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Health & Wellness


Doctors share problems associated with the liver, symptoms, diagnosis, treatment and ways to keep it functioning well.




• Maintain a healthy weight (Ideal BMI being around 23.5)

• Eat a balanced diet. Avoid high calorie-meals, saturated fat, refined carbohydrates (such as white bread, white rice and regular pasta) and sugars.

• Limit your alcohol intake (not more than 2 standard drinks a day in men and 1 standard drink a day in women, a standard drink being a pint of beer or a glass of wine or a peg of hard drinks like whisky)

• Exercise regularly for at least 30-45 min a day for at least 5 days a week

• Practice safe sex and avoid unnecessary sharing of toothbrushes, razors, needles and other personal care items• Avoid illicit drugs and contaminated needles

• Get vaccinated for Hepatitis A and Hepatitis B• Be careful with traditional/alternative medicines and weight loss pills By Dr Mrudul Dharod, Consultant, Gastroenterologist, Wockhardt Hospital Mira Road, Mumbai


• We need to take care of our liver. It is one of the most important organs in our body and is responsible for ensuring bile production and excretion, excretion of bilirubin, cholesterol, hormones, drugs, metabolism of fats, proteins, carbohydrates, and enzyme activation.• Fatty liver and non-alcoholic fatty liver are the two main conditions that indicate that all is not well with our liver. Liver cirrhosis is when the liver is badly scarred or has/is on the verge of failure. These conditions are a result of excessive alcohol consumption, smoking, highly processed food, obesity, and a sedentary lifestyle. The liver does need to cleanse so that it can continue to perform at optimum capacity and to do so diet is essential.• If one has a fatty/ non-alcoholic fatty liver, they need to consume a lot of fruits and vegetables, legumes, and whole grains. Foods like fish, oatmeal, walnuts, avocado, and even coffee need to be included in the diet. In addition to this, garlic, milk products, olive oil, sunflower seeds, and tofu can be included in the diet to make it interesting.• Drinking lots of water prevents dehydration and helps your liver to function better.• Say no to sugar, salt, trans fat, refined carbohydrates, saturated fat, alcohol, white bread, red meat, fried food, raw or undercooked shellfish such as oysters and clams.• Depending on the type of condition one is suffering from they need to speak with their doctor about their consumption of protein, iron and copper.

The liver performs several key functions. It is essential for digesting food and getting rid of toxic substances from the body. There are many liver diseases including hepatitis, liver cancer and cirrhosis. The causes range from genetics to infection and autoimmune diseases. Dr Manish Kak, Senior Consultant, Gastroenterologist, Columbia Asia Hospital, Ghaziabad, says: “Liver disease can be inherited but can also be caused by a variety of factors such as viruses, alcohol use and obesity. Liver disease symptoms vary depending on the underlying cause. However, there are some general symptoms like jaundice, loss of appetite, itchy skin, dark urine, and improper digestion. Several conditions may affect the liver such as hepatitis, autoimmune disease, and genetic conditions like cystic fibrosis. Early diagnosis of liver problem help to start the treatment sooner and chances of cure is higher. Left untreated, it can cause permanent damage. Untreated liver disease may progress to liver failure that is a life-threatening condition. However, acute liver failure may happen suddenly, often in response to an overdose or poisoning.”

He adds that for some people, lifestyle changes such as limiting or abstaining from alcohol, maintaining a healthy weight, drinking more water, adopting a liver-friendly diet that includes plenty of fibre while reducing fat, sugar, and salt are enough to prevent liver disease. Dr Kak shares a piece of advice, “If you have any symptoms of a liver problem or are at risk of developing one, make sure to check with your doctor for routine checkups and screening tests.”

Since with early diagnosis of liver diseases, chances of cure are higher, Dr Ravi Mohanka, Chief Surgeon and Head of Department, Transplant and HPB Surgery, Global Hospital, Mumbai shares the warning signs and treatment:

– Jaundice (yellowness of eyes and urine) treated with some medicines and observation

– Swelling of feet and abdomen (Ascites) can be controlled with diuretics (medicines) that causes patients to make more urine

– Excessive sleepiness, irrelevant talking or even coma, treated by keeping ammonia level low with some medicines and passing frequent stools

– Blood vomiting or very dark black stools, controlled by endoscopy

– Secondary kidney failure

Adding to it, Dr Mrudul Dharod, Consultant Gastroenterologist, Wockhardt Hospital Mira Road says, “the warning signs of underlying liver disease are: Jaundice (yellowish discolouration of eyes and skin), nausea/vomiting, itchy skin (especially over hands and legs, and more at night), chronic fatigue, distension of abdomen (due to water collection in the abdomen), swelling over legs, easy bruising, blood in vomiting and altered behaviour. The foremost treatment for liver diseases is identifying the causative factors like Viruses (HAV, HEV, HBV, HCV), alcohol, drugs or other rare causes and then specifically target the inciting factor. The rest of the treatment is supportive of medical management.”

