Super Specialty Hospital to be built in Bareilly

Bareilly: Chief Minister Yogi Adityanath on Tuesday directed officials to prepare a proposal for the construction of a super-specialty hospital in Bareilly, to be built on the vacant land of the mental hospital, integrating 300 beds.

During the divisional review meeting at the Vikas Bhawan auditorium, the CM directed the officials to submit the proposal to the government, emphasising that this initiative would enhance modern medical facilities in the region.

He also urged public representatives to adopt at least one TB patient each to raise public awareness about the disease. He highlighted the importance of addressing long-pending legal cases, stating that unresolved cases often lead to new crimes. He stressed the need for their swift resolution to maintain law and order, news agency UNI reported.

Reaffirming Bareilly’s status as a Smart City, Yogi directed that all divisional and district-level offices be housed under one roof for better governance. He directed the officials to draft a proposal for this initiative and make necessary arrangements.

Also Read:CM Yogi inaugurates Jhansi’s New Smart City Hospital

To improve crime control and traffic management, he called for the effective implementation of the Intelligent Traffic Management System and mandated the verification of e-rickshaws and taxis.

During the meeting, Divisional Commissioner Saumya Agarwal provided updates on the region’s progress, including completing 25 km of fencing in the Pilibhit Tiger Reserve. She also highlighted that between 2022 and 2024, 12 aspirational development blocks in the division had received recognition from both the central and state Governments.

Reviewing the resolution of revenue cases, the CM reiterated that cases pending for over a year often become flashpoints for disputes, affecting law and order. He directed the officials to expedite their resolution to ensure justice for the common people.

He directed that, as Bareilly serves as the commissionerate headquarters, a comprehensive record of all available government land should be prepared and handed over to the development authority. Besides, he directed that chambers and canteens for lawyers should be kept clean, and a conducive environment should be provided for the public.

Also Read:CM Yogi Inaugurates Sharda Care Health City Super Speciality Hospital

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Dr Abdul Hamid Zargar Takes Charge as Director of Health Services Jammu

Jammu: Dr. Abdul Hamid
Zargar has officially taken over as the Director of Health Services (DHS) Jammu. He was warmly welcomed by the staff upon his arrival at the Directorate, marking the start of his tenure in this esteemed position.

Dr. Zargar completed his
MBBS from Government Medical College (GMC) Srinagar, graduating in the 1983–1989 batch, and later pursued an MS in Surgery from Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Srinagar. With over 15 years of experience in administrative roles, he has held several important positions within the health department.

Also Read:Dr S Raja Sabapathy takes over Presidency of International Federation of Societies for Surgery of the Hand

His career includes
serving as Block Medical Officer from 2011 to 2021, followed by a tenure as
Medical Superintendent at District Hospital Ramban from 2021 to 2022. He
subsequently held the position of Chief Medical Officer in Rajouri (2022-23)
and Doda (2023-24), before taking charge as Medical Superintendent of
Government Hospital Gandhinagar from 2024 until March 2025. 

Dr. Zargar stepped into
his new role as Deputy Director, Headquarters, assuming additional
responsibilities as Director of Health Services, Jammu. Director Health Services
Jammu congratulated the doctor while stating that his vast experience and
leadership in various capacities are expected to contribute significantly to
the healthcare sector in the region.

The staff from District Doda, led by CMO Doda Dr. Om Kumar, also joined in extending their heartfelt congratulations to Dr. Zargar on his appointment to this prestigious position, acknowledging his immense experience and leadership skills. Dr. Om Kumar and the staff expressed their confidence that under Dr. Zargar’s guidance, the department will reach new heights in the health sector.
As a token of respect and admiration, Dr. Zargar was garlanded and presented with a bouquet by the staff. They wished him the very best in his new role and expressed hope for continued progress and success under his leadership. The event marks a new chapter in the administration of health services in Jammu, with Dr. Zargar taking the helm to lead the department toward further advancements and improvements in healthcare delivery.
Also Read:Abbott India appoints Devesh Choudhari as Director – Finance

After assuming the charge
of Director Health Services Jammu, Dr. Zargar visited SDH Jagti on 2nd April,
2025 to monitor and assess healthcare services and facilities being provided
to patients. He discussed with Medical Superintendent SDH Jagti in detail about
the routine functioning of the Hospital and asked to put forward various
deficiencies that the hospital is facing in terms of infrastructure and staff strength. He also conducted a detailed round of various sections of the
hospital, including the Emergency Room, indoor wards, various OPD sections, the labour
Room, and the Ayushman Bharat Section. He also interacted with doctors and
paramedical staff and asked them to be patient-friendly and work with
dedication.

