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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MEDITATION TECHNIQUES TO HELP COPE WITH DEPRESSION
Depression is a widespread health issue, and it is often triggered by stress, anxiety, or hormonal changes. It results in a low mood, reduced energy, and a general disinterest in life. When untreated, it can have serious health complications including an increased risk of heart disease. Therefore, one must immediately seek professional help and build a lifestyle that can help support their recovery. Meditation is one such tool with a vast number of benefits and is helpful in cases of depression.
Here are a few techniques that can help:
• MINDFULNESS MEDITATION
Mindfulness is the practice of being in the present moment, in the here and now. These meditation practices often begin with breath awareness as that helps keep the mind in the moment. In Zen wisdom, happiness is found neither in the future nor in the past. Happiness is only in the present. And a very effective way to anchor our attention to the present is by focussing on the process of breathing in and out. Every time the mind drifts away, you bring it back to your breath. This retrains the brain and teaches us how we can ‘choose’ what we pay attention to.
Visualisation is a beautiful way to replace negative visions with positive, soothing ones. They can work as vision boards to visualise your future, to create more positive outcomes. These can be very helpful for those suffering from fear or anxiety as their mind naturally races towards the worst possible outcomes. They help the body relax and have even been found effective in reducing pain.
• BODY SCAN AND PROGRESSIVE RELAXATION
Body scanning is the method of focussing on one body part at a time and relaxing it consciously. Mental awareness and breath are used to gently ease the tension until the entire body has been scanned and relaxed. Yoga Nidra is the foundational body scanning practice that effectively improves our mood, reducing anxiety. It helps in recovery from any emotional distress.
• YOGA AND PRANAYAMA
When done with breath awareness and followed by Pranayama, traditional Yoga practices help elevate our mood and even prepare us for meditation. Yoga Asanas help us feel refreshed and energised. Pranayama or breathing exercises then help us integrate our mind and channel it away from various distractions. Now, the mind becomes ready for deep meditation. It becomes a lot easier to stay focussed on the breath or a mantra or any other object of meditation. In some traditions, it is believed that practicing energising breathing practices like Kapalbhati can help fight depression.
All these techniques help because they teach us how to deal with stress and influence our brain’s functioning. Regular and consistent meditation practice makes us less impulsive and less fearful because it physically alters our grey matter. It helps us change our thinking. While meditation is not a replacement for medical support, it should be an integral part of our lives to prevent and manage mental health issues.
The writer is yoga and Ayurveda lifestyle specialist and founder of Yoganama.
HOW DIGITAL PLATFORM CO-WIN IS AN INTEGRAL PART OF COVID VACCINE PROGRAMME
After a year since the pandemic began, the entire world continues to deal with cascading effects on human lives. As a big relief, the moment we have all been waiting for is here. India kicked off the world’s largest vaccination drive for Covid-19 on January 16, 2021. Healthcare and frontline workers will be a priority for vaccination and initially, nearly three crore doctors, healthcare and frontline workers would be inoculated. Vaccine administration to 1.3 billion people in India is a mammoth task and digital platforms can play an integral part in the entire process of its implementation.
To start with, digital support would be required for registration, vaccination centre selection, slot booking, beneficiary profile, vaccination certification, and recording e-Health records. Through digital interventions, we would also be able to manage adverse effects, feedback, and grievance redressal mechanism. Artificial Intelligence and Machine Learning would be helpful in mining real-time data to assess the safety and efficacy of Covid-19 vaccines and adverse patient monitoring.
Realising the importance of digital disruption for the smooth function of the vaccination programme, India had developed an Electronic Vaccine Intelligence Network (eVIN) in 2015. The network was initially deployed in 12 states. Now, for Covid vaccine, the Centre has launched CO-WIN, another digital platform, to plan, implement, and monitor the drive. The digital platform would facilitate real-time information of vaccine stocks, storage temperature, and individualised tracing of beneficiaries. CO-WIN is an extension of the government’s eVIN and it digitises vaccine stocks and monitors the temperature of the cold chain through a smartphone application. It supports better vaccine logistics management at cold chain points.
