Delhi, said, “We have been saying this type of ripple will keep on happening. Even during the first and second waves, we predicted that this virus would mutate further and the stage would come where it would become more infectious but at the same time cause less mortality or morbidity.” “So this is, you can say, a fight between the viruses in human beings who are also trying to survive. People are becoming infected but at the same time, it’s not causing the problem that its predecessors, like the delta variant, caused,” said the doctor. 

Also Read:COVID 19 cases jump 52 per cent globally in past one month: WHO

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