COVID-19- New Updates
COVID 19 and dexamethasone
London17062020
Updated 18-06-2020
It was only in April this year that Oxford University published a press release that said it was testing on an experimental vaccine for coronavirus (see below)
Now the same Oxford University has announced that when dexamethasone a corticosteroid is tested on to those patients in ventilation and intensive care with severe and acute symptoms of Covid19, such as cytokine storm, pneumonia, and pulmonary edema has yielded good and satisfactory results. It has relieved more than 50% of the seriously ill patients from the hospital intensive care and artificial ventilation.
The British government and the WHO have appreciated this.
Dexamethasone is a synthetic steroid hormone imitating the natural corticosteroids secreted from the adrenal glands. They are cortisol(hydrocortisone) and cortisone.
The natural hormones are required by the body to sustain many functions such as glucose metabolism, to control over autoimmune responses of the body.
Any person cannot survive without a functioning adrenal gland. If a baby is born without adrenal glands it cannot survive even for half an hour. Adrenal insufficiency may cause life-threatening Addison's Disease in which insufficient secretions of cortisol and aldosterone may cause dangerous hypotension.
THE RECOVERY TRIAL:-
(RANDOMISED EVALUATION OF COVID-19 THERAPY):-The largest randomized laboratory trial at Oxford University find dexamethasone reduced deaths by one third in ventilated patients and by one fifth in patients with only oxygen therapy.
The trial is 6 mg daily dose of dexamethasone was given for ten days to 2100 models, while 4300 models were given normal care without dexamethasone. While after 30 days when the death rate was compared between these two groups dexamethasone gave the above result.
But be aware that this drug is a steroid
Dexamethasone is a synthetic steroid hormone imitating the natural corticosteroids secreted from the adrenal glands. They are cortisol(hydrocortisone) and cortisone.
The natural hormones are required by the body to sustain many functions such as glucose metabolism, to control over autoimmune responses of the body.
Any person cannot survive without a functioning adrenal gland. If a baby is born without adrenal glands it cannot survive even for half an hour. Adrenal insufficiency may cause life-threatening Addison's Disease in which insufficient secretions of cortisol and aldosterone may cause dangerous hypotension.
THE RECOVERY TRIAL:-
(RANDOMISED EVALUATION OF COVID-19 THERAPY):-The largest randomized laboratory trial at Oxford University find dexamethasone reduced deaths by one third in ventilated patients and by one fifth in patients with only oxygen therapy.
The trial is 6 mg daily dose of dexamethasone was given for ten days to 2100 models, while 4300 models were given normal care without dexamethasone. While after 30 days when the death rate was compared between these two groups dexamethasone gave the above result.
But be aware that this drug is a steroid
It is an immune suppressant (IMMUNOSUPPRASSANT), although it is an effective remedy for asthma- infection-free lung inflammatory pneumonia.
Being a steroid can lead to diabetes.
Oxford University reports that it should be used only temporarily in patients with artificial respiration in the intensive care unit.
But the following questions remain unanswered:-
1. Being a glucocorticoid may interfere with glucose metabolism. Then what are the safety measures to be taken for a diabetic patient?
2. Being glucocorticoid dexamethasone can suppress body immunity responses to the ongoing infections. How long the treatment should be continued to an immune-compromised patient with pneumonia and in ventilation?
3. What are the dosage regimen?
They used 6 mg per day for 10 days. Ironically Dexamethasone is a drug that shows its minimum potency at 12 mg.
They used 6 mg per day for 10 days. Ironically Dexamethasone is a drug that shows its minimum potency at 12 mg.
4. Are the other anti-inflammatory drugs such as NSAIDs, and COX-2 inhibitors be preferred as safer medicines for weak immunity and diabetic patients?
Is Vitamin D3 safer than any anti-inflammatory drug mentioned above in relieving the patient with severe illness?
Dexamethasone is not an antiviral drug. It will not kill the virus. But it works as an inflammatory drug. It works on the basis of immune suppression. It reduces inflammatory secretions. It reduces clot formations. Hence it saved some lives of those COVID-19 patients who were at ventilation and need oxygen.
But still, the above questions have remained unanswered.
Current status of vaccine testing: -
Name of vaccine -ChAdOx1 nCoV-19.
Contents:-Adenovirus vectors recombined with the isolated spikes (S-glycoproteins) of the novel coronavirus (HCoV-SARS-2)
Phase-1 has just begun on April 23, with a total of 1100 models. The age limit is fixed between 18 to 55 years old for Phase-1. Each group comprised of 550-persons and have received the Covid-19 vaccine and the other group of 550 models have received the reference control for comparison (CONTROL REFERENCE), which is either a vaccine for meningitis or a sepsis vaccine. This was a single-blind test.
On the first day of the trial (23-04-2020), two Scientists from Oxford University came forward to receive the vaccines.
Two days later six more models have been added as models to receive the vaccines.
By the Grace of God and with great efforts the full size of the experimental unit for Phase-1 composed of 1100 models has been attained.
All of them are from Oxfordshire and its surroundings. Out of the 1100 models, three are from the same family and they have been noted.
These 1100 models are equally divided into two batches with 550 models in each.
One batch has received the newly prepared COVID-19 vaccine and the other batch has received either vaccine of Meningitis or Sepsis as a Reference Control.
All recipients are kept blind from which vaccine they have received. This is a single-blind test.
Blood samples are to be collected from the recipients on their fixed periodical visits to the laboratory.
Still, the Phase-1 is going on.
After this, they will be started with the same unit size that is 1100 models, but with a little extended upper age limit.
Phase-3 with a unit size of 5000 models by then the vaccine would be released for the hospitals by September if not by December 2020.
Aminoquinolines-COVID-19
Dexamethasone is not an antiviral drug. It will not kill the virus. But it works as an inflammatory drug. It works on the basis of immune suppression. It reduces inflammatory secretions. It reduces clot formations. Hence it saved some lives of those COVID-19 patients who were at ventilation and need oxygen.
But still, the above questions have remained unanswered.
Current status of vaccine testing: -
Name of vaccine -ChAdOx1 nCoV-19.
Contents:-Adenovirus vectors recombined with the isolated spikes (S-glycoproteins) of the novel coronavirus (HCoV-SARS-2)
Phase-1 has just begun on April 23, with a total of 1100 models. The age limit is fixed between 18 to 55 years old for Phase-1. Each group comprised of 550-persons and have received the Covid-19 vaccine and the other group of 550 models have received the reference control for comparison (CONTROL REFERENCE), which is either a vaccine for meningitis or a sepsis vaccine. This was a single-blind test.
