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Health Bulletin


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  1. #751
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    Re: Health Bulletin

    Are the days of the stethoscope over?

    Ask any doctor and it's likely they'll remember it — the weight of it, the colour, the pride of wearing it for the first time. The day a medical student gets their first stethoscope is the day they first feel like a doctor.
    Two hundred years since its invention in a French chest clinic , the doctor's listening device remains the most visible symbol of the medical profession.

    But might the days of the "stetho" be numbered? According to two top doctors at New York's Mount Sinai Hospital, the old tool of the trade may soon be consigned to the museum, as the advent of new, hand-held ultrasound technology, which is more accurate than a stethoscope and a good ear ever could, gradually renders the stethoscope obsolete.

    "Certainly, the stage is set for disruption," say Professors Jagat Narula and Bret Nelson. "As LPs were replaced by cassettes , then CDs and MP3s, so too might the stethoscope yield to ultrasound."

    In an editorial for Global Heart, the journal of the World Heart Federation, they chart the rise of the new technology that threatens the stethoscope's place, close to the hearts of every physician, and question whether the modern device will "earn a careful cleaning, tagging , and white-glove placement in the vault" next to the other artifacts of medical history.

    Its possible replacement, ultrasound , is probably most familiar as a technology for scanning pregnant woman, but is also used across the medical spectrum, to look at hearts, lungs and other organs. It has been around since the 1950s, but in its early years it could only be performed by a machine the size of refrigerator. Gradually though, as with televisions, computers and mobile phones, the technology has been reduced to smaller and smaller sizes.

    Devices like GE Healthcare's VScan are already in use in NHS hospitals. A pocket-sized device which resembles a smartphone, the gadget delivers a real time ultrasound image of the patient's insides, on a screen that can be held in the palm of the hand.

    The stethoscope meanwhile, has a slightly older pedigree.

    It was invented in 1816 by the French physicist Rene Laennec, a pioneer in the emerging field of auscultation — in other words, listening to the inner workings of a patient's body to diagnose their condition. In Dr Laennec's day, the best a doctor could do was to press his ear firmly against the part of the body he wanted to listen to.

    When one day a large female patient arrived at Dr Laennec's chest clinic at the Hopital Necker in Paris, he was left with the somewhat delicate dilemma of being unable to hear her lung sounds through her over-large bosom. His solution was to use a rolled up piece of paper. Pressing one end to the patient's chest and putting his ear to the other, he found that the tube magnified the sound. He soon refined his invention into a hollow wooden tube, which he called the stethoscope.

    By the 1850s it had become one of the essential tools of a physician's trade. The modern stethoscope, made of rubber and later plastic, with a bell-like end that is placed on the patient, emerged in the 1890s and since then doctors have rarely been seen without them.

    "Your first stethoscope, although I have a terrible habit of losing them, is a special moment ," said Dr Andrew Collier, a psychiatry trainee and chair of the British Medical Association's junior doctor committee. "It is your first tangible grip on the medical profession. You hold it quite dear. I still have the first one."

    However, Dr Collier said, doctors would always be willing to move with the times in the wake of new technology.

    But in contrast to the relatively cheap stetho, GE Healthcare's hand-held ultrasound device currently costs just under £5,000.


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    Re: Health Bulletin

    Robotic device to heal bruised muscles

    Forget the lingering and painful physical therapy, your dormant ankle muscles can now regain life through a robotic device.

    Called robo-ankle, the device built by scientists at Carnegie Mellon University in the US can also assist people with more serious neuromuscular disorders like cerebral palsy and multiple sclerosis, said a report published in the New Scientist magazine.

    "The device was originally meant for people with long-term conditions while it could also be used by those recovering from injury," said Yong-Lae Park, assistant professor at the robotics institute at Carnegie Mellon University in the US.

    "The device could be used for short-term ankle rehabilitation as well, for example muscle training and exercise after cast or splint removal," he added.

    Park and his colleagues built robo-ankle using soft plastics and composite materials, rather than a rigid exoskeleton.

    The orthotic device includes pneumatic artificial muscles, small sensors and advanced

    control software to mimic the muscles, tendons and ligaments of the lower leg.

