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Higher antibiotics use may raise Parkinson’s disease risk

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Antibiotic Resistance

London, Nov 23 : Excessive use of certain commonly used antibiotics is linked to an increased risk of Parkinson’s disease, a progressive nervous system disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination, says a study.

This connection may be explained by their disruptive effects on the gut microbial ecosystem, said the study published in the journal Movement Disorders.

The strongest associations were found for broad spectrum antibiotics and those that act against against anaerobic bacteria and fungi.

“The link between antibiotic exposure and Parkinson’s disease fits the current view that in a significant proportion of patients the pathology of Parkinson’s may originate in the gut, possibly related to microbial changes, years before the onset of typical Parkinson motor symptoms such as slowness, muscle stiffness and shaking of the extremities,” said research team leader Filip Scheperjans from Helsinki University Hospital, Finland.

“It was known that the bacterial composition of the intestine in Parkinson’s patients is abnormal, but the cause is unclear. Our results suggest that some commonly used antibiotics, which are known to strongly influence the gut microbiota, could be a predisposing factor,” Scheperjans said.

In the gut, pathological changes typical of Parkinson’s disease have been observed up to 20 years before diagnosis.

Constipation, irritable bowel syndrome and inflammatory bowel disease have been associated with a higher risk of developing Parkinson’s disease.

Exposure to antibiotics has been shown to cause changes in the gut microbiome and their use is associated with an increased risk of several diseases, such as psychiatric disorders and Crohn’s disease.

However, these diseases or increased susceptibility to infection do not explain the now observed relationship between antibiotics and Parkinson’s.

The study compared antibiotic exposure during the years 1998-2014 in 13,976 Parkinson’s disease patients and compared it with 40,697 non-affected persons matched for the age, sex and place of residence.

Antibiotic exposure was examined over three different time periods: 1-5, 5-10, and 10-15 years prior to the index date, based on oral antibiotic purchase data.

Exposure was classified based on number of purchased courses. Exposure was also examined by classifying antibiotics according to their chemical structure, antimicrobial spectrum, and mechanism of action.

“The discovery may also have implications for antibiotic prescribing practices in the future. In addition to the problem of antibiotic resistance, antimicrobial prescribing should also take into account their potentially long-lasting effects on the gut microbiome and the development of certain diseases,” Scheperjans said.

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Kerala health guidelines to tackle coronavirus

From Saudi Arabia, reports have come that a Kerala nurse who was kept in isolation for coronavirus has been cleared as it is not the variant that was first reported in Wuhan province in China.

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Coronavirus

Thiruvananthapuram, Jan 24 : In the wake of the coronavirus taking a toll across the world, Kerala on Friday has come out with health guidelines as a precautionary step, said state Health Minister K.K. Shailaja.

“The guidelines that we have come out with are based on the WHO protocols. Necessary precautions have been taken and this would be at all the state-run Medical College hospitals and the district hospitals. Isolation wards will be kept ready, in case need arises,” said Shailaja.

The authorities have also posted health officers at the airports and seaports and all incoming passengers are being screened, if they have visited China.

Meanwhile a man who arrived from China was admitted to a state-run hospital near Kochi after he developed fever. He has been kept in the isolation ward.

From Saudi Arabia, reports have come that a Kerala nurse who was kept in isolation for coronavirus has been cleared as it is not the variant that was first reported in Wuhan province in China.

According to reports, the nurse is set to be discharged on Saturday.

Reports also have surfaced that there are about 25 Indians including Keralite students in Wuhan province waiting to travel to India, but are unable to do so, after the airport there was closed.

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Cancer’s Big Five

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cancer types poster

Cancer is one of the most dreaded ailments, and from amongst the very many types of cancer, there are a few that Indian women are predisposed to.

47.2 percent of cancer in women is accounted for amongst the five types. The surprising fact is that these cancers can be prevented by early screening. Early detection and treatment reduces not only the death rate but the quality of life post cancer treatment. Dr Neena Singh, Associate Director, Obstetrics & Gynecology, Fortis La Femme, Delhi sheds some light on this.

She reveals the following are the top five types of cancer in women in India:

  • Breast Cancer
  • Cervical Cancer
  • Uterine Cancer
  • Ovarian Cancer
  • Colorectal cancer

BREAST CANCER :

Breast cancer is the most common cancer in women in India and accounts for 27 percent of all cases of cancer in women. It is more common in urban areas than rural areas.

High risk factors:

  • Family history of breast cancer
  • Long period of OCP (Oral contraceptive pills)

Screening test for breast cancer:

Self-examination of the breasts. If any abnormality found like lump, pain or change in shape, consult a doctor who would examine clinically if it is cancer.

  • Mammography is done which can detect small lesions.
  • MRI Breast is done for staging the disease.
  • Treatment at early stages carries good prognosis.

CERVICAL CANCER

Cervical cancer is the second most common cancer in India in women accounting 22.86 percent of all cancer cases in women. It is more common in rural women than urban women.

Risk Factors:

  • Young age at first intercourse (less than 16 years)
  • Multiple Sexual partners
  • Cigarette smoking
  • Human papillomavirus infection (HPV)
  • Immunosuppression

Screening test for cervical cancer:

Any abnormal symptoms like abnormal vaginal bleeding, vaginal discharge and contact bleeding (bleeding after intercourse) report to a gynecologist who would do a clinical examination and do some test on cervix.

