Monthly Archives: September 2015

Marijuana use may up pre-diabetes risk: study

marijuana-leaf Marijuana users are more likely to have prediabetes – the state of poor blood sugar control that can progress to type 2 diabetes – than those who have never smoked it, a new study has found.

Marijuana users are more likely to have prediabetes – the state of poor blood sugar control that can progress to type 2 diabetes – than those who have never smoked it, a new study has found.

Previous studies on marijuana use have showed conflicting results, with some suggesting marijuana can reduce the risk of diabetes, despite others showing that the drug is associated with an increased calorie consumption.

In this study, the researchers, led by Mike Bancks of University of Minnesota in US, studied the association between self-reported marijuana use and concurrent and incident prediabetes and full blown type 2 diabetes, considering both quantity used and status of current use.

They also aimed to examine the role of body mass index (BMI) and waist circumference as potential confounding and mediating factors to these associations. They also looked at the effects of sex and race.

Data from Coronary Artery Risk Development in Young Adults (CARDIA) study was used to determine marijuana use and presence of prediabetes and diabetes.

Individuals in the CARDIA study were 18-30 years of age at study recruitment in 1985-1986 and are currently in their 30th year of observation.

The association between marijuana use and prevalence of prediabetes and diabetes was examined in 3,034 participants at CARDIA exam Year 25 (2010-2011) and incidence of prediabetes and diabetes according to previous marijuana use was assessed in 3,151 individuals free from prediabetes and diabetes at Year 7 (1992-1993) who returned for at least one of the four subsequent follow-up examinations over the next 18 years.

There was a 65 per cent increased risk of having prediabetes in individuals who reported current use of marijuana, and a 49 per cent increased risk of having prediabetes in individuals who reported lifetime use of 100 times or more, researchers said.

However, there was no association between marijuana use and full blown type 2 diabetes at CARDIA exam Year 25.

The authors then did further analyses where marijuana use was assessed prior to the development or not of prediabetes.

Over 18 years follow-up, a 40 per cent greater risk for developing prediabetes (but not diabetes) was found for individuals who reported lifetime use of 100 times or more compared to individuals who reported never using marijuana.

“In conclusion, marijuana use, by status or lifetime frequency, was not associated with incidence or presence of diabetes after adjustment for potential confounding factors,” the authors said.

“However, marijuana use was associated with the development and prevalence of prediabetes after adjustment,” they said.

The study was published in the journal Diabetologia.

Source Article from http://indianexpress.com/article/lifestyle/health/marijuana-use-may-up-pre-diabetes-risk-study/

Marital status can impact leukemia patients’ survival

leukemia main Social factors such as marital status, insurance status, and income may affect the chances of survival in young patients with acute myelogenous leukemia (AML), a cancer of the blood and bone marrow. (Source: Thinkstock Images)

Social factors such as marital status, insurance status, and income may affect the chances of survival in young patients with acute myelogenous leukemia (AML), a cancer of the blood and bone marrow.

For the study, the researchers analysed data from 5,541 patients younger than 65 years.

They found that AML patients who were single or divorced, patients who were uninsured, and patients who lived in areas with lower income had substantially elevated risks of dying prematurely.

“We believe these three factors indicate lack of material and social support preventing young patients from successfully walking the long and difficult road towards a cure,” said lead author of the study Uma Borate, assistant professor at University of Alabama at Birmingham in the US.

Over the years, tremendous progress in AML treatment has been made in identifying disease characteristics that cause a patient to have a higher or lower chance of cure following intense treatment, which often involves bone marrow transplantation.

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But the new findings suggest that in addition to age and disease characteristics, other “non-biological” patient characteristics also matter.

“As physicians, we often emphasise more of the biology of the cancer, especially with the recent focus on personalised medicine. But we need to pay the same attention to resources available to our patients, as this greatly impacts their chances to survive leukemia,” senior author Luciano Jose Costa, associate professor at University of Alabama at Birmingham said.