To ward off liver diseases, Dr Mohanka opines, “people should not consume alcohol or have it in moderation, undergo Hepatitis C or B test and if positive opt for treatment, control obesity, diabetes and high cholesterol.”


Does chronic liver disease increase your risk of severe Covid-19? Dr Praveen Jha, Consultant, Gastroenterology, Regency Superspeciality Hospital, Lucknow replies, ‘’People need to be extra cautious if they have any chronic liver disease such as hepatitis B, hepatitis C, fatty liver or cirrhosis as they have a greater risk than other individuals for severe Covid-19 and the occurrence of complications including prolonged hospital stay and mortality. The pandemic is having a major effect on the management of patients with chronic liver diseases, in particular those with cirrhosis, hepatocellular carcinoma and liver transplantation programmes.”

“The potential onset of Covid-19 in patients with chronic liver disease raises two questions: will patients with chronic liver disease develop a more severe form of Covid-19; and will Covid-19 aggravate the course of their liver disease and induce liver-related mortality. Patients with cirrhosis seem to be at greater risk than other individuals for severe Covid-19 and the occurrence of complications including mortality regardless of the aetiology of liver disease. If these patients have associated metabolic comorbidities that include obesity, diabetes, and hypertension, then they are at higher risk of developing severe Covid-19. Therefore, it is crucial to monitor liver enzymes in Covid-19 patients. This is especially true because the liver is the only organ that can regenerate after an injury so patients do not show symptoms of a liver disease till the liver is about 80% damaged,” he adds.

Dr Manjunath Malige, Lead Consultant – Bariatric Endocrinology & Diabetes, Aster RV Hospital, Bengaluru says, “Severe Covid-19 can impact the liver, particularly in those who are already suffering from co-morbidities or liver disease. The exact impact is yet to be fully understood but people with chronic liver disease are at a high risk of suffering from severe Covid-19.”

Dr Sharad Malhotra, Specialist- Gastroenterology Hepatology & Therapeutic Endoscopy, Aakash Healthcare, New Delhi says that the Covid-19 has taken a toll on people who are suffering from liver diseases. The dreaded infection can cause direct inflammation of the liver, deterioration of the existing liver disease, and in some serious cases liver failure also. Dr Malhotra asserts, “In our hospital, we have come across several such patients having liver damage in mild to severe cases of Covid-19. Consuming alcohol should be completely stopped as it can lead to alcoholic hepatitis, fatty liver, liver cirrhosis, and liver cancer.”

How can alcohol consumption impacts liver health, Dr Jha answers, “Alcohol and drug use can translate into a substantial increase in blood-borne virus transmissions as well as in alcoholic liver disorders and decompensations, resulting in many more patients with cirrhosis, hepatocellular carcinoma, liver transplantation and liver-related death.’’


Fatty liver is a condition where excess fat builds up in the liver. Dr Malige says, “Fatty liver does not have very obvious symptoms and often gets detected when it is in a severe state. A liver biopsy is required to determine the extent of fatty liver disease. Often people attribute the symptoms to something else. Bloating or pain in the abdomen, appetite loss, uncharacteristic weight loss, sometimes jaundice, swelling in the legs, fatigue and inability to concentrate are some signs of fatty liver disease. Heavy drinkers, people with type 2 diabetes, and obese people are all at a high risk of developing fatty liver disease.” Talking about the treatment, he says lifestyle changes play a key role in reversing the damage. In people suffering from type 2 diabetes, or obesity, addressing these conditions will help treat the fatty liver. Options such as a weight loss management programme, medications to lose weight, or bariatric surgery will help address fatty liver as well. Alcoholics must quit the habit and follow a healthy lifestyle with a well-balanced diet and sufficient exercise.By Daljit Kaur, Chief Dietitian, Fortis Escorts Heart Institute, New Delhi

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Health & Wellness


Dr Srividya Nandkumar



An insulin disorder that affects over 450 million people across the world, Diabetes Mellitus is one of the leading causes of death worldwide. In India alone, over 70 million people are estimated to be living with diabetes. Poor disease management and ineffective blood sugar control is a major risk factor for a series of life-threatening conditions such as cardiovascular, strokes and renal disease. In fact, diabetes is a major cause of vision loss, kidney failure, heart attacks, stroke and amputations. Worrisomely, the incidence of this lifestyle disorder has grown tremendously over the past three decades largely due to unhealthy lifestyles, increasing consumption of processed foods and a dramatic drop in physical activity.

