Being pregnant is hard and expecting a baby during the coronavirus pandemic is harder. Pregnant women normally have to face certain problems throughout their nine months of pregnancy but with the novel coronavirus, that has been exacerbated. The anxiety of ‘to be’ mothers has grown exponentially as they are among the high-risk group and prone to complications, especially during these times.
Covid-19 has been an overwhelming crisis for the healthcare industry and prenatal care presents a major challenge. Amid a hoard of worries disturbing the mental well-being of pregnant women coupled with restricted movement due to the pandemic, Dr Vivek Jain, Director and Head of Department, Neonatology, Fortis Hospital Shalimar Bagh, lists their common concerns. “One of the problems is lack of physical activity and outdoor exposure that has led to various physical ailments and a psychological impact. Another concern is the difficulty being faced by them in visiting the hospital for their regular antenatal checkups and ultrasound examinations. We call them only for the essential visits and cover their doubts through telemedicine,” he says.
Covid & pregnancy complications
Does Covid-19 increase a patient’s risk of complications during delivery? Dr Sweta Jaiswal, Resident (OBGYN), Holy Spirit Hospital, Andheri East, Mumbai, says, “Usually Covid-19 doesn’t increase risk significantly in mild to moderate cases. But in severe cases, urgent termination may be required to relieve pressure on diaphragm due to gravid uterus so that lungs can expand. The patient may require non-invasive or mechanical ventilation. Pregnancy is a hypercoagulable state and due to Covid-19, it further increases. Hence they should be given low molecular weight heparin in moderate to severe cases.”
“With the advancement of technology, many kinds of childbirth and delivery methods are available among which the safest in case of Covid-19 is Normal Vaginal Delivery as it demands shorter hospital stays, lower infection rates, quicker recovery and babies born vaginally have a lower risk of respiratory problems,” adds Dr Sandeep Chaddha, obstetrics and gynaecologist, Motherhood Hospital Noida.
In the meantime, the precautions Covid-positive mothers should take after delivery like mothers should maintain distance from baby except during feeding, before feeding hands to be washed properly, while feeding she should wear a mask and avoid coughing while feeding. In case if symptoms worsen then visit the hospital immediately.
Does virus transmit from mother to foetus?
Whether or not Covid-19 can be transmitted from a mother who has been tested positive for the virus to the developing foetus is a topic of debate. Research has shown that breastfeeding has to be continued even in Covid-positive mothers as the benefits outweigh the risks.
Breastfeeding mothers (with Covid-19) are advised to continue feeding by taking the usual precautions of masking and strict sanitisation or extracting the breast milk beforehand to avoid infection. Dr Sudeshna Ray, consultant obstetrics and gynaecologist, Jaslok Hospital & Research Centre, Mumbai, says, “The evidence so far is not conclusive of transmission of the virus from the positive mother to the baby while in the womb. There are some studies which have not shown any transmission while some other small studies have shown a neonatal infection of SARSCOV-2 following birth from symptomatic positive mothers. More robust and longer studies are needed to come to a reliable consensus and research is being carried out for the same. So far, breast milk is not found to be carrying the risk of infection to the breastfed baby but the proximity to the positive mother carries the risk.”
Alternatives are asking a positive mother to feed the baby or using an exclusive, well-sanitised breast pump and accessories to avoid transmission through contact and droplet infection. The asymptomatic Covidpositive mothers can follow general precautionary measures such as washing hands, breasts and nipples well before feeding, wearing a well-fitted mask (only the mother) and avoid coughing and sneezing while feeding and continue to do direct breastfeeding.
With regards to vertical transmission (transmission from mother to baby during pregnancy), the data available so far confirms that transplacental transmission is indeed possible in the last weeks of pregnancy, says Dr Sunil Eshwar, lead consultant, obstetrics and gynaecology, Aster RV Hospital. “Since Covid -19 is a relatively new virus, we are learning about its effects on pregnancy and childbirth as time progresses. Although the results so far have not been proven to be detrimental to the baby, the long-term consequences of this virus on the new born are yet to be researched,” he further adds.