The study was published online in the journal CANCER.

Source Article from http://indianexpress.com/article/lifestyle/health/marital-status-can-impact-leukemia-patients-survival/

Junk food may shrink your brain, says study

junk-food-main Eating junk food may shrink the part of your brain involved in learning, memory and mental health, a new study has claimed. (Source: Thinkstock Images)

Eating junk food may shrink the part of your brain involved in learning, memory and mental health, a new study has claimed.

Older adults who eat more unhealthy foods, such as sweet drinks, salty snacks and processed meats, have smaller left hippocampi, researchers said.

The study also shows that older people with healthier diets have larger hippocampi, a region of the brain used for learning, memory and mental health.

As the negative impact of unhealthy foods on the waistline of the population grows, so does the evidence suggesting that our brain health is also affected, said lead author Felice Jacka, associate professor at the Deakin University in Australia.

“We’ve known for some time that components of diet, both healthy and unhealthy, have a rapid impact on aspects of the brain that affect hippocampal size and function, but up until now these studies have only been done in rats and mice,” Jacka said.

“This is the first study to show that this also appears to be the case for humans,” Jacka said.

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The researchers used magnetic resonance imaging to measure the size of hippocampi in adults aged 60-64 years, participating in a large longitudinal study of ageing conducted at the Australian National University (ANU).

They also measured the participants’ regular diets and took into account a range of other factors that could affect the hippocampus.

The study suggests that older adults who eat more unhealthy foods, such as sweet drinks, salty snacks and processed meats, have smaller left hippocampi.

It also shows that older adults who eat more nutrient-rich foods, such as vegetables, fruits and fish, have larger left hippocampi.

These relationships existed over and above other factors that may explain these associations, such as gender, levels of physical activity, smoking, education or depression itself.

These findings have relevance for both dementia and mental health, Jacka said.

“Mental disorders account for the leading cause of disability worldwide, while rates of dementia are increasing as the population ages,” she said.

“This latest study sheds light on at least one of the pathways by which eating an unhealthy diet may influence the risk for dementia, cognitive decline and mental disorders such as depression and anxiety in older people,” Jacka said.

“As the hippocampus is critical to learning and memory throughout life, as well as being a key part of the brain involved in mental health, this study underscores the importance of good nutrition for children, adolescents and adults of all ages,” she said.

The study was published in the journal BMC Medicine.

Source Article from http://indianexpress.com/article/lifestyle/health/junk-food-may-shrink-your-brain-says-study/

How 7-year-old Avinash could have been saved: Healthcare in India is hugely neglected

healthcare-main The death of Avinash and his parents was as haunting as it was frustrating. (Source: Thinkstock Images)

They ran from hospital to hospital, praying for anyone to admit their sick child. By the time someone consented to treat their son, it was too late. 7-year old Avinash Rout died of Dengue in a Delhi hospital. For 24 hours, his panicking parents had run around the city begging for their son to be admitted. Five hospitals in the city refused.

Unable to bear the grief, the parents of the child jumped off a terrace and killed themselves. Hospitals in the eye of the storm will insist that they were inundated with dengue patients and had no place. I don’t doubt it, but how indifferent can one be to turn back a critically ill child? Where was the hippocratic oath that all doctors and hospitals swear by, which makes them promise that ‘they will apply for the benefit of the sick all measures which are required’?

Had the child belonged to a well heeled and well connected family, these hospitals would have found a bed. I saw a room being miraculously arranged in a top hospital during dengue season two years back after initial claims that there was no place. All it took was a phone call. The tragedy of this family was that they were ordinary lower class citizens.

We are a country that measures its changing seasons with the onset of diseases and dengue recurs like a nightmare every year. Yet our health system struggles. Families come to big cities for treatment with hope in their eyes and finances on a budget. But with no access to busy doctors or uninterested administration, patients and relatives merge in the endless stream at these fancy hospitals. They say it is easy to get lost in India’s big cities. What they don’t say is in how many ways. It’s a myth if you think healthcare is accessible to all even in urban India.

