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Health & Wellness

Significance of Radiation Protection in Interventional Cardiology



Image guided interventional procedures have become increasingly popular owing to the higher success rate and minimal invasion associated with it. Interventional cardiology teams face high quantum of radiation exposure due to a large number of complex interventional procedures performed in the Cath lab every day. Other fluoroscopy-assisted procedures, like trans-catheter valve replacements, are creating demand for Cath Lab time and skills. Also, the ability to treat cardiovascular, peripheral, and valve disease in a minimally invasive technique is increasing the addressable patient population and provides benefits like short recovery time and lesser complications. However, these procedures expose the interventional team’s long-term health at risk which calls for adequate radiation protection methods during interventional cardiology procedures. 

Deterministic risks associated with radiation exposure are well established. Termed as ‘exposure threshold’ for tissue injury, the effect of radiation differs at varying radiation dose range. For instance, exposure to a radiation dose of about ≈2 Gy can cause skin erythema while ≈5 Gy dose range can lead to permanent skin injury. Stochastic effects, including cancer, have a long latency period and the lifetime attributable risk is difficult to quantify. Because of the radiosensitivity of tissues, children have the highest risk, followed by adult women, adult men, and then the elderly.

 Role of Radiation Protection measures

 Medical uses of radiation result in the maximum number of occupational collective dose. Over the past several years, a spate of scientific evidence has demonstrated the health risks that interventional teams incur while performing life-saving minimally invasive procedures. The health effects range from skin erythema to premature ageing to cancer. Various studies carried by leading health organizations and regulatory agencies have also linked radiation exposure in health practitioners with various other diseases and disabilities. Studies have also made it clear that practical, safe solutions are needed to protect interventionalists and technicians from ionizing radiation who otherwise will have an increased risk of cancers and other malignancies. Protective steps

 “As low as reasonably achievable” (ALARA) is the guiding principle of diagnostic and interventional procedures that make use of radiation like interventional cardiology and fluoroscopy. It focuses on using protective equipment like lead aprons and other control measures such as distance from the radiation source. 

Use of Radiation Protection Products and Dosimetry

 The effectiveness of Radiation Protection Products rely on the willingness of HCPs to wear all the equipment for the duration of the procedure. Radiation Protection Aprons are an essential accessory worn by healthcare providers during most medical procedures involving ionizing radiation. They play a cardinal role in protecting the healthcare providers from the damaging effects of ionizing radiation generated by X-ray systems, C-Arm systems, Cath labs, Fluoroscopy Systems and CT. 

Protective lead Aprons with a thyroid collar is standard for radiation protection in Cath labs. Additionally, safety accessories such as Radiation Protective eyewear, Radiation Protection gloves, lead barriers, lead drapes mounted on the patient table should be used by interventional Cardiologists to minimize radiation dose accumulated over a time period. Other Radiation Protection accessories such as Head Shield, Gonad and Ovarian shields provide protection to vital organs exposed to radiation hazards and need extra attention, however not frequently practised in Interventional procedures.

 Guidelines also state using dosimeters by health practitioners to be worn under the apron as an additional safeguard if lead <0.5 mm is used. The rationale for wearing personal radiation dosimeters is that interventional HCPs will be restricted from procedures if monthly dosage limits are met or exceeded.

 Control methods 

Other protection methods include shielding and distance from the radiation source. There is an array of shields including equipment-mounted, ceiling- and floor-mounted available. But, research has shown that proper positioning of this equipment is essential to reduce radiation exposure, and that “gaps” between various ceiling- and table-mounted shields can occur.

 Distance from the radiation source is a core element of radiation exposure reduction. Recent advancements in robotic technology have enabled PCI to be performed behind lead-shielded equipment that is not at the bedside, i.e., at a distance from the beam, and the use of robotic systems have been shown to significantly reduce the amount of scatter radiation to which an operating physician is exposed.

 The utility of radiation safety

 The duration of radiation exposure, distance from the radiation source, and physical shielding are the key facets in reducing exposure. The exposure duration can be minimized in several ways. When exposing a patient to radiation, the technician or physician should preplan the required images to avoid unnecessary and redundant exposure. Decreased exposure can be achieved instead by using pulsed fluoroscopy, which obtains about five images per second without sacrificing imaging quality. Lastly, exposure duration should be limited whenever possible. 

