Fatima Sana Shaikh opens up about her epilepsy struggles: What is the chronic neurological disorder?

Ludo actor Fatima Sana Shaikh has opened up about her struggles with epilepsy and how she deals with the neurological disorder. Taking to Instagram, the Bollywood actor in an ‘ask-me-anything’ session answered her followers’ questions about epilepsy and when she discovered that she had it.

“(I) was diagnosed when I was training for Dangal. I got an episode and woke up straight at the hospital… (I) was in denial first (for five years). And now, I have learnt to embrace it, and work and live around it,” she wrote.

On how she copes with the disorder, the Ajeeb Daastaans actor said she has a “good support system” consisting of her family, friends and pet (Bijlee), adding that “some days are good”, but some are “not so great”.

The 30-year-old said the disorder has not affected her passion and instead it “pushes and drives” her to work “harder”.

Shaikh also busted some myths about the condition, saying the struggles are “serious and disabling”. “It’s not all in the mind. It can be fatal and leave you with major disabilities,” she added.

The actor has spoken about the disorder amid National Epilepsy Awareness Month which is observed in November.

What is epilepsy, the condition Fatima Sana Shaikh is suffering from? What are its symptoms, causes and treatments? How common is the disease in India? Let’s take a closer look.

What is epilepsy?

Epilepsy is a disorder of the central nervous system that affects as many as 50 million people globally.

The chronic noncommunicable disease is identified by “recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized) and are sometimes accompanied by loss of consciousness and control of bowel or bladder function,” says the World Health Organization (WHO).

Also called a seizure disorder, epilepsy can affect anyone irrespective of their age, sex or race notes the Cleveland Clinic website.

A seizure is defined as “abnormal and excessive electrical activity” in our brain cells that affect our behaviour and actions.

Epilepsy accounts for 0.5 per cent of the global burden of disease.

The United Nations health agency says those with epilepsy may have higher rates of physical issues like fractures and other injuries related to seizures, and also more psychological conditions such as anxiety and depression.

“The risk of premature death in people with epilepsy is up to three times higher than in the general population, with the highest rates of premature mortality found in low- and middle-income countries and in rural areas,” the WHO elaborates.

Symptoms and causes of epilepsy

The seizure symptoms can differ depending on where the disturbance started in the brain and how far it spread.

Temporary symptoms include loss of awareness or consciousness, stiff muscles, confusion, uncontrollable jerking of arms or legs, psychological symptoms like fear, anxiety or deja vu, blank stare or ‘staring into space’, etc.

Epilepsy can affect anyone irrespective of their age, sex or race. News18 (Representational Image)

According to Mayo Clinic, generally, at least two seizures without a known trigger that occur a minimum of 24 hours apart lead to an epilepsy diagnosis.

The WHO states that the causes of the disorder can be divided into these categories: structural, genetic, infectious, metabolic, immune and unknown.

Some of the known causes include severe head injury, brain infections like brain abscess, meningitis, encephalitis and neurocysticercosis, genetic conditions with associated brain malformations, brain conditions such as brain tumours and strokes, and genetic conditions among others.

Treatment for epilepsy

There is no cure for epilepsy, however, the seizures can be treated.

Seizures can be brought under control with the help of antiepileptic drugs (AEDs), special diets and sometimes surgery.

“About 70 per cent of people become seizure-free with proper treatment within a few years. The remaining 30 per cent are considered to have drug-resistant epilepsy. These people should go to an epilepsy centre to determine if they’re candidates for epilepsy surgery,” suggests Cleveland Clinic.

Epilepsy in India

Around 60 lakh people in India have epilepsy, reports Economic Times.

A few days back, NDTV reported that a Delhi Transport Corporation (DTC) bus driver, who suffered an epileptic fit, rammed the large vehicle into an autorickshaw in front of Tis Hazari Court.

A computer science engineer working in an MNC in Kerala’s Kochi had told Economic Times in February that she had sudden “episodes” where she lost awareness and had no recollection of what happened during that time. She shared that these “episodes”, known as “epileptic fits” or “seizures”, lasted for a few seconds to one minute and would occur twice or thrice a week.

