The coronavirus pandemic has rekindled people’s interest and belief in traditional medicines. They are making conscious lifestyle changes, opting for Ayurvedic products and witnessing its advantages on regular consumption. To cure any disease, Ayurveda goes to the root cause of the ailment and is known for preventive care. When the pandemic struck, people started consuming ‘kadha’, Ashwagandha, turmeric and more to enhance the body’s immunity level.
Although debates around the effectiveness of Ayurvedic treatment for Covid-19 are ongoing, it is to be noted that the Covid Care Centres (CCC) are curing asymptomatic corona-positive patients or those with mild symptoms without serious comorbid conditions. These provide treatment for the people who do not require intensive care. This way, hospital beds remain vacant for patients with complicated cases in need of critical care.
All India Institute of Ayurveda’s (AIIA) Covid-19 Health Centre in Sarita Vihar, Delhi, is administering the majority of patients with stand-alone Ayurveda treatment protocol including Ayurvedic medicine, diet, yoga and relaxation techniques. “Patients were discharged in good health showing 100% recoveries without complications during the treatment period with SPO2 more than 90%. No aggravation of symptoms was observed. It is also observed that there has been 0% mortality till now in admitted patients,” an AYUSH Ministry statement said.
Dr Aneesh T., medical officer, Nirog Street Certified Centre, Roorkee, says, “Covid-19 is a disease affecting multiple systems of the body with clinical features mostly pertaining to the respiratory system. Ayurveda has been successful in treating viral infections. As an Ayurvedic expert, I firmly believe that Covid-19 cases presenting with minimal or nil symptoms can be managed successfully.”
The contribution of Ayurvedic doctors is through three domains: preventive, curative and community interventions. Dr Aneesh explains that advocating a healthy and disciplined lifestyle by including herbal medicines, yoga and Pranayama are crucial and practised widely is the preventive aspect. Whereas the curative part deals with the prescription of time-tested Ayurveda formulae to individuals with a history of contact with Covid-19 cases which have proven successful.
In such uncertain times, Ayurvedic medicines can play a major role in the prevention of Covid-19 virus as well as treatment. It is certainly effective for prophylaxis of the infection too. “I start with precautionary measures for all of my patients which provide complete protection and ensure that the immunity of the individual is at an optimum level. I have treated many patients who have been under home quarantine, with mild to moderate symptoms of fever, loss of taste, abdominal discomfort, dry cough and cold. Generally, I see disequilibrium of the ‘dosha’ and advice appropriate Ayurveda combinations along with nasya and gandusha,” says Dr Bhavana Diyora, Ayurveda doctor and preventive wellness consultant at GALF (Get a Life Fitness).
All Ayurvedic medicines are good immune-boosters which when coupled with lifestyle changes can help to boost the immunity. Some Ayurvedic hospitals have treated Covid-19 patients through Ayurvedic medicines and changes in lifestyle. But these were either asymptomatic Corona-positive or had mild symptoms without serious Comorbidities. Dr Shashi Bala, senior consultant and head of Ayurvedic department at Moolchand Hospital in Delhi says, “You can prevent any kind of virus entering the body through Ayurvedic medicines and way of life. In certain cases, as such, no treatment is required as it depends on how your body is reacting to coronavirus and if it is strong enough to protect you from the virus then there is no need for medication. Only Allopathic treatment can work for patients with Covid-19 complications.”
She suggests the patients follow the three pillars of Ayurveda — Ahara (diet), Vihar (lifestyle) and Brahmacharya (abstinence). To make dietary changes such as consuming cooked food and as per the season. “Bringing about lifestyle changes such as washing hands using a handwash, aloe vera gel or multani mitti, wearing masks, maintaining social distancing, oral cavity should be cleaned in the morning and night through rinsing the mouth with sufficient amount of warm water mixed with turmeric or sendha namak which is called gandusha and lubricating the nostrils with oil and sound sleep can strengthen the immune system,” adds Dr Bala.
Increased emphasis on immunity
Due to Covid-19, people are now giving more importance to immunity. Dr Shiney Linu of Kairali Ayurvedic Centre in Mumbai reveals that they get queries from people about ways to boost immunity as no cure has been found which is specific to Covid-19 in any medicinal form yet. She says, “Preventing yourself from falling sick is possible through Ayurveda for which you have to follow Dhincharya (daily regime) and Rithucharya (seasonal regime), detoxify your body and rejuvenate once a year through Panchakarma therapy.”
She also adds that diet forms a crucial aspect in Ayurveda and should contain ginger, garlic, pepper, turmeric, clove, cumin, fenugreek and cinnamon. Dr Linu asks her patients to consume healthy digestive food of the season and give them their immunity booster kits containing Chyawanprash, Mulbarin, Arogya herbal infusion, Ashwagandha capsules, Anuthylum and Triphala Ghritam.
