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WARNING SIGNS: LONG-TERM EFFECTS OF COVID-19

Do coronavirus-infected patients recover completely? For the majority of them, symptoms become clear after about two weeks, but some experience persistent health problems for weeks and months, warn doctors.

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The impact of Covid-19 is being seen on patients’ lungs, heart and brain, even after recovery. This is raising questions about the risk of long-term health problems due to the infection. The elderly and those with serious medical conditions are most likely to experience lingering Covid-19 symptoms, but it can also happen to people of all ages.

A recent study by King’s College, London, using data from the Covid Symptom Study App and health science company ZOE, showed that 1 in 20 people with Covid-19 is likely to have symptoms for eight weeks or more. This study suggests that prolonged Covid-19 affects around 10% of people in the age group of 18-49 years who were unwell with the virus. “The Covid Symptom Study App has released key findings on long Covid-19 that show that older people, women and those with a greater number of different symptoms in the first week of their illness were more likely to develop long Covid-19. Around 1 in 7 had Covid-19 symptoms lasting for at least four weeks, with around 1 in 20 staying ill for eight weeks and 1 in 50 suffering for more than 12 weeks,” said Dr Claire Steves, a clinical academic at KCL and lead scientist at Covid Symptom Study App.

Dr Ravi Gupta, Cardiologist at Wockhardt Hospital, Mumbai Central, says, “Covid-19 survivors may face a range of problems. Patients with comorbidities like heart conditions or even diabetes should be extra cautious as it can give a tough time to your heart by increasing the risk of problems like angina, chest pain, heart attack, or even heart failure.”

Various studies also show the potential impact of Covid-19 on the neurons, putting those with neurological ailments at an elevated risk. Dr Jaideep Bansal, HOD- Consultant, Neurology at Saroj Super Specialty Hospital, Delhi says, “People with pre-existing conditions or undergoing treatment for epilepsy, Parkinson’s Disease, or those who have had a history of a stroke attack, may be highly vulnerable to elevated symptoms like seizures, loss of steadiness, dizziness, impaired consciousness, cognitive impairment or even loss of smell and taste.” Dr Anil Ramakrishna, Head of Neurology at Columbia Asia Hospital Hebbal, Bengaluru, says, “The neurological complications post Covid-19 are strokes, where patients present with weakness of a hand or legs, and paralysis. This is because the coronavirus can cause damage to the blood vessel cells which can then activate the coagulation pathway and inflammation-causing blockage of the vessels and sometimes rupture the vessels causing a stroke.” He explains, “Some patients post Covid-19 can experience tingling, burning, pain in the hands and legs because of the damage to the nerve, which is called neuropathy. Few patients may also have post-viral encephalitis because of the infection or the inflammation of the brain cells, where patients present with irritability, behavioural issues, restlessness and sleep issues. Few patients may also develop seizures. After Covid, myelin, the covering of the brain and spinal cord, can also get damaged.”

“India is likely to witness a second wave of Covid-19 in the upcoming months. Lower winter temperatures and the rise in pollution levels caused by the burning of crop stubble in North India could lead to a rise in Covid-19 cases. Typically, asthma and COPD (chronic obstructive pulmonary disease) infections are known to go up at this time of the year. People who have recovered from Covid-19 remain particularly susceptible as their lungs are still weak. Therefore, wearing masks and following social distancing norms are a must during this period and will not only help to avoid coronavirus but respiratory infections as well,” advises Dr Gurpreet Sandhu, president of Council for Healthcare and Pharma, a global think tank.

According to research, led by Xiao Wu and Rachel Nethery at the Harvard University T.H. Chan School of Public Health, an increase of just 1 microgram of particulate matter per cubic metre corresponded to a 15% increase in Covid-19 deaths. “Chronic exposure to air pollutants has been associated with lung ACE-2 over-expression which is known to be the main receptor for SARS-CoV-2. Air pollution may affect a person infected with Covid-19 as their lung functions could remain compromised for a while. A possible link between air pollution exposure and Covid-19 related deaths, no matter how small, should be an indication that air pollution needs to be urgently tackled,” opines Dr Yash Javeri, Head, Critical Care, Anesthesia & Emergency Medicine at Regency Super Specialty Hospital, Lucknow.

