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Scientists developing contraceptive that stops sperm in its tracks

by Medically Speaking Team September 5, 2021

Monoclonal antibodies are known for their ability to fight off invading germs and are used to treat and prevent everything from cancer to COVID-19. Scientists are now looking at a new mission for antibodies: immobilizing sperm before it can reach an egg.

Carolina researchers have engineered ultra-potent antibodies that, during animal testing, effectively trapped and blocked more than 99.9% of human sperm. The promising study results published in Science Translational Medicine suggest contraceptives based on antibodies may offer women a non-hormonal option to prevent pregnancy.

“Many women avoid hormonal contraception because of real and perceived side effects,” said Samuel Lai, professor in the Division of Pharmacoengineering and Molecular Pharmaceutics at the UNC Eshelman School of Pharmacy.

These effects can include irregular bleeding, nausea, depression, weight gain and migraines. And for some women estrogen-based hormonal contraception can be harmful.

“There’s a major unmet need for alternative, non-hormonal contraceptives for women,” said Lai.

Source: University of North Carolina at Chapel Hill

September 5, 2021 0 comment

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Gut bacteria influence brain development

by Medically Speaking Team September 5, 2021

written by Medically Speaking Team

Complex interplay: the gut-immune-brain axis

The early development of the gut, the brain and the immune system are closely interrelated. Researchers refer to this as the gut-immune-brain axis. Bacteria in the gut cooperate with the immune system, which in turn monitors gut microbes and develops appropriate responses to them. In addition, the gut is in contact with the brain via the vagus nerve as well as via the immune system. “We investigated the role this axis plays in the brain development of extreme preterm infants,” says the first author of the study, David Seki. “The microorganisms of the gut microbiome — which is a vital collection of hundreds of species of bacteria, fungi, viruses and other microbes — are in equilibrium in healthy people. However, especially in premature babies, whose immune system and microbiome have not been able to develop fully, shifts are quite likely to occur. These shifts may result in negative effects on the brain,” explains the microbiologist and immunologist.

Patterns in the microbiome provide clues to brain damage

“In fact, we have been able to identify certain patterns in the microbiome and immune response that are clearly linked to the progression and severity of brain injury,” adds David Berry, microbiologist and head of the research group at the Centre for Microbiology and Environmental Systems Science (CMESS) at the University of Vienna as well as Operational Director of the Joint Microbiome Facility of the Medical University of Vienna and University of Vienna. “Crucially, such patterns often show up prior to changes in the brain. This suggests a critical time window during which brain damage of extremely premature infants may be prevented from worsening or even avoided.”

Comprehensive study of the development of extremely premature infants

Starting points for the development of appropriate therapies are provided by the biomarkers that the interdisciplinary team was able to identify. “Our data show that excessive growth of the bacterium Klebsiella and the associated elevated ??-T-cell levels can apparently exacerbate brain damage,” explains Lukas Wisgrill, Neonatologist from the Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics at the Department of Pediatric and Adolescent Medicine at the Medical University of Vienna. “We were able to track down these patterns because, for a very specific group of newborns, for the first time we explored in detail how the gut microbiome, the immune system and the brain develop and how they interact in this process,” he adds. The study monitored a total of 60 premature infants, born before 28 weeks gestation and weighing less than 1 kilogram, for several weeks or even months. Using state-of-the-art methods — the team examined the microbiome using 16S rRNA gene sequencing, among other methods — the researchers analysed blood and stool samples, brain wave recordings (e.g. aEEG) and MRI images of the infants’ brains.

Research continues with two studies

The study, which is an inter-university clusterproject under the joint leadership by Angelika Berger (Medical University of Vienna) and David Berry (University of Vienna), is the starting point for a research project that will investigate the microbiome and its significance for the neurological development of prematurely born children even more thoroughly. In addition, the researchers will continue to follow the children of the initial study. “How the children’s motoric and cognitive skills develop only becomes apparent over several years,” explains Angelika Berger. “We aim to understand how this very early development of the gut-immune-brain axis plays out in the long term. ” The most important cooperation partners for the project are already on board: “The children’s parents have supported us in the study with great interest and openness,” says David Seki. “Ultimately, this is the only reason we were able to gain these important insights. We are very grateful for that.”