Not everyone seeks treatment for epilepsy. News18/Shutterstock (Representational Image)

After undergoing epilepsy surgery, the engineer identified as Anita has been seizure-free for six years.

However, not everyone in the country seeks treatment for the disorder due to multiple reasons.

As per National Library of Medicine (NLM), “The lack of knowledge of antiepileptic drugs, poverty, cultural beliefs, stigma, poor health infrastructure, and shortage of trained professionals contribute to the treatment gap”.

The treatment gap in India ranges from 22 per cent among urban, middle-income people to 90 per cent in rural areas, says the NLM‘s 2014 article on Epilepsy: Indian perspective.

Dr Rakesh Agrawal, an expert on epilepsy from Apollo Hospitals had told Times of India in 2012 that there is a serious social stigma linked to epilepsy in rural India. “Epilepsy is quite a serious problem in India. While 60 per cent of people in urban India consult a doctor after suffering a seizure, only 10 per cent in rural India would do so”, Dr Agrawal said.

The burden of epilepsy can be narrowed though.

The NLM article states by poverty alleviation and by reducing the preventable causes of the disorder such as perinatal issues (loss of oxygen or trauma during birth, low birth weight, etc.), parasitic diseases, and head injuries, the burden of the disease can be decreased in the country.

With inputs from agencies

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This children’s day, let us limit video gaming in youngsters

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A few years ago, children used to look forward to going to playgrounds and parks in the evening. However, these days, they just sit for hours at a place and play their favorite video games. Studies claim that over 70% of gamers aged 8-15 play video games every day. Clearly, technology has created problems that we need to solve and electronic gaming is new territory for us when it comes to medical intervention. It is high time that we prioritize the need for children to be physically active and healthy. This children’s day, let us remember the message – ‘let children be children’.

An October 2022 study published in the journal Heart Rhythm highlights how video gaming can be dangerous for children and teenagers. It talks about how children and teenagers are suffering from heart rhythm disturbances while playing video games. In many cases, the children suddenly blacked out, with some going into cardiac arrest- which is fatal without immediate emergency treatment.

Referring to the study, the author, world’s leading cardiac surgeon, encourages caution among children who are overly addicted to video games. In today’s world, it’s no secret that children are spending more time in front of digital screens than ever before – whether it’s for school, entertainment, or socializing with friends. While many children play video games without any harmful consequences, others can become obsessed. Although video games can be enjoyable and sometimes even educational, they should not replace real-life time with family and friends.

Parents who are worried that their child may be addicted to video games, can look for the following signs-

Dry or red eyes

Soreness in the back, neck, or fingers

Irritability when they’re not playing

Avoiding other activities in favor of gaming

Playing for long hours even on school nights.

Experts warn that spending too much time playing video games can lead to social isolation, sleep deprivation, heart issues, and poor grades at school. According to the CDC (U.S. Centers for Disease Control and Prevention), children need to engage in at least 60 minutes of moderate-to-vigorous intensity physical activity every day.

To help your child find a balance, here’s what parents can do to encourage outdoor activities in their children, which are not only good for their heart and body health but also promote bonding and fun.

-Set an example for your children: Make time for outdoor activities yourself. Children try to imitate their parents, once you do the same they would also prefer to go out rather than sit indoors and play on the phone.

-Involve your children in planning family outings: Encourage the inclusion of outdoor activities

-Restrict screen time for children: this will also help to prevent problems like weak eyesight, and reduced brain development among other health issues.

-Make outdoor activity time fun: Incorporate games, picnics, or nature walks into the mix.

-Encourage participation in organized sports: Ensure your children make physical activity a part of their lives.

The author is the world’s leading cardiac surgeon and head of Mumbai’s Asian Heart Institute. He has been conferred the Padma Bhushan in January 2010, the third highest civilian award in India. He is an ambassador for healthcare reform in India and is among the world’s safest heart surgeons with a 99.8% success rate in bypass surgery

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World Diabetes Day: Kill the dreaded killer by creating ‘access to diabetes education’

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Whenever we hear the term “Diabetes,” it not only hits our ears but certainly creates a quake in our body and mind. It’s a global health issue and one of the leading causes of morbidity and mortality. The incidence of diabetes is increasing rapidly among all age groups, shockingly even in children, so much so that there’s a 3% increase in the death rate due to diabetes between 2000-2019.