The CO-WIN is an app designed by the Government of India, to enable citizens to self-register for the Covid-19 vaccination processes, initially will be accessible to healthcare workers and frontline warriors alone and will be open to usage for the general public within a month. Along with healthcare providers and the Covid warriors, the app will be effectively used by Central and State Governments to implement the inoculation drive. It provides much-needed information in bulk for healthcare workers. CO-WIN app would provide beneficiary details and update vaccination status. Digital interventions in the world’s largest vaccination campaign would surely be replicated globally.
Digital platforms are also geared up to support providers to manage post-vaccination adverse events in a better way. Hence, not only vaccination but digital platforms would strengthen the entire continuum of care in post Covid period. Healthtech service providers are ready to provide support as the vaccination for Covid-19 would be a long term event. As per the official schedule, Phase II of the vaccination would continue till December 2022, when the rest of the adult population nearly 50 crore would be covered. Healthtech companies such as DayToDay Health (DTDHI) and many more are all set to collaborate with the government and expecting the issuance of guidelines for leveraging CO-WIN app which would enable them to build on and build around the app. Healthtech service providers would invest in a strong analytics engine for not only tracking purposes, but also for planning and predictive analytics related to prioritisation of beneficiaries, areas to be targeted, reduce drop-outs, and improve vaccine efficacy across target segments.
The writer is CEO and founder of DaytoDay Health.
DOCTORS SHARE COVID-19 VACCINE EXPERIENCE
The vaccination drive against novel coronavirus has begun and the first ones to get the jabs were those who have been in the forefront in fighting the pandemic. They received the first shot of vaccination on 16 January and shared their experience with us.
The pan-India massive vaccination drive against Covid-19 began from January 16. Hospitals had prepared for it beforehand, they followed guidelines issued by the Ministry of Health for the vaccination process, trained the team and did dry runs, some hospitals formed Adverse Effects committee, set up Adverse Events Following Immunisation (AEFI) room or made special arrangements to deal with side effects. For a smooth process, each hospital has a pre-vaccination waiting area, vaccination room and observation area. Taking a leap of faith, many healthcare workers including doctors and medical staff from hospitals across the country came forward to get the vaccination dose. They are urging that if given a chance, people should get the vaccine shot. Scientists have worked hard for the vaccine and doctors are leading by example so people should not hesitate to go for the vaccination.
Talking about the vaccination drive, Dr Shreevidya Venkatraman, senior consultant-Internal Medicine, MGM Healthcare, Chennai said, “Covid-19 is here to stay. Covid cases are less but as seen in Europe, the peak is expected in March/April. Vaccination against Covid-19 is our best option. Safety and efficacy of the Covid vaccines have been proven. Mild malaise, fever, and local pain may be expected. So far we have not seen any major hypersensitivity reactions after the administration of the Covid vaccines.” Health professionals including doctors, who were vaccinated at Manipal Hospital, Dwarka, Delhi, said that they are upbeat as the final assault on coronavirus has begun and this will create a strong safeguard against the infectious disease. Dr Pankaj Dhamija, Centre head, Wockhardt Hospital, Mira Road, Mumbai said, “The news of vaccination has certainly given hopes to people. We are proud to be a part of this vaccination drive and committed to working round-the-clock for the betterment of the patients. Coronavirus vaccination will protect people by creating an antibody (immune system) response without getting sick by the virus.”
Doctors and healthcare workers share their first-hand experience with us about receiving the first shot of Covid-19 vaccine:
It is a moment of victory for the war against Coronavirus. I was excited and eagerly waiting for these vaccines to be made available. When this initiation of vaccination news arrived I was upbeat and after going through all the information I readied myself to get vaccinated. The process was well organised and meticulous. I took the first dose of Covisheild vaccine at 10.30 am on Saturday at Indian Spinal Injuries Centre. I was made comfortable and all the information was given. I am doing fine and feeling confident.
— Dr Gururaj Sangothimath, spine surgeon, Indian Spinal Injuries Centre, Vasant Kunj, Delhi
There was certainly an apprehension about taking the vaccine initially in terms of efficacy and reaction. There were misconceptions and after discussions with doctors, everyone came forward to take the vaccine jab. We were made to wait for 30 minutes post the vaccination for any adverse effects after which I experienced mild nausea and gastritis. I was completely fine after an hour of vaccination.
