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Medically Speaking


Shalini Bhardwaj



New Delhi: Pharma major Dr Reddy’s Laboratories Ltd has completed Phase-3 trials of Russian Covid-19 vaccine Sputnik V. The Phase-3 study of Sputnik V was conducted on about 1,500 subjects as part of the randomised, double-blind, parallel-group and placebo-controlled study in India. The result of trials is expected to come in a few days. According to sources, India will start adding Sputnik V for vaccination in month of April.

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Medically Speaking




The findings of a new study suggest that remotely supervised workout sessions are more effective than face-to-face exercise classes during the COVID-19 pandemic. The findings of the study appeared in the journal ‘Psychiatry Research’. Researchers at the University of Sao Paulo (USP) in Brazil investigated the effects of regular exercise on the physical and mental health of 344 volunteers during the pandemic.

The study compared the effectiveness of three techniques: sessions led in person by a fitness instructor, sessions featuring an online instructor but no supervision, and sessions supervised remotely by an instructor via video call. The two kinds of sessions with professional supervision had the strongest effects on physical and mental health. According to the researchers, this was due to the possibility of increasing the intensity of the exercises over time.

To their surprise, remotely supervised sessions were more effective than face-to-face sessions. Sedentary subjects served as controls. “The findings underscore the benefits of either approach, with the instructor online or physically present, compared with being sedentary. However, the physical and mental benefits have much to do with a secure and progressive increase in the intensity of the exercises, which occurred only when they were supervised by a professional. What’s interesting is that remote supervision by video call was more efficient. The difference was small but statistically significant,” Carla da Silva Batista, last author of the study, told Agencia FAPESP.

Batista is a researcher at the University of Sao Paulo’s School of Physical Education and Sports (EEFE-USP). The study was supported by FAPESP. Volunteers were selected from different age and income groups and came from different parts of Brazil. Some had symptoms of depression. The remotely supervised participants, who worked out using Pilates, Crossfit, yoga, dance and aerobics, exercised more intensely than those who lacked supervision.

“Increasing intensity in supervised online sessions was of paramount importance during the pandemic,” Batista said. “Around half the participants, or 55 per cent, performed high-intensity exercises before the pandemic, but the proportion fell to 30 per cent once lockdown began.” Other research shows intense exercise increases longevity, reduces the risk of developing Parkinson’s disease, and is associated with a reduced risk of 26 types of cancer.

“We don’t know exactly why working out with remote supervision by video call gets better results than when the instructor is physically present,” Batista said. “It’s probably that the participants felt the discomfort of wearing a mask hindered their performance during the pandemic.”

Other reasons could include the possibility that remotely supervised participants were more motivated. “They were doing exercises in safety and at home, but with supervision and without having to wear a mask. They didn’t have to worry about spreading the virus, so the instructor may have felt free to increase the intensity of the exercises safely, without risking injury or discomfort,” Batista said.To evaluate the participants’ physical and mental health, in July-August 2020 the researchers applied validated online questionnaires known as the International Physical Activity Questionnaire – Short Form (IPAQ-SF) and the Montgomery-Asberg Depression Rating Scale – Self-Rated (MADRS-S).

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Medically Speaking

Chemotherapy can induce mutations that lead to pediatric leukemia relapse



A new study has found that a group of chemotherapy drugs can result in mutations that may trigger the relapse of blood cancer in children.Chemotherapy has helped make acute lymphoblastic leukemia (ALL) one of the most survivable childhood cancers. Now, researchers working in the US, Germany and China have shown how chemotherapy drugs called thiopurines can lead to mutations that set patients up for relapse. The findings of the study were published in the journal ‘Nature Cancer’.

The research provided the first direct genomic and experimental evidence in pediatric cancer that drug-resistant mutations can be induced by chemotherapy and are not always present at diagnosis. “The findings offer a paradigm shift in understanding how drug resistance develops,” said Jinghui Zhang, PhD, Department of Computational Biology chair at St. Jude Children’s Research Hospital.

“The results also suggest possible treatment strategies for ALL patients who relapse, including screening to identify those who should avoid additional thiopurine treatment,” added Zhang. Zhang is co-corresponding author of the study with Bin-Bing Zhou, Ph.D., of Shanghai Children’s Medical Center; and Renate Kirschner-Schwabe, M.D., of Charite-Universitaetsmedizin Berlin.


While 94 per cent of St. Jude patients with ALL become five-year survivors, relapse remains the leading cause of death worldwide for children and adolescents with ALL. This study involved ALL samples collected from relapsed pediatric ALL patients in the US, China and Germany. Researchers analysed more than 1,000 samples collected from the patients at different times in treatment, including samples from 181 patients collected at diagnosis, remission and relapse.Co-first author Samuel Brady, PhD, of St. Jude Computational Biology, identified a mutational signature that helped decipher the process. Mutational signatures reflect the history of genetic changes in cells.