This is attributable to the newer lifestyle changes, ignorance, and neglecting the strength of this human enemy. Diabetes affects almost every system of the body, ultimately causing end-organ damage. The complications could be heart attack & heart failure, kidney failure, blindness, and gangrene of limbs leading to amputation.

Most of the patients follow all the prescribed measures to control it. Then, why is the incidence rising? Understandably, the conventional approach to dealing with the disease is insufficient to control the increasing incidence.

Hence, the population needs to be educated for prevention, control, treatment, and reduction of complications of this disease. Here comes the importance of TPE (Therapeutic Patient Education), where all the stakeholders: the patients, patient’s family members, NGOs, media, social networks, technological institutions, policymakers, healthcare staff at various levels, and doctors need to be proactive and have to be on the same page.

We can defeat this enemy of ours collectively. We must not forget to acknowledge, welcome, and embrace the role of technology in-healthcare here prudently and optimally.

The people should be educated regarding all the aspects of the disease, from the cause to the complications, and take it as a mission to spread the word. The theme of the World Health Organization (WHO) on World Diabetes Day, 14th November 2022, is “Access to Diabetes Education,” which aims at transforming “patients and population” into “knowledgeable patients and population” pertaining to diabetes through continuing education involving all the above stakeholders by raising awareness in every individual about the disease. This education should be accessible to everyone at various levels like city, town, panchayat, and even a village, thereby scaling-up knowledge about diabetes and its care.

To spread awareness among the masses, the discussion should also happen at clubs, coffee tables, schools, and colleges frequently and specifically on this day through seminars, quizzes, webinars, health talk-shows, fancy-dress competitions, theatres, and celebrations. Then only we could check this dreaded disease and the complications involving other systems and decrease the death rate because of it.

Let us protect our tomorrow. Let us take an oath to kill the dreaded killer by creating ” Access to Diabetes Education.”

The author is a senior consultant Cardio-Thoracic & Vascular Surgeon (Adult & Paediatric), and a visiting consultant to National Heart Institute, New Delhi

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As world’s diabetes capital, India needs to shift its healthcare system

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Diabetes, which is commonly known as ‘the sugar disease is a condition that impacts the way our body produces or utilizes insulin hormone. The insulin hormone works like a fuel to the body as it converts food into energy. Any kind of abnormality in the amount of insulin eventually results in increased blood sugar levels and can lead to serious health consequences such as heart disease, stroke, kidney failure, blindness, etc.

Diabetes is a chronic and serious health condition that works as a catalyst for developing other health issues. Diabetes is termed as the ‘silent killer since it often goes undetected until it has caused serious health problems.

Unfortunately, India is considered the ‘diabetic capital’ of the world. The diabetic population in India is predicted to reach more than 80 million by the year 2030. The rising number of patients having diabetes mellitus in India is a significant cause for worry, especially since it contributes to the huge healthcare burden on the country.

With a staggering figure of more than 1 billion patients suffering from diabetes, the risk of mortality almost doubles. People with diagnosed diabetes, on average, have medical expenses almost two and a half times higher than what would be in the absence of diabetes.

With the theme of ‘Access to Diabetes Care’ on this year’s World Diabetes Day (observed on 14 November), healthcare providers need to aim towards accessibility and affordability of diabetes care. India needs to go through a mindset shift from curative to promotive and preventive healthcare that can eventually reduce the huge individual out-of-pocket expenditure that goes into the treatment.

To really take a step forward towards achieving Universal Health Coverage by 2030, India needs to put forward continuous efforts in terms of raising awareness and bringing in rapidly growing technologies for managing and monitoring any disease, especially chronic diseases like Diabetes.

The study, titled ‘Variation in health system performance for managing diabetes among states in India: a cross-sectional study of individuals aged 15 to 49 years, and conducted by the Public Health Foundation of India (PHFI), the Madras Diabetes Research Foundation (MDRF), Chennai, and the Harvard School of Public Health with other international organizations, shows, about one in every two Indians (47%) living with diabetes is unaware of their condition, and unfortunately only about 24% people manage to bring it under control.