On the first day of the trial (23-04-2020), two Scientists from Oxford University came forward to receive the vaccines.
Two days later six more models have been added as models to receive the vaccines.
By the Grace of God and with great efforts the full size of the experimental unit for Phase-1 composed of 1100 models has been attained.
All of them are from Oxfordshire and its surroundings. Out of the 1100 models, three are from the same family and they have been noted.
These 1100 models are equally divided into two batches with 550 models in each.
One batch has received the newly prepared COVID-19 vaccine and the other batch has received either vaccine of Meningitis or Sepsis as a Reference Control.
All recipients are kept blind from which vaccine they have received. This is a single-blind test.
Blood samples are to be collected from the recipients on their fixed periodical visits to the laboratory.
Still, the Phase-1 is going on.
After this, they will be started with the same unit size that is 1100 models, but with a little extended upper age limit.
Phase-3 with a unit size of 5000 models by then the vaccine would be released for the hospitals by September if not by December 2020.
Aminoquinolines-COVID-19
Antarctica is the only region not yet infected by the COVID-19.
The F.D.A. gave temporary approval but withdrawn by June 15th of 2020 to use chloroquine and hydroxychloroquine as curative drugs to treat COVID-19.
Both are proven antimalarial and anti-inflammatory drugs. But in the case of COVID-19, its efficacy and safety are yet to be proved.
A combination of hydroxychloroquine and azithromycin seems to produce satisfactory lab results but the combination may cause serious cardiovascular effects in elderly patients and those who have liver and kidney insufficiencies.
Chloroquine seems to be an emergency drug o choice with comparatively lesser toxicity than its counterpart yet these antimalarial treatments are simply anecdotal.
The two antimalarial drugs are in vitro (in the lab),
actively and powerfully inhibiting the ACE2 receptor site of the virus (Spike protein), destroying viral RNA polymerase and thereby destroying the viral machinery for survival and replication.
TREATMENTS BASED ON FURIN
The F.D.A. gave temporary approval but withdrawn by June 15th of 2020 to use chloroquine and hydroxychloroquine as curative drugs to treat COVID-19.
Both are proven antimalarial and anti-inflammatory drugs. But in the case of COVID-19, its efficacy and safety are yet to be proved.
A combination of hydroxychloroquine and azithromycin seems to produce satisfactory lab results but the combination may cause serious cardiovascular effects in elderly patients and those who have liver and kidney insufficiencies.
Chloroquine seems to be an emergency drug o choice with comparatively lesser toxicity than its counterpart yet these antimalarial treatments are simply anecdotal.
The two antimalarial drugs are in vitro (in the lab),
actively and powerfully inhibiting the ACE2 receptor site of the virus (Spike protein), destroying viral RNA polymerase and thereby destroying the viral machinery for survival and replication.
TREATMENTS BASED ON FURIN
Furin is a protein in human cells that helps cell fusions. Thus viruses trick our body cells to fuse with the viral body with the help of furin which is available on the head of every human cell outside and in the Golgi apparatus within the cell. Scientists are working on furin inhibitors for the novel corona treatments. If this is successful then it will be less toxic than those drugs which act directly on the virus.
The SARS CoV-2 is the novel coronavirus that is threatening the entire world with its deadly symptoms of Covid-19. It is in some aspects similar to its counterpart SARS CoV-1 which affected the Foshan city in the Guangdong Province of China in 2002 -November.
Both are from the same family Betacoronoviridae and have many similar aspects but dissimilar in responding to the antibodies developed for SARS CoV-1. The antibodies worked with the former are helpless to control them later and that is the problem now.
This is because of the possible different nature of its spike glycoproteins. This is a hypothesis and yet to be evolved. The novel corona is a mutated genome of the previous SARS CoV-1 genome and hence it becomes resistant to its antibodies.
The target is to develop the antibodies to work either in one of the following two paths or in both.
1.Inhibitors of the furin of the host cell or destroying S-2 glycoprotein of the parasite.
2.Inhibiting the ACE2 receptors of the host or destroying the S1 glycoprotein spikes of the parasite
DIABETOLOGY
DIABETES MELLITUS:-1) Good news for those with high B.P, diabetes and heart failure is used of the ACE (Angiotensin Converting Enzyme) inhibitors and help stay away from kidney complications of Diabetes
Both are from the same family Betacoronoviridae and have many similar aspects but dissimilar in responding to the antibodies developed for SARS CoV-1. The antibodies worked with the former are helpless to control them later and that is the problem now.
This is because of the possible different nature of its spike glycoproteins. This is a hypothesis and yet to be evolved. The novel corona is a mutated genome of the previous SARS CoV-1 genome and hence it becomes resistant to its antibodies.
The target is to develop the antibodies to work either in one of the following two paths or in both.
1.Inhibitors of the furin of the host cell or destroying S-2 glycoprotein of the parasite.
2.Inhibiting the ACE2 receptors of the host or destroying the S1 glycoprotein spikes of the parasite
DIABETOLOGY
DIABETES MELLITUS:-1) Good news for those with high B.P, diabetes and heart failure is used of the ACE (Angiotensin Converting Enzyme) inhibitors and help stay away from kidney complications of Diabetes
3) Diabetics can safely diet with monounsaturated fatty foods
4) New research has shown some times exposure to cow's milk during the first year of life may predispose certain children to Diabetes
5) Hydrochlorothiazide can interfere with some oral anti-Diabetics such as Dia-Beta, Diabetes, Glucotrol, and Micronesia.
6)Dia-Beta a sulphonylurea drug is used to control DM-2, must not be taken by people who are allergic to sulpha drugs. Dia-Beta maybe taken with food especially if it upset your stomach better at breakfast. The toxicology of this medicine and other sulphonylureas are Hypoglycemia, fatigue, shakiness, headache, etc. Alcohol, Aspirin, Cimetidine and Ranitidine may cause a further drop in sugar level when taken with a sulphonylurea.
Thiazolidinediones:
The use of these groups is now under consideration as Troglitazone is withdrawn from the market for its serious hepatitis side effects. The other members of this group such as pioglitazone(Actos), rosiglitazone(Avandia ) are still used in many countries.