Brady and his colleagues linked increased thiopurine-induced mutations to genes such as MSH2 that become mutated in leukemia. The mutations inactivated a DNA repair process called mismatch repair and rendered ALL resistant to thiopurines. The combination fueled a 10-fold increase in ALL mutations, including an alteration in the tumour suppressor gene TP53. The mutation, TP53 R248Q, promoted resistance to multiple chemotherapy drugs, including vincristine, daunorubicin and cytarabine.

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Medically Speaking




It’s a favourite first-order for the day, but while a quick coffee may perk us up, new research from University of South Australia showed that too much could be dragging us down, especially when it comes to brain health.In the largest study of its kind, researchers have found that high coffee consumption is associated with smaller total brain volumes and an increased risk of dementia. The findings were published in the journal ‘Nutritional Neuroscience’.

Conducted at UniSA’s Australian Centre for Precision Health at SAHMRI and a team of researchers, the study assessed the effects of coffee on the brain among 17,702 UK Biobank participants, finding that those who drank more than six cups of coffee a day had a 53 per cent increased risk of dementia. Lead researcher and UniSA PhD candidate, Kitty Pham, said the research delivers important insights for public health. “Coffee is among the most popular drinks in the world. Yet with global consumption being more than nine billion kilograms a year, it’s critical that we understand any potential health implications,” Pham said.

“This is the most extensive investigation into the connections between coffee, brain volume measurements, the risks of dementia, and the risks of stroke – it’s also the largest study to consider volumetric brain imaging data and a wide range of confounding factors,” Pham added.

“Accounting for all possible permutations, we consistently found that higher coffee consumption was significantly associated with reduced brain volume – essentially, drinking more than six cups of coffee a day may be putting you at risk of brain diseases such as dementia and stroke,” Pham further said.Dementia is a degenerative brain condition that affects memory, thinking, behaviour and the ability to perform everyday tasks. About 50 million people are diagnosed with the syndrome worldwide. In Australia, dementia is the second leading cause of death, with an estimated 250 people diagnosed each day.

Stroke is a condition where the blood supply to the brain is disrupted, resulting in oxygen starvation, brain damage and loss of function. Globally, one in four adults over the age of 25 will have a stroke in their lifetime. Data suggests that 13.7 million people will have a stroke this year with 5.5 million dying as a result.Senior investigator and Director of UniSA’s Australian Centre for Precision Health, Professor Elina Hypponen, said while the news may be a bitter brew for coffee lovers, it’s all about finding a balance between what you drink and what’s good for your health.

“This research provides vital insights about heavy coffee consumption and brain health, but as with many things in life, moderation is the key,” Professor Hypponen said. “Together with other genetic evidence and a randomised controlled trial, these data strongly suggest that high coffee consumption can adversely affect brain health. While the exact mechanisms are not known, one simple thing we can do is to keep hydrated and remember to drink a bit of water alongside that cup of coffee,” Professor Hypponen added.

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Medically Speaking




According to a new study, adults and children with COVID-19 who have a history of malnutrition may have an increased likelihood of death and the need for mechanical ventilation. The findings of the study appeared in the journal ‘Scientific Reports’. Malnutrition hampers the proper functioning of the immune system and is known to increase the risk of severe infections for other viruses, but the potential long-term effects of malnutrition on COVID-19 outcomes are less clear.

Louis Ehwerhemuepha and colleagues investigated associations between malnutrition diagnoses and subsequent COVID-19 severity, using medical records for 8,604 children and 94,495 adults (older than 18 years) who were hospitalised with COVID-19 in the United States between March and June 2020.Patients with a diagnosis of malnutrition between 2015 and 2019 were compared to patients without.

Of 520 (6 per cent) children with severe COVID-19, 39 (7.5 per cent) had a previous diagnosis of malnutrition, compared to 125 (1.5 per cent) of 7,959 (98.45 per cent) children with mild COVID-19. Of 11,423 (11 per cent) adults with severe COVID-19, 453 (4 per cent) had a previous diagnosis of malnutrition, compared to 1,557 (1.8 per cent) of 81,515 (98.13 per cent) adults with mild COVID-19.Children older than five and adults aged 18 to 78 years with previous diagnoses of malnutrition were found to have higher odds of severe COVID-19 than those with no history of malnutrition in the same age groups.

Children younger than five and adults aged 79 or above were found to have higher odds of severe COVID-19 if they were not malnourished compared to those of the same age who were malnourished. In children, this may be due to having less medical data for those under five, according to the authors. The risk of severe COVID-19 in adults with and without malnutrition continued to rise with age above 79 years.

The authors suggest that public health interventions for those at the highest risk of malnutrition may help mitigate the higher likelihood of severe COVID-19 in this group.

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Medically Speaking




Coronavirus has left a scar on our minds, and its impact is not only felt by adults but kids as well. The concept of ‘long COVID’ is not well defined yet, but there are several research papers that highlight the long-term effects of COVID on various age groups. Children who have battled COVID are coming back to hospitals with post-COVID symptoms like persistent headaches, fatigue, abdominal pain, gastric issues, heart palpitations, difficulty to sleep, muscle pain, loss of smell, and Tachycardia (increased heart rate). This symptom typically manifests after 2-4 weeks of the initial infection and may last for weeks to months. 