“With stubble burning in the northern plains, plus the winter setting in, the air quality has worsened considerably from low two digits to high three digits. It was around 30-40 in the days of the lockdown, but now, it is nearing 400. And with worsening air quality and increasing air pollution, the compromised lungs of post-Covid patients are even more susceptible to infectious diseases such as pneumonia, superadded bacterial and viral infections. So, we need to be very careful,” says Dr Shuchin Bajaj, a volunteer doctor at StepOne, the telemedicine platform that is helping Covid-19 patients with the state governments.

In winter, in addition to outdoor pollution caused by industries, cars and stubble burning, we also have increased indoor pollution, be it through incense sticks, mosquito coils or other items. Closed doors and windows in winter also lead to indoor pollution rising significantly. Dr Shuchin Bajaj asserts that we need to be very careful and take care of our lungs, throat and respiratory system in the days to come. Moreover, weakened lungs after Covid recovery coupled with high pollution can leave a person susceptible to re-infection by the coronavirus too.

“Anxiety is frequently being seen in patients recovering from Covid-19. The unpredictable nature of the illness and the diverse nature of complications can also be a source of constant rumination and worry for Covid survivors. Major psychiatric disorders such as depression and Post Traumatic Stress Disorder (PTSD) may also get precipitated due to the stress associated with the diagnosis, the unfamiliar experience during admission and the treatment process,” says Dr Kedar Tilwe, Psychiatrist at Fortis Mulund & Hiranandani Hospital, Vashi. Showing support, helping them overcome negative thoughts by letting them vent, relaxation exercises and mindfulness practices are some of the ways in which loved ones can help Covid patients. If needed, the help of mental health professionals should be sought.

SYMPTOMS CORONAVIRUS SURVIVORS SHOULDN’T IGNORE

• Fever, cold, throat pain, body ache, vomiting, diarrhoea, loss of smell, loss of taste, allergic rash, breathing difficulty, leg pain, backache, feeling unwell, headache, giddiness, loss of appetite, tingling in hands and feet, a stroke-like presentation which can mimic a heart attack, difficulty to walk or limb weakness, intermittent fever, chest tightness, blood in sputum, bluish toes and fingers. If one notices these symptoms, they must not ignore them and immediately consult a doctor.

• Neglecting any of these symptoms can be risky. Also, make sure that one takes all the medications prescribed by the doctor and goes for regular follow-ups post Covid. Self-medication is a strict no-no.

• Covid-19 creates havoc on one’s health and constant monitoring is needed to minimise its impacts, because they can range from being moderate to severe and land a person in the hospital.

• It is a known fact that though coronavirus is a respiratory illness, it can also have a negative impact on other body parts.

• Eating a well-balanced diet and exercising daily is important. It is advisable to stick to a healthy lifestyle and follow the Covid-19 protocol: washing hands properly, maintaining six feet distance, and using a handkerchief while coughing and sneezing.

—By Dr Manjusha Agarwal, Internal Medicine Specialist at Global Hospital Mumbai.

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Health & Wellness

IMPORTANCE OF RIGHT COVID SAFETY GEAR GIVEN THE ADVENT OF THIRD WAVE

Hemant Sapra

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The pandemic is not over yet and global experts predict the upcoming third wave to be more dangerous. The breakthrough we achieved by developing the vaccines of high efficacy certainly brings hope and optimism. Unfortunately, for everyone to get vaccinated and gain complete immunity against the Covid-19 would take a long time. So, let us not be complacent during this critical stage. Now, it is a crucial time to increase vigilance and to adhere to the safety measures without any lapse.

STOPPING THE SPREAD STARTS WITH TAKING THE RIGHT STEPS

According to healthcare experts, the third wave of Covid-19 may hit India by the end of this year. The previous waves have renewed the panic amongst people, making them think harder on how to keep themselves safe from the virus. It is widely proven that selecting and proper using of right PPE can prevent you from the third wave of Covid-19 and even upcoming waves. So, wearing protective gear such as a face mask, face shield, gloves, kits etc., can protect you and those around you, even if you are fully vaccinated.