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No Recruitment in 8 years: Karnataka Doctors’ Association Opposes Superspecialist Retirement Age Extension

Bengaluru: Doctors
from the Karnataka Association of Resident Doctors (KARD) have vehemently
opposed the state government’s proposal to extend the retirement age to 65
solely for faculty members in superspecialty departments.

The association expressed
concerns that this move would hinder career advancement opportunities for
younger doctors by prolonging senior faculty tenure, thereby limiting permanent positions.

Also Read:Poor infrastructure, teaching standards! Karnataka Govt crackdown on Paramedical colleges

The retirement age for
faculty is proposed to be increased from 60 to 65 for superspeciality courses, and there has been no permanent recruitment for the last 8 years. However, the association
members pointed out a number of issues related to the decision, including the
capability to handle extreme workloads and long hours of night duties at that
age.

The association is urging
the government to reconsider the proposal and instead focus on increasing
permanent recruitment in superspecialty departments to ensure fair career
growth opportunities for all medical professionals.

Talking to Medical
Dialogues on the condition of anonymity, one of the members of KARD pointed out
that the last round of permanent recruitment in superspecialty departments took
place in 2017. Since then, vacancies have primarily been filled through
contractual appointments, with doctors receiving a fixed monthly salary of Rs 70,000
to Rs 75000. The resident doctors argued that extending retirement age for only
superspecialists would further reduce prospects for younger medical
professionals, who are already struggling to secure stable positions in
government institutions.

Also Read:Stipend hike of 25 percent for Resident Doctors in Karnataka

“Karnataka medical institutions
produce about 70 to 80 superspecialist graduates every year. Hence,
Karnataka has one of the highest outputs of superspecialists. Nearly 400 to 500 young
superspecialists are all ready to join government service but govt needs to create
more permanent posts so that these people can have their career growth. If the
government go ahead with the proposal without holding any permanent recruitment
drive, it would be an injustice to them,” they claimed.

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Oral semaglutide vastly reduces heart attacks, strokes in people with type 2 diabetes, suggests study

Both the injectable and oral forms of semaglutide, a glucagon-like peptide-1 receptor agonist, have gained recent attention for their effectiveness against weight gain, high blood sugar, and even alcohol cravings.

A new clinical trial, co-led by endocrinologist and diabetes expert John Buse, MD, PhD, and interventional cardiologist Matthew Cavender, MD, MPH, at the UNC School of Medicine has shown that the oral form of semaglutide can significantly reduce cardiovascular events in people with type 2 diabetes, atherosclerotic cardiovascular disease, and/or chronic kidney disease.

“Heart attacks and strokes are among the most common and devastating complications of diabetes,” said Buse, who is the Verne S. Caviness Distinguished Professor of Medicine and Director of the UNC Diabetes Care Center. “Semaglutide has been a main stay of our efforts to reduce heart attack and stroke in people with diabetes. Having an oral option to deliver this highly effective therapy is a big advance.”

John B. Buse, MD, PhD

Results from the rather large, international trial were published in the New England Journal of Medicine and presented at the American College of Cardiology’s Annual Scientific Session & Expo in Chicago, Illinois.

Type 2 diabetes is a progressive disease that affects one’s ability to control blood sugar levels.

People with the condition need to closely monitor their diet and activity and may need to take medications as their blood sugar becomes more difficult to manage. Those with type 2 diabetes are at a significantly higher risk of cardiovascular disease because they may develop high blood pressure, high cholesterol, or both, as a result of uncontrolled blood sugar.

