Hepatitis E Virus (HEV) causes acute hepatitis and is a hepatotropic pathogenic virus. Due to insufficient sanitation, this infection is endemic in several impoverished nations, especially in India. HEV infection is one of the leading causes of acute viral hepatitis. This disease is mainly spread orally by contaminated drinking water. World Hepatitis Day is observed on 28 July every year, to raise awareness of the problem of viral hepatitis and how viral hepatitis impacts over 354 million people worldwide.
In India, HEV genotype 1 and genotype 2 which is mostly responsible for the cases of viral hepatitis and is feco-orally transmitted. Viral hepatitis has been a major public health problem in India. HEV infection is responsible for most of the pandemics that have occurred in India and is responsible for 30% to 70% of the sporadic cases of viral hepatitis and the major cause of acute liver failure. It has been observed that viral hepatitis is the most common cause of jaundice during pregnancy and causes HEV infection. Classically acute viral hepatitis occurs during the second and third trimesters of manifesting with malaise and jaundice.
It is not clear why HEV infection has a predilection to occur specifically during pregnancy. Severity had been attributed to the variable immune response or hormonal factors. Many patients are contemplating whether the occurrence of viral hepatitis has a safe course during pregnancy. Most of the patients with viral hepatitis during pregnancy will recover within four to six weeks of the onset of jaundice. However, these patients need to be instructed that they should continue to be under the supervision of physicians and gynaecologists till jaundice settles down clinically and biochemically.
The liver function tests and serological tests (IgM anti-HEV) are the key tools for the diagnosis. In India, HEV infections (genotype 1 and 2) have a fulminant course during pregnancy compared to developed countries where genotypes 3 and 4 are believed to have mild disease. The follow up of the cases during pregnancy is needed to detect complications like acute liver failure, stillbirth and eclampsia, postpartum haemorrhage. Those cases of viral hepatitis during pregnancy that have a severe downhill course, the outcome is associated with premature delivery, stillbirth and abortions.
If there is any indication that the patient has persistent vomiting and altered mental status, it indicates the possibility of acute liver failure and the patient needs immediate hospitalisation and with intensive care, they may recover.
In such a situation the physician and the patient should understand that the termination of the pregnancy does not alter the course of the disease. Early liver transplant has been carried out in some centres even for patients of ALF during pregnancy. This is also possible in some of the centres involved in liver transplantations in India. All patients with viral hepatitis during pregnancy should be advised to have hospital delivery. In conclusion, though viral hepatitis cases during pregnancy may have a safe course, yet it needs close monitoring to detect complications that could be effectively treated.
The writer is a Senior Director & HOD – Gastroenterology, Max Super Speciality Hospital, Vaishali.
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Skincare tips for new mothers and their babies
Motherhood is a blissful period in the life of every woman, however, being a mother we are so focused on the child that our needs tend to take a backseat. While post-pregnancy looks and changes in skin texture is not a bad thing, however, not taking care of your skin may result in a variety of changes such as melasma, acne, stretch marks, and puffy eyes.
At the same time, it is also important to look after baby skincare needs as their skin is sensitive and gets exposed to harsh environments such as pollution, chemicals.
Here, we bring top skincare tips for new moms to get glowing skin post-pregnancy.
It always pays to be organised, to begin with, keep all your skincare needs in one place as it helps to better take care of yourself rather than wasting time looking for essential things. Make optimum use of your ‘Me time’ and manage it properly to pamper your needs.
HAVE A ROUTINE
• Our skin undergoes a renewal cycle by dispensing toxins and debris as we sleep, so it is important to cleanse your skin thoroughly with a face wash suitable for your skin type before you hit the bed.
• Steaming is another important step of your skincare routine, take steam for two to three days a week as it will help to open up your clogged pores.
• Facial scrub removes the dead skin and helps make your skin softer and radiant. Scrub your face for five minutes and wash it with tap water.
• A toner forms a vital part of skincare for new moms. Look for toners that help to maintain the pH value of your skin.
