Dzulkefly said his ministry has submitted several proposals on the matter and is awaiting Prime Minister Anwar Ibrahim’s tabling of the budget.

He pointed out that both health conditions were key contributors to the rising prevalence of non-communicable diseases in the country.

“The National Health and Morbidity Survey 2023 found that 3.55 million Malaysians, or 15.6% of adults aged 18 and above, suffer from diabetes, while 4.58 million, or 21.8%, are obese,” he said after launching a programme as part of an integrated treatment for diabetic patients.

Dzulkefly said obesity, diabetes, heart disease, stroke and cancer accounted for more than 70% of premature deaths in Malaysia, costing the nation over RM64 billion annually in treatment, care, lost productivity and early death.

By Dr Puneet Nandrajog, Consultant Neurosurgeon, Bukit Tinggi Medical Centre (BTMC)

Regular check-ups and awareness of risk factors are crucial for early intervention. A healthy lifestyle is the most effective way to reduce your risk of stroke.

Every year, 15 million people worldwide experience a stroke, with 5 million resulting in death and another 5 million facing permanent disability. In Malaysia, the situation is also alarming. The National Stroke Registry recorded over 47,911 stroke cases in 2019, meaning approximately 130 people experience a stroke every day. Without preventive action, one in four Malaysians may suffer a stroke by 2040.

Stroke is a medical emergency that can change lives in an instant, but timely diagnosis, treatment, and neurological intervention can significantly improve outcomes and quality of life. Early recognition and prompt treatment are crucial when dealing with strokes, especially when surgical interventions are required. Acting quickly can drastically improve a patient’s recovery and long-term quality of life.

This highlights how crucial early detection is in managing strokes effectively, particularly when surgical options are necessary to reduce damage and improve recovery outcomes. Timely neurosurgical intervention, whether it is for ischemic or hemorrhagic stroke, can mean the difference between a full recovery and long-term disability.

Discerning stroke types

Strokes are categorised into two main types, ischemic and haemorrhagic. Ischemic strokes, which make up about 87% of cases, happen when a blood vessel supplying the brain becomes blocked, usually by a clot. This blockage prevents the brain from receiving the blood and oxygen it needs, leading to cell death in the affected areas.

Haemorrhagic strokes, on the other hand, occur when a blood vessel in or around the brain ruptures, causing bleeding that damages brain tissue. The pooling of blood increases pressure inside the skull, causing further damage to brain cells. The type of stroke significantly influences the treatment strategy, as ischemic and haemorrhagic strokes require very different interventions. Early and accurate diagnosis is crucial, as it helps guide the appropriate treatment approach, whether it is clot removal for ischemic strokes or surgical intervention for haemorrhagic strokes.

Recognising stroke symptoms
Recognising the symptoms of a stroke swiftly and accurately is critical, as it can dramatically improve the outcome for the patient. Stroke symptoms often appear suddenly, and the most common indicators include a sudden weakness or numbness, particularly on one side of the body, slurred speech, facial drooping or asymmetry, and a loss or reduction in consciousness. Other signs may include confusion, difficulty understanding speech, vision problems in one or both eyes, and difficulties with coordination or balance. Recognising these symptoms early is key, as stroke is a race against time.

The acronym FAST – Face drooping, Arm weakness, Speech difficulties, and Time to call emergency services, serves as an essential guide in recognising these signs and taking immediate action. When someone is having a stroke, every second matters. The sooner we can start treatment, the more brain function we can preserve.

When it comes to strokes, time is brain. Every minute counts, as early intervention can drastically reduce the extent of brain damage. Prompt recognition and swift action in getting the patient to a hospital can be lifesaving, preventing more severe outcomes such as long-term disability or even death.

Risk factors for stroke

Several factors significantly increase the likelihood of experiencing a stroke:hypertension, dyslipidemia, diabetes, and smoking, which can all damage blood vessels. Cardiac conditions, like atrial fibrillation, as well as excessive alcohol consumption and a sedentary lifestyle, further raises the risk.