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, have shown much potential for lowering blood sugar, but little is known about whether the oral form of semaglutide actually decreases major cardiovascular events, such as heart attacks and stroke.

The Semaglutide cardiOvascular oUtcomes triaL (SOUL) recruited 9,650 people for the study who have pre-existing cardiovascular disease, such as coronary artery disease, symptomatic peripheral arterial disease, cerebrovascular disease, or chronic kidney disease. The trial was sponsored and funded by pharmaceutical company Novo Nordisk, Inc.

Participants were divided into a placebo group (no medication) and a drug group to see if those taking oral semaglutide were more or less likely to experience major cardiac events. Both groups were given standard-of-care glucose-lowering and cardiovascular risk-reducing therapies according to local guidelines. Those in the medication group took a once-daily 14mg dose of oral semaglutide.

Researchers found that oral semaglutide decreased the risk of major cardiovascular events by 14% compared to placebo across age and gender. Of all types of major cardiac events studied in the clinical trial, nonfatal myocardial infarction saw the greatest reductions in risk.

The effect of oral semaglutide on cardiovascular outcomes was consistent with other clinical trials involving injectable semaglutide, but more trials are needed to determine if one method may be more effective than the other at reducing major cardiovascular events.

References: Authors: Darren K. McGuire, M.D., M.H.Sc., Nikolaus Marx, M.D., Sharon L. Mulvagh, M.D., John E. Deanfield, M.D., Silvio E. Inzucchi, M.D., Rodica Pop-Busui, M.D., Ph.D., Johannes F.E. Mann, M.D., +11 , for the SOUL Study Group*Author Info & Affiliations Published March 29, 2025 DOI: 10.1056/NEJMoa2501006

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Routine Thoracentesis in Acute Heart Failure: No Significant Clinical Benefit, Study Reports

Denmark: A recent randomized controlled trial evaluated the impact of routine thoracentesis in patients with acute heart failure and pleural effusion. Thoracentesis, a procedure to drain excess fluid from the pleural space, has been considered a potential adjunct to standard medical therapy in these patients. However, the study findings suggest that upfront thoracentesis does not significantly improve clinical outcomes compared to standard medical treatment alone. 

“For patients with acute heart failure and pleural effusion, routine upfront thoracentesis offered no advantage over standard medical therapy alone in improving clinical outcomes at 90 days,” the researchers reported in Circulation.

Pleural effusion is common in acute heart failure, with large effusions seen in about 20% of cases. Thoracentesis can provide immediate symptom relief but carries risks, and no randomized trials have assessed its benefits in heart-failure-related pleural effusion. With the increasing use of thoracentesis, there is a need for evidence. In the TAP-IT trial, Signe Glargaard, Department of Cardiology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Denmark, and colleagues examined the impact of adding therapeutic thoracentesis to standard medical therapy in patients with acute heart failure and significant pleural effusion.

For this purpose, the researchers conducted a multicenter, unblinded, randomized controlled trial between August 31, 2021, and March 22, 2024, involving patients with acute heart failure, left ventricular ejection fraction ≤45%, and notable pleural effusion. Those with very large effusions (over two-thirds of the hemithorax) were excluded. Participants were randomly assigned to either upfront ultrasound-guided pleural pigtail catheter thoracentesis with standard medical therapy or standard therapy alone.

The primary outcome was days alive out of the hospital over 90 days, while key secondary outcomes included length of hospital stay and 90-day all-cause mortality, analyzed using the intention-to-treat approach.

The study revealed the following findings:

  • The trial included 135 patients with a median age of 81 years, 33% of whom were female.
  • The median left ventricular ejection fraction was 25%.
  • Patients were randomized into two groups: 68 received thoracentesis, while 67 received standard medical therapy.
  • The thoracentesis group had a median of 84 days alive out of the hospital over 90 days, compared to 82 days in the control group.
  • Mortality rates were identical at 13% in both groups, with no significant difference in survival probability.
  • The median hospital stay was similar: 5 days in both groups.
  • Major complications occurred in only 1% of thoracentesis procedures.

