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World Multiple Sclerosis Day 2022 May 30thCOVID-19 VACCINES AND MS- M.A.Aleem Neurologist ABC Hospital Trichy
World Multiple Sclerosis Day 2022 May 30th
COVID-19 VACCINES AND MS
- M.A.Aleem Neurologist ABC Hospital Trichy
World Multiple Sclerosis Day, falling on May 30th. Multiple Sclerosis (MS) is a chronic progressive disease where the insulating covers of the nervous system are damaged. MS is also known as encephalomyelitis disseminata, and its symptoms include muscle weakness, double vision, and mental/physical problems. Due to the lack of research studies on the disease, the exact causes behind it are generally unknown. Many scientists believe that there might be a connection between the onset of the disease and genes and/or nerve-cell dysfunction. Furthermore, there is no permanent cure as of yet. The symptoms can be relieved using the right set of treatments and medication. Im
The first World Multiple Sclerosis Day was celebrated in 2009 by the Multiple Sclerosis International Federation (MSIF). MSIF was officially established in 1967 as an international body that coordinated with national MS organizations belonging to many countries like Turkey, Slovakia, India, and the U.S.
The federation aims to bring light to MS and the scientific research related to it. The theme for this year’s World Multiple Sclerosis Day is ‘Connect.’ This theme, which continues from 2020 through 2022, focuses on bringing the world together by forming a connection with each other as well as the self for the sake of better care.
In this article we will know more about COVID-19 vaccination in patients with Multiple sclerosis
Given the seriousness of COVID-19 – which carries a 1-3% mortality risk as well as risk for serious illness and prolonged ill-health for many it is better to know the following points :
All people with MS should be vaccinated against COVID-19 (provided that they do not have any known allergies to any of the components of the vaccines)
People with MS should be vaccinated as soon as the vaccine is available to them
Even once you have received the vaccine, it is important to follow our country’s guidelines regarding mask wearing (indoors and outdoors), social distancing, social group requirements, and hand washing.
There are 11 COVID-19 vaccines in use in different countries around the world, with new ones being approved regularly. Instead of assessing each vaccine individually, we have provided information below about the main types of COVID-19 vaccines in use and in development.
The spread of the SARS-CoV-2 virus spread is influenced by new COVID-19 variants and ongoing research is investigating how well the current COVID-19 vaccines protect against these new and emerging variants.
We do not know how many people in the COVID-19 vaccine clinical trials had MS, so the guidance is therefore based on data from the general population in the vaccine clinical trials, research on the effects of other types of vaccination of people with MS, and new data emerging on the safety and effectiveness of COVID-19 vaccines specifically for people with MS.
Types of COVID-19 vaccine and how they work
Vaccines work by using a part of the virus that causes the disease (such as its genetic code or ‘spike protein’), or an inactivated or weakened version of the virus, to prompt a response from the human immune system. In turn, this causes the body to produce antibodies and T-cells (a special population of white blood cells) to fight the virus, preventing it from entering and infecting other cells in the body. These vaccines do not lead to any genetic change in our bodies, will not get into the brain, and would not alter the genetic code of a foetus.
There are currently five different types of COVID-19 vaccine in use or in development that work in different ways (with examples below).
1.mRNA vaccines
This have the genetic code for the coronavirus ‘spike’ protein made as an “mRNA” (a type of temporary genetic message), which is formulated into tiny fatty droplets for delivery. The mRNA directs production of the spike protein, which is seen and targeted by the immune system (that makes antibodies and T-cells).
Pfizer-BioNTech (Comirnaty)
Moderna (Moderna mRNA)
2.Non-replicating viral vector vaccines
This have the genetic code for the spike protein in a viral vector. These vectors are best understood as just the shell and delivery mechanism of a virus (commonly from an adenovirus), but they lack the parts a virus needs to replicate and so can never cause an infection. Similar to mRNA vaccines, viral vector vaccines direct the production of the spike protein so that it can be seen and targeted by the immune system.
