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COVID-19 patients who undergo surgery at high death risk: Lancet

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London, May 31 : Researchers, including one of Indian-origin, have found that patients undergoing surgery after contracting COVID-19 are at greatly increased risk of postoperative death, according to a new global study published in The Lancet journal.

Published in ‘The Lancet’ journal, the global study found that amongst SARS-CoV-2 infected patients who underwent surgery, mortality rates approach those of the sickest patients admitted to intensive care after contracting the virus in the community. In the study, the research team led by the University of Birmingham in the UK examined data for 1,128 patients from 235 hospitals and a total of 24 countries participated, predominantly in Europe, although hospitals in Africa, Asia, and North America also contributed.

The researchers noted that SARS-CoV-2 infected patients who undergo surgery, experience substantially worse postoperative outcomes than would be expected for similar patients who do not have the infection. “We would normally expect mortality for patients having minor or elective surgery to be under one per cent but our study suggests that in SARS-CoV-2 patients these mortality rates are much higher in both minor surgery (16.3 per cent) and elective surgery (18.9 per cent),” said study co-author Aneel Bhangu from the University of Birmingham.

According to the study, the 30-day mortality among these patients was 23.8 per cent. Mortality was disproportionately high across all subgroups, including elective surgery (18.9 per cent), emergency surgery (25.6 per cent), minor surgery such as appendectomy or hernia repair (16.3 per cent), and major surgery such as hip surgery or colon cancer surgery (26.9 per cent).

The study identified that mortality rates were higher in men (28.4 per cent) versus women (18.2 per cent), and in patients aged 70 years or over (33.7 per cent) versus those aged under 70 years (13.9 per cent). In addition to age and sex, risk factors for postoperative death included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.

According to the researchers, patients undergoing surgery are a vulnerable group at risk of SARS-CoV-2 exposure in hospital. They may be particularly susceptible to subsequent pulmonary complications, due to inflammatory and immunosuppressive responses to surgery and mechanical ventilation. The study found that overall in the 30 days following surgery 51 per cent of patients developed a pneumonia, acute respiratory distress syndrome, or required unexpected ventilation.

This may explain the high mortality, as most (81.7 per cent) patients who died had experienced pulmonary complications. “Our data suggests that it was the right decision to postpone operations at a time when patients were at risk of being infected with SARS-CoV-2 in hospital,” said study co-author Dmitri Nepogodiev.

Disaster

Preliminary trial success, Covid vax could be out by Dec: Bangladeshi scientist

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Dhaka : Claiming success in preliminary animal modelling trial of Covid-19 vaccine, Globe Biotech Limited has claimed to be the first company from Bangladesh to have a Covid-19 vaccine under development. It says it is aiming for a December 2020 availability of the vaccine in the market.

They received the result after conducting the preliminary trial on five rabbits from June 10 to June 28, says Dr Asif Mahmud, Assistant Manager and incharge of Research and Development, Globe Biotech Limited, in an exclusive interview to IANS.

Earlier, he led the team to claim success in preliminary trial for the vaccine in national capital Dhaka on Thursday afternoon.

Excerpts from the interview of scientist Dr Asif Mahmud

Q: Globe Biotech is a research company in Bangladesh. Is it a branch of any MNC in the world?

A: No, in fact, Globe Biotech Limited is a Biological Drug Discovery Company in operation in Bangladesh since 2015. The project was started by our CEO Kankon Nag and COO Dr Nazneen Sultana. We have prepared 18 bio similar. We are also working on our own Nobel drug. After completing the animal trials of 6 bio similar, we have applied for Ethical Approval through our PRO at the Bangladesh Medical Research Council (BMRC) in Dhaka. We have that ability and experience to invent a vaccine against this pandemic. Under the supervision of our CEO and COO, after a Covid-19 patient was reported in Bangladesh on March 8, we shifted our focus to SARS-Cov2 and started 3 new projects. Number one — we will do kit development; number two — we will do vaccine development for the country; and in the last — the biological molecule development.

Q: Is the research by Globe Biotech independent? Or is your research done under the supervision of any other country?

A: Globe Biotech is researching independently. Under the supervision of our CEO and COO, both of whom supervised the team from Canada. They are experienced in this matter. Dr Kankon was directly involved in the HIV vaccine project. He is using that experience here. We are conducting research under their direct supervision. A 12-member scientific group started research on March 18 under the leadership of both.

We have taken some 76 genome sequences under consideration, wherein we found that a sequence (numbered 614) has a mutation point that they have used for amino acid bonding.

Q: Which method did you follow for the research you are undertaking? And how do you make sure it will work to protect people from Covid-19?

A: We went for the SPR method for the tests. Surface plasmon resonance (SPR) is a phenomenon where electrons in the metal surface layer are excited by photons of incident light with a certain angle of incidence, and then propagated parallel to the metal surface. It is an optical technique utilised for detecting molecular interactions. Actually, we have set a vaccine target. We have analysed the sequences from all the databases we have worldwide, including the sequences in Bangladesh. We set the target by our analysis. We have modified that target according to our needs. We have set multiple targets.