This trial, the first randomized study on thoracentesis for pleural effusion in heart failure, found that adding routine thoracentesis to standard medical therapy did not improve survival or reduce hospital stays over 90 days. The procedure was safe, with a low complication rate of 1%.

“While variability in outcomes may have affected statistical power, these findings provide a foundation for future research to further explore the role of thoracentesis in managing acute heart failure with pleural effusion,” the authors concluded.

Reference: https://doi.org/10.1161/CIRCULATIONAHA.124.073521

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De-escalation Strategy: Ticagrelor to Clopidogrel in AMI Patients improves outcomes in patients with low BMI: JAMA

Researchers have found in a new research that switching from ticagrelor to clopidogrel in acute myocardial infarction (AMI) patients showed improved clinical outcomes in individuals with a lower body mass index (BMI). However, this benefit was not observed in patients with a higher BMI.

The potential benefits of P2Y12 inhibitor deescalation for acute myocardial infarction after percutaneous coronary intervention may be influenced by body mass index (BMI). A study was done to investigate the association of BMI on deescalation outcomes after 12 months in patients with acute myocardial infarction after percutaneous coronary intervention who were initially treated with aspirin plus ticagrelor for 1 month, and to assess whether BMI-based switching from aspirin plus ticagrelor (active control strategy) to aspirin plus clopidogrel (deescalation strategy) is associated with individualized benefits.

This study is a post hoc analysis, based on BMI, of data from the TALOS-AMI (Ticagrelor vs Clopidogrel in Stabilized Patients with Acute Myocardial Infarction) randomized clinical trial. Data were collected from February 14, 2014, to December 31, 2018, with follow-up to January 21, 2021. Analyses were conducted from December 1, 2021, to August 21, 2024. Among 2697 trial participants from 32 centers in South Korea, 2686 participants whose BMI data were available were included. All patients received aspirin plus ticagrelor for 1 month after percutaneous coronary intervention. Stabilized patients were then randomized to either the active control or deescalation strategy for an additional 11 months.

The primary end point was a composite of cardiovascular death, myocardial infarction, stroke, and Bleeding Academic Research Consortium bleeding type 2, 3, or 5 at 12 months after percutaneous coronary intervention. The trial compared the active control and deescalation strategies according to BMIs, including an interaction test. Results Of the 2686 patients included (mean [SD] age, 60.0 [11.4] years; 2234 [83.2%] male), 2344 (1161 in the deescalation group and 1183 in the active control group) had a BMI less than 28, and 342 (184 in the deescalation group and 158 in the active control group) had a BMI of 28 or greater. The deescalation strategy was associated with significantly reduced composite outcomes compared with the active control strategy in the group with a BMI less than 28 (53 [4.6%] vs 98 [8.3%]; adjusted hazard ratio, 0.54; 95% CI, 0.39-0.76; P < .001), primarily due to fewer bleeding complications.

The group had no association with a BMI of 28 or greater. In this post hoc analysis of the TALOS-AMI randomized clinical trial, in stabilized patients with acute myocardial infarction, an unguided deescalation strategy of switching from ticagrelor to clopidogrel after 1 month was associated with better clinical outcomes in those with lower BMIs.

Reference:

Bu S, Kim CJ, Lim S, et al. BMI and Deescalation From Ticagrelor to Clopidogrel in Patients With Acute Myocardial Infarction: A Post Hoc Analysis of the TALOS-AMI Trial. JAMA Netw Open. 2025;8(2):e2461916. doi:10.1001/jamanetworkopen.2024.61916

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Weight-Adjusted Waist Index Identified as Strong Predictor of AMD Risk, reveals research

Researchers have established in a new study that the weight-adjusted waist index is a much better predictor of age-related macular degeneration (AMD) risk than conventional measures of obesity like body mass index (BMI) and waist circumference (WC). In a study from Fujian, China, researchers found that there was a non-linear positive association between the index and prevalence of AMD. Results indicate that those with a greater weight-adjusted waist index have significantly higher odds of developing AMD, highlighting the need for early intervention and screening. The study was conducted by Wu Y. and colleagues published in the Frontiers in Medicine journal.

