Cataracts

What are cataracts?

Cataracts are cloudy patches on the lens in the eye, which cause blurred vision and eventual blindness if left untreated. It is estimated that in the UK one in three people aged 65 has a cataract in one or both eyes.

Most develop due to age-related changes in the lens

• An imbalance between free radicals (unstable atoms that damage cells) and antioxidants (which keep free radicals in check). Cells in the body produce both, but smoking, drinking too much alcohol and exposure to chemicals can speed up production of the damaging free radicals.
• As we age, fewer antioxidants are produced, resulting in oxidative stress, leading to tissue damage; proteins and fibres in the lens start to break down and calcium builds up in the lens.
• Cataracts are also linked to conditions such as diabetes and to medications, includinglong-term use of steroids.

Current treatment

The current treatment is to replace the cloudy lens in a 30-minute operation under local anaesthetic. The cloudy lens is removed through a small cut in the eye, and replaced with a plastic one. About 350,000 cataract operations are performed in the UK each year.

New treatment developed

Scientists at US-based Nacuity Pharmaceuticals have developed a 'pellet' implant (NPI-002) that is injected into the eye to prevent cataracts forming, and might even reverse the growth of existing cataracts without surgery. This is now being tested in the first clinical trial.

• The implant is thought to work by lowering calcium levels in the eye.
• The implant is loaded with antioxidants and injected into the vitreous, the gel-like fluid between the lens and the retina (the light-sensitive area in the eye). The solution includes N-acetylcysteine amide (NACA), an effective antioxidant.
• The implant slowly releases its contents into the vitreous, which carries them to the lens where it acts on the cataract. 

First clinical trial

An animal study by ophthalmologists at Washington University, US, and other centres, reported in the journal BMC Ophthalmology in 2018, showed that the implant prevented and reduced the severity of cataracts. It also led to an increase in protective antioxidants, and reduced calcium levels to 2.5 times lower than a control group.

The first human trial, in the US, will start soon (late 2021) and will involve 30 patients aged 65 and over with cataracts.

Initial interest in the implant is tempered with caution. Gwyn Williams, a consultant ophthalmologist at Singleton Hospital in Swansea, said "It is a very interesting idea and I look forward to seeing the results. Cataracts are multi-factorial and I am sceptical that this one approach will be effective by itself, though this remains to be seen."

Source: Scientists develop 'pellet' that can be injected into patient's eye to prevent cataracts forming - and could even reverse existing traces. Daily Mail (5 Oct. 2021) 

Long Covid Facts

While many people recover from Covid-19 without further problems, some report having long-term health problems. A large range of symptoms are reported by these sufferers, for varying periods after the infection. Symptoms typically fall into four groups.

Types of Long Covid

Post intensive care syndrome (PICS)
Critically ill patients can suffer a range of health problems after a long time in hospital. This can include muscle weakness, and anxiety or another mental health problem. They may also have memory problems, which can affect whether they can return to work.

Post viral fatigue syndrome (PVFS)
Similar to problems following enteritis or rubella, fatigue and 'brain fog' may make it difficult to concentrate or remember things. 

Permanent organ damage (POD)
The lungs and heart, and also liver and pancreas, may have permanent damage.

Long-term Covid syndrome (LTCS)
This group report 'floating' symptoms which mean they do not fit into the other three groups. They suffer illness linked to one part of the body (e.g. respiratory system, brain, cardiovascular system and heart, kidneys, gut, liver or skin), which later abates, but then new symptoms arise in a different part of the body.

Why does this happen? 
Latest: A small study (at Stellenbosch University, South Africa) comparing blood collected from 11 people with long Covid and 13 healthy individuals found that those with long Covid have a large amount of tiny clots of inflammatory molecules trapped in their bloodstream. These blockages have the potential to disrupt the body's ability to distribute oxygen and vital nutrients, which could explain - or help to explain - the most common symptoms of fatigue, headaches and breathing difficulties. Some of the trapped molecules contain clotting proteins such as fibrinogen (helps the body to make clots to stop bleeding) and alpha(2)-antiplasmin (helps prevent blood clots from breaking down). Under normal conditions, the body maintains a balance of clotting and anti-clotting material to help the body reduce blood loss after injury, and preventing clots from growing too large and restricting oxygen flow. High amounts of alpha(2)-antiplasmin stuck in the blood mean the body's ability to break down clots is severely reduced. Other recent studies have also highlighted that the body's clotting system could be involved, while Covid itself has been linked to clotting disorders during the initial infection. More research with larger samples is needed to confirm these findings, and research to identify the type of treatment for the problem.

There are three possible reasons, and long covid may even be a combination of these.