People need to understand that although COVID is not at its peak now, ignoring, or missing vaccinations can lead to the development of other comorbidities. Especially people become vulnerable to several health conditions as they age. Approved and authorized COVID-19 vaccines such as Sputnik V, Covidshield or Covaxin are safe and effective. Although the Government has not mandated the booster shots yet, people should realize the necessity of vaccines and voluntarily come forward for administering the booster shots so that India can reduce the disease burden in the long run.

Diabetes is a condition that cannot be cured, but with consistent management and monitoring, it can be controlled. In today’s time, with the blessings of evolving digital health technology, there has been a fundamental shift in the way people manage their health and access medical care. With the rise of wearable technologies, medical devices are now becoming even more convenient and affordable, helping countries to move a step closer to equitable access to healthcare.

To improve the quality of care for the end-users, these devices are getting better by helping to monitor a patient’s health 24/7, fetching and storing the clinical records of the patients, and providing real-and time feedback to doctors. Talking about lifestyle diseases, diabetes is one such key area where India has recently been witnessing advancement in remote care, thanks to the booming MedTech industry in India for continuously researching and manufacturing these devices which are optimal for self-management.

With more of public-private partnerships and collaborative efforts, Diabetes management can be made accessible, affordable, and seamless. Every stakeholder in the healthcare ecosystem of India – healthcare leaders, physicians, academia, and public health experts should continuously reiterate the importance of regular health screening, choosing a conscious lifestyle by leveraging the privilege of evolving technologies and smart devices that makes the monitoring and management of any disease easier and even can save many lives by indicating certain alarming symptoms in advance.

The author is a the HOD of Deptt of Endocrinology, Marengo CIMS Hospital. Views expressed are personal.

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Lalu Prasad Yadav’s daughter to donate kidney to him: What is a live kidney donor and what are the risks involved?

Lalu Yadav’s younger daughter Rohini Acharya, who is based in Singapore, has ‘stepped in to give her father a new lease of life’. Image Courtesy: @RohiniAcharya2/Twitter

Ailing Rashtriya Janata Dal (RJD) patriarch Lalu Prasad Yadav, who’s been in and out of hospital in recent times, is all set to receive a kidney later this month from his second daughter, Rohini Acharya.

Rohini, who is based in Singapore, has “stepped in to give her father a new lease of life”, a family member was quoted as telling news agency PTI. She later confirmed the same to NDTV, saying, “Yes, that’s true. I am destiny’s child and so proud to give my kidney to papa.”

The RJD president, who is out on bail in five fodder scam cases, had been granted permission by the court to travel abroad for a kidney transplant and his passport was released from court custody to get renewed for this purpose.

As per a PTI report, Lalu is likely to visit Singapore again — he was there last month for treatment — between 20 and 24 November during which it is likely that he will undergo the surgery.

Rohini’s decision to donate her kidney to her father has put the spotlight on organ donation and the risks involved for the donor.

Here’s what we know about living kidney donors and what they can expect after the procedure.

What’s a living kidney donor?

A living-donor kidney transplant is when a kidney from a living person is removed and placed into a recipient whose kidneys no longer functions properly.

Only one donated kidney is needed to replace two failed kidneys, which makes living-donor kidney transplant an alternative to deceased-donor kidney transplant.

According to United States’ Mayo Clinic, about one-third of all kidney transplants performed are living-donor kidney transplants.

Anyone above the age of 18 who is in good physical and mental health can be a living donor.

Living organ donations can be categorised as direct donations or non-direct anonymous donations. The first type of organ donors (direct donations) are family members or person known to the recipient. This can include parents, children, brothers and sisters, grandparents or even a spouse, friend, co-worker.

Also read: With Lalu Prasad Yadav’s daughter donating her kidney, here are some Bollywood stars who pledged to donate their organs

A non-direct anonymous donor is when a person offers to donate a kidney that could go to anyone they match who needs a kidney transplant. In India, a non-related donor needs permission of an Authorisation Committee established by the state to donate his/her kidney. The Authorisation Committee is a governmental body that regulates living donor transplantations by reviewing each case and ensuring that the living donor is not exploited for monetary considerations.