— Dr Prakash K.N., Chief of Medical Services, Columbia Asia Hospital Hebbal, Bengaluru
It feels good to be the first person to be vaccinated in the vaccination site at BLK Super Speciality Hospital. It was just like any other shot that one would have taken. We were really looking forward to this and the process was pretty smooth.
— Dr Sandeep Nayar, Senior Director, Centre for Chest and Respiratory Disease, BLK Super Speciality Hospital, Pusa Road, Delhi
I am glad that I was the first one to get the vaccination at Max Smart Super Speciality Hospital. I did not feel any sign of anxiety or reaction. Everyone should get the vaccine shot and even after the vaccination, people must follow the safety guidelines issued by the government.
— Ashutosh Chaturvedi, Emergency Nursing Head, Max Smart Super Speciality Hospital, Saket, Delhi
I was the first one to get vaccinated at Aakash Healthcare. I was vaccinated at 11:10 am on Saturday and was told to sit for 30 minutes to check if I have got any adverse effects of the vaccine. The government officials assigned were constantly checking with me for any side effects. I had no side effects in my body and I am fine since I got the vaccine shot. I started working after getting vaccination and not experienced any problem. I am having no interruptions due to the vaccine in walking, eating, or working. This is a very appreciable step that the government has taken for healthcare workers.
— Anita Ryder, Support Services Department, Aakash Healthcare Super Specialty Hospital, Dwarka, Delhi
Mental health pandemic could be the next big crisis: Psychonnect battles the stigma, launches ‘ARK’ charter
As the world battles a ravaging pandemic, in an exclusive conversation with NewsX, Psychonnect held a riveting discussion around Mental Health: The Next Invisible Pandemic. The expert panelists on the show were Diya Ganguly Mallick, Psychotherapist (UK) & Co-founder, Psychonnect, and Dr. Eleanor Avinor, Ph.D. & Psychotherapist (Israel).
As the world battles a ravaging pandemic, in an exclusive conversation with NewsX, Psychonnect held a riveting discussion around Mental Health: The Next Invisible Pandemic. The expert panelists on the show were Diya Ganguly Mallick, Psychotherapist (UK) & Co-founder, Psychonnect, and Dr. Eleanor Avinor, Ph.D. & Psychotherapist (Israel) and audience included Ramya Aswathnarayana, Associate Psychologist & Project Coordinator, Psychonnect, Megha Rudrapati, Art Therapist & Course Coordinator, Psychonnect and Shreyah Mantri, Brand Development Manager, Psychonnect.
Addressing the various challenges of Mental Health, Diya, Psychotherapist (UK) & Co-founder, Psychonnect, said “The problem with mental health is we don’t understand its pain points and triggers. Slowly it’s going to enter inside your body, but one will still not know about it or understand its concern, because it’s not tangible, it’s not visible. That is why as a professional, we want to raise awareness on the subject. It’s absolutely necessary. Now to understand the huge wide spectrum mental health challenges can have, whether be the occasional instances of anger, or the existential crisis of depression, these all fall under the realm of mental health. The work we are doing at Psychonnect is creating awareness for people to understand that this is a serious issue and there is no health without mental health.”
Psychonnect is a Premier Mental Health Platform that facilitates Mental well-being, diagnostics, counseling & therapy service. Talking about the thought behind founding the organization Diya said “In the UK I had an opportunity to create an ecosystem that will merge or confluence the traditional approaches we have in India with empirical approaches of the West so that people can have a holistic form of treatment and get more awareness globally. We need more professionals to equip them with the right skills in order to go out and train people and address this issue unless and until we reach a stage where everybody is at least aware of their own mental health and well being.”
Dr. Eleanor Avinor, Author & Psychotherapist based in Israel shared her insights on the mental challenges owing to the pandemic that we as a global community shared and felt the common experience. “Nowadays, stress and anxiety are everywhere. And everybody has it. It is vital for us to know how to lower it, and how to understand what triggers us. Therefore, psychotherapy is important and it can help everybody. Violence in the family or in the whole world is one of the main points that we deal with. Typically, a third of the world population is suffering from anxiety, and depression, or anger, or loneliness. it’s contagious and everybody’s feeling very upset, especially because of the social distancing. People don’t have the contact that they want.”
