Month: August 2023

AMSTERDAM: According to European Society of Cardiology (ESC) Guidelines on Infective Endocarditis, patients with specific cardiac conditions, such as valvular heart disease and congenital abnormalities, or those needing pacemakers, should practice good dental and skin hygiene to help prevent uncommon but potentially fatal infections of the heart’s inner lining and valves.The findings were published in European Heart Journal.“Infective endocarditis is an uncommon but very serious disease that can present with many different symptoms, and thus may be challenging to diagnose,” said Guidelines task force chairperson Professor Michael Borger of Leipzig Heart Centre, Germany. “Patient education is therefore paramount to early diagnosis and treatment. Those with valvular heart disease or previous heart valve surgery should be particularly diligent with regards to prevention and recognizing symptoms.”An infection of the heart’s inner lining, most usually the heart valves, is referred to as infectious endocarditis. It happens when germs or fungus enter the bloodstream, such as after surgery, dental work, or skin diseases. Fever, night sweats, unexpected weight loss, cough, disorientation, and fainting are among the symptoms. The infection may result in the valve being destroyed, abscesses, and cell and microbe clusters that can fragment into smaller pieces and spread to other regions of the body (a process known as embolization). Also possible are heart failure, septic shock, and stroke.Worldwide each year there are nearly 14 new cases of infective endocarditis for every 100,000 individuals and more than 66,000 patients die. “The mortality rate is extremely high and therefore preventive strategies in patients at high risk are pivotal,” said Guidelines task force chairperson Dr. Victoria Delgado of the Germans Trias i Pujol University Hospital, Badalona, Spain.Those at highest risk include survivors of previous episodes of infective endocarditis and patients with prosthetic heart valves, congenital heart disease (not including isolated congenital heart valve abnormalities) or a left ventricular assist device. In these patients, prophylactic antibiotics are recommended before oral or dental procedures. Patients at intermediate risk are those with pacemakers, severe valvular heart disease, congenital heart valve abnormalities (including bicuspid aortic valve) and hypertrophic cardiomyopathy, a disease where the heart muscle is thickened. In these patients, the need for antibiotic prophylaxis prior to dental procedures should be evaluated on an individual basis. Antibiotic prophylaxis is not needed in those at low risk.The main targets for antibiotic prophylaxis are oral streptococci. The document states that “the emerging and increasing antibiotic resistance among oral streptococci is of concern”. Dr. Delgado said: “Streptococci are naturally present in the mouth but can enter the bloodstream when oral hygiene is suboptimal and during dental procedures. Rises in antibiotic use for infectious diseases have led to resistance, meaning that antibiotics become ineffective. Caution in the use of antibiotics is therefore needed and self-medication should be avoided.”The Guidelines recommend other preventive measures for patients at intermediate and high risk including twice daily tooth cleaning, professional dental cleaning (twice yearly for high risk and yearly for intermediate risk patients), consulting a general practitioner for fever with no obvious reason, strict skin hygiene, treatment of chronic skin conditions, and disinfection of wounds. Piercings and tattoos are discouraged.Recommendations are provided for diagnosis, treatment, and management of complications. Diagnosis is based on clinical suspicion, blood cultures, and imaging. Echocardiography is the first-line imaging technique, and new diagnostic criteria include findings on other imaging techniques. There are new recommendations on the use of computed tomography, nuclear imaging and magnetic resonance imaging plus novel diagnostic algorithms when the infection involves native heart valves, prosthetic heart valves, and implanted cardiac devices such as pacemakers and defibrillators.Treatment aims to cure the infection and preserve heart valve function. The Guidelines recommend appropriate antibiotics, determined from blood cultures, as the mainstay of therapy, with duration depending on the severity of infection. Surgery to remove infected material and drain abscesses is indicated for patients with heart failure or uncontrolled infection, and to prevent embolisation. Surgery should generally occur earlier than previously recommended because of improved survival.One of the worst complications of endocarditis is stroke. Decisions about the timing of surgery in patients who have suffered a stroke must balance the risk of neurological deterioration during the procedure against that of delaying surgical therapy. Novel recommendations are to proceed with urgent heart valve surgery in patients with ischaemic stroke due to embolism but delay surgery in patients with haemorrhagic stroke. In addition, thrombectomy (removal of the embolus through a catheter) may be considered in very select patients with stroke.A new section in the Guidelines is devoted to patient-centred care and shared decision-making. Professor Borger said: “Infective endocarditis is a life-threatening condition with lengthy treatment and can be emotionally distressing for patients and families. Patients must be at the centre of care to achieve the best physical and mental outcomes.”

