Medical Bulletin 16/February/2024

Here are the top medical news for the day:

Walking, Jogging,Yoga, and Strength Training may alleviate symptoms of depression

A review study published in the BMJ on 14th February 2024, suggests that walking or jogging, yoga and strength training appear to be the most effective exercises for easing depression, whether used independently or in conjunction with established treatments like psychotherapy and medication.

Even low-intensity activities such as walking or yoga are beneficial, but the results show that the more vigorous the activity, the greater the benefits are likely to be.

The World Health Organization estimates that more than 300 million people worldwide have depression. Exercise is often recommended alongside psychotherapy and drugs, but treatment guidelines and previous evidence reviews disagree on how to prescribe exercise to best treat depression.

To address this uncertainty, researchers searched databases for randomised trials that compared exercise as a treatment for depression with established treatments (SSRI antidepressants, cognitive behavioural therapy), active controls (usual care, placebo tablet), or untreated controls.They found 218 relevant trials involving 14,170 participants with depression for analysis. Each trial was assessed for bias and the type, intensity and frequency of each exercise intervention was recorded.Other potentially influential factors such as participants’ sex, age, baseline levels of depression, existing conditions, and differences between groups were also taken into account.

Compared with active controls, large reductions in depression were found for dance and moderate reductions for walking or jogging, yoga, strength training, mixed aerobic exercises and tai chi or qigong.

Although walking or jogging were effective for both men and women, strength training was more effective for women, and yoga or qigong was more effective for men. Yoga was also more effective among older adults, while strength training was more effective among younger people.And while light physical activity such as walking and yoga still provided clinically meaningful effects, the benefits were greater for vigorous exercise such as running and interval training.

“Our findings support the inclusion of exercise as part of clinical practice guidelines for depression, particularly vigorous-intensity exercise,” researchers say. “Health systems may want to provide these treatments as alternatives or adjuvants to other established interventions, while also attenuating risks to physical health associated with depression.”

Reference: BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-075847

Targeting the microenvironmentmay be the key to healing injured hearts

A study recently published in Nature Cardiovascular Research has revealed a remarkable discovery that may have far-reaching implications for the treatment of heart disease.

Heart disease remains a leading cause of death worldwide, with myocardial infarction, also known as a heart attack, causing irreparable damage to cardiac muscle cells.While current treatments focus on alleviating symptoms and improving blood flow, they fall short in addressing the crucial issue of lost cardiomyocytes (CMs), leading to further complications such as heart failure.

The study reveals that regeneration of CMs requires a complex microenvironment, where a dynamic synergy between CMs, resident immune cells, and cardiac fibroblasts is the driving force behind cardiac renewal.Through intricate signalling mechanisms, these cell types co-ordinately instruct and support each other, facilitating CM proliferation and effectively repairing damaged heart tissue.

"Understanding heart regeneration on a molecular level is an important step towards developing innovative therapeutics that can facilitate CM regeneration," said researchers at theCardiomyocyte Renewal Laboratory and McGill Gene Editing Laboratory at The Texas Heart Institute."Our study challenges the existing paradigm, suggesting that targeting the microenvironment rather than a specific cell type is instrumental in healing the injured heart."

The findings of the research suggest that harnessing the body's natural regenerative ability could offer promising avenues for developing innovative therapies for the millions worldwide impacted by heart disease.

Reference: Rich Gang Li, Xiao Li, Yuka Morikawa, Francisco J. Grisanti-Canozo, Fansen Meng, Chang-Ru Tsai, Yi Zhao, Lin Liu, Jong Kim, Bing Xie, Elzbieta Klysik, Shijie Liu, Md Abul Hassan Samee, James F. Martin. YAP induces a neonatal-like pro-renewal niche in the adult heart. Nature Cardiovascular Research, 2024; DOI: 10.1038/s44161-024-00428-w

42% of dental students spend 8 hours on their phone daily

In a recent study conducted among dental students in Hyderabad and Rangareddy districts, it was discovered that 42% of participants exhibited smartphone addiction. This addiction was associated with lower sleep quality and decreased mental well-being.

Published in the Journal Clinical Epidemiology and Global Health, was led by researchers Turaga Sai Susmitha, S Jagadeeswara Rao, and Dolar Doshi from Government Dental College& hospital in Hyderabad, involved 427 undergraduate dental students and revealed that the main reason for the smartphone usage was social networking, particularlyamong addicts.

“Addicts tended to use smartphones more at night, while non-addicts used them more in the evening,” said the researchers.

The study also highlighted that smartphone addicts exhibited poorer mental well-being compared to non-addicts. Factors contributing to addiction included social media, browsing educational content, and peer pressure.

Despite a higher percentage (79%) of female participants, addiction levels did not significantly differ by gender. Social networking (44%) was the primary reason for smartphone usage among addicts, while phone calls and text messages (37.5%) were preferred by non-addicts.

Addicts typically spend 6 to 8 hours per day on smartphones, leading to disruptions in daily life, poor sleep quality, and mental well-being.

Withdrawal symptoms, such as difficulty concentrating and physical discomfort, were also observed.

The study underscored the detrimental effects of smartphone addiction on dental students’ lives and emphasised on the importance of addressing this issue.

Reference: DOI: https://doi.org/10.1016/j.cegh.2023.101447