Stressing on the fears that people feel while seeking help and how stigmatized issues of mental health still continue to be, Dr. Eleanor elaborated “Many people don’t get help because they are afraid of the negative stigma. Others don’t have the money, sometimes it is very expensive to get professional help, and sometimes there is no professional solution available. And that’s what we’re trying to do now is to prepare professional solutions that anybody can go to and anybody can get help. People have to feel accepted to be happy and everybody needs some sort of psychological help. People need somebody to share with and discuss the problems when and they need help to look at their problems and dilemmas from a different perspective in a positive and effective way. We have patterns that we’ve learned as babies and we’re connected to these patterns. Sometimes they don’t work for us but they worked for us when they were babies. We have to learn to look at these patterns of behavior, the way of thinking that we have, and maybe change them.”
Talking about how it is possible to come up with a large scale of the pattern and the individual context in mental health and generalize something at that scale, Dr. Eleanor shared insights from her professional experiences “Not everything is biochemical. Our thoughts determine how we feel, and how we feel determines how we behave. Actually, we have to be giving you the thoughts, and that’s not medicine. There are medical solutions for people who have schizophrenia, or maybe manic depressive disorders that need medication. While some people need medication but many people need medication together with psychotherapy and talking. I worked in a hospital for many years in the Psychiatric Unit. We had clients, some of them got medication, some of them got only talks, and some of them got both. People need to talk.”
Taking steps to make mental wellbeing “a lifestyle statement” Psychonnect has come up with the A-R-K (Awareness – Recognition – Knowledge) Charter which can be a self-healing tool for everybody. Throwing light on how the Charter aims to take the first steps towards understanding, appreciating & respecting the relevance and importance of Mental Health Wellbeing, Diya told us “Whether it’s depression, or anxiety or any trauma, or PTSD, which is very common when there is a pandemic you can visit our website and talk and literally express your concerns. At the same time, we are building a PR network and support groups where we are actually bringing people who already have a history of mental illness so that they can share their experiences and people can learn from it.”
Adding to the discussion Ramya Aswathnarayana, Associate Psychologist threw attention towards children of various ages and how is it possible to grasp the mental health challenges of them during pandemic who might not be able to self-diagnose. Dr. Elenor said it’s very important to see and understand how our children feel and that everybody needs somebody to love. Diya further added that it is very important to understand that this particular trauma-related to COVID-19 might be very difficult for any children to express their concerns. “Children are usually attached to a routine of going to school, meeting their friends, sitting in a particular classroom, and you’ve taken all those pleasures out of their life and introduced a new form of learning or a new form of making friends or interacting. This can be very overwhelming, and not necessarily they will know that it is stressing them out. For that reason, one can be spending some quality time, maybe going through a picture of family and engaging them in small things and perhaps through that you can actually tap into.”
Dr. Eleanor elaborating on whether there is an international sort of consensus or international perspective on mental health said “ The Coronavirus pandemic is worldwide and hence it is an international problem as it concerns everybody the world over, In other words, everybody has some problems, and when they’re under stress, like such and they are afraid that people close to them will die intensifies the problems. People have to learn to be kind to themselves, to have self-compassion. You can’t be kind to others if you’re not kind to yourself. That’s one of the things we have to teach people in psychotherapy because some people are crying themselves, they don’t do things that make them feel good. They don’t accept themselves, they don’t accept your faults, and so they don’t accept others. So in other words, you have to learn to be kind and this will make the world that kind of place. People also have to seek and find within themselves barriers and all of us who are working in the mental health field know that children build barriers inside themselves. In a time of need, and a time like such all these things come to the surface.”
Diya adding to this said “Today there is a global consensus on the fact that mental health is going to be the next invisible pandemic, because even when COVID becomes a distant reality, members still will face the aftermath of it, because of the emotional and psychological sufferings one is going through. Many families and individuals didn’t even get to say the last goodbye to their loved ones and there are people who have gone through ventilations and treatment, and that itself can be post-traumatic for them. That is why it’s important to understand and not only for mental health professionals but as a community be sensitive to this issue.”
