Case of Treatment of woman with severe vasospastic angina with diltiazem- A report

Japan: Initiatin of diltiazem therapy led to pregnancy and the successful birth of a child in a woman diagnosed with severe vasospastic angina (VSA), a recent case study published in JACC: Case Reports has shown.

Vasospastic angina can sometimes result in acute myocardial infarction (MI) in pregnant women, potentially endangering mother and child lives. Hirohiko Aikawa, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan, and colleagues described a case of a young woman with suspected vasospastic angina who wished to become pregnant.

Vasospasm provocation testing revealed severe vasospasm and subsequent appropriate management led to successful delivery.

The case concerns a 29-year-old woman who presented with chest pain only at rest. The Holter electrocardiogram revealed ST-segment depression at the time of chest pain onset. A trial use of nitroglycerin sublingual tablets was effective. She was suggested to have vasospastic angina and wished to become pregnant. She had no medical history.

The possible differential diagnoses included coronary embolism, atherosclerotic coronary artery disease, and spontaneous coronary artery dissection.

The case was discussed by cardiologists and obstetricians who decided to perform invasive coronary catheterization and vasospasm provocation testing to determine a definitive diagnosis and perinatal cardiovascular risk and, to administer a calcium-channel blocker (CCB) if the test was positive.

Coronary angiography performed via her distal radial artery revealed no stenosis. Vasospasm provocation testing with acetylcholine administration into the left coronary artery resulted in sub occlusion in the left main trunk (LMT) with chest pain, ST-segment depression in the V4 to V6 leads, and hypotension. An intracoronary infusion of nicorandil and isosorbide mononitrate improved the LMT occlusion, eliminated electrocardiogram changes, and increased blood pressure (BP). She was confirmed to have severe VSA.

200 mg daily Diltiazem was initiated. She successfully conceived after a few weeks. Diltiazem’s effectiveness was recognised after the appearance of chest pain shortly after the temporary discontinuation of diltiazem because of hyperemesis gravidarum. Her pregnancy progressed without chest pain after the second trimester, and the fetus developed well.

A labour induction was planned at the 40th gestation week because spontaneous labour did not occur until full term. Epidural analgesia was used at delivery to prevent vasospasm induction caused by hyperventilation or pain stress.

She gave birth to a healthy girl without any anomaly. For postpartum atonic haemorrhage, oxytocin was used instead of methylergonovine. She had no chest pain or electrocardiogram abnormality in the peripartum period.

The patient continued to take diltiazem after delivery and has had no recurrence of angina attacks. The child was growing up without any disabilities. The amount of diltiazem ingested by the infant via breast milk is small and is unlikely to negatively affect breastfed infants.

“It is important to make a definitive VSA diagnosis for women who wish to be pregnant, determine its severity and provide suitable treatment,” the researchers wrote.

“Under conditions of adequate prior consultation with the patient, obstetricians, family, and cardiologists, invasive catheterization including provocation test should be performed, and CCB administration should be considered for VSA,” they concluded.

Reference:

Aikawa H, Murai K, Aoki-Kamiya C, Yoshimatsu J, Noguchi T. Diagnosis and Management of Vasospastic Angina in a Young Woman Wishing to Become Pregnant. JACC Case Rep. 2023 Dec 6;27:102051. doi: 10.1016/j.jaccas.2023.102051. PMID: 38094717; PMCID: PMC10715958.

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NEET PG: In Service Candidate alleges Arbitrary Seat Allotment at RVM Medical College, HC issues notice

Hyderabad: The Telangana High Court bench has recently issued notices in a plea challenging the arbitrary seat allotment to a postgraduate medical candidate in RVM Institute of Medical Sciences and Research Centre, Medak.

Issuing the notice, the HC bench comprising Chief Justice Alok Aradhe and Justice J. Anil Kumar has listed the matter for further hearing after two weeks.

The bench was considering a plea by an in-service PG medical candidate, who also belongs to the scheduled caste category. Approaching the HC bench, the petitioner alleged arbitrary seat allotment at the medical college.