Avoid clinics if not serious, go for telemedicine
With the rising fear among pregnant women to attend the doctor in clinics/hospitals, many are relying on telemedicine for routine checkups and there’s a surge in online consultations. “Since pregnancy itself is considered a physiological immune-compromised state which makes them more vulnerable to infections, it’s desirable to minimise the exposure. A to-be mother comes for a physical consultation when she is assured of the safety measures taken in the hospital,” says Dr Ray.
She adds, “For the birthing process, usually, they have no inhibitions to come to the hospital. The healthcare care providers have to ensure all measures for safety against the virus are strictly in place which needs to be communicated to the pregnant women’s family. Only one relative can stay with the birthing woman throughout her stay these days for as short a period as possible.”
Anxieties and apprehensions of pregnant women can be largely addressed through telemedicine but the occasional need for physical examinations and tests remain unmet. “Often, they have to make do with suboptimal imaging services from nearby facilities, thus impacting diagnosis and eventual care. We are currently encouraging remote consultations for planning and counselling, thereby avoiding extensive in-clinic interactions,” says Dr Rohit Gutgutia, Medical Director, Nova IVF Fertility East.
Hospitals treating Covid-19 patients seem a risky option for delivery, but single super speciality hospitals can be a better choice. Dr Chaddha says that for new-borns, single speciality hospitals are the best as the chances of contracting coronavirus infection are minimum there. They have advanced technology and infrastructure, to take extra precautions and safety guidelines for both deliveries and taking care of newborns. But if the hospitals take precautionary steps to make the would-be mothers feel safe and at ease in a hospital during delivery, then they can be trusted. Dr Jain says, “Since the pandemic, we have trained our staff to exercise additional measures. We have dedicated OTs and delivery rooms, which are separate from those housing Covid-19 patients. There is rigorous screening as per ICMR guidelines.”
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CORONAVIRUS PANDEMIC: THE TRIGGER FOR AYURVEDA RENAISSANCE
When a seemingly innocuous virus entered the city of Wuhan in the last month of the last decade, nobody could predict that the whole world would be paralysed for the next entire year and more! Moreover, the ordeal is far from over and the medical and healthcare fraternity world over is still struggling to find the viral antidote, pinning all the hopes on the highly anticipated vaccine. However, with the collapse of the conventional medicinal system, the general population has realised that a sturdy immune system is the best defence against any pathogen and to achieve this, natural health alternatives are being explored vigorously.
The oldest of all medicinal systems, Ayurveda, has proved its mettle in the pandemic already! Under the guidance of the AYUSH ministry, many Ayurvedic institutions throughout the country have shown excellent results in the management of Covid-19 infections, both in acute and post-Covid phases. Numerous trials are going on and the results look promising.
The science of life, Ayurveda, has generated enormous curiosity in the last few years and many people have shifted to the Ayurvedic way of living and managing disease as it is holistic and believes in reversing the pathology without any side effects. The two-folded aim of Ayurveda is ‘prevention’ and ‘cure’ for which discrete guidelines are given in the stipulated clinical texts about aahar (healthy eating), vihara (healthy lifestyle), nidra (sleeping habits), dinacharya (daily regimen), ritucharya (seasonal regimen), and various treatment modalities incorporating scientific nutrition, thousands of herbo-mineral formulations and detoxifying treatments such as panchakarma.
With the advent of the pandemic can Ayurveda turn this opportunity and redeem itself to its lost glory? Let’s explore in this article:
1. Preventive holistic aspect of Ayurveda in the pandemic – Cellular health support, Immune health support, neuroendocrine support, Nutritional support through phytonutrients
2. Covid-19 and effective Ayurvedic protocol – no side effects, decongestant and lung-protective medications, cardioprotective, immunomodulator, cellular repair, mental support, Rasayan therapy etc. There are numerous successful trials throughout the country.
3. Change in societal perception about health and disease – Recent awareness about the rise and prevalence of metabolical and lifestyle disorders like obesity, diabetes, hypertension, hypercholesterolemia etc and the limitations of conventional medicine to treat them, whereas Ayurveda successfully managing and reversing them.
