Medically Speaking Team

India saw a single-day rise of 6,395 new coronavirus infections, taking the tally of COVID-19 cases to 4,44,78,636, while the active cases declined to 50,342, according to the Union health ministry data updated on Thursday.

The death toll has climbed to 5,28,090 with 33 fatalities, including 14 deaths reconciled by Kerala, the data updated at 8 am showed.

The active cases comprise 0.11 per cent of the total infections, while the national COVID-19 recovery rate has increased to 98.70 per cent, the health ministry said.

A decline of 252 cases has been recorded in the active COVID-19 caseload in a span of 24 hours.

The daily positivity rate was recorded at 1.96 per cent and the weekly positivity rate was recorded at 1.88 per cent, according to the health ministry.

The number of people who have recuperated from the disease surged to 4,39,00,204, while the case fatality rate was recorded at 1.19 per cent.

Covid vaccines

According to the ministry, 214.27 crore doses of Covid vaccines have been administered in the country so far under the nationwide COVID-19 vaccination drive.

India’s COVID-19 tally had crossed the 20-lakh mark on August 7, 2020, 30 lakh on August 23, 40 lakh on September 5 and 50 lakh on September 16.

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It went past 60 lakh on September 28, 70 lakh on October 11, crossed 80 lakh on October 29, 90 lakh on November 20 and surpassed the one-crore mark on December 19.

India crossed the grim milestone of two crore on May 4, three crore on June 23 last year and four crore on January 25 this year.

The National Testing Agency (NTA) released the National Eligibility Cumulation Entrance Test (NEET) UG-2022 results late on Wednesday night.

On July 17, the undergraduate medical admission exam had been held. Both ntaresults.nic.in and neet.nta.nic.in allow users to view test results.

In all, more than 18 lakh applicants registered for the NEET exam, which was held this year at 3,570 centres distributed throughout 497 Indian cities and 14 foreign locations.

Notably, the test’s tentative answer key was made public the week before, and applicants had until September 2 to object to the answer key.

Rajasthan’s Tanishka bagged the topmost rank among the 17.64 lakh candidates who appeared for the medical entrance exam.

Delhi’s Vatsa Ashish Batra and Hrishikesh Nagbhushan Gangule from Karnataka bagged 2nd and 3rd position respectively.

Notably, Tanishka shared the same score (715) with those on the second, third and fourth rank.

Among the top 50 candidates across the country who came out with flying colours, 18 are females on the list while there are 32 male candidates who made it into the list of the top 50 in India.

Others who featured in the top 10 in the country include Rucha Pawashe (715) from Karnataka, Errabelly Sidharth Rao (711) from Telangana, Rishi Vinay Balse (710) from Maharashtra, Arpit Narang (710) from Punjab, Krishna SR (710) from

Karnataka, Zeel Vipul Vyas (710) from Gujarat, and Haziq Parveez Lone (710) from Jammu and Kashmir.

As many as 4,29,160 males out of 7,63,545 who appeared in the exam and 5,63,902 females out of 10,01,015 cleared the NEET UG 2022.

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An expert stated on Wednesday that COVID has severely impacted eye donations and transplants. However, with the decrease of COVID cases across the nation, the situation has begun to improve.

Dr JS Titiyal, Chief of RP Centre, AIIMS, Delhi said, “COVID really killed the eye donation movement in the country during the first wave of COVID. If COVID wave was going up, the collection or donation of eyes was going down.”

Dr Titiyal said that he had hoped to touch 3,000 transplantations per year, however, due to COVID, the target will take another nearly three years to achieve.

“I was hoping that we might touch 3,000 transplantation in a year, which was my goal at that time. But there was a sudden COVID arrival and now last year we could hardly do around 580 cases, which is 1/3rd of what we were doing earlier and there has been a three-fold increase in the number of cases which are being registered for transplantation, That means they are waiting for their turn for surgery,” he said.

However, the doctor stated that the donation has shown some uptick with the decline in the number of COVID cases.

“Now, fortunately, COVID is almost plateauing, similarly eye donation and collection is increasing day by day, which is a good sign for the entire country. I hope that this will be maintained so that we can effectively increase our donation, collection and transplantation also,” he said.

In the year 2018-2019, 2,500 tissues and more than 1,700 eye surgeries were conducted. AIIMS has the capacity to conduct 5000-6000 per year.

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“If I see on national eye bank data before COVID in 2019. We had the maximum number of transplantation and collection at that time,” Dr Titiyal said.

“So, it is a real challenge for a subsequent time to come. For us. Unfortunately, we get patients from across the country because of the faith they have in AIIMS treatment. But the collection is not increasing,” he added.