1. Direct damage by the virus. For example, the heart and lungs can be permanently damaged, which could explain prolonged shortness of breath and chest pains. 
2. It is even possible that the virus could hide in some body tissues, and continually reactivate; some studies are looking into this possibility.
3.  Inadvertent damage that the body can do when it responds to the virus.

Long Covid is less common than first feared.
Initially it was unclear how many people might be affected, nor how long symptoms might last and whether there might be permanent damage. It it is possible to have serious Covid-19 symptoms and not experience long-term syndromes, and for those with mild cases to develop one of the syndromes.

The UK Office for National Statistics (ONS) has been monitoring this, by testing people at random which ensures that the comparison between Covid sufferers and non-sufferers is good. Additionally they carry out long-term follow-ups of those with long covid. Their latest (September 2021), large and comprehensive analysis suggests that one in 40 (2.5%) people with coronavirus has symptoms lasting at least three months.

Those most likely to suffer long-term (at least 3 months after infection) health conditions are:

• Women aged 35 to 69
• Those aged 50 to 69
• People with high levels of virus in their body when testing positive.

Long Covid in children: An Australian study indicates that long covid symptoms in children and teens resolve in four to twelve weeks.

Sources: BBC News 18 Sept. 2021 (link). Article in Daily Mail, (link) 15 Oct. 2020. Article in New Scientist, 31 Oct. 2020. Article in Daily Mail (link) 5 Oct. 2021.

The Perils of MisInformation

Social media networks are playing an increasing role in spreading misinformation about coronavirus Covid-19, and the vaccines that have been developed to prevent infection.

Despite the widespread availability of vaccines in the US, only about half of the people are fully vaccinated. Many of the unvaccinated don't plan to get the vaccine.

A handful of influencers on Facebook, Twitter and other social media are responsible for falsely claiming that the virus does not exist, and that vaccines will harm you. Influencers can reach millions of people, some directly but also many indirectly as people forward their posts to others.

Tagging posts as False often happens after the post has been forwarded multiple times. The problem is how to identify such material quickly and reduce its spread to a minimum.

Social media platforms want to continue to allow "free speech" but in most countries free speech exemptions must also take account of laws controlling certain views, especially if it involves endangering others. Social media platforms also encourage people to participate in debate by bringing to your attention emotional content that encourages people to respond.

Social media platforms, governments and sociologists are currently grappling with how to allow and even encourage free debate, without trolling others for simply holding opposing views, or spreading misinformation that has harmful effects on other people.

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Wider Fit Ladies Shoe Brands in UK

 As we get older, our feet get wider and an added complication is that many people develop bunions (this is now known to be down to genetics and not wearing the wrong footwear). Many high fashion brands don't come in wider sizes, and until recently the styles on offer veered to the 'comfy' rather than the stylish. Here are the ones available in the UK that I have discovered.

• James Inglis Collections from Italy and USA. Free specialist fitting service. Extra narrow to extra wide widths. Sizes 4 to 10 including 1/2 sizes.
• Van-Dal Width fittings are slightly more generous than usual. Van Dal 'D' fit is wider than the average high street shoe. Van-Dal E fit are classed as wide fitting. Van-Dal EE fit are wider again; they also tend to have a lower heel.
• Hotter Offer four width fittings - Slim, Standard, Wide and Extra Wide in UK whole and half sizes.
• Sole Bliss On-trend shoes for women with bunions, wide feet and sensitive soles. Initial range focused on heels, but now offer flats, sandals and trainers.

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Fraudsters Try to Hack Into What'sApp Accounts

If you use What'sApp - please read on.

There have been recent reports of a WhatsApp scam where fraudsters are attempting to hack into people's WhatsApp accounts.

What you get: A text is  received from WhatsApp containing a code with the instruction to tap on to a link so the phone can be verified. This is then followed by another message which appears to be from a contact in your phone, but is actually from fraudsters asking you to forward the code to them saying it was sent to you in error.

What actually happens: Scammers have already hacked your contact's account and are trying to set up WhatsApp using your number on a new device. If successful, they will be able to hack your WhatsApp account as well.

What you should do: If you receive a message like this, ignore it and send a message (not usingWhatsApp) to your contact letting them know they have been hacked.

Protecting yourself in future: As a precaution against this type of scam, you can enable 'Two-Step Verification'. Here you create a unique PIN which will be required if you need to register your phone number with WhatsApp again, and, on occasions, be asked for it before you use WhatsApp.

Here's how to do it: Go to Settings > Account > Two-Step Verification within the App.

For extra security you can set your privacy settings on WhatsApp so only your contacts can see your Last Seen (the last time you used WhatsApp); Profile Photo; About; Groups and Status. To do this go to Settings > Account > Privacy and selecting 'My Contacts' against each one.

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