Category: Medicine

In a landmark medical achievement, a team of neurosurgeons in Chennai successfully excised a deeply embedded insular brain tumor from a 44-year-old woman using a revolutionary eyebrow keyhole technique.

“This unprecedented technique, being the world’s first, marks an important advancement in the field of neuro-oncology,” stated Apollo Cancer Centres (ACC), Chennai, in an announcement on Tuesday.

The tumor was discovered during a routine examination following the woman’s bike accident. It was located within the delicate folds of her dominant-side insular lobe of the brain.

The insula, situated deep within the cerebral cortex, presents substantial challenges for surgical removal due to its proximity to critical areas responsible for speech and movement. It is enveloped by a complex network of blood vessels, making traditional surgical approaches highly risky.

Conventional surgeries involve navigating through vital brain tissue and blood vessels, posing risks of paralysis, stroke, and language impairment. Patients are often required to remain awake during these procedures, heightening their distress and the potential for complications such as seizures and brain bulges. Despite these dangers, surgery is usually the only viable option.

The neurosurgical team at ACC decided to employ the innovative keyhole technique, making a small incision in the eyebrow to access the insula. This decision was informed by their extensive experience with keyhole surgeries for skull base lesions.

The new approach not only offers an alternative for removing deeply seated brain tumors but also exemplifies “clinical excellence, efficiency, and safety.”

“The impact of this achievement cannot be overstated. The eyebrow keyhole approach offers a transformative alternative to reach these deep-seated tumours inside the brain, minimising invasiveness, reducing collateral damage, and significantly enhancing patient safety and overall quality of life,” commented Hrishikesh Sarkar, Senior Consultant in Neurosurgery at Apollo Cancer Centres.

According to the doctor, the patient was discharged from the hospital within 72 hours and is now recovering well.

Expressing her gratitude, the woman said that the advanced treatment not only cured her but also “gave me hope, comfort, and a shorter return to normalcy.”

(Albany, NY – May 23, 2024)  Dr. Hari Krishna Shukla, practicing Medicine in Flushing, Queens in New York for nearly four decades, serving thousands of young patients, was bestowed with the New York State Liberty Medal during a solemn ceremony on the New York Senate Floor in Albany, NY on May 15^th, 2024.

The New York State Liberty Medal is the state’s highest honor, presented to citizens, who have merited special commendation for the actions on behalf of their fellow New Yorkers and their community.

Dr. Shukla, whose discovery of the “Shukla’s Formula” made him popular across the globe, was given the Liberty Medal by New York State Senator Toby Ann Stavisky (11th SD- Queens), recognizing his life-saving work in the field of neo-natal pediatric medicine. Earlier, on March 26, 2024, the New York State Senate passed and adopted a resolution (Senate No. 2010) to honor Dr. Hari Krishna Shukla for his work in the field of Pediatric-Neonatal Medicine.

“Dr. Shukla has received international acclaim for his work in advancing the science of how doctors treat infants born prematurely,” said Senator Toby Ann Stavisky. “Dr. Shukla is most renowned for developing a mathematical formula for ideal position of umbilical catheters in sick infants that helps to deliver critical fluids and medications more safely to premature children both intravenously and through the umbilical cord. Known as “Shukla’s formula.”

Senator Toby Ann Stavisky IS New York state senator since 1999 and Chairwoman  for higher education. This is the first time she has presented the Liberty Medal to any constituent. “Dr. Shukla’s life’s work in the field of neo-natal pediatric medicine warrants this honor,” Sen. Stavisky said.

Dr. Shukla is well known across the world for his work in advancing the science of how doctors treat infants born prematurely. Dr. Shukla is most renowned for developing a mathematical formula  to place umbilical catheters in an ideal position, in order that it causes minimal complications. The umbilical catheters in infants are known as life line  as it helps in maintaining fluid, electrolytes  and nutrition. It is also used for blood drawing, transfusion and admiration of medications.

Since Dr. Shukla published his research article on the topic in 1986, millions of infants have been benefited using Dr. Shukla’s Formula worldwide. Dr Shukla created a mathematical equation to place catheter in a position where it causes minimal complications. Dr Shukla’s Formula is now being used worldwide in  several countries, including the United States, Canada, Unite Kingdom, other European countries, Australia, India, Japan, China Russia, South Korea, Middle east. Every year about fifteen million infants receives umbilical catheterization. Dr Shukla’s equation is quoted in several medical textbooks and manuals throughout the world.