Naturopathic interventions such as diet management, yoga, lifestyle alterations and acupuncture can play a significant role in controlling the diabetes pandemic. Adopting a naturopathic way of life not only helps patients keep their blood sugar level under control, but also help them reduce their dosage of allopathic drugs.

Acupunture as a diabetes control intervention

The widely used alternative healing practice of acupuncture dates back to more than 3500 years. This ancient Chinese practice is based on the belief that life energy also known as qi flows through our bodies through certain pathways, thereby regulating health and vitality. When the flow of this vital energy is obstructed due to some reason, the body experiences diseases. Acupuncture uses the practice of inserting pins and needles on strategic points on the body to remove the obstruction and revive the flow of energy through our organs. There are around 1000 acupuncture points in the human body. 

Acupuncture is an effective therapy for diabetes, especially for type 2 diabetics. It helps regulate pancreatic function and control blood sugar levels in the body. The result is better glycemic control and improved overall health. A study published in the Journal of Traditional Chinese Medicines in 2019 found that when administered along with metformin drug, acupuncture treatment helped significantly reduce levels of both FPG and HbA1c – two critical diabetes indicators – in patients. The study, therefore, recommended the use of acupuncture as an adjuvant therapy among Type 2 diabetics. 

Mainly two types of acupuncture practices are used to treat diabetes — electroacupuncture and wrist-ankle treatment. The former is the most common form of treatment in which needles are pierced at trigger points. Then a low-frequency electrical variation is transferred from one needle to another that helps fight insulin resistance. Wrist-ankle treatment is most effective in bringing down the sugar levels and focuses on deep stimulation of the trigger points. 

However, several myths and misconceptions about acupuncture prevent many people from receiving its benefits. We demystify some common myths related to acupuncture here.

1. It’s painful

The mere thought of needles being pierced into the skin leaves many people petrified, but acupuncture isn’t as painful as you think it to be. The needles used for acupuncture are very thin and you feel very little or almost no discomfort while they are inserted. Many patients don’t even realise when the needles are being pierced into their body. 

2. Doctors don’t recommend this 

The World Health Organization and National Institutes of Health have recognised acupuncture as an effective therapy for treating not just pain but also several other conditions like diabetes. A number of modern medicine practitioners also prescribe acupuncture as an adjuvant therapy along with the regular medicines particularly to patients displaying poor glycemic control. A number of studies have found acupuncture to be effective in controlling blood sugar levels.

3. It has side effects 

Acupuncture is absolutely safe when performed by a certified acupuncture practitioner. Side effects are almost negligible or only minor such as soreness, minor bleeding in some cases or dizziness. However, no serious adverse effect is associated with this therapy.

4. The treatment is expensive

Acupuncture is affordable and does not burn a hole in your pocket. On average, it costs around 1500 to 2000 Rs per session. Overall, the therapy may also help reduce dosage of diabetes drugs. 

5. You get addicted to acupuncture

No, acupuncture is not addictive or dependence creating. The practice does help relieve stress and calm down people but it doesn’t create any dependence.

The writer is Sr. Naturopath at Jindal Naturecure Institute.

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Health & Wellness


Kamayani Naresh



Over time, experts build a strong study of Rasayana – rejuvenation. They studied ingredients available in nature for well-being, immunity, and overall mental and physical health. Rasayanas are known to build the body to fight diseases of the mental and physical kind. These ingredients are also known to build immunity and protect the human body from infliction.

Here are remedies to boost immunity in your kids:

Golden milk: Children often fuss when drinking milk. Make it interesting for them and peg the usual haldi doodh or turmeric milk as Golden Milk. As you might know, Turmeric has anti-inflammatory properties and plays a crucial role in building immunity among children. It is also a staple in Indian cooking. As we use Turmeric in our daily cooking, an added supplement of Turmeric will positively impact your children’s health. 

