Heart surgery? Slate it for the afternoon, study says

PARIS: The risk of serious heart problems after open heart surgery nearly doubles when the operation is performed in the morning rather than the afternoon, researchers said Friday.

Experiments and lab tests pointed to our biological clock as the primary cause of the startling difference in outcomes, they reported in the medical journal The Lancet.

“Our study found that post-surgery heart damage is more common among people who have heart surgery in the morning,” said lead author David Montaigne, a cardiologist at the University of Lille.

“The time of day — that is, the biological clock or circadian rhythm — influences the patient´s reaction to this kind of operation,” he told AFP.

The circadian clock governs the body´s day-night cycles, thus influencing sleep patterns, the release of hormones, and even body temperature.

When disrupted — as with jetlag — repeatedly over long periods, it can aggravate depression, bipolar disorder, cognitive function, and memory formation, research has shown.

Earlier this month, the Nobel Prize for medicine was awarded to three US scientists who pioneered our understanding of how the circadian clock ticks.

The new study unfolded in four steps.

To start, scientists examined medical records for nearly 600 people who had surgery to replace heart valves, half in the morning, half in the afternoon.

Fifty-four of 298 afternoon patients experienced heart attacks or other major cardiac events in the 500 days after the operation, compared to 28 out 298 of the morning patients.

Then, in a year-long clinical trial, 88 patients were randomly scheduled for morning or afternoon valve replacement surgery.

Not only did tissue from the afternoon group show less damage, it also regained the ability to contract more quickly in lab tests that mimicked the heart refilling with blood.

High-risk patients

A genetic analysis of the same tissues showed hundreds of genes linked to circadian rhythms were more active in the afternoon group, suggesting that the heart, too, is influenced by our biological clock.

Montaigne and his team deleted and replaced the corresponding genes in mice to study the impact on the transition between sleep to wakefulness, and vice versa.

Finally, they identified candidate drugs that might modulate these genes in such a way as to protect the heart during surgery.

“The authors have clearly shown that circadian rhythm is of clinical importance,” commented Michel Ovize, a cardiologist from Louis Pradel Hospital, outside Lyon, France.

High-risk patients might be given preference for afternoon surgery in light of the findings, he suggested.

John O´Neill from the Medical Research Council Laboratory of Molecular Biology in Cambridge, England said the results were solid but “not hugely surprising”.

“Just like every other cell in the body, heart cells have circadian rhythms that orchestrate their activity to anticipate the external rhythm of night and day,” he said.

“Our heart ´expects´ to work harder during the day than at night.”

But the discrepancy in outcomes between morning and afternoon operations might also be explained by variance in the biological clocks of the surgeons, he added.

“We know that hand-eye coordination, concentration and cognitive abilities are also affected by time-of-day,” he said.

“The circadian clock may affect outcomes from heart surgery, but understanding why — and how to leverage this information — requires more research.”

Humans have been shown to be either “owls” or “larks”, corresponding to so-called genetic chronotypes that determines whether we function better at night or during the day.

Depression tied to shorter lifespan

People who suffer from depression may not live as long as individuals who don’t experience this mental health disorder, a Canadian study suggests.

Researchers examined six decades of mental health and mortality data on 3,410 adults during three time periods: 1952 to 1967, 1968 to 1990 and 1991 to 2011. Depression was associated with an increased risk of premature death in every decade of the study for men, and starting in the 1990s for women.

The connection between depression and a shorter lifespan appeared strongest in the years following a depressive episode, leading the researchers to conclude that at least part of the risk might be reversed by effectively treating the mental illness.

“For some individuals depression can be very serious condition,” said lead study author Stephen Gilman of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

“Given our finding that individuals whose depression was present at multiple time points in our study were at highest risk, it is very important to seek treatment for depression and to be vigilant about recurrences,” Gilman said by email.

Depression has long been linked to a variety of health problems, in part because it may lead to physiological changes in the body and also because it can contribute to unhealthy habits like a poor diet, inactivity, smoking and excessive drinking.