AIIMS campaign for eye donation

AIIMS will be running various awareness campaigns for eye donations that include “Run for Eye Donation” which will be joined by the faculty, residents, students and staff of AIIMS on September 8.

According to studies, persons in their middle years and older should get seven hours of sleep every night, with too little or too much sleep being linked to worse mental and cognitive functioning.

Sleep is crucial for sustaining psychological health and supporting cognitive function. It also helps the brain stay healthy by getting rid of trash. As we age, our sleep habits frequently change, and we experience issues with falling and staying asleep as well as decreasing quantity and quality of sleep. It is believed that these sleep abnormalities may be a factor in the ageing population’s cognitive decline and mental illnesses.

In a study that was just published in Nature Aging, researchers from the UK and China looked at information from over 500,000 persons in the UK Biobank who were between the ages of 38 and 73. A series of cognitive tests and questions regarding participants’ sleep habits and mental health and wellbeing were also administered. Nearly 40,000 research participants had genetic and brain imaging data accessible.

The team’s analysis of these data revealed that poor sleep quality and quantity were both linked to a decline in cognitive abilities including processing speed, visual attention, memory, and problem-solving abilities.

The best amount of sleep for both cognitive function and mental health was seven hours per night, with participants who reported sleeping for longer or shorter periods of time feeling worse overall and having more symptoms of worry and despair.

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The interruption of slow-wave sleep, sometimes known as “deep sleep,” may be one reason for the link between inadequate sleep and cognitive deterioration, according to the researchers. It has been demonstrated that disruption of this kind of sleep is closely related to memory consolidation and the accumulation of amyloid, a crucial protein that, when it misfolds, can result in the “tangles” in the brain that are indicative of some types of dementia. Additionally, a lack of sleep may make it harder for the brain to get rid of pollutants.

The research team also discovered a relationship between sleep duration and variations in the structure of brain areas related to cognitive processing and memory, with bigger alterations linked to greater or fewer than seven hours of sleep.

It was also crucial for cognitive function, excellent mental health, and overall wellness to get a constant seven hours of sleep every night. Previous research has demonstrated that irregular sleep patterns are linked to increased inflammation, suggesting that older persons are more susceptible to illnesses connected with ageing.

Professor Jianfeng Feng from Fudan University in China said: “While we can’t say conclusively that too little or too much sleep causes cognitive problems, our analysis looking at individuals over a longer period of time appears to support this idea. But the reasons why older people have poorer sleep appear to be complex, influenced by a combination of our genetic makeup and the structure of our brains.”

Risk of excessive sleep duration

The results, according to the researchers, point to a possible risk factor for cognitive deterioration as people age: inadequate or excessive sleep duration. Previous research has suggested a connection between sleep length and the risk of dementia and Alzheimer’s disease, both of which include cognitive loss as a characteristic symptom.

Professor Barbara Sahakian from the Department of Psychiatry at the University of Cambridge, one of the study’s authors, said: “Getting a good night’s sleep is important at all stages of life, but particularly as we age. Finding ways to improve sleep for older people could be crucial to helping them maintain good mental health and wellbeing and avoiding cognitive decline, particularly for patients with psychiatric disorders and dementias.”

In a comprehensive global study, scientists from Uppsala University found DNA regions associated with physical activity or leisure screen use. The findings indicate that a more sedentary lifestyle may be explained by how muscles adapt to training and demonstrate the health advantages of physical activity.

The study’s results were released in the Nature Genetics publication. It is commonly known that living an active lifestyle and spending less time sitting down are linked to greater health. People in better income nations appear to be growing less active, nevertheless, according to patterns across time.

The genetic reason for why some people are more physically active than others is also known from twin and family studies, although the scientific underpinnings of this phenomenon are still poorly understood.

Researchers from Uppsala University integrated genetic information from more than 700,000 participants in 51 research projects in order to better understand the processes that affect physical exercise and its function in illness prevention. They did this in order to identify 99 DNA areas that are connected to the amount of time people report spending engaging in moderate-to-vigorous physical activity or watching a screen in their free time.

“We know that people tend to overreport how much time they spend on physical activity, but around half of the DNA regions we identified also show robust associations with physical activity as measured using devices that people wore during daily life. This adds further credibility to our findings,” says Ruth Loos from the Novo Nordisk Foundation Center for Basic Metabolic Research, at the University of Copenhagen.

The researchers then demonstrated that decreased screen time decreases the risk of obesity using DNA variations as instrumental factors. Less screen time and more time engaged in moderate-to-vigorous physical exercise also lower the risk of developing diabetes, ADHD, depression, and an earlier mortality age.

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“We confirmed that physical activity has beneficial effects on health outcomes. We also found that all outcomes that we examined are driven by physical activity’s beneficial effect on body mass,” says Zhe Wang from Icahn School of Medicine at Mount Sinai in New York and first author of the paper.