Ashwagandha: It is one of the many researched Ayurvedic herbs. It is known to help with numerous serious diseases and ailments. It also has anti-inflammatory properties, which contribute to preventing autoimmune disorders, among others. Research has proven that it improves the functioning of brain cells and common mental health issues. Ideally, give your children this magic herb through warm and sweet milk. You can also add it with Turmeric milk to combine both herbs.  

Liquorice sweets: Liquorice or Mulethi is a herb that is commonly eaten as candy. You can find it at specialised stores or online. The candy is an acquired taste and has many health benefitting properties. The Glycyrrhizin – a saponin found in Liquorice is known for its anti-microbial action. Usually, this root is made into powder, mixed with honey and ghee, to improve immunity. It is a natural revitaliser and also effective as an anti-ageing remedy. 

Vegetable juices with ginger: Give your children vegetable juice with a generous amount of ginger. Ginger is used in Indian cooking, but may not be enough, to impact immunity. Ginger is efficacious in curing coughs and seasonal flu. Its anti-microbial compounds help fight infections and boost immunity. Local stores also stock a large amount of ginger candy that can also be made part of your children’s routine. 

Plant a Tulsi plant together: Tulsi, as you know, is a medicinal plant. It has healing properties and looks beautiful as part of the home decor. Involve your children in planting this plant with you, and together learn the importance of its medicinal properties. Use the plant leaves for wounds and burns. Show your kids how this plant can be used and also consume its juice daily. Allow your children to acquire the taste for it, and they will be build immunity to lead a healthy life. 

Observe your children, as every human body is unique therefore, your child will also respond suitably to different remedies. Preventika an immunity booster by Zyropathy is a combination of Tulsi Leaf, Turmeric, Bael leaf, Sheesham, Gudmar leaf, Arjuna Bark, Mint leaves, Motherwort and more ingredients. It is a healthy option for balancing a child’s immunity. The herbal medicine helps strengthen the internal systems, ensures health and works against 19-various ailments.. Many other remedies and herbs help in building immunity among adults and children. Ensure to learn and include them in your daily routine to protect your family from external harm. 

The writer is the founder of Zyropathy.

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Health & Wellness


Top healthcare experts and doctors share their inputs on all you need to know about Parkinson’s and ways to cope with this condition.




• Have full awareness of their condition. Also, your caregiver must be equally educated about the same

• You can use the voice option in their phone for any work rather than text mode• Exercise regularly to maintain balance, go for massages, and movement therapies

• Take medications on time and listen to your therapist

• Simplify your tasks and set realistic goals

• Plan your tasks like exercising, chores, recreation in advance• Avoid extreme physical activity. Do not push, pull, or lift heavy objects (more than 10 pounds) that require you to strain

• Do not eat too many sugary foods and drinks as these can negatively impact your immune system. Opt for naturally sweetened food and reduce your sugar intake

• To help prevent accidents, install grab bars beside toilets, sinks, and in the tub or shower area depending on your need

—By Dr Rajnish Kumar, Sr. Consultant & Unit Head, Neurology, Paras Hospitals , Gurugram


• Patients are unable to follow up with their neurologist; it is important that they continue to take their medicines regularly and if faced with worsening of symptoms or side effects related to the medicines they should try to contact the neurologist via telemedicine

• Patients with pre-existing Parkinson’s disease when affected with Covid-19 infection can have an exacerbation of the symptoms. They must be evaluated by a neurologist who can adjust the medicines and they should remain in touch with the neurologist whenever possible in person or if not via telemedicine

• Very rarely some patients with Covid-19 infection can present with features similar to Parkinson’s disease. These patients will need hospitalisation and thorough evaluation and treatment under the care of a neurologist.

April is Parkinson’s awareness month. It is the second most common degenerate disorder of the brain after Alzheimer’s disease that has devastating mental and physical implications on the patients who are left untreated otherwise. It is a progressive nervous system disorder that affects movement, says Dr Rajnish Kumar, Sr. Consultant & Unit Head, Neurology, Paras Hospitals, Gurugram.

Researchers suggest that Parkinson’s results from a combination of genetic factors and environmental factors such as exposure to toxins. It usually affects people aged 55 years and above.

—By Dr Prashant Makhija, Consultant, Neurology, Wockhardt Hospital Mumbai Central


On the challenges posed by the pandemic in treating Parkinson’s patients, Dr Anil Venkitachalam, Consultant, Neurology and Movement Disorders, Nanavati Super Speciality Hospital, Mumbai said, “Like every vulnerable section of society, Parkinson’s patients and their treatment was hugely impacted by the pandemic. An increase in requests for home visits was a particularly challenging task. Due to the co-morbidities and risks of infection, the patients were restricted to their homes. Despite the risks involved and the unavailability of necessary instruments and diagnostic paraphernalia, we took all safety precautions and honoured as many home visit requests as possible.”