The research utilized NHANES data from 2005 to 2008, with 20,497 participants. After excluding participants under 40 years old, those with missing information on WC, weight, or other variables of interest, the analysis was finally performed on 5,132 participants. The cohort was close to evenly split by gender, with 50.16% female and 49.84% male. Retinal photography was done in all participants, and AMD was diagnosed according to standard fundus examination criteria.

Weight-Adjusted Waist Index Calculation and Tertile Categorization

Weight-adjusted waist index was calculated by dividing WC by the square root of weight in kilograms. Participants were categorized into three tertiles:

• Tertile 1: 8.59 – 10.85

• Tertile 2: 10.85 – 11.52

• Tertile 3: 11.52 – 15.70

• Participants in the top tertile had 1.9 times increased risk for AMD versus those in the lowest tertile (Odds Ratio [OR] = 2.90, 95% Confidence Interval [CI]: 2.18-3.86; p <.0001).

• Increased weight-adjusted waist index was also associated with raised BMI, WC, weight, diabetes, and hypertension.

• The analysis found a critical threshold effect at an index value of 12.11. Below this threshold, the risk of AMD increased significantly (OR = 1.50, 95% CI: 1.04-2.16; p =.0300).

• Beyond this threshold, however, the risk did not increase (OR = 0.75, 95% CI: 0.39-1.45; p =.3943).

• Furthermore, with every unit rise in the index, the risk of developing AMD rose by 76%.

To determine the predictive value of the weight-adjusted waist index, the researchers conducted receiver operating characteristic (ROC) curve analysis and compared its performance with BMI, WC, and weight. The area under the curve (AUC) values were as follows:

• Weight-adjusted waist index: 0.625

• Weight: 0.560

• BMI: 0.530

• Waist circumference: 0.508

The study authors concluded that the weight-adjusted waist index is a better predictor of AMD risk than BMI, weight, and waist circumference. Those with higher index values are more likely to develop AMD, with a notable threshold effect at 12.11. These results underscore the importance of employing more accurate obesity measures for AMD risk prediction and support the call for early detection and intervention strategies in high-risk groups.

Reference:

Wu Y, Liu Y, Jiao Z, et al. Association between the weight-adjusted waist index and age-related macular degeneration in US adults aged≥40 years: The NHANES 2005–2008. Frontiers in Medicine. 2025;12. doi:10.3389/fmed.2025.1552978

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Long-term practice of Transcendental Meditation may reduce both stress and aging: Study

A collaborative study conducted by researchers at Maharishi International University (MIU), the University of Siegen, and the Uniformed Services University of the Health Sciences reveals that individuals practicing Transcendental Meditation® (TM®) technologies long-term show favorable biological markers of aging and stress. The research compared gene expression, cognitive function (via EEG), and hair glucocorticoids (cortisol and cortisone) in 12-year and 40-year TM groups and non-meditator controls.

“This study provides evidence that long-term practice of TM technologies has a broad range of health benefits at the molecular level,” said Supaya Wenuganen of MIU, one of the lead authors. “The gene expression differences, cognitive function indicators, and lower cortisol levels after long-term TM practice relate to each other in ways suggesting reduction of both stress and aging.”

The article, Possible Anti-Aging and Anti-Stress Effects of Long-Term Transcendental Meditation Practice: Differences in Gene Expression, EEG Correlates of Cognitive Function, and Hair Steroids, appears in a special issue of Biomolecules entitled: “Molecular Advances in Mechanism and Regulation of Lifespan and Aging.”

Altered Gene Expression Indicates Reduced Inflammation, Lower Stress, and Slower Biological Aging

In the study, researchers found that expression of genes associated with inflammation and aging, such as the SOCS3 gene, was lower in TM practitioners (Figure 1). SOCS3 is linked to both chronic stress and energy metabolism, and the results in meditators may indicate lower “allostatic load”-the body’s cumulative burden from chronic stress.

Co-author Kenneth Walton, a senior researcher at MIU, explained “The lower expression of age-related genes and lower hair cortisol in the TM groups extend the findings of short-term studies indicating these practices lead to healthy aging and more resilient adaptation to stress.”