AstraZeneca/Oxford (AZD1222)
Serum Institute of India (Covishield)
Gamaleya Research Institute (Gam-COVID-Vac or Sputnik V)
3.Inactivated virus vaccines
In this an inactivated form of the whole coronavirus used. The coronavirus has been ‘killed’ so that it is unable to get into cells and replicate, and it cannot cause a COVID-19 infection. The immune system recognises the whole virus, even though it is inactivated.
Covaxin (Bharat Biotec)
Sinovac (CoronaVac)
Sinopharm (BBIBP-CorV)
4.Protein vaccines
This have the coronavirus spike protein itself (not the genetic code), along with something that boosts the immune system (an ‘adjuvant’) to ensure the spike protein is targeted.
• Novavax (NVX-CoV2373)
5.Live attenuated vaccines
This use a weakened, but still replicating virus. Such vaccines work by causing a mild infection in people with regular immune function. They can be dangerous in a person with a compromised immune system, so would not suitable for many people with MS, due to the way some disease modifying treatments work.
Currently , there are no live attenuated COVID-19 vaccines in use – they are only being researched.
The following guidance refers to the mRNA, non-replicating viral vWorld Multiple Sclerosis Day 2022 May 30th
- M.A.Aleem Neurologist ABC Hospital Trichy , inactivated virus or protein COVID-19 vaccines (types 1-4 listed above).
COVID-19 VACCINES AND MS
PEOPLE WITH MS SHOULD GET A COVID-19 VACCINE
The science has shown us that the COVID-19 vaccines are safe and effective. Like other medical decisions, the decision to get a vaccine is best made in partnership with your healthcare professional. You should get a COVID-19 vaccine as soon as it becomes available to you. The risks of COVID-19 disease outweigh any potential risks from the vaccine. In addition, members of the same household and close contacts should also get a vaccine as soon as they can to maximise protection against COVID-19.
Most of the COVID-19 vaccines require two doses, and where this is the case, you need to follow your country’s guidelines on the timing of the second dose. (In some countries, you may get offered a third dose if you are categorised as having severe immunosuppression.
You will need to follow your country’s guidelines on the timing of the third dose).
The Johnson & Johnson (J&J) vaccine requires a single dose. Whichever vaccine you receive, it takes 2 weeks after receiving the only or second dose before you are considered immunised (protected).
If you have had COVID-19 and recovered, you should also get the vaccine, because people who have had COVID-19 infection in the past can get infected again. It is normal practice to wait until you have recovered from an illness before being vaccinated. But you should still get vaccinated as soon as you can after recovery, following the government guidelines in your country.
We do not know how long a person is protected from COVID-19 after being vaccinated, although clinical trial data indicate that protection is high for at least multiple months.
There is no evidence that people with MS are at higher risk of complications from the mRNA, non-replicating viral vector, inactivated virus or protein COVID-19 vaccines (1-4), compared to the general population.
There is no vaccine preference for those living with MS.
None of the currently available vaccines contain live virus and the vaccines will not cause COVID-19 disease. These types of vaccine are not likely to trigger an MS relapse or to worsen chronic MS symptoms.
However, people with MS should avoid receiving live attenuated vaccines . Given that there may be COVID-19 vaccines developed in the future that use this technology, it is important to know which COVID-19 vaccine you are offered.
You do not need to self-isolate after the vaccination.
The vaccines can cause side effects, including fever or fatigue, which should not last more than a few days after vaccination. A fever can make your MS symptoms worse temporarily, but they should return to previous levels after the fever is gone. Even if you have side effects from the first dose, it is important to get the second dose of the vaccine (for vaccines requiring two doses) for it to be fully effective. Having side effects, such as fever, muscle discomfort and fatigue are a sign that the vaccine is doing its job (it is getting your body to mount a response against the virus, and therefore is starting to protect you).
IT IS SAFE TO RECEIVE A COVID-19 VACCINE WHEN YOU ARE ON DISEASE MODIFYING THERAPIES (DMTS) FOR MS
Continue taking your disease modifying therapy (DMT) unless you are advised by your MS healthcare professional to stop or delay it. Stopping some DMTs abruptly can cause severe worsening of MS.