Vidaglyptin
It is a Dipeptidyl peptidase 4(DPP4) inhibitor class of medicine. It inhibits the enzyme and thereby promote the action of Glucagon-Like Peptidase (GLP) and Gastric Inhibitory Polypeptide(GIP) and thereby promoting the insulin secretion in the pancreas
New drugs, treatment make diabetes management easier
TNN | Apr 13, 2016, 01.10 AM IST
New drugs, treatment make diabetes management easier
Chennai:
Many people with diabetes have to suffer several needle pricks a day-
they have to get their fingers jabbed for routine blood tests and take
insulin shots to keep their sugar level under control.
Scientists are now trying to reduce the daily discomfort and pain for people with diabetes by advising them to use sensors and devices to check their sugar levels. One such solution is the ambulatory glucose profiler, which works on a coin-sized sensor, and gives 1,400 readings. "You stick it on your upper arm for 15 days. The doctor can remove the sensor and pass it through a reader to get the readings and graphs," said diabetologist Dr. V Mohan. He said technology was changing healthcare, and an example is how a device like Google Glass can give readings by scanning iris.
It
is not just monitoring, even drug delivery can be non-invasive. Insulin pumps, in existence for about three decades as an alternative to multiple daily injections of insulin, are being improved. "Monitoring
devices can be attached to these pumps to switch them on and off automatically. Prototypes of pumps that can manage high and low blood sugar levels have been developed," Dr. Mohan said.
On Tuesday, a company announced in Chennai an injectable drug that can delay a diabetic's switchover from tablets to insulin shots. Edgard Olaizola, MD, Lilly India, said the drug is the first injectible when the patient is not able to keep the sugar under control with oral medication. "It has a molecule that mimics the effects of GLP-1, a hormone that helps keep the sugar level normal by helping the body release its insulin," he said. India has around 65 million diabetics. A paper published recently in Lancet found that 15.3% of adults with diabetes are from India. The paper, based on data from 751 studies, involving 4.4 million adults from 200 countries, showed that the prevalence of diabetes has increased 80% in women and more than doubled in men in the country.
Scientists are now trying to reduce the daily discomfort and pain for people with diabetes by advising them to use sensors and devices to check their sugar levels. One such solution is the ambulatory glucose profiler, which works on a coin-sized sensor, and gives 1,400 readings. "You stick it on your upper arm for 15 days. The doctor can remove the sensor and pass it through a reader to get the readings and graphs," said diabetologist Dr. V Mohan. He said technology was changing healthcare, and an example is how a device like Google Glass can give readings by scanning iris.
On Tuesday, a company announced in Chennai an injectable drug that can delay a diabetic's switchover from tablets to insulin shots. Edgard Olaizola, MD, Lilly India, said the drug is the first injectible when the patient is not able to keep the sugar under control with oral medication. "It has a molecule that mimics the effects of GLP-1, a hormone that helps keep the sugar level normal by helping the body release its insulin," he said. India has around 65 million diabetics. A paper published recently in Lancet found that 15.3% of adults with diabetes are from India. The paper, based on data from 751 studies, involving 4.4 million adults from 200 countries, showed that the prevalence of diabetes has increased 80% in women and more than doubled in men in the country.
Also taking paracetamol in normal dosage during fasting or low-calorie intake, or with alcoholic drinks too may put you in liver damage
Is tuberculosis contributing to more diabetes in Chennai? The early results of an ongoing study seem to indicate this may be the case, said researchers.
Of 209 patients with pulmonary tuberculosis who were studied, 54.1 percent were diabetic, and 21 percent were pre-diabetic. Of these, newly-diagnosed patients with diabetes – 32.7 percent -- had low HbA1C levels, indicating that they may have been pre-diabetic earlier and their tuberculosis infection probably pushed this into full-blown diabetes, said Vijay Viswanathan, head, M.V. Hospital for Diabetes, Royapuram, and one of the co-principal investigators of the study.
The ‘Effects of Diabetes on Tuberculosis Severity’ (EDOTS) study, was begun in early 2014 and is a collaboration between the University of Massachusetts Medical School and the Prof. M. Viswanathan Diabetes Research Centre. The National Institute of Research in Tuberculosis is involved in the immunology portion of the study.
The early results of this study have surprised researchers. “Previous reports had indicated a diabetes prevalence of about 25 percent in TB patients and about 10-22 percent in the general population in and around Chennai. So, the steep increase in prevalence is both surprising and a major cause for concern,” said S. Subash Babu, scientific director, National Institutes of Health -National Institute of Research in Tuberculosis-International Center for Excellence in Research.
The data said Hardy Kornfeld, professor of medicine at the University of Massachusetts Medical School, “suggests that becoming sick with TB can push people from pre-diabetes into a diabetic range of high blood sugar”.
However, Prof. Kornfeld, also a co-principal investigator of the study, pointed out that these were only interim results and that the study was ongoing.
“An important question that we hope to answer in the future is whether patients who progress from pre-diabetes to diabetes as a result of TB will revert to pre-diabetes or normal blood sugar after TB treatment or if some of them will be left persistently diabetic,” he said, in an email.
“We know that diabetic patients are vulnerable to tuberculosis. This study was initiated to determine if, when a patient who had TB and was on treatment contracted diabetes, would this be a problem in his cure?” said Dr. Viswanathan. He explained that an earlier study had shown that treatment failure rates of tuberculosis patients were higher if they had poorly-controlled diabetes.
Chennai is estimated to have a diabetes prevalence of 18.5 percent, Dr. Viswanathan said. The city’s prevalence of smear-positive TB is 228 per 100,000, said Dr. Babu.
If patients with pre-diabetes are becoming diabetic due to TB, and, as is known, diabetes increases the severity of TB, more public health efforts may need to be focused in this direction, the researchers say.
“The TB control program now needs to concern itself with screening for diabetes in all its patients and instituting appropriate diabetic treatment to ensure good TB control. Bidirectional screening for TB and diabetes, especially at TB centers, becomes a priority in this case,” said Dr. Babu.
And diabetes too: “I would say that our current findings provide another justification to focus limited public health resources on diabetes prevention,” said Prof. Kornfeld.
Most Patients Inaccurately Self-Report Antibiotic Allergy
Published Online: Monday, March 21, 2016
Pharmacists should double-check patients self-reporting allergies to ensure that they’re taking accurate and appropriate treatment.
A recent study presented at the American Academy of Allergy, Asthma, & Immunology (AACI) 2016 Annual Meeting investigated the extent to which self-reported allergies were actually true. To do so, researchers from the Cleveland Clinic compiled demographic and allergy data for outpatients and inpatients who received an “allergy” point-of-care assessment between August 1988 and August 2015.