EEG Analysis Shows Slower Age-Related Decline in Cognitive Function

Cognitive function, known to decline with age, was another key area of the study. Using EEG recordings, researchers measured latency of N2 and P3 evoked potential responses—a marker of cognitive processing speed-and observed that older TM practitioners had processing speeds close to those of younger participants (Figure 2). Additionally, TM practitioners scored higher on the Brain Integration Scale (BIS), a comprehensive measure of cognitive performance that includes reaction time, brainwave coherence, and attention.

“The findings around cognitive function are particularly exciting,” added co-author Frederick Travis. “Both younger and older TM practitioners showed higher scores on the BIS compared to non-meditators. The older meditators performed on par with young controls. This reinforces the findings on evoked potential responses, further suggesting a protective effect against cognitive decline with age.”

Lower Ratio of Cortisol to Cortisone in Hair May Indicate Increased Resilience

Hair cortisol concentration (Hair F) and concentration of its inactive precursor, cortisone (Hair E), were measured in all participants. The results showed that the ratio of active to inactive forms was consistently lower in TM practitioners compared to non-meditators, providing further evidence of reduced stress levels (Figure 3). This result aligns with previous findings indicating that regular practice of TM helps maintain a state of lower stress.

“Cortisol plays a critical role in the body’s response to stress, and chronically high cortisol levels are associated with a host of age-related health issues in addition to cognitive decline” Walton explained. “The reduced cortisol-to-cortisone ratio in meditators suggests they have more adaptive reserve, more resilience, contributing to overall health and longevity.”

Building on Previous Research in the Field of Meditation and Aging

The study builds upon prior research from MIU and elsewhere indicating health benefits of Transcendental Meditation technologies, including reduced cardiovascular risk, and improved mental health. By examining a range of biological, cognitive, and stress-related markers, this study offers a look at how meditation might holistically influence health long-term.

Future Directions

This research adds to a growing body of evidence supporting meditation as a tool for health and wellness. Future studies will focus on the biological pathways involved in the observed changes, such as the role of energy metabolism and inflammation pathways in mediating the anti-aging effects.

Reference:

Wenuganen, S.; Walton, K.G.; Travis, F.T.; Stalder, T.; Wallace, R.K.; Srivastava, M.; Fagan, J. Possible Anti-Aging and Anti-Stress Effects of Long-Term Transcendental Meditation Practice: Differences in Gene Expression, EEG Correlates of Cognitive Function, and Hair Steroids. Biomolecules 2025, 15, 317. https://doi.org/10.3390/biom15030317

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JAMA: Oral mizoribine with glucocorticoids safe and effective for treatment initiation in lupus nephritis

A new study published in the Journal of American Medical Association showed that when taken with glucocorticoids for induction treatment of active lupus nephritis, oral mizoribine was well tolerated and noninferior to intravenous cyclophosphamide.

Intravenous cyclophosphamide is commonly used to treat lupus nephritis, however it has significant side effects. An option to induction treatment for lupus nephritis might be oral mizoribine. There are not many extensive, long-term clinical trials with mizoribine, though. Thus, to evaluate the safety and effectiveness of oral mizoribine against IV cyclophosphamide as induction treatment for Chinese patients with lupus nephritis, Zheyi Dong and colleagues carried out this investigation.

The patients with class III, III+V, IV, IV+V, or V lupus nephritis between the ages of 18 and 70 were recruited from 40 Chinese facilities for this clinical study. A 24-hour urine protein level of 1.0 g or more and a systemic lupus erythematosus disease activity index of 8 or higher were prerequisites for inclusion. The trial concluded on March 14, 2019, with the first patient being enrolled on November 29, 2014. 52 weeks was the follow-up period.

Analysis of the data took place between September 4, 2019, and January 21, 2020. For 52 weeks, oral glucocorticoids were administered together with oral mizoribine (50 mg, three times a day) or cyclophosphamide (6 intravenous doses at 0.5-1.0 g/m2 body surface area, with a maximum dosage of 1.0 g/d).

