Latest Study Finds Fixed-Dose Combination of Paracetamol, Phenylephrine, and Chlorpheniramine Maleate Effective and Safe for Common Cold in Indian Adults

The fixed-dose combination (FDC) of Paracetamol 500 mg, Phenylephrine 10 mg, and Chlorpheniramine maleate 2 mg was effective and safe for the symptomatic
treatment of common cold in adults, according to a recent study published in
the Journal of The Association of Physicians of India.

Common cold is an acute and self-limiting upper respiratory tract
infection, causing symptoms like fever, nasal congestion, sore throat, and coughing. It generally affects adults 4-6
times annually, with symptoms lasting 5-7 days, and rhinovirus is the most
common cause. Despite the viral nature of the infection, antibiotics are often
over-prescribed, contributing to antibiotic resistance. Paracetamol, Phenylephrine, and Chlorpheniramine maleate are commonly used to treat
symptoms, but limited research exists on the efficacy and safety of their FDC.

This led the researchers to
conduct a study evaluating the efficacy and safety of FDC of Paracetamol 500 mg,
Phenylephrine 10 mg, and Chlorpheniramine maleate 2 mg for treating common cold
symptoms in Indian adults.

Researchers enrolled 420 patients, aged 18
to 65 years, to assess the efficacy and safety of the FDC of the
investigational product. Of these, 318 patients completed the study. The FDC
was administered as one tablet orally three times, every 8-hourly, for 5 days. The patients visited
the clinical trial site on Day 1 (baseline), Day 3
(re-evaluation), and Day 5 (conclusion) for evaluation of efficacy and safety.
The efficacy
was measured using the total symptom score (TSS), while safety was evaluated
based on adverse events reported by the patients.

Key
findings from the study, are detailed below:

Efficacy
assessment:

  • The
    Total Symptom Score (TSS) decreased significantly from 9.016 at baseline to
    5.011 on the second visit and 0.495 on the third, reflecting a 44.42% reduction
    by the second visit and 94.51% by the third visit over five days.
  • At
    baseline, 315 patients presented with severe symptoms, while three exhibited
    moderate symptoms. By the third visit, none had severe symptoms, two had
    moderate, 48 had mild, and 268 (84.276%) were symptom-free, showing the
    treatment’s efficacy over five days. (Fig. 1A and B)

Fig. 1A and B: (A) Mean TSS on visit first, second, and third; (B) Percentage reduction in the mean TSS on visit second and third compared to baseline

Safety
assessment:

  • During
    the study, only 13 patients experienced mild adverse effects. Hyperacidity was
    reported by four patients, and drowsiness by nine patients likely due to the
    presence of Paracetamol and Chlorpheniramine maleate in the treatment. All
    adverse events were mild, non-serious, and did not require medical
    intervention.

The
researchers concluded that the study provides substantial evidence supporting
the efficacy and safety of the FDC containing Paracetamol 500 mg, Phenylephrine
10 mg, and Chlorpheniramine maleate 2 mg for managing common cold symptoms in
Indian adults. The findings demonstrated a significant reduction in TSS and a
high percentage of patients achieving complete relief.

They
recommended further randomised clinical trials with a larger sample size to
evaluate the treatment’s efficacy and potential adverse effects in Indian
adults suffering from the common cold.

Dr Mayuresh
Dilip Kiran, (MD Pharmacology) and lead author of the study
said, “The results of our study confirm the efficacy and safety of the
fixed-dose combination of Paracetamol, Phenylephrine, and Chlorpheniramine
maleate in providing rapid relief from common cold symptoms. With over 84% of
patients achieving complete symptom resolution by the fifth day, this
combination therapy offers a reliable and well-tolerated option for managing a
condition that significantly impacts daily productivity and quality of life”.