4. Governmental recognition and approval – The current government with its pro-Swadesi approach has renewed its efforts in reinforcing the traditional Indian medical system. Ayurveda is being given a crucial place in the annual health budget and rigorous steps are being taken to integrate Ayurveda in the present healthcare infrastructure at the ground level.
5. Rise in popularity outside India – Worldwide, Ayurvedic medicine and products are increasing in popularity. Many students have been coming to India in recent years to learn Ayurveda and practice and propagate it back in their countries.
6. Rise in demand for Herbal supplements – With health and wellness being the biggest priorities now, the demand for nutraceuticals and immunity boosters is globally increasing. Many companies like Patanjali and Himalaya have given reports of a phenomenal rise in sales of immune-boosting supplements and respiratory medication.
7. Refurbished standardisation protocol of Ayurvedic medications and supplements – There have been tremendous upgrades in the standardisation protocols for Ayurvedic medications and nutritional supplements making them safer for a bigger audience and an easy entry into the global market. The required regulations are under the FSSAI, FDA, Good Manufacturing Practices (WHO-GMP), ISO 9000 and Hazard Analysis and Critical Control Points (HACCAP) certifying boards.
8. India as an emerging leader in the global herbal drug market – India is currently the number 1 producer, manufacturer and exporter of herbal raw material and end products. Even the modern pharma industry relies largely on the herbal raw material supplied by India for its active ingredient extraction that is used in numerous modern medications.
9. Vast scope for the investment in Ayurveda – Multisectoral industries like health, pharma, food, agriculture, media and trade are renewing their investment interests in Ayurveda looking at the current growth patterns in the market trends.
10. Rediscovering and redefining marketing strategies – All that Ayurveda needs right now is an on-point marketing strategy to reach the masses and the capitalists. There have to be scientific studies, researches and relevant clinical trials that can show the documented potential of Ayurveda to the world. The preventive aspect of Ayurveda should reach the common stakeholders through proper educational channels and the various treatment modalities within Ayurveda should be researched and re-established through relevant institutions and hospitals making it easier for the common man to embrace Ayurveda.
The writer is the Founder of Nyrrvana Cosmetics.
POST-COVID COMPLICATION: MIS-C GETS PARENTS WORRIED
Covid-19 was not known to affect children in the first wave. However, it has not been the same in the second wave, as children and youngsters have been affected by the coronavirus. Though they are experiencing mild or moderate symptoms of the infection, post-Covid complications are what worry the parents.
COVID-19 AMONG CHILDREN
Adults were mostly affected by Covid-19 in the first wave. The immediate lockdown and closure of schools helped children to skip Covid’s radar. Though few children got infected, the symptoms among them were mostly mild or were asymptomatic. However, in the second wave, the number of children getting infected due to coronavirus has increased. The most concerning part are the increasing cases of MIS –C (Multi-system inflammatory syndrome in children).
MIS-C IN CHILDREN
Children affected by Covid-19 in the second wave are experiencing mild or moderate symptoms. However, post their recovery from Covid within two to four weeks or in few cases even beyond, they are found to develop high-grade fever and other complications which are known as MIS-C. This Multi-system inflammatory syndrome in children affects multiple organs like the heart, lungs, and brain. A child can experience different symptoms like:
• Rash on the body
• Abdominal pain
• Swelling in the neck
• High-grade fever
• Feeling tired
Some of the severe symptoms of the MIS-C could be trouble in breathing, pain or pressure in the chest, pale, grey or blue-coloured skin, lips, or nail beds, and severe abdominal pain. In few children, these symptoms may go to an extent of seizure or septic shock.
MIS-C mostly affects children after two to three weeks of testing positive for Covid-19. It is to be noted that, MIS-C is not a life-threatening condition and can be treated effectively if it is identified early. MIS-C is considered as an immunological reaction to a past Covid infection. Children with the condition may commonly test negative for RT-PCR/antigen test and will only be antibody positive. In one-third of infected children, MIS-C can mimic another disease called Kawasaki Disease associated with inflammation of the blood vessels to the heart. While most children with MIS-C recover extremely well with no significant long term sequelae, a small proportion can develop complications related to the heart.