Growth of Ayurvedic products
Philipe Haydon, CEO of The Himalaya Drug Company informs that over the past few months, there has been a demand for preventive care. It includes wellness products including Guduchi, Tulasi, Amalaki, Ashvagandha tablets and more are seeing a huge demand. Besides this, the proprietary formulations, Septilin and Immusante, have seen a significant rise in demand. Haydon says, “Evidence on the potential and strength of AYUSH systems to help promote immunity and improve respiratory systems has contributed to an increase in demand for Ayurvedic and immunityboosting medicines in the recent past.”
At this time, immunity is a buzz word across the globe and consumers are turning to the goodness of ancient Ayurveda, believes Arjun Vaidya, CEO of Dr. Vaidya’s. He says that the consumers have also understood the significance of a healthy lifestyle and while the pandemic has proven to be adversity for most businesses, it’s a huge opportunity for Ayurveda and e-commerce brands. Dr Saurabh Arora, founder of Arbro Pharmaceuticals informs that their immunityboosting products are being widely used and not only by individuals but corporates, organisations and hospitals. People are consuming their chyawanprash, immunityboosting Curcumin (increases the body’s antioxidant capacity which helps in boosting immunity) capsules and Ayush Kwath powder.
AIIA recently began Covid-19 trials with Nisarga Herbs. A double-blind, randomised, placebo-controlled trial is being held at ESIC Medical College and Hospital, Faridabad wherein the neem formulation will be tested on their 250 frontline medical and non-medical staff who are highly exposed to Covid-19 patients. The results of the clinical trials are expected by the end of November. Girish Soman, CEO, chairman and founder of Nisarga Biotech Group says, “Our neem formulation will prove to be an effective antiviral in preventive use and we are looking at strategic funding for further research to introduce it as a standard drug.”
Nisarga’s neem extract is already being used in the University of Texas, San Antonio for the past few years on cancer research. Soman adds, “During this research, we found good anti-inflammatory activity due to the presence of compounds such as Nimbolides, Nimbin and Salinin in our proprietary neem extract. With pre-clinical studies demonstrating excellent anti-inflammatory and antiviral activity, neem was a natural choice. With our proprietary patented extraction technique, we are confident that the neem capsules will show good preventive action.”
He informs that they were working on a new product (tablet), Respirade before the pandemic struck. “We have administered the tablet twice a day to our employees, their families and companies in the vicinity for the last four months and no one has reported cough, cold and flu symptoms. There have also been any Covid-positive cases so far. Respirade is a much more affordable version of Imuplus but has been specifically designed for respiratory tract infections and their treatment.”
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DEBUNKING MYTHS ABOUT PREMATURE DELIVERIES
Childbirth is a life-changing experience. It is an experience that is cherished and looked forward to by parents-to-be. However, one may encounter the challenge of preterm delivery. Due to several cases of preterm birth leading to chronic health problems, myths around preterm births include concerns that the baby could suffer from long-term mental and physical incapability.
Here are some of the instances that dispel the myths and concerns surrounding premature births. Quality care provided at the time of birth can achieve excellent outcomes of ‘intact survival’ in these babies.
Until recently, most medical facilities lacked advanced technology. However, Manipal Hospitals’ neonatal care is equipped with various facilities for newborn care, such as synchronised ventilation, PSV/SIPPV/VG modes of ventilation, high-frequency oscillatory ventilation, inhaled nitric oxide therapy, CPAP, non-invasive ventilation, continuous renal replacement therapy, intense phototherapy, total parenteral nutrition, bedside functional echocardiography, real-time cranial ultrasonography and advanced diagnostics.
One such case was that of Kavya (name changed). The year 1994 earmarked the first-ever application of exogenous surfactant therapy in India. The baby of Kavya, who was born prematurely at 32 weeks in a small nursing home, was found to have severe breathing difficulty on account of his premature lungs.
The baby was immediately transported by his relatives, to the advanced NICU at Manipal Hospital, Bangalore. The neonatal team immediately revived the baby and connected him to a ventilator, despite which his condition remained poor. The team quickly decided to perform the exogenous surfactant therapy to improve the baby’s lung function. This was the first time this procedure was performed in India. Subsequently, after another month of intensive care support, the baby was discharged. Today, the baby is an energetic 26-year-old who has joined his father’s business.