References:

  1. Kiran MD, Waghambare PD, Pawaskar L,
    Singh A. Fixed-dose Combination Therapy of Paracetamol, Phenylephrine, and
    Chlorpheniramine Maleate for the Symptomatic Treatment of Common Cold in Indian
    Adults. J Assoc Physicians India. 2024 Nov;72(11):45-48. doi:
    10.59556/japi.72.0729. PMID: 39563116.
  2. Worrall G. Common cold. Can Fam
    Physician. 2011 Nov;57(11):1289-90. PMID: 22084460; PMCID: PMC3215607.

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ICMR Develops AI Tool to Predict IVF Outcomes for Infertile Men

New Delhi: The Indian Council of Medical Research (ICMR), in collaboration with Amity University, has developed an artificial intelligence-based tool aimed at detecting ‘Y’ chromosome microdeletion (YCMD) — a genetic cause of male infertility — and predicting the outcomes of in-vitro fertilization (IVF) treatments.

According to the PTI report, the study regarding the AI tool was published in the Journal of Assisted Reproduction and Genetics last week. 

In nearly 50 per cent of couples experiencing infertility, the problem is with the male partner, said Dr Deepak Modi, senior scientist at ICMR’s National Institute for Research in Reproductive and Child Health (NIRRCH) and the lead author of the study.

“In them there could be problems with sperm production. One of the leading causes, Y chromosome microdeletion (YCMD) is observed in one in every 10 men with infertility. Because of this genetic defect, the testes are unable to make enough sperm leading to infertility,” Dr Modi said.

Also Read:ICMR left indelible mark on India’s healthcare landscape, says Shri JP Nadda

Men with YCMD cannot benefit from medical treatment for improving the sperm count.

To become fathers, such men require assisted reproductive techniques such as in-vitro fertilization (IVF) for parenthood, he said.  

The AI-based tool — ‘Fertility Predictor’ — developed by the ICMR-NIRRCH in collaboration with Amity University, Noida can predict sperm retrieval rates and success rates of assisted reproductive technology (ART) in men having this genetic problem.

It also predicts the rate of fertilization, clinical pregnancy and live birth rates based on the type of Y chromosome microdeletion, Dr Modi said. This helps the couples make informed decisions, he said.

However, Dr Modi cautioned that the male babies born through IVF from men with YCMD will inherit the same defect and will be infertile as it is 100 per cent transmitted from fathers to their sons, news agency PTI reported.

Developing this tool took about two years by collating data of more than 500 men having YCMD and undergoing ART.

After applying an artificial intelligence algorithm based on machine learning on this data, the tool could predict the outcomes. This was then validated on another sub-set and it was found to have accuracy of about 80 per cent, Dr Stacy Colaco, a scientist at NIRRCH and the first author of the study, said.

“Fertility Predictor also provides a numerical output for chance of clinical pregnancy and live birth in men with YCMD. The validation studies indicated its robustness and high accuracy in predicting both these parameters solely based on the type of YCMD,” said Dr Abhishek Sengupta of Amity University, Noida.

Also Read:’First in the World Challenge’: ICMR calls for proposals to develop innovative health solutions

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Hamidia Hospital unveils Toy Ward to Alleviate Children’s Anxiety during Surgery

Bhopal: Bhopal’s Hamidia Hospital has unveiled a unique “Toy Ward” within its Pediatric Surgery Ward to alleviate the stress and anxiety faced by hospitalized children. The new ward is adorned with colourful decorations, cheerful toys, and bright paintings to create a welcoming and comforting environment for children.

The goal is to ease the psychological and emotional challenges children often face during hospitalization, helping them cope with medical procedures more positively. 

Dr Kavita N Singh, Dean of Gandhi Medical College (GMC), officially inaugurated the Toy Ward and praised the hospital for its thoughtful initiative in enhancing the treatment experience for children. According to doctors hospitalization is a challenging experience for both children and their families.

Also Read: MP CM Mohan Yadav inspects Hamidia Hospital, announces facilities worth Rs 199 crore

During their hospital stay, a child’s routine is disrupted, and the hospital environment often evokes stress, fear, anxiety, and emotional trauma. This can affect both their physical and psychological well-being, making it more difficult for them to manage medical procedures. To address this, the hospital has worked to create a less intimidating environment, aiming to reduce negative emotions such as fear and anxiety, and ultimately make the treatment experience more positive and less stressful for young patients.