The number of patients with self-reported allergies totaled nearly 1.5 million, and 47% of them claimed an allergy to beta-lactams, namely penicillin, and amoxicillin. Other top-reported allergens were sulfa, codeine, morphine, seasonal allergies, aspirin, latex, contrast, and iodine.
Ultimately, however, the researchers observed an actual penicillin allergy in just 4.6% of cases analyzed, and those patients were predominantly male and primarily aged between 35 and 56 years. Nevertheless, “the overwhelming majority of self-reported ‘allergy’ involves antibiotic or analgesic medications,” the researchers wrote.
“These data highlight the substantial morbidity related to medications, particularly beta-lactams, withheld due to self-reported ‘allergy’ in a large tertiary care center population,” they concluded.
Patients who believe that they’re allergic to penicillin are typically given alternate antibiotics prior to surgery in order to ward off infection, but those alternatives can be more toxic, more expensive, and less effective.
Notably, previous studies have also shown that many patients who claim to have a penicillin allergy may not actually be allergic to the antibiotic. In fact, the literature suggests that only 10% of patients labeled with a penicillin allergy have a true immunoglobulin E -mediated allergic reaction.
In 1 such study, researchers tested the skin of 38 patients at a particular medical center who claimed they were allergic to penicillin in order to determine whether the testing could help reduce the cost of expensive alternative antibiotics. Every patient in the study tested negative for penicillin allergy, which ultimately led the medical center’s staff to alter the medication regimen for 29 patients. Those changes significantly lowered the prescription costs for those patients, the researchers reported.
“When you are told you have an allergy to something, it's important to be seen and tested by an allergist who has the specialized training needed for accurate diagnosis and treatment,” ACAAI President-Elect James Sublett, MD, previously stated. “If you're truly allergic to a medication, your allergist will counsel you on an appropriate substitute.”’
Pharmacists can play a critical role in curbing inaccurate allergy reports by asking patients at the time of medication review whether they’ve sought the opinion of an allergist to confirm their allergy. Health systems should consider implementing guidelines to ensure such medication reconciliation occurs.
A recent study presented at the American Academy of Allergy, Asthma, & Immunology (AACI) 2016 Annual Meeting investigated the extent to which self-reported allergies were actually true. To do so, researchers from the Cleveland Clinic compiled demographic and allergy data for outpatients and inpatients who received an “allergy” point-of-care assessment between August 1988 and August 2015.
The number of patients with self-reported allergies totaled nearly 1.5 million, and 47% of them claimed an allergy to beta-lactams, namely penicillin, and amoxicillin. Other top-reported allergens were sulfa, codeine, morphine, seasonal allergies, aspirin, latex, contrast, and iodine.
Ultimately, however, the researchers observed an actual penicillin allergy in just 4.6% of cases analyzed, and those patients were predominantly male and primarily aged between 35 and 56 years. Nevertheless, “the overwhelming majority of self-reported ‘allergy’ involves antibiotic or analgesic medications,” the researchers wrote.
“These data highlight the substantial morbidity related to medications, particularly beta-lactams, withheld due to self-reported ‘allergy’ in a large tertiary care center population,” they concluded.
Patients who believe that they’re allergic to penicillin are typically given alternate antibiotics prior to surgery in order to ward off infection, but those alternatives can be more toxic, more expensive, and less effective.
Notably, previous studies have also shown that many patients who claim to have a penicillin allergy may not actually be allergic to the antibiotic. In fact, the literature suggests that only 10% of patients labeled with a penicillin allergy have a true immunoglobulin E -mediated allergic reaction.
In 1 such study, researchers tested the skin of 38 patients at a particular medical center who claimed they were allergic to penicillin in order to determine whether the testing could help reduce the cost of expensive alternative antibiotics. Every patient in the study tested negative for penicillin allergy, which ultimately led the medical center’s staff to alter the medication regimen for 29 patients. Those changes significantly lowered the prescription costs for those patients, the researchers reported.
“When you are told you have an allergy to something, it's important to be seen and tested by an allergist who has the specialized training needed for accurate diagnosis and treatment,” ACAAI President-Elect James Sublett, MD, previously stated. “If you're truly allergic to a medication, your allergist will counsel you on an appropriate substitute.”’
Pharmacists can play a critical role in curbing inaccurate allergy reports by asking patients at the time of medication review whether they’ve sought the opinion of an allergist to confirm their allergy. Health systems should consider implementing guidelines to ensure such medication reconciliation occurs.
Beta-blockers could reduce the risk of COPD exacerbations: Beta-blockers could be used to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations, according to new findings.
Govt bans 350 drugs, including Phensedyl, Corex
Sushmi Dey | TNN | Mar 12, 2016, 04.36 AM
The health ministry has banned around 350 fixed-dose combinations (FDC) drugs that were widely available in the market till now.
NEW
DELHI: In a significant move ensuring safety and efficacy of medicines,
the health ministry has banned around 350 fixed-dose combinations (FDC)
drugs that were widely available in the market till now. These medicines
include FDCs based on codeine, used in popular cough syrups like
Phensedyl and Corex.
The government has decided to prohibit manufacturing and sale of these medicines because they were found to be "irrational" without any therapeutic efficacy and use. Also, in some cases, there were concerns about the misuse of such medicines considered unsafe for mass consumption, official sources told TOI.
While the health ministry has already approved the ban order with the immediate effect from Friday, the gazette notification is likely to be printed by Monday, a health ministry official said.
A fixed-dose combination of FDC is one that contains two or more drugs combined in a fixed ratio of doses and available in a single dosage form.
The government has decided to prohibit manufacturing and sale of these medicines because they were found to be "irrational" without any therapeutic efficacy and use. Also, in some cases, there were concerns about the misuse of such medicines considered unsafe for mass consumption, official sources told TOI.
While the health ministry has already approved the ban order with the immediate effect from Friday, the gazette notification is likely to be printed by Monday, a health ministry official said.
A fixed-dose combination of FDC is one that contains two or more drugs combined in a fixed ratio of doses and available in a single dosage form.
Health experts say many unapproved formulations and FDCs are sold in India. Most of these medicines are in the analgesics, anti-depressant and psychotic condition segment. Industry estimates suggest the move is likely to impact pharmaceutical sales to the tune of around Rs 1,500 crore.
A study published in 2015 in journal PLOS Medicine pointed out that over 12% of non-steroidal anti-inflammatory, FDCs contain drugs that have either been withdrawn from the market or have had their use restricted.
Courtesy by TOI 12-02-2016
What is meldonium and why did Maria Sharapova take it?