KARACHI: The metropolis has witnessed a surge in viral eye infections during the ongoing rainy season, with dozens of cases being reported on a daily basis. Public and private hospitals across the city have been grappling with the mounting cases of conjunctivitis, commonly known as red eye. Jinnah Hospital, a prominent medical facility in the city, has recorded 50 instances in its Outpatient Department (OPD) each day. Of these, 25 cases pertain specifically to the red eye infection, afflicting both children and adults alike. Leading Consultant Ophthalmologist, Dr Muhammad Moizuddin, has attributed this sudden surge to the transmission of the infection through direct contact with the ocular discharge of affected individuals. The infection, known to linger for a period of 8 to 10 days, manifests with a reddening of the eye, accompanied by moisture and discomfort. Dr Moizuddin advises the affected individuals to maintain strict hygiene practices, including separating their personal items such as towels and toiletries. In the midst of this growing concern, the afflicted are advised to employ prescribed eye drops and clean tissues for the cleansing of their eyes. Cold water, it is noted, brings relief to the affected eyes, offering a temporary reprieve from the discomfort. The consensus remains that adherence to cautionary measures and impeccable cleanliness are pivotal in stemming the transmission of this highly contagious eye infection. Detailing the symptoms of conjunctivitis, Dr Rabia Chaudhry, Assistant Ophthalmologist at Jinnah Hospital Karachi, emphasised the emergence of redness, itching, and inflammation of the eyes. She further noted the formation of lumps near the ears and, in some instances, the involvement of the cornea, potentially affecting the visual acuity of the individual. Read also: Treatment of genetic diseases stressed While a swift recovery is anticipated if the infection confines itself to the white part of the eye, instances where the cornea is compromised demand a longer healing timeline, spanning two to three weeks. Dr Chaudhry highlighted the significance of precautionary measures, given the infection’s propensity for person-to-person transmission. Unlike common misconception, she asserts that the infection isn’t contracted through mere eye contact; rather, it is facilitated by direct exposure to the infected individual’s ocular fluids. Notably, many cases have shown a co-occurrence of red eye with cold, flu, and cough symptoms. Dr Chaudhry further imparted crucial advice on how to mitigate the risk of transmission within households and workplaces. By maintaining personal hygiene and avoiding shared items, individuals can considerably reduce the chances of spreading the infection. Proper hand washing before administering eye drops, coupled with careful application, forms a vital line of defence. The sting of light often accompanies the infection, for which sunglasses and cold compresses can provide respite. Children have not been spared by this contagion; therefore special attention is urged to their well-being.

