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Placenta changes in older moms not good for male child’s heart

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London: Changes occur in the placenta in mothers over age 35 leading to a greater likelihood of poor health in their male offspring and now, scientists have found in animal studies that placenta changes could put male child of older mothers at heart problems in later life.

Both male and female foetuses do not grow as large in older mothers, but there are sex-specific differences in changes to placental development and function.

These are likely to play a central role in the increased likelihood of later-life heart problems and high blood pressure in males, said the team from the University of Cambridge.

In humans, women over 35 are considered to be of advanced maternal age. The study, published in Scientific Reports, looked at pregnant rats of a comparable age.

“This new understanding of placental development and function could contribute to better management of human pregnancies, and development of targeted interventions to improve the long-term health of children born to older mothers,” said Dr Tina Napso, a postdoctoral fellow at the University of Cambridge and first author of the study.

Pregnancy in older mothers is associated with a heightened risk of complications for both the mother and her baby.

These include preeclampsia – raised blood pressure in the mother during pregnancy, gestational diabetes, stillbirth and foetal growth restriction.

Until now there has been limited understanding of how the placenta is altered by advanced maternal age.

“With the average age of first pregnancy in women becoming higher and higher, and especially so in developed countries, it is very important to understand how the age of the mother and the sex of the baby interact to determine pregnancy and later-life health of the child,” said Dr Amanda Sferruzzi-Perri, lead author of the study.

The placenta transports nutrients and oxygen from mother to foetus, secretes signalling factors into the mother so she supports foetal development, and is the main protective barrier for the foetus against toxins, bacteria, and hormones – such as stress hormones – in the mother’s blood.

It is highly dynamic in nature, and its function can change to help protect the growing fetus when conditions become less favourable for its development, for example through a lack of nutrients or oxygen or when the mother is stressed.

The study found that advanced maternal age reduced the efficiency of the placenta of both male and female foetuses. It affected the structure and function of the placenta more markedly for male fetuses, reducing its ability to support the growth of the fetus.

“A pregnancy at an older age is a costly proposition for the mother, whose body has to decide how nutrients are shared with the foetus. That’s why, overall, foetuses do not grow sufficiently during pregnancy when the mother is older compared to when she is young,” said Dr Napso.

“We now know that growth, as well as gene expression in the placenta is affected in older mothers in a manner that partially depends on sex: changes in the placentas of male fetuses are generally detrimental.”

The research involved collaboration between scientists at the University of Cambridge, the University of Alberta in Canada, the Robinson Research Institute and the University of Adelaide, Australia.

An earlier study performed by the collaborators showed that offspring from mothers who enter pregnancy at an older age have poor heart function and high blood pressure as young adults, and particularly so if they are male.

This new research was conducted to understand why, and whether this sex difference may be due to how the male and female foetuses are supported within the womb in an aged mother.

Although further studies in humans are required, the results suggest the importance of considering the sex of the foetus when giving advice to older pregnant women.

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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 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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Health

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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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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