We have placed multiple delivery systems in consideration.

By applying the delivery system we have done an animal trial on rabbits.

By this we have got a very good antibody titer. And those antibodies have shown strong binding affinity with our antigen. We have additional candidates, some of which we have presented to the press. But the company is yet to apply for a patent or any publication; and before the patent is ensured it would not disclose the data received from the trial. We have said that we need to convert the data from the preliminary animal trial into a regulated animal trial. That we will do within the next 6 to 8 weeks. Then we will apply for Ethical Approval.

Q: This 6 to 8 weeks period, to get proof of animal trial? Or, for trial on humans?

A: No, we have already got proof of antibody generation in the preliminary animal trial. Now, it needs to be converted to a regulated animal trial. Because, for human trial, we have to submit it to the regulatory body for Ethical Approval. Regulated trials will require some further characterisation. Then, we will apply for human trials.

Q: Did you inform about your research to the drug administration of the country?

A: Not yet. There is no role of the regulatory body now. When we do a regulated animal trial, of course, we go to the regulatory body.

Q: What are your expectations? When will the vaccine be released?

A: We have already formulated the regulated animal trial guidelines and the tests would be concluded within four to six weeks. Thereafter, the company will seek Ethical Approval from the Bangladesh Medical Research Council (BMRC) in early September, when the data from the Regulated Animal Trial reaches us within 6 to 7 weeks.

And then, we will apply for market authorisation to the regulatory authority in December within three months after completing the phases 1, 2 and 3. If everything goes smoothly, we expect to be able to bring our vaccine to the market by December.

Q: If you get government support, do you think success for you can be faster or smoother?

A: Obviously! This will be the first discovery of this vaccine in Bangladesh. The first task always comes with more obstacles and hindrances. We will remove the obstacles with the support of the government and will bring the vaccine to the market in due course.

(Sumi Khan can be contacted at [email protected])

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Oats, rye bran may reduce weight gain, hepatic inflammation

The findings suggest that both brans have the capacity to create a favourable environment in the gut by supporting the growth of beneficial microbes.

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Oats Idli

London, July 5 : Want to lose some weight? Read on. Researchers have found that the consumption of dietary fibre from oat and rye brans increased the growth of beneficial microbes in the intestines and reduced hepatic inflammation.

In addition, diets enriched with oat or rye bran were shown to attenuate weight gain. The effects of oat and rye were partly different, but both were beneficial for health.

For the study, published in the Molecular Nutrition & Food Research, the research team from the University of Eastern Finland, VTT Technical Research Centre of Finland collaborated with the University of Hong Kong.

The health benefits of oat, rye and other whole-grain products have been widely studied, and their use has been associated with decreased inflammation and improved glucose, lipid and adipose tissue metabolism in human and animal experimental research.

In addition, they have been linked to a decreased risk of obesity, metabolic syndrome, cardiovascular diseases and type-2 diabetes. Different dietary fibres are also known to have different health effects.

In the current study, the research team wanted to investigate differences in metabolites produced by gut microbiota and their interactions with host metabolism in response to supplementation with oat and rye bran fibres.

The study was an animal experiment during which mice were fed a high-fat Western diet for 17 weeks. Two groups were fed the same diet enriched with 10 per cent of either oat or rye bran.

Among the various gut microbial metabolites, this study focused on those especially relevant to the development of fatty liver disease, which is often associated with obesity. Thus, microbial metabolites were assessed by measuring cecal short-chain fatty acids (SCFAs), ileal and faecal bile acids, and the expression of genes related to tryptophan metabolism.

The findings suggest that both brans have the capacity to create a favourable environment in the gut by supporting the growth of beneficial microbes.

Both bran fibres enhanced the production of SCFAs, leading to improved gut integrity, reduced liver inflammation. “In addition, both oat and rye supplementation were shown to attenuate weight gain associated with a high-fat diet,” the authors noted.

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Disaster

Rahul questions performance of ventilators funded by PM CARES

Quoting a former employee, the news article alleged that PM CARES Ventilator Maker AgVa has “fudged” software in order to hide “poor performance”.

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Rahul Gandhi

New Delhi, July 5 : Congress leader Rahul Gandhi on Sunday alleged that the Central government is putting Indian lives at risk by purchasing sub-standard ventilators for the fight against coronavirus.

Quoting an article, Gandhi tweeted, “PMCares opacity is: 1. Putting Indian lives at risk. 2. Ensuring public money is used to buy sub-standard products.”

He even used a hashtag “BJP fails Corona Fight”.

Quoting a former employee, the news article alleged that PM CARES Ventilator Maker AgVa has “fudged” software in order to hide “poor performance”.

Gandhi”s tweet comes soon after Congress asked four specific questions to the Centre, mostly revolving around the makers, the tendering process and price.

Earlier on Sunday, Congress spokesperson Gaurav Vallabh asked, “Multiple government hospitals of repute and expert panel of doctors had reported that ventilators supplied by AgVa Health Care are of sub standard quality and are of no use. Why Government is compromising with the health of lakhs of patients with such sub standard equipment at such a critical time?”

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