The writer is president, Medical Imaging at Trivitron Healthcare Pvt Ltd.

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Health & Wellness


Dr Sumit Singh



Evolving lifestyle, unhealthy eating habits, adaptation to extended work-from-home routine and ever-transforming job culture have drastically influenced the sleeping patterns of Indians today. The risk potentials are such that insomnia- a sleep disorder in which a person faces trouble falling or staying asleep- is now emerging as an unrecognised health burden on the country.

   According to a report, the fear of insomnia increased from 19% last year to 24% this year, with Delhi NCR topping the list of cities where people are most worried about sleeplessness. Over 50% of Delhiites reported being anxious about suffering from insomnia. The 2021 report reveals that 42% of Gurugram residents complained about work keeping them up late at night. Last year, the corresponding number was 17%. Also, it is not surprising that people who used their phones just before sleeping was as high as 94 per cent in Delhi-NCR despite greater awareness about the perils of using electronic devices before bedtime. The report further says that the blurring boundaries between work and home have resulted in 81% of Delhiites feeling sleepy during work hours one to three times a week.

  Insomnia is a condition that can be acute or chronic. It can also come and go. The condition can be termed chronic only when it happens for at least three nights a week for three months or more. It is further categorised into two types- primary and secondary. While the former is not linked to any other health condition or illness, the latter can bring trouble sleeping due to health conditions like high blood pressure, obesity, depression, anxiety, asthma, arthritis, cancer, pain, medication, or substance use like cigarettes or alcohol, and many others. Binge TV watching, particularly the addictive TV serials & web series available on several OTT platforms, an impulsive attachment to social media platforms and peer pressure of catching up with the “new normal” of sleeping late are some added reasons for insomnia. 

  The condition not only impacts physical health but causes major mental health problems with symptoms like inability to focus, anger issues, depression, irritability, daytime fatigue, night terrors or bad dreams, waking up too early or throughout the night or taking hours to fall asleep. Studies show that sad or sudden events like accidents or traumas like job loss, exam results, death of dear ones, financial distress, chronic health conditions, etc. are some of the major causes of insomnia. Furthermore, disturbed sleeping patterns due to jet lag, work shifts, bad lifestyle choice also catapult sleep disorders. Restless legs syndrome, an overactive thyroid, sleep apnea, chronic obstructive pulmonary disease (COPD) also cause difficulty in sleeping.

 Today, insomnia can be diagnosed by doing a physical examination and by taking note of medical and sleep history. Patients are advised to carry a journal or a notepad for a couple of weeks to track sleeping patterns. In certain cases, special tests are also conducted at specialised sleep centres. While acute conditions may not require treatment, a doctor may prescribe sleeping pills for a very short time. However, it is always advised to not use over-the-counter drugs for insomnia which can cause side effects. Cognitive-behavioural therapy is also suggested.

  Insomnia can be stressful but the condition can be easily managed by making simple lifestyle changes and adopting a healthy “Sleep hygiene”. These include going to sleep at the same time each night and waking up at the same time the next morning, avoiding the use of phones or electronic gadgets before sleeping, avoiding caffeine, nicotine or alcohol, regular exercises, avoiding heavy meals, etc. Patients who find trouble sleeping should try to make the bedroom comfortable, dark & silent with a controlled temperature. Using eye masks and earplugs work wonders in controlling disturbing factors like light or noise. Reading a book, listening to soothing music or taking a bath also helps in falling asleep.

Today, lack of awareness and poor knowledge about insomnia has brought negative consequences on people’s health and well-being. Insomnia is a common condition and can result from various issues. Anyone who is battling this condition should see a doctor or a counsellor who can identify the root cause and recommend a solution for overall recovery.

The writer is the Chief Neurologist at Artemis Hospitals Gurgaon.

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Health & Wellness


Samira Gupta



In crisis situations, such as the one Covid-19 has created, children are more vulnerable to get trapped with feelings of anxiety and stress. Depending on their age and their personality, the response to this situation may be varied. Some may become overly affected and some may withdraw, some may become anxious, angry or agitated and some may live in denial while others would accept it.