Additional research revealed that DNA polymorphisms linked to screen time during leisure are more frequently found among genes whose activity in skeletal muscle is altered by strength training. This shows that by changing the reaction to exercise, these genes may affect the chance of pursuing an active lifestyle.

More in-depth study on one gene led to the discovery of a DNA variation that alters a protein building block found only in fast-twitch skeletal muscle fibres.

“Our results show that this change results in more elastic muscle fibres that can deliver less force, but are likely less susceptible to exercise-induced muscle damage. We think that this reduced risk of muscle damage after exercise makes it easier for people to have a more active lifestyle,” says co-author Andrew Emmerich from the Department of Cell and Molecular Biology, Uppsala University.

Genes that may lead to less physical activity

In total, the researchers identified 46 genes in the 99 DNA regions that could be relevant for linking genetics and physical activity. The findings suggest that pathways related to locomotion and muscle weakness due to dysfunction of the muscle fibre are probably involved.

“We cannot currently claim that these 46 genes cause someone to be more or less physically active in daily life, but they provide great leads for further studies. Perhaps in the future it will even be possible to trigger the beneficial effects of physical activity without the need to be physically active,” says Marcel den Hoed, researcher at the Department of Immunology, Genetics and Pathology at Uppsala University, and lead author of the paper.

A study suggests that receiving an annual flu vaccine may reduce the risk of stroke. The American Academy of Neurology’s medical journal reported the study’s findings.

“Studies have shown that getting the flu increases your risk of having a stroke, but research is still being collected on whether getting the flu vaccine can help protect against a stroke,” said study author Francisco J. de Abajo, MD, MPH, PhD, of the University of Alcala in Madrid, Spain. “This observational study suggests that those who have a flu shot have a lower risk of stroke. To determine whether this is due to a protective effect of the vaccine itself or to other factors, more research is needed.”

The most prevalent kind of stroke, ischemic stroke, which is brought on by a restriction in blood flow to the brain, was the subject of the study.

In order to gather data for the study, researchers searched a Spanish healthcare database for individuals who were at least 40 years old and had their first stroke within the previous 14 years. Five persons of the same age and sex were compared to each stroke victim. There were 71,610 persons who did not suffer a stroke and 14,322 people who did.

Then, for individuals who did not experience a stroke, the researchers looked at whether persons had gotten the influenza vaccination at least 14 days before to the stroke.

In comparison to 40.5% of those who did not have a stroke, 41.4% of those who did had had the flu vaccination. However, those who received the injection had a higher likelihood of being older and having additional health issues, such as high blood pressure and high cholesterol, that would increase their risk of having a stroke. After adjusting for those variables, researchers discovered that those who took a flu vaccination had a 12% lower risk of having a stroke than people who did not.

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Additionally, the risk of stroke was examined to determine if the pneumococcal vaccination had any preventive effects.

“These results are yet another reason for people to get their yearly flu shot, especially if they are at an increased risk of stroke,” de Abajo said. “To be able to reduce your risk of stroke by taking such a simple action is very compelling.”

As an observational research, it cannot be concluded that the flu vaccination lowers the risk of stroke. Only an association is displayed. Other elements that potentially have an impact on stroke risk were not assessed.

The ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH) has released guidelines in The Lancet Regional Health-Southeast Asia journal for managing monkeypox (MPX) infection in pregnant women in India.

Pregnant or breastfeeding women, as well as young infants, are particularly prone to MPX, which can cause severe sickness and bad results.

Previously, the ICMR-NIRRCH had launched the ‘National Registration of Pregnant Women with Covid-19 (PregCovid registry)’ in partnership with the Municipal Corporation of Greater Mumbai’s Medical Education and Drugs Department and BYL Nair Hospital.

Based on the experience of this registry, the authors have recommended strategies for addressing monkeypox infection in pregnant women in India.

Dr Rahul Gajbhiye, Scientist D and DBT Wellcome India Alliance Clinical and Public Health Fellow at ICMR-NIRRCH, said, “We recommend the development of guidelines for diagnosis and management of MPX in pregnant women and newborns in India. We need to involve global experts engaged in the management of MPX in pregnant women and newborns for developing evidence-based guidelines appropriate for India and low-resource settings. These guidelines shall be revised from time to time based on real-time experience from India and the global data. We also recommend development of a registry of pregnant women and their newborns exposed to MPX virus.”

Dr Niraj Mahajan, Associate Professor, Obstetrics and Gynaecology at BYL Nair Hospital, Mumbai, and co-author of the study, said in an official statement issued on Wednesday: “For our Indian settings, we recommend discussing the risk of neonatal MPX infection and the benefits and risk of Cesarean section with the pregnant woman and her relatives. Since there is evidence of risk of vertical transmission and fetal demise, we recommend close monitoring to provide appropriate care to the pregnant woman infected with MPX”.