How does living donation affect the donor?

Once a person has decided to become a donor, he/she has to undergo a thorough medical examination before donating a kidney. All the medical parameters of the potential donor are checked and only once it is confirmed that the person has no medical issues, will he/she be permitted to become a donor.

For those who are wondering how the surgery is performed — Dr Madhuri Jaitley, Associate Consultant at Department of Nephrology in Paras Hospital, Gurugram was quoted as telling the Indian Express that the procedure is performed using the laparoscopic technique.

She added that the length of stay in the hospital will vary depending on the individual donor’s rate of recovery although the usual stay is one to three nights.

Post the hospital stay, a living donor has an additional four to six weeks of recovery time. Doctors advise that kidney donors should avoid driving for two weeks and also should avoid picking up heavy items for six weeks following surgery.

Additionally they should keep away from heavy contact sports where they could get injured accidentally and should resume normal life gradually. Depending on the type of work the living donor does, he/she can return to their job as soon as two or as long as eight weeks after surgery.

Post surgery, a living donor also has to follow some dietary restrictions; one should keep away from stressors like alcohol, caffeine and high protein foods. A living kidney donor is recommended to have an annual follow-up with a nephrologist (kidney specialist).

Graphic: Pranay Bhardwaj

Are there any long-term risks to live kidney donation?

There are several myths about being a live-kidney donor. One of the most prominent one is that life expectancy is affected. However, doctors debunk this notion.

Several studies have found that living donation does not change life expectancy, and does not appear to increase the risk of kidney failure. In fact, studies show that people who donate a kidney outlive the average population. One study showed how 20 years after donating, 85 per cent of donors were still alive.

What are the benefits of a living kidney donation?

For patients who are eligible for a kidney transplant, a kidney from a living donor is the best treatment.

According to medical experts, a kidney from a living donor usually lasts longer than kidney from a deceased donor. Moreover, a living kidney donation can reduce or even prevent the patient’s need for dialysis.

When a recipient has a living donor, the wait time for transplant is shorter and the transplant can be scheduled. This allows for donations to take place when the recipient is in good health and when it is convenient for both the donor and the recipient.

Many people who have donated a kidney also say that helping someone in need is a positive personal experience.

With inputs from agencies

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Can you get heart pain without blockages in major arteries?

Representational image. News 18

Heart Pain or Angina pectoris is the pain a person feels in their chest mainly due to low blood supply to the heart muscles. The heart muscles are supplied by the coronary arteries. Two main branches of coronary arteries are left and right which would divide into major branches. The person feels heart pain when these arteries get blocked by either a thrombus or an atherosclerotic plaque. This is known as coronary artery disease.

Can you get heart pain without blockage of major arteries?

Although major coronary artery blockage is one of the main reasons for getting heart pain there are other causes too. Microvascular angina and Prinzmetal’s angina are two other forms. Microvascular angina is caused when there is poor function of tiny blood vessels nourishing the heart. This results in heart pain. Prinzmetal’s angina is caused when there is a spontaneous spasm of the vessels leading to poor blood flow.

What causes Microvascular angina?

Endothelium is the lining of microvessels. Endothelial dysfunction is considered the main cause of microvascular angina. Endothelial dysfunction is a multifactorial disorder. It is related to smoking, obesity, hypercholesterolemia, and inflammation. Also, low levels of high-density lipoprotein (HDL) are a cause. Apart from endothelial dysfunction, patients who have microvascular angina have abnormal pain perception. It is mainly due to the potassium and adenosine release which ultimately leads to abnormalities in the central pain perception.

How is Microvascular angina diagnosed?

Cardiac catheterization with coronary flow reserve (CFR) is the gold standard for diagnosing microvascular coronary disease. However, practically the diagnosis is clinical, where the patient presents with typical angina but normal epicardial arteries. Coronary flow reserve is the ratio of maximum blood flow in a coronary vessel compared to resting blood flow. In this test, a catheter is inserted into the coronary arteries and the resting blood flow is detected. Then vasodilators are given to the person to maximally dilate the coronary blood vessels. Again the coronary blood flow rate is measured which is considered the maximal blood flow. The ratio between the two values is the coronary flow reserve. In patients with microvascular angina, the coronary flow reserve is low. Non-invasive techniques such as cardiac PET, cardiac MRI, and CT scans are also reliable diagnostic tools available for diagnosis.

