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Fear of getting judged: Are you really ignoring your mental illness?

Covid-19 has aggravated mental stress, anxiety and paranoia amongst people, including the youngsters. This is not the time to delay your mental health treatment, advise psychiatrists and counsellors.

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A non-judgmental and caring approach is what people suffering from mental health issues seek from a therapist, psychiatrists, clinical psychologists or counsellors. Finding the right diagnosis can considerably reduce the anxiety and depression levels and if wrongly diagnosed, it can make the situation worse. This is a valid concern for the youth who are often uncertain about whether they need counselling and how to seek professional help. From helping people identify what triggers the negative behaviour to develop positive coping mechanisms, individuals, couples, youth and children will notice a magnitude of difference in their lives. The pandemic has heightened the mental health issues amongst those who were already finding it difficult to cope up with it. Covid-19 has aggravated mental stress, anxiety and paranoia amongst people including the youngsters, says Shumita Kakkar, founder and director of United We Care. 

The Indian Lunacy Act was passed in 1912 and it took the government 75 years to finally amend it to the Indian Mental Health Act 1987. However, despite rapid urbanisation of culture and lifestyle changes, and despite rising incidences of mental illness in the country, it took the government a good 30 years before it amended the previous Act and passed the Indian Mental Health Care Act 2017. Dr Ishita Mukerji, a senior psychologist at mental wellness centre kaleidoscope, a unit of Dr Bakshi’s Healthcare asserts, “Ignorance, disinformation, stigma and a lack of appreciation are few of the barriers that stand in the way of an effective mental healthcare system. This timeline indicates that the field of mental health has not received an adequate amount of economic and political importance that it should have long back.” 

NIMHANS carried out a national-level survey on mental health care and disease burden in the country back in 2016. Few of the major points they indicated are mental health programs in India are a low priority on the public health agenda; health information system across the country do not prioritise mental health; existing health care facilities often lack a proper mental health care program; an acute paucity of mental health professionals across the country; lack of proper institutional care facilities and low coverage of the District Mental Health Programme. 

Discussing the complication associated with complex mental illnesses, Vidit Bahri, MD at Sukoon Hospital, clinically governed by Fortis Healthcare says, “Mental Health conditions such as bipolar, schizophrenia, clinical depression etc, require medical intervention in a controlled and monitored environment. The team of psychiatrists, psychologists, neurologists, counsellors, social workers and art-based therapists offer patients a haven to recover amidst surroundings equipped with the latest technology and equipment.” He further adds, “Recovery in mental health is a gradual process as patterns take time to observe, diagnose and manage. We have made sure that patients have the environment and care to recover. The residential patients got through a rigorous daily schedule of activities, therapy, yoga and physical therapy. In some cases, we encourage family members to stay with the patients to add an extra layer of comfort.”

 Shumita says that like one consults a doctor for a physical illness, there should not be any hesitation to seek the help of a professional who is trusted, unbiased and nonjudgmental. “We are here to solve your mental health problems, bring positive change in your life and not know your identity. The National Health Department says that therapy is the best cure for stress and anxiety. Open up and talk it out, get the right advice and take the right decision,” she adds. Ever since the pandemic started, experts have been receiving increased queries in terms of issues pertaining to relationships, uncertainty as well as anxiety amongst LGBTQIA+ and children. Men have a different coping mechanism and therefore needed to be catered accordingly by the experts. Shumita asserts that mental health problems amongst youth are also on a spike. 

Roadblocks in treatment

 For the youth, seeking professional help becomes difficult due to uncertainty regarding when to seek help and how besides the financial constraints. Talking about the unsatisfactory experience with therapists, Pratishtha Nangia, 25 says, “I was suffering from depression for two years and didn’t even know then. It was when the anxiety also kicked in and along with it came the realisation that it can get worse, I decided to consult a therapist. It was a problem looking for who to contact since many people here do not go for therapy.” 

