The World Health Organisation (WHO) has classified the new Covid variant detected in southern Africa this week as the 'Variant of Concern' following the Technical Advisory Group meeting on Friday.
"Based on the evidence presented indicative of a detrimental change in Covid-19 epidemiology, the TAG-VE has advised WHO that this variant should be designated as a Variant of Concern and the WHO has designated B.1.1.529 as a VOC, named Omicron", said the global health body in a statement.
The B.1.1.529 variant was first reported to WHO from South Africa on November 24, 2021. The epidemiological situation in South Africa has been characterized by three distinct peaks in reported cases, the latest of which was predominantly the Delta variant. The first known confirmed B.1.1.529 infection was from a specimen collected on November 9, 2021.
The WHO has asked the countries to enhance surveillance and sequencing efforts to better understand circulating SARS-CoV-2 variants and submit complete genome sequences and associated metadata to a publicly available database. The WHO has reminded to take measures to reduce their risk of Covid-19, including proven public health and social measures such as wearing well-fitting masks, hand hygiene, physical distancing, improving ventilation of indoor spaces, avoiding crowded spaces, and getting vaccinated.
The WHO said that this variant has a large number of mutations, some of which are of concern.
Preliminary evidence suggests an increased risk of re-infection with this variant, as compared to other VOCs. The number of cases of this variant appears to be increasing in almost all provinces in South Africa. Current SARS-CoV-2 PCR diagnostics continue to detect this variant. Several labs have indicated that for one widely used PCR test, one of the three target genes is not detected and this test can therefore be used as marker for this variant, pending sequencing confirmation. Using this approach, this variant has been detected at faster rates than previous surges in infection, suggesting that this variant may have a growth advantage, said the WHO.
The Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE) is an independent group of experts that periodically monitors and evaluates the evolution of SARS-CoV-2 and assesses if specific mutations and combinations of mutations alter the behaviour of the virus. The TAG-VE was convened on 26 November 2021 to assess the SARS-CoV-2 variant: B.1.1.529. (agency)
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With a whopping 77 million people in India living with diabetes, a simultaneous and sharp rise has been observed in the prevalence of diabetes-related preventable vision loss, particularly among the young people, say experts.
Diabetic retinopathy is a chronic, progressive retinal disease that is a leading cause of vision impairment in today's young adults, working population. It's of major concern among children suffering from juvenile diabetes (Type-1 diabetes) and especially if they have had diabetes for over 10 years.
It is estimated that approximately 1.1-crore people are suffering from retinal disorders in India and more alarmingly, about one in every three people living with diabetes have some degree of diabetic retinopathy, a diabetes complication that affects eyes.
"With the growing incidence of diabetes, it has been estimated that diabetic retinopathy affects one in three people with diabetes and remains the leading cause of blindness in young working-aged adults," Dr Mahipal Sachdev, Medical Director and Chairman, Centre for Sight Group of Eye Hospital, told IANS.
"Approximately 7-10 per cent of young diabetics will go on to develop diabetic retinopathy, of which 2-4 per cent will have vision threatening sequelae if not taken proper treatment." added Dr. Aditya Sudhalkar, M.S. Ophthalmology, Consultant Vitreoretinal Surgeon.
The most common form of diabetic retinopathy is Diabetic Macular Edema (DME) which arises when the damaged blood vessels swell and flow into the macula of the retina causing visibility issues in the normal vision.
According to Dr. Chaitra Jayadev, senior vitreo-retinal consultant, Narayana Nethralaya Eye Institute Karnataka, studies have shown that the prevalence of DME and diabetic retinopathy is higher and more severe in young diabetics with a longer duration of diabetes.
"Diabetes in the younger is a distinct pathological entity characterised by a more aggressive presentation and manifestation. An earlier onset of diabetes leads to a longer exposure to insulin resistance and hyperglycemia. This gives rise to a greater propensity for developing long-term microvascular and macrovascular complications," Dr. Jayadev said.
Thus, screening for diabetes is of utmost importance, even if one is "young" and has no symptoms. It becomes more crucial if one has risk factors such as family history, obesity, sedentary lifestyle, or on long term steroid medications.
Dr. Sudhalkar said that in India, there is a general reluctance towards attending clinics and nearly 25 per cent of young patients with DME come late for diagnosis.
"It's important to know, only 11 per cent of diabetic retinopathy patients can actually reverse vision threatening sequelae once they set in. The rest continue to progress even with strict glycemic control," he noted.
"Retinopathy, unfortunately, is the most neglected complication of diabetes. We see so many patients come to OPD where eyes have not been checked for. So the screening, also known as Funduscopy, should be done at the time of diagnosis of Type-2 diabetes, in adults, and in children, five years after the onset of diabetes, and thereafter annually," Dr Dheeraj Kapoor, HOD, Endocrinology at Artemis, Gurugram, told IANS.
If diabetes occurs near puberty, then funduscopy should be checked for potential retinopathy.