Source: University of Vienna

September 5, 2021 0 comment

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Eating more plant foods may lower heart disease risk in young adults, older women

by Medically Speaking Team September 5, 2021

written by Medically Speaking Team

In two separate studies analyzing different measures of healthy plant food consumption, researchers found that both young adults and postmenopausal women had fewer heart attacks and were less likely to develop cardiovascular disease when they ate more healthy plant foods.

The American Heart Association Diet and Lifestyle Recommendations suggest an overall healthy dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes and non-tropical vegetable oils. It also advises limited consumption of saturated fat, trans fat, sodium, red meat, sweets and sugary drinks.

One study, titled “A Plant-Centered Diet and Risk of Incident Cardiovascular Disease during Young to Middle Adulthood,” evaluated whether long-term consumption of a plant-centered diet and a shift toward a plant-centered diet starting in young adulthood are associated with a lower risk of cardiovascular disease in midlife.

“Earlier research was focused on single nutrients or single foods, yet there is little data about a plant-centered diet and the long-term risk of cardiovascular disease,” said Yuni Choi, Ph.D., lead author of the young adult study and a postdoctoral researcher in the division of epidemiology and community health at the University of Minnesota School of Public Health in Minneapolis.

Choi and colleagues examined diet and the occurrence of heart disease in 4,946 adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants were 18- to 30-years-old at the time of enrollment (1985-1986) in this study and were free of cardiovascular disease at that time. Participants included 2,509 Black adults and 2,437 white adults (54.9% women overall) who were also analyzed by education level (equivalent to more than high school vs. high school or less). Participants had eight follow-up exams from 1987-88 to 2015-16 that included lab tests, physical measurements, medical histories and assessment of lifestyle factors. Unlike randomized controlled trials, participants were not instructed to eat certain things and were not told their scores on the diet measures, so the researchers could collect unbiased, long-term habitual diet data.

After detailed diet history interviews, the quality of the participants diets was scored based on the A Priori Diet Quality Score (APDQS) composed of 46 food groups at years 0, 7 and 20 of the study. The food groups were classified into beneficial foods (such as fruits, vegetables, beans, nuts and whole grains); adverse foods (such as fried potatoes, high-fat red meat, salty snacks, pastries and soft drinks); and neutral foods (such as potatoes, refined grains, lean meats and shellfish) based on their known association with cardiovascular disease.

Participants who received higher scores ate a variety of beneficial foods, while people who had lower scores ate more adverse foods. Overall, higher values correspond to a nutritionally rich, plant-centered diet.

“As opposed to existing diet quality scores that are usually based on small numbers of food groups, APDQS is explicit in capturing the overall quality of diet using 46 individual food groups, describing the whole diet that the general population commonly consumes. Our scoring is very comprehensive, and it has many similarities with diets like the Dietary Guidelines for Americans Healthy Eating Index (from the U.S. Department of Agriculture’s Food and Nutrition Service), the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet,” said David E. Jacobs Jr., Ph.D., senior author of the study and Mayo Professor of Public Health in the division of epidemiology and community health at the University of Minnesota School of Public Health in Minneapolis.

Researchers found:

During 32 years of follow-up, 289 of the participants developed cardiovascular disease (including heart attack, stroke, heart failure, heart-related chest pain or clogged arteries anywhere in the body).
People who scored in the top 20% on the long-term diet quality score (meaning they ate the most nutritionally rich plant foods and fewer adversely rated animal products) were 52% less likely to develop cardiovascular disease, after considering several factors (including age, sex, race, average caloric consumption, education, parental history of heart disease, smoking and average physical activity).
In addition, between year 7 and 20 of the study when participants ages ranged from 25 to 50, those who improved their diet quality the most (eating more beneficial plant foods and fewer adversely rated animal products) were 61% less likely to develop subsequent cardiovascular disease, in comparison to the participants whose diet quality declined the most during that time.
There were few vegetarians among the participants, so the study was not able to assess the possible benefits of a strict vegetarian diet, which excludes all animal products, including meat, dairy and eggs.