Highlights
Sharapova reacts as she addresses the media regarding a failed drug test. (AFP Photo)
MOSCOW: Russian tennis star Maria Sharapova says she failed a drug test for meldonium at the Australian Open. The drug was only banned in January and there has been a string of failed tests by athletes in several sports since.
Maria Sharapova confirms failed drug test, sanction uncertain
Here are some things to know about meldonium:
WHO'S TESTED POSITIVE?
As well as Sharapova, one of the world's top ice dancers also said Monday that she tested positive.
Ekaterina Bobrova is a former European champion who was part of the Olympic gold medal-winning Russian team at the 2014 Winter Olympics. She told Russian media the positive test was "a big shock." Another Russian case last month saw cyclist Eduard Vorganov test positive.
Besides notable Russians, Swedish media reported in February that former world champion 1,500-meter runner Abeba Aregawi had tested positive for meldonium. Two other cases involved Ukrainians competing in the winter sport of biathlon.
Docs surprise walkers, push glaucoma point
Here are some things to know about meldonium:
WHO'S TESTED POSITIVE?
As well as Sharapova, one of the world's top ice dancers also said Monday that she tested positive.
Ekaterina Bobrova is a former European champion who was part of the Olympic gold medal-winning Russian team at the 2014 Winter Olympics. She told Russian media the positive test was "a big shock." Another Russian case last month saw cyclist Eduard Vorganov test positive.
Besides notable Russians, Swedish media reported in February that former world champion 1,500-meter runner Abeba Aregawi had tested positive for meldonium. Two other cases involved Ukrainians competing in the winter sport of biathlon.
Docs surprise walkers, push glaucoma point
CHENNAI: Morning walkers at Anna Nagar Tower Park were surprised on Sunday when they spotted a group o people holding hands, forming a human chain. What they didn't know was they were looking at some of the best eye doctors in the city who chose to spend a Sunday morning to spread awareness on glaucoma -a group of eye diseases that gradually cause blindness.
A----There are two types of glaucoma -open-angle and closed-angle. Doctors say it is easier to detect closed-angle glaucoma as there is pain.
"We are more worried about open-angle glaucoma as vision loss is gradual and patients come to us too late," said Dr. K Vasantha, president-elect Tamil Nadu Ophthalmic Association. She described the gradual loss of vision as looking through a tube. As glaucoma is hereditary, doctors detect cases early mostly in families who have a history of glaucoma. "I have seen three generations of people suffering from it. They are the more fortunate as their cases were diagnosed early and treated. But many patients who are missed," M N Eye Hospital chairman Dr. Mathivanan Natarajan said. He advised all people over 40 to get their eyes tested.
Glaucoma is the third leading cause of blindness in India. Although it is more prevalent above the age of 40, it can affect any age group, including newborns. Those with diabetes, thyroid disease, and hypertension are among the high-risk groups.
Poop test can tell if you are diabetic, say docs
TNN | Mar 3, 2016, 07.09 AM IST
CHENNAI: Stool tests may gross out many people but doctors are increasingly taking a closer look at poop -to check if Indians are at greater risk of diabetes, obesity, and cardiovascular diseases.
The Research Center has tied up with the Danish Univerity of Copenhagen for the research which earlier found a strong link between gut bacteria and diabetes. At least 1.5kg of bacteria in the human body mostly in the gut plays an active role in not just digesting food also in the development and functioning of the immune and neural systems as also in a wide range of metabolic functions, doctors said.
Danish scientists spearheading the study, including Dr. Oluf B Pedersen, a professor of molecular metabolism and metabolic genetics at the University of Copenhagen, Denmark, said bacterial DNA extracted from stool samples of 292 individuals showed 23% of Danish adults had a 40% reduction in the abundance of bacterial genes. The DNA sequence of the bugs is represented what is going on in the colon.
Recommended By Colombia mark World Glaucoma Week ophthalmologists in the city converged at Anna Nagar Tower Park to distribute pamphlets and talk to people about the disease, which often goes undetected. Glaucoma is usually painless, tends to develop slowly, and shows no symptoms until the disease has progressed significantly. It is the leading cause of irreversible blindness worldwide and is estimated to affect over 11million Indians.
"We are more worried about open-angle glaucoma as vision loss is gradual and patients come to us too late," said Dr. K Vasantha, president-elect Tamil Nadu Ophthalmic Association. She described the gradual loss of vision as looking through a tube. As glaucoma is hereditary, doctors detect cases early mostly in families who have a history of glaucoma. "I have seen three generations of people suffering from it. They are the more fortunate as their cases were diagnosed early and treated. But many patients who are missed," M N Eye Hospital chairman Dr. Mathivanan Natarajan said. He advised all people over 40 to get their eyes tested.
Glaucoma is the third leading cause of blindness in India. Although it is more prevalent above the age of 40, it can affect any age group, including newborns. Those with diabetes, thyroid disease, and hypertension are among the high-risk groups.
Poop test can tell if you are diabetic, say docs
TNN | Mar 3, 2016, 07.09 AM IST
CHENNAI: Stool tests may gross out many people but doctors are increasingly taking a closer look at poop -to check if Indians are at greater risk of diabetes, obesity, and cardiovascular diseases.
The Research Center has tied up with the Danish Univerity of Copenhagen for the research which earlier found a strong link between gut bacteria and diabetes. At least 1.5kg of bacteria in the human body mostly in the gut plays an active role in not just digesting food also in the development and functioning of the immune and neural systems as also in a wide range of metabolic functions, doctors said.
Danish scientists spearheading the study, including Dr. Oluf B Pedersen, a professor of molecular metabolism and metabolic genetics at the University of Copenhagen, Denmark, said bacterial DNA extracted from stool samples of 292 individuals showed 23% of Danish adults had a 40% reduction in the abundance of bacterial genes. The DNA sequence of the bugs is represented what is going on in the colon.
"We found people with fewer and less diverse types of bacteria had a higher body fat percentage and elevated blood lipids," Pedersen said. "This is a significant correlation. We are curious to know if results are similar in Indians."His Indian counterparts are curious about this too. They have sequenced DNA from bacteria found in more than 450 stool samples from an equal number of diabetics, pre-diabetic, and non-diabetic people.
"Our hypothesis is that Indians are at greater risk because we have less good bacteria that reduce diabetes risk and more
"Our hypothesis is that Indians are at greater risk because we have less good bacteria that reduce diabetes risk and more
Energy healing may help treat Type 1 diabetes patients, says new study the subjects, with minimum settings of DAMM Therapy and medium dosage of insulin intake," says Dr. Krishnaswami.
