Medical Bulletin 21/November/2023

Here are the top medical news of the day:

Oral/vaginal misoprostol better methods oxytocin for labor induction in pregnant women

Oral/vaginal misoprostol is a better method than oxytocin for labor induction, states a recent study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology.

The updated systematic review and meta-analysis of RCTs revealed that compared with oxytocin, the administration of vaginal misoprostol led to a significant increase in the rate of vaginal delivery and Tachysystole risk and a significant reduction in the rate of cesarean. Oral misoprostol was tied to a significant reduction in cesarean rate and a significant rise in the hypertonicity risk but had no significant effect on vaginal delivery versus oxytocin.

For this purpose, the researchers conducted a systematic search of online databases up to April 2023 to identify articles investigating the effect of oxytocin and oral/vaginal misoprostol on delivery outcomes including neonatal and maternal outcomes. A total of 45 RCTs comprising 8406 participants were included.

Reference: Ameri, A., Jafari-Azar, Z., Anabi, M., & Dolatabadi, M. D. (2023). Effect of misoprostol versus oxytocin on delivery outcomes after labor induction in pregnant women: A systematic review and meta-analysis of randomized controlled trials. European Journal of Obstetrics & Gynecology and Reproductive Biology. https://doi.org/10.1016/j.ejogrb.2023.11.006

Insulin resistance from high-sugar diets tied to increased neurodegeneration risk

A recent study published in PLOS Biology has shown evidence suggesting a high-sugar diet causes insulin resistance in the brain, lowering the brain's ability to remove neuronal debris, thus increasing neurodegeneration risk.

Neurodegenerative diseases, such as ALS, Parkinson's disease, and Alzheimer's disease affect millions of people worldwide; about 15% of people around the world have a neurodegenerative disease. There is still no clarity on the main cause of many neurodegenerative disorders, but it is known that certain risk factors play a role.

The researchers, using a common fruit fly model, believed a high-sugar diet causes insulin resistance in the brain, lowering the ability of the brain to remove neuronal debris, thus raising neurodegeneration risk.

Reference: Alassaf M, Rajan A (2023) Diet-induced glial insulin resistance impairs the clearance of neuronal debris in Drosophila brain. PLoS Biol 21(11): e3002359. https://doi.org/10.1371/journal.pbio.3002359

Among long Covid patients, prolonged cough and cold highly associated with severe Covid-19

In a study on Japanese population with long COVID, prolonged cough and sputum production were closely associated with severe COVID-19. The study has been published in Respiratory Research emphasizes on a preventive approach including appropriate vaccination and contact precaution and further development of therapeutic drugs for COVID-19 are highly recommended for patients with risk factors for severe infection to avoid persistent respiratory symptoms.

Prolonged symptoms are reported in patients who recover from acute coronavirus disease 2019 (COVID-19), defined as long COVID. Cough and sputum are presented by patients with long COVID during the acute and post-acute phases.

Researchers in the current study aimed to identify specific risk factors for cough and sputum in patients with long COVID. Hospitalized patients with COVID-19 aged 18 years were enrolled in a multicenter cohort study at 26 medical institutions.

Reference: Watase, M., Miyata, J., Terai, H. et al. Cough and sputum in long COVID are associated with severe acute COVID-19: a Japanese cohort study. Respir Res 24, 283 (2023). https://doi.org/10.1186/s12931-023-02591-3.