A total of 250 patients in all were randomized, and 243 of them received treatment (120 patients [49.4%] received cyclophosphamide, and 123 patients [50.6%] received mizoribine). The relative risk ratio (mizoribine vs. cyclophosphamide) was 0.861, and the overall remission rate at 52 weeks was 66.1% (76 of 115 patients) for the mizoribine group and 76.8% (86 of 112 patients) for the cyclophosphamide group.

Mizoribine was not inferior to cyclophosphamide, as shown by the 2-sided 95% CI’s lower limit being higher than the noninferiority margin of 0.726. Kidney function and other immunological parameter changes were mostly comparable among the groups.

Upper respiratory tract infections were the most common adverse event in both groups, with the frequency of any treatment-related treatment-emergent adverse events being 80.5% in the mizoribine group and 78.7% in the cyclophosphamide group. Overall, this study found that induction treatment with oral mizoribine in conjunction with glucocorticoids seems to be both safe and effective for Chinese patients with lupus nephritis.

Reference:

Dong, Z., Luo, P., Sun, S., Ni, Z., He, Y., Huang, X., Liu, Z., Wu, Z., Zhang, X., Liao, Y., Zhao, J., Lin, H., Zhang, X., Fu, R., Ding, G., Xu, Y., Wang, L., Xiao, Y., Shi, S., … Chen, X. (2025). Mizoribine or cyclophosphamide for lupus nephritis: A randomized clinical trial. JAMA Network Open, 8(3), e250648. https://doi.org/10.1001/jamanetworkopen.2025.0648

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Excessive Water Intake Identified as Rare Trigger for Asthma Exacerbation: Case Report

China: A recent case report has highlighted an unusual trigger for asthma exacerbation—excessive water consumption. While asthma is commonly worsened by allergens, air pollution, smoking, and viral infections, fluid overload as a contributing factor remains largely unreported. This rare case emphasizes the need for clinicians to consider fluid balance in asthma management.

The case, published in Clinical Medicine Insights: Case Reports, involved a 72-year-old man in China who had been managing bronchial asthma for two years with inhaled and oral medications. Upon hospitalization for worsening chest tightness, wheezing, and shortness of breath, he was treated with standard asthma therapies, including nebulized bronchodilators, corticosteroids, and oxygen therapy. Initially, his symptoms showed mild improvement, but his condition unexpectedly worsened despite ongoing treatment.

“Upon further investigation, we discovered that the patient had been consuming large amounts of water—approximately 3.5 liters daily, in addition to intravenous fluids—due to persistent dry mouth from oxygen therapy. However, his fluid output was significantly lower, resulting in a serious positive fluid balance. The excessive fluid retention was suspected to contribute to pulmonary congestion, further aggravating his asthma symptoms,” Huachen Jiao, Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China, and colleagues described in their case report.

As his condition deteriorated, his medical team introduced diuretics, including intravenous furosemide and bumetanide, to reduce fluid overload. Simultaneously, his fluid intake was strictly regulated, and careful monitoring of his daily intake and output was initiated. Over the following days, his asthma attacks became less frequent and severe, and his breathing difficulties gradually improved. The patient’s condition stabilized, and he was eventually discharged with well-controlled symptoms.

This case suggests that excessive fluid intake may exacerbate asthma symptoms by increasing blood volume and promoting pulmonary edema, leading to breathing difficulties. The findings emphasize the importance of fluid balance in asthma management, particularly in hospitalized patients receiving oxygen therapy. While rare, this report highlights the need for clinicians to be vigilant about excessive fluid consumption as a potential risk factor for asthma exacerbation.

“Given the limited data available on this phenomenon, further studies are necessary to establish the exact mechanisms by which excessive water intake influences asthma and to develop guidelines for fluid management in patients with respiratory conditions. Recognizing and addressing fluid overload may help improve asthma outcomes and reduce prolonged hospital stays for affected individuals,” the authors concluded.

Reference:

Lv, S., Jiao, H., Qu, Y., Zhang, M., Wang, R., Li, Y., Jiang, F., & Xin, L. (2024). A Case Report of Asthma Exacerbation Induced by Excessive Drinking Water. Clinical Medicine Insights: Case Reports. https://doi.org/10.1177/11795476241253107

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