Dr. Shukla developed a formula for rapid estimation of insertional length of Endo-tracheal tubes in infants. This formula is used widely in the hospitals in United States, and has been made as part of the required training in BLS, PALS and ACLS courses in United States, given to residents, fellows, physician assistants, nurse practitioners prior to commencing employment and in continuing medical education courses required for maintenance of licensure.

Additionally, Dr. Shukla’ work has significantly contributed to the field of Pediatric Medicine. Dr. Shukla was the first US Physician to use surfactant in Preterm babies in the City of New York in 1986 under Investigational New drug (IND) protocol of Unite States Food and Drug Administration and NIH. The Surfactant therapy is now the standard mode of therapy for preterm infants with premature lungs all over the world. Dr Shukla received a Citation from United States Congress for being the first physician in New York to use surfactant.

Another area, where his contributions have helped are the patients with jaundice. His investigative research on how jaundice causes Kernicterus after his basic research on rats in an animal laboratory at the NYU School of Medicine was the first to demonstrate blood brain barriers for Bilirubin. This research helps in understanding how bilirubin reaches brain tissue and causes damage to Neurons.

His skills and love for the patients was witnessed during the Covid epidemic, when Dr Shukla treated over four hundred Covid positive children, from one-day- old to eighteen years old, with zero mortality.

Dr Shukla is the recipient of the “Pasteur, Merieu and Connought” (The Makers of Polio Vaccine) Award for his work toward eradication of Polio in the United states and India.

Dr Shukla has served as a Consultant Pediatrician for over 38 years for the Permanent Missions of numerous countries to the United Nations and Consulate General of India. He is also the Civil Surgeon for the United States Department of Justice, Immigration and Naturalization Service since 1990.

Dr. Shukla, a triple Board certified by the American Board of Pediatrics, Neonatal-Perinatal Medicine & Forensic Medicine, is a Clinical Associate Professor at the New York University, School of Medicine and has nearly four decades of experience in training over 300 Residents and Fellows and he continues to provide state of the art care to preterm infants and children in the US and abroad.

Dr. Hari Shukla came to the United States in 1980 as a Rotary International exchange scholar from India. He is married to Kirti Shukla. The couple are blessed with two boys Mrugank and Mehool, who are American Medical Graduates, practicing in New York.

Understanding your body’s water needs can be tricky, especially during periods of extreme heat. With sweat working overtime to keep us cool, our bodies demand more water to stave off dehydration. Neglecting this essential need can result in fatigue, blood pressure spikes, and irregular heart rhythms.

The ubiquitous advice to drink eight glasses of water a day, each containing 8 ounces, has long been a staple. Referred to as the “eight-by-eight” rule, it suggests consuming 64 ounces of water daily. However, this guideline lacks scientific grounding and may not suit everyone’s hydration requirements.

While some adhere faithfully to this rule, it’s important to recognize its origins are more tradition than science. Although consuming 64 ounces of water daily isn’t harmful, it might not suffice for some individuals.

While the eight-by-eight guideline is prevalent, it’s far from the only recommendation. The absence of a universal consensus on daily water intake underscores the individual variability in hydration needs.

An “adequate intake” of water exists for adults, though it fluctuates among individuals. This includes fluids from sources beyond water, such as milk, sports drinks, tea, and even coffee, as well as water-rich foods like fruits and vegetables. For men, this intake is around 15.5 cups (3.7 liters or 125 ounces), while for women, it’s approximately 11.5 cups (2.7 liters or 91 ounces). Nevertheless, these figures remain general, subject to personal variation based on several factors.

Certain circumstances warrant higher water consumption:

– Active Jobs:Occupations demanding physical activity, especially outdoors, necessitate increased water intake to replenish lost fluids and electrolytes.

– Regular Exercise:Even without a physically demanding job, individuals engaging in frequent exercise, whether at the gym or through recreational activities, should augment their water intake to compensate for fluid loss.

– Hot Climates:Elevated temperatures lead to more sweating, accentuating the need to replace lost fluids. Dry environments exacerbate fluid loss, making hydration particularly crucial in desert regions.

– Pregnancy and Breastfeeding:Expectant and breastfeeding individuals require additional water to support physiological processes vital for their health and that of their baby.

Various hydration strategies exist, offering diverse approaches:

– Thirst as a Guide:Some advocate drinking when thirsty, though opinions vary on its efficacy, with concerns that thirst may signal dehydration.