Dr Dhirendra Srivastava, head of the Pediatric Surgery Department at Hamidia Hospital, explained that the ward has been specially designed for children who are admitted for surgical procedures. This aids in the children’s swift recovery and contributes to their mental well-being. The doctor also mentioned that the new setup is intended to make the hospital environment less stressful for both the children and their families.

Also Read: Sir Ganga Ram Hospital celebrates National Pediatric Surgery Day

As per the recent media report, GMC dean Dr Kavita N Singh told Free Press Journal, “It is a positive initiative on the part of the hospital administration and it is very important to take care of the happiness and comfort of children during their treatment. The toy ward will give new energy and confidence to the children and serve as an inspiration to other hospitals to take up similar initiatives.”

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Infertility Clinics Set Up at Nanded Government Hospitals

Chhatrapati Sambhajinagar: Nanded district has achieved an important milestone in the field of reproductive healthcare by becoming the first district in Maharashtra to establish infertility treatment centres in every government hospital. This initiative aimed at providing accessible reproductive healthcare especially beneficial to rural communities.

This initiative launched in March of this year, started with 19 government hospitals across the district, including one district hospital, six sub-district hospitals, and 12 rural hospitals. Since its inception, the program has successfully assisted 600 couples in addressing fertility challenges. The initiative is expanding to include all rural hospitals and primary health centres in the district, comprising one district hospital, six sub-district hospitals, 15 rural hospitals, and 72 primary health centres.

Also Read: Karnataka to Launch First Government-Funded IVF Centre at KMCRI by March

According to a recent media report, Nanded district collector Abhijit Raut told TOI, “As the initiative progresses, it offers hope to countless couples longing to start a family, proving that timely intervention and proper medical care can make a significant difference. We will hold a training camp in the first week of January, following which the services will start across the district.”

He stated that these centers have been operating every Thursday at the Nanded district hospital, six sub-district hospitals, and 12 rural hospitals since March. These centers are staffed with trained gynecologists, radiologists, and other specialists who offer counseling, conduct examinations and recommend appropriate treatments for couples struggling with infertility. He mentioned that the aim is to provide early intervention and support, particularly addressing the growing infertility concerns linked to stress and modern lifestyle factors.

The inability to conceive often causes significant distress, especially in rural areas, where the stigma surrounding infertility remains prevalent. This can have devastating emotional and psychological effects on couples. He emphasized that providing easy access to fertility services is crucial for reducing these challenges and ensuring that couples receive the support they need to overcome infertility.

Commenting on the standard operating procedure that will be followed at PHCs, Nanded district civil surgeon Dr Nilkanth Bhosikar told TOI, “We are training our existing health staffers for reorientation and imparting training for counseling of couples as well as basic investigations to ascertain the cause of infertility. Once it is clear that a couple requires specialized treatment, they are sent to centers at the district level with advanced facilities.”

Also Read: Natural cycles with properly scheduled oocyte retrieval benefits women with low ovarian reserve undergoing IVF: Study

Medical experts working in these clinics observed that over 50% of couples facing fertility challenges can become parents with basic counselling, initial investigations, and timely treatment. These clinics aim to address the issue holistically, reducing the stigma and emotional strain associated with infertility. “Our focus is to provide comprehensive support to couples and ensure that they have access to necessary medical care and guidance,” he said.

The initiative has received widespread praise, particularly for its focus on addressing infertility at the grassroots level. Its approach goes beyond just medical treatment, offering vital emotional and psychological support to couples, and helping them navigate the challenges of infertility without the stigma or isolation that often accompanies it. Health department officials believe this initiative will have a far-reaching impact and is seen as a model that other districts in Maharashtra, and potentially across the country, could replicate. By integrating fertility services into the public healthcare system, Nanded underscores the importance of accessible reproductive healthcare.