Stopping the spread starts with taking the right steps. As responsible manufacturers of personal protective equipment, it is our duty to provide the most accurate information to educate users with the right tools of safety.

HOW TO CHOOSE THE RIGHT FACE MASK

Your face mask not only protects you but also helps protect those around you. One of the biggest challenges faced by users today is the quest to find the right mask.

Let us begin by understanding the difference between cotton masks, surgical masks and N95/FFP2 respirators. A cotton mask is a loose-fitted mask that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. A surgical mask is a 3-ply mask meant to be used by medical personnel during procedures. N95 or FFP2 respirators, on the other hand, are personal protective equipment that protects the wearer from airborne particles and aerosols from entering the respiratory system.

The first step in selecting the right face mask for any user is to look for the correct certification on its packaging. In India, ISI Marked FFP2 certification is the most important to look out for. N95 is an American Certification provided by NIOSH (certifying body based in the USA) which is the equivalent to the ISI FFP2 standard. Both these certifications claim 94/95% filtering efficiency, which is most suited for protection against coronavirus.

The next important criterion is the mask should completely seal the mouth and nose to prevent any air leakage. The nose clip should be flexible enough to take the shape of the nose and you should be able to breathe properly.

An N95 or FFP2 Mask is recommended to be used for 12 cumulative hours. The mask can be reused multiple times until 12 hours of usage is achieved. After use, it should be properly disposed-off in a closed bin by tearing off its loops or headband to prevent reuse. Please refrain from washing the mask as it destroys the filtering fabric thereby making it ineffective against coronavirus.

Face masks when used in combination with other personal protective gears, can provide the most effective protection from any of the waves of Covid-19.

THE TAKEAWAY

We need to emphasise and promote practising safety protocols including social distancing, maintaining hand hygiene and wearing face masks even after getting vaccinated. Pandemic or not, face masks are here to stay and should consciously be made a part of our lives for the good health and safety of our loved ones.

Many started considering the third wave lightly and started showing utter disregard for the precautionary measures. Considering the speed of spread, we should not forget that the only way out is to obey the rules and wear the right certified PPEs. And most importantly, get vaccinated at the earliest since it reduces the possible complications in case you contract the virus. Encourage your friend and family also to take the vaccines without delay and to continue following the safety measure.

The writer is Co-founder and President, Global Marketing at KARAM Group and President of Safety Appliances Manufacturing Association (SAMA).

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ARTHRITIS AND OSTEOPOROSIS HAVE ADDED TO CRIPPLING THE ELDERLY DURING THE PANDEMIC

Dr Lavindra Tomar

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It has been increasingly witnessed in the elderly that they are more vulnerable to Covid-19, and this is compounded by the fact that they also have poor outcomes for survival. A higher risk has been associated with comorbid pre-existing medical conditions. The elderly with pre-existing arthritis and osteoporosis have progressed to debilitatingly painful symptomatology during the Covid era.

Sedentary lifestyles and poor exercise tolerability have increased the risks significantly with the deterioration of already pre-existing medical ailments. Reluctance for consultation due to lockdown restrictions, societal pressures to remain homebound to avoid Covid exposure, fear of affecting family members and re-allocation of resources in hospitals have all contributed immensely to the delay and initiation of timely management for arthritis and osteoporosis.

The Covid vaccine diplomacy along with the early vaccine hesitancy has also contributed to the fear of psychosis amongst both the educated and uneducated masses of the population.

Add to the above, surgical procedures and arthroplasty have been delayed in the management of arthritis.

The rescheduling of surgical replacements has presented now with multi-fold additional challenges in these times of the Covid pandemic. Poor chest compliance, lower exercise tolerance, thrombotic episodes, susceptibility to secondary infections, weak cardiac health have significantly increased risks in the elderly planned for elective surgery. The pre- Covid fit elderly population has now been graded as high-risk candidates for procedures.