Some DMTs may reduce the effectiveness of the COVID-19 vaccinations
There is some evidence that people taking some types of DMT (fingolimod, siponimod, ozanimod, ponesimod, ocrelizumab, rituximab, ofatumumab) may have a reduced antibody response to the COVID-19 vaccines. The data are limited so far, but are in line with what we expect, given our understanding of these treatments.
Note that there is a range of different antibody tests that are used to measure responses to the COVID-19 vaccines. There is currently no global agreement about which antibody is the best for monitoring vaccine responses and predicting protection from COVID-19.
If you use one of these DMTs and take an antibody test it may show a low or no response. This does not mean that the vaccine is ineffective. Antibodies are only one part of the immune response to vaccination. There are other components of the immune system that are triggered by the vaccine and could contribute to your protection. The COVID-19 vaccines may also activate T-cells, which could also protect against COVID-19. This T-cell reponse is not measured in antibody tests.
However, it may be that people taking these DMTs have less protection from their vaccinations. We strongly advise people to still get vaccinated, but be aware that you could still be vulnerable to infection and take precautions against COVID-19 infection.
Delaying the start of a DMT, or altering DMT timing, is a strategy to allow the vaccine to be fully effective
If you are able to plan when you receive your vaccine, please discuss with your MS healthcare provider how and whether to coordinate the timing of your vaccine with the timing of your DMT dose – if you are on a DMT where this is relevant (see section further down the page). This should help ensure the vaccine is as effective as possible at generating an immune response to the coronavirus. Given the potential serious health consequences of COVID-19 disease, getting the vaccine when it becomes available to you may be more important than optimally timing the vaccine with your DMT.
Even once you have received the vaccine, it is important to continue to take precautions against COVID-19
Even when vaccinated, you can still be infected with COVID-19 and give it to others. This is even more likely for those on DMTs that might reduce the effectiveness of the vaccines (fingolimod, siponimod, ozanimod, ponesimod, ocrelizumab, rituximab, ofatumumab).
The safest approach is to ensure that those close to you are fully vaccinated, and that you continue wearing masks, practise social distancing,wash hands and follow your country’s guidelines about getting tested for COVID-19 when necessary.
VACCINATION ADVICE FOR YOUNG PEOPLE
The following guidance for young people applies to vaccines currently authorised for use for this age group, and should be read together with the general advice above.
The science has shown us that the COVID-19 vaccines are safe and effective. India at present recommend COVID-19 vaccination for all above 18 years of age and older (who do not have ‘contraindications’ – a medical reason that prevents them from having the vaccine) using one of the COVID-19 vaccines that is authorised for this age group. Vaccination of this age group brings us one step closer to ending this pandemic and is an additional layer of protection for the most vulnerable among us.Young people are at risk of severe illness from COVID-19
Cases of COVID-19 infection are rising in children and adolescents. While most COVID-19 infections in children and adolescents are mild, some infections are severe or even fatal. In addition to health risks due to COVID-19 infection, children and adolescents are at risk for Multisystem inflammatory syndrome in children (MIS-C) two to six weeks after infection with COVID-19. MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. MIS-C is serious, even deadly, although with prompt and often intensive care most young people with MIS-C survive. The risks of COVID-19 and MIS-C outweigh any potential risks from the vaccine.
The importance of COVID-19 vaccination for young people with MS mirrors the advice for this age group in general, as well as the advice for adults with MS. While there is no evidence to date that young people with MS experience more severe COVID-19 infection, nor that they are at higher risk for MIS-C compared to young people who do not have MS, vaccination is strongly encouraged.
Household and family members of people with MS should be vaccinated against COVID-19
People who live in the same household as anyone with MS should also get vaccinated – including young people over the age of 18 in India. Vaccination of an entire household reduces the risk of spreading COVID-19 between people in close contact with each other.
