Toronto, June 21 (IANS) Multisystem inflammatory syndrome is rare but possible in adults who recover from Covid-19, say researchers. The condition has, so far, been detected only in children.
The researchers from University of Calgary in Canada's Alberta stressed the need for clinicians to suspect multisystem inflammatory syndrome in adults when a patient has prolonged fever, with multiorgan involvement, after recovery from SARS-CoV-2 infection, the virus causing Covid-19.
The team described the possibility of the syndrome in adults in a study published in CMAJ (Canadian Medical Association Journal).
The team described a 60-year-old man, who had tested positive for SARS-CoV-2 four weeks before, and visited hospital for a range of symptoms, including prolonged shortness of breath, high fever, swelling and severe fatigue. Tests found an enlarged heart and lung swelling as well as other issues.
"Given the patient's recent history of SARS-CoV-2 infection, fevers without localising symptoms, oral mucosal changes, cervical lymphadenopathy, conjunctivitis and lower extremity changes, we suspected inflammatory post-Covid-19 syndrome," wrote the team including Genevieve Kerkerian and Stephen Vaughan, infectious disease specialists from the varsity's Department of Medicine.
"The presentation was similar to reported cases of an uncommon but severe complication in children and adolescents infected with SARS-CoV-2, called multisystem inflammatory syndrome in children (MIS-C), as well as to Kawasaki-like illness," they added.
Prompt initiation of medication helped the patient to recover.
MIS-C was first described in April 2020 as a hyperinflammatory syndrome with features resembling Kawasaki disease. As of May 3, 2021, 3,742 children in the US had been formally diagnosed with MIS-C, with 35 related deaths.
Much is unknown about multisystem inflammatory syndrome in adults.
In October 2020, the US Centers for Disease Control and Prevention published a review of 27 adult cases that fit the description of a multisystem inflammatory syndrome. The preliminary case of MIS-A, described to date has been in patients younger than 50 years.
"As we continue to learn about MIS-A, however, it is prudent not to assume any age limitation when considering the diagnosis, as our case suggests," the researchers said.
"Unlike for MIS-C, there is currently no requirement to report cases of MIS-A to provincial or state authorities, but this should be encouraged to facilitate research and improve patient outcomes," the authors noted.
Chennai, June 17 (IANS) After 11 children admitted to Government Rajaji Medical College hospital in Madurai were diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) as a post-Covid-19 condition, health officials feel an urgent need for revival of post-Covid-19 clinics that are now non-functional.Reports from the Government Rajaji Medical College Hospital, Madurai indicates that 37 children under the age of 13 were treated for MIS-C with zero casualties during the two waves of the pandemic.Of the 37, a total of 26 were treated till March 2021 while 11 children were treated since April 2021.Balashankar, head of the department of Pediatrics, Government Rajaji Medical College Hospital, Madurai told IANS: "We are preparing ourselves for a probable third wave and arrangements are being made to set up a dedicated wards for children with 102 beds including 30 ICU beds in the ground floor of the super-specialty block of the hospital."Tamil Nadu Health Department officials said that there is a steady increase in the MIS-C cases across the state and the department is in the process of diagnosing and treating these children. However, fatality rates are around zero.Rajani Arun, senior pediatrician, at a Government hospital in Chennai told IANS: "The children who develop MIS-C symptoms, including high fever for more than two days, conjunctivitis skin rashes, pain in the abdomen, sudden dullness and breathlessness require immediate attention."She said: "MIS-C may lead to a multi-organ failure affecting the heart, lung, liver, and brain, and hence early detection is very important and this disease can be diagnosed clinically and through screening of kidney, heart or lungs using MRI techniques."Mild and moderately affected patients are treated using steroids while severe cases are treated using Immunoglobulin (IV-IG) and doctors agree that IntraVenous treatment has given the desired results and patients were getting cured.While Covid cases are coming down in the state, the post-Covid cases like the mucormycosis (black fungus) and MIS-C are rapidly increasing and hence there is a need to reopen the post-Covid treatment centres in Medical colleges which are defunct now.Ali Satar, a retired professor of Community medicine in Tamil Nadu government service told IANS: "Several medical colleges in the state have now converted the post-Covid treatment centres into extensions of other departments and these defunct post-Covid treatment centres have to be restored to counter post-Covid complications."However, hospital authorities are of the opinion that even after repeated calls to the families of the recovered Covid patients, the response was not good and hence most of the hospitals have also dropped the tracking of post-Covid patients.--IANSaal/in
If you have felt increased screen time is doing a number on your eyes and potentially contributing to digital eye strain, a survey shows you're not alone. Findings show that 80 per cent of respondents say pandemic-prompted screen time put their eyes in "overdrive".