• Moisturising your face is the last step to give hydration
Baby products being mild in nature are ideal for new mothers as well. They are created in such a way as to lock moisture in the baby’s skin, so new moms can use them as well. Every time you use body oil, lotion or cream for your baby, you can apply some on your skin as well, this way you do not need to dedicate extra time every day for your skincare needs.
All said about skincare routine for new moms, we cannot ignore skincare needs of newborns as well. Their skin being sensitive needs to be protected from the harsh environment—pollution, high temperature etc. here we bring some simple and easy tips to help you with the skincare needs of your young one.
Babies need to bathe only two to three times a week with warm and not hot water to stay clean. Their skin being soft and sensitive may be ripped-off of essential oils and nourishment with a regular bath.
REGULAR BODY MASSAGE
Regular massage with coconut, olive or almond oil hydrates the skin and helps in a good blood flow which finally results in glowing skin. Moreover, slightly heating the oil before the massage has therapeutic benefits on the skin.
PROTECT FROM THE HARMFUL RAYS OF THE SUN
While early morning rays of the sun work wonders for your baby, direct exposure to sun rays in the later hours can irritate the skin. Therefore, if you happen to venture out with your young one during the day, make sure to cover the baby adequately to prevent the sun from directly hitting the skin.
DIAPER BASICS UNEARTHED
It is important to get the diaper basics right or else it may end up in diaper rashes and harm your baby’s sensitive skin around the area of use. Make sure to change the diaper at regular intervals and as and when it gets spoiled, cleaning tenderly however completely each time with child wipes. While several myths surround the use of diapers such as rashes and irritation of the skin, nevertheless, it is not due to the diaper itself but due to lack of attention and knowledge about proper usage of diapers.
PROPER AWARENESS OF BABY PRODUCTS
Do not forget to read the product label before you purchase your baby’s products. It is best to avoid chemical and alcohol-based products and instead use products made explicitly for infants. Baby’s skin is very delicate and needs optimum care, a single mistake here-and-there could make things worse.
While you work hard to take optimum care of your newborn, still you may come across rashes, skin-peeling, acne or flea-bite like marks on the baby’s skin. Some of these are quite normal and would fade away quickly as they come. If they take time to go away, consult your doctor as it might take a toll on a newborn’s sensitive skin.
The writer is a Plastic and Cosmetic Surgeon, Jupiter Hospital, Pune.
WHY CERVICAL CANCER SCREENING IS MUST
Cervical cancer is a disease that originates in the cells lining the cervix. It can expand to various parts of the body. Cervical cancer is the most common cancer in women between 20 and 35 years old. It develops from the cells of the cervix, which is at the lower part of the uterus (womb). Many women do not have symptoms early on and may not know they are at risk for cervical cancer until it’s too late. Regular Pap tests can find changes to cells before a woman notices anything wrong. Most cases happen among women who have not been regularly screened for cervical cancer.
SYMPTOMS OF CERVICAL CANCER
Cervical cancer often doesn’t cause symptoms until it’s in the late stages, so knowing your body and being aware of your health is important. To help fight cervical cancer, we aim to keep you informed with the latest news and research on this disease.
Regular cervical cancer indications are:
• Unusual bleeding, such as within periods, after sex, or after menopause
• Vaginal discharge that seems or smells unusual than normal
• Discomfort in the pelvis
• Requiring to pee more often
• Burning during urination
Cervical cancer was once one of the most well-known reasons for cancer death for women. The cervical cancer death rate declined significantly with the increased screening. (This screening method can find changes in the cervix before cancer forms. It can also find cervical cancer at an early stage− when it’s tiny and easy to cure.)
SCREENING INFORMATION FOR CERVICAL CANCER
Cervical cancer is the most common gynecologic cancer. It is preceded by premalignant cervical changes, which are slow-growing and often asymptomatic. Screening tests can detect the presence of these changes before they develop into invasive cancers. Evidence supports that both HPV DNA testing and Pap cytology (with or without HPV DNA testing) decrease mortality rates from cervical cancer by 20% to 55%.