Connecting practitioners, world-leading experts, and institutes from across the world with their clients, students & partners at Psychonnect, Diya said “Our main agenda is to create awareness on the subject which needs you to understand their trigger points and understand why they are behaving the way we do. At Psychonnect we are constantly building multilingual content so that you don’t have to come online but you have easily accessible WhatsApp videos or even a booklet to manage the different emotions they go through at different points of the day. Changing routines can be very unsettling and anxiety-provoking for such people. We actually not only teach them the traditional theories, but we also give them case studies, role plays, and how they can then translate this knowledge with real-life clients.”
Psychonnect is actively working to make resources available and translating into different multilingual contexts such as Gujarati, Bengali, Hindi so that many people who are not that comfortable with English still will have access to this material and understand that there are real mental health challenges. Megha Rudrapati, Art Therapist addressed the issue that most of the research or even approaches on Mental Health that we rely on are from the west, and hence when can we create a knowledge base of our own that is more culturally relevant to our population and also help us make mental health as equally valued and efficient here in India as well.
Dr. Elenor focusing on the cultural correlation said “Every culture has stories that you can build on. One of the things I would be doing is collecting the stories and using them with people and hence connecting those stories to their private lives and what they can learn from them.”
Diya on the other hand stressed de-stigmatizing and raising awareness about mental health back in India and said “I think it’s important to understand in our culture when it comes to mental health there’s a massive stigma, first of all, we need to address that people who are battling any kind of mental health challenges, have been subjected to unfair treatment and discrimination, or being tagged as lunatics. We need to move from that and that’s the first thing we need to do when it comes to India. Moreover, we are kind of short-staffed when it comes to mental health.”
“First, we need to make the right kind of interventions available and make our community aware that this is a serious issue making relevant help available to them and most importantly, it’s very important now to understand that mental health illness, must be under, I would say the ambit of all these life insurance or medical coverages. Until and unless we do that in our society people won’t see mental illness as the same as physical dysfunctions, they will never give that respect,” concluded Diya.
To know more about the ARK Charter, visit: www.psychonnect.com/a-r-k-charter
Watch the entire telecast here:
FIVE ASANAS THAT YOU SHOULD PRACTISE DURING WINTERS
Winter is a time of hibernation for many considering the cold mornings and the chilly nights. Lack of activity results in the muscles of the body becoming stiff and gradually leading to weight gain. Therefore, it is necessary to cultivate a discipline that can keep us working out in the winter season. Combine regular exercise routine along with a healthy nutritious diet to manage your weight. Staying active not only keeps you physically fit and mentally happy but it also brings in numerous other benefits. Yoga is a holistic science for overall well-being which improves your metabolism and digestive process.
Yoga is a tool for wellness to keep our bodies and minds productively occupied. Yoga brings dynamism and positivity into life. Less exposure to sunlight during winters leads to Vitamin D deficiency which can make you feel weak and dull. Yoga can help you to feel energetic and keeps laziness at bay. Follow these 5 simple poses and include them in your daily or weekly exercise regimen.
URDVA MUKHI: ADOMUKHI MARJARIASANA (CAT COW POSE)
To perform this Cat Cow stretch, gently bring your knees down to the ground and place your palms under your shoulders. Inhale, curl your spine and look up. As you exhale arch your back to drop your chin low and look towards your navel.
Step with your left knee in between your palms. Open the heel out as much as you can and keep the back straight. Place one palm on your knee and the other palm on your foot as you try to straighten your back. Do only as much as you can. Inhale and look up. Repeat with the other leg.
Start in Vajrasana, slowly straighten the left leg fold and place the foot on the other side of the right thigh. Twist your body turning towards the left bringing your right shoulder across the left knee to look back. Your right hand can hold your left foot, ankle, or toe. Place the left palm behind your back with a straight spine and look back. Repeat on the other side.
EKA PADA MARICHIASANA
Start in Malasana, stretch any one leg out and reach out with the same hand to hold your big toe. Ensure that your pelvis remains on the ground and your second foot is flat.