It was submitted by the counsel for the petitioner that he belonged to the SC Category and he has secured 220 marks, whereas another candidate (Respondent No.3) was admitted to the Medak-based medical college while only obtaining 160 marks in the Postgraduate medical entrance examination, i.e. the National Eligibility-cum-Entrance Test Postgraduate (NEET-PG). The petitioner’s counsel also informed the court that the petitioner had submitted an option for the concerned medical institute as well.

The petitioner prayed to the court to issue an order or mandamus declaring the action of Kaloji Narayana Rao University of Health Sciences (KNRUHS) in not allotting a seat to the petitioner in PG SPM in terms of his web options, and allotting a PG SPM seat to another candidate who scored less as “illegal and arbitrary and discriminatory” violating the Article 14 and 21 of the Constitution of India.

Also Read: KNRUHS affiliated private medical, nursing colleges must pay GST on inspection, affiliation fee: HC

During the hearing of the case on 07.11.2023, the counsel for KNRUHS invited the Court’s attention to the notice dated 19.08.2023 issued by the Union Government which provides that the candidates who have participated in the first three rounds of counselling are not entitled to participate in the stray round of counselling.

It was submitted by the KNRUHS counsel that the petitioner has participated in up to the first three phases of counseling and had already been allotted a seat. Therefore, the petitioner was not entitled to participate in the stray round of counselling, which was held on 11.10.2023.

On 15.12.2023, when the matter came up for hearing before the HC bench, the counsel for KNRUHS invited the attention of the court to the stand taken by the university in paragraph 18 of the counter affidavit. 

As per the latest media report by Deccan Chronicle, the respondent informed the court that based on his marks, the petitioner had four options but he had applied for three. The petitioner’s counsel stated that one of the options was RVM Institute of Medical Sciences. While considering the matter, the HC bench said that without hearing the other candidate no orders could be passed and therefore, it directed to issue notice to the other candidate and adjourned the matter by two weeks.

“However, at this point of time, it is noticed that service on respondent No.3 has not been effected. Let service report be filed within two weeks. List thereafter,” the HC bench mentioned in the order.

To view the HC order, click on the link below:

https://medicaldialogues.in/pdf_upload/telangana-hc-kvm-institute-228151.pdf

Also Read: Telangana HC junks pleas seeking cancellation of MBBS seats allotted in stray round counselling

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Doctors cannot be blamed for consequences of pre-existing conditions: Consumer Court Relief to Orthopaedic Surgeon, Hospital

Chennai: The District Consumer Disputes Redressal Commission, Chennai (North), recently exonerated an Orthopaedic surgeon and a hospital from charges of medical negligence while opining that doctors cannot be held negligent for the consequences of treatment arising due to pre-existing conditions. 

Referring to relevant legal precedents, the Commission reiterated that medical practitioners would be liable only where their conduct fell below the standards of a reasonably competent practitioner in his field.

It further pointed out that in the realm of diagnosis and treatment, there is scope for difference of opinion and one professional doctor cannot be held negligent merely because his conclusion differs from that of other professional doctors. Doctors cannot be held negligent so long the doctor persons his/her duties with reasonable skill and competence.

With such opinions, the Commission exonerated a Chennai-based hospital and its Orthopaedic doctor (head of the Orthopaedics department) from charges of medical negligence while treating a patient diagnosed with comminuted intera articular supra condylar fracture of left distil femur.

After perusing the medical records, the consumer court opined that the doctor followed and adopted recognized medical procedure in respect of the surgery. Further, the Commission found that the increase in pain and the second surgery were because the complainant did not have normal shape or strength in his left leg due to pre-existing polio. Referring to this, the Commission opined that the doctor and the hospital cannot be blamed in this context and therefore they were not liable to pay the alleged medical expenses as demanded by the complainant.

The matter goes back to 2009 when the complainant sustained an injury on his left knee and was admitted to St. Isabel Hospital for treatment. He was diagnosed with comminuted intera articular supra condylar fracture of left distil femur with pain and swelling on his left knee. He was admitted as an in-patient and the head of the department of Orthopaedics in the hospital, the treating doctor, advised him to undergo surgery.