MIS-C can occur in children of any age, however, it is mostly seen in kids in the age group of 3 to 12 years. Babies or older children may also have the risk of developing MIS-C.
COMPLICATIONS OF MIS-C
MIS-C is a complication that occurs due to Covid-19. Therefore, identifying the symptoms is crucial. A delay in treatment or inappropriate management can lead to severe problems to the vital organs like the heart, lungs, and kidney. In rare cases, MIS-C can lead to permanent damage to the organs or could be even fatal.
STEPS TO BE TAKEN TO KEEP THE CHILDREN AWAY FROM INFECTION:
• Hand hygiene –Ensure kids wash hands often with soap and water for at least 20 seconds. If soap is not available, use a hand sanitiser with at least 60% alcohol content.
• Keep children away from people who are sick –It is suggested to keep children away from unwell people, in particular, people who are coughing and sneezing.
• Social distancing – Ensure that your child maintains social distancing when outdoors.
• Wear face masks when in the outdoors – There is a high risk of Covid transmission when you and your child are outdoors. Make sure both of you wear a face mask that covers both nose and mouth.
• Avoid touching your nose, eyes and mouth – Encourage your child to follow your lead and avoid touching his or her face without washing hands.
• Cover your mouth when you sneeze or cough – Advise the kids to practice covering their mouths when they sneeze or cough to avoid spreading germs.
• Disinfect surfaces –Clean and disinfectareas of your home such as doorknobs, light switches, remotes, handles, countertops, tables, chairs, desks, sinks and toilets.
The writer is a Consultant, Columbia Asia Referral Hospital, Yeshwanthpur (A unit of Manipal Hospitals).
IS VACCINE POLITICS LEADING TO VACCINE HESITANCY?
Covid-19 vaccination programmes can affect meaningful resolution only with sufficient participation rates to achieve herd immunity.
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.
WHY VACCINE HESITANCY
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.
ANALYSING DEVELOPMENTS IN MENSTRUAL HYGIENE SPACE IN LAST DECADE
About a few years back, the only conversation that was happening around menstrual hygiene was about the performance of the sanitary pads/napkins. All the big FMCG brands, that are still the biggest brands in India, were talking about parameters like absorption capacity, length of the sanitary pad, dryness of the pad, so it was all performance-based. Everything in performance was indirectly related to a brand offering something that will prevent staining. With modern start-ups entering the menstrual hygiene space, the conversation has radically shifted from performance to comfort. Women started asking if performance guaranteed comfort. Since then, a lot of startups have started offering natural sanitary pads, nobody was talking about natural and organic sanitary pads before, because the conversations earlier were not on comfort, but now the discussions are also on what is my pad made of, how comfortable am I feeling while I am wearing it, how soft it is, do I feel like I’m wearing a diaper? While it prevents staining, but am I really comfortable doing my everyday work wearing it, moreover is it rash proof?
Another major observation that perplexed me and was one of the main reasons I started this company is the whole convenience aspect of using period products and nobody was talking about that. And as I said earlier, it was all about performance, but women wondered about the post-use convenience, disposal aspects. Also, these days there is a lot of focus on product packaging and providing a holistic experience to the end-user. With the new entrants, brands have become conscious and are striving to deliver an overall experience. The shift has also been to make sure that the customer experience is at par with other personal care products that the customer is using because she’s a young, mature woman making better choices for her body and the brand needs to deliver an experience that stands and pairs with her lifestyle.
One more significant change that we are observing today is that personal hygiene is no longer limited to sanitary pads; people are exploring many more options to take care of their menstrual hygiene, which is directly related to the fact that women are becoming more knowledgeable or conscious about menstrual hygiene. Pantyliners, tampons, menstrual cups, and intimate cleansers, were all non-existent more than a decade ago. Today, however, women are actively seeking information on these products, reading up on them, trying them and asking questions about them, so it’s not only about sanitary pads, women are actively looking for better options, more convenient and comfortable solutions. Sustainability is not a new concept, but sadly, few individuals in India base their purchasing decisions on picking a product because it is sustainable. While sustainability isn’t a deciding factor for many women today, it has become a criterion that women are becoming more cognisant of.