The comprehensive aim of cervical cancer screening is to:
• Lessen the number of people who die from cancer, or entirely exclude deaths from the cancer
• Lessen the number of people, developing the cervical cancer
A Pap test and an HPV test work together to help prevent cervical cancer. The Pap test checks for cell changes in the cervix, while the HPV test checks for a virus that can lead to these changes. HPV is a virus that develops through sexual contact and can spread throughout the entire body. It also leads to cancer. If your screening tests are not under control, your doctor may do more tests, such as biopsy.
IMPORTANCE OF REGULAR SCREENING FOR CERVICAL CANCER
This article is about the importance of regular screening for cervical cancer. Pap test screening has lowered the death rate from cervical cancer by more than 50%. But it misses cases that develop into cervical cancer. So, now we are using a newer HPV test to find infections that may lead to cervical cancer.
• Early detection of cervical cancer may save your life
• A Pap test is an important part of a woman’s regular healthcare
• Early screening can find changes in the cervix before they turn into cancer
• Having a test every year is as important to your health as brushing your teeth, eating healthy and exercising regularly
Women who get the recommended screening tests for cervical cancer are more likely to find out if they have any abnormal cells in their cervix before they turn into cervical cancers. If a woman finds out she has abnormal cells, she can take steps to get them removed so that she doesn’t develop cervical cancer.
The writer is Director, Lifeline Laboratory.
5 LIFESTYLE CHANGES TO MANAGE YOUR WEIGHT
It is never too late to begin your journey towards good health and weight loss. But stop depending on any kinds of shortcut methods or fad diets, instead proceed in your weight loss journey in a scientific and planned way.
Did you know one of the most searched queries on weight loss over the internet is—‘How to lose weight fast?’ There are numerous ways described to help one get the answer. But despite the knowledge and the widely available tips, India remains the third most obese country in the world (according to a 2014 report). So why do we fail to lose weight? Lack of motivation? Lack of knowledge? Or trying something that doesn’t really work?
The real reason is lack of proper knowledge and the wrong approach. You should take the right steps in reducing your weight and expanding waistline. Else the dangers could cost you your health and well-being.
WHY YOUR BODY WILL THANK YOU FOR LOSING WEIGHT
Obesity sets the stage for insulin resistance which happens prior to the onset of prediabetes or type 2 diabetes. Insulin basically works like a key to let the sugar get into cells where it is needed. If it doesn’t function properly, sugar levels increase in the blood leading to prediabetes and diabetes.
Incidentally, insulin resistance also leads to obesity. Controlling one factor can considerably lessen the risk of the other and reduce the chances of developing related consequences.
Weight gain is known to compromise one’s heart health. Over time, fatty deposits on the arteries can increase the chances of heart attack, cholesterol levels and triglycerides.
Obesity increases the risk of developing sleep problems like sleep apnea. The fat deposits around the neck can momentarily stop breathing at night. Snoring is a common symptom of sleep apnea.
Obesity can lead to fatty liver, scarring the organ and leading to other related complications. Obesity is also considered to be a significant risk factor for various kinds of cancers.
There is a strong correlation between obesity and major depressive disorders. Also, discrimination based on body size has a significant effect on one’s mental well-being.
WHAT YOU CAN DO
It is never too late to begin your journey towards good health and weight loss. But stop depending on any kinds of shortcuts methods or fad diets, instead proceed in your weight loss journey in a more scientific and planned way. Here are a few things that you can do:
1. Understand what’s causing you to put on weight or not letting you lose weight easily: Remember every body type is different. Each of our metabolism is different and responds differently to food and exercise. While people are now aware of body composition analysis where they know their percentage of fat, muscle, etc., they still do not understand what’s increasing their fat percentage, especially the visceral fat.
One needs in-depth assessments in terms of their diet, fitness levels, stressors and sleep. All of these are factors that affect metabolism, insulin resistance, blood sugar levels can cause increased obesity.
2. Opt for a personalised approach to diet: Did you know that all healthy foods might not be good for you? Sometimes you might be eating healthy, in moderation, but your blood sugar levels say a different story. This is because everyone has a unique glycemic response to foods, which means how your blood sugars respond after having a certain food. For instance, two people will have different blood sugar readings after having the same food. This is why a personalised approach to diet is necessary to know. Our programs come with a CGMS device that painlessly monitors blood sugars for 14 days in response to food, activity, sleep patterns, and mood swings. It takes around 1300 such readings which are mapped with the food and activity of a person through specialised software. This helps to track and tweak diet and behaviour for better blood sugar control and weight loss.