However, simply searching online for good psychologists or therapists can be tricky. Pratishtha adds, “It becomes a hit and trial process. I tried talking to threefour therapists, on a phone and video calls and couldn’t connect with them mainly because they were repeating things that I already knew. One of the therapists I spoke to, sounded amateur. It proved to be a bad experience.” She informs that the charges for sessions are too high at times. To be able to take sessions at a young age with monetary constraints and that too without family’s in several cases, as they will not understand the need for therapy, becomes difficult.

 There aren’t many quality therapists and psychiatrists in our country in my experience as many of those I consulted had biases which caused hindrance to improve the condition, believes Priyanka Ramesh, 27. She says, “My bout with depression started in 2017 and I initially sought help from a counsellor in my college. He was judgmental and it somehow didn’t work out for my benefit. Then there was another who put the whole blame on me which made my situation worse. Unfortunately, even after seeing many psychiatrists including those who charged hefty amounts, it did not prove to be of much help.” Her disappointment and bad experiences led her to take the situation in her hands by making conscious changes in her lifestyle, reading books, cutting off ties with toxic people and adding positivity. She says that it’s still a struggle on some days and a constant battle.

 Similarly, anxiety issues prompted Nikita Chaudhary, 25 to look up therapists on the internet. However, most of them were psychologists and she could hardly find therapists. Sharing the difficulties she faced, Nikita says, “I hesitated to reach out to most. I’d filled some online forms on different platforms which claimed they had a good team of therapists and started receiving desperate calls from them about their monthly and weekly plans. I was already in a bad state and this scared me, even more. It’s a per session game for them but a lifetime experience for us.”

 It took her almost two months to find the right person through a friend’s reference. She elaborates, “I looked up on Instagram and found a page. It was a team of 10-15 people but they were counsellors which I did not want. I even took a session with a counsellor but she told me that she was not the right person. A friend of mine who’s a psychologist referred me to a therapist and that finally helped me.” 

Most of the people are afraid of the uncalled judgments by society and sometimes their family in addition to the myths and stigmas related to mental health issues.

 Even when a person decides to seek professional help, the first step is realising and recognising the symptoms which take time, believes Deepak Kumar Bhagatt, 29. “In 2015, I was dealing with trauma and stress related to exams besides my sexuality. From Satyamev Jayate, I came across the Naz Foundation (India) Trust. It took me a month to muster the courage to seek help, it was not an easy decision, since there were apprehensions about psychotic drugs and treatment which was fuelled by society. I consulted two counsellors there, had therapy sessions and they helped me a great deal to overcome the mental health issues,” adds Deepak. 

Rakshit, 22, came in contact with the counsellor through Sanjivini Society for Mental Health. “I used to find myself very irritable, crying, lacking confidence and couldn’t understand what is happening in my life. I reached out to the organisation to seek the answers. They arranged a meeting with the counsellor. After a few sessions, one major problem that surfaced was suppressed emotions. After this, all the bottled up emotions were following out of control. After regular counselling sessions for around eight months in 2019, I was alright. This was the best decision of my life.”

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Health & Wellness

COVID CONTROL VIA BETTER PUBLIC AWARENESS AND BOLD INSTITUTIONAL RESPONSE

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From the unusual anatomical challenges of Covid-19 swiftly exhausting the common man’s savings, followed by acute depression, and anxiety-ridden days in two spells, people have had enough in the last 15 months. The existing gap in the number of deaths vis a vis rapid reduction in confirmed cases after 55 days, makes it apparent that the role of science appears subdued. Instead, the psychological dimensions are assuming a greater role. After the first anniversary of the Janta Curfew on 22 March 2020, we have a choice of at least eight vaccines (four in India) as compared to none earlier.

These are the fresh developments:

(a) Alpha (B.1.1.7) to Delta (B.1.617.2) variant switch leading to most devastating spike from 99,181 cases on 10 September (fell to 88,198 on 2 April) to a rise to 93,249 on 4 April and again to 4,14,188 cases on 7 May 

(b) Findings of Indian scientists of NCDC and IGIB, that prior infections and one dose vaccination are insufficient against the virus, need to be flagged first. Thus, light on the necessity to have upgraded public awareness, conduct, and behaviour may have to be thrown. It will have to be supported by a robust public health response.