RISK FACTORS FOR KIDS: Adolescents and teenagers may be prone to witness long COVID symptoms. Moreover, children with higher BMI or obesity are at higher risk of experiencing long COVID.  Initially, we were under the impression that long COVID can occur in kids having acute infections. However, that has changed over time, and we see a lot of children with asymptomatic and mild infection also experiencing long COVID. Having said that it is important to note that kids experiencing such symptoms should be properly screened by medical experts as many of these could be a result of mental health issues induced by the lockdown and pandemic. 

 There are studies that indicate that isolation and lockdown have resulted in mental health issues among kids, further resulting in headaches, fatigue, anger, misbehaviour, and similar issues. Parents and doctors need to ensure proper diagnosis of these health ailments. 

MULTISYSTEM INFLAMMATORY SYNDROME (MIS-C) A CAUSE OF MANY SUCH LONG COVID ISSUES IN KIDS: MIS-C in children is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. We know that many children with MIS-C had the COVID virus or had been around someone with COVID19. When a child’s immune system reacts extensively to fight the virus in such cases, the immune system adopts in abnormal ways to fight the disease and that’s when organs start to get inflamed causing MIS-C. MIS-C can be serious, even deadly, but most children diagnosed with this condition have gotten better with medical care. 

SYMPTOMS OF MIS-C: Signs and symptoms of MIS-C in children include: 

• High-grade fever that lasts 24 hours or longer 

• Vomiting 

• Diarrhoea 

• Pain in the stomach 

• Skin rash 

• Feeling unusually tired 

• Fast heartbeat 

• Rapid breathing 

• Red eyes 

• Redness or swelling of the lips and tongue 

• Redness or swelling of the hands or feet 

• Headache, dizziness, or light-headedness 

DIAGNOSIS AND TREATMENT OF MIS-C: If MIS-C is suspected, a diagnostic or antibody test for COVID19 can help confirm current or past infection with the virus, which aids in diagnosis and treatment. 


• CBC Blood tests 

• C-reactive protein test 

• Chest X-ray 

• Heart ultrasound (echocardiogram) 

• Abdominal ultrasound 

Usually, supportive care for symptoms i.e., medicine and/or fluids are given to make your child feel better, coupled with various medicines to treat inflammation. Most children who become ill with MIS-C will need to be treated in the hospital. To treat this condition normally, Intravenous Immunoglobulin (IVIG) to improve antibody content or steroids in appropriate dosages is given. All these medications are given, and the children are kept under observation. Some children may need to be treated in the Paediatric Intensive Care Unit (ICU) if they are severely ill. 

Above all, prevention is always better than cure. Vaccinate your kids with the flu vaccine to reduce the impact of any viral infection. More so, follow COVID-appropriate norms at home and outside. Ensure that your kids stay hygienic and maintain COVID19 norms. 

The Author is Consultant Paediatrics & Neonatology, Fortis Hiranandani Hospital Vashi & Dr Asmita Mahajan, Consultant Neonatology & Paediatrics, SL Raheja Hospital, Mahim. 

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Medically Speaking

Benefits and afflictions of using Giloy

Meenakshi Upreti



A year and a half have passed since the Covid-19 pandemic swept across the globe. While there seemed no possible cure for the disease and researchers intensified their search for effective treatment and vaccine, many clinical trials were happening around the world and herbs emerged as a possible alternative treatment. Two of them include Giloy and Ashwagandha.

Giloy is a popular ayurvedic remedy for a number of health conditions including fever, infections and diabetes. However, there have been numerous debates about its benefits. While Ayurvedic doctors have claimed that the herb is not harmful, there have also been some reports claiming that giloy can lead to liver damage. A study published in the Journal of Clinical and Experimental Hepatology claimed the herb is harmful to the liver. On the other hand, the Ministry of AYUSH argued that giloy had been scientifically proven to be an effective remedy for multiple disorders.

To comprehend the facts related to the medicinal herb, we interviewed some eminent personalities from the field of gastroenterology and hepatology. An expert from the field of liver and gastroenterology suggested that alternative medications like giloy can cause some serious liver injuries. Dr Kaushal Madaan, Head of Hepatology, Max chain of hospitals, said: “When this pandemic came, we realised that there were many patients who came to us with unexplained liver failure and liver injury and some of them had even died. Only after a few months, we realised that they were taking a concoction and the most common ingredient of that concoction in these particular patients was giloy.” He pointed out that people were consuming kadhas or concoctions, twice or thrice a day, for a year, which could have caused serious liver damage.

“Even before the pandemic started, we had been advising our patients, whether or not they have underlying liver disease, to avoid taking herbal medicines of whose ingredients we are not sure about,” Dr Kaushal added, in the context of herbal and alternative medicines.

Alluding to the fact that all medicines — allopathic, homoeopathic or ayurvedic — have their pros and cons, Dr Sarin, Director, ILBS, said, “I can certainly say that there are certain herbs that can be harmful. There are certain preparation; unless they have published data, or they have data that they are only beneficial, just don’t take them if they have no scientific evidence.”

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