Sit down with a straight back and lift your feet, folding your legs and grabbing your big toes. Balance as you straighten both legs and open them as wide as possible. Keep your back straight and look forward.
Yoga contains many differentpractices such as physical postures, pranayama, meditation, mudras, and much more. These are techniques that can invigorate the mind, uplift your mood and strengthen your body. If you want to bring in a cardio element to your workout, you can practice Himalaya Pranam. The Himalaya Pranam is derived from the ancient tradition of the Himalayas; it is an 11-step flow of movements which contains backbends, forward bends etc. This is a powerful sequence that can heat the body and keep excess fat away.
Practice these asanas holding each posture for 20 seconds and repeat up to three sets.
The writer is an internationally acclaimed spiritual yogic master, author and TEDx speaker
BIRTH DEFECTS CAN BE CORRECTED, DON’T IGNORE OR DELAY
Every year over 1.7 million children in India are born with birth defects. Birth defects are common and are one of the major causes of infant hospitalisation. They are also called as congenital abnormalities or congenital anomalies. Birth defects are the major cause of infant deaths which may occur as early as a few days after birth. The birth defects can result in a long term disability with a significant impact on the individuals, their families, and also on society. As per the recent newsletter of WHO, an estimated 2,95,000 newborns die within 28 days of birth every year worldwide due to congenital anomalies.
A birth defect can be of physical malformations, that is the abnormal development of any organ of the body like heart defects, club foot, cleft-lip or chromosomal abnormalities like down syndrome or functional defects like congenital deafness or congenital blindness. While some birth defects affect the functions of normal human living severely, others can be a minor defect which is not so visible externally. As per the latest newsletter of WHO, the most common severe congenital anomalies are heart defects, neural tube defects and down syndrome.
CAUSES OF BIRTH DEFECTS
Most babies are born healthy. However, some may have birth defects. In approximately 50% of babies born with congenital abnormalities, the exact cause is unknown and the fetus develops them during pregnancy period. Birth defects are common globally. Family health history, age of the parents, care during pregnancy, and other factors are part of the risk factors.
Some of the causes are:
– Socioeconomic and Demographic factors (maternal age)
– Certain medications
– Exposure to chemicals
– Infections during pregnancy
– Maternal nutritional status
– A combination of the above causes
SURGICAL TREATMENT OPTIONS
With the advancement in health care, many birth defects can be diagnosed before birth with accuracy. Complete cure is possible through various paediatric surgeries for many structural birth defects and also its impact can be reduced.
Early treatment is possible for many functional abnormalities like congenital blood abnormalities such as (Thalassemia, sickle cell disease), and congenital hypothyroidism (decreased functioning of thyroid). Remember, surgical treatment options are available for most physical birth defects.
The most common structural defects and the surgical interventions to treat it are listed below:
Heart defects: There are a wide variety of cardiac abnormalities that affects the flow of blood through the heart and impacts the heart’s functioning and development. Depending on the heart’s abnormality, surgery can range from minor to open-heart surgery using a heart-lung machine, which will take over the functioning of the heart and lungs so that the surgeon can perform the surgery.
Spina bifida: In this condition, a portion of the babies spinal cord is exposed to the outside without overlying muscle and skin cover. Surgical repair is essential to prevent further injury and infection of the exposed spinal cord. A neurosurgeon replaces the exposed part of the spinal cord in the spinal canal and closes the defect with muscle and the skin.
Cleft lip or palate: Here the infant’s lip or the roof of the mouth has an opening or split. The surgery aims to close the separation in the lip and or roof of the mouth and provide a more normal function and appearance of the upper lip.
Club foot: When the infant’s foot is pointing inwards instead of outward, we call the condition as club foot. Surgeries are done to align the foot in a normal position by releasing and lengthening the tight tendons.
Birth defects can have a lasting impact on a child’s life if left untreated. Advancements in medical science allow us to correct these birth defects at a very early stage. Hence, consult your pediatrician and take their advice on the treatment. Hospitals are safe to visit and all precautions for patients’ safety are taken with utmost care.
The writer is senior consultant, obstetrics and gynecology at Columbia Asia Hospital, Sarjapur Road, Bengaluru.
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