‘FOREIGN’ MUTATIONS AND VARIANTS

From a period of disturbing developments between the first week of 13 April to 14 May, showing creeping up 24-hour cases, positivity, CFR, and active case rates, there was a downward trend but a slow reduction in the number of casualties disturbs. One of the English dailies hinted at 771 Covid variants, whereas another daily had presented a very grim picture of Maharastra and Kerala on one hand and Punjab and Chattisgarh on the other. These were all having cases of Alfa, now renamed to Delta by the WHO, these are cases of Californian, the U.K. type, South African, and the Brazilian variant. In a vast, congested, and casual India, fresh Covid awareness and appropriate conduct are very much necessary. 

Interestingly, one study of AIIMS had indicated that the common cold virus may have saved many Indians. Further, cross-reactive T cells from coronavirus that cause common cold may not protect from Covid but by responding to SARS-CoV-2 protein, they may restrict the severity of the disease. Also, immunity from Indian food habits may have been a contributing factor.

Whatever it may be, longer resistance or distance of about seven feet cannot always be enforced or guaranteed by the executive, each time an announcement is made regarding lockdown or Covid curfew.

BETTER CARE AND CONDUCT A MUST

As opposed to blanket 68 days of lockdown of the first wave, the liberal measures of the second wave lockdown (54 days) and slowly emerging concessions, have not boomeranged exactly but the government can always be ‘taken for granted’.

While the desire for a change or ‘breathing out’ after a long spell may be imagined, if not appreciated, a close look at people’s habits and reactions in the last few weeks even while rushing for vaccinations are not at all encouraging. 

FAITH OR FEAR

Unconvincing and inconclusive debate on this issue has been on since the beginning of Maha Kumbh. Despite meticulous planning, mobilisation of large manpower and sizeable expenditure, not only hundreds of pilgrims died but very aged heads of eight Akharas also expired. Hence, taking a chance itself proved to be a ‘sin’. Further, threats emerged from apparently essential festivities, weddings, death ceremonies, unwanted urge for window shopping, recreating networking, away from home offices and whatnot. 

MEGA SPREADERS

The mega spreaders were three day Holi celebrations and five weeks of the election process in four states and one Union Territory that made a mockery of all Covid protocols. Not only the election-bound states together with the Election Commission of India avoided adopting strict measures, Covid data collection, its analysis and final report to the Centre too suffered. And as yet, a very modest number of cases and casualty figures are being reported from otherwise tension causing and volatile states of Bihar, West Bengal, and Assam.

NORTHEAST SCENE

Though Northeast states of Sikkim, Manipur, Mizoram, and Meghalaya did not undergo elections, they are reporting case-fatality ratio (CFR) and positivity rates higher than the national average for a month, mainly on account of the public non-cooperation.

Incidentally, the above-indicated parameters were within limits during the first wave and the first quarter of 2021. This speaks of a clear compromise on Covid awareness and prescribed protocols.

SOME REMEDIES

According to a study of Cellular and Molecular Biology (CCMB), Hyderabad while there is an immediate need to avoid crowded places and hygiene will have to be ensured and the earlier practice of carrying sanitiser may have to be insisted upon. Taxi and TSR drivers must refix plastic sheets. One should carry minimum cash and valuables while leaving home.

NATIONAL SCENE

We are taking pride in being the world leader in vaccinations(almost 23.11 crore doses so far) but one forgets the loss factor, at a time when some of the countries are yet to begin even the first round. The average 10% loss of vaccines in Andhra Pradesh, Telengana, and Uttar Pradesh is something unpalatable.

60 PLUS DESERVE CARE 

Also, slow coverage of 60 plus category is a matter of extreme concern. Not more than 50 % achievement has been recorded. Thus one can imagine the time to be taken for vaccinating over 20.2 crore people in this group. Not always official callousness may cause misery. Experience of many states has shown that people are in double mind even after registration and taking the first dose. Another threat comes from the listeners/viewers picking up a few shortfalls quickly and circulating the same without realising the consequences. But genuine success stories are mostly ignored.

NEGLECT OF VILLAGERS

Another disturbing development is very little focus on rural areas. Not only precious time is lost but rural folks are also manoeuvred easily by the negative news. Further, carelessness can be fatal in future, irrespective of ongoing summer and freak weather conditions.

