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Enforce Unlock 4.0 strictly as Covid doesn’t spare anybody: Dr Trehan

As India holds a dubious distinction of recording highest new cases in the world for 22 days, Dr Naresh Trehan, chairman of Gurugram’s Medanta Hospital, says that the government has to play a balancing act between life and livelihood and has to open carefully with strict protocols.

Shalini Bhardwaj

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Dr Naresh Trehan, chairman of Gurugram’s Medanta Hospital.

As the country prepares for Unlock 4.0 from 1 September with more than three million Covid cases, Dr Naresh Trehan, chairman of Gurugram’s Medanta Hospital, says that the government has to play a balancing act between life and livelihood and has to open carefully with strict protocols. “We have to be very careful in understanding that we are no different from the rest of the world. Virus doesn’t spare anybody. No matter how much we open, unless we do it in a very strict and enforced protocol manner, we will keep having the numbers that we are seeing,” he says.

On 28 August, India recorded a single-day spike of 77,266 cases and the country’s total Covid tally stood around 33.87 lakh cases. States like Uttar Pradesh, Karnataka, Tamil Nadu, Andhra Pradesh and Maharashtra are reporting most of the Covid-19 cases. India also holds a dubious distinction of being a country with the highest new cases in the world for 22 days.

 “There were states having much less numbers which are now rising. We need to check from where high numbers are coming from. Uttar Pradesh and Bihar are in bad shape now. The first survey done in Delhi showed 23 percent developing antibodies and one month later, it came to 29 percent. There are pockets in Pune which are showing 50 percent. The pattern of this infection is like other countries have it, peaks in one area and at other places it goes down,” says Dr Trehan.

 Explaining the facts and the reasons behind the spike in the number of cases and what has to be done to control the situation, the doctor adds,” There are three aspects to it. One is the fact that once the number starts going up, the government gets alerted more and governments which may have thought that they were ahead of the curve, realise that they were as bad as anybody else. So, then they start reacting and try to control it. The second thing that happens is that medical facilities in those areas then wake up and start treating properly. And the third thing that happens is that the public gets scared.”

Giving the example of Bengaluru, the doctor said that the city thought that it had controlled it very well and people became careless and started going out and restaurants opened up.“ But then it spreads like wildfire. Public gets scared and they start protecting themselves. Then the third waves come out and the numbers go down. This is the difficult pattern which is in India today. So, the basic thing is where and when will it end,” he says.

 On the possibility of a vaccine and herd immunity, he adds, “There is hope, maybe real or maybe not so real, is a vaccine. The other is if we do another survey in Delhi now and we get an antibody count 29 percent gone up to 40 percent, that shows there is some amount of herd immunity happening. So, the herd immunity to get effective, we have to reach 60-70 percent which will happen in the next 2-3months. Even before the vaccine arrives, we will have areas that will peak and come down. Then the population is immunizing itself as it goes along. These are three factors which are paying in this Covid-19 pandemic which we have to observe very carefully.”

 According to the doctor, people themselves play an important role and their carelessness is the biggest concern. “The government has to do what it can do and it’s the people who need to stop being careless and then saying that they are fed up and going out,” he says.

 However, speaking about the country’s battle against the deadly virus so far, he says that on a brighter side, 90 percent people are going through it without much trouble and those who are unhealthy are suffering but the proportion of them is still surviving that’s why the mortality rate is less.

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Medically Speaking

Active Covid cases have decreased, with 3,947 cases reported in the last 24 hours

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COVID-19

According to Union Health Ministry data updated on Friday, India’s COVID-19 case tally increased by 3,947 in a day to 4,45,87,307, while active cases decreased to 39,583.

The death toll has risen to 5,28,629, with 18 more deaths, including nine fatalities reconciled by Kerala, according to data updated at 8 a.m.

According to the health ministry, active cases account for 0.09 per cent of total infections, while the national COVID-19 recovery rate has increased to 98.73 per cent.

The daily positivity rate was 1.23 per cent, with a weekly positivity rate of 1.44 per cent.

