Medical Bulletin 31/ December/ 2024 - Video

Here are the top medical news for the day:

Are Digital Consultations Safe for Assessment of Tonsillitis?

Digital healthcare consultations are not enough for a safe assessment of tonsillitis, according to a study from the University of Gothenburg. Reliability will not be sufficient, thus increasing the risk of over- or undertreatment of a sore throat. The findings are published in the journal Infectious Diseases.

To determine whether a patient needs antibiotics, doctors use the so-called Centor Criteria for tonsillitis. The criteria include fever, tender and swollen lymph nodes in the angles of the jaw and inspection of the tonsils.

However, it has been unclear how well these criteria can be assessed during digital healthcare consultations compared to traditional in-person consultations. This lack of scientific evidence has become a growing concern as digital healthcare consultations become more common.

The current study examines whether digital assessments are as reliable as physical examinations in determining whether antibiotic treatment is warranted. The study includes 189 patients who sought care at healthcare clinics and urgent care clinics in Region Västra Götaland, Sweden, between January 2020 and October 2023.

Each patient in the study underwent two assessments: a digital medical assessment via video and a physical examination conducted by another doctor. The results show that digital healthcare consultations are not sufficient to assess some of the most important criteria, such as tonsil inspection and lymph node examination.

“Our study shows that although digital healthcare consultations are convenient for many patients, they are not reliable enough to assess tonsillitis. To ensure a correct diagnosis and treatment, it is still important to conduct a physical examination,” Patrycja Woldan-Gradalska, a PhD student at Sahlgrenska Academy at the University of Gothenburg and a Resident Physician at Sätila Healthcare Clinic, said

Reference: Woldan-Gradalska, P., Gradalski, W., Moradi, S., Franzelius, M., Folkerman, S., Fuchs, E. M., … Sundvall, P. D. (2024). Inter-rater reliability of Centor score assessments between telemedicine and in-person examinations in patients with an acute sore throat. Infectious Diseases, 1–9. https://doi.org/10.1080/23744235.2024.2434878

Researchers Highlight Optimal Delivery Time for Females with Chronic Hypertension

In a study published recently in the journal O&G Open, researchers found 39 weeks of gestation is optimal for delivery when chronic hypertension is a factor.

Researchers used U.S. Centers for Disease Control and Prevention birth records from 2014 to 2018, which included about 227,000 women, making it the largest study to date to look at delivery timing in pregnant moms with chronic hypertension.

Data shows 3% to 10% of pregnant women have hypertension, a vascular disorder that affects blood flow to the uterus and placenta and can impact the growth of a fetus. Chronic hypertension can lead to preeclampsia, preterm birth, stillbirth, low birth weight and newborn death after delivery.

The research concluded that among patients with chronic hypertension, delivery at 39 weeks provides the optimal balance between the risk of stillbirth associated with ongoing pregnancy and the risks of infant health issues or death associated with a birth before 39 weeks.

The research team also found the same optimal delivery timing in African American women, who are disproportionately impacted by chronic hypertension during pregnancy and are at higher risk for stillbirth and infant death.

“For every roughly 100 patients with chronic hypertension who deliver at 39 weeks instead of 40 weeks, we would expect to see one less stillbirth, infant death or adverse newborn outcome,” said corresponding author Robert Rossi, MD, associate professor in the Department of Obstetrics and Gynecology and director of the Division of Maternal-Fetal Medicine

Optimal delivery timing is essential, he explained, because the prevalence of chronic hypertension during pregnancy is increasing.

“In the future, it will also be important to study patients who are medicated for their chronic hypertension during pregnancy to see if they should also deliver at 39 weeks, or if earlier delivery is more beneficial to this specific group,” said Rossi.

Reference: Hamilton, Ira MD; Liu, James MD; Wajahat, Labeena MD; DeFranco, Emily A. DO, MS; Rossi, Robert MD. Optimizing Delivery Timing in Pregnant Patients With Chronic Hypertension at Term. O&G Open 1(4):p 050, December 2024. | DOI: 10.1097/og9.0000000000000050

Predicting Lifespan Using AI Based Aging Clock: Study Finds

A recent study showed that a metabolomic clock developed using a specific machine learning algorithm, called Cubist rule-based regression, was most strongly associated with most health and ageing markers. They also found that algorithms which can model non-linear relationships between metabolites and age generally performed best at capturing biological signal informative of health and lifespan. The study was published in Science Advances

Researchers conducted a comprehensive study to evaluate artificial intelligence based ageing clocks, which predict health and lifespan using data from blood.

The researchers trained and tested 17 machine learning algorithms using data on markers in the blood from over 225,000 UK Biobank participants, aged 40 to 69 years when they were recruited.

A person's metabolomic age, their "MileAge," is a measure of how old their body seems to be on the inside based on markers in the blood called metabolites. The difference between a person's metabolite-predicted age and their chronological age, termed MileAge delta, indicates whether their biological ageing is accelerated or decelerated.

Individuals with accelerated ageing were, on average, frailer, more likely to have a chronic illness, rated their health worse, and had a higher mortality risk. They also had shorter telomeres, which are a marker of cellular ageing and linked with age-related diseases such as atherosclerosis. However, decelerated biological ageing was only weakly linked with good health.

Ageing clocks could help spot early signs of declining health, enabling preventative strategies and interventions before disease onset. They may also allow people to proactively track their health, make better lifestyle choices, and take steps to stay healthy for longer.

Reference: https://www.kcl.ac.uk/news/researchers-ai-ageing-clocks-predict-health-lifespan

AIIMS Delhi Study Finds Health and Nutritional Benefits of Jharkhand’s Kachnar Plant

A pilot study conducted by AIIMS New Delhi has brought attention to the health benefits of the Kachnar plant (Bauhinia Variegata), commonly found in Jharkhand’s forests. The study showed that that individuals who consumed Kachnar exhibited reduced levels of inflammatory markers in the body compared to non-consumers. The plant was found to provide essential micro- and macronutrients, especially in regions with limited access to diverse food resources.

The study was initiated in 2020 under the leadership of Sanjiv Kumar, the then Regional Chief Conservator of Forests (RCCF), Hazaribagh. Researchers sought to understand the nutritional value of Kachnar and its potential molecular and dietary effects on human health.

The Kachnar plant is deeply embedded in the diet and healthcare practices of Jharkhand’s tribal communities. These forest-dependent communities follow unique socio-cultural traditions, including the use of plants like Kachnar for both food and medicine.

AIIMS researchers noted that traditional plants such as Kachnar play a critical role in the primary healthcare of these communities, helping them address nutritional deficiencies and common health issues.

“The research aimed to analyse the nutritional content of Kachnar and its micro-nutrients, while also exploring its interactions with human physiology. The goal was to identify reliable biomarkers in Kachnar consumers,” said Sanjiv Kumar, now the Additional Principal Chief Conservator of Forests (PCCF), Jharkhand.

The study further explored Kachnar’s potential to promote or reduce inflammation in the body. The plant was found to contain beneficial compounds such as polyphenols and tannins, which have antioxidant and anti-inflammatory properties.

“This study marks the first step in identifying the health benefits of Kachnar. Its compounds, including polyphenols and tannins, can help combat inflammation in the body,” Kumar added.

Reference: https://thejharkhandstory.co.in/aiims-delhi-study-recognises-jharkhands-kachnar-plant-for-health-benefits/