Endorsing the Dynamic Acupuncture Mediated Metaphysical therapy (DAMM), Dr. Krishnawami says since efforts for prevention or cure of Type 1 diabetes had failed, despite spending billions of dollars on studies over nearly a hundred years, an exploration in other kinds of medicine is the obvious step. He credits therapist Rajan Iyer for introducing this treatment. "While we have been working on finding the cure for almost 50 years, the work with DAMM therapy began about four years ago," said the senior diabetologist. The therapy is said to infuse and transfer healing energy from the environment (cosmos) through the therapist, to the patient using acupuncture.
Lack of access to expensive insulin, limited health professional expertise concerning childhood diabetes, and extreme poverty can result in misdiagnosis of the disease which may lead to loss of vision, end-stage renal failure, and severe neuropathy in the 20s or even earlier. With the advent of this new study, which reports no apparent side-effects in the treatment, the cost of treatment can be greatly reduced, believes Dr. Krishnaswami. "Though the incidence of Type I diabetes is much lower in India as compared to the western countries, the numbers are still sizeable in our country," he added.
Located inside the VHS campus, TAG-VHS, a 40-bedded hospital, was established in 2011. It uses a range of "non-invasive procedures" based on energy medicine, which Krishnaswami says science is now recognizing.
Lack of access to expensive insulin, limited health professional expertise concerning childhood diabetes, and extreme poverty can result in misdiagnosis of the disease which may lead to loss of vision, end-stage renal failure, and severe neuropathy in the 20s or even earlier. With the advent of this new study, which reports no apparent side-effects in the treatment, the cost of treatment can be greatly reduced, believes Dr. Krishnaswami. "Though the incidence of Type I diabetes is much lower in India as compared to the western countries, the numbers are still sizeable in our country," he added.
Located inside the VHS campus, TAG-VHS, a 40-bedded hospital, was established in 2011. It uses a range of "non-invasive procedures" based on energy medicine, which Krishnaswami says science is now recognizing.
Gut bacteria could help understand diabetes better
Could the trillions of bacteria in our gut hold the key to understanding why some people get diabetes and also offer a potential cure?
To find out, doctors in India and Denmark are collecting samples of stool from about 900 people in both countries, extracting DNA from it and studying it — to figure out for instance, if Indians have more aggressive gut bacteria leading to insulin resistance, or how diverse the bacteria are, and how they are affecting the health of people.
The study called ‘Microbdiab’— jointly funded by the Danish government and the department of biotechnology, Government of India — is a collaboration between three organizations in India, including Dr. Mohan’s Diabetes Specialties Centre, as well as the University of Copenhagen.
The stool samples are from people who are pre-diabetic, diabetic, and normal — 450 samples in each country.
Oluf Pedersen, professor of molecular metabolism and metabolic genetics, faculty of health and medical sciences, University of Copenhagen, Denmark, says, “Gut bacteria produce thousands of compounds that enter the bloodstream, are circulated to all organs, and have an impact. Studies have shown they impact the brain too. They can cause diabetes or lead to obesity.
Different disorders
They have an enormous capacity for inducing different disorders. Is there a role for gut bacteria in the development of pre-diabetes and type 2 diabetes and is there a universal gut bacteria that are contributing to causing diabetes worldwide — these are some of the questions we are studying,” said Prof. Pedersen.
Prof. Pedersen was presented the 25th DMDSC Gold Medal Oration Award on Wednesday. Research has indicated that certain gut bacteria are linked to type 2 diabetes, but whether they are innocent bystanders or part of the causation is yet to be explored, he said.
The Microdiab study began a year ago, and is expected to come up with findings in about six months or so, said R. M. Anjana, joint managing director of the Centre.
Indians could have less good bacteria or less diverse bacteria or more bad bacteria, said V. Mohan, chairman of the Centre.
The Indian diet could be a contributing factor, as diet affects gut bacteria.
Prof. Pedersen, in previous research, has been able to show that those who have more diverse gut bacteria are protected from various diseases like type 2 diabetes and obesity, he said.
Eventually, the goal would be to develop prebiotics or probiotics, to help good bacteria flourish so as to prevent type 2 diabetes, said Prof. Pedersen.
His research has shown that even monozygotic twins have different gut bacteria.
Elaborating on his experiments, he said injecting the gut bacteria of an obese mouse into a germ-free mouse could make the latter obese.
Injecting a lean mouse’s gut bacteria into a germ-free mouse led to the mouse remaining lean — showing that gut bacteria could influence obesity
900 stool samples will be taken from people who are pre-diabetic, diabetic and normal in India and Denmark
Doctors say an increasing number of youngsters also require hip replacement surgeries; most patients are in their twenties and
the thirties
Over the last few years, doctors in the city have begun to notice a worrying trend – an increasing number of young people are losing movement in their hips and many require hip replacement surgeries.
The reasons, doctors say are due to the excessive use of alcohol, increased use of anabolic steroids in sports and bodybuilding and also, the unregulated use of steroids. These patients are mostly in their early twenties and thirties.
“What large amounts of alcohol or steroids can do is block the blood supply to the hip joint. This eventually causes pain and loss of movement. As the disease progresses, the pain becomes worse. Eventually, if the patient is in the later stages, a hip replacement is required,” said Samuel Chittaranjan, the former head of the orthopedics department at Sri Ramachandra University.
“When blood supply is blocked, the tissue in the ball of the hip joint or the head of the femur begins to die. This is known as avascular necrosis. As a consequence, the joint becomes irregular, and patients in the prime of their life can become disabled. In India, the most common reason for hip replacement is avascular necrosis — completely opposite to what is in the West,” said Vijay C. Bose, consultant orthopedic surgeon at SRM Institutes for Medical Science. In the last year, Dr. Bose said, he has seen around 200 such cases.
A lot of young people, especially men, use steroids for body-building, and often this is unsupervised, said Dr. Chittaranjan. “There is also a rise in the instances of substance abuse, including alcohol and the giving out of steroids by quacks,” he said. Some young people are on steroids for medical disorders and vascular necrosis could be an unfortunate side effect of this too, said Dr. Bose
In the last five years, Prakash Selvam, consultant orthopedic surgeon at Soundarapandian Bone and Joint Hospital, has seen about 50 such patients. “These cases were not very common 20 years or so ago, but now, 40 percent of the avascular necrosis cases I see are alcohol or steroid-related,” he said.