 He adds, “The other challenge was the ‘loss to follow-up’ of our many patients. Several patients were on schedule H drugs such as anti-depressants or anti-psychotics etc. Due to movement restrictions, they couldn’t visit their physicians and renew the subscriptions. In the meantime, the pharmacies stopped honouring the old prescriptions or even new digital prescriptions and patients had to go on without medication for a long time. The hospital couriered hundreds of prescriptions to the patients so that they don’t stop the medication.”

Similarly, as February-March mark the financial year-end, many patients needed disability certification to avail the benefits announced by the government. Since they couldn’t get out of the house, the hospital team filled and mailed the necessary documents for the disability certification. Nanavati Super Speciality Hospital started online patient support group programs to offer holistic solutions and guidance to patients and caregivers.

 “Parkinson’s may not affect the patient’s immune system directly. However, in few cases, such patients may have other health conditions which may increase the risk of contracting the Covid infection. They are strongly advised to follow Covid appropriate behaviour,” asserts Dr Guruprasad H, Senior Consultant, Neurology, Columbia Asia Referral Hospital Yeshwanthpu, Bengaluru. 


  What are the symptoms of Parkinson’s? Dr Rajnish replies the condition is characterised by four cardinal symptoms: tremor (trembling) mainly in hands, arms, legs, jaw, or head; stiffness in the limbs and trunk; generalised slowness of movements and stooped posture; and impaired balance and coordination. “Early symptoms of Parkinson’s are subtle and occur gradually. Symptoms often begin on one side of the body or even in one limb on one side of the body. As the disease progresses, it eventually affects both sides. However, the symptoms may still be more severe on one side than on the other,” he adds. Mental and behavioural changes sleep problems, depression and anxiety, memory difficulties (Parkinson’s associated dementia), chronic fatigue, severe constipation, difficultly in urination, persistent dizziness, altered sweating, excessive salivation, altered smell perception, and dramatic fluctuations in blood pressure are some of the prominent symptoms which may need treatment.


Parkinson’s occurs when nerve cells, or neurons, in the deeper areas of the brain called ‘substania nigra para compacta’, that controls the movement, tone and coordination of the body, become impaired and/or die. Normally, these neurons produce an important brain chemical known as Dopamine that helps send signals in your brain. When the neurons die or become impaired, they produce less dopamine, which causes the disease, informs Dr Rajnish. He points out that since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible. 


There are several myths associated with Parkinson’s. Talking about it, Dr Guruprasad says, “It is believed that everyone with the condition will have tremors, there is no treatment for Parkinson’s, and it is a mental disorder among others. It is a neurological condition and not everyone will experience tremors. Few patients may show other symptoms like balance issues. The advancement of technology has given way to new treatment techniques like deep brain stimulation with directional leads and pump delivered therapy for the management of the condition. Parkinson’s can be managed with medications and lifestyle changes.”


On how to manage this condition, Dr Guruprasad says, “Exercise, balanced diet, rest, speech therapy and physical therapies will aid in the management of Parkinson’s. The patients should follow Covid appropriate behaviour. Medications are the important factors to control physical and mental symptoms affecting the people with this condition. Taking the medications regularly, following an indoor physical activity regimen, and engaging in hobbies will be beneficial for them.”


Early detection of the disease and starting treatment is very essential, as it drastically changes the quality of life of a patient and arguably, also impedes the rate of progression of the disease. Although there is no cure for Parkinson’s, medicines, surgical treatment, and other therapies can often control the symptoms, informs Dr Rajnish.

Adding to it, Dr Prashant Makhija, Consultant, Neurology,Wockhardt Hospital Mumbai Central says, “Since Parkinson occurs due to progressive loss of nerve cells in the brain which produce Dopamine, the treatment is directed towards external replacement with Dopamine in the form of tablets or with medications that facilitate the action of internally produced Dopamine. The non-motor symptoms (such as sleep disturbances, constipation, memory as well as mood and behaviour changes) are symptomatically managed. Patients also require gait/balance training and speech/swallow therapy. Owing to the multiple issues the patients face, they need to be periodically evaluated by a neurologist who can titrate the medicines to provide them optimum benefit while minimising the adverse effects related to the medicines.”