Measures like night curfew, 33 % office attendance, restarting metro with 50% occupancy, and partial building activity etc. may not help at the moment. The behaviour pattern of relatively well-off citizens looks incorrigible while the poor continue to suffer. The desire to have fresh air gets multiplied day after day.  While a thorough review of institutional mechanism should be on cards, the Central government will also have to extend the present lockdown and reconsider the decision to delay the second dose of the vaccine.

In the public domain, it is not always an ideal-typical scenario. Life is full of compromises, especially in a happening place like India. For right-thinking individuals, the dictum of self-help being the help may also work. More and more casual behaviour will prove counterproductive. Also expecting everything from the government may not be fair.

The writer is the ex-Chief Secretary, the Government of Sikkim. The views expressed are personal.

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Health & Wellness

HEALTHCARE BEYOND CORONAVIRUS

Christina A. D'Souza

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Covid-19 has dominated the health discourse for over a year now but it doesn’t feel like a ‘Happy Anniversary’. Newspaper headlines aren’t going to change much in the next few months; public attention is focused on more possible lockdowns, rising Covid-19 numbers and higher mortality. 

Meanwhile, another crisis may be brewing just below our national radar.

Covid-19 has had significant effects on healthcare workers, the healthcare infrastructure and healthcare systems. Most of all, the pandemic has had a serious impact on patients that fall into two categories:

• First, interruptions in treatment, testing and monitoring on patients – particularly those with non-communicable diseases (NCDs) like diabetes, cancer and heart disease – are expected to raise long-term risks

• Second, many medical experts also believe Covid-19 will have even more serious effects on patients with NCDs

Both impacts need deeper analysis.

The Ministry of Health & Family Welfare’s (MoHFW) Health Management Information System data reported that inpatient admissions declined by 45% in the first quarter of FY 2020-21 (April to June), compared to the same period in the previous year. Anecdotal reports suggest that things haven’t improved since then, though we will have to wait for more updated information.

Outpatient visits declined by 43%, including treatment of cancer and acute heart disease. Doctors fear that the delays in treatment can have longer-term effects; patients’ conditions could have become much more dangerous. A large number — 28% — of patients with kidney disease have missed at least one dialysis session. 

Before the pandemic, NCDs were already the biggest cause of deaths globally; they killed 41 million people each year, or 71% of deaths (in India that number is 61.8%. According to the World Health Organisation’s (WHO) Global Burden of Disease study, more than 182 million people in India suffer from NCDs. In a rapid assessment of service delivery for NCDs reported in June 2020, the WHO found that health facilities in rural India received 30% fewer patients with acute cardiac emergency patients in March 2020, compared to the previous year.

Mortality rate analysis could provide other clues on the pandemic’s impact on NCD patients. The Consumer Pyramids Household Survey (CPHS) covers the same 232,000 households three times a year and captures data on mortality (but not cause of death). An analysis by Renuka Sane and Ajay Shah of the National Institute of Public Finance and Policy (NIPFP) showed that it almost doubled in 2020 over 2019. Covid-19 couldn’t fully account for the increase, but death from one or more NCDs could at least partially explain the significant jump in mortality.

From the currently available information, how long the pandemic will persist, is not clear, but it is not expected to be permanent. NCDs, however, are going to be around for a long time. The Covid-19 pandemic shows us the urgency of addressing gaps in our healthcare system that could significantly reduce national health risks over the long term. 

WHAT CAN WE DO?

The first challenge is to improve access to healthcare services; this is partly addressed by telehealth/telemedicine, but more is needed. Providing access to medicines, vaccines, and services even to the most remote locations is necessary. The healthcare system should be able to respond to situations like Covid-19, quickly and effectively. How? Private-public partnerships: and solutions should increase both the scope and scale of access.

Second, the spirit of Atmanirbharata or self-reliance will have to be real. Nowhere is this more critical than in the domestic manufacturing capacity of APIs, or active pharmaceutical ingredients, a key input in drug-making. Almost all our entire API needs are met by imports; this is unsustainable. Government can create self-reliance with the right policy incentives.