Even though many women seem to be hesitant to try this because of the mental barrier, the concept of inserting something inside the vagina is a daunting task. Conversations around period positivity are catching up actively through multiple initiatives on various platforms aimed at creating awareness about the menstrual cup which can be cleaned and reused. To build a society that is more inclusive and kinder, it is important to raise awareness on issues that are important to women. Menstruation is one such subject that doesn’t get the attention it deserves. Apart from the societal taboos associated with menstruation, menstrual hygiene products do generate a lot of plastic waste that is detrimental to the environment. Hence, we need to choose wisely.
The last thing that I would like to point out is that this segment specifically was restricted to the offline space, no education, no awareness, just selling your products. All the education and awareness was just on product features and performance. But today with consumers demanding information and awareness, not just on the product but how can I take care of my body. With access to social media, information on Google, YouTube, Instagram, Facebook, brands are adopting a strategy of education on menstrual hygiene and we can see that consumers are relating more with brands who are actively contributing to awareness, not just to the product but also overall issues like why does heavy bleeding happen, what is the menstrual cycle, what are causes of concern, what are issues like PCOS, PMS, etc. Brands that are actively engaging in distributing information like this, making their consumers more aware about all these issues, nobody was talking about PMS and PCOS even though one in every five women in India goes through it in India. There is a very high percentage, 50% to 70% of women are facing PMS symptoms and nobody is talking about it. So the whole game has shifted from just selling the product to offering transparency and awareness and actively educating consumers. People have also started associating more with brands that are actively contributing to this information and being more transparent and taking initiatives to make the consumers aware and speak in a way that’s bold and relatable and not hushed. This also propelled the brands in the FMCG space who are not focused on digital at all to actively start doing campaigns on empowering the users and telling users it’s not something to hide. These have been some of the major changes in the women’s hygiene space over the last decade and it’s great to see women embracing their bodies and wanting to understand the other aspects of menstruation as opposed to just worrying about the performance of their period product.
The writer is Founder & CEO, Carmesi.
TIPS TO PROTECT YOUR EYES FROM INFECTIONS DURING MONSOON
Monsoon is cherished by people as it brings that much-needed relief from the scorching heat. But, with the monsoon season, not just rain, even notorious eye infections such as conjunctivitis, dry eyes, and stye will be at one’s doorsteps. Here, personal hygiene can play a vital role in managing eye infections. Don’t forget to follow these essential tips to take care of your peepers.
The eyes are one of the vital and sensitive organs of the body that are prone to infections in the rainy season. Enjoying the monsoon and getting drenched is blissful, right? However, the monsoon season brings along a plethora of infections and diseases as the air becomes a commuting medium for bacterias and viruses. Along with waterborne diseases and allergies, even eye infections can steal your peace of mind. Neglecting eye hygiene can turn into a nightmare for you.
Beware of these common eye infections during monsoon
You will be shocked to know that conjunctivitis (pink eye) is an inflammation or swelling of the conjunctiva (the transparent membrane covering the outer surface of the eye and the inside of the eyelids) commonly seen during monsoon. It is an infectious disease and spreads from one person to person due to increased moisture in the air. The symptoms of conjunctivitis are redness of the eye, swelling, discharge, eye itching, and pain. The moisture content in the air during monsoons creates a favourable condition for the viruses to grow and multiply, and one may get a corneal ulcer that is the wound on the surface of the cornea. The symptoms are red eyes with eye discharge, and blurry vision. When the eyes are not able to provide adequate moisture owing to insufficient tears then the eyes can become dry. It happens because of the dust and pollutants during the monsoon. A stye is a bacterial infection seen in monsoon and can be worrisome. Don’t delay in seeking the treatment once you notice these eye problems.
Make sure that you prioritise your eye health and follow these vital tips during monsoon:
• Wash your hands and avoid hand-to-eye contact to keep eye infections at bay. Do not rub your eyes with your fingers as they contain germs and can lead to an infection.