In the current study, however, researchers found a link between depression and premature death even after accounting for things like obesity, smoking and drinking habits.

“It is known that depression is associated with an increased risk of death from heart disease,” said Dr Ralph Stewart, a researcher at the University of Auckland in New Zealand who wasn’t involved in the study.”

“This study suggests that this increased risk of death extends to other causes of premature death and persists over decades,” Stewart said by email.

The researchers examined data from the Stirling County Study, which began in 1952 in Canada and is one of the first community-based studies on mental illness.

People were about 50 years old on average when they joined the study. Across the three time periods examined, researchers followed half of the participants for at least 19 years.

Researchers calculated life expectancies at age 25 for men and women with and without depression in each wave of the study.

In the first wave, life expectancy with depression was 10 and 12 years shorter for women and men, respectively, researchers report in CMAJ. It was 7 years shorter for men with depression in the second wave, and 7 and 18 years shorter for women and men with depression, respectively, in the last group.

Men with depression were almost three times as likely to die early at the beginning of the study, but the increased risk declined to 52 percent by the end.

Women’s risk of a premature death increased, however. At the start of the study, women with depression were 8 percent more likely to die prematurely, and by the end their increased risk was similar to men’s odds at 51 percent.

Limitations include a long interval between participant interviews, which prevented the research team from determining the exact timing of depression and recurrences, the authors note.

Even so, the findings underscore the importance of diagnosing and treating depression, said Dr. Gjin Ndrepepa, a researcher at the German Heart Center and Technical University in Munich, Germany, who wasn’t involved in the study.

“Since the risk related to depression decays over time, great efforts should be made to improve treatment and prevent recurrences of depressive episodes,” Ndrepepa said by email.

Treating depression, Ndrepepa added, “can reduce depressive symptoms, improve quality of life and potentially prolong life.”

Global measles deaths fall, but elimination goals far off: WHO

Annual deaths from measles dropped below 100,000 worldwide last year for the first time, to 90,000, the World Health Organization (WHO) and other international agencies said on Thursday.

Reporting an 84 percent drop in 16 years, to 90,000 deaths in 2016 from more than 550,000 in 2000, the Measles and Rubella Initiative (M&RI) said more children getting vaccinations was the main reason for the decline.

The report warned, though, that the world is still far from eliminating measles. Coverage with the first of two required doses of measles vaccine has stalled around 85 percent since 2009, it said, short of the 95 percent needed. Coverage with the second dose was only 64 percent in 2016.

“We must strive to reach zero measles cases,” said Jean-Marie Okwo-Bele, the director of the WHO’s immunization department. “Measles elimination will only be reached if measles vaccines reach every child, everywhere.”

M&RI is a partnership of the American Red Cross, the US Centers for Disease Control and Prevention, the United Nations Foundation, the UNICEF children’s fund, and the WHO.Its report said that since 2000, an estimated 5.5 billion doses of measles vaccine have been provided to children in routine immunization services and mass vaccination campaigns.

It added, however, that some 20.8 million children are still missing their first measles vaccine dose.

More than half of these unvaccinated children live in six countries: Nigeria, India, Pakistan, Indonesia, Ethiopia and the Democratic Republic of the Congo.

It said large outbreaks of measles continue to occur in those countries as well as others in Europe and North America, putting children at risk of severe health complications such as pneumonia, diarrhea, encephalitis, blindness, and death.

Seth Berkley, chief executive of the GAVI global vaccine alliance, welcomed the decline in measles deaths.

But he added but added: “We cannot afford to be complacent. Too many children are still missing out on lifesaving vaccines. To reach these children and set ourselves on a realistic road to measles elimination we need to dramatically improve routine immunization backed by strong health systems.”

Eight die after consuming poisonous milk in Muzaffargarh

MUZAFFARGARH: As many as eight people have died after reportedly consuming poisonous milk in Wahlot area between Rajanpur and Muzaffargarh, Geo News reported on Thursday.