– Scheduled Intake:Structuring water consumption around meals can establish a hydration routine, though its effectiveness may vary depending on meal frequency.

– Eight Glasses a Day:While convenient, this rule overlooks individual differences in hydration needs, potentially resulting in under or overhydration.

– Half Your Body Weight in Ounces:This straightforward guideline adjusts water intake based on body weight, yet overlooks other crucial factors like activity level and climate.

Ultimately, finding the right hydration strategy involves experimentation. Monitoring signs of dehydration, such as fatigue or headaches, and observing urine color can help gauge hydration levels effectively.

The widely propagated notion of walking 10,000 steps daily as the pinnacle of good health prompts the question: Is this figure truly substantiated? Lindsay Bottoms, an expert in exercise and health physiology at the University of Hertfordshire, underscores the multifaceted benefits of walking, including enhanced cardiovascular fitness, weight management, mood improvement, better sleep, cognitive function enhancement, and decreased risk of chronic illnesses like dementia and certain cancers, and even the amelioration of conditions like type 2 diabetes.

While any form of exercise bolsters immune function and mental well-being, walking stands out for its simplicity, accessibility, and versatility, rendering it suitable for individuals of all ages. Notably, recent research findings highlight the significance of relatively lower step counts. A study published in the European Journal of Preventive Cardiology unveiled that walking approximately 3,967 steps daily is associated with a reduced risk of all-cause mortality, while a mere 2,337 steps correlate with diminished cardiovascular disease mortality. Another study, featured in JAMA Neurology, suggests that around 8,900 steps per day may decelerate cognitive decline and brain volume loss among high-risk individuals.

However, the genesis of the ubiquitous 10,000-step goal traces back to a marketing initiative by Yamasa Clock in Japan during 1965. This “Manpo-kei” pedometer, translating to ‘10,000 steps meter,’ served as a promotional tool for the device, cementing the 10,000-step benchmark globally. Nevertheless, some individuals advocate for the benefits of surpassing this target by walking 20,000 steps daily. But is this level of activity truly necessary? Bottoms advocates for a pragmatic approach, suggesting that while there’s merit in breaking up sedentary time and staying active, aiming for 20,000 steps might prove demoralizing and unattainable for many.

Empirical evidence suggests that the threshold for optimal health outcomes lies significantly below the 10,000-step mark. Research indicates that mortality rates and cardiovascular disease incidents plateau at approximately 7,500-8,500 steps, with some studies even demonstrating mortality reduction in women with as few as 4,400 steps daily.

So, what’s a reasonable step goal to support overall health? Bottoms advises aiming for as many steps as feasible while prioritizing the interruption of prolonged sitting. A target of 7,000 steps daily serves as a practical benchmark, with incremental increases recommended for those falling short. She emphasizes the importance of integrating physical activity into daily routines, such as walking during work calls or opting for brisk walks with pets in lieu of sedentary breaks.

Bottoms further stresses that it’s not solely about step counts but overall physical activity. The World Health Organization recommends a minimum of 150 minutes of moderate-intensity exercise per week (or 75 minutes of vigorous exercise), coupled with at least two muscle-strengthening sessions.

In essence, while the 10,000-step goal persists in public consciousness, emerging research suggests that reevaluating this standard may be prudent. Embracing physical activity in various forms, including walking, remains pivotal for fostering holistic well-being.

Loneliness and social isolation, prevalent global issues, may play a significant role in mitigating health risks associated with obesity, according to a recent study. The findings are particularly noteworthy as individuals classified as obese tend to experience higher levels of loneliness, according to the report.

Dr. Lu Qi, the lead author of the study published in JAMA Network Open, emphasized the current focus on dietary and lifestyle factors in preventing obesity-related illnesses. However, he highlighted the importance of considering social and mental health to improve the well-being of individuals with obesity. Dr. Qi, a professor and interim chair of the department of epidemiology at Tulane University School of Public Health and Tropical Medicine in New Orleans, conveyed this message via email.

The research, drawing data from nearly 400,000 individuals in the UK BioBank, a comprehensive biomedical database, explored the long-term impact of loneliness on health. Participants initially did not have cardiovascular disease when data collection commenced, and the study followed up between March 2006 and November 2021.

The results revealed a notable 36% lower rate of all-cause mortality for individuals classified as obese who reported lower levels of loneliness and social isolation over the study period. Dr. Qi suggested integrating social and psychological factors into intervention strategies to prevent obesity-related complications.