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Metabolic Syndrome Increases Risk of Glaucoma, Study Finds

Researchers have established that metabolic syndrome (MetS) patients are at a considerably increased risk of suffering from glaucoma, a common cause of irreversible blindness around the world. A recent meta-analysis that included more than 2.25 million participants revealed that MetS raises the odds of suffering from glaucoma by 34%. The study was conducted by Fei Li and colleagues which was published in the journal Diabetology and Metabolic Syndrome.

Metabolic syndrome includes hypertension, hyperglycemia, obesity, and dyslipidemia, which increase the risk for cardiovascular diseases and diabetes. Glaucoma is defined as a progressive optic nerve damage and has multifactorial risk factors, including intraocular pressure and vascular dysregulation. Despite some potential link between MetS and glaucoma, no consensus has been reached; thus, there is not enough evidence. This study aimed at performing a systematic review of the association of MetS with the risk for glaucoma by collecting data from several observational studies.

This meta-analysis looked at observational studies that appeared up to August 12, 2024. Databases searched included PubMed, Embase, and Web of Science for the inclusion of relevant studies. In all, nine studies that included 2,258,797 participants were incorporated into this analysis. ORs with 95% CIs were used to measure the association between MetS and risk of glaucoma.

Heterogeneity was assessed by the I² statistics. A random-effects model was used due to high heterogeneity with I² = 75%. Subgroup and meta-regression analyses were conducted for the investigation of factors that may modify the findings.

The authors also looked at the associations of individual components of MetS, that is, hypertension, hyperglycemia, obesity, and dyslipidemia with the risk of glaucoma.

Key Findings

Overall Association:

  • MetS was strongly associated with an enhanced risk of glaucoma (OR: 1.34, 95% CI 1.15–1.55, p < 0.001).

  • Hypertension and hyperglycemia were significantly related to glaucoma.

  • Obesity and dyslipidemia show no significance but differences were not statistically significant (p=0.05).

Further research is needed to explore the underlying mechanisms linking MetS to glaucoma. Exploring whether controlling MetS can reduce glaucoma risk would also be valuable. This meta-analysis confirmed that metabolic syndrome is significantly associated with an increased risk of glaucoma. Such findings call for heightened awareness and integrated screening approaches for glaucoma among individuals with MetS to mitigate the risk of vision loss.

Reference:

Li F, Luo Y, Li X, Dai Y, Xiang Q. Association between metabolic syndrome and the risk of glaucoma: a meta-analysis of observational studies. Diabetol Metab Syndr. 2024 Dec 18;16(1):300. doi: 10.1186/s13098-024-01532-4. PMID: 39696489.

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Seven-Fold Increase in Depressive Symptoms Among Men with Type 1 Diabetes Signals Need for Intervention: Study

USA: Findings from a recent study highlight that men with type 1 diabetes were over seven times more likely to experience elevated depressive symptoms compared to men without diabetes (OR 7.4). Interestingly, no significant increase in risk was observed among women (OR 1.4).

“Elevated depressive symptoms were also associated with poorer diabetes self-management and reduced physical activity, emphasizing the importance of routine depression screening for men with type 1 diabetes,” the researchers wrote in Diabetes Research and Clinical Practice.

The researchers note that depression is more prevalent in diabetes, with 9–17.5% of adults with type 1 diabetes reporting elevated symptoms. Limited studies highlight sex differences, with higher rates in women. Depression negatively impacts insulin use, glucose monitoring, physical activity, and HDL, while increasing HbA1c, BMI, cholesterol, and cardiovascular complications in type 1 diabetes.

Against the above background, Kimberly A. Driscoll, University of Florida Diabetes Institute, University of Florida, Gainesville, FL, United States, and colleagues aimed to examine differences in the prevalence of elevated depressive symptoms between individuals with type 1 diabetes and those without diabetes, both overall and by sex, as well as the associations between depressive symptoms, HbA1c levels, self-management behaviors, and cardiovascular health.

