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Does hydroxychloroquine cut COVID-19 mortality? Expert urges caution

by admin - Jul 10, 2020

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Female Doctor Talking With Patient Along Coworker — Female doctor talking with patient along coworker in ICU. Man is lying on bed amidst essential workers. Healthcare workers are in protective workwear.

The antimalaria drug hydroxychloroquine has generated significant controversy. A new study suggests that if it is given early, it can reduce mortality in people with severe COVID-19. But our expert points out weaknesses in the study’s design.

Amid an ongoing search for an effective COVID-19 treatment, the debate about the antimalaria drug hydroxychloroquine (HCQ) continues.

There was plenty of hype about the drug during the early months of the pandemic. On March 28, 2020, the Food and Drug Administration (FDA) granted Emergency Use Authorization (EUA), allowing doctors to use HCQ and chloroquine (CQ) products in situations where clinical trials were not an option.

Last month, the FDA withdrew the EUA. The agency explains that it “has determined that CQ and HCQ are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA. Additionally, in light of ongoing serious cardiac adverse events and other serious side effects, the known and potential benefits of CQ and HCQ no longer outweigh the known and potential risks for the authorized use.”

Clinical trials using the drug have shown mixed results and been marred with controversy. After an investigation by The Guardian into the quality of data analysis provided by a company called Surgisphere, the authors of one high-profile study in The Lancet retracted the paper.

Several institutions have since halted their HCQ studies, including the World Health Organization (WHO) and the National Institutes of Health (NIH).

Now, a new study in the International Journal of Infectious Diseases — by researchers from the Henry Ford Health System, in Michigan — reports that treatment with HCQ alone and in combination with the antibiotic azithromycin reduced the number of deaths among people in the hospital with severe COVID-19.

Comparing mortality rates

The corresponding author is Dr. Marcus J. Zervos, an infectious disease specialist at Henry Ford Hospital and the Wayne State University School of Medicine, both in Detroit, MI.

For their study, the team retrospectively reviewed the medical records of 2,541 individuals who received treatment for COVID-19 in Henry Ford Health System hospitals.

The aim of the research was to compare how many people with COVID-19 died while in the hospital after receiving either HCQ, HCQ and azithromycin, azithromycin on its own, or “other treatments for COVID-19,” as the authors explain in their paper.

Treatment with HCQ, azithromycin, or both began within 24 hours of hospital admission in 82% of cases, and within 48 hours of admission in 91% of cases.

Among the 2,541 patients in the study, 460 died, which equates to an overall mortality rate of 18.1%. In the group of 409 patients who received neither HCQ nor azithromycin, 108 died, representing a mortality rate of 26.4%.

A total of 1,202 patients received only HCQ, of whom 162 died, a mortality rate of 13.5%, while out of the 147 patients who received only azithromycin, 33 died, equating to a mortality rate of 22.4%.

Among the 783 patients who received a combination treatment of HCQ and azithromycin, 157 patients died. This reflects a mortality rate of 20.1%.

While these results sound encouraging, Dr. Hanh Le, who is the senior director of medical affairs at Healthline Media, shared her concerns about the study with Medical News Today.

“As an observational study, it would have been good to have insights into what factored into the treatments that the patients received. For example, of the patients who received neither drug, why were most of them 65 or older?” Dr. Le pointed out. “Unfortunately, the study authors did not address that.”

Study limitations

Dr. Le explained that the average age of those who received neither HCQ nor azithromycin was significantly higher than those who received HCQ.

Specifically, the average age in the group who received other COVID-19 treatments was 68.1 years, the median age was 71 years, and 64.1% were over the age of 65. In the HCQ group, on the other hand, the average age was 63.2 years, the mean age was 53 years, and 48.9% were over 65.

Patients in the HCQ group were also significantly more likely to receive steroids in addition to the drug. While 78.9% of patients in this group received steroids, only 35.7% of patients in the other COVID-19 treatment groups did.

“In addition, white race is a risk factor they identified, and it too was unbalanced,” Dr. Le added.

In the group receiving other COVID-19 treatments, 45.5% were white, while in the HCQ group, 27.6% were white.

