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Covid-19 vaccination programmes can affect meaningful resolution only with sufficient participation rates to achieve herd immunity.

Dr Kishore Kumar



The pandemic can be overcome only with herd immunity — which is achieved either by everyone suffering from the disease or some suffering from it and others getting immunity from the vaccines. Ultimately when 80% of the population has either antibodies from natural disease or vaccination — we can beat the pandemic by herd immunity. To achieve this, vaccine uptake by susceptible individuals is crucial. 

Vaccine hesitancy, also known as anti-vaccination or anti-vax, is a reluctance or refusal to be vaccinated or to have someone dependent vaccinated — is becoming a problem especially in the middle of this pandemic, which can delay our fight against the pandemic.In fact, hesitancy has led to a decline in vaccine uptake and an increase in the prevalence of vaccine-preventable diseases. The Covid-19 pandemic has created a new reality where individuals are facing a previously unknown disease and its effects, providing a unique opportunity to investigate vaccine attitudes during a period of heightened disease salience. Unfortunately, there are always going to be some people who will have anxiety and uncertainty with vaccines leading to vaccine hesitancy  — but some people have been misguided to become hesitant to vaccinate due to a lot of mis/disinformation.

Vaccine Politics as I call it — for lack of better words — is politics behind the vaccine for Covid-19. If you carefully analyse the events that took place over the last 16 months, vaccine politics has played a significant role in vaccine hesitancy. Be it discrediting vaccines, spreading rumours to fuel vaccine hesitancy, frequently changing position on the vaccine distribution process, deliberately asking for the vaccine to be ‘opened up for all’ despite knowing the government was following a scientific order of priority, everything possible has been done to harm India’s vaccination drive. 

At the international level, initially, the Pfizer-Biotech vaccine was licensed in the US — as an emergency use authorisation for political reasons way ahead of schedule than completion of the trial. The initial reports of the adverse effects of the vaccine being highlighted led to a lot of conspiracy theories and vaccine hesitancy. Subsequently, AstraZeneca vaccine faced the wrath of many European countries — for all wrong reasons — as the UK had ordered enough doses first they were supplied first — leading to sanctions/highlighting the adverse effects of clotting — which affected 1:6,00,000 population as opposed to Covid-19 disease itself affecting 1:40 people. Now, in turn, the EU is trying to penalise AstraZeneca by not recognising it as a valid vaccine, especially if it is produced outside the EU? 

At the national level, we saw how the Covaxin licensing controversy initially led people to abandon it, as they felt it was “imperfect vaccine” being hastened in licensure due to its “Made in India” issue. It was not until Covieshield (AstraZeneca) controversies in Europe — people started embracing Covaxin after that. This continued for some time and confused people. At the state level, there were accusations that BJP and non-BJP states are being discriminated against with the supply of Covaxin vs Covieshield that further confused people.  At the district/hospital levels, there were accusations that corporate chains got more vaccines allotted for various reasons than nursing homes which subsequently meant the government took control of the vaccine distribution and effectively issued a new policy from 21 June 2021.

India launched the world’s largest vaccine drive earlier this year. But even before the rollout could take place, the country witnessed many efforts that began to spread vaccine hesitancy, confuse and mislead the public about the vaccination process. In fact, after months of deliberation and discussions, the government’s advisory group for vaccines has allowed pregnant women to get jabbed. It took almost seven months, precisely on 2 July, to release an operational guideline for vaccinating pregnant women. It included details on educating them about the risks from the vaccines vs the risks of being Covid-positive. Those eligible will be able to get any of the three vaccines currently authorised in India — Covishield, Sputnik V or Covaxin. In my view, vaccinations are among the most important public health tools for reducing the spread and harm caused by dangerous diseases. Despite considerable evidence showing vaccines are safe there is increasing scepticism towards vaccination.


Here are some reasons behind vaccine hesitancy:

1. There are too many rumours about vaccine efficacy. Rumours are nothing but information that is either inaccurate or accurate – with a twisted meaning used in a different context and circulated within a network of people. Ex: Last year, so much information was circulated on social media around steam inhalation + vitamin D, and zinc supplements that it became a standard of treatment by many doctors, many not realising that zinc and vitamin D toxicity could be harmful too. Overuse of steam, inhalation has been blamed for the spread of black fungus by damaging the mucous membranes of people.