Off-label use of drugs such as steroids, antivirals, DMARDs, immunomodulators, and plasma therapy for the management of Covid related illness has also had deleterious effects leading to a silent disaster-in-making. Significant alterations to an individual’s immune system, decreased glycaemic diabetic threshold, susceptibility to uncommon inflammation or infection including fungal and variability of inflammatory markers have confounded the clinician’s judgement. The diagnostic dilemma and unconventional treatment protocols have delayed the timely offer of surgery for the arthritic joint.

The contagious evolution of the Covid pandemic poses new challenges in the surgical management of joint arthritis. Personal observation suggests that there has been a 40% decline in replacement surgeries with additional delay in rescheduling of the planned surgeries. There is an urgent need to identify the crippling effects of arthritis and osteoporosis in the elderly to provide timely management.

The writer is Director & Unit Head, Department of Orthopaedics Max Super Specialty Hospital, Patparganj.

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WHY YOU NEED TO ADDRESS DIABETES DISTRESS

Positively accepting the diagnosis through proper counselling can help overcome diabetes distress and lead to better outcomes.

Dr Arbinder Singal

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A diagnosis like diabetes can bring with it some amount of distress because most of the time it comes as a shock to many people since the condition is asymptomatic. But a recent survey done on 250 people with diabetes by a team of psychologists at Fitterfly saw that 83% of people were willing to bring in desired behaviour changes to take charge of their health and bring down blood sugar levels. With proper counselling and education about the condition, about 70% of people felt motivated enough to stay on the prescribed course of treatment and attain healthy habits. This also shows that positively accepting the diagnosis through proper counselling can help overcome diabetes distress and lead to better outcomes. This is the first-ever diabetes distress survey done in India. 

THE DANGERS OF TOILING WITH DIABETES DISTRESS 

While most of us don’t speak much about the psychological impact of diabetes, this kind of distress is genuine and overwhelming. Diabetes distress can also manifest in different ways :

Emotional distress: Making one angry, frustrated, guilty, or panicky

Physician distress: Unhappy with a physician due to lack of time spent or inability to express one’s fears and concerns 

Regimen distress: The continuous monitoring of blood sugar levels, diet watch and exercise, taking timely medication and more

Interpersonal distress: Problems between partners or limited involvement in family matters 

Diabetes distress has been associated with poor self-management and increasing levels of HbA1c. Many people give up too soon and stop taking insulin or oral medications. Uncontrolled diabetes distress can lead to diabetes burnout, with high sugar levels turning it into a life-threatening incident. While it is natural to feel distressed after a diagnosis, it isn’t advisable to deal with it alone. Sometimes one needs considerable help to overcome this feeling. 

It is critical to identify the signs of diabetes distress to reign control over the same. Here are a few signs that indicate diabetes distress: 

• Feeling angry about the diagnosis and frustrated about managing the same

• Worrying about not being capable of managing diabetes well 

• Being fearful about the complications or fearful of being dependent on medications 

• Avoiding going to appointments or checking blood sugars and being in denial 

• Making unhealthy food choices or indulging in emotional eating 

• Feeling alone, dejected or isolated

GET HELP BEFORE IT IS TOO LATE 

If you feel any of the above signs, get help immediately. Diabetes distress is not depression, but if ignored for long, it can lead to the same. In such a scenario, the consequences can be disastrous. Depression interferes with the ability to think clearly. It causes indecisiveness and the inability to perform tasks like taking the medications and meals on time, exercising, etc. Depression causes a rise in a stress hormone — cortisol, which interferes with glucose metabolism, increases insulin resistance, and causes accumulation of belly fat. It is ideal to get help before one reaches this stage. 

WHAT YOU CAN DO 

Pay attention to your feelings and act promptly: Rather than feeling frustrated, try to concentrate on the positives that can be controlled. Plan for a reversal if possible, or take control of your lifestyle choices to lessen the risks of complications.

Talk to other people who have diabetes: Alternatively, you can also check for support groups and share your struggles and coping strategies. Reaching out to people always has a positive impact on one’s mental well-being. 