“We attribute our findings that differ from other studies to early treatment, and part of a combination of interventions that were done in supportive care of patients, including careful cardiac monitoring,” Dr. Zervos comments in a press release.

“Our dosing also differed from other studies not showing a benefit of the drug. And other studies are either not peer-reviewed, have limited numbers of patients, different patient populations, or other differences from our patients,” he continued.

The study authors do urge caution in light of their findings:

“Our results should be interpreted with some caution and should not be applied to patients treated outside of hospital settings,” they write in the paper. “Our results also require further confirmation in prospective, randomized controlled trials that rigorously evaluate the safety, and efficacy of [HCQ] therapy for COVID-19 in hospitalized patients.”

Managing fatty liver disease

by - Sep 25, 2017

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Nowadays, Nigerians who lead sedentary lifestyles and who have adopted irregular food habits, appear to be more prone to liver diseases than others. Fatty liver disease is the result of a build-up of fat in the liver. If the liver is healthy, there should be little or no fat in it. However, sometimes, fat molecules begin to collect in the liver cells. Small amounts of fat in the liver usually cause no problems. However, when too much fat builds in this organ, it can pose a lot of health hazards.

With the exception of the brain, the liver is the most complex organ and second largest organ in the body. Its function is to process everything we eat or drink and filter harmful substances from the blood. This process is however interrupted when the liver contains too much fat. When fat accounts for more than five percent of the liver’s weight, the condition is described as fatty liver.

It is becoming one of the most common types of liver disease and it’s also one of the causes of liver cancer and cirrhosis. The disease may also occur due to metabolic problems such as diabetes, obesity or Hepatitis B and C infection.

A diagnosis of fatty liver could raise the alarm for an impending Type 2 diabetes. Fatty liver disease can lead to an inflamed liver and scarring. This is called alcoholic hepatitis if it’s caused by drinking too much alcohol and non-alcoholic steatohepatitis if it’s not related to alcohol.

Risk factors

From what I have explained so far, it should be obvious that fatty liver disease is a lifestyle disease. Most people living with this disease are fat, obese and they take alcohol.

It is more common in men and persons above the age of 50. Hypertensive and diabetic patients are most likely to be diagnosed with fatty liver as they are already battling with high blood sugar, glucose and cholesterol.

However, chemicals like methotrexate and tamoxifen can, but rarely cause non-alcoholic fatty liver.

Symptoms

Non-alcoholic fatty liver disease usually causes no signs and symptoms. When it does, they may include fatigue, poor appetite, pain in the upper right abdomen and weight loss.

Its complications include a swollen abdomen, itchy skin, vomiting of blood, confusion or poor memory, weakness and muscle wasting and jaundice.

Diagnosis

Fatty liver disease can sometimes be difficult to diagnose because one may not have any symptoms. There is no single test that can be used to diagnose fatty liver disease, but one may carry out some blood tests, liver biopsy, ultrasound, CT or MRI scan which help to create images of the liver. These images will show if there are any forms of fat in the liver.

Prevention

You may be able to prevent non-alcoholic fatty liver disease by maintaining a healthy weight for your height. Being active try to do at least 150 minutes of moderate exercise each week or 30 minutes of exercise for days.

Those who are obese or overweight, a gradual weight loss and regular exercise is advised. This not only helps with fatty liver but also it will help to reduce other risks of developing cardiovascular problems.

Limit or avoid alcoholic beverages because alcohol even in modest amounts may make fatty liver worse.

Eating healthy foods that are low in saturated fat and reduce your sugar intake to control your blood sugar. Manage your cholesterol levels and use liver supplements.

Conclusion

Alcoholic fatty liver disease is reversible. The liver should return to normal if one stops drinking alcohol. Even if one has been a heavy drinker for many years, reducing or stopping alcohol intake will have important short and long-term benefits on the liver and one’s overall health.

5 Super Foods That Prevent High Cholesterol

by - Sep 19, 2017

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Our eating habits control various body functions for the healthy you. Whatever you eat balances the amount of nutrients and essential elements in the body, so it is always recommended to pick healthy foods and keep the munching on junkies minimal. Our heart is one of the most important organs as it pumps out the blood through the entire body. You must have heard the doctors and dietitians advise to adapting with a diet that lowers the cholesterol for a healthy heart. This is a list of superfoods to keep your bad cholesterol level lower and enhance the buildup of good cholesterol.