2. Misinformation – Inaccurate information. Ex: Last year before the first wave affected India, so much information was propagated about BCG and MMR protecting Indians against Covid-19 that many people came to get BCG and MMR done, only to realise that it was not correct.

3. Disinformation – The misinformation that is specifically designed to achieve an agenda. Ex: A lot of homemade drops and other unproven therapies were being projected as treatments for Covid-19 without proper studies. Ex: Ghee drops into nostrils.

4. Infodemic – What’s happening currently on many WhatsApp groups — an overabundance of information, including mis/disinformation — accompanying this pandemic. Ex: There is so much information recommending steam inhalation, vitamin C, and zinc supplementation — that almost everyone is doing it. This is similar to Hydroxychloroquine prophylaxis last year and the information was so strong that almost everyone took these to “try and protect” themselves.

5. Heuristic behaviour – Heuristics are commonly defined as cognitive shortcuts or rules of thumb that simplify decisions, especially under conditions of uncertainty. They represent a process of substituting a difficult question with an easier one. Ex: The repeated news that certain vaccines can cause a clot in the brain, without mentioning that it is rare and Covid-19 can cause that in 1:40 people, led people to avoid the vaccine.

All these issues led to already confused/infodemic loaded individuals with more confusion and vaccine hesitancy.


Public health leaders may wish to tap medical providers to herald in more vaccine-positive messages, the data showed. Across both vaccine-hesitant and vaccine-enthusiastic adults, clinicians will prove to be the most trusted advisor on the matter. Many hesitant people have high levels of trust in their healthcare providers, which underscores how crucial it is for clinicians to reach out to patients — especially those who have been most impacted by Covid-19 — to explain the benefits of vaccination. We need to continue to ensure that vaccination efforts shall continue to scale up in the weeks ahead and it’s critical that people receive accurate information from people they trust. Our country should adopt a multi-modal communication approach. Very few people in India have access to good quality and affordable healthcare. Many of the vaccine-hesitant adults don’t have a usual source of care (personal clinicians) and many of them are not even insured. We need more targeted outreach so that the benefits of vaccines can be understood.  

Herd immunity is the most decisive route to freedom from Covid-19. Thanks to the unprecedented efforts of the scientific community, we finally have a solution: safe and effective vaccines. Experts are estimating that up to 90% of the population need to have antibodies to achieve herd immunity. To reach it, we must see society trusting medical professionals and governments to accept vaccination. We need greater transparency on data and consistent messaging on safety.  Despite the science, there is still a section of society that perceives vaccination to be a bigger threat than Covid-19. And India is full of quacks, a lot of people depend on the knowledge of these quacks and suffer. As the Covid-19 pandemic continues to surge worldwide, recent approvals of Covid-19 vaccines raise hope for a light at the end of the long and dark tunnel. In my view, Covid-19 vaccination programs can affect meaningful resolution only with sufficient participation rates to achieve herd immunity. 

The writer is Founder Chairman & Neonatologist, Cloudnine Group of Hospitals, Bengaluru. He is also a healthcare delivery graduate from Harvard Business School.

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Health & Wellness




In recent years, meditation has gained popularity. It has somewhat become a sign of a person “taking care of themselves” and their mental health and rightfully so. With on-growing connectivity and constant digital reach, our traditional boundaries of ‘working hours’ have become blurred. With no sense of working hours and stretched responsibility, many of us find ourselves anxious and confused at times. Thus, our stress response, one of our innate physiological mechanisms that should only be triggered in life-threatening situations, is triggered constantly and we find ourselves in constant despair. In today’s time, on-standing traditional fears have been replaced with fear of traffic jams, lagging behind or never-ending pending work piles. 

