Stable thyroid function despite regular use of povidone-iodine throat spray for SARS-CoV-2 prophylaxis.

BACKGROUND: It is unclear whether unintentional ingestion of povidone-iodine following its application to the oropharyngeal space could affect thyroid function. OBJECTIVE: To examine thyroid function among individuals who regularly apply povidone-iodine throat spray for SARS-CoV-2 prophylaxis. METHODS: We designed a case-control study to compare thyroid function among participants who received povidone-iodine throat spray three times a day for 42 days ('cases') and those who received vitamin C ('controls'). Thyroid function was assessed by profiling serum TSH, free T3, and free T4; iodine status was estimated using serum thyroglobulin level, while infection status was determined by measuring anti-SARS-CoV-2 antibody against the nucleocapsid antigen. All measurements were performed in pairs, at baseline and 42 days later. Pre-post changes in thyroid function were compared between groups, before and after stratification according to baseline TSH quartiles. RESULTS: A total of 177 men (117 cases and 60 controls) (mean age, 32.2 years) were included. Despite comparable demographics and clinical profiles, no clinically or statistically significant differences were observed in thyroid indices between 'cases' and 'controls' before and after stratification according to TSH quartiles. None of the participants developed symptomatic hypo- or hyperthyroidism throughout the study. Post-hoc analysis did not reveal differences in thyroid function according to infection status. CONCLUSIONS: Data from this study support the overall safety of povidone-iodine use in the oropharyngeal space for SARS-CoV-2 prophylaxis among individuals with normal thyroid function and subclinical thyroid disease.

Long-term outcomes of ischaemic stroke patients with diabetes in a multi-ethnic cohort in Singapore.

INTRODUCTION: Diabetes increases the risk of ischaemic stroke especially among Asians. This study aims to investigate contemporaneous long-term cardiovascular outcomes of ischaemic stroke patients with diabetes in a multi-ethnic Asian cohort. METHODS: Consecutive patients with ischaemic stroke were recruited from the National University Hospital, Singapore. Data on age, gender, ethnicity, risk factors (including diabetes status and body mass index [BMI]), stroke severity and mechanisms were collected. These patients were followed up until the day of the first cardiovascular event or July 2016, whichever was earlier. The primary endpoint was the time from enrolment to the first occurrence of a composite of cerebrovascular and coronary artery events. RESULTS: Between July 2011 and December 2013, 720 patients (mean age 60.6 years, 71% men, 43% with diabetes, median National Institute Health Stroke Severity scale 2) were enrolled and followed up. A total of 175 cardiovascular events occurred during a median follow-up of 3.25 years (6.90 events per 1,000 person-month), comprising 133 cerebrovascular and 42 coronary artery events. The adjusted hazard ratio of diabetes was 1.50 (95% CI 1.08-2.10). In a multivariable Cox proportional hazards model, Malay and Indian ethnicities, BMI <23kg/m2 and a prior diagnosis of diabetes were identified as independent predictors of recurrent cardiovascular events. CONCLUSION: Our study provides quantitative data on the event rates of ischaemic stroke patients with diabetes. These findings provide insights on stroke predictors in a multi-ethnic Asian population, which may have implications in the design of future interventional studies.

Aged Garlic Supplement Protects Against Lipid Peroxidation in Hypercholesterolemic Individuals.

The health benefits of raw garlic intake has been extensively studied, but little is known about the biological effects of aged garlic consumption. A randomized, placebo-controlled, parallel-arm, double-blinded trial involving 41 hypercholesterolemic individuals was conducted to simultaneously examine and compare the blood lipid lowering and antioxidant effects after acute and extended exposures to aged and raw garlic supplements (1080 mg daily). Aged and raw garlic did not affect blood lipid concentrations in these hypercholesterolemic participants after acute and 13-week supplementation. The plasma and urinary F2-isoprostanes concentrations were significantly decreased after 13 weeks of aged garlic treatment. Aged garlic supplementation over 13 weeks also significantly decreased serum lipid hydroperoxide concentration and myeloperoxidase activity. Raw garlic treatments did not affect the F2-isoprostanes concentrations in blood plasma and urine, and lipid hydroperoxides in blood sera. Acute effects on the measured parameters were absent for both garlic treatments. In separate in vitro experiments, aqueous methanolic extract of aged garlic inhibited F2-isoprostanes formation and myeloperoxidase activity in freshly isolated human neutrophils to a greater extent than the raw garlic extract and S-allylcysteine at equivalent dosing concentrations. The aged garlic preparation was found to contain significantly higher total phenolic and S-allylcysteine contents than the raw garlic precursor. Our data showed that supplementation with aged garlic, not its raw garlic precursor, reduced oxidative stress and alleviated lipid peroxidation, possibly via the inhibition of myeloperoxidase. The differential antioxidant actions of the aged and raw garlic may be related to their different total phenolic contents and, to a lesser extent, their S-allylcysteine contents.