Minor stroke needs quick medical attention, too

Agencies
July 4, 2018

Jul 4: Minor strokes and “mini-strokes,” or transient ischemic attacks (TIAs), need early medical attention, just like major strokes, but a public education campaign in the UK had little success convincing the public to act fast after these events.

“Although the campaign worked well for behavior after more major stroke, patients were still slow to act on, or ignored completely, the symptoms of minor events,” said Dr. Peter M. Rothwell from John Radcliffe Hospital, University of Oxford.

“It was almost as though the messages from the campaign about major stroke had falsely reassured them that the more minor event that they had experienced was probably nothing to worry about,” said Rothwell, senior author of a study on the campaign´s impact.

“If you have a minor ‘warning’ event, the risk of a more major stroke over the next week is about 10 percent if you are not treated,” he said in an email. “However, that risk is reduced by 80 percent if simple medical treatments are started urgently.”

If you have sudden, temporary neurological symptoms that you haven’t had before, he advises, “Don’t delay. . . get checked.”

Also, he said, “The most important immediate thing that you can do yourself if you have a ‘TIA’ is to take an aspirin (same as is advised after a suspected heart attack). Take an aspirin and seek medical attention.”

Rothwell’s team looked at the impact of the Face, Arm, Speech, Time (FAST) public education campaign on the likelihood that patients would seek medical attention within three hours of their symptoms.

The campaign warned, “When stroke strikes, act FAST. Face: has it fallen on one side? Arms: can they raise them? Speech: is it slurred? Time: if you notice any of these signs, it’s time to call (for an ambulance).”

Facial weakness, arm symptoms and speech disturbance were less common among people with minor stroke or TIA than among those with major stroke, and only about 35 percent of patients with TIAs who didn’t seek medical attention had any of these signs.

Before the campaign, about 68 percent of people with major stroke obtained medical attention within three hours; after the FAST campaign this increased to 81 percent, according to the report in JAMA Neurology.

In contrast, only about 40 percent of patients with TIA and minor stroke obtained medical attention within three hours both before and after the FAST campaign.

Surprisingly, fewer patients correctly attributed their symptoms to TIA or minor stroke after the FAST campaign (28 percent) than before it (37 percent), and 5 percent of patients did not even report their symptoms until the next routine appointment with their doctor.

“Campaigns rightly stress the need to seek emergency medical attention if you have signs of a major stroke,” Rothwell said. “The symptoms of TIA and minor stroke are very similar - but just less severe and more transient (often lasting only minutes). Current campaigns would really only need to add that message at the end of the TV advertisement or poster – ‘and don’t ignore symptoms that might be a small ‘warning stroke’ either - that is an emergency, too.’”

“For any of the stroke symptoms, major, minor, or transitory, time remains of the essence,” said Dr. Victor Loh from National University Health System, Singapore, who recently detailed the outpatient management of TIA, but was not involved in the study.

“Perhaps after the primary message of needing to head to hospital within the time window for patients with major stroke, the secondary message needs to be emphasized: that even if symptoms are mild or transitory, early review and intervention can drastically reduce the risk of a major stroke,” he said by email.

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Agencies
June 19,2020

While coughing, fever and difficulty in breathing are common symptoms of COVID-19, a new case study has found that pink eye is also a reason to be tested for the disease.

The study, published in the Canadian Journal of Ophthalmology, determined that conjunctivitis and keratoconjunctivitis can also be primary symptoms of COVID-19.

The researchers noted that in March, a 29-year-old woman arrived at the Royal Alexandra Hospital's Eye Institute of Alberta with a severe case of conjunctivitis and minimal respiratory symptoms.

After the patient had undergone several days of treatment with little improvement -- and after it had been determined that the woman had recently returned home from Asia -- a resident ordered a COVID-19 test.

The test came back positive, according to the researchers.

"What is interesting in this case, and perhaps very different to how it had been recognised at that specific time, was that the main presentation of the illness was not a respiratory symptom. It was the eye," said Carlos Solarte, an assistant professor at the University of Alberta in Canada.

"There was no fever and no cough, so we weren't led to suspect COVID-19 at the beginning. We didn't know it could present primarily with the eye and not with the lungs," Solarte said.

Academic studies at the outset of the pandemic identified conjunctivitis as a secondary symptoms in about 10 to 15 per cent of COVID-19 cases, he said.

Since then, scientists have gained greater knowledge of how the virus can transmit through and affect the body's mucous membrane system, of which the conjunctiva -- the clear, thin membrane that covers the front surface of the eye -- is an extension.

While the finding provides important new health information for the public, it also makes eye exams more complicated for ophthalmologists and staff, the researchers noted.

"The patient in this case eventually recovered well without any issues. But several of the residents and staff who were in close contact with the patient had to be under quarantine," said Solarte.

"Fortunately, none who were involved in her care also tested positive," he said.

Patients coming into an eye clinic with conjunctivitis and keratoconjunctivitis are now treated as potential cases of COVID-19 and extra precautions are taken by staff, according to the researchers.

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Agencies
May 23,2020

Food with high water content is highly prescribed by doctors to stay hydrated during the summers, a season that summons a wave of soaring temperatures, higher than 40-degrees.

A much-loved fruit in India, apples are hydrating heros' in such a situation. A heatwave can affect human health in a varied manner and to maintain ideal body temperature in this soaring summer, one must remain adequately hydrated, be protected from the sun and maintain hygiene.

Working professionals and people who must step out in summers, are prone to the heatwave impact. Pediatric experts and doctors agree on the benefits of drinking water and eating fruits, especially, apples. 'An apple a day, keeps the doctor away' is true as they are rich in a number of vitamins with great anti-inflammatory benefits and many other essential minerals. Washington Apple Commission spells how apples can prove to be a summer-friendly fruit.

People often don't realise the danger of exposing themselves to extreme heat. Older adults, young children, and people with chronic illnesses are most at greater risk for serious problems. The nutrition benefits of apples may help not only in avoiding such illnesses but may also protect against many such conditions.

As popular as apples are as a fruit, they are enriched in antioxidants, dietary fibers, vitamins and a range of other nutrients that are greatly beneficial in maintaining good health. The fruit is rich in soluble fibers which may help prevent several health conditions and may lower the risk of major diseases such as heat strokes, diabetes and cancer.

The soluble fiber also promotes weight loss and improves gut health. The prebiotic effects of apples help feed the good bacteria in the gut, thus, improving digestion.

Apples are made of 85 percent water and contain vitamins, fibres and antioxidants. A high fibre content is a particularly beneficial property of apples, as improper digestion is a major health concern in the tropical climatic region. Apples are also enriched in antioxidants that help protect the lungs from oxidative damage and help oxygen flow through the blood.

Apple-based recipes

Make interesting snacks, dessert, beverages and savoury meals with this miraculous fruit during summers.

Salted apple caramel galette

Caramel apples get a grown-up makeover with this Salted Caramel Apple Galette. Warm, gooey, and delicious, this pastry is loaded with apples and homemade caramel. It's a sophisticated take on a childhood favorite and since it's easier to make than pie, it's perfect for summer get-togethers.

Caramel apple pie ice-cream sandwiches

Nothing is better at a cookout on a warm day than a cold, refreshing ice cream sandwich. In Caramel Apple Pie Ice Cream Sandwiches, the comforting flavor of apple pie is recreated in a creamy frozen banana-based ice cream studded with apple and date pieces. Then that scoop of ice cream is sandwiched between two pieces of no-bake cinnamon oat cookie dough.

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Agencies
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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