COVID-19 was never just another cold. We knew it was going to stick around and keep changing to try to get the upper hand on our immune systems.Related video above: New EG.5 COVID-19 variant spikes in parts of the U.S.But we’ve changed, too. Our B cells and T cells, keepers of our immune memories, aren’t as blind to this virus as they were when we first encountered the novel coronavirus in 2020. The U.S. Centers for Disease Control and Prevention has screened blood samples and estimates that 97% of people in the U.S. have some immunity to COVID-19 through vaccination, infection or both.Then there’s science: We have updated vaccines and good antivirals to lean on when cases start to rise. Masks still work. Rapid tests are in stores. We now know how to filter the air and to ventilate our spaces.Those strategies, plus our hard-won immunity, had helped bring our national numbers of infections, hospitalizations and deaths down to levels that felt almost forgettable.Almost.Now that COVID-19 infections have started to rise again, it feels like people all over the country are testing positive, and it’s hard to know how to react. The government has been dialing back its response since the end of the public health emergency in May. Good COVID-19 data is hard to come by and harder to interpret.So if people are less likely to be hospitalized or die from a COVID-19 infection now, has the danger passed? Is there still reason to worry if you do catch the infection for a second, third or fourth time?Experts say it’s less risky to catch COVID-19 than it used to be, but there are still good reasons not to treat it casually.”At this point, the risk is lower because of our prior immunity, whether for severe outcomes or for long COVID,” said Dr. Megan Ranney, an emergency physician and dean of the Yale School of Public Health.”COVID is still more dangerous than the flu, but its level of danger is becoming less,” she said, noting that we’re still very early in our human experience with the coronavirus, even four years in, and there are still things we don’t know.”But for it to behave like other respiratory viruses in terms of seasonality and surges is entirely expected,” she added.It would be “really weird” for COVID to disappear or for it not to cause illnesses, hospitalizations and deaths. “It is still a virus,” Ranney said.But a somewhat predictable waxing and waning of infections doesn’t make COVID-19 something to turn our backs on.Our immune systems are better at spotting dangerAfter more than three grueling years, nearly all Americans have some immunity against COVID-19.That means our immune systems – as long as they’re healthy and working as they should – will remember most forms of the coronavirus when it next comes our way.That process takes some time to get going, however. That lag may give the virus enough of a window to get a foothold in our nasal passages or lungs, and we get sick. We may feel crummy for a few days, but then our B cells and T cells get their antibody production up and running. Eventually, they shut the virus down, and we get better.That’s what should happen. But for many, their immune system just doesn’t kick in as quickly or as vigorously as it should.Immune function drops off naturally with age. About 1 in 4 Americans is over the age of 60, according to census data. Then there are certain medications and health conditions that suppress immune function. About 3% of the U.S. population – 7 million people – is severely immunocompromised, according to the National Institutes of Health. This is a group taking medications to protect organ transplants or who are getting powerful drugs for cancer treatment, for example.Then there’s individual variability. Through genetic bad luck, some people may just be at higher risk of serious reactions to COVID-19 infections, and they probably wouldn’t know it.Taken together, that’s a sizeable pool of people who benefit greatly from having antibodies at the ready to take on the coronavirus as fast as possible. Vaccines get those antibodies in place and ready to work as soon as they’re needed.Sometimes, people are so immunocompromised that vaccines can’t help them much, either. They benefit from preventive shots containing COVID-fighting antibodies that are built to stick around the body for a few months. Until this year, there was such a preventive product available, Evusheld. But the virus has evolved so much that Evusheld lost its potency, and in January, the FDA revoked its authorization.Since then, people who have very low immune function haven’t had anything to protect them from infection or severe disease. But that could change. The government announced this week that it’s funding the development of a new preventive antibody through the drug company Regeneron. Trials of that drug are expected to start this fall, according to the U.S. Department of Health and Human Services.While nearly all of us have immune systems that can recognize key parts of the virus now, even that memory to the infection fades over time. The longer it has been since you’ve been infected or vaccinated, the more forgetful your immune system becomes.Those B cells and T cells, “they’re going to be a little slower to respond. They’re not they’re not as primed and ready to go,” Ranney said.Your strongest immunity will be in the two weeks to two months after you get your vaccines. That means it’s smart to try to get your shots shortly before COVID is expected to be on the upswing. Just like for flu, experts expect the worst of COVID to hit in the fall and winter.CDC Director Dr. Mandy Cohen said that even though cases are going up now, most people will be better off waiting a few weeks to get the newly updated COVID-19 vaccines rather than trying to get one of the older bivalent vaccines right now. But this is dependent on personal risk, so if you’re concerned, talk

(CNN) — Liam Payne is taking a step back from professional commitments for health reasons. The former One Direction member announced on his Instagram on Friday “with a heavy heart” that he has “no other choice but to postpone” his upcoming tour in South America, since he has been in the hospital “with a serious kidney infection.” He added in the caption to the video post that the ordeal is “something I wouldn’t wish on anyone, and doctors orders are that I now need to rest and recover.” “I was beyond excited to come play for you guys. To all of you who have bought tickets: I’m so sorry. We’re working to re-schedule the tour as soon as we possibly can, but for now we will be refunding the tickets,” Payne added. In his video address, he concluded that once he’s well again, “hopefully we’ll put on an even bigger, better show.” According to the singer’s official website, Payne was slated to play six dates in early September, in Peru, Colombia, Chile, Brazil, Argentina and Mexico. Last month, the crooner shared that he was six months sober after spending 100 days in a rehabilitation facility. “I just needed to take a little bit of time out for myself actually because I kind of became somebody who I didn’t really recognize anymore,” Payne said in the video, adding “And I’m sure you guys didn’t either.” He continued of his rehab experience, “I was in bad shape up until that point and I was really happy more than anything after I arrived to kind of put a stopper to life and work.” “Ever since then, I’ve just been trying to learn to get to know this new guy,” he added. Thanks for reading CBS NEWS. Create your free account or log in for more features.