Another distinctive case is that of Kala (name changed) baby. Kala was referred to the high-risk perinatal unit of Manipal Hospital at 26 weeks of pregnancy for safe consignment. It was observed that the foetus was not growing too well in the uterus and was also suffering from high blood pressure. Previously, Kala had aborted thrice and she was understandably anxious about this childbirth. The 27-week-old baby, weighing about 620gms, was admitted in the advanced NICU and was treated under the expert care of Dr N Karthik Nagesh and his team.
Aggressive intervention through ventilation, exogenous surfactant replacement therapy, parenteral nutrition, thermoregulation, intensive care, and other measures were carried out over the next four months for the child. Today, he has blossomed into a brilliant young poet and is currently pursuing journalism, and no longer suffers from the earlier complications.
Similarly, in 1993, a pregnant Neeraja (name changed) was rushed to the hospital due to the severity of her condition. Neeraja delivered her baby at 28 weeks of pregnancy. The baby, who weighed about 1.1 kg at birth and suffered from breathing difficulties, had to be immediately supplied artificial ventilation. The baby also required advanced intensive care support for the next two-and-half months. During this period, a cardiac procedure was also performed to close the patent ductus arteriosus (PDA). The PDA had opened up, obstructing the breathing, making the baby ventilator dependent. The baby also developed a fulminating complication of severe necrotizing enterocolitis due to which the baby’s small intestine had perforated and emergency surgery was needed. Several such complications were circumvented. Post-treatment, the baby’s weight increased to 1.6kg and was discharged.
All these babies were premature and today are all leading healthy lives! Many carry the notion that these babies are born “too soon.” These notions have been proven wrong. With diligent care and support in the Neonatal ICU, the babies have survived well. Quality of care during the tough neonatal period plays a vital role during the crucial period. It ensures intact neurological and developmental function allowing them to perform to their best.
The writer is Chairman & HOD, Neonatology & Neonatal ICU at Manipal Hospital Old Airport Road, Bengaluru.
INCREASED NEED FOR RT-PCR TESTS AS COVID CASES SHOOT UP
Amid a massive spike in coronavirus cases in the national capital, expansion in testing capacity is the need of the hour. But are we prepared for it? Let’s find out.
Due to the recent spurt in the number of Covid-19 cases in the country, especially the national capital, the testing capacity has been further increased. RT-PCR diagnostic tests along with others are being utilised for the same. The growing number of cases has increased the Central and state governments’ concern. Besides aggressive RT-PCR testing, house-to-house surveys are going on in Mumbai and Delhi to somehow curb the spread. Contact-tracing is underway on a large scale. The Real-Time Polymerase Chain Reaction (RT-PCR) testing mobile laboratory, a joint initiative of SpiceHealth and the government, was recently launched in Delhi. It will conduct free RT-PCR tests and the results will be available in six to eight hours.
The outbreak of Covid-19 is not likely to subside anytime soon and gauging the situation, a huge number of kits would be needed in the near future that means manufacturing indigenous testing kits on a larger scale. As a country, are we equipped to meet this demand and tackle the overwhelming burden caused by the pandemic? Test kit manufacturers and vendors are affirmative.
“Until we get access to the vaccine, we have to internalise that we have to live with the pandemic. The central and state governments have been vigilant and responding to the evolving situation effectively. They have stayed on the course of expansive testing, and are continuing to do their best, opines Aishwarya Vasudevan, Group Chief Operating Officer, Neuberg Diagnostics.
With the onset of winter, we are still trying to get a grip on how pandemic will fare. The possibility of the second Covid-19 wave cannot be ruled out. Vasudevan adds, “As we move ahead, the government will have to consider multiple factors including availability of indigenous RTPCR test kits. Since the outbreak, by encouraging domestic manufacturers to develop indigenous testing kits, the government has given a thrust to Make in India initiative. When it comes to complete self-reliance, we still have some distance to cover. This can very well be overcome by incentivising the indigenous manufacturers.”
Talking about the soaring demand of RT-PCR tests, Jatin Goyal, MD, Corosure says, “There has been a certain increase in the demand for RT-PCR tests in the country in recent times owing to the rapid scale at which coronavirus is spreading. In the last week, we have seen that people with little symptoms are getting themselves tested. Surprisingly, even low symptomatic patients are getting positive results as the virus is behaving little differently.”
He adds that there is an immediate demand for tests as a large number of people are not taking necessary precautions and coronavirus is spreading severely, especially in Delhi and many people are ignoring the symptoms and not getting tested. Due to media reports, there is fear amongst masses so noticing symptoms some of them are getting their Covid-19 tests done. “Also, in recent times people have started travelling to other states, supposedly fear of Covid-19 has gone away from their minds, due to which the demand for RT-PCR tests has gone up,” Goyal points out.
