High iron levels may up gestational diabetes risk: study

November 11, 2016

Washington, Nov 11: Higher levels of iron in pregnant women may lead to an increased risk of gestational diabetes, a new study has warned.

diabetesThe study by researchers from US National Institutes of Health (NIH) also raises questions about routine recommendations on iron supplementation in pregnancy.

Iron is regarded as a double-edged sword in living systems, as both its deficiency and excess can be harmful, researchers said.

While many guidelines recommend screening and treatment only as necessary for iron deficiency, several other groups such as the World Health Organisation (WHO recommend routine iron supplementation among pregnant women.

Emerging evidence has pointed to a possible link between higher iron stores and abnormal blood sugar control (including type 2 diabetes) in non-pregnant individuals.

Researchers did a case-control study of 107 gestational diabetes (GDM) cases and 214 controls (matched on age, gestational week of blood collection and race/ethnicity).

They looked at several biomarkers of iron status, including plasma hepcidin, ferritin, and soluble transferrin receptor (sTfR), and these data were used to calculate the sTfR:ferritin ratio, which captures both cellular iron need and availability of body iron stores.

These markers were longitudinally measured or calculated four times during pregnancy, twice before GDM diagnosis (gestational weeks 10-14 and 15-26), and twice afterwards (gestational weeks 23-31 and 33-39).

GDM diagnosis was ascertained from medical records based on oral glucose tolerance test results.

Statistical modelling was then used to calculate the odds ratio of GDM with iron status, accounting for factors such as demographics, pre-pregnancy body mass index (BMI), and other major risk factors.

Researchers found that for both hepcidin and ferritin, in the second trimester of pregnancy, those in the top 25 per cent of levels of these markers had around a 2.5 times increased subsequent risk of developing GDM compared with those in the bottom 25 per cent.

Similar findings were observed for ferritin levels in the first trimester. Describing the findings as biologically plausible, researchers offer various potential explanations.

Iron may play a role in the development of GDM through several potential mechanisms. As a strong pro-oxidant, free iron can promote several cellular reactions that generate reactive oxygen species and increase the level of oxidative stress.

Oxidative stress induced from excess iron accumulation can cause damage to and death of pancreatic beta cells which produce insulin and consequently, contribute to impaired insulin synthesis and secretion.The study was published in the journal Diabetologia.

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July 2,2020

The American pharmaceutical giant Pfizer Inc. and the European biotechnology company BioNTech SE have conducted an experimental trial of a COVID-19 vaccine candidate and found it to be safe, well-tolerated, and capable of generating antibodies in the patients.

The study, which is yet to be peer-reviewed, describes the preliminary clinical data for the candidate vaccine -- nucleoside-modified messenger RNA (modRNA), BNT162b1.

It said the amount of antibodies produced in participants after they received two shots of the vaccine candidate was greater than that reported in patients receiving convalescent plasma from recovered COVID-19 patients.

"I was glad to see Pfizer put up their phase 1 trial data today. Virus neutralizing antibody titers achieved after two doses are greater than convalescent antibody titers," tweeted Peter Hotez, a vaccine scientist from Baylor College of Medicine in the US, who was unrelated to the study.

Researchers, including those from New York University in the US, who were involved in the study, said the candidate vaccine enables human cells to produce an optimised version of the receptor binding domain (RBD) antigen -- a part of the spike (S) protein of SARS-CoV-2 which it uses to gain entry into human cells.

"Robust immunogenicity was observed after vaccination with BNT162b1," the scientists noted in the study.

They said the program is evaluating at least four experimental vaccines, each of which represents a unique combination of mRNA format and target component of the novel coronavirus, SARS-CoV-2.

Based on the study's findings, they said BNT162b1 could be administered in a quantity that was well tolerated, potentially generating a dose dependent production of immune system molecules in the patients.

The research noted that patients treated with the vaccine candidate produced nearly 1.8 to 2.8 fold greater levels of RBD-binding antibodies that could neutralise SARS-CoV-2.

"We are encouraged by the clinical data of BNT162b1, one of four mRNA constructs we are evaluating clinically, and for which we have positive, preliminary, topline findings," said Kathrin U. Jansen, study co-author and Senior Vice President and Head of Vaccine Research & Development, Pfizer.

"We look forward to publishing our clinical data in a peer-reviewed journal as quickly as possible," Jansen said.

According to Ugur Sahin, CEO and Co-founder of BioNTech, and another co-author of the study, the preliminary data are encouraging as they provide an initial signal that BNT162b1 is able to produce neutralising antibody responses in humans.

He said the immune response observed in the patients treated with the experimental vaccine are at, or above, the levels observed from convalescent sera, adding that it does so at "relatively low dose levels."

"We look forward to providing further data updates on BNT162b1," Sahin said.