    The artificial muscles are controlled by compressed air and circuits, which move the wearer's foot through a series of exercise movements designed to strengthen weak muscles and improve the ankle's range of motion while the patient is sitting, added the report.

    Future incarnations of the device may even allow for people to wear the device while going about their daily life.

    "Controlling the device using the wearer's motion or muscle intention is our ongoing and future work," Park was quoted as saying.


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    Re: Health Bulletin

    Infertility now mostly a male thing: Experts

    Pointed stares, audible whispers and snide comments - every time a couple are not able to conceive, the woman is subjected to this trauma, as many assume it is "her problem." Experts now have a different tale to tell: More than 60% of cases of infertility among couples are because of the male partner's condition.

    Infertility experts from across the world who gathered in the city on Saturday for the international conference on 'Challenges in infertility management' said there was a paradigm shift over the past few years. Dr Geetha Haripriya, of Prashanth Hospital and organizing secretary of CIIM said a decade earlier, male infertility contributed only to 40% of the cases, but now the numbers had increased to 60%.

    "Environmental factors and lifestyle changes are the major reasons for this transition. Especially those with white-collar jobs have problems because they have an improper biological cycle due to unusual working hours. Stress, eating at odd hours, tobacco and alcohol consumption and poor nutritional intake are the additional factors," she said. The gynaecologist also pointed out that earlier most of the infertility issues arose due to infections but now it had been replaced by environmental toxins.

    Dr Sonal Panchal of Dr Nagori Institute of Infertility, Ahmedabad, said men these days were open to getting themselves tested and treated. "Most of them come with problems like erectile dysfunction, low sperm motility and sperm deformity. Rising temperatures and increased chemical content in the air also contribute to the increasing incidence of infertility," she said.

    Women on the other hand have been queuing up with problems of polycystic ovaries and endometriosis (cells from the lining of the uterus grow outside the uterine cavity) which results in infertility. Doctors pointed out that more couples above the age of 35 were approaching infertility clinics. Dr Haripriya said, "Most of them try to avoid a donor egg. So we have been asking them to undergo soft stimulation technique which has a good success rate in helping women conceive on their own." In this technique, we use a combination of drugs to stimulate the patient's ovaries in repeated cycles to produce at least a couple of healthy eggs, she added.


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    Re: Health Bulletin

    'Love makes water taste sweet'

    Love really is sweet. Both candy and water taste sweeter when people think about love, a new study has found.

    However, jealousy fails to bring out bitter or sour tastes, despite metaphors that say it might, researchers said.

    The finding that love alters one's sensory perceptions and jealousy does not is important to psychologists who study "embodied" metaphors, or linguistic flourishes that people quite literally feel in their bones.

    "We always say, 'love is sweet'. We thought, let's see whether this applies to love," said researcher Kai Qin Chan, at Radboud University Nijmegen in the Netherlands. Chan and colleagues conducted three experiments on 197 students at the National University of Singapore.

    In the first two studies, researchers asked students to write about an experience either with romantic love or with jealousy, or about a neutral topic. Next, scientists had the students taste either sweet-and-sour gummy or bittersweet chocolates. The students ranked the treats' sweetness, bitterness and sourness. Those who had written about love ranked both candies as sweeter than those who had written about jealousy or a neutral topic.

    Writing about jealousy had no effect on rankings of bitterness, researchers found.

    The researchers then asked 93 new student-volunteers to sample distilled water. The students were told the water was a new drink and they had to rate its sweetness, bitterness and sourness. Love made the water taste sweeter while jealousy did not affect the water's taste, the researchers found.


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    Re: Health Bulletin

    Should you pop vitamin D pills regularly?

    Vitamin D supplements have no significant effect on preventing heart attack, stroke, cancer or bone fractures, according to a review of scientific evidence published Friday.

    Researchers led by Mark Bolland of the University of Auckland in New Zealand looked at 40 high-quality trials to see if supplements met a benchmark of reducing risk of these problems by 15 percent or more.