Covid-19 cases are increasing at a fast pace but there are enough RT-PCR test kit manufacturers and vendors to meet the present need. “We wish to find the active cases more diligently and effectively and thus will need more RT-PCR testing kits. RT-PCR is the gold standard of Covid testing globally and is the most effective way to detect active infection. Therefore, we have to follow the test, isolate, track and treat regime as there is no other substitute. We have not faced any issue with the supply of RT-PCR test kits yet as there are around 142 ICMR-approved kit manufacturers and vendors in India. They will be able to address the current need,” believes Chetan Kohli, COO, Genestrings labs.
Till a vaccine is launched, the country needs to aggressively step up testing. For the same, one of the most widely used Covid-19 tests includes molecular assays to detect SARS-CoV-2 viral using PCR based techniques. The RT-PCR depends on its ability to amplify the minute quantity of viral genetic material in a sample, underlines Rajesh Patel, CEO, IVD India, Trivitron Healthcare.
Patel continues, “RT-PCR tests are constantly evolving with improved diagnostic methods and with the integration of more automated procedures. As cases rise rapidly, to encounter the Covid-19, RT-PCR testing is the best available option. We are on the front foot of large-scale manufacturing and supplying high-quality RT-PCR tests to various state governments, central testing agencies and private labs.”
“India is witnessing a significant rise in Covid-19 cases with the number of infected patients continuously increasing. Over the past few months, companies like ours have been focused on scaling and upgrading the testing infrastructure to ensure availability of testing kits in the country. With several test kits available, testing platforms that can consistently deliver superior sensitivity and specificity would be essential in enabling our response to the pandemic,” asserts Amit Chopra, Managing Director, India and Middle East, Thermo Fisher Scientific.
Globally, the company has scaled up production of their RT-PCR assay kits to 10 million tests a week, and have a capacity of supplying at least 3,00,000 Covid-19 RT-PCR test kits per day in India. Chopra adds, “, we are working with several pharma and biotech customers to extend our end-to-end Covid-19 workflow solutions to quickly ramp up testing infrastructure and vaccine research and manufacturing.”
Most regions across India, specifically key centres like Delhi, Maharashtra and Tamil Nadu are going through the second wave of Covid-19. There is an urgent need for enhanced awareness about the coronavirus symptoms and increased RT-PCR testing. More importantly, as India has a very high rate of asymptomatic cases, there is a need to cover as much ground as possible with RT-PCR testing, opines Dr Vikram Sanghi, CEO, Sanghi Medical Centre.
“Government and private labs need to scale up capacity to conduct tests. In the last 15 days, we have almost doubled our capacity to cater to the needs of patients in Delhi. The government has tied up with premium private labs like ours to ramp up testing,” informs Dr Sanghi. “Collaboration between people, government authorities and labs will help India to possibly flatten the curve and eventually drop the curve. Next four weeks are key to this journey of keeping India safe,” he concludes.
THE TRIPLE THREAT OF SMOKING: LUNG CANCER, COPD & PNEUMONIA
Time and again, the message of caution that smoking is injurious to health has been propagated over various mediums of communication. Smoking alone puts an individual at the risk of developing over 50% of serious illnesses. Some of these illnesses can be fatal, and others can cause long-term irreversible damage to your health. Second-hand smoking is also as good as direct smoking and exposes individuals to the same health risks as smokers. The death rate for any smoker is two to three times higher than that for non-smokers. Half of the smokers eventually die as a result of their smoking. Despite these dramatic and proven health risks, many people find it hard to kick the habit and put themselves at a high risk of developing smoking-related diseases.
LET US EXPLORE THE TOP 3 ILL-EFFECTS OF SMOKING
1. Lung Cancer: Smoking is the number one risk factor for lung cancer. It doesn’t matter if a person smokes only one cigarette or multiple times a day, or only smokes occasionally, the chances of developing lung cancer increase for sure. Smoking produces more than 4,000 chemicals including carbon dioxide, tars and nicotine, and these are capable of transforming normal cells into cancer cells over time. The cancer risk is directly proportional to the number of cigarettes one smokes every day. People who quit smoking have a lower risk of developing lung cancer, and this risk gradually decreases over time. Do not continue the habit by thinking that you are already too far in. Stopping can slowly reduce and reverse the damage already caused to your body.
There is a misunderstanding among people that smoking can only lead to mouth cancer. However, smoking can contribute to cancer anywhere in the body, and lung cancer is one of the most common and dangerous ones caused directly by smoking. Symptoms of Lung cancer will show up only when the disease is in an advanced stage. Some of the symptoms are bone pain, shortness of breath, weight loss and coughing up blood.