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Health & Wellness


Dr Prakash Desai



Have you, as a parent, thought about vaccines your child might need? Making your child get flu shots every year is a great idea, but even more this year as the Covid-19 virus continues to spread. Many parents don’t realise it, but the flu can be a very serious illness and the highest risk group are children up to the age of 5 years and above, senior citizens and can lead to long term health conditions. It is even more important to protect your child from viruses like influenza by giving them an annual flu shot. Vaccinating children not only prevents them from catching flu, it also prevents them from spreading it. 

As a paediatrician and neonatologist, I often come across parents who ask many questions like “my child had the flu vaccination last year” Do they need another one this year? Yes; flu viruses change every year so the vaccine may be updated. For this reason, we recommend that your child is vaccinated against flu again this year, even if vaccinated last year. In young children, flu can cause pneumonia (lung infection) and bronchiolitis (infection of the tiny airways that lead to the lungs causing wheezing and difficulty breathing) and sometimes the resulting high fever can lead to febrile fits. 

Below are some Q&A’s which will help you in deciding to consider vaccinating your child with flu vaccine if not done already? 

Influenza or flu is a respiratory infection caused by an influenza virus. In India, limited influenza activity is usually seen throughout the year with a clear peaking during the changing weather seasons and mostly during the rainy season all over the country. Parents need to understand, Influenza isn’t just in schools — it’s also out in our communities, in stores and in parks and in individuals around you. It’s still very important for kids to get vaccinated to protect themselves and everybody else around them from influenza. Considering the seriousness of influenza, and the susceptibility of young kids to this illness, doctors and specialists have all been motivating parents to get the seasonal influenza vaccinations to be better equipped for the flu seasons.

Always remember from age 4 through 6, your child needs additional doses of some vaccines, as well as a flu vaccine every year. If your child has missed any vaccines, work with your doctor to make sure he or she gets them on time. 

How does influenza spread?

Influenza viruses are found in the nose and throat. Children can catch influenza from siblings, parents, other family members, playmates or caregivers.

Germs usually spread in one of three ways:

• Direct contact — such as touching or holding hands with an infected person. 

• Indirect contact means touching something a toy, doorknob or a used tissue, that has been touched by an infected person and now has germs on it and can stay on surfaces for many hours. 

• Some germs spread through the air via droplets when a person coughs or sneezes.

How do I know if my child has influenza?

The flu strikes more quickly than a cold, and makes children feel worse typical influenza symptoms include:

• sudden fever and chills 

• headache or muscle aches,

• extreme fatigue

• dry cough and sore throat and,

• loss of appetite

What are the benefits of the vaccine? 

Having the vaccine will help protect your child from what can be a very nasty illness in children. Children under the age of 5 years have the highest rate of hospital admissions due to flu. It will reduce the chance of others in your family, who could be at greater risk from flu, such as grandparents or those with long term health conditions, getting flu from your child. 

Does taking the flu vaccine stop you from getting the flu?

Flu illness can be caused by several viruses. As the flu vaccine given has been derived from four prevalent viruses for that time of the year, the circulating virus has to match the virus strain for the best protection. It also depends on an individual’s immune response to produce antibodies. Though it might not provide complete protection, there is a good chance that the incidence of Flu illness will reduce and chances of complications and hospital admissions due to flu illness will come down. 

Can all children get a flu vaccine?

Yes, the minimum age is 6 months. Only in the first year, two doses of Flu vaccine need to be given 1 month apart to reinforce the immunity and subsequently once every year to provide maximum immunity as the circulating strain and the matching vaccine strain keeps changing.

Ideally, it’s recommended until the child is 5 years old but children with recurrent respiratory illness, asthma and other long-term conditions would benefit from yearly vaccination to be continued till later. 

Are there side effects of the flu vaccine?

The influenza vaccine is very safe. It cannot cause the flu. Side effects are usually mild and could include:

• Mild soreness where the needle went into the arm for 1 to 2 days.

• A mild fever or aching for the first day or two after immunisation


Apart from immunisations, there are some simple ways to protect yourself and your child from flu:

· Good hand hygiene is the most important factor to prevent the spread of flu. Wash your and anyone who will be looking after the baby hands often with soap and water or an alcohol-based sanitiser.

· If your baby is already reaching out for toys and crawling around, be sure to wash her hands as well and clean the surfaces which are frequently handled.

· Breastfeeding your baby helps to protect her health in more ways than one. Breastmilk contains antibodies that will pass on to your baby. Breastfed babies have a lesser incidence of colds and other respiratory and gut infections. 