• One should avoid using common towels, napkins, or handkerchiefs to clean their eyes as could lead to conjunctivitis.
• One using the lenses should clean them frequently, wipe the spectacles with a clean cloth and use eye drops on the recommendation of doctors.
• Avoid rubbing the eyes, regularly wash your eyes with the help of cold water to protect them from dust particles.
• Avoid eye make-up if you are having eye pain or an allergy.
• If you notice unusual symptoms such as blurriness, itchiness, and eye pain, avoid using over-the-counter medication and consult the doctor.
• Blinking often will help you keep the eyes feeling fresh, clean, and hydrated and tackle dry eyes problem. Drink plenty of water, and follow the 20-20-20 formula that is after every 20 minutes, take a 20-second break to focus the eyes on something 20 feet away to relax your eyes.
• Debris in the eye can irritate the eye and invite infections, use glasses when exposed to wind or dust.
• Wearing contact lenses without cleaning causes major eye infections during the monsoons. Clean them properly before wearing and carry an extra pair when you are out. Do not share your lenses with anyone.
• Avoid using a swimming pool during monsoon as doing so will raise your risk of bacterial eye infections or use an eye mask while swimming.
The writer is MS Ophthalmology, Apollo Spectra Karol Bagh, Delhi.
HOW BEST TO TAKE CARE OF YOUR HEART IN THE 40S
Is there a relation between heart health and ageing? If there is any connection, then what can people in their 40s do to prevent heart diseases? Let’s find out.
A heart attack is a condition when the arteries supplying blood to the heart (one or more) are blocked by a clot formation, cutting off the blood supply to part of the heart it is supplying. This results in a shortage of oxygen and other nutrients that lead to the death of the muscle cells of the heart. Actress Mandira Bedi’s husband, filmmaker/producer Raj Kaushal recently passed away after suffering a cardiac arrest, he was only 49. It is pertinent to mention that middle-aged men and women indeed have an increased risk of heart disease, therefore, they should follow a heart-healthy lifestyle. Here, we will discuss how people, who are in their 40s, can prevent heart-related problems.
At 40 years of age one is at the twilight of youth and steps into middle age. There are hormonal changes in both the sexes as a part of ageing which has a complex relationship with the body’s metabolism that is affected leading to several changes in the body.
Forty is an age where most are at an important stage of their professional career along with added responsibilities in their family life. The peer pressures of performance at work along with various other difficulties makes it a very vulnerable period of ones’ life. This is an age where diseases like Type II Diabetes, High BP, dyslipidemia and various other diseases manifest or are detected. The psychological pressures push people into excessive stress resulting in lack of sleep, unhealthy eating, increased alcohol consumption and smoking. Due to scarcity of time, there is a lack of physical exercise too. All these contribute to weight gain, high BP, high blood sugar, high cholesterol which pushes a person into the vicious cycle of bad health with a very high risk of life-threatening heart attack and stroke. 20% of people who have a heart attack are 40 or younger and this rate has risen by 2% every year in the last decade.
SYMPTOMS OF HEART ATTACK
It’s crucial to be aware of the symptoms of a heart attack. Some of these are:
• Chest pain perceived as a feeling of pressure or tightness
• Pain in the centre of the chest with radiation to the left arm, shoulder and jaw associated with sweating
• Shortness of breath
• Excessive unexplained sweating
• Feeling dizzy and fainting
• Pain in the upper abdomen radiating upwards to the chest and back with nausea and vomiting
SMOKING AND HEART DISEASE
Every cigarette smoked makes you more likely to get a heart attack or stroke. Roughly one out of five deaths from heart disease are directly related to smoking. People who smoke are two to four times more likely to get heart disease. The risk is even greater in women who smoke and also take birth control pills.
How does cigarette smoke harm your heart and blood vessels?
1. It causes endothelial activation and dysfunction by reducing vascular NO availability, biomolecule oxidation and endothelial damage. The endothelium is the innermost layer of a blood vessel
2. It causes pathogenic alterations in lipid profile and lipid oxidation
3. It induces a local and systemic proinflammatory status leading to injury to the endothelium
4. It causes a procoagulative environment leading to thrombus formation (blood clotting)
5. Smoking causes the heart rate to rise and also increases blood pressure
There are 7000 toxic substances found in cigarette smoke.