The number of active Covid cases fell by 1,167 in a single day, while the number of people who recovered from the disease rose to 4,40,19,095. The case fatality rate was calculated to be 1.19 per cent.

According to the ministry, the Nationwide Vaccination Drive has resulted in the administration of 218.52 crore total vaccine doses (94.84 crores second dose and 21.19 crore precaution dose).

Two deaths were reported in Maharashtra and West Bengal, and one each in Uttar Pradesh, Punjab, Karnataka, Haryana, and Chhattisgarh. Kerala has made amends for nine deaths.

On August 7, 2020, India’s COVID-19 case tally surpassed 20 lakh, followed by 30 lakh on August 23, 40 lakh on September 5, and 50 lakh on September 16. It surpassed 60 lakh on September 28, 70 lakh on October 11, 80 lakh on October 29, 90 lakh on November 20, and one crore on December 19.

Last year, the country passed the two crore mark on May 4 and the three crore mark on June 23. On January 25, this year, it surpassed the four-crore mark.

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Medically Speaking

PREVENTION: HOW TO KEEP YOUR HEART HEALTHY AT AGE 40

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PREVENTION: HOW TO KEEP YOUR HEART HEALTHY AT AGE 40

An individual becomes more concerned about their health as they reach a certain age. As the most vital organ of the body, the heart requires extreme care as its chances of developing cardiac diseases increase with age.
Among older people, heart disease is the leading cause of morbidity. To reduce the risk of CVD in middle age, it is recommended to maintain or increase physical activity. Dr AnbuPandian, Medical Advisor, Agatsa, shared some tips to keep the heart healthy at 40 with us.

Stay Active
The most effective way to prevent heart disease at 40 is to adopt a healthy lifestyle. If you work nine hours in an office job, take short breaks every two hours. Taking the stairs instead of the lift, walking short distances instead of using a vehicle or public transportation. Exercise, meditate, swim, play basketball, dance, and do yoga—whatever you love.

Exercise Regularly
Physical exercise has been shown to have a positive effect on heart health in comparison to sedentary lifestyles in various studies. A great quality of life is dependent on a healthy heart. Maintaining a regular exercise routine will keep the heart healthy for years to come.

Regular Heart Health Check-ups
A heart health check-up is essential at every stage of life, but becomes especially crucial after age 40. There are several factors that determine how often a person should get a check-up, including smoking, alcohol consumption, heart disease in the family, being overweight, and diabetes. Blood sugar and cholesterol levels should also be monitored closely. Heart diseases can be better treated if they are detected early. Once a person crosses the age of 40, a yearly checkup is mandatory. The physician may recommend more frequent check-ups if heart disease is detected.
As age increases, metabolism tends to decrease by 5 % every decade after 40. Hormonal imbalance and bone density are two other significant changes that the body registers while getting old. Increase the intake of fruits rich in Vitamin C. All citrus fruits, for that matter, have a bonus heart-healthy benefit. The best diet for preventing cardiac disease is one that is full of fruits and vegetables, whole grains, nuts, fish, poultry, and vegetable oils. Individuals who follow their dietary pattern have a 31% lower risk of heart disease than those who consume junk food.

Remote Monitoring Machines
Remote monitoring machines have been around for years but have gained significant prominence recently, thus resulting in high demand. Such devices are used on a daily basis to monitor diseases such as heart attacks, hypertension, and diabetes. These devices are very portable, user-friendly and capture patients’ health parameters via cables and sensors. These devices are cost-effective for patients because they reduce medical care costs and provide more timely intervention for chronic conditions. No one can slow down the ageing process. However, with proper care, one can be more fit, look younger, and lead a more energetic and active life. Life doesn’t end, but begins afresh again at 40!
The author is a Medical Advisor at Agatsa.

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Medically Speaking

Why heart attacks are on the rise among women

Even though heart ailments are on the rise among women, a lack of awareness has prevented many from getting timely treatment and diagnosis of the disease.