“A nutritionally rich, plant-centered diet is beneficial for cardiovascular health. A plant-centered diet is not necessarily vegetarian,” Choi said. “People can choose among plant foods that are as close to natural as possible, not highly processed. We think that individuals can include animal products in moderation from time to time, such as non-fried poultry, non-fried fish, eggs and low-fat dairy.”

Because this study is observational, it cannot prove a cause-and-effect relationship between diet and heart disease.

In another study, “Relationship Between a Plant-Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings from the Women’s Health Initiative (WHI) Prospective Cohort Study,” researchers, in collaboration with WHI investigators led by Simin Liu, M.D., Ph.D., at Brown University, evaluated whether or not diets that included a dietary portfolio of plant-based foods with U.S. Food and Drug Administration-approved health claims for lowering “bad” cholesterol levels (known as the “Portfolio Diet”) were associated with fewer cardiovascular disease events in a large group of postmenopausal women.

The “Portfolio Diet” includes nuts; plant protein from soy, beans or tofu; viscous soluble fiber from oats, barley, okra, eggplant, oranges, apples and berries; plant sterols from enriched foods and monounsaturated fats found in olive and canola oil and avocadoes; along with limited consumption of saturated fats and dietary cholesterol. Previously, two randomized trials demonstrated that reaching high target levels of foods included in the Portfolio Diet resulted in significant lowering of “bad” cholesterol or low-density lipoprotein cholesterol (LDL-C), more so than a traditional low-saturated-fat National Cholesterol and Education Program diet in one study and on par with taking a cholesterol-lowering statin medication in another.

The study analyzed whether postmenopausal women who followed the Portfolio Diet experienced fewer heart disease events. The study included 123,330 women in the U.S. who participated in the Women’s Health Initiative, a long-term national study looking at risk factors, prevention and early detection of serious health conditions in postmenopausal women. When the women in this analysis enrolled in the study between 1993 and 1998, they were between 50-79 years old (average age of 62) and did not have cardiovascular disease. The study group was followed until 2017 (average follow-up time of 15.3 years). Researchers used self-reported food-frequency questionnaires data to score each woman on adherence to the Portfolio Diet.

The researchers found:

Compared to women who followed the Portfolio Diet less frequently, those with the closest alignment were 11% less likely to develop any type of cardiovascular disease, 14% less likely to develop coronary heart disease and 17% less likely to develop heart failure.
There was no association between following the Portfolio Diet more closely and the occurrence of stroke or atrial fibrillation.

“These results present an important opportunity, as there is still room for people to incorporate more cholesterol-lowering plant foods into their diets. With even greater adherence to the Portfolio dietary pattern, one would expect an association with even less cardiovascular events, perhaps as much as cholesterol-lowering medications. Still, an 11% reduction is clinically meaningful and would meet anyone’s minimum threshold for a benefit. The results indicate the Portfolio Diet yields heart-health benefits,” said John Sievenpiper, M.D., Ph.D., senior author of the study at St. Michael’s Hospital, a site of Unity Health Toronto in Ontario, Canada, and associate professor of nutritional sciences and medicine at the University of Toronto.

The researchers believe the results highlight possible opportunities to lower heart disease by encouraging people to consume more foods in the Portfolio Diet.

“We also found a dose response in our study, meaning that you can start small, adding one component of the Portfolio Diet at a time, and gain more heart-health benefits as you add more components,” said Andrea J. Glenn, M.Sc., R.D., lead author of the study and a doctoral student at St. Michael’s Hospital in Toronto and in nutritional sciences at the University of Toronto.

Although the study was observational and cannot directly establish a cause-and-effect relation between diet and cardiovascular events, researchers feel it provides a most reliable estimate for the diet-heart relation to-date due to its study design (included well-validated food frequency questionnaires administered at baseline and year three in a large population of highly dedicated participants). Nevertheless, the investigators report that these findings need to be further investigated in additional populations of men or younger women.

Source: American Heart Association

September 5, 2021 0 comment

Kids OTHERS Uncategorized

Right approach towards children as schools reopen

by Medically Speaking September 5, 2021

written by Medically Speaking

Experts suggest honest dialogue and recitation of rules like “I wear a mask when in class and on the grass’ alleviating parents’ anxiety regarding reopening of schools.

Are we prepared to take the on sought of the third wave as far as the children are concerned?