Also, one needs to be attentive towards including micronutrients in the diet. Essential nutrients like calcium, phosphorus, zinc, magnesium, iron, potassium, sodium iodine and vitamins like Vitamin A, B, C, D, E, and K help in proper muscle development, build immunity, improve metabolism and energy expenditure and help you to lose weight. So balancing these micronutrients in the diet is crucial.
3. Upgrade to personalised fitness plans: Probably walking 10,000 steps a day is not what is going to work for you or just doing 30 minutes of Zumba. Sometimes you need a combination of exercises or a personalised plan to fight the fat war. Look for an expert who can help you.
4. Don’t neglect other aspects that affect it: Lack of sleep and weight gain have a strong link. Fewer hours of sleep in the night can increase the secretion of the hunger hormones (ghrelin) that make one eat more or trigger mindless emotional eating. It also slows down metabolism and increases glucose levels in the bloodstream.
When the body and mind are deprived of rest and rejuvenation, it takes a toll on one’s mental health, which can significantly derail one’s efforts in the weight loss journey. So it is advisable to have your eight hours of shut-eye and pay attention to your mental well-being to fight the flab.
5. Focus on long-term behaviour change: Don’t aim for completing 10,000 steps on the first day of your fitness journey, try walking for 30 minutes every day and be consistent with your routine. Gradually upgrade yourself from walking to jogging to weight training. Make small changes that are sustainable.
We know weight loss isn’t easy. It is a lonely journey that needs some exceptional commitment and self-discipline. Probably having a buddy in the form of a digital therapeutics or a DTx program can help. We have come up with a unique DTx weight management program, Reset23, which focuses on helping reduce weight and attain a healthy BMI below 23 while shrinking your waist circumference to a healthy measure.
The program offers detailed macro and micronutrient analysis through our wellness app to help coaches draft a diet chart and work on your nutritional deficits for personalised weight loss meal plans. A team of physiotherapists’ guides on exercise regimens to help lose weight as well as ensure stamina building and muscle strength with minimal risk of injury.
Proper psychological counselling is offered to help one make small behaviour changes that help stay on track with weight loss goals and make sustainable changes to adapt to a healthy lifestyle and keep the flab at bay. Proper stress and sleep management tips also help to bring in these positive lifestyle changes. Weight loss needs a 360-degree approach and that is what Reset23 promises.
The writer is Co-founder and CEO, Fitterfly.
Why do we fail to lose weight? The real reason is lack of proper knowledge and the wrong approach. You should take the right steps in reducing your weight and expanding waistline. Else the dangers could cost you your health and well-being.
6 WINTER TEAS AND THEIR HEALTH BENEFITS
Tea has to be India’s most beloved and well-consumed drink. The joy that comes from having a warm cup of delicious tea can even be therapeutic, especially in winters. Below is a list of six healthy winter teas.
Teas differ based on how much they have been oxidised since the level of oxidisation primarily dictates the strength of aroma and taste of a given tea. White tea is a type of tea that is least processed and thus contains a subtle taste and fragrance. Packed with antibacterial properties, white tea is considered helpful in regulating cholesterol and blood sugar levels. It is also a go-to option for people who are wary of caffeine because of its very low caffeine content. Lastly, white tea works wonders for your skin and joints as well by promoting collagen and elastin productions in the body.
Green tea is best known for its rich anti-oxidant content that is considered an elixir for skin and hair problems. Green tea also promotes healthy cell rejuvenation and helps reduce cholesterol levels. Another popular benefit of green tea is that it speeds up the metabolism of the body and aids weight loss. It is also said to assist memory and is viewed to be beneficial for Alzheimer’s and dementia. To make the most out of its several benefits, you should consume it piping hot without any milk and sugar.