Tomatoes

The juicy vegetable tops the list as it is really easy to incorporate the tomatoes in your diet throughout any season. Filled with great benefits, they have the higher amount of lycopene, which gives them beautiful red colour, and eating these will keep the LDL cholesterol lower to a great extent. The healthy heart diet vegetable releases, even more, lycopene when they are cooked.

Almonds

The crunchy nut has several benefits and we cannot ignore them anyway. The great source of Vitamin E, Biotin, Manganese, Monounsaturated Fats, and Fibers which help to prevent the production of high cholesterol and fight with the bad fat. It reduces heart diseases and risk of diabetes as it is high in HDL cholesterol. Therefore, without giving any second thoughts make them the part of your grocery list.

Garlic

It is known for its various properties to kill the bacteria and fungi to aid digestive disorders and lower the bad cholesterol level. The high amount of allicin helps to keep the long-term effects for the same. Through any of the medium i.e. powder, extract, tablet, oil, or raw it has same benefits.

Dark Chocolate

Who else would say no to the super delicious food? You must have heard from the doctors that the dark chocolates are healthy for the heart. They are pure and contain theobromine, which is an active compound for increasing the good cholesterol in the blood. It also prevents blood platelets from sticking together and keeps the consistency of the blood accurate as to prevent the arteries from clogging.

Apple

We have heard many times that an apple a day keeps the doctor away. It is actually true for the heart patients who daily eat apples has good amount of antioxidants and soluble fats that keeps the bad cholesterol at the bay.

7 Health Benefits of Eating Cucumber

by - Sep 18, 2017

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Though commonly thought to be a vegetable, cucumber is actually a fruit. It’s high in beneficial nutrients, as well as certain plant compounds and antioxidants that may help treat and even prevent some conditions. Also, cucumbers are low in calories and contain a good amount of water and soluble fiber, making them ideal for promoting hydration and aiding in weight loss.

This article takes a closer look at some of the top health benefits of eating cucumber.

1. It’s High in Nutrients

Cucumbers are low in calories but high in many important vitamins and minerals. One 11-ounce (300-gram) unpeeled, raw cucumber contains the following:

Calories: 45
Total fat: 0 grams
Carbs: 11 grams
Protein: 2 grams
Fiber: 2 grams
Vitamin C: 14% of the RDI
Vitamin K: 62% of the RDI
Magnesium: 10% of the RDI
Potassium: 13% of the RDI
Manganese: 12% of the RDI

Although, the typical serving size is about one-third of a cucumber, so eating a standard portion would provide about one-third of the nutrients above.

Additionally, cucumbers have a high water content. In fact, cucumbers are made up of about 96% water.

To maximize their nutrient content, cucumbers should be eaten unpeeled. Peeling them reduces the amount of fiber, as well as certain vitamins and minerals, in a serving.

Cucumbers are low in calories but high in water and several important vitamins and minerals. Eating cucumbers with the peel provides the maximum amount of nutrients.

2. It Contains Antioxidants

Antioxidants are molecules that block oxidation, a chemical reaction that forms highly reactive atoms with unpaired electrons known as free radicals.

The accumulation of these harmful free radicals can lead to several types of chronic illness.

In fact, oxidative stress caused by free radicals has been associated with cancer and heart, lung and autoimmune disease.

Fruits and vegetables, including cucumbers, are especially rich in beneficial antioxidants that may reduce the risk of these conditions.

One study measured the antioxidant power of cucumber by supplementing 30 older adults with cucumber powder.

At the end of the 30-day study, cucumber powder caused a significant increase in several markers of antioxidant activity and improved antioxidant status.

However, it’s important to note that the cucumber powder used in this study likely contained a greater dose of antioxidants than you would consume in a typical serving of cucumber.

Another test-tube study investigated the antioxidant properties of cucumbers and found that they contain flavonoids and tannins, which are two compounds that are especially effective at blocking harmful free radicals.