With the surge in cases again, we have come back to where we were exactly a year ago. Due to the critical situation, maintaining health precautions is extremely important, hence the board exams for class 12th have been postponed and schools closed again.

While we understand that with exams postponed and schools closed again, children may feel disheartened, the following suggestions will help to ease their stress and anxiety:

1. Encourage children to indulge in activities that help them relax like painting, dancing, power yoga, Zumba or anything else. Even better, if you can join them! This would not only help them reduce stress but also strengthen their bond. If you could not make the most of the previous lockdown, this is your opportunity to do it.

2. Remember this is going to be an emotional ride. Children may feel frustrated, angry or sad. There may be instances where they thunder at you. Support them through this emotional journey. Help them accept the situation and that they have a choice to make – either to get stressed or focus on studying consistently each day.

3. Keep your children closer to you. Have regular conversations, become liberal and let them speak their heart. This will ensure that they do not withhold the stress inside. What children most miss is being able to speak with their friends. Take this situation as your opportunity to build a bond of friendship with your children.

4. Establish a daily routine. While this may be hard, it is critical! When children go to school, having a fixed schedule and tasks to do keeps them focused. With more time at home and fewer tasks to do, children might start to worry about their future or studies. A daily routine will help them stay motivated! Create a routine where they also participate in household activities and get time to play, study and rest.

5. Be mindful of the environment you create at home. Avoid strained conversations when children are around. Evaluate situations and try to co-create solutions with your family.

6. Help your children to focus on building themselves – emotionally, physically and/or psychologically. The pandemic situation will get under control because nothing lasts forever. When it does, you must have lessons and experiences you have learnt during this time to share with the world. These are going to be unique to you and help you grow.

7. The most important tip for parents is to ensure their personal well-being. Unless your cup is over-flowing, you will not be able to fill your child’s cup. Ensure that you eat well, rest well and give yourself enough time to rejuvenate from the personal and professional life.

8. Lastly, children follow what they see. Instructing your children will not create a sustainable change. How you conduct yourself and deal with stress is how your child will learn to do the same.

Many of us reminisce back to our lives before the Covid-19 pandemic and hope for things to go back to how they were while we simultaneously try to adapt to the new normal. This is bound to take a toll on our children’s mental health. As parents, guardians or caretakers, it is vital we keep our children engaged, focus on their nutrition and exercise and ease the transition to the new normal.

The writer is a Life Coach and Image consultant.

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Health & Wellness


It’s wise to be prepared for the hot days and scorching temperatures. And to help you with that, nutritionists share tips to cool down your body and mind this summer.



The summer season is here and the mercury is going to rise rapidlywith passing days. The heat can affect your body in various ways and lead to heat stroke and other health issues. So, it becomes crucial to take care of yourself, be mindful of your food and water intake. Consume summer foods and drinks which are hydrating, electrolyte-rich, and cooling for the digestive system. Curd, onions, mint, watermelon, cucumber, fenugreek and coconut water are some of the best options when it comes to summer foods. The nutritionists share how you can keep your body hydrated and mind fresh in the hot weather. Celebrity & Sports Nutritionist Ryan Fernando says staying hydrated is the key. “Consume fruit-infused water and green tea lemonade. To prepare the fruit-infused water cut the orange, strawberry, papaya, mosambi, watermelon, apple or pears into cubes or slices and mix it in two litres of chilled water and leave it for some time as the fruit infuses its flavour into the water and you can enjoy better-tasting water. Green tea lemonade is a concoction of concentrated green tea mixed with sweet or salty iced lemonade. Don’t forget to add watermelon and cucumber to your diet as these have high water content,” he mentions.

Talking about how ACs impact air’s humidity, Ryan points out, “During summer, people use AC but it strips the air of all its humidity and water content. If you are in a room with the AC on and a humidifier is measuring the humidity, it will be below 40% but when the AC is not on it will be 60%. So when you sleep or work in an AC room, you are losing valuable water from your body. During the day if you are sitting with the AC on, keep a water bottle or jug near you to stay hydrated. Before sleeping keep a water bottle at the bedside table to sip from it in case you get up in the night or have a glass of water before going to bed. Also, you can keep a wet towel or use a humidifier to ensure higher water content in the room.”