In fact, two-thirds of respondents report experiencing some degree of eye discomfort every day and nearly a quarter say their eyes feel worse now than they did a year ago. All that is adding up to a new sense of urgency: 90 per cent say it's important to take care of their eyes -- starting now.
The VSP Vision Care survey also found that a quarter say their eyes feel worse now than before the pandemic.
Also, Read► Boost Your Well-Being While in Isolation
Over half of the respondents report looking at a computer most of the day, every day, say the findings, adding that nearly 2 in 3 experience some degree of eye discomfort on a daily basis. Eighty per cent would be willing to schedule routine computer breaks to relieve digital eye strain, while roughly 1 in 5 prioritise paying regular visits to the eye doctor.
In the survey, more than half of respondents defined a "digital detox" as a break from screen time. However, there are other ways to relieve your eyes other than stepping away from screens completely:
Finding relief from digital eye strain: Digital eye strain can occur from prolonged and frequent use of screens, which engages our near vision, and exposes us to the blue light emitted by screens. Symptoms can appear as watery, dry, sore eyes, blurred vision and headaches. Although around 65 per cent report experiencing eye discomfort on a daily basis, half of Americans sometimes miss their annual exam or never go, according to the survey.
Even if you have perfect vision, prolonged screen time -- pandemic-related or not -- can tire out your eyes. During an eye exam, your eye doctor may suggest a computer lens or a blue light-reducing, anti-reflective lens coating that can help reduce your exposure and combat digital eye strain. If you don't wear prescription glasses, non-prescription lenses with a blue light-reducing, anti-reflective coating can be used.
In the 20-20-20 rule, where every 20 minutes, you take 20 seconds to look at something 20 feet away. This will help to reset your focus and help your eyes feel less fatigued due to digital eye strain. Blinking more frequently also helps to relieve discomfort by moistening your eyes.
Keeping an eye out for kids: The survey found that more than half of parents are worried about the effects of their children's increased screen time. Men are more likely than women to be worried about their children's eyes and, when it comes to millennial dads, 6 in 10 are concerned about their children's vision due to increased screen time.
Eye care is health care, and through a comprehensive eye exam, an eye doctor can detect early signs of serious health conditions like diabetes and hypertension.
Read More► Protect Yourself Against The Summer Sun
New York, April 7 (IANS) The risks of acute myeloid leukemia (AML)-- a type of blood cancer -- in children with Down syndrome is stronger than expected, according to a new study.The study led by researchers from the University of Chicago, Davis Health and San Francisco, examined medical data of more than 3.9 million children born between 1996-2016 in seven US healthcare systems or in Ontario, Canada. It showed that 2.8 per cent of children with Down syndrome were diagnosed with leukemia, compared to 0.05 per cent of other children.Compared to other children, kids with Down syndrome had a higher risk of AML before 5 years of age and a higher risk of acute lymphoid leukemia (ALL) regardless of age. In children with Down syndrome, ALL was more common between ages 2-4 years, while AML was more common in younger kids -- the highest during the first year of life. For other children, AML incidence remained very low through 14 years, whereas ALL peaked at 3 years and steadily declined until 8 years.Further, male children were more likely to be diagnosed with Down syndrome and more likely to develop leukemia than their counterparts, revealed the findings published in The Journal of Pediatrics. "The good news is that childhood leukemia can be very treatable if caught early," said Diana L Miglioretti, Professor at the UC Davis Department of Public Health Sciences.The researchers urged parents of kids with Down syndrome to keep an eye for signs of leukemia. Common symptoms include fatigue or pale skin, infections and fever, easy bleeding or bruising, shortness of breath and coughing. Parents are advised to talk to the pediatrician if their children exhibit any of these symptoms.Moreover, exposure to higher levels of radiation such as CT scanning have shown increases in leukemia risk."Given the potential for ionising radiation to increase leukemia risk in children with Down syndrome, other non-ionizing radiation modes of imaging, such as ultrasound and MRI, should be used as the first line image tests," said Rebecca Smith-Bindman, professor at UCSF.--IANSrvt/bg
New York, Heightened activity in the brain, caused by stressful events, is linked to the risk of developing a rare and sometimes fatal heart condition, a new study suggests.
The study, published in the European Heart Journal, found the greater the activity in nerve cells in the amygdala region of the brain, the sooner the condition known as Takotsubo syndrome (TTS) can develop.
"The study suggests that the increased stress-associated neurobiological activity in the amygdala, which is present years before TTS occurs, may play an important role in its development and may predict the timing of the syndrome," said researcher Ahmed Tawakol from the Massachusetts General Hospital in the US.