  • Visual inspection with acetic acid (VIA)
  • Visual inspection with legal Iodine (VILI)
  • Magnified VI! Under colposcopy
  • Exfoliative cytology (Pap smear)-is gold standard for screening.
  • HPV-DNA testing

Do Cervical biopsy for confirmation. Early detection and treatment have very good prognosis.

Prevention by prophylactic vaccinations in childhood.

UTERINE CANCER (CANCER OF UTERUS)

Uterine cancer is a type of cancer that begins in the uterus in its lining called the endometrium. Hence also named as endometrial carcinoma.

Risk Factors:

It is an estrogen dependent cancer. Persistent unopposed stimulation of endometrium with estrogen is the single most important factor for development of cancer endometrium:

Polycystic ovaries

  • Granulosa cell tumor of the ovary which secret estrogen
  • Hormone replacement therapy-unopposed estrogen therapy
  • Early onset of periods & late menopause (after the age of 50)
  • Age: – 75 percent women are post-menopausal

Nulliparity

  • Obesity, Hypertension & Diabetes (corpus cancer syndrome)
  • Tamoxifen therapy given in breast cancer
  • Endometrial hyperplasia especially atypical
  • Following radiation exposure to the pelvis
  • Family history of cancer uterus breast, ovary & colon

Screening test for uterine cancer:

If any irregularity in menstrual cycle, post-menopausal bleeding, contact bleeding and unhealthy vaginal discharge report to a gynecologist who would do

  • Clinical examination
  • Transvaginal sonography (TVS) to know endometrial thickness or irregularity.
  • MRI pelvis can be done for more details
  • Fractional curettage of uterus for histopathology examination or Hysteroscopy & directed biopsy from suspicious area. Early diagnosis & treatment has very good prognosis.

OVARIAN CANCER

Ovarian cancer constitutes 15-20 percent of all genital cancers. 85-90 percent of all cancers are epithelial in origin. Germ cell constitutes 5-7 percent.

Risk Factors:

Unfortunately, ovarian cancer doesn’t produce any specific symptoms. By the time symptoms appear its already in advanced stages. However, if patients have pain in the abdomen, back ache, indigestion, bloating not responding to basic treatment and lasts for more than two weeks then consult a gynecologist.

Screening test for uterine cancer:

No specific screening method is available. Doctor would do a pelvic examination to feel for ovarian mass.

  • Transvaginal sonography (TVS) to confirm ovarian mass solid or cystic.
  • Blood test like CA125 which is found raised in ovarian cancer.
  • CT Scan /MRI to know spread of cancer

Treatment:

Early diagnosis and treatment carry good prognosis.

COLORECTAL Cancer

When a cancerous growth originates in the colon and then spreads to the rectum, it leads to colorectal cancer. The risk of colorectal cancer is higher after the age of fifty years.

Risk Factors:

  • Smoking
  • Fat rich diet
  • Crohn’s disease
  • Colitis
  • Family history of colorectal cancer or polyp
  • Non residual diet
  • Chronic constipation

Screening test for Colon Cancer:

  • Frank blood in stools
  • Fecal occult blood test is positive
  • Double contrast barium enema (DCBE)
  • CT Scan
  • Colonoscopy
  • Stool DNA test
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Advisory issued to Indians visiting China after virus outbreak

According to the WHO, the situation is still evolving and preliminary investigations suggest a link to the seafood market.

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Japan China Pneumonia

New Delhi, Jan 17 : The Union Ministry of Health and Family Welfare on Friday issued an advisory for travellers visiting China in the wake of the Novel Coronavirus outbreak in the neighbouring country.

The advisory said: “Travellers to China should follow simple public health measures at all times. They should observe good personal hygiene, practice frequent hand washing with soap, follow respiratory etiquette, cover your mouth when coughing or sneezing. Avoid close contact with people who are unwell or showing symptoms of illness, such as cough, runny nose etc. Avoid contact with live animals and consumption of raw/undercooked meat. Avoid travel to farms, live animal markets or where animals are slaughtered. Wear a mask if you have respiratory symptoms such as cough or runny nose.”

As on January 11, 41 Novel Coronavirus (nCoV) confirmed infection case have been reported from China, of which one has died. One travel related case each has been reported in Thailand and Japan.

The clinical signs and symptoms are mainly fever with a few patients having difficulty in breathing. The mode of transmission is unclear as of now. However, so far there is little evidence of significant human-to-human transmission.

The advisory also said: “All travellers to China, Wuhan city in particular, to monitor their health closely. Cover your mouth while coughing or sneezing, Don’t plan travel if sick. Seek medical attention promptly.”

The travellers were also advised to inform the airlines crew about illness and seek a mask from the crew and avoid close contact with family members or fellow travellers if they feel sick on flight, while travelling back to India.

The ministry confirmed that they are closely monitoring the situation after the reports of 41 confirmed cases of the nCoV including one death from Wuhan, China on January 5.

According to the WHO, the situation is still evolving and preliminary investigations suggest a link to the seafood market.

Health Secretary Preeti Sudan said: “We are regularly reviewing the public health preparedness in the country since the news broke out. The public health preparedness is being reviewed on day-to-day basis and the core capacities to timely detect and manage importation of the nCoV into the country are being strengthened further.”

She added: “The situation is being monitored in consultation with WHO and keeping in view the limited human to human transmission the risk at global level is perceived to be low.”

In view of precautionary measures, the Ministry of Health has ordered screening of international travellers from China at designated airports namely, Delhi, Mumbai and Kolkata through thermal scanners.

State governments have also been advised to take necessary precautions. The Ministry is also in touch with the Ministry of External Affairs, and the immigration officers at the airports have been sensitised.

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