Dr Krishan Chugh: our hospitals are conducting drills on the strategies to control the third wave. We are preparing our action plan to treat n number of patients. We know that the hospital bed ratio to the population ratio is not in our favour even when it comes to children.

In the last wave, many children produced antibodies, and the number is pretty large. Is this the reason for the confidence?

Dr Smita Malhotra: sero positivity rate is evident in children. We should emphasize that all children take influenza vaccine before going to school which will provide an additional protection till we are able to vaccinate them against Covid. Any child who are immunocompromised should take online classes which would be a prudent option for everyone.

As a career counselor, what would you tell the patents of high school students to alleviate their anxiety?

Dr Amrita Dass: There is a digital divide even in urban areas. It is important for parents to make informed decisions and discussions where they hear medical point of view also is very useful. Places where SOP’s and Covid protocols have been followed are the safest places today. Sending kids to school on alternate days with parents’ permission is very essential. I attended webinars with schools from Maharashtra, Uttar Pradesh, Himachal Pradesh and Uttarakhand where they have been reopened and initially the attendance was at 50% attendance which later went up to 60% and for the senior students it was 80% because the board exams will not be held online this time unless there is something unforeseen.

Would you say that the parents joined with your association would be convinced with these points?

Sumit Vohra: we agree as parents that we go to public places but there the children are under parents’ supervision. When in school, kids are the responsibility of the school faculty. It is a doubt among the parents whether the schools will follow SOP’s properly or not. Had this hype of third wave not been created, parents would have been much assured about sending the kids to school. We are aware that we need to send our children for practical exams and offline board exams but then we would prefer waiting for 10 to 15 days and then allow our kids to go to school.

Dr Prakamya: we do want to protect our children and that comes out from a very legitimate point of parenting but at some point of time we need to let out children venture out. At some point we need to use this as an opportunity to develop resilience among our child. Even in the urban strata, there are a lot of children with special needs, with learning disabilities, ADHD. These children need special educators and counselors for their all-round development. Adolescent is a stage where the brain is undergoing synaptic transformation and this is an important time to intervene and provide them an environment for social and mental development. Instead of being problem-oriented, we should be more solution-oriented, which brings me to having an honest conversation between the parent and the ward, and the school administration and children.

It is difficult to teach the concept of wearing mask to a 2 or 3 year old but can students in class 9 and 10 be taught with the help of a constructive dialogue in the school and at home?

Dr Shweta Sharma: we can trust our own children to follow SOP if not school authority and if you have that bond and trust with your children, they are going to follow up this thing. Schools are second parent to the kids and they are more responsible for the overall development of the children. Therefore, trust is all the more essential.

Dr Amrita Dass: there is a policy intervention I would state here. I believe authorities should prioritize vaccinating children atleast above 12 years of age as soon as possible. Government of UP has already started this and I would urge all state governments start doing this early as possible.

Is basic vaccination more important than the so called Covid vaccination?

Dr Krishan Chugh: No vaccine other than the Covid vaccine can provide significant protection against the Covid virus. Only proper vaccine with proper dosage at proper interval can ensure that children are reasonably safe. Fortunately some vaccines like Covaxin and Zydus Cadila will be approved by the regulatory authorities to be used for children soon. But once these vaccines are approved for children, they should not be used for adults except for those who have received the first dose of the same vaccine. This will ensure that we have enough vials for kids.

We have seen more number of critical cases among adults. Would you not agree with the government for prioritizing the elderly first, then 18 above and children at last?

the last wave we have seen many mortalities among the 30’s and 40’s and fortunately children have been spared of that fatality till now. Adults have been prioritized all over the world, not just India. Even the scientific evidence suggest that this is the correct protocol to be followed.

What is your advice for policy makers, parents and students?

Dr Smita Malhotra: I think it is in the individual’s hands. Children are smarter and wiser now and they can be taught how to be responsible. If each individual in the society learns to be responsible, it is not a difficult pandemic to control.

What would you like to suggest parents like Mr Vohra?

Dr Prakamya Singal: we need to be more solution-oriented and I think the best precaution against Covid is to wear mask. But how do they wear mask for a 4-5 hour stretch? Children will behave casual and it is natural so I believe we should first ask our children if they are comfortable wearing the mask that they have. They can be engaged in mask making activities, they can use their favorite colour, have their favorite cartoons on it.