Recent trends also show a rise in strokes among younger populations in Malaysia, emphasising the need for increased awareness and preventive actions. Managing these risk factors through regular health check-ups and lifestyle changes is crucial in reducing the risk of stroke.

Diagnostic process

Once a stroke is identified, the diagnostic process must be initiated immediately to determine the type of stroke and the best treatment approach. The first line of imaging is usually a CT scan, which can rapidly detect a haemorrhagic stroke by showing bleeding in or around the brain. A CT scan is our first tool in emergencies because it is fast and readily available, giving us crucial information about whether a stroke is haemorrhagic.

However, for ischemic strokes, where a clot blocks blood flow to the brain, more detailed imaging is often needed. MRI scans offer superior detail, allowing for the detection of smaller areas of ischemia that may not
be visible on a CT scan. CT scans offer a quick look into haemorrhagic strokes, but an MRI is crucial for identifying ischemic strokes early. It helps us make informed decisions on the appropriate course of treatment, particularly in smaller or more complex cases.

These diagnostic tools are essential in quickly assessing the severity and location of the stroke. Thus, guiding the medical team toward the most effective treatment path, whether it is clot-dissolving drugs, surgical intervention, or other therapies.

Once a stroke is diagnosed, the next step is determining the most effective treatment. Neurosurgery plays a pivotal role in this process, especially for severe cases.

Neurosurgery in stroke management

Neurosurgery plays a vital role in both the acute phase of stroke treatment and in long-term recovery. The primary treatment for ischemic strokes is thrombolysis, which involves injecting a medication into a vein to dissolve the blood clot that is blocking blood flow to the brain. Another option for treating ischemic strokes is a thrombectomy, a procedure that may be performed with or without angioplasty to remove the clot directly from the blocked artery. In cases of large ischemic strokes, a decompressive craniectomy may be necessary to relieve pressure on the brain and prevent further damage.

One of the most critical treatments for ischemic stroke is thrombolysis, which involves administering clot-dissolving drugs. However, there is always a risk of intracranial haemorrhage, which might necessitate further surgical intervention.

For haemorrhagic strokes, treatment can be divided into non-surgical and surgical approaches. Non-surgical treatment primarily focuses on controlling blood pressure and stabilising the patient, while surgical options vary depending on the type of haemorrhagic stroke. These procedures may include decompressive craniotomy to relieve pressure in the brain, removal of a blood clot, clipping of an aneurysm, or draining excess fluid from the brain.

Each intervention is tailored to the individual patient’s condition, emphasising the importance of restoring blood flow and reducing pressure on the brain.

Post-stroke rehabilitation; reclaiming quality of life

After the immediate danger of a stroke has passed, rehabilitation becomes a critical part of recovery. Stroke patients may need physiotherapy, speech therapy, and occupational therapy to regain lost functions and prevent complications such as bedsores and pneumonia.

Rehabilitation is as essential as the treatment itself. Starting rehab early and continuing it diligently can make all the difference in a patient’s quality of life.

Prevention remains the best cure. Maintaining a healthy lifestyle – regular physical activity, a balanced diet, and avoiding smoking and excessive alcohol consumption can significantly reduce the risk of stroke. Managing conditions like hypertension, high cholesterol, and diabetes is also vital.

AI, other emerging treatment strategies

Recent advancements in stroke-related neurosurgery have transformed treatment options, particularly through the adoption of minimally invasive procedures. These techniques reduce complications and promote quicker recovery times. Image-guided navigation and technological advances in neurosurgery are key innovations, offering surgeons greater precision and control. Many of these technological advances in neurosurgery are game changers, allowing us to operate more precisely and safely, often through a keyhole incision. It is less invasive, which means quicker patient recovery.

Additionally, artificial intelligence (AI) enhances diagnostic accuracy and treatment planning by rapidly analysing imaging data and identifying stroke patterns earlier than traditional methods. The integration of AI and robotics into stroke care is expected to continue evolving, further improving patient outcomes and surgical precision.