Accordingly, the doctor conducted surgery and the complainant was discharged on 12.06.2009. However, even after discharge, the pain continued and therefore the patient first consulted the treating doctor and later prof. Dr.P.V.A Mohandas at MIOT Hospitals Manappakkam, Chennai for a second opinion.

The complainant was shocked when the second doctor, after studying the X-ray, opined that the report showed a poor reduction of the fracture and therefore, he advised the complainant to have corrective surgery for realignment and knee-spanning fixation. Another doctor advised removal of entire implants assembling refixation after proper alignment of the supra condylar fracture and bone grafting. The Plan II, as advised by the doctor was that in case of deep infection, implant removal wound debridement and external fixation. Plan III was after the control of infection to plan for a definitive internal fixation and bone grafting.

Consequently, the patient was admitted to Balaji Hospitals Chennai to undergo corrective surgery on 22.06.2009 and the concerned doctor conducted the same. Under the corrective surgery after administering to the complainant spinal anaesthesia, the implant was removed and the madiel femur condyle was displaced and refixed. Then a vascular edge of shift of femur nibbled and fractured aligned and fixed with a contoured locking plate with screw. Post operative period was uneventful and the complainant was discharged from the hospital on 08.07.2009.

However, the complainant alleged that he had to pay substantial amount of money for the 1st surgery and also for the corrective surgery later which was necessitated because of gross negligence of the treating doctor at the first hospital. He demanded Rs 4,87,362.50 from the doctor and the hospital as compensation. 

On the other hand, the hospital submitted that it is a Charitable institution governed by nun sisters on a non-profitable basis. It also mentioned that the complainant was a known case of post-polio residual paralysis that had affected both his lower limbs even before the accident. Further, the hospital submitted that it did not decide to operate the very same day of admission but it was done later as a last resort attempt to extend the flexed knee.

It claimed that the nature and probable consequence of the surgery was explained to the complainant who was convinced that it was only an attempt to provide relief to the complainant from not only what he had sustained as a result of the alleged injury but also from what he had been suffering from prior to the fall.

As per the hospital, the patient was advised non-weight bearing knee brace and a review after 6 weeks and the requirement for a further review was also mentioned in the discharge summary which the complainant did not follow.

The treating doctor informed the consumer court that the complainant suffers from post polio residual paralysis of both legs with approximately 90 degree fixed flexion of the knees due to which he will not be able to straighten his legs at all.

He further submitted that as a reputed Orthopaedic surgeon, he was of the opinion that surgery should be done to correct the flexion deformity in the knee on the left leg to the maximum extent possible and due to pre existing polio the affected bone in his left leg does not have normal shape or strength. He also informed that the consequences of surgery were informed to the complainant prior to surgery and post operative pain is a common one and it takes time to for the fracture to heel.

Further, the doctor contended that he cannot be blamed for different opinions among professionals and further contended that the second treating doctor in no manner decry the earlier surgery it find fault with the same and the opinion of Dr Mohandass was based on X-ray showing poor reduction of fracture. The treating doctor opined that Dr. Mohandass’s opinion was misplaced since the complainant at no point in time had normal anatomy.

He further claimed that his attempt was to achieve flexibility in the complainant’s lower limb in the left leg so as to make the patient to stand up and the surgery done by him has been of the highest order and comparable with the services offered anywhere in the world.

After perusing the entire records and considering the arguments by both parties, the consumer court noted that the treating doctor conducted the surgery aiming at union of the fracture and to achieve strengthening of the lower limb in the left leg so that the patient  may try to stand since he was previously crawling with his knees.