We can use the initial days before the schools open up to ease them and help them get used to the sensation of wearing a mask. We need to give out clear rules and revise them on the daily basis before they leave for school to ensure that they follow the precautions. We can recite something like, ‘I wear a mask in the class and on the grass’.

Would you agree the same method would work for 6 or 7 standard students?

Dr Shweta Sharma: Yes the same method would work because if we see children as individuals, they are efficient. Thus, please trust your ward, they will take care of their hygiene and you do not need to repeat the instruction again and again because since the last two years we have been repeated the same message.

What would you say about this Dr Dass?

Dr Amrita Dass: where schools are open, students being responsible and parents being engaged has made a difference. So let us be more pragmatic about it and look ahead and bring in all the stakeholders. Schools do care about the kids as much as the parents and want to ensure that they do not have to be kept at home again. Let us trust the stakeholders.

Dr Chugh, what would you about the increasing numbers in Kerala which might probably be adding to the anxiety of the parents?

Dr Krishan Chugh: it is not just the schools that led to increase in Kerala, I believe Delta Variant was the major cause. It is the virus that is going to decide. Science is predicting that the change in the virus is not going to be a major one.

Would you suggest parents to have a healthy dialogue with the kids or maybe engage with the schools directly?

Dr Shuchin Bajaj: prediction is not our work but we have a graded action plan. Currently the positivity rate is less than 0.04% and our action plan will start when it arrives at 0.5%. Our mistake during the last wave was that we started after it crossed 5% and then it was too late. The government will be more cautious this time and lockdown will be imposed at 0.5% positivity and schools will be shut down first. Let us trust the government on this.

What do you think is a right approach as we eventually have to send our children to schools?

Sumit Vohra: the parent should take the initiative and the schools should build trust among the children ensuring that there are no mishappenings and children do not catch virus. Let us see for 10-15 days if the SOP’s are being followed properly. If the schools build up the confidence, parents would easily send their kids to school.

September 5, 2021 0 comment

Kids OTHERS Uncategorized

Alleviating Parents’ Anxiety with Reopening of Schools

by Medically Speaking September 4, 2021

written by Medically Speaking

Parents are becoming increasingly concerned about the prospect of a third wave, as numerous states mandate school reopenings. Parents’ fears and anxieties about their children’s safety are palpable, and many argue that authorities should wait until the vaccine is ready for youngsters. Learning to control anxiety and accept uncertainty are vital skills for anybody, but they’re especially critical for parents in this circumstance. Medically Speaking spoke with a few specialists about how to deal with this anxiety and what the best course of action is in this circumstance.

Shweta Sharma, Clinical Psychologist and Founder of Mansa Foundation says, “The children are utterly stranded and dissatisfied. Anxiety disorders are far more prevalent among youngsters, and parents are experiencing mixed emotions as they are both frightened and happy that their children will soon be able to return to the real world.”

She further said, “In such instances, we recommend that they communicate with the youngster in a nice manner so that they understand and do not feel compelled to wear the mask all the time. Hugs and physical touch are widespread among teenagers. Only a pleasant interaction with the parents would assist in this instance.”

Dr Prakamya Singal, Psychiatrist from Safdarjung Hospital observed, “It is very legitimate and natural for parents, children, teachers, and school people as well to have all these anxieties because these are unprecedented times, and no one can really ever be sure as to what is going to happen next. I think one of the most important things that needs to be at the center of all of this is an open and honest dialogue between all of the stakeholders.”

“I think we can also have a shift in the way that we are perceiving the situation. Having a unimodal view where we’re only looking at the harms of reopening schools is going to lead us to make probably not so wise decisions. Opening up schools right now might be a risky venture, but then there are also a lot of disadvantages to having our children locked up in their houses. Teenage is a critical stage where the mind needs to develop emotional quotient. Children need to learn how to be able to read others’ faces. This is what schooling and education is about,” she added.

Dr Sharma said, “We’re concentrating on different activities where public spaces are available, and we’re really going with the kids just to change the setting. So, what exactly is the problem with schools? There is an option. You are not required to send them on a regular basis. You don’t have to send them on alternate days. You should send them at least two or three times a week, if not more.