RECOMMENDATIONS FOR TIMING DMTS AND THE COVID-19 VACCINES
The decision of when to get the COVID-19 vaccine should include an evaluation of your risk of COVID-19, (see the list near the beginning of this advice on groups who are more at risk), and the current state of your MS. If the risk of your MS worsening outweighs your risk of COVID-19, do not alter your DMT schedule and get the vaccine when it is available to you. If your MS is stable, consider the following adjustments in the administration of your DMT to enhance the effectiveness of the vaccine. This suggested scheduling is not always possible and getting the vaccine when it becomes available to you may be more important than timing the vaccine with your DMT. Work with your MS healthcare provider to determine the best schedule for you.
Interferons, glatiramer acetate, teriflunomide, monomethyl fumarate, dimethyl fumarate, diroximel fumarate, natalizumabIf you are about to start one of these DMTs for the first time, do not delay starting it for your COVID-19 vaccine injection. If you are already taking one of these DMTs, no adjustments to your DMT administration are needed.Fingolimod, siponimod, ozanimod, ponesimodIf you are about to start one of these medicines, consider getting fully vaccinated* two to four weeks before starting fingolimod, siponimod, ozanimod or ponesimod. If you are already taking one of these medicines, continue taking it as prescribed and get vaccinated as soon as the vaccine is available to you.AlemtuzumabIf you are about to start alemtuzumab, consider getting fully vaccinated* at least four weeks before starting alemtuzumab. If you are already taking alemtuzumab, consider getting vaccinated at least 24 weeks after the last alemtuzumab dose. When possible, resume alemtuzumab at least four weeks after getting fully vaccinated*.Oral cladribineIf you are about to start cladribine, consider getting fully vaccinated* two to four weeks before starting cladribine. If you are already taking cladribine, the currently available limited data does not suggest that timing the vaccine in relation to your cladribine dosing is likely to make a significant difference in vaccine response. Getting the vaccine when it becomes available to you may be more important than coordinating timing of the vaccine with your cladribine treatment. If you are due for your next treatment course, when possible, resume cladribine two-four weeks after getting fully vaccinated*.Ocrelizumab, rituximabIf you are about to start ocrelizumab or rituximab, consider getting the fully vaccinated* two to four weeks before starting ocrelizumab or rituximab. If you are already taking ocrelizumab or rituximab, consider getting vaccinated at least 12 weeks after the last DMT dose. When possible, resume ocrelizumab or rituximab at least 4 weeks after getting fully vaccinated*.OfatumumabIf you are about to start ofatumumab, consider getting fully vaccinated* two to four weeks before starting your DMT. If you are already taking ofatumumab, there is no data to currently guide timing of the vaccine in relation to your last DMT injection. When possible, resume ofatumumab injections two to four weeks after getting fully vaccinated*. High-dose steroidsConsider getting the vaccine injection three to five days after the last dose of steroids.
*Fully vaccinated = once you have received the single dose of the J&J vaccine or the second dose of any other type of vaccine.
Note that vaccine protection occurs 2 weeks after the single dose of the J&J vaccine or the second dose of any other type of vaccine.
Thursday, May 26, 2022
Wednesday, May 25, 2022
Tuesday, May 24, 2022
Monday, May 23, 2022
Re:Healthcare Ecosystem in India in Future M.A.Aleem BMJ 2022;377:o1234
BMJ British Medical Journal
Editor's Choice
Erosion of healthcare for those who need it most
BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1234 (Published 19 May 2022)
Cite this as: BMJ 2022;377:o1234
Response
Re: Erosion of healthcare for those who need it most
Healthcare Ecosystem in India in Future
Now a days healthcare delivery in India has witnessed a renewed focus on leveraging digital technology during the COVID-19 pandemic and after.
Various healthcare reforms launched before and during the pandemic such as, National Health Digital Mission (NDHM) and teleconsulting guidelines combined with burgeoning health tech start-up ecosystem, have evolved to make healthcare journey better for Indian population.
The new normal in Indian healthcare ecosystem will be about how healthcare delivery will innovate in the coming decade and what it means for both patients and healthcare providers.