Indulge in therapies that give you solace: Whether journaling your feelings or art therapy, or other hobbies that help you stay motivated, indulge in them to keep your mind agile and upbeat. 

Trust your near and dear ones: Most of the time, when you are in denial, you reject the support from your family and friends. But don’t, if you have trusted people around you, talk to them about your feelings (to relieve the stress) and don’t deny the help they extend to you, whether it is moral support or reminding you about your medications. 

Look for expert help: Sometimes, it gets overwhelming to counter diabetes distress all alone; in such a case, reaching out to an expert is an ideal solution. With DTx programs that promise highly personalised care and a holistic approach to diabetes, mental well-being is taken into consideration along with nutrition therapy and exercise plans for better outcomes. Fitterfly’s DTx diabetes care program – Diabefly focuses on psychological well-being for people with diabetes along with a proper nutrition plan and exercise regime. A proper psychological intervention can help one:  

• comply with the treatment plan

• adhere to diet and exercise routines 

• be timely with medication

• practice proper sleep hygiene

• positively control emotions and reduce stress levels 

• have a positive outlook 

• focus on healing and reducing risks of diabetes complications

Studies have also shown that better control over diabetes distress leads to better glycemic control and blood sugar levels. A positive mind is imperative in proper diabetes control and management.  

The writer is CEO & Co-founder, Fitterfly. 

Diabetes distress has been associated with poor self-management and increasing levels of HbA1c. Many people give up too soon and stop taking insulin or oral medications. Uncontrolled diabetes distress can lead to diabetes burnout, with high sugar levels turning it into a life-threatening incident. While it is natural to feel distressed after a diagnosis, it isn’t advisable to deal with it alone. Sometimes one needs considerable help to overcome this feeling.

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BEYOND MEDICINE: THE ART OF SELF-HEALING

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Medicine has limitations

Nutrition has limitations

Exercise has limitations

But, the human mind and body? Limitless.

Doctors don’t heal you. Medicines don’t heal you. Nutrition doesn’t heal you. Pranayama doesn’t heal you. Your body heals you. What heals a fractured bone that’s put in a cast? Your body again! Doctors, nutritionists, medicines, superfoods, all of this can create an environment that’s conducive to healing, but it’s your own body that does the magic.

So, while you continue to take medicines, foods apt for you, advice from your nutritionist, what are some of the things that lie in your capacity? Let’s go through some superpowers you already have so you can put them to use.

YOUR OWN ATTITUDE

Most people struggling to reach their goals have the wrong attitude. The attitude of an individual is as important (if not more) than the drug and the treatment. Yes, no one likes to be told that or hear that they lack the right attitude. But those who realize this, accept it and start to make changes, the magic begins to flow into their lives.

When someone is struck with a disease or illness, you do not throw your life and body into the hands of your doctors and healers. You must involve yourself in the process of healing. When you are not involved, you put full responsibility on your doctor or healer, you open up the doors to blame, complain, find fault, judge and all this only goes against creating a conducive environment for healing. Yes, your experts can put in their knowledge, wisdom and experience to bring you back to normalcy, but it cannot work effectively if you do not equally participate.

The worst attitudes are those of blame, complaining and ungratefulness. These attitudes poison you, rusts your soul, robs you of happiness and weighs you down like an anchor.

To have the right attitude you should also be able to have trust and faith in the team that is treating you. If you can’t feel that faith and trust, it is important you change the team that is handling your health and life. Nothing works without faith, trust and belief.

YOUR MIND

Our mind is the most powerful drug that we have, however for it to become our best asset or biggest enemy is totally under our control and that can be achieved by controlling the quality of our thoughts. Simply changing the way, you think and taking charge of what occupies your mind, can improve your physical health and well-being.

More and more studies done around holistic health today prove that human beings are more than just the physical body and that emotions, thoughts, attitudes, and spirituality play an essential role in healing. No amount of healing can occur if our mind believes otherwise. Healing starts the very moment we believe we can heal. This is why when we consult our patients, our first question to them is – Do you believe your health can improve? If they say – yes, we know the next few months are going to be successful. If they say – no, then we put in the effort to first work on their mindset.