Referring to the operation notes and discharge summary, the commission opined that the treating doctor

“…followed and adopted the recognized medical procedure in respect of the surgery undergone by the complainant and no fault and defectiveness in the surgery is established by the complainant or by the two other doctors who subsequently gave opinion by examining the complainant and therefore the question of negligence will not arise since the complainant fail to prove that the surgery has not be done in accordance with the normal and acceptable practice in the medical field…”

Noting the pre-existing polio of the complainant, the consumer court observed that the doctor cannot be held negligent for the consequences of the pre-existing condition of the patient and noted,

“…it is further found that the increase in pain and the 2nd surgery by Dr.L.Subramaniyan were due to the fact that the complainant does not have normal shape or strength in his left leg due to pre existing polio and for which the opposite parties cannot be blame by the complainant and hence the opposite parties or not liable to pay the alleged medical expenses of Rs.487362.50/- as claimed in the complaint.”

The Commission referred to Supreme Court order in the case of Kusum Sharma and Others versus Batra hospital and medical research centre and others and the landmark judgment in the case of Kusum Sharma and others Versus Batra hospital and medical research centre and others.

Referring to these orders, the Commission reiterated that a medical practioner would be liable only where is contact fell below that of the standards of a reasonably competent practioner in his field. It further opined that in the realm of diagnosis and treatment there is scope for difference of opinion and one professional doctor is not negligent merely because his conclusion differs from that of other professional doctors. It further reiterated that one professional doctor is not negligent merely because his conclusion differs from that of other professional doctors and negligence cannot be attributed to a doctor so long as he perform his duties with reasonable skill and competence.

Therefore, exonerating the doctor and the hospital, the Commission mentioned in the order,

“In the present complaint also the 2nd opposite party has done surgery with reasonable skill and competence and hence he cannot be held liable for medical negligence. The 2nd opposite party relied upon a decision reported in (2009) 9 Supreme Court Cases 709 and contended that without examining the expert as a witness in court no reliance can be placed on an opinion alone and hence contended without examining the two doctors who gave opinion it is not possible to come to a conclusion that the 2nd opposite party as committed medical negligence in performing surgery. The above said case is applicable to the present complaint and hence it is found after careful scrutiny of documents that the complainant failed to prove the alleged medical negligence on the part of opposite parties and hence there is no deficiency in service on the part of opposite parties.”

“Based on findings given to point.no.1 since there is no deficiency in service or medical negligence on the part of opposite parties hence the complainant is not entitled for sum of Rs.487362.50/- with interest as claimed in the complaint. Point no.2 is answered accordingly. In the result the complaint is dismissed. No cost,” it added.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/chennai-dcdrc-228131.pdf

Also Read: Anaesthetist Alleges Wrongful Removal of Kidney, Consumer Court junks plea

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Study finds hypothyroidism closely associated with chronic kidney disease

A recent study published in Renal Failure uncovered a substantial association between hypothyroidism and chronic kidney disease (CKD), highlighting the prevalence of urine protein in patients with both conditions. The investigation wanted to unravel the mechanisms linking thyroid hormones and urine proteins, providing critical insights into the complex interplay between hypothyroidism and CKD.

The study conducted from November 2016 to August 2018, included 99 Japanese CKD patients with proteinuria. Major parameters assessed here were thyroid function (serum free T3, free T4, and thyroid-stimulating hormone), kidney function (estimated glomerular filtration rate), thyroid antibodies, and albumin. The research also looked into a comprehensive urine examination, examining levels of total T3, total T4, TSH, Alb, preAlb, thyroid-binding globulin, and overall protein.

The participants were of 60 years in average, with a slight male predominance (50.5%). Notably, around 70% of the patients displayed thyroid dysfunction, with 51.5% experiencing overt or subclinical hypothyroidism, irrespective of antibody status. Also, 21.2% of patients were diagnosed with nephrotic syndrome with a significant association between hypothyroidism and this renal complication. The study found higher urinary levels of thyroid hormones in patients with nephrotic syndrome, suggesting a more severe form of hypothyroidism.

These underscore that urinary loss of thyroid hormones may be a crucial factor influencing hypothyroidism independently of autoimmune factors. This established a link between hypothyroidism and nephrotic syndrome emphasizes the need for a comprehensive understanding of thyroid-kidney interactions in clinical management.

The outcomes deepens our understanding of the intricate relationship between hypothyroidism and chronic kidney disease and also opens avenues for targeted interventions. As we look further into the complexities of these interconnected health issues, this study marks a significant stride forward in advancing personalized treatment strategies for patients grappling with both hypothyroidism and chronic kidney disease.