Third, as the world’s pharmacy, we have to get bigger and better. In short, Indian pharma companies need to innovate, invent, and discover new drugs and therapies. This is a long-haul affair, but even the longest journey begins with the first step. Investing in research and development needs both initiative, and a supportive and stable policy environment. Drug companies say they have the inclination and can make up for the lost time.

US President John F Kennedy once pointed out that the Chinese word for crisis is made up of two characters: one represents danger and the other opportunity. We are living through the danger; let’s also take on the opportunity and press down on the accelerator pedal. 

The writer is Healthcare Practice Lead at SPAG.

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Health & Wellness

HOW TO MANAGE STRESS IN HYPERTENSION PATIENTS

Psychological issues in Covid-19 times may take a toll on health in already-at-risk hypertensive patients. Read and find out the reasons and ways to cope with it.

Dr Sandesh Prabhu

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The Covid-19 pandemic poses a significant effect on physical and psychological stress. The whole world is witnessing a high rate of morbidity and mortality. It is common to have mental issues, including fear, anxiety, and depression during such a scenario. However, it is necessary to manage these conditions, especially in people with cardiovascular diseases such as hypertension. Psychological issues may take a toll on health in already-at-risk hypertensive patients.

IMPACT OF THE PANDEMIC ON CARDIOVASCULAR HEALTH

The pandemic has affected the life at every quarter including the physical and mental health of an individual. Several studies have revealed an increase in psychological stress in the people who have recovered from Covid-19. People who are living in an environment filled with fear and uncertainty also experience stress.

Hypertensive patients with advanced age and other conditions such as previous heart problems, diabetes, obesity, and chronic kidney disease have a poor outcome from Covid-19 infection. Such patients must take care of their physical and mental health.

Psychological stress due to the pandemic may occur at any age. However, the symptoms of poor psychological health vary with age. Stress in adults includes lack of interest, lethargy, increased irritation and shouting, emotional outbursts, alteration in the sleep cycles, and depression. 

Various reasons contribute to poor mental health due to the pandemic in patients with hypertension. Some of them are:

Fear: There is an unparalleled fear in the environment. The fear of losing oneself and the loved ones’ lives 

Reduced Physical Activity: Studies revealed a significant reduction in sleep quality, mental health, and physical activity in people with hypertension due to the pandemic. Low physical activity results in poor control of blood pressure 

There is evidence of poor mental health in the people categorised into high-risk groups. Patients with chronic conditions such as hypertension and heart problems experience a high level of anxiety, stress and depression. Mental health further takes a toll when such people contract Covid-19.

Lack of Social Interaction: Hypertension occurs more commonly in adults and the elderly. However, the increased risk of serious illness due to Covid-19 have confined them within the home boundaries. It has affected blood pressure control and cardiac health 

Negativity in the Environment: Social media, newspapers and news channels are continuously delivering information about Covid-19. Further, people are also receiving information about the severe illness or death of their relatives. It creates a negative environment around patients with cardiovascular disease, thereby impacting their cardiac health.

Admissions in the Hospitals: The healthcare system is working at full stretch, and people are searching for beds, oxygen, and ventilators. Patients admitted to the hospital witnesses death and panic resulting in mental stress.

Increase in Domestic Issues: The incidences of domestic violence and family fights have increased during a pandemic. It may be due to spending more time among family members in close contact. Irritation due to job losses and financial constraints further compounds stress, anxiety, and depression.

Functional Limitations: Functional limitations in hypertensive patients due to lockdown had increased mental stress. Cardiac patients may have severe illness due to Covid-19, which results in extended recovery time. Confined to bed also causes psychological stress.

COPING STRATEGIES FOR MANAGING PSYCHOLOGICAL STRESS

There are various ways to manage stress in hypertensive patients during Covid-19. Some of them are:

Physical Activity: Indulging yourself in physical activity may reduce stress and anxiety. Make exercise part of your daily routine. Various online exercise classes will help to maintain physical activity.

People with chronic diseases require a regular follow-up that reduces the probability of deterioration. All people should strictly follow the universal Covid-19 protocols. Minimising media exposure, practising relaxation technique, and monitoring blood pressure helps in reducing stress.