We handle so many cases of cancer as of today, but no two cancer cases of the same type and stage respond to the treatment in a similar way. One reason could possibly be that everybody is different and unique and the second one is the mind. While some approach the disease with a positive attitude and mindset, some lose hope completely – which automatically reflects on their response to the treatment.

FORGIVENESS

Today, science proves the connection between unforgiveness and its effects on our health. Something as small as the inability or unwillingness to forgive can cause immense stress in the body and suppress our immune system.

While you can continue taking medications for anxiety and stress, none of that truly addresses a problem at an emotional level which might probably be caused due to your inability to forgive. Let go. Release all the grudging you are holding onto. You too have been forgiven by others several times. So, what is holding you back from not forgiving others? Do it for you, and see how smoothly that emotional burden lifts off your chest, and your health improves. Yes, it’s not easy, but difficult does not mean we do not try.

The list of self-healing tools is endless because there is so much an individual can do beyond their usual protocol to assist their own healing and health. It doesn’t matter if you are white, black, brown, man or woman, child or senior. It doesn’t matter if you are Muslim, Hindu, Sikh, Jewish. These powerful self-healing tools remain the same and hold the same values. You can spend a fortune on medications and treatments, but at the end of the day, it becomes our personal responsibility to participate in the process of healing and getting better. Know that you have immense power in you, which is beyond medicine to enable a healing internal environment and restore your health. Use them well.

The writer is a Holistic Lifestyle Coach – Integrative and Lifestyle Medicine and Founder of You Care – All about You.

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SATTVIC FOOD AND ITS IMPACT ON FMCG SECTOR

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Sattvic diet has its origins in Ayurveda. Those who follow and live a sattvic lifestyle fundamentally consume all-natural nutrition-rich foods, consisting primarily of fresh produce and nuts. The Sattvic diet is a high fibre, low-fat pure vegetarian diet associated with a predominant intake of micronutrients.

As per Ayurveda, shifting to a Sattvic lifestyle and diet is the best choice for enhancing longevity, physical energy, and mental health. A Sattvic diet is abundant in fresh, nutrient-dense foods. All the ingredients in a Sattvic diet provide your body with a healthy source of protein, healthy fats, fibre, vitamins, minerals, and antioxidants.Also incorporating a sattvic diet has been proven to promote a clearer mind, help free the body of built-up toxins, thus, purifying both the body and mind.

The sattvic diet is nutritious as 40% of the diet involves raw vegetables and fruits in salads. Consuming natural fresh foods delivers all the necessary nutrients, dietary fibre, antioxidants, proteins, minerals and healthy fats. Furthermore, promoting the body’s immunity and supporting a more robust immune system.

Composed primarily of low carbs and calories, the ingredients in a Sattvic diet are loaded with vitamins, minerals, and proteins. Also sattvic food is generous in fibre, which helps in reducing calories and retains the feeling of being content and well-fed after mealtimes. Thus, Sattvic food promotes weight loss.

Being on a sattvic diet involves consuming fresh foods. Vegetables and fruits have the highest nutrients, minerals, and fibre when consumed raw. Thus, promoting easy digestion ensuring wholesome absorption of nutrients. A simplistic approach to understanding toxicity in your body is to observe how often you feel bloating, headache, skin rashes, fatigue or nausea. Switching to a sattvic diet can help detox and heal your body. The sattvic diet is packed with goodness that promotes the balance of the body and mind.

With sattvic lifestyle showing visible benefits, more Indians are shifting to a vegetarian, pulses, legumes, and lentils-rich diet. This has contributed to the surge in the income generated by the FMCG sector in the country. Moreover, the sudden change in the working world and work from home becoming a reality for many has led the FMCG sector to experience a transformation.

The past year saw an unexpected development in homegrown brands that promise to deliver chemical-free, all-natural FMCG products. Many people shifted their preference from big brand names to more modest newer brands and products.

The efficiency of selling their products digitally or via social media made the private labels brands obtain a substantial market size moderately quickly. Furthermore, building an association with their target audience through brand ambassadors has helped private and notable brands in the FMCG sector make sales in the past year.