    Previous research had seen a strong link between vitamin D deficiency and poor health in these areas. But the new study, published in The Lancet Diabetes & Endocrinology, strengthens arguments that vitamin D deficiency is usually the result of ill health -- not the cause of it. Its authors say there is "little justification" for doctors to prescribe vitamin D supplements as a preventive measure for these disorders.

    "Available evidence does not lend support to vitamin D supplementation and it is very unlikely that the results of a future single randomised clinical trial will materially alter the results from current meta-analyses," they write.

    Vitamin D is a key component for healthy bones, teeth and muscles. It is produced naturally when the skin is exposed to sunlight or derived from foods such as oily fish, egg yolks and cheese.

    In March last year, British scientists, in a comparison of 4,000 women, found that vitamin D supplements taken in pregnancy made no difference to the child's bone health. And in September 2012, researchers at New York's Rockefeller University saw no evidence that vitamin D supplements lowered cholesterol, a factor in heart disease, at least over the short term.

    In contrast, a November 2012 investigation into pregnant women who lived in high-latitude, northern hemisphere countries with long, dark winters found a link between low levels of natural vitamin D and an increased risk of multiple sclerosis (MS) in their offspring.

    For these women, taking vitamin D supplements to offset the effects of long periods without sunlight could be advisable, according to that research.


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    Re: Health Bulletin

    One can sniff the fat in food, says new research

    Believe it or not! Humans can smell whether the food on the dining table or in a restaurant is low or high on fat. New research reveals humans can use the sense of smell to detect dietary fat in food. However, it remains unclear which sensory systems contribute to this ability.

    "That we have the ability to detect and discriminate minute differences in the fat content of our food suggests that this ability must have had considerable evolutionary importance," said senior author Johan Lundström, a cognitive neuroscientist at Monell Chemical Senses Centre in the US.

    The researchers added that fat detection via smell would have the advantage of identifying food sources from a distance. To understand this, they asked participants to smell milk containing an amount of fat that might be encountered in a typical milk product - either 0.125 percent, 1.4 percent or 2.7 percent fat.

    The milk samples were presented to blindfolded subjects in three plastic vessels. Two of the containers had milk with the same percent of fat while the third had milk with a different fat concentration. Participants could use the sense of smell to discriminate different levels of fat in the milk, said the research published in the journal PLOS ONE.

    "We now need to identify the odour molecules that allow people to detect and differentiate differentiate levels of fat," said lead author Sanne Boesveldt, a sensory neuroscientist. Innovative methods using odour to make low-fat foods more palatable could someday aid public health efforts to reduce dietary fat intake, the study said.


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    Re: Health Bulletin

    Pesticides exposure linked to Alzheimer's disease

    A new study has revealed that patients with Alzheimer's disease have significantly higher levels of DDE, the long-lasting metabolite of the pesticide DDT, in their blood than healthy people.

    In a case-control study involving 86 Alzheimer's patients and 79 healthy elderly controls, researchers found that DDE levels were almost four times higher in serum samples from Alzheimer's patients than in controls.
    Having DDE levels in the highest third of the range in the study increased someone's risk of Alzheimer's by a factor of four.

    "This is one of the first studies identifying a strong environmental risk factor for Alzheimer's disease. The magnitude of the effect is strikingly large -- it is comparable in size to the most common genetic risk factor for late-onset Alzheimer's," co-author Allan Levey, MD, PhD, director of Emory's Alzheimer's Disease Research Center and chair of neurology at Emory University School of Medicine, said.

    The study was published in JAMA Neurology.


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    Re: Health Bulletin

    Simple blood test could help detect diabetes early

    Researchers have discovered that a simple blood test reveals an individual's risk of developing type-2 diabetes before they develop either condition - far earlier than previously believed.

    The findings could help doctors provide earlier diagnosis and treatment. Dr. Michal Shani and Prof. Shlomo Vinker of the Sackler Faculty of Medicine and Clalit Health Services collaborated on the study.

    To get a picture of blood glucose levels over time, doctors test for levels of glycated hemoglobin, or A1c, in the blood. When blood glucose levels are high, more A1c is formed. So A1c serves as a biomarker, indicating average blood glucose levels over a two- to three-month period.