Minimise Exposure to Media Coverage: Limit your media exposure. Overburdening yourself with Covid-19 information throughout the day may result in poor mental health outcomes. Do not believe in fake information and educate yourself from the trusted sources.

Maintain Good Sleep: Pandemic had caused a disturbance in the sleep cycle. You may experience difficulty sleeping or problem waking up. Keeping a healthy sleep routine improves immunity and helps in managing blood pressure control and maintaining a good cardiac condition 

Practice Relaxation Techniques: There are various relaxation methods available that may help you in managing psychological issues. You may practice yoga or meditation. 

Monitor Your Blood Pressure: You must have your blood pressure under control. Take medicines strictly as prescribed by your doctor. Do not skip scheduled appointment and seek video consultation if possible. Monitor your blood pressure.

Seek Support: Do not hesitate to share your feelings with your family and friends. It is a powerful stress buster. If you have a persistent fear of getting infected, share your feelings.

Follow Passion: Indulge yourself in the activities you love. It may be gardening, cooking, painting, music or dancing. It will divert your mind from all the negativities and improve your cardiac health.

Instil Positive Attitude: Fear and a negative attitude may worsen your cardiac health. Many patients suffering from Covid-19 had deteriorated their condition due to sadness, depression, and hopelessness.

Taking care of physical and mental health during the pandemic is critical, especially in people suffering from cardiovascular disease. It will help in coping with psychological issues and taking care of cardiac health

The writer is a Consultant – Cardiology & Electrophysiology, Manipal Hospitals Whitefield, Bengaluru.

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Health & Wellness

PLANT-BASED OR ANIMAL-BASED? CHOOSE YOUR PROTEIN WISELY

Let’s understand the benefits of plant-based protein diets over animal protein diets.

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In recent years, the requirement of protein in the daily diet has gained significant popularity. Using alternative forms of protein has burgeoned and more people are fueling themselves with healthier supplements, i.e., plant-based protein diets such as soy products like tofu or soybeans. People are increasingly moving away from conventional animal-based proteins and are opting for plant-based alternatives.

When compared to an animal-based protein diet, these plant-based alternatives are best consumed in either whole-food or minimally processed form. Vegetables, fruits, legumes (beans), nuts, seeds, tubers (potatoes, for example) and whole grains make up most of the plant-based diet. The term “animal-based” refers to a diet high in animal products such as meat, dairy, eggs, and so on.

The existence of plant-based proteins has created a platform to start cutting the amount of meat on your plate in half and replace it with them instead. Provided below are some of the benefits:

Plant-based proteins are complete proteins

It’s a common myth that plant protein is inferior to animal protein. To ensure an adequate amount of protein intake in one’s daily diet, it isn’t necessary to consume meat. If one doesn’t want to give up on animal-based protein completely, maybe consider switching to a “flexitarian” diet, i.e., eating more plant-based foods but also include animal proteins in a minimal amount. Being on a plant-based diet is more of an eating philosophy than a specific diet. Instead of keeping track of calories or hitting daily macronutrient targets, it just boils down to consuming plant-based foods.

Plant-based proteins are more sustainable

Climate change and depleting natural resources make it all the more important than ever to consider the planet’s well-being when deciding what to eat. It’s not all doom and gloom, and shifting to a healthy, plant-based diet is an important part of the answer. Plant protein is more resource-effective and efficient to produce than animal protein, making it a more sustainable choice. Foods such as beans, peas, and lentils are some examples of low-resource crops.

Plant-based proteins keep the body healthy

Vitamins, minerals, fibres, antioxidants, and other compounds are abundantly rich in plant-derived proteins. A large number of healthy fats can also be included in certain ways. Plant proteins such as beans, nuts, seeds, and whole grains include a certain amount of healthy fat and are high in nutrients. Plant proteins also help in balancing the body weight and keep it in control. An effective way to begin weight-loss attempts is to try a diet that excludes added fats and animal products. Adding more plants to your diet is a great way to achieve your ideal weight.