In the next few years, we expect significant advancements in neurosurgery and stroke treatment. AI and robotic technologies are set to revolutionise how we diagnose and treat stroke patients, offering greater precision and improved outcomes

Associate Professor Keisuke Kuwahara, a member of the research team, highlighted the importance of early intervention. The study surveyed 81,876 individuals aged 20 to 64 who underwent regular health checkups and were not on hypertension treatment during fiscal years 2010 and 2011. Follow-ups over nine years tracked the relationship between blood pressure and disease development.

Related: When Exercise Becomes a Risk to the Heart

Of the participants, 334 developed cerebral or cardiac vascular diseases. Among them, 55 had high normal BP (systolic 120-129 mmHg and diastolic below 80 mmHg), facing nearly double the risk compared to those with normal blood pressure (systolic below 120 mmHg and diastolic below 80 mmHg). The risk increased to 2.10 times in the elevated blood pressure group (systolic 130-139 mmHg and diastolic 80-89 mmHg) and escalated further in the hypertension groups, with risks ranging from 3.48 to 7.81 times higher.

Related: Millennials and Gen-Z at risk of heart disease

Japan has an estimated 43 million hypertension patients, according to the Japanese Society of Hypertension, with untreated hypertension leading to severe health issues like strokes, heart, and kidney diseases.

Source: www.japantimes.co.jp

By Dr. Joyce Pauline Joseph, Consultant Neurologist at Aurelius Hospital Nilai

The Covid-19 pandemic has reshaped human health on a global scale, extending far beyond its commonly acknowledged respiratory effects. This virus has shown its capacity to affect multiple bodily functions, leading to significant physiological changes. Its impact ranges from intricacies within the immune system to complexities in cardiovascular health, introducing unprecedented alterations in individuals’ physiological well-being.

But what are the correlations, if any, between Covid-19 and an increase in stroke incidences especially amongst the young? In light of the increasing number of cases of Covid-19 in Malaysia again, in this article, we attempt to investigate the links.

Related: Covid-19: are we out of the woods yet?

Traditionally, when we speak about strokes, it tends to be an “elderly persons” disease, a health concern prevalent amongst those aged 50 and above. However, over the past three years since the first outbreak of Covid-19 pandemic caused by the novel coronavirus SARS-CoV-2, an intriguing and worrying connection has emerged between the virus and incidences of strokes in younger individuals.

Emergence of a concerning link with stroke

Covid-19 is indeed associated with a higher risk of stroke, a majority of them being ischemic strokes (caused by a blockage in an artery that supplies blood to the brain). A study by PubMed Central, a highly respected database from the National Institutes of Health, did suggest a connection between the high prevalence of vascular risk factors and concurrent elevation of proinflammatory and procoagulation biomarkers in this.

Related: New finding to prevent plaque buildup and heart attack/stroke

In the same study, it has been proposed that the virus that causes Covid-19 infects the cells that line the inside of the blood vessels and these infected cells release several pro-inflammatory factors that attract other immune cells to the affected area. In turn, this leads to damage to the lining cells, activating platelets and other factors involved in clotting. This chain of events eventually increases the risk of a blood clot that could potentially travel up to the brain and cause a stroke.

In essence, hypercoagulability and inflammatory response cause vascular complications, increasing the risk of strokes, regardless of age.

Stroke risk factors

Findings from another large-scale study conducted by BMJ, wholly owned by the British Medical Association (BMA), suggested that Covid-19 is a risk factor for deep vein thrombosis, pulmonary embolism, and bleeding. The risk of developing blood clots in the lungs and legs is significantly elevated for up to six months upon contracting Covid-19.

From data collected from the US Department of Veteran Affairs, which consisted of 153,760 individuals who contracted Covid-19, evidence suggested that after the initial 30 days of infection, individuals afflicted with Covid-19 displayed heightened susceptibilities and endured a year-long burden of newly emerging cardiovascular conditions. These encompassed a spectrum of disorders, ranging from cerebrovascular issues and dysrhythmias to inflammatory heart disease, ischemic heart disease, heart failure, thromboembolic disease, and assorted cardiac disorders.