Cucumbers contain antioxidants, including flavonoids and tannins, which prevent the accumulation of harmful free radicals and may reduce the risk of chronic disease.

3. It Promotes Hydration

Water is crucial to your body’s function, playing numerous important roles.

It is involved in processes like temperature regulation and the transportation of waste products and nutrients.

In fact, proper hydration can affect everything from physical performance to metabolism.

While you meet the majority of your fluid needs by drinking water or other liquids, some people may get as much as 40% of their total water intake from food.

Fruits and vegetables, in particular, can be a good source of water in your diet.

In one study, hydration status was assessed and diet records were collected for 442 children. They found that increased fruit and vegetable intake was associated with improvements in hydration status.

Because cucumbers are composed of about 96% water, they are especially effective at promoting hydration and can help you meet your daily fluid needs.

Cucumbers are composed of about 96% water, which may increase hydration and help you meet your daily fluid needs.

4. It May Aid in Weight Loss

Cucumbers could potentially help you lose weight in a few different ways.

First of all, they are low in calories.

Each one-cup (104-gram) serving contains just 16 calories, while an entire 11-ounce (300-gram) cucumber contains only 45 calories.

This means that you can eat plenty of cucumbers without packing on the extra calories that lead to weight gain.

Cucumbers can add freshness and flavor to salads, sandwiches and side dishes and may also be used as a replacement for higher calorie alternatives.

Furthermore, the high water content of cucumbers could aid in weight loss as well.

One analysis looked at 13 studies including 3,628 people and found that eating foods with high water and low calorie contents was associated with a significant decrease in body weight.

Cucumbers are low in calories, high in water and can be used as a low-calorie topping for many dishes. All of these may aid in weight loss.

5. It Could Help Lower Cholesterol

Research shows that cucumbers contain certain compounds that could reduce blood cholesterol levels.

These compounds include phytosterols, or plant sterols, which can be found in many types of fruits and vegetables.

Studies show that plant sterols can reduce LDL cholesterol levels by an average of 5–15% in most people.

One study had participants with and without diabetes supplement with plant sterols. It found that LDL cholesterol levels were reduced by 15% in non-diabetic participants and by an impressive 26.8% in diabetic participants.

Cucumbers also contain pectin, a naturally occurring type of soluble fiber that could decrease blood cholesterol.

An animal study found that administration of pectin extracted from cucumbers caused a significant decrease in both blood cholesterol and triglyceride levels.

Cucumbers contain plant sterols and pectin. Studies show that these two substances could potentially help reduce blood cholesterol levels.

6. It May Lower Blood Sugar

Several animal and test-tube studies have found that cucumbers may help reduce blood sugar levels and prevent some complications of diabetes.

One animal study examined the effects of various plants on blood sugar. Cucumbers were shown to effectively reduce and control blood sugar levels.

Another animal study induced diabetes in mice and then supplemented them with cucumber peel extract. Cucumber peel reversed most of the diabetes-associated changes and caused a decrease in blood sugar.

In addition, one test-tube study found that cucumbers may be effective at reducing oxidative stress and preventing diabetes-related complications.

However, the current evidence is limited to test-tube and animal studies. Further research is needed to determine how cucumbers may affect blood sugar in humans.

Test-tube and animal studies show that cucumber may help lower blood sugar and prevent diabetes-related complications, although additional research is needed.

7. It Could Promote Regularity

Eating cucumbers may help support regular bowel movements.

Dehydration is a major risk factor for constipation, as it can alter your water balance and make the passage of stool difficult.

Cucumbers are high in water and promote hydration. Staying hydrated can improve stool consistency, prevent constipation and help maintain regularity.

Moreover, cucumbers contain fiber, which helps regulate bowel movements.

In particular, pectin, the type of soluble fiber found in cucumbers, can help increase bowel movement frequency.

One study had 80 participants supplement with pectin. It found that pectin sped up the movement of the intestinal muscles, all while feeding the beneficial bacteria in the gut that improve digestive health.

Cucumbers contain a good amount of fiber and water, both of which may help prevent constipation and increase regularity.