However, those adjustments are necessary for their psychological well-being. Because anxiety and depression in youngsters are already at an all-time high. They’re irritable. They are coming with the issues. The problem is also affecting parents. Especially with that age bracket, that interpersonal bond is already strained. So, in my judgement, if we are going to explore it, and with all the safeguards in place, I believe the government should applaud this initiative.”

Analysing the move of the government and the impact of online classes on children, Dr. Amrita Dass, Founder of ICS Institute for career studies says, “It has a significant negative impact on students because, while epidemic classes and, to some extent, virtual co-curricular activities are possible, they are insufficient for a student’s all-round development, and it is through all-round development that they develop employability skills, as well as opportunities for leadership, creativity, and teamwork. There are also many students who do not have access to online classes because many schools do not offer them, and some schools that do offer them have students with poor internet access. As a result, there are students who have completely missed out, and they are looking forward to returning to school and getting back into the excitement of teaching and co-curricular activities. There has been a great deal of worry and tension about the future, particularly since the board examinations were cancelled. They were unconcerned about the cancellation, but they were concerned about the future of higher education.”

Dr Dass added, “There’s another essential point to consider. Nobody is talking about the impact on preschool and kindergarten children. Younger children require experiences that cannot be duplicated online for their social and mental development. We should help them in small groups, with parents volunteering. In terms of emotional, social, and linguistic development, these children have suffered the most. Parents are not adequately prepared to provide the type of education that nursery and KG children require.”

September 4, 2021 0 comment

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Covid R-value is rising with a third wave threat: everything you need to know

by Medically Speaking September 4, 2021

written by Medically Speaking

The increasing R-value is a most concerning issue when the states in India rise to control coronavirus (Covid-19) spread before the anticipating third wave in October. According to researchers at the Institute of Mathematical Sciences, Chennai, in the last week of August the R-value rose to 1.17 compared with 0.89 between 14-17 August.

The R-value determines how rapidly the Covid-19 pandemic is spreading.

“Not only is it greater than one, it is much higher than the last time there was a scare of a third wave (it was 1.03 at that time),” Sitabhra Sinha, who is leading the team of researchers, told news agency PTI.

“This is driven by several states having their R-value go over 1 in the last few days of August – most notably Kerala and Maharashtra, but also Mizoram and Jammu and Kashmir,” Singh added.

Why is R-value important?

The Reproduction number or R denotes how fast an infection is spreading. When a wave is at its peak, it is evident that the virus is spreading at a faster rate. But at a time when the wave is receding, a slight increase of R-value can indicate an impending upward trend in the wave again.

Why is R-value important?

If R is greater than 1, the number of infected people is increasing in each round – this is what is called the epidemic phase. In other words, it tells how ‘efficiently’ a virus is spreading.

States with highest R-value

The R-value of Kerala stood at 1.33, which is the highest number of active cases in the country, according to the Institute of Mathematical Sciences. It was 1.36 for Mizoram, 1.25 for Jammu and Kashmir, 1.09 for Andhra Pradesh and 1.06 for Maharashtra.

R-value during the second wave

When the second wave swept through the country between March to May, the R-value was 1.37 (between March 9 to April 21).

From May 15-June 26, the R-value stood at 0.78. However, it slowly started increasing – it was 0.88 from June 20-July 7, 0.95 from July 3-22, 0.96 from July 24-27.

It breached the value of 1.03 for the first time after the second wave during July 27-31. However, since then it has slowly started to decline.

The R-value was 0.92 from August 6-9, and rose to 0.99 between August 12-14. But it slipped to 0.89 between August 14-17.

September 4, 2021 0 comment

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Which variation is the Mu? And are we going to see more about variants?

by Medically Speaking September 4, 2021

written by Medically Speaking

A new “variant of interest” of coronavirus, termed Mu variants, has been named by the World Health Organization this week. It was initially found in January 2021, in Colombia, and has been discovered so far in around 39 nations.

Mu has modifications, known as mutations, which could elude part of the protection we get from COVID vaccinations.

However, one of the reassuring elements is that Delta, the dominating variation throughout the most part of the world, does not appear to be out of the competition since January 2021.