Strikingly, these risks manifested consistently across various demographic factors, such as age, race, and gender, as well as other established cardiovascular risk factors like obesity, hypertension, diabetes, chronic kidney disease, and hyperlipidemia. Notably, even those without any pre-existing cardiovascular conditions prior to exposure to Covid-19 exhibited these risks, suggesting a propensity for these complications to manifest in individuals traditionally considered at low risk for cardiovascular diseases.

In summary, data and evidence gathered do point to a heightened risk of stroke brought about by Covid-19, regardless of age. Even though it remains an uncommon occurrence, it remains a risk especially for individuals pre-existing health conditions that are known to boost the risk of stroke.

Young ones with pre-existing health conditions may be at more risk

Young individuals who have pre-existing health conditions such as hypertension, diabetes, or obesity face an elevated risk of experiencing severe complications from Covid-19, including the potential for strokes. Effectively managing these underlying health conditions emerges as a critical measure in preventing adverse outcomes and improving the overall prognosis for those affected by the virus. Prioritising the control and treatment of these existing health issues not only supports overall well-being but also plays a pivotal role in mitigating the severity of Covid-19-related complications.

Focus on prevention

Maintaining vigilance and monitoring for symptoms associated with stroke, such as sudden weakness or numbness, difficulty speaking, or severe headache, is crucial for early detection and intervention. Seeking prompt medical attention can significantly improve outcomes in case of a stroke.

While the correlation between incidences of stroke, Covid-19 and how it affects younger individuals remains a subject of ongoing research and study, it remains crucial in recognising the potential risks and taking appropriate and proactive measures.

Risk mitigation strategies

Staying informed through reliable health sources, maintaining healthy lifestyle habits, proper diet, and consulting medical professionals play essential roles in reducing stroke risk.

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Spotting harmful dietary fats from labels

Fast food and ready-to-eat meals are becoming more and more popular among Asian city dwellers as a result of the region’s growing urbanization and fast-paced lifestyle. However, these prepackaged foods and ‘comfort foods’ may be full of trans fats – the dietary fats which are bad for one’s health.

The American Heart Association claims that eating trans fats increases your risk of developing heart disease, stroke, and type 2 diabetes because they lower your good (HDL) cholesterol levels and raise your bad (LDL) cholesterol levels.

Trans fats are present in a wide variety of foods, such as fried foods like doughnuts , baked goods, and other packaged foods, as well as certain ingredients like margarines, shortening and other fatty substances. So, whenever you bite into your favorite snack, consider whether you may be consuming trans fats.

Related: Southeast Asia tackles healthy diet, balancing food intake

To find out how many trans fats are in packaged food, consult the Nutrition Facts label. When a product is advertised as having no trans fats, it may actually mean that it only contains less than 0.5 grams of trans fat per serving. The food’s ingredient list refers to transfats as “partially hydrogenated oils.”

Transfats are putting billions of people worldwide at risk of heart disease

According to a recent WHO report, Countdown to 2023 WHO Report on global trans fat elimination 2022, five billion people worldwide are already unprotected from harmful trans fats, increasing their risk of developing heart disease and dying from it.

Population coverage of best-practice policies has increased nearly six-fold since WHO first called for the global elimination of industrially produced trans fat in 2018 with an elimination target set for 2023. At this point, 43 nations have put best-practice regulations against trans fat in food into place, protecting 2.8 billion people worldwide.

However, despite significant progress, this still exposes five billion people to the devasting health effects of trans fat, making the global goal for its complete eradication in 2023 currently unachievable.

Packaging, baked goods, cooking oils, and spreads frequently contain industrially produced trans fat, also known as industrially produced trans-fatty acids. Up to nearly half million early deaths from coronary heart disease occur worldwide each year as a result of trans fat consumption.

There is currently no best-practice policy in place in 9 of the 16 nations with the highest estimated percentage of coronary heart disease deaths attributed to trans fat consumption. Australia, Azerbaijan, Bhutan, Ecuador, Egypt, Iran, Nepal, Pakistan, and South Korea are among them, according to WHO.