For this purpose, the researchers analyzed data from adults with type 1 diabetes (n = 414; mean age 52 ± 9 years, diabetes duration 38 ± 9 years, mean HbA1c 7.8 ± 1.1 mg/dL, 55% female) and without diabetes (n = 488; mean age 51 ± 9 years, 51% female) from the fourth visit of the CACTI observational study.

Participants completed questionnaires on depressive symptoms and dietary intake, with those having type 1 diabetes also reporting on self-management behaviors. Hierarchical logistic regression models were used to identify demographic and clinical factors associated with depressive symptoms.

The following were the key findings of the study:

  • Depressive scores were higher in individuals with type 1 diabetes compared to those without diabetes, overall and across both sexes.
  • Men with type 1 diabetes had more than sevenfold increased odds of elevated depressive symptoms compared to men without diabetes (OR 7.4).
  • There was no significant increase in odds for women with type 1 diabetes compared to those without diabetes (OR 1.4).
  • There was a significant interaction between sex and diabetes status.
  • Higher depressive symptoms were linked to lower engagement in self-management behaviors and reduced physical activity.

The researchers report that 10% of adults with type 1 diabetes experience depressive symptoms based on BDI-II assessments.

“There is an urgent need to incorporate routine screening for depressive symptoms in adults with type 1 diabetes as part of standard medical care and to explore interventions aimed at reducing their impact on diabetes outcomes,” the researchers concluded.

Reference:

Driscoll, K. A., Geno Rasmussen, C. R., O’Donnell, H., Trojanowski, P., Alman, A. C., Keshawarz, A., & Snell-Bergeon, J. K. (2024). Men with type 1 diabetes had more than 7-fold odds of elevated depressive symptoms compared to men without diabetes. Diabetes Research and Clinical Practice, 111947. https://doi.org/10.1016/j.diabres.2024.111947

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Coffee May Enhance Cognition and Reduce Inflammation in Atrial Fibrillation

Researchers found that repeated consumption of coffee can be associated with enhanced cognitive performance and reduced inflammatory levels in older patients presenting with atrial fibrillation (AF). AF by itself is a known independent predictor of cognitive impairment, though coffee has been reported to have cognitive-enhancing benefits in healthy populations, and no data are available about its effect on vulnerable ones such as AF. Thus, a recent study was published aiming at this in the Journal of the American Heart Association conducted by Massimo B. and colleagues.

Daily coffee consumption was assessed by a structured nutrition questionnaire. Cognitive performance was measured using a comprehensive neurocognitive test battery that included the Montreal Cognitive Assessment (MoCA), Trail-Making Test, semantic fluency, and the Digit-Symbol Substitution Test.

Composite cognitive construct scores were obtained from these tests, thereby giving an overall measure of cognitive performance. The relationship of inflammatory markers, that is, high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6), with consumption of coffee was measured in this study. Linear mixed-effects models, adjusted to confounders, were adapted to analyze the data.

Key Findings

Cognitive Performance:

  • Results indicated that patients who consumed lesser than one cup of coffee were associated with a cognitive construct score of −0.24 (95% CI, −0.27 to −0.16).

  • Those who consumed more than five cups per day scored −0.10 (95% CI, −0.10 to 0.04; p=0.048).

  • MoCA score was 24.58 (95% CI, 24.58–25.32) for the reference group (<1 cup/day) and 25.25 (95% CI, 24.98–26.85; p=0.163) for the highest consumption group.

Inflammatory Markers:

  • Hs-CRP levels were lower with increased coffee consumption, with a factor of 0.78 (95% CI, 0.54–1.13; p=0.188) for the group consuming five or more cups compared to the reference group.

  • IL-6 levels were significantly lower by a factor of 0.73 (95% CI, 0.57–0.95; p=0.017) in the highest coffee consumption group.

This study may suggest an association between habitual coffee consumption, improvement in cognitive performance, and reduction in inflammation among older patients with atrial fibrillation. Further studies are essential to confirm the above conclusions and provide recommendations on incorporating coffee into the counseling approach for dietary management of AF.