To add to the surge in sales via online platforms, most FMCG brands started delivering their goods straight to the customers’ doorstep. Thus, making consumers rely more on those brands that offered a home delivery option.

With the increase in income per household and social media platforms highlighting the lifestyle of others, there has been an escalation in interest and purchasing capacity of branded FMCG products that help sustain a healthy and sattvic lifestyle.

Growing acceptance, more convenient access, and enriching lifestyles are the primary growth operators for FMCG products and a sattvic diet.

The writer is CEO and MD, Annakoot by ISKCON Bangalore.

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DIAGNOSIS AND TREATMENT FOR THYROID CANCER

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The present sedentary lifestyle habits have given way to multiple health concerns. One of the most common among them is thyroid disorder. We often come across a lot of women and men facing thyroid issues regardless of age but are little aware of thyroid cancer. Thyroid cancer is an unusual form of cancer that grows in the thyroid cells. The thyroid gland secretes a hormone called Thyroxine which is required in the regulation of the body’s metabolic rate, cardiovascular, neural, and digestive functioning. It functions through almost every cell of the body.

A genetic (mutations) change in the cells of the thyroid gland leads to thyroid cancer. Because of these mutations, the cells grow and develop rapidly and they also lose the ability to die, as normal cells. The exact reason for thyroid cancer in the majority of the cases has not been delineated. The most important cause is radiation exposure. It is also common among patients who got radiation treatment for other diseases like lymphoma at a younger age. Usually, thyroid Cancer is manifested after a gap of 15 to 20 years. Other genetic mutations have been identified but the exact cause for most of these mutations has not been explained.

SYMPTOMS 

• Pain and swelling in the neck

• Hoarseness

• Difficulty swallowing

• Cough

• Weight loss

• Trouble breathing

• Fatigue

Other symptoms include swelling over bones, headache, seizures, and respiratory distress due to lung involvement etc.

DIAGNOSIS 

Ultrasound examination of the neck and fine-needle aspiration cytology are the basic investigations, which are administered to confirm thyroid cancer. In advanced cases, Computerised tomography, iodine scan or positron emission tomography (PET) is done. Iodine scan is mostly done after thyroidectomy to observe any residual thyroid tissue and distant metastases.

TREATMENT 

Thyroid cancer is normally treatable, even if the case is at an advanced stage and some effective treatment options ensure a great chance for a recovery. Surgery is the most important step in the management of thyroid cancer. Complete removal of the thyroid gland called thyroidectomy is the initial treatment procedure. If imaging suggests the involvement of surrounding structures or lymph nodes, those structures and lymph node dissections also needs to be planned to eliminate thyroid cancer. 

RADIOACTIVE IODINE THERAPY POST-TREATMENT

Radioactive iodine therapy is used to ablate (destroy) any thyroid tissue not removed by surgery or to treat some types of thyroid cancer that have spread to lymph nodes and other parts of the body.

After the surgery, the patient undergoes a scanning called radioiodine scan to know about any residual thyroid tissue or thyroid cancer in any part of the body. This must be done after thyroid gland removal, as in the presence of the thyroid gland, most of the iodine will be taken up by thyroid follicular cells and the scan will be negative for other deposits. Usually, it is done three to four weeks following thyroid removal. It may be normal or residual tissue detected. 

PREVENTION

Thyroid cancer can be prevented by avoiding unnecessary exposure to radiation, including emission from medical imaging procedures, especially in young children. Genetic tests can be administered to detect the gene mutations found in familial medullary thyroid cancer (MTC). Due to this, most of the familial cases of MTC can be treated early by removing the thyroid gland. 

A healthy lifestyle routine plays an important role in detecting cancer in its early stage. This ensures timely diagnosis leading to effective treatment and management of the disease. It is always advisable to eat healthily and stay fit which will eventually improve the body immunity. Overall, thyroid cancer is completely curable in the majority of patients even in advanced stages and standard guidelines are available. 

The writer is a Consultant Surgical Oncologist, HCG Panda Cancer Hospital.

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