2. Chronic Obstructive Pulmonary Disease (COPD): When we smoke, the airways, air sacs and the lining of the lungs get damaged. Though long term exposure to lung irritants can lead to COPD, a common risk factor of it is smoking. The airways lose their ability to stretch and shrink back and the walls between the air sacs are destroyed. In the initial stages, there will be hardly any symptoms or mild symptoms which worsen over time. The symptoms are difficulty in breathing, wheezing, tightness in the breath, prolonged cough and breathing difficulty.
3. Pneumonia: Our body has a natural defence system against bacteria and viruses. But when you smoke, the body’s defence system gets compromised. With compromised immunity, you are susceptible to any infection. The action of the cilia or hair-like projections in the trachea to sweep fluids and any foreign particles out of the airways gets impaired leading to pneumonia.
Symptoms of Pneumonia are fever, coughing up mucus and chest pain.
EARLY DETECTION IS THE KEY
Catching the above three diseases in its early stage often allows for a higher likelihood of successful treatment. This is also when the treatment is easy and the body’s response to it will be more favourable. Pneumonia, COPD and lung cancer are closely related and have similar symptoms. The common culprit of smoking can worsen the symptoms and the impact of these diseases on the body. The lungs, which is the primary organ in the respiratory system bears the brunt of the attack of such diseases.
It is also a known fact that COPD is a significant risk factor for lung cancer. That’s the reason why to prevent both the diseases, COPD screening in smokers should be started at the earliest and quitting smoking should be the first thing to do.
WHY PREVENTION IS IMPORTANT
All the above diseases if not prevented in its early stages can be fatal, and a key factor to this is to quit smoking immediately. All those patients who get hospitalised when the symptoms worsen lament over holding on to the unhealthy practice of smoking. It will all be fine until the day your body says it can no longer take smoking and then teach you the smoke-free lesson at the hospital bed in the hardest way possible. Not to forget the cost of treatment and the valuable time you end up losing due to the unhealthy practice. It’s not only the above three diseases, but smoking is also linked to diseases of nearly all the organs of the body.
Remember that you are not only compromising your health by smoking but are also threatening the lives of people near you, especially children, pregnant women and elderly as passive smoking is as harmful as taking the real puff.
The writer is a Consultant, Interventional Pulmonology at Aster RV Hospital.
BENEFITS OF DIGITAL HEALTH TECHNOLOGIES
Mobile health applications and services are becoming an essential tool in extending healthcare resources. There is a lot of scope for the growth for digital health in our country and thus, innovative, efficient, technology-supported interventions are the current need. To discuss this and more, PHDCCI recently organised a webinar on Digital Health: The Future, Series III on Mobile Digital Health Devices: The Covid-19 Pandemic Impact and Mobile Digital Health Roadmap. It also highlighted the benefits and role of digital health/telehealth technology. Pradeep Multani, sr. vice president, PHDCCI, talked about the global healthcare emergency led by Covid-19 which has exposed the gaps in handling pandemics even in the most advanced economies of the world. Multani further added that numerous apps are now available to assist healthcare professionals with many crucial tasks such as information and time management; health record maintenance and access; communications and consulting; reference and information gathering; patient management and monitoring; clinical decision-making; and medical education and training. However, the lack of standards and regulations, limited guidance from physicians in selecting healthcare apps, and resistance from traditional healthcare providers are some of the key factors restraining the growth of the market. He said, “the wearable medical device market is expected to reach over USD 27 million by 2023, a spectacular jump from almost USD 8 million in 2017 and shared some common wearable devices.”Mobile digital health is not a product, its a process, said Dr Jitendar Sharma, managing director, Andhra Pradesh Med Tech Zone (AMTZ). He added, “mobile digital health is a spectrum through which multiple products can be fitted which leads to the desired outcome.” Dr Sharma talked about three baskets of digital health innovation starting from traditional and evolving telemedicine program to smart wearables to the penetration of mobile health in medical equipment. He mentioned that the output should be safe, effective delivery of services with a seamless flow of data in a well-controlled architecture. Dr Sharma shared the details of EMRAI (Electronic Medical Records Alliance of India), which consists of two parts, the provider and service user part for accessing the patients’ records. He added, “there is a need for creating a platform so that it becomes easier for any hospital for getting the records of the patients for which every smaller hospital needs to come into the electronic medium in rural areas as well.” Dr N. Subramanian, chair-health committee, PHDCCI and director, medical services, Indraprastha Apollo Hospitals told that the first telehealth centre was established in Aragonda in 2000 and after that, there has not been much improvement since long but as the pandemic affected the world, they have created controlled centres in the remotest part of India. He said, “telehealth has significantly addressed the major healthcare challenges like accessibility, availability and affordability.”Levi Shapiro, founder, mHealth Israel touched upon the major healthcare challenges in 2020 and particularly Covid-19 which has obscured many long-term structural needs in the health sector. Shapiro spoke about how the health tech investment transformed during these times from telemedicine to software applications to personalised medicines using AI and big data. Digital health and AI play a crucial role and combining these with digital health could be beneficial in various ways especially in rural areas, believes Dr Deep Goel, sr. director, Dr. B. L. Kapur Memorial Hospitals. He also talked about critical care and home care, where digital health could be very beneficial for better output. Dr Goel said, “some new applications and products like smart bedsheet can seamlessly record patient data like BP, heart rate etc and transfer it to the monitor, which lessens the doctor/nurse visit to the patient.”He also talked about the personalised treatment of a disease for a particular person which can be possible with mobile AI devices including robotic surgery. Dr Goel exclaimed, “the future of digital health is exciting and there’s a need for creating opportunities to make the life of a common man better by improving primary and secondary health care needs.”