The cardiovascular diseases caused by smoking are: coronary artery disease (arteries of the heart), hypertension, heart attack, stroke (brain), aortic aneurysm (dilation due to thinning of the walls of the vessel), and peripheral vascular disease (affect the vessels of the limbs).
HOW DOES QUITTING SMOKING HELP?
Twenty minutes after you quit smoking your heart rate drops.Just twelve hours after quitting the carbon monoxide level in blood drops to normal, allowing more oxygen to vital organs.Within four years of quitting, your risk of stroke drops to that of lifetime non-smokers.
HOW TO PROTECT YOUR HEART?
Get moving: Aim for at least 30 to 60 min of activity per day. Regular or daily physical activity can lower your risk of heart disease by reducing your weight, blood sugar, cholesterol and BP. It can be 150 minutes a week of moderate aerobic exercise like walking, cycling or jogging or a 75 minutes of vigorous aerobic activity or two or more strength training sessions a week.
Eat a Heart-Healthy diet: A healthy diet will protect your heart by reducing your weight, controlling BP, cholesterol, and diabetes. A heart-healthy diet includes vegetables and fruits, beans or other legumes, lean meats and fish, low fat or fat-free dairy products, whole grains, and healthy fats like Olive oil. Limit the intake of salt, sugar, alcohol, saturated fat (found in red meat and full-fat dairy products), trans fat (found in fried fast food, chips and baked food).
Maintain a Healthy weight: A BMI of 25 and above is considered overweight. Overweight especially around the middle part of the body increases the chance of developing heart disease, hypertension, dyslipidemia, and Type II Diabetes.
Waist circumference is a useful tool to measure abdominal fat. 40 inches for men and 35 inches for women are considered the cut-off point. Reducing your weight by just 3% to 5% can be beneficial as it can decrease certain fats (triglycerides), blood sugar, BP, and cholesterol.
Get good quality sleep: Lack of sleep leads to a higher risk of obesity, high BP, heart attack, diabetes, and depression. Most adults need seven hours of sound sleep. Make sleep a priority in your life by setting a schedule and sticking to it. Thus going to sleep and getting up at the same time every day. If you feel tired throughout the day or have a disturbed sleep where you wake up several times at night then get yourself evaluated for obstructive sleep apnoea, which manifest as snoring, stopping of breath, and waking up gasping. This is treated with a CPAP continuous positive airway pressure and weight reduction. This is one of the reasons for high BP, heart failure, and sudden cardiac death.
Stress management: Cope with stress properly and not by indulging in smoking, eating unhealthy food, and drinking alcohol. Exercise and sports are good ways to reduce stress. Meditation and yoga are the best but getting counselled by a Clinical Psychologist is helpful.
Regular Screening tests: Regular screening help you identify your risk for heart disease, especially if have a strong family history of one.
BP screening should begin from the age of 18 and measured at least once in two years. For people in their 40s, who are not hypertensive, should have their BP screened at least annually.
Cholesterol screening should also begin at the age of 20 and done annually for people with a family history of hypertension or heart disease. Once detected to have abnormal levels, tests should be repeated every six months or else annually.
Screening for diabetes: If one has a strong family history of diabetes or is overweight then screening should begin early. But for those, who have neither, screening should begin at 45.
Electrocardiogram: People with a family history of sudden cardiac death should be screened in their teens. Several familial and sporadic diseases cause a sudden increase in heart rate resulting in cardiac arrest and death. They have certain characteristic ECG by which they are diagnosed. A 24 Hr Holter (ECG) monitoring is also advised to them.
Imaging: Ultrasonographic (Echocardiography) imaging helps identify certain familial and congenital conditions which can cause sudden death. Hence, it is advised for people with a family history of premature deaths.
The writer is Consultant – Senior Interventional Cardiologist, Cardiac Science, HCMCT Manipal Hospital, Dwarka.
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