Black tea is yet another popular form of tea that people consume. Its anti-inflammatory properties help curb and prevent cough, cold, and flu. They also support a healthy heart by alleviating the risks of several heart diseases. Yet another one of its benefits is that it helps regulate blood sugar levels. Black tea is also used to tone the body and get rid of cellulite. Finally, it promotes a fresh glow on the skin as well.
Oolong teas are a powerful source of calcium, manganese, potassium, copper, and selenium, which help replenish vital nutrients in the body. It is also considered to be very helpful in preventing cavities and tooth decay and hence promotes good dental health. Another perk of the consumption of Oolong tea is that it allows metabolism regulation and aids weight loss in people, thereby bringing you closer to your fitness goals.
With the brimming goodness of anti-oxidants and vitamins, herbal tea is a miraculous stress buster. It is also an immunity-boosting drink that helps prevent symptoms of cough and cold. It is also beneficial for nausea. Lastly, it serves digestion, helps detoxify, and supports weight loss which makes it the ultimate choice for people seeking fitness in the winter season.
Bubble tea is a relatively new introduction to the eminent Indian tea choices but is equally beneficial. It helps prevent free radical damage and is healthy for the heart. It is also a good source of strength and energy for the body. Additionally, it is said to reduce stress levels and enhance mood. It is also useful in keeping diseases at bay as it boosts immunity.
The winter season is raging, and it is only expected to grow colder with time. In this scenario, one can’t help but look for warmth in all things around them. Tea is a prominent drink that is consumed in winters to retain heat. The scope of this article stretches to provide a list of six delectable options that you can choose from, this winter, to not only keep you warm but also bolster your health with their various medicinal properties.
The writer is the founder of The Tea Planet.
How does radiation therapy help overcome breast cancer?
Breast cancer is ranked the number one cause of cancer amongst Indian women with an age-adjusted rate of 25.8 per 100,000 women. The number of women who succumb to this disease is almost 12.7 per 100,000 women. Radiation therapy forms an integral and important part of the armamentarium for the treatment and cure of breast cancer. The aim of radiation therapy is to kill the DNA of the cancer cells that persist and lead to relapse after surgery and chemotherapy. Radiation is delivered with megavolt X-Ray generating machines to the breast and lymph node areas after surgery to create a cancer-free zone.
Radiation is always recommended after breast-conserving surgery and over eight randomised trials since the 1980s have established the role of radiation in breast cancer. The trials done in the 1980s-1990s showed remarkable control rates of >90% for stage 1-2 breast cancer post Breast Conserving Surgery (BCS). Data has shown that radiation reduced the risk of local recurrence by 50% when given post-surgery versus the patients who did not receive radiation. The biggest benefit was seen in women less than 40 years of age where only 10% women developed recurrence as compared to 19.5% in women not receiving radiation. The study had been conducted by the European Society for Radiotherapy and Oncology enrolling 5300 women with stage 1-2 breast cancer. Women with stage 1-2 breast cancer with negative nodes in the axilla do not need radiation unless they have other aggressive features like lympho-vascular invasion, margin positive disease or triple receptor-negative breast cancer.
For stage 2-3 breast cancer with lymph node involvement in the axilla, radiation therapy is recommended as it reduces the risk of local recurrence by 67% and the risk of death by 6%. A study published in the New England Journal of Medicine reported a decrease in the risk of death from cancer by 33% and the probability of survival at 10 years with radiation treatment increased from 54% to 64%. Hence the current recommendation is to support the use of radiation therapy for women in stage 2-3 breast cancer after surgery and chemotherapy. Women at high risk of recurrence include
Cancer size >5 cms
lymph nodes involved in the armpit (axilla)
Cancer at the surgical specimen cut margin
In stage 4 breast cancer or post radical treatment with surgery and chemotherapy, the incidence of relapse is 36% in patients not treated with radiation versus 19% in patients treated with radiation. Radiation is also an effective tool for pain palliation in bone metastases and stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT) is the recommended treatment for brain metastases and lung/liver metastases respectively. SRS & SBRT have been shown to aid and prolong the intracranial/intrapulmonary control of cancer in addition to chemotherapy/immunotherapy/hormone therapy.
To summarise, radiation is a key member of cancer care in breast cancer for local, loco-regional, recurrent and metastatic disease control.