· Avoid close contact with persons who may already be showing signs of Flu symptoms if possible. 

There has been a surge of flu vaccinations in the current Covid pandemic and vaccines are available at your local paediatrician or can be arranged through hospitals that provide home vaccination services. Don’t forget to protect your kids, and others, take a Flu jab for your children. 

The writer is Consultant – Pediatrician & Neonatologist, Cloudnine Group of Hospitals, Bangalore (Malleshwaram).

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Health & Wellness




Multiple myeloma is a type of blood cancer in which there is excess production of white blood cells, especially plasma cells. Plasma cells are the end-stage or most mature variant of B-Cells, the latter being responsible for the antibody formation in the body and for immune response. The B-Cells originate in the bone marrow and hence Multiple Myeloma starts commonly in the bones, however may later affect other organs as well. Actress -politican Kirron Kher was recently diagnosed with multiple myeloma.


a) Bone pains, commonly affecting the central or axial bones of the vertebral column, pelvis and hips, skull bones, followed by ribs, sternum, clavicles, long bones of arms and legs

b) Weakness, fatigue, weight loss with low haemoglobin (anaemia), high calcium levels in the blood

c) Mental fogginess

d) Constipation

e) Kidney failure in advanced stages due to the breakdown of myeloma proteins and blockage of kidneys

f) Frequent infections due to reduced immunity

g) Bone fractures with minor trauma

h) Paralysis of upper or lower limbs or loss of bladder and bowel control in case the Myeloma is growing inside the vertebra and pressing the spinal cord


The definite causative factors for Multiple Myeloma are not

known, however the risk factors include

a) Age >60 years

b) Male gender

c) Family history of multiple myeloma

d) Pre-existing Monoclonal Gammopathy of un- determined significance (MGUS)


The recommended tests for diagnosing Multiple Myeloma are

a) Complete blood counts – can pick up anaemia, high white cell count, low platelets

b) Serum electrophoresis – a special blood test to identify the monoclonal (M) band of myeloma protein/s and the type of Myeloma and estimate the quantity of Myeloma protein production

c) Kidney function tests may show a high level of creatinine, urea, calcium or uric acid

e) Liver function tests may show a reversal of albumin and globulin ratio with a high globulin level

f) Bone marrow biopsy is a test done to find out the number of plasma cells in the bone marrow

g) Radiology imaging- Total body X-Rays may show punched out bones where the myeloma has affected the bone. A CT scanner PET-CT can show the whole body myeloma involvement at an earlier stage than an X-RAY.

Sometimes the physician may ask for an MRI of the affected vertebra to see the level of the collapsed vertebra and whether a patient needs surgery /radiation to improve the neurological function.

The treatment of Multiple myeloma depends upon the stage of the disease and it is classified into 3 stages I, II, III.

The treatment includes symptom relief, reduction in bone pain, preventing complications like kidney failure, fractures and paralysis.

It includes Targeted therapies, chemotherapy, steroids, immunotherapy, Bone marrow transplant, renal dialysis, surgery, and radiation therapy.

Besides the disease directed therapy the common things recommended for a patient are adequate water intake to remove the Myeloma proteins by proper flushing of kidneys (urination) and keeping up a good mobility/exercise program to avoid bone loss.

The writer is Chairperson Radiation Oncology, Cancer Institute, Medanta – The Medicity.

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Health & Wellness


Is excessive social media use among teenagers in the ongoing pandemic leading to anxiety, burnout, depression, and other mental health issues? Mental health experts and psychologists share their take on it.



The Covid-19 pandemic has led to a major surge in social media usage among teenagers in addition to other age groups. Although social media has been a life-saver during the pandemic when it comes to being updated with health-related information and other news from reliable sources, killing boredom, loneliness or taking a break by consuming light and humourous content, spending too much time on it can have a deleterious effect on the mental health and wellbeing of teenagers. There can be harmful consequences of over-use including poor sleep, irritability, stress, anxiety, depression, low self-esteem and difficulty in concentration. Therefore, it becomes important to unplug from time to time and engage in productive and recreational activities. Mental health experts and psychologists share their opinions on how excessive social media use is affecting adolescent minds. 