It may come as a surprise to some but the WHO predicts burnout will become a global pandemic within a decade and suffering through one, we can all assess the severity of this prediction. In a world where ‘off’ or a ‘pause’ button has ceased to exist, meditation can act as a circuit breaker for this non-stop lifestyle, giving the mind and the body a chance to recharge. Meditation is the practice of thinking deeply or focusing on one’s mind for some time. This can be done in silence or with the help of chanting and is done for several reasons. The primary aim of this practice is to attain mental peace and calmness. Different forms of meditation gives everybody a chance to choose what works for them and is suited to their aim and desires.  Here are few of the meditation techniques:

Guided Meditation: It is also called guided imagery or visualisation. With this method of meditation, you form mental images of places or situations you find relaxing. You try to imagine yourself in a situation or a time that is particularly relaxing to you, it can be some smell that is pleasant to you or a sound or a place you associate with happier times. Anything that brings you joy. You may be led through this process by a guide or teacher.

Mantra Meditation: You silently repeat a calming word, thought or phrase to prevent distracting thoughts. ‘Om’ is a common mantra people recite over and over. The idea is to let the outer vibration beat within and find oneness with body and mind. 

Mindfulness Meditation: This type of meditation is based on being mindful or having an increased awareness and acceptance of living in the present moment. You broaden your conscious awareness and focus on what you experience during meditation such as the flow of your breath. You can observe your thoughts and emotions, but let them pass without judgment.

Yoga: In today’s time, everyone is familiar with yoga. As you move through poses that require balance and concentration, you’re encouraged to focus less on your busy day and more on the moment.

It is a common reluctance or misconception about meditation that its effect is short reached but that is simply not true. Meditation, at its very core, is a practice of conquering or rather composing your mental being in a way that no sudden seen or unseen actions can rattle you easily. The benefits don’t end when your meditation session ends. Meditation can help carry you more calmly through your day and may help you manage symptoms of certain medical conditions. When you meditate, you clear away the information overload that builds up every day and contributes to stress. The many benefits of meditation include:

• Attaining a positive perspective 

• Gaining tools to manage stress

• Heightened self-awareness 

• Present becomes priority

• Helps to navigate negative thoughts

• Increasing patience and tolerance 

As modern life becomes more and more entangled with exaggerated details of success, meditation can be the branch you need to hold on to in this raging current of development. The fiercely competitive environment coupled with the pressure to meet deadlines may keep people on their toes but only through meditation can we regain proper footing in this world. 

The writer is an author & digital marketer.

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Health & Wellness





This is a story of an 11-year-old girl who was diagnosed with dilated cardiomyopathy at 5 years of age. Dilated cardiomyopathy is a life-threatening condition where the heart enlarges and is unable to pump blood effectively. She had undergone a heart valve repair surgery five years back for the same and was being managed with medications. But her condition deteriorated, requiring heart transplantation for survival. Luckily, a matching paediatric donor heart was found just in time, saving her life. 

In January 2021, unfortunately, she developed a clot in the heart which obstructed the blood flow to one of the blood vessels of the brain, producing an acute brain stroke. She was rushed to the hospital, and within hours, the clot was removed by the Neurological team, and she recovered almost completely. In December 2020, she was allocated two potential heart donors, but due to the positive crossmatch (pre-existing antibodies against the donor, or the recipient and the donor are incompatible), this did not materialize. Finally, on 19 May 2021, she had a paediatric heart (the donor was of the same age and weight) which matched her perfectly. She underwent successful transplantation and was discharged after 3 weeks of mandatory hospital stay. 

There are several children suffering from congenital cardiomyopathy or viral dilated cardiomyopathy or other myocarditis that result in the development of severe heart dysfunction needing heart transplantation. But, unfortunately, the donor pool in this segment is very limited. Especially, during the pandemic when there is a lack of organ donors, we are very lucky to get a suitable heart donor for this child. We have still many children waiting for transplantation, but she was lucky enough to get a matching donor. She is our first paediatric heart transplant recipient at our hospital while all nine previous patients were adults. 

Paediatric Heart Transplantation Carries Multiple Challenges at Multiple Levels

• Very few parents of unfortunate brain-dead children come forward to donate the organ. Hence, many times, nearly matching adult donors by weight and height are used. Finding such a compatible match often takes time. 

• Managing their post-operative care like immunosuppression can be challenging compared to adults.


This is the first-ever paediatric heart transplant performed at our hospital and a successful one. Heart transplantation in a child always poses extra challenges. Moreover, in this case, it was the child’s second heart operation. We made sure that the child’s body was able to accept the new heart, and she was monitored continuously for any post-surgical complications. “We are happy the transplantation was a successful one, and we were able to return the child back to her parents safely.