    According to the ADA, having an A1c level of 6.5 percent or more is an indicator of the disease and an A1c level of between 5.7 and 6.4 percent is an indicator of prediabetes.

    To evaluate the A1c test's ability to screen for diabetes in high-risk patients, the researchers analyzed the medical history of 10,201 patients who were given the test in central Israel between 2002 and 2005.

    They found that overall, 22.5 percent of the patients developed diabetes within five to eight years. Patients with A1c levels as low as 5.5 percent - below the official threshold for diagnosing diabetes were significantly more likely to develop diabetes than patients with A1c levels below 5.5 percent.
    Every 0.5 percent increase in A1c levels up to 7 percent doubled the patients' risk of developing diabetes. Obesity also doubled patients' risk of developing diabetes, the researchers found.

    The findings have been published in the European Journal of General Practice.


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    Re: Health Bulletin

    Jipmer, John Hopkins University set up centre of excellence to treat lung diseases

    Jawaharlal Institute of Postgraduate Medical Education and Research (Jipmer) and Bloomberg School of Public Health, John Hopkins University (JHU), have launched a centre of excellence for lung diseases to treat and cure patients with chronic obstructive pulmonary disease (COPD) and lung cancer in the country.

    JHU has come forward to extend $50,000 (Rs 30 lakh) for the centre while Jipmer will also release a matching grant to the centre as its contribution.

    Jipmer director T S Ravikumar said the centre would undertake population and community-based research to study the
    prevalence of lung diseases in the country. The study will initially focus Puducherry and Tamil Nadu.

    The centre will come out with a registry to identify patients susceptible to lung diseases with special emphasis on COPD in an effort to extend quality medical care to them when required.

    JHU chair and professor (environmental health sciences) Marsha Wills Karp said young women and children in India were more prone to COPD than their counterparts in the United States.

    Professor (environmental health sciences) Shyam Biswal said there was no data about COPD in Puducherry.


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    Re: Health Bulletin

    Life expectancy in India goes up by 5 years in a decade

    If your child was born in the last couple of years, he or she is likely to live five years more than children born a decade ago.

    Statistics released by the Union ministry of health and family welfare show that life expectancy in India has gone up by five years, from 62.3 years for males and 63.9 years for females in 2001-2005 to 67.3 years and 69.6 years respectively in 2011-2015. Experts attribute this jump — higher than that in the previous decade — to better immunization and nutrition, coupled with prevention and treatment of infectious diseases.

    The World Health Organization defines life expectancy as "the average number of years a person is expected to live on the basis of the current mortality rates and prevalence distribution of health states in a population". In India, average life expectancy which used to be around 42 in 1960, steadily climbed to around 48 in 1980, 58.5 in 1990 and around 62s in 2000.

    The overall health indicators have also shown significant improvement across the country in the past 10 years. Infant mortality ratio has come down to 42 in 2012 from 58 per 1,000 live births in the 2005. "Maternal mortality ratio has declined from 301 per 100,000 live births in 2001-03 to 212 in 2007-09," the health ministry said.

    "A steady supply of food is the prime reason for increased life expectancy," says Dr George Thomas, editor of the Indian Journal of Medical Ethics. Since the time of Independence, famine has reduced dramatically in our country and people have a decent supply of nutrition. However, the real challenge lies in taking the numbers beyond this."



    Disease control

    Thomas pointed out that increasing life expectancy beyond 70 years would depend on environmental factors. "Supply of clean drinking water and better control of non-communicable diseases would play a major role. However, India is still grappling with communicable diseases," he said.

    Dr S Balasubramanian, joint director of Tamil Nadu public health, said the increase shows health policies are in the right direction. "Earlier, people had more children, and the chances of all the kids getting a balanced diet were low. Family planning has helped. Childhood vaccination has checked epidemics and saved lives," he said. Life-threatening diseases like diphtheria, tetanus and whooping cough have been eliminated completely. "India has also been recently declared a polio free nation, which is an added feather to the cap," he said.

    Some experts still advocate caution. "With increased life expectancy, the disease burden would increase," said geriatrician Dr B Krishnaswamy. "Yes, we will live longer, but the big question is how healthy our lives would be," he said.


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