TTS, also known as "broken heart" syndrome, is characterised by a sudden temporary weakening of the heart muscles that causes the left ventricle of the heart to balloon out at the bottom while the neck remains narrow, creating a shape resembling a Japanese octopus trap, from which it gets its name.A
Since this relatively rare condition was first described in 1990, evidence has suggested that it is typically triggered by episodes of severe emotional distress, such as grief, anger or fear, or reactions to happy or joyful events.
Patients develop chest pain and breathlessness, and it can lead to heart attacks and death. TTS is more common in women with only 10 per cent of cases occurring in men.
The amygdala is the part of the brain that controls emotions, motivation, learning and memory. It is also involved in the control of the autonomic nervous system and regulating heart function.
For the study, the team involved 104 participants patients had undergone PET-CT scans between 2005 and 2019.
The researchers matched 41 people who went on to develop TTS between six months and five years after the scan with 63 who did not. The interval between the scan, the onset of TTs, last follow-up or death was an average (median) of 2.5 years for the 104 patients.
The researchers found that people who went on to develop TTS had higher stress-related amygdalar activity on initial scanning (measured as a ratio of amygdalar activity to activity of brain regions that counter stress) compared to individuals who did not subsequently develop TTS. (IANS)
The most common endocrine disorder in a woman of reproductive age, it affects up to 10% of women of reproductive age.
It is a set of symptoms related to an imbalance of hormones that can affect women and girls of reproductive age. Defined and diagnosed by a combination of signs and symptoms of androgen excess/ovarian dysfunction/polycystic ovarian morphology on ultrasound. In PCOS condition, woman has an imbalance of a female sex hormones. It may lead to menstrual cycle changes/cysts in the ovaries/ trouble getting pregnant /and other health factors/ issues.
According to Ayurveda, PCOS is closely related to artava- kshaya vyadhi. And according to types, it is of two types : one is kapha pradhana and other pitta vataja.
Polycystic Ovarian Syndrome: Symptoms
Symptoms of PCOS include changes in period(menstrual cycle).
Irregular periods, that sometimes maybe light/heavy.
No period after had one/normal ones during puberty ( secondary amenorrhea).
PCOS can cause to develop male-like characteristics, virilization. It includes symptoms like-
Body hair growing on the chest/ belly/ face/ around the nipples.
Decreased breast size
Enlargement of the clitoris.
Thinning of the hair on the head = male pattern baldness.
Deeper voice/acne that gets worsen.
Dark/ thick skin markings and creases around the armpits/groin/ neck/breasts.
Dermatological Features - hirsutism/ oily skin/ balding/ skin discoloration/ acne.
Menstrual Disorders - amenorrhea/ oligomenorrhea/ menorrhagia.
Polycystic Ovaries - enlarged ovary/ excessive follicles.
Metabolic - obesity/metabolic syndrome/ Insulin resistance, type 2 diabetes.
When To See Your Doctor For PCOS Disease?
When irregular/heavy/ missed periods occur due to missed ovulation and with the above-mentioned signs and symptoms appear, then you should consult doctor for proper diagnosis and treatment.
Polycystic Ovarian Syndrome: Causes
Generally, PCOS is linked to changes in the level of certain hormones: estrogen and progesterone, female hormones and small amount of androgens in women.
The reason behind PCOS syndrome is not completely understood. Changes make it harder for a woman’s ovaries to release fully grown (=mature) eggs/ovaries. Normally, one/ more eggs are released during a woman’s period, called ovulation. In PCOS/PCOS, mature eggs are not released from the ovaries, instead, they form small-sized cysts in the ovary.
It can lead to infertility. Other symptoms that appear are due to the hormone imbalances occur. Some doctors believe that high levels of male hormones prevent the ovaries from producing hormones and disturb the ovarian functions. Genes/insulin resistance/ inflammation also linked to excess androgen production.
Polycystic Ovarian Syndrome: Diagnosis
Diagnosis is based upon the presence of any two of the following three criteria considered basically :
[American society for reproductive medicine (ASRM)/or European society of human reproduction and embryology (ESHRE, 2003)].
1) Oligo and / anovulation
2) Hyperandrogenism (clinical/ biochemical)
3) Polycystic ovaries.
Lab Investigations: estrogen, LH, FSH, Blood sugar, lipid profile, vaginal ultrasound.
Ultrasonography: USG showing necklance appearance of ovaries. Ovary enlarged with multiple cysts.
Serum: high level of free estrogen in serum.
Polycystic Ovarian Syndrome: General Tips / Preventive Measures
Maintain a healthy weight/normal BMI.
Change your lifestyle = moderate exercise activities + suitable diet plan.
Weight loss can reduce insulin and androgens levels and can restore ovulation.
Exercise and YOGA regularly.
Regular exercise patterns prevent insulin resistance and help to keep your weight in control.
Limit your carbohydrate diets.
Vigorous exercise- asanas/ pranayama.
What To Avoid?