Surprisingly, social isolation emerged as a greater risk factor for all-cause mortality, including cancer and cardiovascular disease, compared to depression, anxiety, and lifestyle risk factors such as alcohol consumption, exercise, and diet.

Dr. Philipp Scherer, a professor of internal medicine at the University of Texas Southwestern Medical School, expressed that while the findings weren’t surprising, they underscored the potential of improving social isolation as a remedy to reduce mortality.

Loneliness, often overshadowed by discussions on diet and exercise, has gained recognition as a major risk factor for poor health outcomes. A study from June 2023 found that socially isolated individuals were 32% more likely to experience premature death than their socially connected counterparts. Chronic loneliness can act as a form of stress, adversely affecting the body through stress hormones, as explained by Turhan Canli, a professor of integrative neuroscience at Stony Brook University.

Canli suggested that the link between loneliness and poor health outcomes might also be tied to socially isolated individuals having reduced access to medical care or engaging in other unhealthy habits, such as smoking and excessive alcohol use. He emphasized the importance of maintaining a social network as a health-promoting activity, akin to regular exercise and a balanced diet.

Rachael Benjamin, a licensed clinical social worker based in New York City, highlighted that despite the plethora of online connections available, individuals might still feel lonely. Feeling known by others and integrated into the community is crucial for combating loneliness. Benjamin pointed out that fatphobia could make it challenging for people with obesity to feel understood and accepted within their communities.

Addressing bias on an individual level may be challenging, but Benjamin outlined steps to foster quality relationships. She defined a quality relationship as one where individuals can be themselves without the pressure to pretend. Benjamin encouraged self-reflection to identify self-imposed isolation habits and recommended making an effort to connect with people regularly, even if it feels uncomfortable initially. Building quality connections, she noted, takes time, effort, and patience.

The study sheds light on the interconnectedness of social well-being and physical health, particularly for individuals classified as obese. Integrating strategies to alleviate loneliness and social isolation alongside traditional approaches may contribute to more comprehensive efforts in preventing obesity-related complications.

Novavax has secured emergency-use authorization from the World Health Organization (WHO) for its updated COVID-19 vaccine, extending its eligibility to individuals aged 12 and older. This approval, granted on Tuesday, follows the previous authorization the vaccine received in the United States just last month. The enhanced Novavax shot is designed to combat a variant stemming from the XBB lineage of the coronavirus, which held global prominence earlier this year.

The World Health Organization’s emergency use listing serves the crucial purpose of expediting regulatory approvals for the importation and administration of these vaccines by member states. This streamlined process is fundamental in ensuring a swift and efficient response to the ongoing challenges posed by the COVID-19 pandemic, allowing for more expedited deployment of the Novavax vaccine.

Novavax faced setbacks during the initial stages of the pandemic, missing out on the vaccine success experienced by mRNA counterparts. Manufacturing issues hampered the company’s ability to file for regulatory approval during the peak of the pandemic. As a result, its original COVID-19 vaccine obtained authorization in the United States in July 2022, a considerable delay compared to the earlier approvals granted to Pfizer and Moderna vaccines.

In contrast to the mRNA-based vaccines developed by Pfizer and Moderna, Novavax’s updated shot employs a more conventional protein-based technology. This marks a departure from the innovative mRNA approach that has characterized many of the widely used COVID-19 vaccines.

The market responded positively to Novavax’s recent developments, with shares of the Maryland-based vaccine maker experiencing a 1.8% rise to $5.6 in premarket trading. This increase reflects the optimism surrounding the expanded authorization and the potential impact of Novavax’s vaccine on a broader age range.

In reflecting on the journey of Novavax, the challenges it faced in manufacturing, and the subsequent delay in regulatory approval, the company has now taken a significant step forward with the WHO’s emergency-use authorization. This approval not only validates the safety and efficacy of the updated Novavax vaccine but also facilitates a more efficient global response to the ongoing COVID-19 crisis.

As we delve into the details of Novavax’s updated vaccine, it is crucial to highlight the technology behind it. While Pfizer and Moderna relied on mRNA-based approaches, Novavax has opted for a more traditional protein-based technology. This choice comes with its own set of advantages and considerations, contributing to the diversity of strategies employed in the fight against COVID-19.