Embracing plant-based protein diets can also help in lowering blood pressure, cholesterol levels, and body mass index and reduces the risk of stroke and heart attacks. Owing to its advantages, doctors and nutritionists prescribe a plant-based diet to most of their patients.

Plant-based proteins are budget-friendly

Plant-based protein products are extremely cost-effective. Beans, lentils, and peas are some of the most cost-effective and great sources of protein from the plant. Other high-protein alternatives that might cost a little more (nuts and seeds, for example) can be of a good nutritious value. They also include healthy fats and other vital nutrients, allowing you to get more bang for your buck.

Switching to plant-based protein alternatives is beneficial to one’s health and replaces some (or all) animal protein in one’s diet. Plant-based protein has several advantages, including higher fibre intake, a lower risk of cardiovascular disease and some forms of cancer, and weight loss benefits. This changing image represents a shift in how we think about nutrition: whatever the diet choice is, one should know which food to avoid and which food to seek out.

The writer is Director, Veggie Champ.

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Health & Wellness

SMOKING AND COVID-19 CAN OVERBURDEN YOUR LUNGS

As the lungs of a smoker are already in a bad shape, Covid-19 can further worsen its condition. Therefore, it is advised to quit smoking and take all precautions to safeguard the lungs.

Dr. Hirenappa Udnur

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The lungs were not given the importance as they ought to be until the second wave of Covid-19 surfaced. Lungs are often taken for granted. The wellness of the lungs is given priority only when any complication arises. Lungs are the vital organ in our body that converts the oxygen from the air which we inhale and transfer to the bloodstream. For many years healthcare professionals have stressed the importance of maintaining healthy lungs and advising people to quit smoking. However, many have not paid heed to this advice. 

All of us are aware that the SARS-CoV-2 virus that causes Covid-19 disease obstructs the respiratory system majorly affecting the lungs. This infection is certainly testing our lungs. As lungs play a major role in the overall working of the body, it becomes crucial to ensure lung health to put up a fight against this infectious disease. 

Covid-19 can cause lung complications like pneumonia, acute respiratory distress, and in some fatal cases, total collapse of the lungs. In cases of pneumonia, the air sacs in the lungs are filled with fluid and the valves of the lungs get inflamed resulting in difficulty in breathing and severe cough. Many people recover from pneumonia without much effect on the lungs. But in cases of pneumonia due to Covid-19, people face severe breathing difficulties which take a longer time to recover putting an extra burden on the lungs. If pneumonia progresses it can lead to acute respiratory diseases in which more of the air sacs will get filled up with the fluid leaking from the blood vessels in the lungs. This can lead to severe shortness of breath. 

As Covid-19 infection takes the respiratory route to enter a person, the burden on the lungs is phenomenal. This burden on the lungs increases among people who smoke. As the smoke moves into the respiratory tract, more soluble gases are adsorbed and particles are deposited in the airways and alveoli. This in the long run can lead to severe problems related to the lungs. Smoking can increase the chances of COPD among people leading to a faster decline of lung functioning. The chemicals in the cigarettes can also cause irreversible lung damage. In addition, smoking can destroy the cilia or tiny hairs that are present in the airways. These hairs keep dirt and mucus out of your lungs. When these cilia are destroyed, one can develop a chronic cough that is often seen in long-term or daily smokers.

Though there is no proof that smoking can make a person vulnerable to develop Covid-19 or the severity of the infection increases if the person is smoking, it is a known fact that both smoking and Covid-19 infection is putting an extra burden on the lungs. As the lungs of a smoker are already in a bad shape, Covid-19 can further worsen its health. Therefore, it is advised to quit smoking and take all precautions to safeguard the lungs. 

Two functions determine the overall health of lungs — Lung capacity and lung function. While lung capacity is depending on the genes, making the lungs function properly is up to us.

Here are a few tips you can follow to have healthy lungs:

Exercise — At least 30 minutes of daily exercise is imperative for adults to avoid any lung distress. Indulge in a physical activity that makes you breathe heavily. It increases the flow of oxygen in your bloodstream that increases airflow to your muscles, heart, and lungs. Running, brisk walking, cycling, and swimming are the few suggested exercises. 