According to a statement from Pfizer, the initial part of the study included 45 healthy adults 18 to 55 years of age.

It said the priliminary data for BNT162b1 was evaluated in 24 subjects who received two injections of 10 microgrammes ( g) and 30 g -- 12 subjects who received a single injection of 100 g, and 9 subjects who received two doses of a dummy vaccine.

The study noted that participants received two doses, 21 days apart, of placebo, 10 g or 30 g of BNT162b1, or received a single dose of 100 g of the vaccine candidate.

According to the scientists, the highest neutralising concentrations of antibodies were observed seven days after the second dose of 10 g, or 30 g on day 28 after vaccination.

They said the neutralising concentrations were 1.8- and 2.8-times that observed in a panel of 38 blood samples from people who had contracted the virus.

In all 24 subjects who received two vaccinations at 10 g and 30 g dose levels, elevation of RBD-binding antibody concentrations was observed after the second injection, the study noted.

It said these concentrations are 8- and 46.3-times the concentration seen in a panel of 38 blood samples from those infected with the novel coronavirus.

At the 10 g or 30 g dose levels, the scientists said adverse reactions, including low grade fever, were more common after the second dose than the first dose.

According to Pfizer, local reactions and systemic events after injection with 10 g and 30 g of BNT162b1 were "dose-dependent, generally mild to moderate, and transient."

It said the most commonly reported local reaction was injection site pain, which was mild to moderate, except in one of 12 subjects who received a 100 g dose, which was severe.

The study noted that there was no serious adverse events reported by the patients.

Citing the limitations of the research, the scientists said the immunity generated in the participants in the form of the T cells and B cells of their immune system, and the level of immunity needed to protect one from COVID-19 are unknown.

With these preliminary data, along with additional data being generated, Pfizer noted in the statement that the two companies will determine a dose level, and select among multiple vaccine candidates to seek to progress to a large, global safety and efficacy trial, which may involve up to 30,000 healthy participants if regulatory approval to proceed is received.

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Agencies
March 11,2020

With the sales of chicken and mutton going down due to the coronavirus scare, it is the humble 'Kathal' (jackfruit) is emerging as an acceptable alternative.

'Kathal' is now selling at ₹120 per kilogram -- an increase of more than 120 per cent over the normal ₹50 per kilogram.

The jackfruit, in fact, is now priced higher than chicken which is selling at ₹80 per kilogram due to poor demand.

"It is better having a 'Kathal' biryani instead of a mutton biryani. It tastes reasonably good. The only problem is that 'Kathal' has been sold out in the vegetable market and is difficult to find," said Purnima Srivastava whose family savours non-vegetarian food on a regular basis.

The corona scare has hit poultry business so hard and the Poultry Farm Association recently organized a Chicken Mela in Gorakhpur to dispel the misconception that birds are carriers of the deadly virus.

"In fact, we gave away plateful of chicken dishes for Rs 30 to encourage people to savour the delicacies. We cooked one thousand kilograms of chicken for the Mela and the entire stock was sold out," said Vineet Singh, head of the Poultry Farm Association.

However, the Mela did not do much to dispel the fears about chicken, mutton or fish consumption amid the virus outbreak.

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Agencies
February 11,2020

Using smartphone for long hours every day may do you more harm than you can probably think of. Researchers have found that spending a lot of time with the device and on social media may lead to mental distress and suicidality among adolescents.

The findings, published in the journal CMAJ (Canadian Medical Association Journal) contains guidance for physicians, parents and teachers on how to help teenagers manage smartphone and social media use for a healthy balance between sleep, academic work, social activity, interpersonal relationships and online activity.

"Physicians, teachers and families need to work together with youth to decrease possible harmful effects of smartphones and social media on their relationships, sense of self, sleep, academic performance, and emotional well-being," said lead author of the study Elia Abi-Jaoude from Toronto Western Hospital in Canada.

This review of evidence, led by the Hospital for Sick Children (SickKids), focuses on smartphone use and does not consider online gaming.

"For adolescents today, who have not known a world without social media, digital interactions are the norm, and the potential benefits of online access to productive mental health information -- including media literacy, creativity, self-expression, sense of belonging and civic engagement -- as well as low barriers to resources such as crisis lines and Internet-based talking therapies cannot be discounted," the authors wrote.

The researchers recommend that doctors should ask teenagers to reduce social media use rather than eradicate it completely and encourage parents to be part of the conversations.

Parents should discuss appropriate smartphone use with teenagers to determine together how to reduce risks and set boundaries.

A recent poll from the US indicates that 54 per cent of teenagers think they spend too much time on their smartphones and about half said they were cutting back on usage.

"Encouragingly, youth are increasingly recognising the negative impact of social media on their lives and starting to take steps to mitigate it," the authors wrote.

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