By Soonia Fernandez, UC Santa Barbara Indigenous peoples suffered disproportionately from the COVID-19 pandemic, experiencing a lack of sovereignty, limited infrastructure and discrimination in local healthcare systems that make them particularly vulnerable to infectious diseases. Yet little research exists to guide interventions and public health efforts tailored to remote-living Indigenous populations during pandemics. In Bolivia, for example, a team of researchers including UC Santa Barbara’s Tom Kraft and Michael Gurven, and local collaborators, attempted to mitigate SARS-CoV-2’s impact on the Tsimané, a small-scale Indigenous society living in remote areas of the Amazon. The effort centered on a strategy of voluntary collective isolation, in the hopes that remoteness, coupled with self-sufficiency in food production and a culture of resilience, would act as a buffer against disease. A new study by the same team, now published in the journal PLOS Biology, set out to test whether voluntary collective isolation was likely to be effective at preventing rapid spread of COVID-19 transmission among Tsimané. The authors used 20-plus years of data on Tsimané population structure, movement patterns and social networks to build a computer model to assess Tsimané vulnerability to COVID-19. The simulation predicted that without any intervention, approximately four out of every five Tsimané would be infected during an outbreak, and that even the most remote communities (more than 100 km from the nearest market town) would be affected. It also revealed that without severely curtailing travel, voluntary collective isolation was likely to fail. Sadly, the researchers confirmed their model’s predictions, observing a nearly identical rate of infection in the real world across Tsimané communities, based on serological testing of individuals after a first wave of COVID-19 infections. “Remote-living, small-scale populations are highly vulnerable to global diseases,” said Kraft, an anthropologist from both UC Santa Barbara and the University of Utah, and the lead author of the study. “We can’t rely on remoteness and voluntary isolation alone to mitigate risks — we need to plan to direct medical resources to these communities.” The Tsimané are one of several Indigenous tribes who hold collective title for much of the Estación Biologica del Beni and Pilón Lajas Biosphere Reserves and Indigenous Communal Lands, protected areas on the eastern flank of the Andes Mountains. They share characteristics common to many small-scale Indigenous societies, making this case study a useful reference for understanding infectious disease dynamics and public health interventions in other populations globally. The researchers designed their model to simulate the introduction of SARS-CoV-2 from the closest urban market town, and its spread among Tsimané communities. The idea for the study began at the outbreak of the pandemic. Many of the authors have worked with the Tsimané through theTsimané Health and Life History Project, which operates a mobile medical team that travels between villages to provide aid, while also conducting biomedical and anthropological research. Senior author Gurven, a professor of anthropology at UC Santa Barbara, co-founded the project back in 2002. For this work amidst the pandemic, the team wanted to understand how best to direct public health messages and deploy their limited medical resources. “At the time, there was great concern about what COVID might do if it reached the remote Amazon,” Gurven said. “So we shut down our normal operations and went into full COVID prep, hoping it wouldn’t spread. When COVID hit anyway, we then went into full surveillance mode, poised to help lessen the spread, and to help treat severe cases.” The Tsimané are mostly self-sufficient by small-scale farming of plantains, manioc, rice and corn, and by hunting and fishing. But with better roads and outboard motors, they now come into greater contact with Bolivian merchants, colonists and others in local towns. About 18,000 Tsimané live in over 95 villages spread along rivers and logging roads — the farthest requires a multi-day boat trip to the market