Staying hydrated with busy schedules is tough. We all know we need to drink more water but how much is enough? What if you don’t like the taste of water? Celebrity Dietician Shweta Shah replies, “The temperature is rising and you may be tempted with ice creams, sodas, juices but infused water with herbs, fruits, spices is a much healthier way to cool down your body. Detox water is not merely about good taste it’s much more than that. They not only energise you but helps in lifting mood, detoxify, and cleanse toxins. Lemon, mint, fennel, apple, cinnamon, cucumber, celery are some popular detox waters to beat the heat in busy schedules.”

Clinical Nutritionist Dr Megha Jaina believes it’s very important to keep yourself hydrated during summer as it can keep you mentally cool and physically refreshed. She says, “You can drink water-based beverages with every meal. It is recommended to consume fluids before you feel thirsty. Adding a slice of lemon to water may improve your immune system and promotes hydration.”

Dr Megha shares two healthy, easy and refreshing summer drinks:

Melon & Grape juice

Melon has a high content of water, which helps in hydrating our body.

Black Grapes are known for their antioxidants content.

Take one cup of muskmelon cubes, one cup of black grapes and two cups of water. Blend till smooth and the drink is ready.

Detoxifying Green Smoothie

Take one-third cup of spinach leaves, one apple, half teaspoon roasted jeera powder, juice of half lemon and one glass of water. Grind all and the drink is ready.


With the surge in Covid-19 cases, you should continue working towards strengthening your immunity. Whole food nutritionist Kajal Bhatia tells us some of the immunity-boosting foods you can have in summer. She says immunity and micronutrients are closely linked as they build gut strength and that’s what is needed for the body this summer. Kajal adds, “Increase the intake of plant foods especially antioxidant-rich fruits and vegetables in their whole form or smoothies, chutneys, salads dips etc. Fruits and vegetables rich in Vitamin C are great immunity boosters such as mangoes, grapes, papaya, kiwis, and dark green leafies especially spinach, lemons, bell peppers, and broccoli (if you don’t prefer taking broccoli raw saute or steam it).”

She emphasises increased liquid intake and consumption of fermented kanji and kombucha which are mineral-rich probiotic boosters. Foods rich in zinc and magnesium including sprouts, nuts, and seeds should be included in the diet.

Holistic nutritionist and founder of Saurasya Teas Vriti Srivastav, shares simple ways to boost immunity this summer :

Hydration: The very first step is to stay hydrated which most people struggle to keep up. In this pandemic time, we don’t want our organs to focus more on surviving in a dehydrated body than working on immunity. Drink at least 10 to 12 glasses of water. Also, prepare kadhas made from natural herbs and spices to boost immunity.

Eat natural to strengthen the gut: Your gut influences your immunity, emotional well-being, hormones and hence overall health. Consume a wide variety of nutrients by including colourful vegetables and fruits along with whole grains and pulses. The need for supplements arises today as all the processed foods and irregular lifestyle has hampered the absorption of nutrients in the gut. Squeeze fresh lime on your meals to add a dose of vitamin C. Give the gut a break from digestion by having an early dinner by 8 pm.

Here’s my mantra to a strong gut: fixed meal timings, eat natural, balance sleep-wake cycle, meditate and chant, exercise, hydrate, and include fibre.

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Health & Wellness


Dr Srividya Nandkumar



An insulin disorder that affects over 450 million people across the world, Diabetes Mellitus is one of the leading causes of death worldwide. In India alone, over 70 million people are estimated to be living with diabetes. Poor disease management and ineffective blood sugar control is a major risk factor for a series of life-threatening conditions such as cardiovascular, strokes and renal disease. In fact, diabetes is a major cause of vision loss, kidney failure, heart attacks, stroke and amputations. Worrisomely, the incidence of this lifestyle disorder has grown tremendously over the past three decades largely due to unhealthy lifestyles, increasing consumption of processed foods and a dramatic drop in physical activity.

Naturopathic interventions such as diet management, yoga, lifestyle alterations and acupuncture can play a significant role in controlling the diabetes pandemic. Adopting a naturopathic way of life not only helps patients keep their blood sugar level under control, but also help them reduce their dosage of allopathic drugs.