For most adolescents, more time spent at home during the pandemic has meant increased hours of being glued to a screen. While social media can prove to be an invaluable tool, living a virtual life can harm their healthy state of mind. Heavy social media dependence has been linked to emotional issues like negative wellbeing, low self-esteem, experiencing feelings of depression, disturbed sleep patterns, and an impaired attention span. Bothering yourself with the feelings of the thousands of your social media followers can indeed make you feel anxious. It is a common sight to witness teenagers constantly scrolling their phones. Parents need to be mindful of this activity since it tends to keep the brain on high alert, averting the child from falling asleep and can destroy the release of melatonin, a hormone that makes us feel tired. Parents must ensure to shorten the time spent on virtual mediums by engaging the child in mind-boosting activities like concentration games, breathing exercises, or brain-body coordination workouts. A pause in social media usage can help them connect with their real life, making them emotionally happier and healthier. The younger generation seems to be the hardest hit by the pandemic. Hence it is more important than ever that they can access support with their emotional health during such critical times.

Kanchan Rai, Mental & Emotional Wellbeing Coach, Founder, Let Us Talk


It has been well established that human beings are social creatures and the ongoing pandemic has made most of us crave a social life. Studies suggest that boredom and loneliness are strong predictors of social media use among teenagers. It helps teenagers self-regulate emotional mood states, feel aroused when they are bored as applications such as Instagram, YouTube, etc. provide entertaining content, it also helps boost self-esteem among them as 66% of Indian teens feel acceptance on social media. Studies also suggest that during the Covid pandemic, browsing through social media and interacting with friends help teenagers reduce their feelings of loneliness. Teenagers in India are spending the majority of their online activity on Instagram or YouTube and consuming humour-based content to feel happier. However, the problem arises when the time spent on social media exceeds the four hours per day limit. It has been noticed that with excessive use, 70% of teens share sensitive information about themselves, and 66% of teens experience some amount of cyber-bullying. Psychologists and researchers agree that excessive social media usage during this time is also causing discontentment in physical appearance, reducing levels of happiness, leading to anxiety, depression, and even lower self-esteem among teenagers. Thus, impacting the mental health of the youth. 

  The best way to thus manage the harmful impact of social media is by limiting the use of social media and including exercise as a part of one’s daily regime. The time spent on social media should not be more than four hours per day, parents should understand if their child is feeling anxious or upset and even help them improve their self-esteem by reminding them that social media is not real, it is simply a virtual world. In certain cases, professional help must be sorted. Moderate and controlled use of social media is an enabler of healthy relationships, when it becomes excessive and addictive it becomes a deterrent to positive mental health.

Dr Prerna Kohli, eminent Psychologist, Founder,


The challenging times of the Covid-19 pandemic created tremendous turbulence through all walks of life. The global lockdown led to the shutting of many important physical settings, one of them being schools. The schools were operating online, allowing the children an increase in the usage of mobiles, laptops, computers, and other electronic gadgets. As the parents also went online with their occupation, they were unable to provide supervision concerning the amount of screen time and the content watched by the children. With the provision of interesting social media platforms like Instagram, Twitter, Facebook, and Whatsapp, there is a constant urge and impulsivity in the children to post or watch the content on these social media sites. This excessive usage is likely to bring up issues like body image concerns, peer pressure, cyberbullying, exploitations, low self-esteem and many others.

  Here comes the responsibility of the parents to supervise their children. They can divide this into two categories, mandatory and recreational. Since mandatory cannot be avoided, recreational usage can be altered. The parents must fix a time discussing with their children regarding the usage and should also make verbal contracts with them to make them feel responsible. Positive and negative reinforcements can be applied by the parents. Being friendly will help them open up with the kids. The possibility of exploitative content available on the media should be conveyed by the parents. 

Further, a cognitively stimulating environment will help them avoid engagements in such platforms. We often blame our children for using the internet but as parents, it is important to safeguard our children from such addictions by enriching their environment.

Prachi Kohli, counselling psychologist, Apollo spectra hospital, Karol bagh


The Covid pandemic has impacted the lives of children from toddlers to teenagers in a major way. They seem to spend more time at home due to restrictions; learning is happening on screens, chatting with friends and peers is also happening on various social media platforms. While social media has become a major medium of entertainment, flaunting one’s skills and looks, it has also turned into a major source of information for teenagers who spend their major time on phones or laptops. However, they need to know that no child can have a personal social media account before 13 years of age. They must refrain from sharing their friends’ pictures or content. Bullying can happen on social media and teenagers need to be aware of that. For any news, do not refer to social media rather perform a detailed search on their own as the information on social media can be personal views and may not be reliable. While our teenagers have access to this new media, they must be made aware of their rights and responsibilities and their legal implications.

Dr Himani Narula, Developmental Pediatrician and Co-Founder, Continua Kids

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