Reference:

Barbagallo, M., Springer, A., Vanetta, C., Allemann, M., Lee, P., Saeedi, S., Aeschbacher, S., Luciani, M., Bonati, L. H., Moschovitis, G., Scheu, V., Rutishauser, J., Kobza, R., Di Valentino, M., Meyre, P. B., Rodondi, N., Conen, D., Kühne, M., Osswald, S., … the Swiss-AF investigators. (2024). Coffee consumption correlates with better cognitive performance in patients with a high incidence for stroke. Journal of the American Heart Association. https://doi.org/10.1161/jaha.124.034365

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Substituting pure maple syrup for refined sugars may reduce several cardiometabolic risk factors in humans: Study

A new study published in the The Journal of Nutrition, found that substituting two tablespoons of pure maple syrup for refined sugars reduced several cardiometabolic risk factors in humans. It was the first placebo-controlled clinical trial exploring potential health benefits of maple syrup in humans.

“We know from decades of research that maple syrup is more than just sugar. It contains over 100 natural compounds, including polyphenols, that are known to prevent disease in part through their anti-inflammatory effects,” remarked Dr. André Marette, PhD, and lead scientist on the study. “Because the fundamental chemistry of maple syrup is unique, I wondered if ingesting maple syrup instead of an equivalent amount of refined sugar would differently impact the cardiometabolic health and the intestinal microbiota in humans. The results were extremely encouraging. I did not expect to see so many improvements of risk factors within a relatively short treatment period.”

The study was conducted by a Laval University team led by Dr. André Marette, PhD, at the Quebec Heart and Lung Institute and Dr. Marie-Claude Vohl, PhD, at the Institute of Nutrition and Functional Foods.

Study Protocol

Forty-two volunteers from the greater Québec city area, between the ages of 18-75 in good health, and with a BMI of 23-40, participated in the study. Participants substituted 5% of their daily caloric intake (corresponding to 2 tablespoons) from refined sugars with either Canadian maple syrup or an artificially flavored sucrose syrup. Each phase lasted 8 weeks with participants switching between maple syrup and sucrose syrup groups after a four-week washout period. The cross-over design ensured that the same test subject was his or her own control, consuming both placebo and maple syrup. Primary outcomes focused on the oral glucose tolerance test, the OGTT. Secondary outcomes included changes in blood lipid profile, blood pressure, body fat composition (measured by DEXA scan) and changes in gut microbiota composition.

Maple, the Smarter Sweetener, Improves Multiple Cardiometabolic Risk Factors

Blood Sugar Lowered

Study participants who consumed pure maple syrup had an improved response to the oral glucose tolerance test (OGTT) than those who received a flavored syrup of refined sugar. Their bodies managed blood sugar levels better after eating (-50.59 vs. +29.93).

Blood Pressure Lowered

Blood pressure was also lowered in the subjects who consumed maple syrup during the trial. Systolic blood pressure decreased significantly in the maple syrup group (-2.72 mm Hg) while it increased slightly in the sucrose group (+0.87 mm Hg). “Lowering blood pressure continues to be an important factor in lessening the risk of cardiovascular disease,” Dr. Marette commented. “Natural sweeteners, such as pure maple syrup, when substituted for refined sugars, can be part of an overall solution in helping to prevent metabolic diseases.”

Abdominal Fat Reduced

Visceral fat is the deep fat that wraps around the internal organs in your belly. It can increase an individual’s risk of serious health problems such as heart disease, diabetes and stroke. The maple syrup trial showed that android fat mass, the fat in the abdominal region, significantly decreased in the maple syrup group as compared to an increase in the group consuming the sucrose solution (-7.83 g vs. +67.61 g).

Healthier Gut

An unexpected discovery was the improved levels of potentially beneficial gut bacteria and a decrease in levels of potentially harmful gut bacteria in the maple syrup participants. The study showed a reduction in Klebsiella species and Bacteroides pectinophilus, which are linked to inflammation and metabolic disorders, and the increased growth of beneficial bacteria like Lactocaseibacillus casei and Clostridium beijerinckii.