The importance of WHO’s emergency use listing cannot be overstated, particularly in the context of a global health crisis. By streamlining the regulatory processes for member states, the WHO enables a more rapid deployment of vaccines, thereby enhancing the collective effort to curb the spread of the virus. Novavax’s inclusion in this list underscores its role as a valuable tool in the global vaccination strategy.

Novavax’s updated vaccine receiving emergency-use authorization from the World Health Organization signifies a pivotal moment in the ongoing battle against COVID-19. The extended eligibility to individuals aged 12 and older expands the reach of this vaccine, while the more traditional protein-based technology adds a distinctive element to the array of vaccination strategies. As the world grapples with the challenges of the pandemic, such developments underscore the resilience of scientific innovation and global collaboration in the pursuit of public health

In a bid to gain global recognition for India’s traditional medicine, the Indian government has made a formal request for the inclusion of Ayurveda and related systems in the 11th revision of the World Health Organization’s International Classification of Diseases (ICD). This move is aimed at establishing a standardized language that can be utilized by healthcare professionals worldwide.

Vaidya Rajesh Kotecha, the Secretary of the Ministry of Ayush, emphasized the significance of this proposal, underscoring that it would play a crucial role in effectively regulating and integrating traditional medicine into the existing healthcare system. He shared his thoughts in an interview with The Hindu.

The envisioned inclusion of the second module for Ayurveda in ICD-11 is anticipated to streamline research and evaluation processes, ultimately establishing its efficacy within the global healthcare framework. This development follows the successful integration of Module-1, covering traditional medicine conditions originating from ancient China, into ICD-11.

The digitization of ICD-11 is an essential aspect of this effort, and the proposed integration of Ayurveda is seen as a major stride towards achieving various goals. It is expected to lead to better insurance coverage, improved reporting of adverse events, and the alignment of traditional medicine practices with global healthcare standards.
The Ministry of Ayush is actively involved in the development of Module-2, drawing upon the knowledge and experiences gained through the National Ayush Morbidity and Standardized Terminologies Electronic portal and the Ayush Health Information Management System.

This initiative is not just limited to the inclusion of Ayurveda in a global classification system; it is expected to have far-reaching implications. It is poised to facilitate the integration of traditional medicine into mainstream health information systems, bridging the gap between traditional and modern healthcare practices. Additionally, it aligns with the objective of achieving universal health coverage, a vision endorsed by the World Health Organization.

The proposed inclusion of Ayurveda and related traditional systems in the 11th revision of the International Classification of Diseases (ICD) is a significant step in promoting these age-old healthcare practices on a global scale. This initiative, led by the Indian government, is aimed at providing a common language for healthcare professionals worldwide to better understand and integrate traditional Indian medicine.

Vaidya Rajesh Kotecha, the Secretary of the Ministry of Ayush, highlighted the importance of this move. He emphasized that it would not only support the effective regulation of traditional medicine but also facilitate its integration into the existing healthcare system. This integration is crucial for ensuring that traditional Indian medicine, including Ayurveda, can coexist harmoniously with modern healthcare practices.

The proposed inclusion of the second module for Ayurveda in ICD-11 is expected to have several positive outcomes. It will streamline research and evaluation processes, allowing for a more comprehensive understanding of the effectiveness of Ayurveda and related systems in the context of global healthcare.

ICD-11 has already successfully included Module-1, which covers traditional medicine conditions originating from ancient China. With the digital transformation of ICD-11, the integration of Ayurveda is a significant step forward. It is anticipated to lead to better insurance coverage for traditional Indian medicine, improved reporting of adverse events, and the alignment of traditional healthcare practices with global healthcare standards.

The Ministry of Ayush is actively involved in the development of Module-2, drawing upon the experiences and knowledge gained through the National Ayush Morbidity and Standardized Terminologies Electronic portal and the Ayush Health Information Management System. This involvement demonstrates the government’s commitment to ensuring that Ayurveda and related systems are well-represented in the global healthcare classification system.

Furthermore, this move goes beyond the mere inclusion of Ayurveda in a classification system. It is expected to promote the seamless integration of traditional Indian medicine into mainstream health information systems. This integration will bridge the gap between traditional and modern healthcare practices, creating a more holistic approach to healthcare.

In line with the vision of the World Health Organization, this initiative aligns with the objective of achieving universal health coverage. By recognizing and standardizing traditional Indian medicine, it takes a step closer to making healthcare accessible to all. This is a noteworthy development that has the potential to positively impact the global healthcare landscape.