“There is a need to establish a multidisciplinary team for management of MPX in pregnant women and their newborns and also strengthen public and private healthcare system for MPX outbreak in India,” said Dr Geetanjali Sachdeva, Director, ICMR-NIRRCH and co-author of the publication.

According to a recent study, the third Covid-19 vaccination dosage boosts the degree and duration of protection against the Omicron variant and hospitalisation compared to the first two vaccine doses.

According to the study, which was published in the journal PLOS Medicine, two vaccination doses give only minimal and short-term protection against SARS-CoV-2 infection with the variation.

“Our findings indicate that a third dose is necessary to maintain protection against infection for a longer time and to ensure a high level of protection against Covid-19 hospitalisation with the Omicron variant,” said researcher Mie Agermose Gram at Statens Serum Institut, Copenhagen, Denmark.

“Continued emergence of new variants and waning vaccine durability requires ongoing evaluation of vaccine effectiveness against infection and hospitalisation to inform future vaccination strategies,” Gram added.

The introduction of new SARS-CoV-2 mutations may reduce vaccine durability in the long run, increasing the risk of infection and hospitalisation.

However, information on the vaccination efficacy of three vaccines over time is scarce.

The researchers used individual-level data to perform a countrywide cohort analysis of all previously uninfected Danish inhabitants aged 12 and older for this investigation.

After correcting for age, gender, geographic location, and comorbidities, the researchers evaluated vaccine efficacy using vaccination status as a time-varying exposure before comparing infection and hospitalisation rates to uninfected people.

The researchers discovered that a third vaccination dosage gave better protection against Omicron variant infection and hospitalisation than two doses, and that there was less indication of diminishing protection.

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The new COVID- After the Centers for Disease Control and Prevention approved the new doses, 19 boosters targeting today’s most frequent omicron strains are slated to begin soon.

The decision was made by CDC Director Rochelle Walensky on Thursday, only days after the agency’s advisors advised that if enough people roll up their sleeves, the vaccinations might prevent a winter spike.

They were meant to give broader protection and can help restore protection that has diminished after earlier vaccinations, she added in a statement.

Pfizer and competitor Moderna’s altered injections provide Americans with the most up-to-date protection at yet another vital point in the epidemic.

They are combination or bivalent injections that include half of the original vaccination and provide half protection against the BA.4 and BA.5 omicron variants that are currently responsible for virtually all COVID-19 infections.

The CDC’s advisors debated who should receive the new booster and when, because only a similarly adjusted vaccination, rather not the precise mix, has been evaluated in humans thus far.

However, the panel concluded that it was the wisest choice given that the United States is still seeing tens of thousands of COVID-19 cases and around 500 fatalities each day, even before the predicted next winter wave.

I think they’re going to be an effective tool for disease prevention this fall and into the winter, said CDC adviser Dr Matthew Daley of Kaiser Permanente Colorado.

Comparing the tweak that has been studied in people and the one the US actually will use, “it is the same scaffolding, part of the same roof, we’re just putting in some dormers and windows, said Dr Sarah Long of Drexel University.

The CDC is anticipated to endorse that proposal soon, which will be the final step before vaccinations can begin. Pfizer stated that three million doses will be delivered to immunisation locations across the country by Tuesday.

The original COVID-19 vaccinations continue to provide effective protection against serious illness and death, particularly among younger and healthier persons who have received at least one booster.

However, those vaccinations were created to combat the HIV strain that was prevalent in early 2020. As more mutations arise and more time passes since someone’s previous shot, effectiveness decreases. According to the CDC, hospitalisation rates in persons over the age of 65 have increased since April.

In the United States, the FDA desired that fall boosters target the presently circulating omicron strains. Rather of waiting until November for further human research, the government approved mouse data that indicated the current modification elicited a similarly strong immune response.

The CDC emphasised that this is how flu vaccinations are adjusted each year.

The sole CDC consultant who voted against prescribing the injections was Dr Pablo Sanchez of Ohio State University. He feels the bivalent vaccination is safe and will most likely receive it.

But I just feel that this was a bit premature given the absence of human data on how well it works, he said.

According to some CDC consultants, patients will need to wait longer between their previous immunisation and the new booster than the FDA’s two-month minimum. They recommended waiting at least three months.

Another difference is that the FDA no longer approves the use of the original-recipe boosters for anybody 12 or older, which may cause uncertainty for anyone who expected to obtain a standard booster this week but now must wait for the new kind to arrive at their local pharmacy or clinic.

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