Dr. Tedros Adhanom Ghebreyesus, director general of the WHO. claimed that transfat has no known benefits and significant health risks, which result in significant costs for healthcare systems. Contrarily, eliminating trans fat is affordable and has significant positive health effects. Simply put, trans fat is a poisonous chemical that causes death and has no place in food. It’s time to permanently get rid of it.

Best practices to eliminate trans fat

Policies for the elimination of trans fats restrict the use of industrially produced trans fat in all contexts and follow certain standards advised by the WHO: a mandatory national limit of 2 grams of industrially produced trans fat per 100 grams of total fat in all foods, and a mandatory national ban on the production or use of partially hydrogenated oils as an ingredient in all foods.

While higher-income nations like those in the Americas and Europe have implemented the majority of trans fat elimination policies, middle-income nations like Argentina, Bangladesh, India, Paraguay, the Philippines, and Ukraine are increasingly doing the same.

In 2023, best-practice policies are also being considered in Sri Lanka, Mexico, and Nigeria. No low-income nation has yet to adopt a best-practice policy to ban trans fat.

WHO suggests that nations concentrate on these four areas in 2023: implementing best-practice policies, monitoring and surveillance, healthy oil replacements, and advocacy. To assist nations in moving forward quickly in these areas, WHO guidance has been developed. The organisation supports the International Food and Beverage Alliance’s (IFBA) pledge to remove industrially produced trans fat from its products. The biggest food producers in the world have been urged to stop using industrially produced trans fats in their products.

SOURCES:

https://www.who.int/news/item/23-01-2023-five-billion-people-unprotected-from-trans-fat-leading-to-heart-disease

https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/trans-fat

The most recent development in world of health and medicine has been the acceptance that we will be living with COVID-19 into the longer term. Masks, social distancing, vaccine passports and travel restrictions will now bean inseparable part of our daily dealings. While most of these initiatives serve the common purpose of safeguarding people and curbing spread of the infectious disease, there are simple and small measures around our diet and lifestyle that can help support the immune system.

Since most of this information is available to public on various government websites, the concern is not really about lack of awareness. Research has shown that most nutritional and health initiatives are not adopted in individuals due to lack of habit formation. For adults who have spent a larger part of their lives with lesser focus on nutrition or a healthy diet, this time might pose many challenges. Healthcare practitioners (HCPs) have been looked up to for the most credible advice on nutrition – something which was also reflected in a Nutrition Myth Survey conducted by Herbalife Nutrition in 2020. And therefore, we HCPs must do more to help consumers in this journey of achieving a healthy immune system and lifestyle.

Here are a few tips that can help you create an “immunity toolkit” for patients and consumers:

1. Advise less added salt and sugar

Sugar is the known culprit for impacting innate immunity of one’s body, and recent evidence has linked high dietary sodium intake to sodium toxicity which is associated with comorbid conditions of COVID-19 such as hypertension, kidney disease, stroke, pneumonia, obesity, diabetes, and a few others.

The severity of these complications is well known to the health care community. However, the emphasis may not be as well understood by consumers. Therefore, encourage your patients and consumers to reduce their intake of added salt and sugar, particularly from highly processed foods that are often the primary sources of sodium and sugar.

• The Dos don’t come without a habit

WHO recommends individuals to eat four servings of fruits, five servings of vegetables, 180 g of grains, and 160 g of meat and beans, in their daily diet. Now, for individuals who have not been following any regime for their diet, this might come as a severely complicated process to follow. More so, in absence of a habit, this might fizz out too soon.

Meal plans are often underrated but very useful when it comes to forming habits. The beauty of a meal plan is in its flexibility, and the fact that it doesn’t feel like following a strict regime. As HCPs, we can help patients develop the right meal plans to suit different body needs and health conditions. In addition, various meal plan tools and apps exist to aid a faster and more effective adoption process.  Having a healthy meal pattern to follow is more likely to lead to better dietary habit formation, rather than a rigid, prescriptive diet.