town. Multiple generations live together in large extended households. The close-knit community is quite social, and individuals travel frequently between villages to visit friends and family. The authors evaluated how these characteristics would influence the extent and trajectory of disease spread, the community- and individual-level risk factors for susceptibility of infection and the effect of various intervention scenarios. “The Beni region of Bolivia is pretty remote, and medical facilities are hard to come by,” said Dr. Daniel Eid Rodriguez, a physician and medical coordinator for the Tsimané project based in Bolivia. “Any information that can help us make informed choices to best direct limited health resources is a blessing.” “We can’t rely on remoteness and voluntary isolation alone to mitigate risks — we need to plan to direct medical resources to these communities.” To the researchers’ surprise, the remoteness of the Tsimané communities made little difference in preventing the spread of COVID-19, both in computer simulations and observed infections. Once introduced, the disease spread in a chain reaction to even the most isolated villages, as predicted by the model. The timing and magnitude of infection differed in the short term, with communities closest to market towns getting infection peaks earlier than remote villages. Yet the smaller, more isolated villages experienced the largest outbreaks proportionally, challenging the intuition that epidemics are likely to be limited in remote, low-density populations. The authors suggest that for maximum impact, public health efforts in the future should focus on dispersing limited medical and messaging resources across remote communities, rather than concentrating efforts solely on denser communities closer to urban centers. Michael Gurven – Professor Gurven’s research links the evolved life history of humans with high levels of intragroup cooperation. He has conducted fieldwork for two decades with South American indigenous populations, and his work takes an evolutionary perspective on behavior, health, physiology and psychology. (Photo: Matt Perko) Simulations of different intervention strategies had mixed effectiveness. Restricting travel to market town alone slowed transmission, but made essentially no difference in the final outbreak size. Even extreme travel restrictions showed limited efficacy; simultaneously reducing 90% of travel to town and between villages substantially slowed transmission but was predicted to reduce

ByParmita Uniyal, New Delhi Aug 28, 2023 08:50 PM IST Share Via Copy Link Give a boost to your immune system by including seasonal foods, drinking plenty of fluids and avoiding roadside food. Here are expert tips to prevent dengue. Dengue cases have been increasing at an exponential rate this year across the country due to incessant rains, waterlogging and floods. It is important to build immunity against the disease by doing regular exercise, sleeping adequately and eating a nutritious diet. Experts recommend seasonal fruits and vegetables, adequate fluids, nuts, proteins, vitamins to stay healthy and prevent infections. One should also avoid consuming sugary drinks, junk food, deep-fried foods, baked and processed foods. (Also read: Dengue outbreaks: 9 reasons why dengue cases are getting more severe; what role does global warming play) Practising mindful eating behaviours, choosing seasonal foods, staying physically active and being positive is the best way to maintain good health status(Freepik) “Dengue season is here. Bolstering the immune system is the key mantra in the current scenario, which helps the body to build resistance and combat infections. Practising mindful eating behaviours, choosing seasonal foods, staying physically active and being positive is the best way to maintain good health status,” says Deepti Khatuja, Head – Clinical Nutritionist, Fortis Memorial Research Institute, Gurgaon. Food groups to be added in the diet regimen during this season and in dengue to boost immunity and keep infections at bay are as follows: • Fluids Plenty of fluids, potable water is as vital as consuming warm, concoctions, herbal teas, broths, and