The author is Chairperson Radiation Oncology, Cancer Center Medanta – The Medicity.
TRENDS EXPECTED IN THE WELLNESS INDUSTRY IN 2022
With new concepts taking shape, certain trends are expected to disrupt the wellness industry in 2022.
The wellness industry has been evolving at a rapid pace over the last few years and the outbreak of the pandemic has added more fuel to fire. With health and wellness becoming a top priority for people all over the globe, the concept of wellness is gaining broader significance and constantly evolving to meet consumer demands. As per reports by McKinsey, the global wellness industry is presently worth US$1.5 trillion and continues to grow at 5% to 10% every year. With new concepts taking shape, certain trends are expected to disrupt the wellness industry in 2022. Here we take a look at some of the trends which are expected to make a major mark in the forthcoming year.
NUTRITION AND MINDFUL EATING
Food is always a crucial part of overall wellness. However, with the pandemic re-shifting the focus on better nutritional habits, people nowadays not only want their food to taste good but help them achieve their nutritional goals. As per studies, more than a third of the people around the world plan to increase their focus and spending on nutritional food, juice cleanses and diet programs over the coming year.
Another trend that’s taking the world by storm is mindful eating. Mindful eating is more about the attention the sensory awareness of eating instead of being distracted by other things that are happening around. It is also encouraging people to move away from restrictive eating habits while still allowing them to carefully consider the nutritious value of food.
Living through the Covid-19 pandemic has made people more aware of the importance of a strong immune system. Online search trends clearly indicate that immunity and other related areas continue to be hot topics suggesting that the trend is expected to continue further. People have understood the concept that there is no magic to boosting immunity but there are certain practices that can help optimise the immune strength of the body. Eating a balanced diet, exercising regularly, getting good sleep and less stress are some of the key factors that are getting increasing attention from wellness seekers.
YOGA AND PRANAYAMA
The pandemic and accompanying lockdown measures caused major disruptions in people’s lives. As people were restricted inside their homes, physical and mental well-being suffered a huge blow. However, thanks to the age-old science of yoga and pranayama, people were able to maintain their physical well-being as well as deal with the uncertainties of the pandemic. During the initial lockdown and in its aftermath, an increasing number of people have turned to online yoga classes to regain balance and strength. It shows the growing importance of yoga to post-Covid-19 wellbeing. Breathing techniques like pranayama helped improve the functioning of the respiratory system. Across the world, yoga has come to be recognised as an effective tool to improve health, which, in turn, helps maintain an all-important work-life balance. In the coming years, it is expected that the popularity of yoga and pranayama will rise further and reach every corner of the globe. For those interested in reaping the benefits of yoga, there’s a wide variety of poses to try out. While some require the assistance of practitioners, others are very basic and can be practised with little to no experience.
Adaptogens are the latest superfoods known for their stress-busting properties. Adaptogenics are natural pharmaceuticals; they’re mushroom and herbal extracts that are used to alter the body and mind, whether that’s to boost mood, help sleep, strengthen the immune system or give a burst of energy. Adaptogens have been used for thousands of years in ancient Chinese and Indian medicine, but the west is only just waking up to the natural power of these superfoods.
The pandemic has had a deep impact on nearly every consumer category which has led to new consumer behaviours. There’s been a marked change in how people access wellness in an age defined by the pandemic. With restrictions and lockdowns bringing life to a standstill there was no option left to people but to accept digital wellness. These new behaviours rely on the power of the internet to maintain human connection and interaction. Digital healthcare is taking the centre stage with virtual conferencing and meeting technology more popular than ever. Now it takes only a few seconds to book virtual sessions with nutritionists, personal trainers, physical therapists, mental health professionals and sleep specialists. Digital healthcare will continue to shape the future of wellness and consumer behaviours.
The significance of nature cure and wellness is expected to gain more prominence in the years to come. It’s just not about nutrition or exercises or superfoods but the combination of all these natural therapies that’ll play a crucial role in guiding people towards health and wellness in the foreseeable future. This will remain a priority for millions of people for a long time to come.
The writer is Senior Chairman, Jindal Naturecure Institute.
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