"It is important because the condition poses no symptoms in the initial days. And once symptoms set in, such as bleeding in the eye, red vision, sudden loss of vision, it's too late," Kapoor said.
The doctors advised to adhere to the treatment and maintain a healthy lifestyle to effectively manage diabetes and to prevent the onset or progression of eye diseases.
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While Covid-19 spared none, people with diabetes were among the hardest hit. The infectious disease not only raised the risk of severe disease progression and death among diabetics, affecting even the recovery, it also contributed towards the burden of diabetes in the country.
World Diabetes Day is observed annually on November 14 to raise awareness on the high blood sugar condition and related consequences.
India, known as the diabetes capital of the world, is home to one in six diabetics in the world. The country has also suffered significantly from Covid-19.
While on an average, diabetes reduces life expectancy by 4-10 years increasing the risk of death due to other comorbidities, which include heart attacks, kidney failures and infections, Covid infection fast forwarded that among people with diabetes.
Diabetes increased inflammatory response among Covid patients, spiking their blood sugar levels. It then complicated the course of Covid, resulting in excess morbidity and mortality, as well as posing severe challenges in the recovery of patients.
"During Covid patients were succumbing to it, not because of the original disease, but because despite all other efforts their glucose levels remained high. Thus recognising glucose as a vital sign very similar to blood pressure and pulse rate, respiratory rate, became more necessary during the pandemic," Jothydev Kesavadev from Jothydev's Diabetes Research Centres, Kerala, told IANS.
"Studies from all over the world show that the majority of the deaths from Covid were linked to high glucose values, and this includes both patients with no diabetes and with the new onset of high glucose," he added.
Further, the use of steroids, to control the serious manifestations of Covid-19, worsened the glucose levels in the patients.
High blood sugar levels, coupled with increased use of steroids, also led to other complications such as an unprecedented surge in cases of mucormycosis, commonly known as black fungus. It is a fungal infection, which occurs by inhalation of spores and can disseminate to various organs rapidly.
According to a recent study, published in Diabetes and Metabolic Syndrome: Clinical Research and Reviews, more than 86 per cent of mucormycosis or black fungus cases related to Covid in India, had uncontrolled glucose values.
"While the Covid cases are closely related to diabetes, mucormycosis is also very closely related to diabetes in Covid. Whenever the glucose is high, there is a deranged immune mechanism and in the presence of an infection it is persuaded rapidly," Kesavadev said.
Another study, published in the same journal showed that people with Type-2 diabetes who also suffered Covid-19 were more likely to experience severe fatigue than those who did not have the infectious disease, emerging as a major roadblock in the recovery of patients infected with SARS-CoV-2.
Moreover, among diabetes patients, those with increased fatigue level post Covid-19 also had increased postprandial blood glucose levels.
Covid also contributed to new onset of diabetes in many people, particularly the young. On one hand, Covid-induced lockdowns increased diabetes cases as people spent more time indoors, while eating more and exercising less.
On the other hand, Covid also contributed to nearly 25 per cent rise in diabetic patients in the country, according to an analysis of OPD data from a private hospital in Delhi.
Doctors found that among patients with confirmed Covid-19 infections, there was nearly 25 per cent of new onset of diabetic patients. Stress induced hyperglycemia -- high blood sugar -- was seen in 10 per cent of patients who had Covid-19 infection.
"The younger population is increasingly affected. We have seen that happening during Covid-19 epidemic. Increasing number of young people with more severe diabetes are now being seen," Dr Anoop Misra, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, told IANS.
As per a recent study, among the younger generation in India, below the age of 30 years, there is a rapid increase in the occurrence of diabetes over the last 10 years.
"For these, diabetes as a disease will result in complications after 10 to 15 years. Imagine a situation where more and more people are developing diabetes at the age of 25 years or 30 years, which means even during the productive age group, by the time they are 35 years or 40 years, they will start developing complications. if the disease is not treated properly," Kesavadev said.
"There is an urgent need to decrease the screening age of diabetes to 25 years, from the current 30 years, in India," Dr Misra said, adding that "there is increasing urgency to ensure that young people follow correct lifestyle practices including more exercise, correct food choices, and maintenance of weight to normal, or even leaner category".
While diabetes cannot be treated it can be controlled and reversed by adopting a healthy lifestyle, diet and having proper sleep, as well as exercising for at least half an hour every day, suggested the experts. (Rachel V Thomas)
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Chronic inflammation caused by obesity may trigger the development of cells that break down bone tissue, including the bone that holds teeth in place, finds a new research.
The study, completed in an animal model, found that excessive inflammation resulting from obesity raises the number of myeloid-derived suppressor cells (MDSC), a group of immune cells that increase during illness to regulate immune function.
MDSCs, which originate in the bone marrow, develop into a range of different cell types, including osteoclasts (a cell that breaks down bone tissue).
"This research promotes the concept that MDSC expansion during obesity to become osteoclasts during periodontitis is tied to increased alveolar bone destruction," said researcher K.H. Kwack from the University at Buffalo.