Digitization, technological enablement, and automation are affecting industries today in profound ways. Healthcare is no exception. The paradigm of healthcare delivery in India is changing and is poised for a big leap forward. Healthcare and drug innovation have come into sharp focus as never before in India
The COVID-19 pandemic has demonstrated that health care organizations become more resilient, agile, and innovative through digitally enabled business models with data at the core. The pandemic added urgency and accelerated the process of change for healthcare to become more digitally enabled.
In India healthcare delivery is moving outside the four walls of traditional health system . Health care providers have realized that products or services alone, no matter how strong they are technically, will not be enough in future. They should look into the future to engage with their users across the health care value chain, whether that be physicians or patients, and deliver to them not just a better care product or care service, but a better care experience. Also, one needs to keep an eye on developments coming from non-core sources like technology companies which could further help in diagnosis or early detection and aid the healthcare ecosystem.
Hence, as health care organizations consider to move ahead, creating the right data environment to support a more human-centered approach to health care is an urgent need.
In India the explosion of health care data requires a new ecosystem to be built around the needs of an individual enabled by technical standards, open data models and empowered by governance systems that deliver trust.
In our country,rising technologies generating data will need equally powerful tools to organize, interpret and draw insights from them — Artificial intelligence (AI)is critical in this journey to turn complex information into usable insights, including individualized wellness solutions and show how to efficiently provide care across the ecosystem.
To keep up with the velocity and variety of health data generated today in India, the health information infrastructure must enable providers to connect, combine, analyze, and share health and social data.
Trusted intelligence systems also will emerge to secure confidence and participation of consumers and other stakeholders in India in near future.
In India clinicians will need to leverage medical, data and behavioral science knowledge and skills in the near future to deliver a personalized care demanded by patients. To support this shift, healthcare entities must decide now where to invest in education, training and recruiting.
Healthcare delivery in India witnessed a renewed focus on leveraging digital technology during the pandemic. The sector, predominantly recognized for sick care delivery, has looked at building next-gen capabilities that will be a differentiator in the decade ahead. Several reforms launched before and during the pandemic such as National Health Digital Mission (NDHM), teleconsulting guidelines combined with burgeoning health tech start-up ecosystem enabled by innovation, have evolved to make the healthcare journey better for Indian population. It is good that the private equity/ Venture capital funding is also coming to support the health tech start up eco system.
Maximizing the clinical, financial, and operational value of these new digital offerings and services requires biopharma, medtech and other health care stakeholders to reinforce digital as an entirely new business model and ecosystem to deliver better outcomes and drive stakeholder awareness, adoption, engagement, and growth.
Competing interests: No competing interests
21 May 2022
M.A. Aleem
Emeritus Professor of Neurology * Visiting Specialist in Neurology ** Consultant Neurologist ***
The Tamilnadu Dr.M.G.R. Medical University * Dhanalakshami Srinivasan Medical College ** ABC Hospital ***
Chennai 600032* Perambalure 621212** Trichy 620018*** Tamilnadu India
@drmaaleem
Sunday, May 22, 2022
இந்து சமயம் உருவான இடம் தமிழ்நாடு - டாக்டர் அலீம் திருச்சி
தமிழ் நாட்டில் பிறந்ததற்கு ஒவ்வொரு தமிழரும்* *பெருமை
*இந்து சமயம் உருவான இடம்* :*
*தமிழ்நாடு*
*இந்து சமயத்தின் ஏழு பெரும் பிரிவுகள்*:
1.*சைவம்*
2.*சாக்தம்*
3.*வைஷ்ணவம்*
4.*கணாபத்யம்*
5.*கெளமாரம்*
6.*செளரம்*
7.*ஸ்மார்த்தம்*
*சைவத்தின் முழு முதற் தெய்வமான சிவன் கோவில்கள் 283 இல்*
*276 கோயில்கள் தமிழ்நாட்டில் தான் உள்ளது* !!!
*வைணவத்தின் 108 வைணவ திவ்ய*
*தேசத் தலங்களில்*
*96 ஸ்தலங்கள் தமிழ்நாட்டில் தான் உள்ளது*!!