One of the problems said Dr. Chittaranjan is that many of the patients come in only during the late stages. “At first, there may be no symptoms or mild pain in the groin area. They may take painkillers for this. Another problem is that the condition is not visible in an X-Ray in the early stages – an MRI is needed. So it’s only when the pain is unbearable that they come in for treatment, by which time hip replacement is usually needed,” he said.
The surgery is expensive, said Dr. Chittaranjan, and while patients do go back to work and even sports afterward, an implant can never be as good as the natural hip, he said. “And with young patients, the issue is that the implant may last 15 or 20 years but after this, they’d need another revision surgery. And, this is even more expensive and complex. The more surgeries that are done, the more that natural bone is lost,” he said.
Other options in the early stages include medical therapy said, Dr. Bose. “About 40 percent of patients do well on this,” he said. Decompression surgery to encourage blood supply to the joint is also done in the early stages and stem cell therapy to help regenerate damaged tissue is now being tried out, said Dr. Chittaranjan.
While newer, more sophisticated implants for surgery are now available that could last up to 30 years and offer a better range of motion, these are expensive, said Dr. Bose. More studies, he said are needed in India to find ways to salvage the joint early, especially as the disease seemed to affect the Asian population more than those in the west.
For 29-year-old Rishi,* the pain began five years ago. “But as time went on, it became worse. I could not use an Indian toilet and when I sat on the floor, I had difficulty getting up again,” he said. Both of Rishi’s hips are affected and while the left has been replaced, he is waiting for surgery on the right hip.
Chennai: Ten years ago, a Chennai-based
To find out, doctors in India and Denmark are collecting samples of stool from about 900 people in both countries, extracting DNA from it and studying it — to figure out for instance, if Indians have more aggressive gut bacteria leading to insulin resistance, or how diverse the bacteria are, and how they are affecting the health of people.
The study called ‘Microbdiab’— jointly funded by the Danish government and the department of biotechnology, Government of India — is a collaboration between three organizations in India, including Dr. Mohan’s Diabetes Specialties Centre, as well as the University of Copenhagen.
The stool samples are from people who are pre-diabetic, diabetic, and normal — 450 samples in each country.
Oluf Pedersen, professor of molecular metabolism and metabolic genetics, faculty of health and medical sciences, University of Copenhagen, Denmark, says, “Gut bacteria produce thousands of compounds that enter the bloodstream, are circulated to all organs, and have an impact. Studies have shown they impact the brain too. They can cause diabetes or lead to obesity.
Different disorders
They have an enormous capacity for inducing different disorders. Is there a role for gut bacteria in the development of pre-diabetes and type 2 diabetes and is there a universal gut bacteria that are contributing to causing diabetes worldwide — these are some of the questions we are studying,” said Prof. Pedersen.
Prof. Pedersen was presented the 25th DMDSC Gold Medal Oration Award on Wednesday. Research has indicated that certain gut bacteria are linked to type 2 diabetes, but whether they are innocent bystanders or part of the causation is yet to be explored, he said.
The Microdiab study began a year ago, and is expected to come up with findings in about six months or so, said R. M. Anjana, joint managing director of the Centre.
Indians could have less good bacteria or less diverse bacteria or more bad bacteria, said V. Mohan, chairman of the Centre.
The Indian diet could be a contributing factor, as diet affects gut bacteria.
Prof. Pedersen, in previous research, has been able to show that those who have more diverse gut bacteria are protected from various diseases like type 2 diabetes and obesity, he said.
Eventually, the goal would be to develop prebiotics or probiotics, to help good bacteria flourish so as to prevent type 2 diabetes, said Prof. Pedersen.
His research has shown that even monozygotic twins have different gut bacteria.
Elaborating on his experiments, he said injecting the gut bacteria of an obese mouse into a germ-free mouse could make the latter obese.
Injecting a lean mouse’s gut bacteria into a germ-free mouse led to the mouse remaining lean — showing that gut bacteria could influence obesity
900 stool samples will be taken from people who are pre-diabetic, diabetic and normal in India and Denmark
Doctors say an increasing number of youngsters also require hip replacement surgeries; most patients are in their twenties and
the thirties
Over the last few years, doctors in the city have begun to notice a worrying trend – an increasing number of young people are losing movement in their hips and many require hip replacement surgeries.
The reasons, doctors say are due to the excessive use of alcohol, increased use of anabolic steroids in sports and bodybuilding and also, the unregulated use of steroids. These patients are mostly in their early twenties and thirties.
“What large amounts of alcohol or steroids can do is block the blood supply to the hip joint. This eventually causes pain and loss of movement. As the disease progresses, the pain becomes worse. Eventually, if the patient is in the later stages, a hip replacement is required,” said Samuel Chittaranjan, the former head of the orthopedics department at Sri Ramachandra University.
“When blood supply is blocked, the tissue in the ball of the hip joint or the head of the femur begins to die. This is known as avascular necrosis. As a consequence, the joint becomes irregular, and patients in the prime of their life can become disabled. In India, the most common reason for hip replacement is avascular necrosis — completely opposite to what is in the West,” said Vijay C. Bose, consultant orthopedic surgeon at SRM Institutes for Medical Science. In the last year, Dr. Bose said, he has seen around 200 such cases.
A lot of young people, especially men, use steroids for body-building, and often this is unsupervised, said Dr. Chittaranjan. “There is also a rise in the instances of substance abuse, including alcohol and the giving out of steroids by quacks,” he said. Some young people are on steroids for medical disorders and vascular necrosis could be an unfortunate side effect of this too, said Dr. Bose
In the last five years, Prakash Selvam, consultant orthopedic surgeon at Soundarapandian Bone and Joint Hospital, has seen about 50 such patients. “These cases were not very common 20 years or so ago, but now, 40 percent of the avascular necrosis cases I see are alcohol or steroid-related,” he said.
One of the problems said Dr. Chittaranjan is that many of the patients come in only during the late stages. “At first, there may be no symptoms or mild pain in the groin area. They may take painkillers for this. Another problem is that the condition is not visible in an X-Ray in the early stages – an MRI is needed. So it’s only when the pain is unbearable that they come in for treatment, by which time hip replacement is usually needed,” he said.
The surgery is expensive, said Dr. Chittaranjan, and while patients do go back to work and even sports afterward, an implant can never be as good as the natural hip, he said. “And with young patients, the issue is that the implant may last 15 or 20 years but after this, they’d need another revision surgery. And, this is even more expensive and complex. The more surgeries that are done, the more that natural bone is lost,” he said.