"Taken together, this data supports the view that obesity raises the risk of periodontal bone loss," Kwack added.
Bone loss is a major symptom of gum disease and may ultimately lead to tooth loss.
Also known as periodontal disease, gum disease affects more than 47 per cent of adults 30 years and older, according to the Centers for Disease Control and Prevention.
For the study, published in the Journal of Dental Research, the team examined two groups of mice fed vastly different diets over 16 weeks -- one group, a low-fat diet that derived 10 per cent of energy from fat, the other group a high-fat diet that drew 45 per cent of energy from fat.
The investigation found that the high-fat diet group experienced obesity, more inflammation and a greater increase of MDSCs in the bone marrow and spleen compared to the low-fat diet group.
The high-fat diet group also developed a significantly larger number of osteoclasts and lost more alveolar bone (the bone that holds teeth in place).
Also, the expression of 27 genes tied to osteoclast formation were significantly elevated in the group fed a high-fat diet.
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An immediate challenge today is the prevention of Diabetes among the youth and pregnant women, Union Minister of State Dr. Jitendra Singh said on Sunday.
The minister, also a renowned Diabetologist, called for a mandatory diabetes test in all maternity hospitals and for every pregnant women, adding that more than 70 per cent of India's population is below 40 years of age.
Calling for an integrated and holistic approach to fight Diabetes, Singh said: Covid has prompted us to discover new norms in adversity and underlined the importance of combining traditional Indian management modalities with the Allopathic System."
"Diabetes is a growing epidemic globally and more so in India. A total of 88 million adult populations in India has diabetes in 2019 as per the latest International Diabetes Federation (IDF) estimates and this is projected to rise by almost 74 per cent to 153 million by 2045, giving India the dubious distinction of becoming the diabetes capital of the world," Singh said.
Sharing the concerns about of Diabetes that is making fast inroads in rural India with huge economic bearing on poor families, Singh said that there is a need to popularise Telemedicine to provide easy and affordable access to the ailing population.
Talking about the National Digital Health Mission, Singh said it can revolutionise healthcare in India as citizens will be issued a health card that will have all their medical information.
He said, the details of medical tests, illnesses, doctors' prescriptions and medical reports will be on a single identity card and will be the first of its kind in the world.
The Union Minister was speaking at a webinar on diabetes on the occasion of World Diabetes Day, jointly organized by Swami Vivekananda Yoga Anusandhana Samasthana, S-VYASA, Bengaluru and Central Council for Research in Yoga and Naturopathy, CCRYN, New Delhi.
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About 60 per cent of people suffering stroke in India face various degrees of disability, some lifelong, said experts here.
A stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.
As brain cells begin to die in minutes, prompt treatment is crucial and early action can reduce brain damage, other complications and death.
"While the numbers of stroke patients continue to rise exponentially, like many other brain diseases, there is still a remarkable lack of awareness regarding this condition. Timely treatment in stroke will go a long way in improving a patient's quality of life, and reducing lifelong morbidity and mortality," said Pankaj Agarwal, Senior Consultant -Neurology, Head, Movement Disorders Clinic & In-Charge, Deep Brain Stimulation (DBS) Programme, Global Hospital Mumbai.
"Stroke patients who get help from paramedics are more likely to reach hospital for care -- in India, that number is only 1.8 per cent. We need uniform emergency medical services (EMS) system and certification of stroke ready hospitals across the country so that people know where to go when they recognise the signs of stroke," added Dr P.N Sylaja, Professor and HoD, Neurology, In-Charge, Comprehensive Stroke Care Programme, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).
While traditionally stroke affects older age groups, a large number of ischemic strokes are now known to also affect young people - in their 30s or 40s. Sometimes even adolescents in their teenagers or early 20s are affected.
"Stroke affects as many as 18 lakh Indians every year, which means one Indian suffers stroke every 40 seconds. One-fourth of these people are aged less than 50 and increasingly, a large proportion of stroke patients are found in the age group of 19 to 30 years. The burden of stroke on the most productive sections of society not only affects the person and their family but leaves a cascading effect on the countrya¿s socio-economic condition," said Kamal Narayan, CEO, Integrated Health and Wellbeing (IHW) Council.
Covid has also increased the risk of stroke, particularly among the young patients between 20 and 30,as the virus triggers abnormal and severe clotting in blood. While the risk is around 1 per cent (higher if other risk factors for stroke are present), it is still life-threatening or leads to severe disability.
"In India, about 30 per cent of people suffering stroke die and a whopping 60-70 per cent people suffer various degrees of disability. The number of disabled people is more as we move into the interiors where hospitals do not even have a CT scan machine. We need to ensure they get treatment," said Prof M.V. Padma Srivastava, Head, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi.
Eating a well-balanced diet, avoiding processed foods and sugary drinks, limiting salt, alcohol, smoking, and exercising daily can lower the risk of stroke, the doctors said.
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