Acupunture as a diabetes control intervention

The widely used alternative healing practice of acupuncture dates back to more than 3500 years. This ancient Chinese practice is based on the belief that life energy also known as qi flows through our bodies through certain pathways, thereby regulating health and vitality. When the flow of this vital energy is obstructed due to some reason, the body experiences diseases. Acupuncture uses the practice of inserting pins and needles on strategic points on the body to remove the obstruction and revive the flow of energy through our organs. There are around 1000 acupuncture points in the human body. 

Acupuncture is an effective therapy for diabetes, especially for type 2 diabetics. It helps regulate pancreatic function and control blood sugar levels in the body. The result is better glycemic control and improved overall health. A study published in the Journal of Traditional Chinese Medicines in 2019 found that when administered along with metformin drug, acupuncture treatment helped significantly reduce levels of both FPG and HbA1c – two critical diabetes indicators – in patients. The study, therefore, recommended the use of acupuncture as an adjuvant therapy among Type 2 diabetics. 

Mainly two types of acupuncture practices are used to treat diabetes — electroacupuncture and wrist-ankle treatment. The former is the most common form of treatment in which needles are pierced at trigger points. Then a low-frequency electrical variation is transferred from one needle to another that helps fight insulin resistance. Wrist-ankle treatment is most effective in bringing down the sugar levels and focuses on deep stimulation of the trigger points. 

However, several myths and misconceptions about acupuncture prevent many people from receiving its benefits. We demystify some common myths related to acupuncture here.

1. It’s painful

The mere thought of needles being pierced into the skin leaves many people petrified, but acupuncture isn’t as painful as you think it to be. The needles used for acupuncture are very thin and you feel very little or almost no discomfort while they are inserted. Many patients don’t even realise when the needles are being pierced into their body. 

2. Doctors don’t recommend this 

The World Health Organization and National Institutes of Health have recognised acupuncture as an effective therapy for treating not just pain but also several other conditions like diabetes. A number of modern medicine practitioners also prescribe acupuncture as an adjuvant therapy along with the regular medicines particularly to patients displaying poor glycemic control. A number of studies have found acupuncture to be effective in controlling blood sugar levels.

3. It has side effects 

Acupuncture is absolutely safe when performed by a certified acupuncture practitioner. Side effects are almost negligible or only minor such as soreness, minor bleeding in some cases or dizziness. However, no serious adverse effect is associated with this therapy.

4. The treatment is expensive

Acupuncture is affordable and does not burn a hole in your pocket. On average, it costs around 1500 to 2000 Rs per session. Overall, the therapy may also help reduce dosage of diabetes drugs. 

5. You get addicted to acupuncture

No, acupuncture is not addictive or dependence creating. The practice does help relieve stress and calm down people but it doesn’t create any dependence.

The writer is Sr. Naturopath at Jindal Naturecure Institute.

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Health & Wellness


Kamayani Naresh



Over time, experts build a strong study of Rasayana – rejuvenation. They studied ingredients available in nature for well-being, immunity, and overall mental and physical health. Rasayanas are known to build the body to fight diseases of the mental and physical kind. These ingredients are also known to build immunity and protect the human body from infliction.

Here are remedies to boost immunity in your kids:

Golden milk: Children often fuss when drinking milk. Make it interesting for them and peg the usual haldi doodh or turmeric milk as Golden Milk. As you might know, Turmeric has anti-inflammatory properties and plays a crucial role in building immunity among children. It is also a staple in Indian cooking. As we use Turmeric in our daily cooking, an added supplement of Turmeric will positively impact your children’s health. 

Ashwagandha: It is one of the many researched Ayurvedic herbs. It is known to help with numerous serious diseases and ailments. It also has anti-inflammatory properties, which contribute to preventing autoimmune disorders, among others. Research has proven that it improves the functioning of brain cells and common mental health issues. Ideally, give your children this magic herb through warm and sweet milk. You can also add it with Turmeric milk to combine both herbs.  

Liquorice sweets: Liquorice or Mulethi is a herb that is commonly eaten as candy. You can find it at specialised stores or online. The candy is an acquired taste and has many health benefitting properties. The Glycyrrhizin – a saponin found in Liquorice is known for its anti-microbial action. Usually, this root is made into powder, mixed with honey and ghee, to improve immunity. It is a natural revitaliser and also effective as an anti-ageing remedy. 