Heart transplantation is also an expensive surgery. Not all patients can afford it. In this case, too, the child’s parents were unable to bear the entire expenses of the surgery. Thanks to the timely help from NGOs and the child’s well-wishers, the surgery was possible. Expressing his gratitude, Dr Devananda NS appreciated the online donations and Pranic healing trust for their contributions in raising funds for this transplantation.  

The writer is HOD & Consultant – Cardiothoracic Vascular Surgery, Heart and Lung transplant surgery, Manipal Hospitals Old Airport Road.

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Health & Wellness


Dr Gunita Singh



Stress is the biggest devil in today’s time it affects our overall health physical and social wellbeing. But unfortunately, it has blanketed us like never before. We had not heard of the stress word when we were kids may because we grew up in a healthier environment or because we were not too open to talk about it or maybe it was a combination of both. But not anymore today stress is a part of our lives and is affecting every part of our body so how will oral health be spared.

Stress contributes to teeth grinding, gum disease, dry mouth Canker sores, ulcers, and bad breath. It may impact your dental health routine and diet increases the risk of tooth decay stress makes it harder for your body to fight any kind of infection. So any infection in the oral cavity then takes longer to heal resulting in a poor prognosis


1. Grinding of teeth

Stress leads to grinding your teeth it is a very common health problem. One probably does grinding or clenching at night and gets up with an ache in the morning commonly headache, sore jaw and ache in the temporomandibular joint. Too much clenching and grinding can damage your tooth structure causing loose teeth, broken teeth and loss of teeth as well. Stress and anxiety are the major reasons for this and later it becomes a habit. 

Treatment plan: Nightguard appliance, meditation, counselling and yoga

2. T M J Disorders

Stress grinding leads to TMJ disorders. TMJ is the joint that helps in the movement of the lower jaw. Stiffness and the swelling of this joint due to stress can lead to pain in the joint. It’s very common in young adults just before exams and interview.

Treatment plan: Laser physiotherapy, soft diet, meditation, and face yoga

3. Dry/burning mouth 

Stress leads to dehydration even the use of anti-anxiety pills cause dry mouth that’s a condition where the saliva of the mouth reduces and the mouth becomes very sticky. This leads to cavities and bad breath, actually, saliva helps flush out all bacterias and food particles from the oral cavity when the amount of saliva reduces the problems increase.   

Treatment plan: Drink a lot of water, meditate, and visit a dentist for saliva substitutes

 4. Acidity

Stress also leads to acidity. Acidity leads to acidic reflux with come as a bout and badly effects inside of the lower anterior. They get eroded much before time also the saliva becomes more acidic and one suffers from bad breath. 

Treatment plan: Guards to protect teeth, small frequent meals, and meditation

5. Nail Biting 

Nail-biting, chewing on a pencil/pen are manifestations of stress, and cause severe damage to the teeth and overall health it can move your teeth out of position and also cause wearing of tooth enamel. It is a very unhygienic practice and can lead to a lot of bacterial infections in the oral cavity and beyond that. 

Treatment plan: Itincludes habit breaking appliances, counselling, and meditation

6. Mouth Ulcers 

Stress can lead to digestive issues leading to constipation which is one of the major reasons for oral and peptic ulcers. These ulcers can be very painful further leading to the inability to eat anything. 

Treatment plan: Visit your dentist

The writer is a practising Cosmetic and Laser dental surgeon for 20 years, Director at Dentem & is an Associate Consultant to Sir Ganga Ram Hospital.

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Health & Wellness


Here are some tips by a healthcare expert to ward off diseases in the monsoon.

Dr Manoj Sharma



Every year, we welcome monsoon with utmost delight. This season brings much-needed relief from the scorching summer heat. Monsoon give a sudden flip to extreme temperatures, replenish the water reservoirs and groundwater levels, bring delight to the areas suffering from water scarcity and plays an important role in the GDP for our country being primarily agriculture-dependent. Because of this, the monsoon season in India is very much awaited across all states.

However, rains also bring woes in the form of floods and various diseases. This year when we are grappling with the Covid-19 pandemic, our worries are more profound as rains may drain our already overburdened healthcare system. During rains we have a sudden surge in a plethora of diseases, be it seasonal flu, waterborne or vector-borne and they do have many overlapping symptoms. 