Source:

Yuasa, R., Muramatsu, M., Saito, A., Osuka, H., Morita, T., Hamasaki, Y., & Sakai, K. (2023). Urinary excretion of thyroid hormone in CKD patients: a proof-of-concept of nephrogenic hypothyroidism. Renal Failure, 45(2). https://doi.org/10.1080/0886022x.2023.2293224

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Shweta Rai takes over as MD of Bayer Zydus Pharma

Thane: Bayer today announced that Shweta Rai will take over as Managing Director of Bayer Zydus Pharma Private Limited and Country Division Head (CDH) for Bayer’s Pharmaceuticals Business in South Asia effective, January 1, 2024. Manoj Saxena will move out of his present role to take on the role of CDH for Bayer’s Pharmaceuticals Division and Senior Bayer Representative, Bayer Group for the Australia & New Zealand (ANZ) cluster, with effect from the same date.

Shweta joined Bayer in 2019 and her last assignment was Business Unit Head. With a distinguished career spanning over 22 years, Shweta has a strong track record of leading high performance diverse teams across strategic business positions in the pharmaceuticals and medical device sectors. Her expertise extends across a myriad of therapy areas, including Cardiology, Diabetes, Women’s Health Care, Immunology, Virology, Anti-infectives, Vaccines, Neurology, Orthopedics and Pain Management. Prior to this, she worked with companies of repute like Johnson & Johnson, MSD Pharmaceuticals, IQVIA and Pfizer.

Shweta holds a bachelor’s degree in Zoology (Honors) from Miranda House Delhi University, a Postgraduate degree in Management Studies, Mumbai and completed a Strategic Management Program from the Indian Institute of Management (IIM), Kolkata.

Speaking about taking on the leadership role, Shweta said, “I am honored to take on this new role within the organization. I am committed to build on the strong foundation that has been laid by Manoj. I am confident we can continue to build on the successes we have witnessed in the region so far and take Bayer’s mission of ‘Health for All, Hunger for none’ forward. I am excited to work closely with internal and external stakeholders to continue delivering innovative healthcare solutions and exceptional value to our patients.”

Commenting on the appointment, Manoj said, “As I transition to a new role and country within our incredible organization, I am excited about the fresh challenges and opportunities that lie ahead. I am happy that Shweta is taking over this role for South Asia. She has been part of the India leadership team and demonstrated strong leadership over the years. I am equally confident that she will take Bayer’s Pharmaceuticals business to greater heights and help us leverage the emerging growth opportunities in this region. I am grateful for the unwavering support of our dedicated teams and look forward to contributing to our shared success in this exciting new chapter”.

Manoj joined Bayer in 2009 and has served in various leadership positions across multiple Asia Pacific countries. He is also currently the President-Elect at the Organization of Pharmaceutical Producers of India (OPPI).

Read also: Bayer, Salus Optima collaborate on AI-Enabled Healthy Aging Journey

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ACOG Recommendations Highlight Importance of Influenza Vaccination for Pregnant women

A recent set of recommendations from the American College of Obstetricians and Gynecologists (ACOG) underscores the critical role of influenza vaccination for pregnant individuals in preventing severe complications. The recommendations, backed by the Centers for Disease Control and Prevention (CDC), emphasize the significance of timely immunization against influenza and provide guidance for obstetrician-gynecologists in managing respiratory illnesses during pregnancy.