HOW TO STAY SAFE AMID POLLUTION IN COVID-19 TIMES
With air pollution rising alarmingly in the city, doctors fear that it would lead to a major spike in Covid-19 cases. It’s a lethal cocktail that threatens to take infections to new, dangerous levels.
Air pollution does not always cause serious lung problems right away but can create complications in the long run. Dry throat, sore throat, cough, feeling of blocked nostrils (when you do not have a cold), hoarseness of voice, breathlessness while climbing stairs or after mild workouts among other symptoms might be caused by air pollution. “We do not pay much attention to these symptoms on a routine basis, but with time, such issues build up and compromise the airway mechanisms, damage cells in the lungs, and affect the blood vessels as well,” says Dr Pradeep Mahajan, Regenerative Medicine Researcher at StemRx Bioscience Solutions Pvt Ltd, Navi Mumbai. The national capital, among other states, was already bearing the brunt of stubble burning and Diwali celebrations added to it leading to increased pollution levels. Even young individuals are suffering from such conditions because of the current scenario. Air pollution should not be neglected as it can lead to serious health hazards. However, by taking simple and effective steps, people can stay safe and healthy.
Air pollution badly affects the lungs; similarly, Covid-19 causes inflammation in the lining of the windpipe and lungs. Both reduce the immunity and ultimately increase the vulnerability to the infection. When you have injured and inflamed lungs and a certain dose of the virus enters into the lungs, such people will be more prone to infection than a person with healthy lungs, asserts Dr (Col) Vijay Dutta, internal & respiratory medicine at Indian Spinal Injuries Centre.
“Post-Diwali we have got several patients who have recovered and are complaining about chest and breathing problems again. This is because their immune system is still running low. Having lung problems because of air pollution is aggravating the issues of Covid positive patients. Inflamed lungs will be more prone to infection than healthy lungs. We are recommending air purifiers and asking patients to keep indoor plants for better recovery and avoid going out these days, eat healthy and avoid morning walks as well,” adds Dr Dutta.
Air pollution is directly responsible for an increased number of people suffering from asthma. In the long term, air pollution can increase the non-communicable disease burden of India by making more people develop diseases of heart, lungs, and blood vessels, to mention a few. Elderly people, babies and young children are more at risk. Those living in urban slum clusters and crowded, poorly-ventilated houses are also vulnerable to air pollution, says Kamal Narayan – CEO of Integrated Health & Wellbeing (IHW) Council.
“Lower winter temperatures and the rise in pollution levels caused by the burning of crop stubble in North India could lead to the rise in Covid-19 cases. Typically Asthma and COPD (chronic obstructive pulmonary disease) infections are known to go up at this time of the year. People who have recovered from Covid-19 remain particularly susceptible as their lungs are still weak. Therefore, wearing masks and following social distancing norms is a must during this period and will not only help to avoid Covid but respiratory infections as well,” says Dr Gurpreet Sandhu, president of Council for Healthcare and Pharma.
“Environmental exposure plays a vital role in pregnancy. Approximately 6-8% risk has been associated with exposure to air pollution for pregnant women by increasing toxic chemicals in the blood and causing immune system stress, which can weaken the placenta covering the fetus and lead to preterm birth. Preterm babies born with low birth weight are susceptible to infections like pneumonia, asthma as lungs of such babies are weak and not fully developed. High pollution environment can also damage the brain and other organs of newborns,” says Dr Archana Dhawan Bajaj, gynaecologist and obstetrician and IVF expert at Nurture IVF Centre.