• Talk about the“boosters”

Once the dos and the don’ts have been well addressed, share additional tips with your patients. We can encourage a diet of nutrient-dense foods, including plenty of whole fruits and vegetables, more whole grains than refined grains, lean proteins from both plant and animal sources, as well as healthy fats from nuts, seeds, seafood, avocado and seed oils. Examples of some specific nutrient-dense “superfoods” include tea, nus, spinach, berries and red beans.

Nutrition supplements can help, especially when there is a deficiency in the body which is going unnoticed. Many people do not meet the recommended intakes for several vitamins and minerals including potassium, magnesium, and vitamins A, C, and D.  HCPs can recommend regular nutrition check-ups for those who lead very active lifestyle or suffer from impaired nutrient absorption. 

Regular physical activity is imperative for a healthy body and it works in tandem with nutrition. In a recent review, it was noted that several micronutrients, including selenium, zInc and vitamins A and D as well as nutraceuticals and probiotics may be beneficial in enhancing immunity during the COVID-19 pandemic.

With this toolkit, you can follow the progress of your patients, making sure they are engaged, forming healthy habits and being conscious about what they are consuming. Consumer education about nutrition and healthy living is more important than ever, and it’s become a driving agenda and responsibility for many in the HCP community.

Read also: Study: immunity post-Covid-19 infection lasts up to 8 months

The field of communication neuroprosthetics has so far focused on restoring some degree of speech to patients who have lost the ability due to stroke, disease, or an accident; it typically involves spelling-based approaches to type out letters one-by-one in text – a slow and laborious task. Fortunately, University of California, San Francisco (UCSF) neurosurgeon Dr. Edward Chang has seen fit to develop a novel technology that instead “decodes full words from the brain activity of someone who is paralysed and cannot speak.”

Read also: Experimental smart hearing aid tracks user’s brain waves

Dr. Chang’s prototype system translates signals intended to control muscles of the vocal system for speaking words, rather than signals to move the arm or hand to enable typing. According to the Joan and Sanford Weill Chair of Neurological Surgery at UCSF, this approach not only taps into the natural and fluid aspects of speech, but also promises more rapid and organic communication.

Previously, Dr. Chang and colleagues in the UCSF Weill Institute for Neurosciences mapped brain activity patterns associated with vocal tract movements that produce each consonant and vowel, facilitated by patients with normal speech. Postdoctoral engineer David Moses then developed new methods for real-time decoding of those patterns into speech recognition of more accurate, full words.

However, the team’s success in decoding speech in participants who were able to speak didn’t guarantee that the system would work in patients with a paralysed vocal tract. “Our [custom neural network] models needed to learn the mapping between complex brain activity patterns and intended speech,” said Moses. “The best way to find out whether this could work was to try it.”

This prompted the launch of the “BRAVO” (Brain-Computer Interface Restoration of Arm and Voice) Study, with participant BRAVO1 – a 30-year old male suffering from a devastating brainstem stroke that severely damaged the connection between his brain and his vocal tract and limbs. Since his injury, he has had extremely limited head, neck, and limb movements, and can only communicate by using a pointer attached to a baseball cap to poke letters on a screen.

For the study, Dr. Chang surgically implanted a high-density electrode array over BRAVO1’s speech motor cortex. After the participant’s full recovery, Dr. Chang’s team recorded 22 hours of neural activity in this brain region over 48 sessions and several months. In each session, BRAVO1 attempted to say specific vocabulary words while electrodes recorded brain signals from his speech cortex; at the same time, the custom models worked to distinguish subtle patterns in brain activity to detect speech attempts and identify which words he was trying to say.

The team found that the system was able to decode words from brain activity at a rate of up to 18 words per minute with up to 93% accuracy (75% median), helped in part by a language model that implemented an “auto-correct” function, similar to what is used by consumer texting and speech recognition software today.

“This is an important technological milestone for a person who cannot communicate naturally,” said Moses, “and it demonstrates the potential for this approach to give a voice to people with severe paralysis and speech loss.”