“Both individually and collectively, the study findings are quite significant,” Dr. Marette noted. “The combined decrease of such key risk factors may help to reduce the risk of diabetes and cardiovascular disease. Making a commitment to lifestyle changes and small adjustments to our everyday diets is important and can be a powerful tool in preventing future diseases.”

According to one participant: “Before the study, I would consume pure maple products regularly but not consistently. I have always enjoyed it. Today my routine is to replace refined sugars with 2 tablespoons of pure Canadian maple syrup daily.”

First Human Trial Builds Upon American Researcher’s Cellular and Animal StudiesNavindra P. Seeram,

Dr. Marette’s clinical study builds upon his own work in animal models of diabetes and previous work on maple syrup and its bioactives by American scientist  PhD, of the University of Rhode Island, College of Pharmacy. Dr. Seeram’s extensive foundational work with maple syrup set the stage for this first human clinical trial. “With each new study, we learn more benefits that natural products from medicinal plants and functional foods, like maple syrup, provide.” noted Dr. Seeram. “The significant promising results of this first human trial provide more reasons for us to educate consumers about maple syrup’s many health benefits. It is truly a ‘smarter sweetener’ and a healthier alternative to refined sugar.”

“While this study was limited to a relatively small sample size (42 men and women) and took place during a relatively short duration of time, the results are still significant,” Dr. Marette remarked. “We now have human evidence to support replacing refined sugars with maple syrup, a natural sweetener, for preventing metabolic diseases. Our next goal is to conduct larger studies with other populations to explore how replacing refined sugars with maple syrup might impact their unique health conditions.”

General nutrition claims for 2 tablespoons of maple syrup:

• Excellent source of manganese (35%).

• Good source of riboflavin (15%).

• Source of calcium (2%), thiamin (2%), potassium (2%) and copper (8%).

• It contains 12% fewer calories than in light corn syrup.

• By comparison, refined sugar requires a large amount of processing and therefore lacks any real nutritional value. 

Reference:

Arianne Morissette, Anne-Laure Agrinier, Théo Gignac, Lamia Ramadan, Khoudia Diop, Julie Marois, Thibault V Varin, Geneviève Pilon, Serge Simard, Éric Larose, Claudia Gagnon, Benoit J Arsenault, Jean-Pierre Després, Anne-Marie Carreau, Marie-Claude Vohl, André Marette, Substituting Refined Sugars With Maple Syrup Decreases Key Cardiometabolic Risk Factors in Individuals With Mild Metabolic Alterations: A Randomized, Double-Blind, Controlled Crossover Trial, The Journal of Nutrition, https://doi.org/10.1016/j.tjnut.2024.08.014.

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Prenatal SSRI Exposure Increases Risk of Functional Constipation: Study

Prenatal selective serotonin reuptake inhibitors (SSRIs) have been related to an increased risk of functional constipation in children, according to researchers. A recent Danish study was conducted by Kildegaard and colleagues which was published in the journal Molecular Psychiatry.

Previous preclinical data suggested that serotonin is critical for the development of the gut because it regulates gut innervation and colonic motility. The objective of this population-based study conducted by using Danish registries was to investigate the relationship between maternal SSRI use during pregnancy and disorders of gut-brain interaction (DGBI) in offspring.

All single-birth children from Denmark born between 1997 and 2015 were included in the study with follow-up until a diagnosis of DGBI, 15 years of age, death, emigration, or to the end of December 2018. The cohort was divided into two: the SSRI-exposed group and the unexposed group.

  • SSRI-exposed group: Children whose mothers took SSRI during pregnancy.

  • The unexposed group: Children whose mothers stopped taking SSRI before their pregnancy.

Cox regression analysis was used to estimate the risk of developing DGBI, including functional nausea and vomiting, abdominal pain disorders, functional diarrhea, and functional constipation. Laxative use prescribed by physicians was also included as an indicator of functional constipation.