*கெளமாரத்தின் 21 முருகன் கோவில்களில்*
*18 கோவில்கள் தமிழ்நாட்டில்*
*தான் உள்ளது*
*கணாபத்தியத்தில் அஷ்ட கணபதிகள்* *கோவில்கள் அனைத்தும் தமிழ்நாட்டில் தான்* *உள்ளது*
*செளரத்தில் சூரியனை தெய்வமாக* *தைப்பொங்கல் தினத்தன்று வழிபடுவது* *தமிழ்நாட்டில் தான்*
*சாக்தத்தில் பராசக்தி நவதுர்க்கை கோவில்கள்* *அம்மன் கோவில்கள்*
*பெண் தெய்வங்களுக்கு கோவில்கள் இருப்பது* *தமிழ்நாட்டில் தான்* !!
*மேற்கண்ட ஏழு பெரும் பிரிவு தெய்வங்களையும்* *ஒட்டு மொத்த இந்துக்களாக வணங்கும்*
*ஸ்மார்த்தர்கள் இருப்பதும் தமிழ்நாட்டில் தான்* !!
*பதிணெட்டு சித்தர்கள் தோன்றி, வாழ்ந்து* !!
*ஜீவ சமாதி அடைந்ததும் தமிழ்நாட்டில் தான்* !!
*ஆழ்வார்கள்*...., *நாயன்மார்கள்*..
*தோன்றி வாழ்ந்து முக்தி அடைந்தது*
*தமிழ்நாட்டில் தான்* !!
*பஞ்சபூத கோவில்களில்*
*நிலம்*,
*நீர்* ,
*ஆகாயம்* ,
*நெருப்புக்கான*
*ஸ்தலங்கள்இருப்பது தமிழ்நாட்டில் தான்* !!
*நவக்கிரக கோவில்கள் அனைத்தும் இருப்பது தமிழ்நாட்டில் தான்*.
*12 ராசிகள்,* *மற்றும் 27*
*நட்சத்திரங்களுக்கான*
*கோவில்கள் இருப்பது தமிழ்நாட்டில் தான்* !!
*சப்தலிங்க ஸ்தலங்கள் இருப்பது*
*தமிழ்நாட்டில் தான்* !!
*இந்து பண்பாட்டின் அடையாளமே*
*தமிழ்நாடு தான்* !!
*இந்து பண்பாட்டின் வாழ்வியல் முறையே* *தமிழ்நாடு தான்* !!
*இந்து பண்பாட்டின் மருத்துவமான*
*இயற்கை சித்த மூலிகை மருத்துவம் உருவானதே* *தமிழ்நாட்டில் தான்* !!
*இந்து பண்பாட்டின் இயற்கை வேளாண்மை* *தோன்றி செழித்தோங்கியது தமிழ்நாட்டில் தான்* !!!
*தமிழ்நாடு முழுக்க* *முழுக்க ஆன்மிகபூமி* .!!!
#WHA75 #India 's#ASHA (Accredited Social Health Activist Workers) got @WHO 's Global Health Leaders Award 2022ASHA (means hope in #Hindi) are the more than 1 million female volunteers in India, honored for its crucial role in linking community with health system congratulations -M.A.Aleem Neurologist #Trichy #Tamilnadu #India
Saturday, May 21, 2022
Tuesday, May 17, 2022
Dr.Ambedkar Road Over Bridge - M.A.Aleem Neurologist #Trichy #Tamilnadu #India
Dr.Ambedkar Road Over Bridge
Work has been restarted for the Completion of Five ways Road Over Bridge (RoB) near Trichy railway junction after the gap of eight years . This RoB is around Dr.Ambedkar statue near Aristo. So this RoB can be named as Dr.Ambedkar Road Over Bridge - Request by M.A.Aleem Neurologist #Trichy #Tamilnadu #India
Monday, May 16, 2022
Re:Guidelines needed to limit the total and added sugar in sweets, chocolates and beverages to safe and healthy level in India-M.A.Aleem , A.M.Hakkim, H.Irfan Ahamed. BMJ 2022;377:o1079
BMJ British Medical Journal
Editorials
New calorie labelling regulations in England
BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1079 (Published 04 May 2022)
Cite this as: BMJ 2022;377:o1079
Response
Guidelines needed to limit the total and added sugar in sweets, chocolates and beverages to safe and healthy level in India
Dear Editor
One in six people with diabetes in the world is from India. The numbers place the country among the top 10 countries for people with diabetes, coming in at number two with an estimated 77 million people affected.