Parents must watch all symptoms which may indicate any respiratory problem in newborns, recurring cough, chest tightness, difficulty in breathing, clear watery discharge from the nose and sneezing should be informed to a doctor, suggests Dr Bajaj.
“A pregnant woman needs to be alert and take effective measures to protect herself from harmful air pollution by avoiding toxic air exposure, use of air purifier, avoid exposure to dust and use organic repellents, avoid travelling in congested areas as it increases the risk of stroke, heart attack, diabetes, lung cancer and other chronic lungs diseases,” adds Dr Bajaj.
According to reports, approximately 40% of all respiratory tract infections, and almost 20% of coronary diseases and diabetes cases are caused by air pollution. Residing in areas with poor air condition exacerbates such medical conditions and makes respiratory illnesses deadlier. This has become a major concern for Covid-19 as well. Several diabetes-related factors such as poor glycemic control can affect the body’s immune system. “When a person suffers from viral infections such as Covid-19, diabetes patients are likely to find it more challenging to manage the condition. It can also lead to secondary bacterial infections in the lungs, etc,” emphasises Dr Manoj Chawla, director and consultant diabetologist at Lina Diabetes Care & Mumbai Diabetes Research Centre. Short-term exposure to air pollution can increase your immediate risk of having a stroke if you have existing risk factors, such as high blood pressure, atrial fibrillation (AF) or diabetes. Studies have suggested that people who have a heart ailment and are living in areas where air pollution is worst are significantly more likely to have a stroke.
Dr Chawla advises, “Avoid outdoor exercises and walks in open spaces where there is a lot of smog and air pollution. Wearing face masks is necessary as it provides protection from air pollution as well as the virus. Frequent hand-washing with soap and water especially before consuming food or touching the face is recommended. Managing diabetes levels is an absolute must. Diabetics should regularly monitor their blood glucose levels and adhere to prescribed medications.”
The government needs to invest more in energy-efficient housing and power generation and manage industry and municipal waste effectively, opines Dr Sandhu. He adds, “The government must take steps to control the burning of agricultural waste and crop residue and prevent forest fires. It must encourage safe and affordable public transport systems and pedestrian- and cycle-friendly tracks. Strict rules and regulations must be enforced for pollution emitting sources and stricter action must be taken against those who break the law.”
Adding to it, Dr Mahajan says, “Government is making efforts to curb the spread of pollution; however, it is also our duty to protect our body and cell-based therapy, functional medicine, and a disciplined lifestyle are a step towards ensuring healthy lungs and overall health.” Every person should make an effort to modify their lifestyle by understanding what their body needs and adopt healthy habits as well as focus on enhancing the overall well-being.
Bone of no contention
With the drop in temperature, some people experience ache
or discomfort in their joints and bones. Doctors suggest ways
to relieve it and prevent its occurrence to some extent.
Staying warm is important as temperature is dripping with every passing day, so is taking care of your health to ward off common diseases during this season: Flu, common cold, fever, tonsil, eczema, joint pain and cold sores among others. Various studies show that viruses tend to multiply faster in wintertime which can make people fall ill. Thus, it’s wise to stay extra vigilant about your well-being.
Most often, the elderly experience acute pain in bones and joints during winters though young people complain of lower back pain at times. Dr Nitiraj Oberoi, director Orthopedics / Bone and Joint Surgery at Fortis Escorts Bone and Joint Institute, Delhi agrees, “Some of us are likely to suffer from common aches and pains, especially pain in lower back and joints as winter sets in. The elderly are more prone to have stiffness in the large joints of the lower limb and sometimes the fingers. Young active people can experience early morning lower back pain.” Adding to it, Dr Chandrashekhar Dixit, consultant- Orthopedic and Joint Replacement at Jupiter Hospital, Pune says, “Knee and hip pain are the most common complaints, joint pain can affect any part of your body be it from your ankles to your shoulders or hands. It can range from mildly irritating to excruciating pain and can last for a few weeks.”
If you experience any unusual or new symptoms including persistent swelling and redness consult your orthopedic specialist, advises Dr Dixit. “The onset of winters sees flaring up of the bone pain and joint discomfort in people with preexisting arthritis and osteoporosis. Staying indoors decreases the activity levels and inadequate amount of sunlight exposure adds to it, culminating in joint stiffness and decreased amounts of Vitamin D production,” says Dr Ramneek Mahajan, senior director, Orthopedics & Joint Replacement at Max Super Speciality Hospital, Saket, Delhi. But what causes pain in bones and joints or makes the existing condition sever. “Though it may not be the temperature directly, several factors make winters more difficult for people with joint pain.