Vegetable juices with ginger: Give your children vegetable juice with a generous amount of ginger. Ginger is used in Indian cooking, but may not be enough, to impact immunity. Ginger is efficacious in curing coughs and seasonal flu. Its anti-microbial compounds help fight infections and boost immunity. Local stores also stock a large amount of ginger candy that can also be made part of your children’s routine. 

Plant a Tulsi plant together: Tulsi, as you know, is a medicinal plant. It has healing properties and looks beautiful as part of the home decor. Involve your children in planting this plant with you, and together learn the importance of its medicinal properties. Use the plant leaves for wounds and burns. Show your kids how this plant can be used and also consume its juice daily. Allow your children to acquire the taste for it, and they will be build immunity to lead a healthy life. 

Observe your children, as every human body is unique therefore, your child will also respond suitably to different remedies. Preventika an immunity booster by Zyropathy is a combination of Tulsi Leaf, Turmeric, Bael leaf, Sheesham, Gudmar leaf, Arjuna Bark, Mint leaves, Motherwort and more ingredients. It is a healthy option for balancing a child’s immunity. The herbal medicine helps strengthen the internal systems, ensures health and works against 19-various ailments.. Many other remedies and herbs help in building immunity among adults and children. Ensure to learn and include them in your daily routine to protect your family from external harm. 

The writer is the founder of Zyropathy.

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Health & Wellness


Top healthcare experts and doctors share their inputs on all you need to know about Parkinson’s and ways to cope with this condition.




• Have full awareness of their condition. Also, your caregiver must be equally educated about the same

• You can use the voice option in their phone for any work rather than text mode• Exercise regularly to maintain balance, go for massages, and movement therapies

• Take medications on time and listen to your therapist

• Simplify your tasks and set realistic goals

• Plan your tasks like exercising, chores, recreation in advance• Avoid extreme physical activity. Do not push, pull, or lift heavy objects (more than 10 pounds) that require you to strain

• Do not eat too many sugary foods and drinks as these can negatively impact your immune system. Opt for naturally sweetened food and reduce your sugar intake

• To help prevent accidents, install grab bars beside toilets, sinks, and in the tub or shower area depending on your need

—By Dr Rajnish Kumar, Sr. Consultant & Unit Head, Neurology, Paras Hospitals , Gurugram


• Patients are unable to follow up with their neurologist; it is important that they continue to take their medicines regularly and if faced with worsening of symptoms or side effects related to the medicines they should try to contact the neurologist via telemedicine

• Patients with pre-existing Parkinson’s disease when affected with Covid-19 infection can have an exacerbation of the symptoms. They must be evaluated by a neurologist who can adjust the medicines and they should remain in touch with the neurologist whenever possible in person or if not via telemedicine

• Very rarely some patients with Covid-19 infection can present with features similar to Parkinson’s disease. These patients will need hospitalisation and thorough evaluation and treatment under the care of a neurologist.

April is Parkinson’s awareness month. It is the second most common degenerate disorder of the brain after Alzheimer’s disease that has devastating mental and physical implications on the patients who are left untreated otherwise. It is a progressive nervous system disorder that affects movement, says Dr Rajnish Kumar, Sr. Consultant & Unit Head, Neurology, Paras Hospitals, Gurugram.

Researchers suggest that Parkinson’s results from a combination of genetic factors and environmental factors such as exposure to toxins. It usually affects people aged 55 years and above.

—By Dr Prashant Makhija, Consultant, Neurology, Wockhardt Hospital Mumbai Central


On the challenges posed by the pandemic in treating Parkinson’s patients, Dr Anil Venkitachalam, Consultant, Neurology and Movement Disorders, Nanavati Super Speciality Hospital, Mumbai said, “Like every vulnerable section of society, Parkinson’s patients and their treatment was hugely impacted by the pandemic. An increase in requests for home visits was a particularly challenging task. Due to the co-morbidities and risks of infection, the patients were restricted to their homes. Despite the risks involved and the unavailability of necessary instruments and diagnostic paraphernalia, we took all safety precautions and honoured as many home visit requests as possible.”