Dr. Chang and Moses are also working to increase the number of words in the system’s available vocabulary, as well as improve its rate of speech.

In a stroke, damage to motor function on one side of the brain affects movement on the opposite side of a person’s body. Just this year, a novel device designed to help stroke patients recover wrist and hand function by overcoming this specific problem has been approved by the US Food and Drug Administration (FDA) – the IpsiHand system, the first brain-computer interface (BCI) device to ever receive FDA market approval.

The system is based on a discovery made by Eric Leuthardt and colleagues at the Washington University School of Medicine back in 2008: even if signals for body movement can be detected on the same side of the brain, these signals are still futile when the opposite side of the brain, which is actually responsible for executing the movement, is damaged. This specific brain activity was called ipsilateral brain signals.

The idea behind the IpsiHand BCI device was to find a way to detect those ipsilateral signals and use them to control an electronic hand brace. It was later demonstrated how patients using an experimental BCI device for 12 weeks, in the context of rehabilitation, significantly improved some degree of motor function by essentially retraining their brain to communicate with their hand.

“Generally, any motor impairments experienced by a patient six months after a stroke have been considered permanent,” said Leuthardt. “What we’ve found with this device is that many patients can get a meaningful improvement in recovery of upper extremity movement when we wouldn’t expect them to get any. That’s not really true for any of the current therapies for stroke aimed at restoring function after the initial recovery period.”

The IpsiHand device consists of two separate parts – a wireless exoskeleton that is positioned over the wrist, and a small headpiece that records brain activity using non-invasive electroencephalography (EEG) electrodes. The device wirelessly measure brain activity and, via a tablet, communicates with a hand brace allowing stroke patients to regain movement in a paralysed hand.

Although the IpsiHand is currently not available to patients, commercialisation and eventual clinical access should follow in late 2021, thanks to the FDA’s market authorisation. The approval was primarily based on clinical trial data showing significant motor function improvements when the device was used for 12 weeks, for around five times per week for at least 10 minutes each day.

“It is exciting to say that this is the first FDA-approved brain-computer interface for rehabilitation,” Leuthardt added. “People have been trying for a long time to convert BCI from an experimental technology into something that will truly help patients. With this, we’ve shown that BCI is finally ready for prime time. I sincerely hope there are many more such devices to follow.”

Read: Portable MRI pinpoints strokes that need surgical treatment

An expansive study led by researchers at the University of Exeter, UK, is the first to find that increasing differences in the blood pressure between each arm is linked to poorer cardiovascular health – the greater this differential in pressure, the greater the patient’s risk of heart attack, stroke and early death.

Blood pressure rises and falls in a cycle with each pulse. Large differences in blood pressure measurements (measured in millimeters of mercury/mmHg) may be a sign of blocked or stiffening arteries, or some other factor affecting blood flow. International hypertension guidelines recommend that physicians record blood pressure in both arms at the initial consultation and if there is a difference of greater than 20 mmHg, then further investigation is warranted.

In this global study, concerning nearly 54,000 people from Europe, the US, Africa and Asia, university GP Dr. Chris Clark and colleagues investigated how inter-arm differences tracked with heart attacks, strokes and death over a 10-year period.

The researchers found that every mmHg of difference between the systolic, or maximum, pressure, in each arm corresponded with a one percent increase in the subject’s chance of experiencing new angina, a heart attack or stroke in the following 10 years.

“It really is critical to measure both arms to establish which patients may be at significantly increased risk. Patients who require a blood pressure check should now expect that it’s checked in both arms, at least once,” said Dr. Clark.

Read: Isometric resistance training shown to safely reduce high blood pressure

A cardiology professor from Dupuytren University Hospital in France, Victor Aboyans, pushes to include this information into future guidelines and clinical practice in assessing cardiovascular risk. “We believe that a 10 mmHg difference can now reasonably be regarded as an upper limit of normal for systolic inter-arm blood pressure, when both arms are measured in sequence during routine clinical appointments.”