High calorie / carbohydrates/ fat rich diet.
Bakery items/ junk foods.
Avoid excessive sleeping.
Pastries/ white bread/ fried foods.
Sugary beverages = soda or energy drinks.
Processed meats/ hot dogs/ sausages.
Solid fats = margarine/lard
Excessive red meat = steaks/ hamburgers/ pork.
What To Eat?
Low glycemic index food like - whole grains/ legumes/ nuts/ seeds/ fruits/ starchy vegetables/ unprocessed low carbohydrate foods.
Berries/ leafy greens
Extra virgin oil
Natural/ unprocessed foods.
Spinach/ dark/ leafy greens.
High fiber foods.
Dried beans/ other legumes.
Walnuts/ almonds/ pistachios.
Polycystic Ovarian Syndrome: Questions And Answers
Q.1) What physical signs will suggest PCOS ( Polycystic Ovarian Syndrome) ?
Ans.- On examination with women, the following findings suggest PCOS:
Enlarged ovaries, etc.
Q.2) What are the other signs of PCOS?
Ans.- Other signs include infertility, oily skin, patches of thickened, velvety, darked skin called acanthosis nigricans, skin tags, obesity/weight gain.
Q.3) How does PCOS affect health?
Ans.- It can cause other problems including metabolic syndrome, high blood pressure, excess body fat around waist, abnormal cholesterol levels, can cause cardiovascular disease/ strokes/ diabetes, type-2 diabetes, endometrial hyperplasia, cancer risk factors, gestational diabetes, miscarriage/ premature birth, liver inflammation, sleep apnea, mental health issues( depression/anxiety/ eating disorders).
Q.4) Is PCOS syndrome a lifelong condition?
Ans.- The hormone imbalance of PCOS and the symptoms can be persist throughout life if not treated in a proper time. If signs and symptoms occur, then you should consult doctor immediately to make it more critical situation.
Q.5) What are the clinical features of PCOS?
Ans.- Clinical features include:-
- Patient complaints of increasing obesity ( abdominal- 50%), menstrual abnormalities (70%) in the form of oligomenorrhea, amenorrhea/ dysfunctional uterine bleeding/ infertility. Presence of hirsutism /acne are the important features considered (70%). Virilism is rare. Often characterized by acanthosis nigricans/ HAIR-AN syndrome.
Q.6) How serum levels give result in PCOS ?
Ans.- For better investigation of PCOS, Doctor suggest serum test. Serum values that suggest PCOS include:-
Elevated LH levels/ LH:FSH > 2:1
Raised level of estradiol and estrone.
Raised serum testosterone/ DHEA( dehydroepiandrosterone sulfate) marginally elevated.
Raised fasting insulin levels.
Q.7) What causes androgen levels to raise in PCOS?
Ans.- Abnormal regulation of the androgen forming enzyme P450 C17 is thought to be the main cause for excess production of androgens from the ovaries and adrenals. The principal source of androgens are - ovary, adrenal, systemic metabolic alteration.
Q.8) How management of PCOS occur?
Ans.- Management of PCOS needs individualization of the patient. Present symptoms of patient is generally noted. Treatment is primarily targeted to correct the biochemical abnormalities on pcos/pcod. In obese patients, first line of treatment includes weight reduction, It improves the metabolic syndrome and reproductive function.
Q.9 ) Why insulin level increases in PCOS? What are its causes?
Ans.- Women having PCOS also have insulin resistance - a condition that leads to high glucose levels and leads to prediabetes / type 2 diabetes. The pancreas in our body produces insulin along with other functions. Typically insulin is secreted in response to increased blood levels of glucose, a small sugar molecule. Insulin allows cells in our body to take glucose for energy from carbohydrates. When someone has insulin resistance, the body does not respond to insulin as efficiently/ quickly which leads to high glucose levels in the blood and low energy. Therefore, Insulin level increases as the body begins to deal differently with sugar.
Q.10) What are the various treatment available in Ayurveda for PCOS?
Ans.- Principles of Treatment in Ayurveda is mainly depended on kapha pradhana/ pitta pradhana type. According to which, snehana, vamana, virechana, yoga basti; panchakarma procedures included. For Shamana, weight loss treatment, exercise and diet along with some classical and proprietary formulations is given to the patient.
1) Longmore, Wilkinson, Davidson, Foulkes, Mafi, Oxford Handbook of Clinical Medicine 8th Edition.
2) Ayurveda Prasuti Tantra evum Stree Roga, Prof.Premvati Tiwari 2nd edition.
3) Hiralal Konar, DC Dutta’s Textbook of Gynecology 7th Edition.
4) Charak Samhita Volume-2, by Acharya Vidyadhar Shukla and Prof. Ravi Dutt Tripathi.
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