  • Vaccination During Pregnancy: ACOG and CDC strongly advocate for influenza vaccination in pregnant individuals during the flu season, recommending an inactivated or recombinant influenza vaccine as soon as it becomes available. While October is an ideal timeframe, vaccination at any point during the flu season is encouraged for safeguarding against prevalent circulating viruses.
  • Safe Vaccination Practices: The recommendations highlight the safety and efficacy of influenza vaccination during pregnancy, supporting its administration irrespective of prior vaccine doses received in previous pregnancies. Studies consistently demonstrate the benefits of maternal immunization in protecting both pregnant individuals and their newborns against influenza-related complications.
  • Respiratory Illness Assessment and Treatment: Healthcare professionals should assess pregnant individuals presenting with respiratory symptoms for both influenza and SARS-CoV-2 infection, initiating prompt antiviral treatment within 48 hours of symptom onset for suspected influenza cases. Additionally, considering the potential co-infection of influenza and SARS-CoV-2, clinicians recommend specific antiviral treatments in such instances.
  • Disparities and Addressing Vaccination Hesitancy: Acknowledging disparities in vaccination rates, particularly among racial and ethnic minority groups, ACOG advocates for obstetric healthcare providers to actively recommend and advocate for influenza vaccination. Strategies include culturally responsive communication and engagement with community groups to address concerns and increase vaccination rates in underserved communities.

Influenza vaccination remains a pivotal aspect of obstetric care, significantly reducing the risk of severe illness in pregnant individuals. ACOG’s comprehensive recommendations emphasize the importance of healthcare providers’ recommendations, fostering confidence in vaccinations, and addressing disparities to ensure better outcomes for pregnant patients.

Reference:

Influenza in pregnancy: Prevention and treatment. (2023). Obstetrics and Gynecology, 10.1097/AOG.0000000000005479. https://doi.org/10.1097/aog.0000000000005479

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Control of Anthropometric Measures and Lipids may improve Gout Outcomes

A recent study, published in Rheumatic and Musculoskeletal Diseases, delved into the nuanced relationship between gout outcomes, lifestyle changes, and lipid levels. The research aimed to analyze the impact of anthropometric measures and lipid levels on gout outcomes in patients receiving treatment. Among the key determinants of gout outcomes, waist circumference and lipid levels emerged as crucial predictors.

Led by Dr. Till Uhlig and colleagues, the study included 211 patients with gout, predominantly male with an average age of 56.4 years. Over the 2-year duration, anthropometric measures remained relatively stable, whereas cholesterol and low-density lipoprotein cholesterol (LDL-C) showed a noticeable decrease by the end of the first year. Notably, high waist circumference (WC) and lipid levels emerged as strong predictors of unfavorable gout outcomes at the end of the 2-year period.

Patients with a recent gout flare and elevated serum urate levels received comprehensive gout education and were initiated on a ‘treat-to-target’ urate-lowering therapy over a year. Anthropometric measures including body mass index (BMI), waist circumference (WC), and waist-height ratio (WHR) were recorded yearly alongside lipid level assessments for the 2-year duration.

  • Proportion of Patients: Anthropometric measures remained largely unchanged over the 2-year study duration.
  • Cholesterol Levels: Demonstrated a reduction at the end of the first year.
  • Low-Density Lipoprotein Cholesterol (LDL-C): Showed a noticeable decrease by the end of the first year.
  • Association with Gout Outcomes: High waist circumference (WC) and elevated lipid levels were predictors of unfavorable gout outcomes after the 2-year study period.
  • Odds Ratio for Achieving sUA Target at Year 2:
  • WC: 0.96 per cm (95% CI: 0.93 to 0.99)
  • High-density lipoprotein cholesterol: 5.1 per mmol/L (95% CI: 1.2 to 22.1)
  • Odds Ratio for Gout Flare during Year 2:
  • High LDL-C: 1.8 per mmol/L (95% CI: 1.2 to 2.6)

The study’s findings underscore the significance of monitoring anthropometric measures and lipid levels in patients receiving continuous treatment for gout. Predictive relationships between high waist circumference, lipid levels, and unfavorable gout outcomes highlight the importance of managing these factors to optimize gout management strategies.

Reference:

Uhlig T, Karoliussen LF, Sexton J, Kvien TK, Haavardsholm EA, Hammer HB. Lifestyle factors predict gout outcomes: Results from the NOR-Gout longitudinal 2-year treat-to-target study. RMD Open. 2023;9(4):e003600. Published 2023 Dec 1. doi:10.1136/rmdopen-2023-003600

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Doctors remove 300 kidney stones from woman who consumed bubble tea instead of water

More than 300 stones were removed from the kidney of a 20-year-old woman in Taiwan who used to hydrate herself only with beverages such as bubble tea, fruit juice, and alcoholic beverages for years instead of water.