The growing number of diabetes patients will continue to put India in second place right up to the year 2045. And the numbers are staggering — just over 134 million Indians will have diabetes in the next 25 years.
Diabetes, being a lifestyle disorder with multidimensional causative factors, definitely needs a multidimensional approach.
A stricter added-sugar limit of no more than 100 calories per day (about 6 teaspoons or 24 grams) for most adult women and no more than 150 calories per day (about 9 teaspoons or 36 grams of sugar) for most men, and children aged 7 to 10 should have no more than 24g of free sugars a day are ideal for a healthy life.
Many health problems occur when you consume too much added sugar — that is, sugar that food manufacturers add to products to increase flavor or extend shelf life.
The effects of added sugar intake — higher blood pressure, inflammation, weight gain, diabetes, and fatty liver disease — are all linked to an increased risk for heart attack and stroke.
Reading food labels is one of the best ways to monitor your intake of added sugar.
Look for the following names for added sugar in your sweets, chocolate, beverages and try to either avoid, or cut back on the amount or frequency of the sweet rich products where they are found:
brown sugar, corn sweetener, corn syrup, fruit juice concentrates, high-fructose corn syrup, honey, invert sugar, malt sugar, molasses, syrup sugar, molecules ending in "ose" (dextrose, fructose, glucose, lactose, maltose, sucrose).
Total sugar, which includes added sugar, is often listed in grams. Note the number of grams of sugar per serving as well as the total number of servings. It might only say 5 grams of sugar per serving, but if the normal amount is three or four servings, you can easily consume 20 grams of sugar and thus a lot of added sugar.
It is better to control the level of total sugar and added sugar in sweets, chocolate and beverages at the production level itself and in retail shops, wholesale shops and in hotels in India.
Also, keep track of sugar you add to your sweet food or beverages.
India needs to pause and re-evaluate its strategy to combat diabetes.
Guidelines are needed to limit the total and added sugar in sweets, chocolates and beverages to safe and healthy level.
The need of the hour is to develop and implement multi-sectoral strategies to combat the growing diabetes epidemic in India.
Competing interests: No competing interests
14 May 2022
M.A. Aleem
Emeritus Professor of Neurology * Visiting Specialist in Neurology ** Consultant Neurologist ***
A.M.Hakkim,
H. Irfan Ahamed
The Tamilnadu Dr.M.G.R. Medical University * Dhanalakshami Srinivasan Medical College ** ABC Hospital ***
Chennai 600032* Perambalure 621212** Trichy 620018*** Tamilnadu India
@drmaaleem
Friday, May 13, 2022
Wednesday, May 11, 2022
Old is Good with Healthy Brain- M.A.Aleem Neurologist #Trichy #Tamilnadu #India
*Brains of Senior Citizens *
The director of the George Washington University School of Medicine argues that the brain of an older person is much more practical than is commonly believed. At this age, the interaction of the right and left hemispheres of the brain becomes harmonious, which expands our creative possibilities. That is why among people over 60 years of age you can find many personalities who have just started their creative activities.
Of course, the brain is no longer as fast as it was in youth. However, it gains in flexibility. Therefore, with age, we are more likely to make the right decisions and are less exposed to negative emotions. The peak of human intellectual activity occurs around the age of 70, when the brain begins to function at full strength.
Over time, the amount of myelin in the brain increases, a substance that facilitates the rapid passage of signals between neurons. Due to this, intellectual abilities increase by 300% compared to the average.
Also interesting is the fact that after 60 years, a person can use 2 hemispheres at the same time. This allows you to solve much more complex problems.