The Deputy Commissioner Saif Anwar also shared that additional nine people are currently seeking treatment in the same case; seven have been admitted to Nishtar Hospital Multan while two are being treated in Dera Ghazi Khan’s District Headquarter Hospital.

The case was reported after 13 members of a family reported feeling sick after consuming milk and butter early Thursday morning.

The rescue sources shifted the family members to the hospital during which time two people passed away. Since, then casualties have risen to as many as eight.

The DC also shared that food and drinking items, such as wheat, curry, butter and other spices, have been confiscated and their samples have been taken.

The forensic report will reveal the actual details of the case, remarked Anwar.

Novartis sees bright future for eye unit

ZURICH: Swiss pharmaceutical giant Novartis said Tuesday a strategic review of its eye care unit showed that Alcon can deliver strong growth, but that a possible spin-off or listing is at least two years away.

While a decision on Alcon´s fate had been expected by the end of this year, the firm said it wanted further quarters of sales growth and better profit margins before taking a decision, meaning that no action was likely before the first half of 2019.

Novartis also released Tuesday quarterly results which showed a 7 percent increase in net profit to $2.08 billion on a 2 percent increase in sales to $12.4 billion.

But over the first nine months of the year net profit was down 1 percent to $5.7 billion.

Novartis confirmed its annual outlook of sales similar to the $48.5 billion registered last year and operating profits near or slightly below the $12.9 billion recording in 2016.

The firm said it had made significant progress in its strategic review of Alcon, part of which was a decision to transfer over-the-counter Novartis ophthalmic products into the division beginning in January.

As part of the review it “updated Alcon´s strategic plan which confirms that it has the potential to grow sales at or above market while delivering profitability at least in line with the industry,” the company said in a statement.

Sales rose by 6 percent in the third quarter to $1.5 billion. Over nine months, the rise in sales was 3 percent to $4.5 billion.

“Alcon delivered strong growth in both sales and core operating income,” chief executive Joseph Jimenez said in the statement.

Numerous analysts had doubted Novartis would come to a decision on Alcon´s fate by the end of the year given the upcoming change in leadership.

Jimenez, who has been chief executive since 2010, is set to hand over the reins at the end of January to Vasant Narasimhan, who has been the firm´s global head of drug development and chief medical officer since February last year.

California judge tosses $417 million talc cancer verdict against Johnson & Johnson

A California judge on Friday threw out a $417 million verdict against Johnson & Johnson in a lawsuit by a woman who claimed she developed ovarian cancer after using its talc-based products like Johnson’s Baby Powder for feminine hygiene.

The ruling by Los Angeles Superior Court Judge Maren Nelson marked the latest setback facing women and family members who accuse J&J of not adequately warning consumers about the cancer risks of its talc-based products.

The decision followed a jury’s decision in August to hit J&J with the largest verdict to date in the litigation, awarding California resident Eva Echeverria $70 million in compensatory damages and $347 million in punitive damages.

Nelson on Friday reversed the jury verdict and granted J&J’s request for a new trial. Nelson said the August trial was underpinned by errors and insufficient evidence on both sides, culminating in excessive damages.

Mark Robinson, who represented the woman in her lawsuit, in a statement said he would file an appeal immediately.

“We will continue to fight on behalf of all women who have been impacted by this dangerous product,” he said.

J&J in a statement said it was pleased with the verdict, adding that it will continue to defend itself in additional trials.

The judge added that there also had been misconduct of the jury during the trial.

J&J said declarations by two jurors after the trial showed that three members of the 12-person jury who voted against finding the company liable were improperly excluded from determining damages.

J&J says it faces lawsuits by 4,800 plaintiffs nationally asserting talc-related claims. Many of those cases are in California, where Echeverria’s case was the first to go to trial, and in Missouri, where J&J has faced five trials.