If Mu was truly a really bad variant, we would have expected to have started to see indications of this, and we haven’t yet.

What’s a variant of interest?

An impressive element of our COVID response has been frequent genomic sequencing, which we haven’t done before on this scale. This tracks and maps the evolution of the virus in real time, as it adapts and mutates.

Some mutations will be detrimental to the virus, but some will be beneficial, allowing it to spread better, escape the protection offered by vaccines or even evade COVID tests.

If there are changes to the virus that mean it looks like it has the potential to do more harm, then we might designate it a “variant of interest”.

Mu has mutations that might confer some of these properties, but evidence is still emerging.

The four other variants of interest are Eta, Iota, Kappa and Lambda.

If there’s good evidence Mu is more serious and beginning to overtake other variants such as Delta, it might be upgraded to a “variant of concern”. The four variants of concern are Alpha, Beta, Gamma and Delta.

Can it escape vaccines?

Most COVID vaccines target the “spike protein” of the virus, which it uses to enter our cells. Our vaccines expose our bodies to a part of the virus, commonly the spike protein, so our immune system can learn to fight the virus off if it encounters it.

If a variant has significant changes in the spike protein, this may decrease the effectiveness of our vaccines.

The WHO said preliminary evidence suggests the Mu variant could partially evade the antibodies we get from vaccination.

But because this data is from lab studies, we can’t be sure how the variant will actually play out in the population.

We need more research to be certain about how it behaves in humans, and work on this is ongoing.

The good news is our vaccines currently protect well against symptomatic infection and severe disease from all variants of the virus so far.

Vaccines may not protect forever

There’s a high probability a new variant will arise one day that can significantly escape the protection offered by our vaccines, which are based on the original strain of the virus. We would call this an “escape variant”.

It’s hard to know if and when this would happen, but rampant community transmission of the virus increases the chances of such a variant emerging.

However, the leading COVID vaccine manufacturers are well prepared if this eventuates. Some are already developing vaccines for new variants, such as Delta.

If we did discover an escape variant, some vaccine manufacturers could alter their existing vaccines to match the new variant, possibly within 6-8 weeks. Medical regulators around the world would likely accelerate the approval process to make this possible. Certain studies would be required but these could be done quickly, so long as the new vaccine had basically the same properties as the existing vaccine.

It’s possible we could see a variant overtake Delta in terms of infectiousness eventually. Scientists think it’s at least 50% more infectious than the Alpha variant, which was about 50% more infectious than the original strain.

Evolutionary theory predicts the virus may become more transmissible over time, but less severe, as a virus wants to spread as much as possible and doesn’t want to kill its host before it can do so. But this may not necessarily be how SARS-CoV-2 plays out, and realistically we’re still in the early days of this virus.

The best way of combating variants is to get as many people vaccinated as possible, so there are fewer susceptible hosts for the virus to reproduce and mutate.

There is a risk that once we have the majority of the world vaccinated, vaccines may place “selective pressure” on the virus to evolve to escape vaccines. But the benefits of having more people vaccinated outweighs this risk.

I don’t think it’s time to be concerned about Mu yet. If it became a “variant of concern”, then we might be more worried. But we have some amazing tools to fight this virus, including many successful vaccines — the majority of which can be adapted quickly to new variants.

It’s likely we’ll have regular booster shots to protect us against variants in the future.

September 4, 2021 0 comment

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Experts indicate monoclonal therapy of antibodies may prevent progression of COVID if timed right

by Medically Speaking September 4, 2021

written by Medically Speaking

New Delhi: Doctors from all around India agreed to show favourable results for monoclonal antibodies among high-risk patients by reducing illness severity and opportunities for admission. This test drug was implemented in the country at highest level when the second wave was reported every day with multiple COVID patients.

Trails of recovery have revealed that monoclonal antibody usage can be prolonged to 7-10 days. Experts also underlined that monoclonal antibodies used in advance in sero-negative autoimmune patients have helped to reduce the likelihood of severe disease and hospitalisation.