Diet — Choice of food is crucial for lung and immune system health. It is being noticed that people with underlying ailments have been affected badly due to Covid-19. It could be due to chronic inflammation. Many foods assist the body with decreasing inflammation in the airways. Consume proper nutritional food, particularly food high in antioxidants like fruits and vegetables.

Quit smoking —It is not only lung cancer but inhaling anything other than air into your lungs causes them to become inflamed. This can lead to mucus build-up that impacts the lung’s ability to process oxygen into the bloodstream. For a person already having lung damage, treatment becomes a factor and the recovery may get delayed. 

Oral health —Maintain good oral health. Avoid the buildup of plaque and infection in the mouth. These infections could also affect the lungs. 

With Covid-19 second wave affecting both the young and older generation, the number of cases of Covid-19 and people needing oxygen support has increased. We are at a juncture where paying attention to our lung health and working towards its betterment gains utmost importance.  

The writer is a Consultant – Pulmonologist, Columbia Asia Hospital, Hebbal (A unit of Manipal Hospitals).

Covid-19 infection takes the respiratory route to enter a person so the burden on the lungs is phenomenal. This burden on the lungs increases among people who smoke. As the smoke moves into the respiratory tract, more soluble gases are adsorbed and particles are deposited in the airways and alveoli. This in the long run can lead to severe problems related to the lungs.

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Health & Wellness

IMPACT OF MATERNAL MENTAL HEALTH ON FOETUS

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Pregnancy brings in a mixed bag of feelings, at one end it gives unending happiness as it is an exciting time for every woman. On the other hand, don’t be surprised if you experience some emotional change at this time.

Studies have shown that maternal mental health issues can begin during pregnancy and persist for longer with far more significant consequences for children than most people understand. Therefore, mental health and wellbeing during pregnancy are just as important as your physical health. A mentally fit woman is in the best position to manage the challenges of pregnancy and life with a new baby.

MENTAL HEALTH AND WELLBEING

As you prepare to have a baby come into your life, it’s normal to have some worries and fears. While many people feel unusually stressed thinking about the big change in their lives and that they can’t fully prepare for or control, it’s also an exciting time and when handled with care it gives utmost satisfaction.

At the same time, pregnancy can be stressful and along with dealing with hormonal and physical changes, you may feel the additional burden of antenatal tests and particularly if you’ve had a prior bad experience, such as a miscarriage.

For these reasons, there is a likelihood of developing a mental health condition during pregnancy.

MENTAL HEALTH ISSUES DURING PREGNANCY

Both women and men are likely to experience mental health issues during the pregnancy i.e., antenatal period, as well as after the birth, postnatal period. Some of them experience depression, anxiety and bipolar disorder (less common) during pregnancy.

While antenatal depression is seen in up to 1 in 10 women and 1 in 20 men, antenatal anxiety is also common and many people even experience anxiety and depression at the same time.

Some studies suggest that pregnant women have higher anxiety and a greater psychological impact in the Covid-19 outbreak. Therefore, it is important to identify high-risk women to suggest early psychological interventions and prevent some pregnancy stress-related complications.

BABY BLUES AND POSTPARTUM DEPRESSION

Postpartum “baby blues” after childbirth commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues usually begin within the first two to three days after delivery and may last for up to two weeks.

While some new moms experience baby blues that may last for a few days, few may experience a more severe, long-lasting form of depression known as postpartum depression. prompt treatment can help you manage your symptoms of postpartum depression and help you bond with your baby.

Rarely, some women may develop an extreme mood disorder called postpartum psychosis after childbirth.

Tips to manage your mental wellbeing:

• Be realistic and don’t expect too much of yourself

• Avoid major changes at this time, like moving house or changing jobs

• Keep physically active, consult your doctor before you start an exercise program.

• Stay away from drugs and alcohol to deal with stress.

• Eat healthy meals at regular intervals

• Ask for help if you need it

• Eat healthy meals at regular intervals

• Stay away from drugs or alcohol to deal with stress

• Mingle with other expectant parents to support each other

The writer is Gynaecologist, Obstetrician and IVF Expert, Nurture IVF.

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