 He adds, “The other challenge was the ‘loss to follow-up’ of our many patients. Several patients were on schedule H drugs such as anti-depressants or anti-psychotics etc. Due to movement restrictions, they couldn’t visit their physicians and renew the subscriptions. In the meantime, the pharmacies stopped honouring the old prescriptions or even new digital prescriptions and patients had to go on without medication for a long time. The hospital couriered hundreds of prescriptions to the patients so that they don’t stop the medication.”

Similarly, as February-March mark the financial year-end, many patients needed disability certification to avail the benefits announced by the government. Since they couldn’t get out of the house, the hospital team filled and mailed the necessary documents for the disability certification. Nanavati Super Speciality Hospital started online patient support group programs to offer holistic solutions and guidance to patients and caregivers.

 “Parkinson’s may not affect the patient’s immune system directly. However, in few cases, such patients may have other health conditions which may increase the risk of contracting the Covid infection. They are strongly advised to follow Covid appropriate behaviour,” asserts Dr Guruprasad H, Senior Consultant, Neurology, Columbia Asia Referral Hospital Yeshwanthpu, Bengaluru. 


  What are the symptoms of Parkinson’s? Dr Rajnish replies the condition is characterised by four cardinal symptoms: tremor (trembling) mainly in hands, arms, legs, jaw, or head; stiffness in the limbs and trunk; generalised slowness of movements and stooped posture; and impaired balance and coordination. “Early symptoms of Parkinson’s are subtle and occur gradually. Symptoms often begin on one side of the body or even in one limb on one side of the body. As the disease progresses, it eventually affects both sides. However, the symptoms may still be more severe on one side than on the other,” he adds. Mental and behavioural changes sleep problems, depression and anxiety, memory difficulties (Parkinson’s associated dementia), chronic fatigue, severe constipation, difficultly in urination, persistent dizziness, altered sweating, excessive salivation, altered smell perception, and dramatic fluctuations in blood pressure are some of the prominent symptoms which may need treatment.


Parkinson’s occurs when nerve cells, or neurons, in the deeper areas of the brain called ‘substania nigra para compacta’, that controls the movement, tone and coordination of the body, become impaired and/or die. Normally, these neurons produce an important brain chemical known as Dopamine that helps send signals in your brain. When the neurons die or become impaired, they produce less dopamine, which causes the disease, informs Dr Rajnish. He points out that since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible. 


There are several myths associated with Parkinson’s. Talking about it, Dr Guruprasad says, “It is believed that everyone with the condition will have tremors, there is no treatment for Parkinson’s, and it is a mental disorder among others. It is a neurological condition and not everyone will experience tremors. Few patients may show other symptoms like balance issues. The advancement of technology has given way to new treatment techniques like deep brain stimulation with directional leads and pump delivered therapy for the management of the condition. Parkinson’s can be managed with medications and lifestyle changes.”


On how to manage this condition, Dr Guruprasad says, “Exercise, balanced diet, rest, speech therapy and physical therapies will aid in the management of Parkinson’s. The patients should follow Covid appropriate behaviour. Medications are the important factors to control physical and mental symptoms affecting the people with this condition. Taking the medications regularly, following an indoor physical activity regimen, and engaging in hobbies will be beneficial for them.”


Early detection of the disease and starting treatment is very essential, as it drastically changes the quality of life of a patient and arguably, also impedes the rate of progression of the disease. Although there is no cure for Parkinson’s, medicines, surgical treatment, and other therapies can often control the symptoms, informs Dr Rajnish.

Adding to it, Dr Prashant Makhija, Consultant, Neurology,Wockhardt Hospital Mumbai Central says, “Since Parkinson occurs due to progressive loss of nerve cells in the brain which produce Dopamine, the treatment is directed towards external replacement with Dopamine in the form of tablets or with medications that facilitate the action of internally produced Dopamine. The non-motor symptoms (such as sleep disturbances, constipation, memory as well as mood and behaviour changes) are symptomatically managed. Patients also require gait/balance training and speech/swallow therapy. Owing to the multiple issues the patients face, they need to be periodically evaluated by a neurologist who can titrate the medicines to provide them optimum benefit while minimising the adverse effects related to the medicines.”

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