The Missouri litigation led to four verdicts against J&J in which juries issued verdicts totalling $307 million. The company has only won one trial.

But the Missouri cases, which have largely been brought by out-of-state plaintiffs, have faced jurisdictional questions after the Supreme Court issued a ruling in June that limited where personal injury lawsuits could be filed.

On Tuesday, a Missouri appellate court threw out a $72 million verdict by a jury in February 2016 to the family of a deceased Alabama woman after ruling the case should not have been tried in St. Louis.

Chinese scientists find fungus used in traditional medicine can fight cancer

Chinese scientists have discovered a fungus that carries anti-cancer benefits in it and might be the next painless solution for getting rid of cancer.

The fungus carries properties that initiate detoxification in the body when a certain harmful substance, cordycepin reaches an abnormal level in the body.

The research was underway for the past eight years and was recently published online on Thursday on International Journal cell Chemical Biology website.

Bright orange or yellow coloured Cordyceps militaris is a meal-friendly ingredient in Chinese households.

Cordyceps fungi is popularly used in soups and stews for its immunity-enhancing and energy-boosting properties. The uses of these herbs date back to the time of the Ming Dynasty in 15th century.

Before the research people had been using this herb based on their experience. “It’s a major breakthrough that our team has scientifically proved that Cordyceps militaris really carries such properties,” said Guo Jinhua, Party chief of the institute.

Woman gives birth outside Raiwind hospital after being refused entry by staff

A woman in Raiwind gave birth outside the District Headquarters (DHQ) Hospital, Raiwind early Monday morning after staff at the hospital refused to treat her.

Initial investigation conducted by the hospital suggests that a lady health worker refused Sameera Bibi — who was experiencing severe labour pains — any medical help because “there were no doctors available at the hospital in the early hours of the morning.”

Bystanders at the scene told DawnNews that no Rescue 1122 ambulances were available at the hospital, and one had to be called to the scene. By the time it arrived, however, the child had already been born.

When contacted, Punjab Minister for Health Khawaja Imran Nazir told Dawn that the provincial ministry had ordered an inquiry into the matter.

“No doctor or staff member involved in the incident will be spared and a committee has been formed to look into this matter,” Nazir said.

“All gynaecology-related facilities are available at DHQ Raiwind,” Secretary Health Ali Jan Khan told Dawn while reiterating that a committee had been formed to probe the matter.

According to sources within the hospital, the inquiry team created by the provincial government has reached the DHQ and an investigation into the matter is underway.

“The child and the woman are both safe, and the hospital is also conducting an inquiry into the matter,” said DHQ Medical Superintendent Doctor Amir.

The hospital is just miles away from ousted prime minister Nawaz Sharif’s Jati Umra residence in Raiwind.

Earlier this year, on January 1, Zohra Bibi, 60, of Tibbi Kambovan, lost her life on the floor of Jinnah Hospital in Lahore because there were no beds available at the medical facility.

Investigation into the case had revealed that the woman, who was experiencing severe pain, also visited DHQ Kasur and was refused treatment there, before visiting the Lahore hospital.

KTH staffer dies of dengue; death toll in KP rises to 49

PESHAWAR: A staff member of Khyber Teaching Hospital (KTH) died on Sunday of dengue virus, taking the death toll due to the mosquito-borne disease in Khyber Pakhtunkhwa to 49.

According to the KTH administration, ward boy Altaf was admitted to the hospital due to high fever three days ago but later succumbed to the disease.

The deceased belongs to Peshawar’s Paoka area.

Authorities had found dengue larvae in water samples in various areas of the city, including Tehkal, Safaid Dheri, Shadi Peer and Palosi.

The Peshawar district administration has said several teams were working towards eradicating the dengue virus and have fumigated over 15,000 houses so far in an attempt to kill dengue mosquitoes and their eggs.

Moreover, the local administration has decided to begin a dengue awareness campaign in all educational institutes as well.