Professor Monchi Uri, from the University of Montreal, believes that the old man's brain chooses the path that consumes less energy, eliminates the unnecessary and leaves only the right options to solve the problem. A study was conducted involving different age groups. Young people were very confused when passing the tests, while those over 60 years of age made the right decisions.
Now, let's look at the characteristics of the brain between the ages of 60 and 80. They are really pink.
*CHARACTERISTICS OF THE BRAIN OF AN ELDERLY PERSON.*
1. Neurons in the brain do not die, as everyone around you says. The connections between them simply disappear if one does not engage in mental work.
2. Distraction and forgetfulness arise due to an overabundance of information. Therefore, it is not necessary for you to concentrate your whole life on unnecessary trifles.
3. From the age of 60, a person, when making decisions, does not use one hemisphere at the same time, like young people, but both.
4. Conclusion: if a person leads a healthy lifestyle, moves, has viable physical activity and is fully mentally active, intellectual abilities do NOT decrease with age, they simply GROW, reaching a peak at the age of 80-90 years .
So do not be afraid of old age. Strive to develop intellectually. Learn new crafts, make music, learn to play musical instruments, paint pictures! Dance! Take an interest in life, meet and communicate with friends, plan for the future, travel as best you can. Do not forget to go to shops, cafes, shows. Don't shut up alone, it's destructive to anyone. Live with the thought: all good things are still ahead of me!
SOURCE: New England Journal of Medicine.
Pass this information on to your family and friends in their 60s, 70s and 80s so they can be proud of their age. 👍
Bending work of Mannarpuram end of RoB of Ambedkar Circle near Aristo Trichy railway junction has restarted today 11.5.22 after 8 years. Thank to the initiative of our urban development minister KN NEHRU our MP Thirunavkarasar and the Defence minister rajnath singh for clearance - M.A.Aleem Member Tiruchirappalli District Welfare Fund Committee
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News Sodium valproate continues to be prescribed in hundreds of pregnancies, data show BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1013 (Published 21 April 2022) Cite this as: BMJ 2022;377:o1013 Response -M.A.Aleem Trichy Tamilnadu India
News
Sodium valproate continues to be prescribed in hundreds of pregnancies, data show
BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1013 (Published 21 April 2022)
Cite this as: BMJ 2022;377:o1013
Response
Re: Sodium valproate continues to be prescribed in hundreds of pregnancies, data show
Dear Editor
Valproic acid was synthesized in 1882. The antiepileptic properties of valproic acid, which is structurally unrelated to other antiepileptic drugs, were discovered by chance in 1963.
The first clinical trials with valproic acid were reported in 1964. It was marketed in France in 1967 and released in the United States in 1978.
In late 1970s, valproic acid was marketed worldwide and attained the status of a major antiepileptic drug.
Valproic acid may cause serious or life-threatening damage to the liver that is most likely to occur within the first 6 months of therapy.
The risk of developing liver damage is greater in children who are younger than 2 years of age and are also taking more than one medication to prevent seizures, have certain inherited diseases that may prevent the body from changing food to energy normally, or any condition that affects the ability to think, learn, and understand.
Valporic acid In patients having an certain inherited condition that affects the brain, muscles, nerves, and liver (Alpers Huttenlocher Syndrome), urea cycle disorder (an inherited condition that affects the ability to metabolize protein), or liver disease may have more adverse effects.
Valproic acid can cause serious birth defects especially affecting the brain and spinal cord and can also cause lower intelligence and problems with movement and coordination, learning, communication, emotions, and behavior in babies exposed to valproic acid before birth.
Competing interests: No competing interests
01 May 2022
M.A. Aleem
Emeritus Professor of Neurology * Visiting Specialist in Neurology ** Consultant Neurologist ***
The Tamilnadu Dr.M.G.R. Medical University * Dhanalakshami Srinivasan Medical College ** ABC Hospital ***
Chennai 600032* Perambalure 621212** Trichy 620018*** Tamilnadu India
@drmaaleem
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