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Obesity tripled in the last four decades, and was called a “global pandemic in its own right” by United Nations in 2020. Obese people are more susceptible to suffering or dying from Covid-19 complications and vulnerable to heart disease, stroke, cancer, diabetes, fatty liver, and chronic kidney disease. Diet, lack of exercise, social environment and genetics are major triggers for obesity.
Moreover, consumption of ultra-processed food items, fast-food restaurant meals, soft drinks, and industrially processed convenience food with salt, sugar, fat, and additives lead to obesity. Besides having an adverse impact on respiratory and cardiac problems, obesity is a major risk factor for stone formation in the body. Considering the startling facts and statistics, on this World Digestive Day, let’s zoom in on problems such as gallstones that are a result of obesity.
Inputs by Nirmaljeet S Malhi, Director and Senior Consultant at AGI — The Gastrociti, Ludhiana and Debasis Datta, Senior Consultant Gastroenterologist and Hepatologist Director, Fortis Hospitals, Kolkata and Overseas Advisor at Royal College of Physicians, London.
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How are Body Mass Index and Bile Duct Stones Linked?
Body mass index (BMI) defined as weight in kilograms divided by square of height in centimetres, is a measure of body fat that applies to adults, and its results ranges from underweight to obesity. More than 135 million people are obese (BMI > 30Kg/cm2) in India. Now, with the increase in BMI, the risk of non-cardiac diseases has grown exponentially.
People who eat a high fat diet, have a sedentary lifestyle and are obese develop gallstones that in turn lead to bile duct stones. When cholesterol, calcium salts and bilirubin deposit in gallbladder, they form gallstones. The gallbladder contains digestive fluid called bile that is passed into the small intestine via bile duct. In some cases, stones that form in gallbladder slip into bile duct and get trapped in it. These are known as common bile duct (CBD) stones.
A stone in the bile duct can cause pain, block the bile duct, and damage the liver, pancreas, and digestive system. A person with bile duct stones usually experiences pain in the upper abdomen, back or shoulder, and around the ribs. Some people can also develop jaundice which may cause their skin and eyes to appear yellow along with fever and/or chills. A subset of patients can develop pancreatitis due to CBD stones that is a major medical emergency and could result in death in 5-10 per cent of cases, if not treated in time. When one develops such symptoms, it becomes imperative to seek timely medical invention and to undergo the required treatment.
Treating Bile Duct Stones with Advanced Technologies
The doctor can confirm the diagnosis through medical history, physical examination of the abdomen, blood tests and imaging tests like ultrasonography of the abdomen. In cases of diagnostic uncertainty, Endoscopic Ultrasound (EUS) or MRCP have emerged as the modalities of choice. The treatment of CBD stones is done by a specialised endoscopic procedure called as ERCP (Endoscopic retrograde cholangiopancreatography). The dye is injected into the bile duct during this procedure that provides a clear visibility to locate bile duct stones causing the blockage, which in turn are removed by giving a small incision in a region called papilla in upper part of small intestine.
ERCP has been used for decades for diagnosis and treatment of bile duct stones. However, today, technological breakthroughs have redefined healthcare in India. We now have procedures like Cholangioscopy that enable faster and more accurate treatment in difficult to remove CBD stones, reduced risk associated with repeated procedures and give patients a better quality of life. The therapy is used to treat bile duct stones that cannot be treated using traditional methods and for elderly patients. A small straw like tube with a camera and light at the end is used to disintegrate stones. The doctor monitors the stone location on a screen and bursts the stone using a tiny probe attached in the tube.
Reducing Obesity to Prevent Bile Duct Stones
While an outright control of gallbladder problems is inevitable, people can take appropriate measures to reduce the risk of developing stones and associated symptoms and complications. To prevent gallbladder or bile ducts stones, it is imperative to reduce overweight and obesity. Choice of healthier foods and regular exercise can go a long way in preventing obesity. One can limit energy intake from sugars and total fats, increase consumption of vegetables, fruits, grains, and nuts and engage in physical activities for at least 60 minutes a day.
Although a lifestyle modification is the key to weight loss, newer endoscopic approaches like Intra-Gastric Balloon and Endoscopic Sleeve Gastroplasty are new additions to a Gastroenterologist’s armamentarium to tackle obesity. As per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), women and people over 40, obesity and a family history of stones are more prone to getting gallstones or bile duct stones. Gallbladder problems are usually managed easily in expert hands now-a-days. The main solution for managing stones is to spread awareness about the root cause and potential treatment options available. (IANS/KR)
The US researchers have discovered a class of immune cells that plays a role in miscarriage, which affects about a quarter of pregnancies.
Researchers at the University of California-San Francisco found that the recently discovered subset of cells known as extrathymic Aire-expressing cells in the immune system may prevent the mother's immune system from attacking the placenta and fetus.