Other options in the early stages include medical therapy said, Dr. Bose. “About 40 percent of patients do well on this,” he said. Decompression surgery to encourage blood supply to the joint is also done in the early stages and stem cell therapy to help regenerate damaged tissue is now being tried out, said Dr. Chittaranjan.
While newer, more sophisticated implants for surgery are now available that could last up to 30 years and offer a better range of motion, these are expensive, said Dr. Bose. More studies, he said are needed in India to find ways to salvage the joint early, especially as the disease seemed to affect the Asian population more than those in the west.
For 29-year-old Rishi,* the pain began five years ago. “But as time went on, it became worse. I could not use an Indian toilet and when I sat on the floor, I had difficulty getting up again,” he said. Both of Rishi’s hips are affected and while the left has been replaced, he is waiting for surgery on the right hip.
Chennai: Ten years ago, a Chennai-based
gastroenterologist found a statistical link between eating tamarind-based dishes and gallstones, one of the established causes of cancer of gall bladder. Though the causes for tamarind causing stones in the organ are still not clear, doctors now suspect the link is more than just a casual relation as every year in the past 30 years, there has been a substantial increase in gallstones and a 10% increase in gall bladder cancers in Chennai.
We have not done any major studies but we cannot ignore the correlation between tamarind and gall bladder diseases anymore," said Apollo Hospitals senior surgical Gastroenterologist Dr. Prasanna Kumar Reddy ahead of Sunday's international conference on Biliary Diseases. The gall bladder is a small sac-shaped organ beneath the liver that stores bile secreted by the liver before releasing it into the intestine.
In 2005, Dr. Jayanthi V and her team from the department of gastroenterology at Government Stanley Medical College and Hospital, Chennai found there was a significant risk of gallstone formation when tamarind was consumed more than 3 times a week. The study was published in the Indian Journal of Gastroenterology.
Surgeons will also push for a consensus Courtesy by TOI-29-02-2016
TOP TEN FRUITS IN LOWERING BAD CHOLESTEROL:-
1. Avocados a large berry type fruit with a central stone-like seed is rich in Mono Unsaturated and Poly Unsaturated Fatty Acids very similar to olive fruits. Scientists believe that 75% of the unsaturated fatty acids are responsible for reducing LDL cholesterol
4. Oranges are though not having cholesterol but they have good fiber contents that are responsible for lowering cholesterol. Even though oranges are not placed in the top ten fruits to lower the cholesterol it is of having high beneficial effects to reduce cardiovascular insufficiency, coronary heart disease because of its antioxidant properties. Oranges are rich in Vit-C, flavenoids, and enormous fibers.
6. Grapes are tasty sweet juicy fruit available as black and green grapes. Grapes contain a chemical known as Pterostilbene this can reduce bad cholesterol and triglycerides in the blood just as a prescription medicine known as Ciprofibrate according
to Dr.Agnes Rimendo, Ph.D. of Department Agricultures National Products
Utilization Research center in Oxford, Mississippi.
7. Pomegranate not only reduces bad cholesterol it also protects HDL from damage. This is very important to those who are under metabolic woes such as for overweight, obesity, developing DM in which there are unprotected good cholesterol like HDL.Paraoxonase an enzyme that is helping HDL to absorb LDL before it gets broken and thus protecting the arteriolar wall. Pomegranate as well as Grapes are acting through this enzyme.
8.Lemon
contains pectin an enzyme which is good for reducing bad cholesterol
along with Vitamin-C a powerful antioxidant and fibers which makes
Lemon is a perfect fruit in the fight for bad cholesterol.
9.Grapefruit
is one kind of citrus fruit, Like other citrus fruits such as orange
, and lemon grapefruit also contains pectin, Vit-C, and fibers to lower
the bad Cholesterol
10. Blueberry is the fruit very similar in appearance and taste to grapes and hence they too have the wonderful cholesterol-reducing enzyme Pterostilbene which works very similar to the commercially available cholesterol-lowering drug Ciprofibrate said by Dr.Agnes Rimando, Ph.D. of Department Agricultures National Products Utilization Research center in Oxford, Mississippi. Also, the blueberries are rich in Vit-C and fiber contents which also help to reduce bad cholesterol in the blood.
In 2005, Dr. Jayanthi V and her team from the department of gastroenterology at Government Stanley Medical College and Hospital, Chennai found there was a significant risk of gallstone formation when tamarind was consumed more than 3 times a week. The study was published in the Indian Journal of Gastroenterology.
Surgeons will also push for a consensus Courtesy by TOI-29-02-2016
TOP TEN FRUITS IN LOWERING BAD CHOLESTEROL:-
1. Avocados a large berry type fruit with a central stone-like seed is rich in Mono Unsaturated and Poly Unsaturated Fatty Acids very similar to olive fruits. Scientists believe that 75% of the unsaturated fatty acids are responsible for reducing LDL cholesterol
 | ||||||
AVOCADO |
2. Apples are really wonderful and miraculous fruits to lower LDL bad cholesterol. The researchers from Florida State University in 2011 explained this in The Experimental Biology Meeting in Washington DC.
3. Strawberries are good antioxidant properties and recent researches by some Italian scientists also proved that strawberries are powerfully reducing bad LDL cholesterol and triglycerides as they enriched with monounsaturated and polyunsaturated fatty acids.
4. Oranges are though not having cholesterol but they have good fiber contents that are responsible for lowering cholesterol. Even though oranges are not placed in the top ten fruits to lower the cholesterol it is of having high beneficial effects to reduce cardiovascular insufficiency, coronary heart disease because of its antioxidant properties. Oranges are rich in Vit-C, flavenoids, and enormous fibers.
5. Pineapples are found to be good for reducing bad cholesterol. Pineapple is rich in vitamins, minerals, and fibers. Its main content Bromelin is said to be good for digesting, assimilating, and metabolizing proteins and fats. It also prevents excess fats from hovering into the blood.
10. Blueberry is the fruit very similar in appearance and taste to grapes and hence they too have the wonderful cholesterol-reducing enzyme Pterostilbene which works very similar to the commercially available cholesterol-lowering drug Ciprofibrate said by Dr.Agnes Rimando, Ph.D. of Department Agricultures National Products Utilization Research center in Oxford, Mississippi. Also, the blueberries are rich in Vit-C and fiber contents which also help to reduce bad cholesterol in the blood.
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Thank you Mr.Sharma.I cordially welcome your appreciation.-M.A.S
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