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Top doctors in metro cities now churn out treatment like a machine, some even performing as many as twenty surgeries in a day. Medical care is as much a corporate business as any other profession and chances are, many times services rendered don’t match the exorbitant bill you get served. Doctors operate and then leave you to take care of your post-op complications yourself. The more well known the doctor, the more his detachment. There is a reason why I still trust doctors in my hometown Jalandhar. Smaller towns still care.

Two very contrasting stories captured my heart together. The death of Avinash and his parents was as haunting as it was frustrating. Then I read the other news by a former colleague. A tale of grit and bravery against all odds by an 11-year-old girl in Jharkhand. She walked 8 kilometres carrying her younger brother on her shoulders to a hospital to save his life. He was suffering from cerebral malaria, the same disease that took their parent’s life. Doctors say he will pull through.

The apathy is our country is three fold. One, within our health system. Second, by successive governments, of our health system. Lastly, an indifferent society that does not even stop to give a helping hand to an accident victim, let alone allow an ambulance to overtake. We are no better than the hospitals who refused to treat little Avinash.

The lure of big money at top hospitals, which increasingly look more and more like hotels, has taken the noble cause out of the profession. Perhaps the expensive medical education in our private institutions hardens them. Doctors no longer want to serve the poor in our villages, though fortunately we still have exceptions. Those who are in charge of our rural healthcare are not trained adequately. Neither is the staff at majority of our government hospitals, which is usually what most Indians can afford.

Strengthening our system at the grass roots to reduce the urban pressure continues to be a challenge. It doesn’t help that healthcare is one of the most neglected sectors in the country. Even in this year’s budget, allocation in the health sector was less than expected. The dream of universal medical care for families like the Rout’s will remain a battle of life and death.

Instead we are promoting our country as a destination for medical tourism. A body with stakeholders, ministry officials, hospitals and experts is likely to be set up to organise the system better. It brings in the revenue, but as many would argue, it does not put our own house in order. Nor will it get rid of the callousness in our system. Or bring back Avinash.

Source Article from http://indianexpress.com/article/lifestyle/health/how-7-year-old-avinash-could-have-saved-healthcare-in-india-is-hugely-neglected/

Fixing the spine to fix ligament

spine-main The conventional method of treating ossified posterior longitudinal ligament is anterior corpectomy fixation or posterior approach

A 55-year-old Bangladeshi resident with ossified posterior longitudinal ligament approached us at KEM hospital after consulting several doctors in his country. This condition involves thickening of ligament between spinal cord and vertebral column which in his case caused acute limb weakness.

When he was brought to us, he could not walk without support, could not dress himself or function on his own. The ligament becomes ‘bone like’ and affects the nerves in the spine. He had developed weakness in all four limbs.

The conventional method of treating this disorder is anterior corpectomy fixation or posterior approach, in which a surgery to remove the affected ligament is done from the front or the back side. In both the methods, the spinal cord may get affected which can make the patient bed-ridden permanently or, worse, damage his nerves.

In this case, we adopted a different philosophy to treat him. We assumed that the disorder is caused by spinal cord’s instability (several in the medical world believe it is a genetic condition). So if we fix the spine, the ligament can also be fixed. We adopted transarticular posterior fixation procedure in which screws were put below the neck in the spine to make it stable.

Within three days, he recovered well as the ligament became stable. Now, he can move and function on his own. The limbs became much more active. The same philosophy has also been published by us in the US-based World Neurosurgery Journal. The procedure is less risky.

As told by Dr. Dr Atul Goel (Head, Neurosurgery department, Tertiary-care KEM Hospital, Mumbai) to Tabassum Barnagarwala

Source Article from http://indianexpress.com/article/lifestyle/health/fixing-the-spine-to-fix-ligament/