The researchers showed that pregnant mice who did not have this subset of cells were twice as likely to miscarry, and in many of these pregnancies fetal growth was severely restricted.
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"When you're pregnant, the immune system is seeing the placenta for the first time in decades -- not since the mother made a placenta when she herself was a fetus," said Eva Gillis-Buck, from UCSF.
"Our research suggests that this subset of immune cells is carrying out a sort of 'secondary education' -- sometimes many years after the better-known population of the educator cells have carried out the primary education in the thymus -- teaching T cells not to attack the fetus, the placenta and other tissues involved in pregnancy," she added. The findings are published in the journal Science Immunology.
The immune system has to be educated not to attack one's own tissues and organs to prevent autoimmune disease. But pregnancy presents a unique challenge since the fetus expresses proteins found in the placenta as well as proteins whose genetics are distinct from the mother.
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"It was a conceptual leap to link Aire-expressing cells, which are critical for preventing autoimmune disease, to pregnancy," said Tippi Mackenzie, Professor of Surgery at UCSF's Center for Maternal Foetal Precision Medicine.
In the thymus, Aire-expressing cells begin interacting with other immune cells very early in life to teach them what not to attack. The thymus begins to shrink and is nearly gone by adulthood, by which time most immune cells have been educated. But as the thymus shrinks, the population of eTACs in lymph nodes and the spleen expands, the researchers explained.
The study suggests a healthy pregnancy may depend on having these cells around, they added. (IANS/KB)
The tiny emojis being shared on billions of devices worldwide can play a major role in digital communication, with most people saying that emoji compels them to feel more empathy towards others, according to an Adobe report.
Adobe's global emoji study found that emoji even helps people overcome language barriers and form connections that would otherwise be difficult to do.
"We were surprised and delighted by the discoveries made in the survey, most notably how enthusiastic respondents were for emoji as a means to express themselves," the company said in a statement.
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Emojis sometimes get criticized for being overly saccharine, but this sweetness is key when it comes to diffusing some of the heaviness of online communication.
"Many of the emoji are focused on positive emotions, so it's easy to insert them into our conversations and lighten the mood," the Adobe study said.
It's not surprising that over half of those surveyed feel more comfortable using emojis than talking on the phone or in person.
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This applies to less intense situations too. Dating, for example, can be tricky — especially when it's online or via digital apps, as it often is now.
The study also found that emoji even helps people overcome language barriers and form connections that would otherwise be difficult to do.
In celebration of World Emoji Day on Saturday, Adobe's '2021 Global Emoji Trend Report' surveyed 7,000 people in the US, the UK, Germany, France, Japan, Australia, and South Korea. (IANS/KB)
Following the grand Richard Branson show where he carried Andhra Pradesh-born Sirisha Bandla and fellow space travelers on his shoulders after successfully flying to the edge of space, it is time for Amazon Founder Jeff Bezos to applaud Sanjal Gavande, one of the key engineers who designed the New Shephard rocket set to take Bezos and the crew to space on July 20.
Billionaire Bezos is set to fly to the edge of space aboard what is touted as the world's first unpiloted suborbital flight. Born in Kalyan, Maharashtra, Gavande is a systems engineer at Blue Origin who always dreamt of designing aerospace rockets.
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After completing Bachelor's in mechanical engineering from the University of Mumbai, she flew to the US in 2011 to pursue a Master's in mechanical engineering from the Michigan Technological University. She also applied for an engineering job at the US space agency NASA but finally landed her dream job at Blue Origin
Sirisha flew to the US in 2011 to pursue a Master's in mechanical engineering from the Michigan Technological University.IANS
Bezos, his brother Mark, aviation pioneer Mary Wallace 'Wally' Funk, and other passengers are set to liftoff from west Texas and travel just beyond the edge of space on July 20. Blue Origin announced this week that Oliver Daemen, an 18-year-old high school graduate from the Netherlands, would join the crew.
Oliver is the son of millionaire Joe Daemen, Founder, and CEO of the Dutch investment company Somerset Capital Partners. Blue Origin, however, did not reveal how much Daemen paid for his son's trip to space. Bezos chose July 20 as the launch date to honor the 52nd anniversary of the Apollo 11 moon landing.
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The launch site for Blue Origin's first human flight will be in a remote location north of Van Horn, Texas, from where the firm had launched New Shepard for previous flights. Blue Origin has received final approval from the Federal Aviation Administration (FAA) to carry humans on the New Shepard rocket into space.
On July 12, Bandla touched the edge of space with three others, including Virgin Galactic's billionaire CEO Richard Branson. Bandla vaulted into space onboard VSS Unity 22. After the successful spaceflight, Branson carried the Indian-American on his shoulders while celebrating their flight to space, at Spaceport America in New Mexico. (IANS/KB)