soups should be consumed to build immunity. Along with these hot liquids, cold liquids like lemon water, buttermilk or lassie, coconut water etc. are also beneficial. These drinks are rehydrating that maintain electrolyte balance, detoxifies the system and essential for building a robust immune system. • Fruits Adding seasonal fruits like jamun, pears, plum, cherries, peaches, papaya, apples, and pomegranates supports meeting the increasing demands of nutrients like vitamins A, C, antioxidants, and fibre. These fruits aids to improve digestion, maintain gut flora and triggers the immune response. • Vegetables Seasonal and different coloured vegetables should be made part of your regular diet to foster good gut health and immune activity. Various vitamins present in different coloured vegetables like Vitamin A, C along with minerals like Zinc, magnesium etc. are good antioxidants and provide the immunity. • Spices Spices and herbs like turmeric, ginger, garlic, pepper, cinnamon, cardamom, and nutmeg are bestowed with anti-inflammatory, antifungal, antiviral, antimicrobial, anti-bacterial and immune-boosting activities. They work amazingly well to support the immune system by regulating immune cells like T-cells that helps the body to defend off the pathogens. Add these spices generously in your regular cooking during this weather and uplift your overall health. • Nuts Nuts and seeds are loaded with proteins, healthy fats, vitamins, minerals, and antioxidants. Proteins and amino acid are the basic building blocks of body and helps keep the GI tract and immune system healthy. They support immune functions by activation of immune cell functions, multiplication of immune cells and production of antibodies. • Probiotics Include probiotics in the diet: Opt for yogurt, buttermilk, cheese kefir, kombucha, and soybeans. Probiotics are packed with good bacteria that act on our digestive system and boost immunity. Prachi Jain, Chief Clinical Nutritionist & HOD (Nutrition & Dietetics), CK Birla Hospital, Gurgaon says to Strengthen our immune system adequate nutrition is the key. To attain strong immunity, one needs to modify the lifestyle as it cannot achieved in one day. Jain suggests the following foods: Indian food plate which contains all the food groups in proper proportion i.e.– healthy and balanced diet. Eat enough proteins – 0.8 to 1 gm per kg body weight at least. In case of any deficiencies, protein intake can be increased to 1.2 to 1.5 gm after consulting nutritionist or doctor as proteins help in muscle building, maintaining, repairing body tissues, healing and speeding up recovery. E.g., milk and milk products, paneer, soya, tofu, lentils, nuts, boiled egg etc. Vitamins and minerals – Include properly washed fresh seasonal fruits and vegetables as they are rich in antioxidants. You can boost your immune system by including these nutrients: Vitamin A: Carrot, sweet potato, papaya, apricots Vitamin C: All citrus fruits like lemon, amla, tomatoes, oranges, sweet lime etc Vitamin E: Sunflower seeds, saf flower seeds, almonds & pistachios Vitamin D: Fortified milk and milk products, exposure to sunlight, mushrooms, egg, fish Zinc & selenium: Seeds like chia seeds, pumpkin seeds, sunflower seeds, whole pulses, whole cereals, black til, eggs, fish Include probiotics and prebiotics like curd, yoghurt, and fermented foods. Indian herbs & spices – These have anti-inflammatory, anti-microbial and anti- bacterial properties. Examples are tulsi, dry ginger, lemongrass, garlic, turmeric, black pepper, and coriander etc. Omega 3 include nuts and seeds, almond, walnut, chia seeds, flax seeds, pumpkin seeds, sunflower seeds. Hydration – Stay hydrated by including coconut water, lemonade, fresh homemade soups, buttermilk, green tea. Maintain 2- 2.5 litre of fluid intake on a daily basis. Foods to avoid: 1. Avoid carbonated drinks, cold drinks, squashes etc. 2. Avoid roadside, raw, stale food to prevent infection. 3. Avoid fried, deep fried food. 4. Avoid bakery food, maida which includes junks – pizza, pasta, burgers & fries. 5. Avoid processed foods like cheese, mayonnaise etc. 6. Avoid alcohol. 7. Quit smoking and tobacco. Topics Dengue