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Why heart attacks are on the rise among women

Heart diseases are no longer a “men’s problem” and women too are equally prone to them. According to a recent report published by the National Family Health Survey, it was found that the overall prevalence of undiagnosed hypertension in women of the age group 15–49 years is 18.69% in India, which busts the myths that heat conditions are most prevalent among men.
Several other international studies have also indicated that heart ailments are now a leading cause of death among women, resulting in ten times more fatalities than breast cancer. Even though heart ailments are on the rise among women, a lack of awareness has prevented many from getting timely treatment and diagnosis of the disease.
Why are heart diseases going undetected in women? While ensuring the well-being of their loved ones, women in India tend to ignore their own needs and often neglect their health. For instance, if a woman has mild chest pain, she would rather ignore the symptoms and focus on managing the work/household chores rather than visiting a doctor. The patriarchal setup of our society also expects women to keep the well-being of others at the forefront rather than taking care of themselves, which results in late diagnosis and is one of the primary causes of increasing heart ailments among women in the country.
As the symptoms of a heart attack are different in both men and women, many women often don’t know if they have already suffered one or two heart attacks in the past until eventually, they visit a doctor. While in men, a heart attack usually results in extreme and sudden chest pain and breaking out in cold sweats, whereas in women, the symptoms are usually mild and heart attacks can be frequent and smaller. The symptoms in women can range from jaw pain to fatigue to pain in the neck and back to sweating or just heartburn, indicating the need for them to undergo regular health check-ups and take proactive measures to ensure overall well-being.
Which age group is most susceptible to heart attacks and what are the major concerns?
Women of the age group 45–55 years are at a high risk of experiencing a heart attack due to low levels of estrogen post menopause, work and family-related stress, loneliness, and lack of physical activity. More women in this age group may go undiagnosed and have atypical symptoms compared to men.
The second most affected age group is 60 years of age, where the biological deterioration makes both men and women more susceptible to heart attacks. High cholesterol, blood pressure, obesity, smoking, sedentary lifestyle, and diabetes are also some of the main concerns that make women more prone to cardiovascular diseases.
How can women take care of themselves and keep heart attacks at bay?
There are several steps that women can take to prevent heart ailments, such as:

  1. Educate yourself and increase awareness about the risk factors that can lead to blockages.
  2. Avoid smoking or the use of tobacco.
  3. Engage in physical activities like yoga, dancing, running, and walking for 30–45 minutes every day to maintain heart health and overcome obesity.
  4. Avoid junk food, aerated drinks and adopt a balanced diet. Healthy heart diets that include complex carbohydrates, legumes, fruits, vegetables, and less sugar, salt, and fat can have a positive impact on heart health.
    Lastly, it is important to note that gender has nothing to do with heart attacks, and the condition affects both men and women equally. However, adopting a healthy lifestyle and undergoing regular health checkups can help you get the gift of good health.

The author is a Senior Consultant at Interventional
Cardiology, Aster CMI
Hospital, Bangalore.

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Medically Speaking

HEALTHY LIFESTYLE: Role of nutraceuticals in heart health

The never-ending work of the heart and the constant workload necessitate healthy dietary patterns and lifestyles.

Dr Anish Desai

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HEALTHY LIFESTYLE: Role of nutraceuticals in heart health

The growing evidence of cardiovascular diseases (CVDs) in both developing and developed nations over the last 20 years has made CVDs a global healthcare priority. As per the WHO, heart attacks and strokes account for 85% of all CVD deaths. It is responsible for an estimated 31% of all deaths worldwide, with 17.9 million deaths yearly. More than 75% of all cardiovascular events occur in low- and middle-income countries. CVDs are the leading cause of death worldwide, with more people dying from them each year than from any other cause.
Role of diet in the maintenance of a healthy heart:
The never-ending work of the heart and the constant workload necessitate healthy dietary patterns and lifestyles. One of the most important factors that can be changed to promote heart health is diet. An unhealthy diet high in saturated fat and carbohydrates is linked to abnormal blood lipid levels, which increases the risk of heart disease.