Key Findings

The study analyzed a total of 1,158,560 children, of whom:

  • 21,969 children (1.9%) were exposed to SSRIs prenatally.

  • 30,174 children (2.6%) were born to mothers who discontinued SSRIs before pregnancy.

The 15-year cumulative incidence of any DGBI was:

  • 15.5% (95% CI, 14.9–16.2%) in the SSRI-exposed group.

  • 14.7% (95% CI, 14.0–15.3%) in the unexposed group.

  • SSRI-exposed children had an 8% higher overall risk of DGBI (HR: 1.08, 95% CI: 1.02–1.14).

  • SSRI-exposed children had a 19% higher risk of functional constipation (HR: 1.19, 95% CI: 1.10–1.28).

No significant associations were found for other DGBIs:

  • Functional nausea and vomiting: HR 0.97 (95% CI: 0.83–1.13).

  • Functional abdominal pain disorders: HR 0.90 (95% CI: 0.81–1.00).

In conclusion, this large population-based study demonstrated an association between prenatal exposure to SSRIs and an increased risk of functional constipation in children. These results support preclinical evidence emphasizing the role of serotonin in gut development and function. These findings underscore the importance of further research into long-term consequences of maternal SSRI use on offspring gastrointestinal health.

Reference:

Kildegaard, H., Bliddal, M., Ernst, M.T. et al. Prenatal exposure to selective serotonin reuptake inhibitors and risk of disorders of gut-brain interaction in children. Mol Psychiatry (2024). https://doi.org/10.1038/s41380-024-02848-3

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Intralesional corticosteroids remain effective treatment option for patchy Alopecia areata: Study

Intralesional corticosteroids remain an effective treatment option for patchy Alopecia areata, reveals research published in the Archives of Dermatological Research.

Alopecia areata (AA) is a chronic, immune-mediated inflammatory disorder characterized by nonscarring hair loss. The management of Alopecia areata poses challenges due to its unpredictable course and variable response to treatment. In this comparative study, we evaluated the efficacy and safety of oral apremilast, intralesional corticosteroids (ILC) and a combination of both in patients with patchy Alopecia areata. Sixty patients with patchy Alopecia areatawere randomly assigned to three treatment groups: oral apremilast (Group A), ILC (Group B), and a combination of both (Group C). The Severity of Alopecia Tool (SALT) score was used to assess the extent of hair loss before treatment, after 3 months, and at 6 months of follow-up. Adverse events and complications were also monitored. The changes in SALT score from baseline between the three groups were assessed by using non-parametric statistical tests. The statistical significance was judged at 5% level of significance. Results: Findings demonstrated significant higher reduction in median SALT scores after treatment i.e., 2.47 (1.76, 5.07), p < 0.001 as well as after six months follow up 5.08 (3.80, 7.53), p < 0.001 in patients treated with ILC compared to other two groups. Neither apremilast monotherapy nor its combination with ILC demonstrated statistically significant improvement, although individual responses were observed. Complications were minimal, with transient pain and burning sensation reported during ILC injections and a few cases of gastritis and relapse in the oral apremilast group. These findings suggest that ILC remains an effective treatment option for patchy Alopecia areata. This study did not demonstrate statistically significant efficacy of oral apremilast, either as monotherapy or in combination with ILC, though larger studies may be needed to evaluate potential benefits in specific patient subgroups. Further research with larger sample sizes and longer-term follow-up is needed to validate these findings and optimize treatment approaches for Alopecia areata.

Reference:

Awasthi, S., Nijhawan, M., Mishra, A. et al. Comparing the efficacy of oral apremilast, intralesional corticosteroids, and their combination in patients with patchy alopecia areata: a randomized clinical controlled trial. Arch Dermatol Res 317, 129 (2025). https://doi.org/10.1007/s00403-024-03642-5

Keywords:

Intralesional, corticosteroids, remains, effective, treatment, option, patchy, Alopecia areata, reveals, research, Archives of Dermatological Research, Awasthi, S., Nijhawan, M., Mishra, A

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