This was observed at the Emerging COVID-19 Treatment Therapies session organised by Integrated Health & Wellbeing (IHW) Council in association with Cipla. Some noted speakers and experts present at the event included Dr Randeep Guleria, Director, AIIMS, New Delhi, Dr Dhruva Chaudhary, Head, Department of Pulmonary and Critical care Medicine, PGIMS, Rohtak, and Dr Shashank Joshi, of Lilavati Hospital and Research Centre, Mumbai.

Speaking about Monoclonal antibodies as a treatment for COVID, Dr Joshi, said, “We can say monoclonal antibodies are a reasonable treatment based on the compelling data from elite trails for high-risk patients, even in people who have not developed any antibody. The first 48 to 72 hours of infection is the most opportune time for administering monoclonal antibodies, but most of the patients come after that. Now, we have data from recovery trials which show the use of monoclonal antibodies can be extended up to 7 to 10 days and in exceptional cases, can be used in hospitalised patients as well.”

Monoclonal antibodies are different from the commonly used steroids that are commonly used and perceived as the only drugs available for treatment, as was noted by Dr Chaudhary. The cost factor of using monoclonal antibodies however, is to be examined.

“Our treatment strategy has evolved and we are using both empirical and repurposed drugs. Monoclonal antibodies have been useful for patients with high risk of severe disease but more data is needed on its efficacy. Besides, the challenge is to ensure they are not used across the board. The bottom-line is when to give which drug and when not to use which drug. A lot of investment has been done in vaccine development but not in antivirals. We need to invest more in developing good antivirals that can be given easily to patients and useful in the long run,”Dr Guleria added.

September 4, 2021 0 comment

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WHO South-East Asia Health Ministers to discuss COVID

by Medically Speaking September 4, 2021

written by Medically Speaking

New Delhi: Next week, the WHO South East Asia Region’s health ministers will meet for deliberation on the ongoing pandemics and actions to “build better” essential health services so that universal health coverage can be achieved.

The 74th WHO South East Asia Regional Committee will be held from 6 to 10 September. Nepal will host this meeting.

The session of the Committee will include Dr Tedros Adhanom Ghebreyesus, WHO Director General, Dr Poonam Khetrapal Singh, Regional Director, Health Ministers and Senior Health officials from Member States, UN Agencies, partners, donors, representatives of civil society, etc.

Strengthening public health emergency preparedness and response, accelerating progress for prevention and control of non-communicable diseases, and ending viral hepatitis, HIV and STI are among other key issues that will be discussed at the annual meeting. This meeting will be held virtually for the second consecutive year in view of the pandemic.

Monitoring progress on universal health coverage, revitalizing school-health, and the regional framework for vaccine action plan will also be tabled for discussion.

The meeting will also take stock of the progress being made in the region on resolutions adopted at previous Regional Committee meetings. The session will also cover measles and rubella elimination by 2023, improving access to essential medical products, the South-East Asia Regional Health Emergency Fund and strengthening health systems to accelerate delivery of services for non-communicable diseases at the primary health care level.

September 4, 2021 0 comment

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DCGI nodded to the COVID-19 Reliance Life Sciences vaccine phase-I clinical trial

by Medically Speaking September 4, 2021

written by Medically Speaking

On Friday, the Indian Drug Controller General (DCGI) authorised Reliance Life Sciences, owned by Mukesh Ambani, to conduct a phase I clinical trial with certain conditions of its indigenous COVID 19 vaccine.

They said that the phase-I clinical trial will assess SARS-CoV-2 vaccine for recombinant protein in healthy volunteers according to their safety, tolerability, and immunogenicity.

The firm is required to submit the revised clinical trial protocol for immunogenicity to be assessed on Day 42, instead of Day 14, as recommended by the Subject Expert Committee (SEC) of the Central Drugs Standard Control Organisation, a source said, citing the conditions set for the trial.

The DCGI gave the permission based on the recommendations given by the SEC which deliberated on the company’s application on August 26.

The trials will be conducted at eight sites in Maharashtra.

India’s drug regulator has so far issued emergency use authorisation to six COVID-19 vaccines — Serum Institute’s Covishield, Bharat Biotech’s Covaxin, Zydus Cadila’s ZyCoV-D, Russian-made Sputnik V and the two made by US firms Moderna and Johnson & Johnson.

September 4, 2021 0 comment

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