There is going to be a huge diagnostic dilemma in front of physicians, even for mild illnesses like simple seasonal flu or viral fever where we may need to subject those patients to Covid-19 screening as the spectrum of Covid-related illness is very varied from asymptomatic to life-threatening complications.

The incidence of vector-borne diseases such as dengue fever, malaria, and chikungunya rises exponentially during monsoon, all these diseases are associated with high-grade fever, myalgias, headache, and joint pain necessitating to rule out Covid-19 illness. On top of that, if there is co-infection with these pathogens and Covid-19, the outcome could have serious implications. Take an example of dengue where a patient may be in shock and if he lands up in respiratory failure because of Covid-19 the combination could be disastrous.

Food and water-borne diseases like gastroenteritis, cholera, typhoid, and hepatitis increase during this season as a humid and wet environment with ideal temperatures provide optimal conditions for micro-organisms to grow and multiply. These diseases will certainly have an impact on the ongoing pandemic in an adverse way, increasing both morbidity and mortality.

Whatever are the circumstances, we must prepare and guard ourselves against the imminent multi-pronged attack at the individual level as well as helping the authorities in overcoming adversaries. We are currently battling with the pandemic and have done well also but we cannot ignore our fight with dengue, malaria, and other infectious diseases and this fight is in no way smaller.

Precautions for the rainy season diseases albeit difficult but are practical and all of us must contribute towards them. Here are few ways to protect yourself in monsoon:

Maintain proper hygiene and sanitation and using clean water will ward off most of these illnesses.

For mosquito-borne diseases, their breeding is to be prevented by keeping clogged areas clean and preventing yourself from mosquito bites by using repellents and covering up. 

More than any other time, these times demand us to keep yourself healthy by strengthening the immunity via a nutritious diet, healthy sleeping habits, and regular exercise. Monsoon is the perfect time for the senior citizens to sit back, spend time with your loved ones, and relax at home. Their digestive capacity is said to be at the lowest point. So, it’s important to avoid street junk food and include fruits, vegetables, and increase fibre intake. Fruits such as apples, bananas, and pears can improve digestion.In addition to a healthy diet, senior citizens need to take extra care while walking on wet surfaces like balcony, terrace, porch, garden etc. It is recommended that you use walking support aid to be on the safe side. You could also consider patching these surfaces with anti-slip rubber mats to avoid accidents.

The writer is a Senior Consultant, Internal Medicine at Fortis Hospital Vasant Kunj.

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Health & Wellness




Q. How menstrual cups are better than sanitary pads?

A. Menstrual cups are new and safe as compared to sanitary pads. They collect the period blood instead of absorbing the blood and hence there are no chances of vaginal infection. Depending on the flow, one cup can last for four to 12 hours. With lesser chances of leakage, one can sleepy freely with menstrual cups. Sanitary pads tend to give you rashes. They are cost-effective as well, as one cup sanitised the right way, can last for years.

Q. What are the benefits of using menstrual cups for both females and the environment?

A. Menstrual cups are safe and effective as they are cost-effective as well. As cups collect the blood and do not absorb them, so there are no chances of vaginal infection. In terms of environment, Menstrual cups are environment friendly as well as they reduce waste and water usage. Women can reduce plastic waster by using a menstrual cup. One cup produces an estimated 0.4% of the plastic waste that single pads build up or 6% of them is created by tampons in 10 years.

Q. Tell us about the change in the consumer demands of the menstrual cups?

A. With women understanding the usage of menstrual cups and their benefits, there has been a considerable increase in the demand for menstrual cups. A cup could cost roughly five to seven per cent of the cost of using 12 pads (on average $ 0.31 each) or tampons (on average $ 0.21 each) per period. 

Q. What are the things one should keep in mind while buying the cup?

A. Here are the key factors which one should keep in mind while buying the cups:

• The material of menstrual cups, as to what it is made of. Is it medical grade silicone, latex, plastic or rubber? Cups made of medical-grade silicone are the best ones

• Thesize of the cupas per your requirement is small or large. Small-sized cups are good for women below the age of 30 and large size cups are recommended for above 30 women

• Functionalities of the cup in terms of stem, firmness, shape, and seams

Stem: Most menstrual cups have a stem on the bottom. It acts as a guide, which helps you to locate your cup easier while removal.