The threshold of pain resistance lowers in winters as with the drop in air pressure, nerve endings in our body become more sensitive and tissues swell. Even a minor injury or minor stiffening of muscles can cause intense pain even in people who did not have any joint issues previously. Colder temperature also affects the blood circulation patterns that can aggravate joint pain and stiffness,” emphasises Dr Ashutosh Jha, consultant, Orthopaedics at Columbia Asia Hospital, Ghaziabad. Ample physical activities, exercise and a proper diet can lead to strong bones and joints.
Dr Mahajan says, “Exercise, even if indoors, to keep those joints supple and muscles well perfused. Increase the intake of milk products, green leafy vegetables, eggs and cod liver oil. Always consult a doctor before starting supplementation.”
Dr Jha adds, “Limit outdoor exposure and wear warm clothes, ensure sound sleep and right posture—sleeping on your stomach may stress the low back and spine, so sleep on either of your sides, take a hot shower to promote blood circulation and release muscle spasms, drink at least two to three litres of water daily to stay hydrated and flush the toxins from your system.”
To maintain bone and joint health, Dr Kiran Reddy Mekala, senior consultant – Orthopaedic at Apollo TeleHealth suggests: a) Physical exercise for at least 20 minutes regularly. It can be walking, cycling, treadmill or jogging. b) Hot water bath and hot fomentation is advised. c) Yoga practice helps maintain the flexibility of joints. d) Exposure to sunlight between 8 a.m. to 11 a.m. She adds that the middle-aged and old aged people should avoid cross-legged sitting, brisk walking, running, stair climbing and walking down or top the hill.
Ways to keep bones and joints stronger naturally Healthy
bones are the pillars of overall good health. Therefore it is essential to take good care of your bones from the right age since you achieve maximum bone mass in your 30s. If your bone mass is low by the time you reach your 30s, chances are you’ll face bone loss later in life, says Dr G. Prakash, Deputy Chief Medical Officer at Jindal Naturecure Institute, Bengaluru. Bones can be strengthened naturally in different ways.
Dr Prakash asserts that one of the most critical factors that determine good bone health is how much vegetables you include in your diet. Rich in Vitamin C, vegetables promote the production of bone-forming cells. Also, the antioxidant properties of Vitamin C restrict any damage to the bone cells. The absorption and processing of Vitamin C in the body occur with the help of Vitamin D which is why you need to get plenty of sunlight and consume foods rich in Vitamin D. Other than that, he suggests improving the protein intake since protein improves the strength of your bones.
Your diet should include rich sources of protein like lentils, legumes, dairy products, eggs, nuts, and seeds. “Maintain the required amount of magnesium and zinc in the body as magnesium activates Vitamin D to absorb calcium. Zinc plays a crucial role in mineralisation and bone metabolism. Besides focusing on your diet, you should focus on maintaining a good lifestyle and indulge in a proper exercise routine,” concludes Dr Prakash.
Tips to maintain healthy bones and joint
1. Exercise works best to maintain good bone health as it maintains bone density and is preventive against osteoporosis. The advantage of exercise during peak winters is that the soreness or stiffness of the joints is kept in check due to adequate blood supply which counters the effects of vasoconstriction. Exercise works even better for the elderly as their joints get better coordinated and this prevents falls.
2. Eating citrus fruits like oranges, amla, etc, in any form helps the body to build adequate stores for good bone, joint and skin health. A balanced diet is a key to overall healthy living.
3. People who are overweight have higher chances of getting arthritis. Maintain your weight to keep the knees healthy. As knees handle the weight of full-body they need to be strong and flexible.
4. Warm water shower relieves the stiffness in joints and also gives relief from arthritis pain. Warm water bath also makes you feel better by reducing stress.
5. Bone mineral density may reduce if you take excessive amount of tobacco and alcohol, therefore consumption of tobacco and alcohol should be minimised.
P.S: People who are above 50 years should get a regular test done for bone mineral density. This will help in determining the number of minerals one has in their bones.
Common mistakes one must avoid
1. High heels put extra stress on your knees so avoid anything that’s bigger than one and a half inches.
2. You should use your strongest, largest joints and muscles; when you lift or carry items, use your palms or arms instead of fingers. Also, hold the weight close to your body to cut down stress.
3. Improper stretching techniques, always do dynamic stretches.
4. During winters, people stop exercising, hence, cutting down on this activity only leads to decreased range of motion and more joint pain.
5. Wearing ill-fitting shoes and clothes while exercising may hamper the joints. Therefore, wear proper shoes to ensure it provides shock absorption and stability. Also, good hydration helps reduce injury.
Dr Nitiraj Oberoi, director Orthopedics/Bone and Joint Surgery at Fortis Escorts Bone and Joint Institute, Delhi
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