For more news & updates, check out the link given below:

https://medicaldialogues.in/

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Ten Tips To Guard Your Lungs This Winter – Dr Raja Dhar

As winter approaches,
it’s crucial to understand how the changing weather can affect our breathing
and overall health. This overview breaks down the impact of seasonal shifts on
our respiratory well-being, focusing on things like the transition from warm to
cold weather, how it can affect people with existing lung problems and the
challenges posed by winter air pollution.

It is expected that there will be an
increase in respiratory issues, especially for kids, those with chronic lung
diseases, and older adults. In such times, children are more sensitive to air
quality, and parents should be mindful of outdoor plans.

Additionally, getting
vaccinated against various illnesses, is highlighted as a crucial step for
protection. Here are some practical tips to stay healthy, and avoid falling
prey to such illness, by taking care of your lungs and adopting healthy habits,
to enjoy a safe and healthy winter season.

1. Climate Impact on
Respiratory Health:

 
– Seasonal changes, especially from summer to winter, can lead to
increased viral replication in the upper respiratory tract.

 
– The transition from winter to warmer seasons may also trigger
respiratory issues, affecting both upper and lower airways.

2. Vulnerable Populations:

 
– Individuals with chronic lung diseases like asthma and COPD are at
higher risk of exacerbations during seasonal transitions.

 
– Hospitalization rates tend to rise significantly during the winter
period.

3. Air Pollution and Winter
Challenges:

 
– Post Diwali, air pollution intensifies due to a phenomenon called
‘temperature inversion.’

 
– Cold air traps pollutants at the earth’s surface, leading to poor air
quality and higher respiratory ailments.

4. 2023 Outlook:

 
– Anticipated increase in respiratory ailments in the next two months,
especially affecting children, those with chronic lung diseases, and the
elderly.

5. Additional Threats:

 
– New virus strains, including the reported COVID variants, pose risks,
particularly for individuals with comorbidities.

 
– Post-COVID symptoms may persist, with a continued risk of lung-related
issues for the next two years.

6. Preventive Measures:

 
– Avoid sudden temperature changes to prevent breathing passage spasms
and viral replication.

 
– Steer clear of chilled drinks and abrupt temperature shifts, such as
going from sweating to air conditioning.

 
– Quit smoking to protect both personal and public health.

7. Healthy Lifestyle Practices:

 
– Maintain a nutritious diet and engage in regular exercise.

 
– Exercise indoors during poor air quality to minimize exposure to
outdoor pollutants.

 
– Use masks, especially when the air quality index exceeds 150, to
mitigate the impact of pollutants.

8. Children’s Health
Considerations:

 
– Children are particularly vulnerable to ambient air particulate
matter, influencing school holiday schedules.

 
– Parents should stay vigilant and adapt plans based on air quality
conditions.

9. Vaccination Recommendations:

 
– Encourage vaccination against pneumonia, influenza, shingles,
pertussis, and stay updated on COVID vaccination guidelines.

10. Closing Thoughts:

 
– Emphasize the importance of healthy breathing and a positive
lifestyle.

 
– Wishing everyone a safe and healthy winter season.

Disclaimer: The views expressed in this article are of the author and not of Medical Dialogues. The Editorial/Content team of Medical Dialogues has not contributed to the writing/editing/packaging of this article.

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COVID sub-variant JN.1 case detected in 79-year-old woman in Kerala

A case of COVID-19 sub-variant JN. 1 has been detected in Kerala as part of an ongoing routine surveillance activity of the Indian SARS-CoV-2 Genomics Consortium (INSACOG), a senior official from the Indian Council of Medical Research (ICMR) said on Saturday.

The case was detected in an RT-PCR positive sample from Karakulam in Thiruvananthapuram district of the southern state on December 8, Dr Rajiv Bahl, Director General of the ICMR, said.

For more news & updates, check out the link given below:

https://medicaldialogues.in/

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