Firmness: Finding the right firmness for your body, makes a huge difference in comfort and effectiveness.

Shape: Determine the shape of the cup depends on the cervix height as everybody is different.

Seams:In some cups, the seams are around the rim, some have a seam running from stem to rim, while some are seamless. It is important to understand the seam as in some cases a rough seam can cause irritation or scratch in the vaginal wall.

Q. Share some tips to keep the cup clean and sanitised?

A. Tips to keep the cup clean and sanitised:

1. Wash your hands properly before touching the cup.

2. Since silicone cups are bacteria resistant, you don’t need to wash yours every time you empty them. Simply rinsing it in the sink is enough to clean it out before reinserting. To avoid stains, you can initially rinse with cold water, then follow it up with a hot rinse to disinfect.

3. Once your period is over, you might want to give your cup a good clean before you store it, both for peace of mind and to remove any stains.

4. Boil three cups of clean water on the stove. (Tap water is fine if you’re in a place with safe water but if not, use bottled water instead.) Submerge your cup but make sure the cup isn’t touching the bottom or sides of the pot. One way to do this is to put your cup inside a whisk to hold it away from the sides. Boil for five to eight minutes then drain the cup and let it air dry. It is completely safe to boil the cups, but don’t boil the pot dry as this will destroy the silicone. If you feel strange about using a pot you cook with, you can buy a small one specifically for boiling your cup and store it separately.

5. Sterilising tablets for baby bottles isgreat because you can use them in cold water so they’re ideal if you live in a dorm room with no access to a stove or just don’t feel comfortable boiling your cup in a shared kitchen. Follow the manufacturer’s instructions. These tablets are also great at removing stains.

The writer is Director, Namyaa Skincare.

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Health & Wellness





Protein is an essential nutrient present in every single cell in our body and is required for the growth and repair of the body. Approximately one-fifth of our body weight is protein. The protein requirement for an adult is 0.8g per kg body weight per day for adults. You have to eat protein every day. The body can’t store protein like it can store carbohydrates and fats. The Protein Week is observed from 24 to 30 July to spread awareness about the need to incorporate protein in our daily diet.

There are many myths around protein consumption. The most common myth is protein is only for muscle development and not so important for the general population. On the contrary, protein is an essential nutrient that is key to building immunity and for growth and immunity. It is required not only for muscle but also for bone, joints, tendons, ligaments, hair, antibodies, hormones, and enzymes. The body is made of muscle mass, fat mass, bone and water. A healthy body should have more muscle mass and less fat mass. And replacing our diet with healthy proteins instead of fats and carbohydrates is the ideal way to have a healthy body. 

The other common myth is intake of protein can lead to kidney damage. Most believe that taking a protein-rich diet puts loads on the kidney and damages it. On the contrary, protein is an essential macronutrient and is needed for survival. Also, the common perception is that with age one should reduce protein intake as it can damage the kidneys. Muscle loss is a natural part of ageing, and if one doesn’t take adequate proteins, it leads to reduced energy levels and low muscle strength. The recommended dietary allowance is 0.8 to 1 g /kg body weight, for a healthy adult which is around 50g to 60g per day grams daily, whereas the daily need increases during illness or increased activity level. Deficiency of protein can lead to impaired physical development, oedema, low immunity, and low muscle mass. One can meet the daily needs of protein by eating eggs, fish, dairy, legumes, meat, poultry, and nuts. 

Another very common myth is intake of protein leads to weight gain. Proteins are the key to losing weight the healthy way. Taking good amounts of good quality proteins like eggs and poultry can help healthy weight loss, by increasing satiety, boost up metabolism and loss of fat mass and build-up of muscle mass. Consuming insufficient protein on the other hand can actually make it harder to lose weight. Even if one loses weight by cutting the protein, chances are that its muscle — not fat — will lose. Not eating enough protein can lead to side effects including fatigue, weakness, and a low immune system. Including protein in daily diet is essential and 10% to 15% of the total calories should come from protein. So let’s pledge this Protein Week that we all will make protein a part of our diet plan.

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