Use of
Nutraceuticals in heart health:
Nutraceuticals refer to substances that are either food or a component of nutrition that help in the prevention, protection, and/or treatment of chronic diseases. Nutraceuticals can maintain health, slow the progression of lifelong or chronic diseases, and slow aging. Nutraceuticals are considered superior to chemical medicines due to their lack of side effects and ease of access.
• Omega-3 fatty acids: They possess a beneficial effect on the heart as it helps in reducing the risk and advancement of cardiovascular disease. Clinical studies have found that omega-3 fatty acids lower serum triglyceride levels, increase fatty acid degradation, and clear plasma triglycerides. They also help to lower systolic and diastolic pressure in hypertension patients. Foods which are rich in omega-3-fatty acids are flax seed, mackerel, salmon fish, cod fish, etc.
• Coenzyme Q10 (CoQ10): Clinical data revealed that a high dose of CoQ10 helps maintain a healthy heart by reducing lipoprotein oxidation and forming atherosclerotic lesions. Foods such as oily fish (salmon, tuna), grape seed, soyabean, avocado, broccoli, peanuts, and soybeans contain a high amount of CoQ10 in them.
• Carotenoids: Carotenoids such as lycopene can reduce the risk of atherosclerosis by prohibiting endothelial dysfunction and lowering LDL levels. Tomato, red cabbage, beet root, papaya, and watermelon are good sources of carotenoids.
• Polyphenols: Polyphenols present in fruits and vegetables improve lipid metabolism, reduce blood pressure and delay the progression of heart diseases. Almonds, cherries, berries, black olives, cloves contain a high concentration of polyphenols.
• Use of micronutrients: Supplementation with micronutrients such as zinc, selenium, magnesium, selenium, vitamin C, and vitamin E exerts a protective effect on the heart by reducing endothelial cell damage, production of nitric oxide, and inhibiting LDL-c oxidation.
Due to the modern lifestyle, it is imperative to maintain a healthy heart. Regular consumption of nutraceuticals will help to prevent cardiovascular diseases and help to follow a healthy lifestyle.

The author is MD, Clinical Pharmacologist and
Nutra-ceutical Physician, Founder and CEO IntelliMed Healthcare Suctions.

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Health & Wellness

Kashmiri ASHA worker serves as inspiration by donating blood 28 times

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A 32-year-old woman named Bilqees Ara, an ASHA worker, has donated blood 28 times since 2012. She has served as an inspiration to others across the nation.

Bilqees, who is from the Handwara Tehsil in the Kupwara area of North Kashmir, stated that she understands the “importance of blood”.

She said that by donating a pint of blood, she not only saves a precious life but an entire family.

She began donating blood in 2012 and has since given 28 pints.

She expressed her gratitude and pride at being the saviour of so many patients in the Kashmir valley.

I’ve seen people cry helplessly as they try to get blood to save their loved ones, but I’m proud of myself because I’ve arranged blood for them as well. “I felt an inner joy after that,” she said.

In Kashmir, she is known as the “Blood Woman of Kashmir”.

She is a registered blood donor. Whenever a need arises, the officials at the Blood Bank at Handwara hospital call her and, within the shortest span of time, she makes herself available to donate blood.

Women should come forward and do this as there is nothing to be afraid of. This is to be done for society, she said. She also said that she wondered who else would do it if she refused.

If a person has blood and courage, why can’t he give it to someone else in a time of need? She asked.

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Covid facilities to reduce in Delhi amid drop in cases

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The Delhi government has closed 11 Covid care facilities because to a consistent reduction in cases. Two Covid Care Centers are operational at Ambedkar Nagar Hospital, which has 50 beds, and Balak Ram Hospital, which has 25 beds, according to a government report. Only five admissions were registered at Ambedkar Nagar Hospital over the past three months, while there were none at Balak Ram Hospital.

The number of patients has steadily decreased at the remaining CCCs as well, according to reports.

According to officials, the Delhi Disaster Management Authority on Thursday decided to scale back the medical staff and infrastructure that had been deployed for COVID management in a planned manner. The health department will now formulate an action plan in response to this decision.

“The deven CCCs were closed and dismantled by Delhi government and one by the Centre and three others with total 4000 bed capacity- Radha Saomi Satsang ,Chattarpur, Sawan Kirpal, Burari , and Sant Nirankari, Burari- were closed but not yet dismantled”, officials said.

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