What are the available treatment options?

As microvascular angina is affected by various factors, lifestyle modification is important in its management. Cessation of smoking, regular exercise, dietary modification, and weight loss is advised. Managing other health conditions like high blood pressure, high blood cholesterol, and diabetes is also helpful. Pharmacological treatment can be used, which includes the use of beta-blockers, calcium channel blockers, nikorandil and nitrates. These drugs would cause dilation of coronary blood enabling a better blood supply.

The author is the Director of Cathlab and Interventional Cardiologist, Symbiosis Hospital, Mumbai. The views are personal.

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Cervical cancer: Silent killer that can be prevented

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Termed a ‘silent killer’, cervical cancer is one of the most common forms of cancer among women globally. It is also highly prevalent in India, with one in 53 Indian women estimated to develop this disease, compared to one in 100 women residing in developed nations.

Approximately 1.25 lakh Indian women are diagnosed with the condition annually, primarily affecting women between the age groups of 45-55 years. Nearly 95% of the cases are caused by human papillomavirus (HPV) infections.

While these numbers paint a grim picture, cervical cancer is definably preventable. The situation can be more problematic for people from the lower economic strata, where there are multiple knowledge gaps and ill-equipped infrastructure.

In addition, factors like age, sexual activity, genital hygiene, use of contraceptives, nutrition, tobacco usage, or weak immune system also contribute to rising cervical cancer prevalence. Thus, there is a pressing need to implement community-centric plans focusing on educating women and strengthening the existing healthcare systems to track and prevent cervical cancer burden in rural as well as urban areas.

However, one may not know about the disease until it starts to spread. While HPV vaccines are available today, early screening and detection are important to reduce the cervical cancer burden. Cervical cancer is one form of cancer that can be prevented.

Challenges with detection and treatment

The good news is that cervical cancer can be prevented through early screening tests available in India. Early screening helps in the detection of any pre-cancerous signs which can be easily treated and reversed, thus significantly reducing cervical cancer cases and deaths.

However, despite the significant benefits of screening, only a handful of women reported getting screened, with a majority constricted to urban areas. With most women unaware of the availability of preventive screening, most of the cases are detected after the onset of symptoms. The unavailability of accessible and cost-effective HPV test(s) and vaccines can also hinder widespread adoption.

Eliminating cervical cancer with preventive strategies

As per international guidelines, cervical cancer screening is recommended every five years. Conventionally, cervical cancer screening is done with the help of a PAP smear test or Visual Inspection with the Acetic Acid (VIA) method. It is the most common method to detect cervical cancer.

The Department of Health proposes three smears per lifetime, with a 10-year interval between each smear, commencing at not earlier than age 30 years. There must be a referral system in place, and patients with a normal Pap smear must be informed of their next Pap smear date.

Less invasive liquid-based cervical cytology (LBC) tests are also available and gaining more traction since the accuracy of diagnosis is greatly improved with this technique. The new and emerging screening modality in the form of HPV mRNA testing which detects traces of active HPV infection is a great tool for accurate and early detection of any abnormality before it develops into full-fledged cancer!

Cervical cancer is preventable and treatable

An integrative approach based on awareness based on timely screening and treatment is fundamental in tackling the health burden and social ramifications of cervical cancer. It is essential to establish adequate infrastructural support to ensure accessibility and affordability.

Women who have been screened should be instructed to return to the screening centre to collect the results. Depending on the conditions, the interval between screening and follow-up should be between 1 and 4 weeks.

In addition to enhancing screening and sensitization, there is a need to curtail misinformation and stigma that hinders women from seeking help. While the development of the indigenous vaccine is a laudable effort, enhanced screening and mass immunization for vulnerable populations can pave the way for equitable access to care and save countless lives.

The author is a Senior Consultant in Gynaecology, Max Nanavati Super Specialty Hospital, Mumbai. Views are personal.

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Diabetes: What are natural ways of reversing it

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Many diabetics empty their wallets by purchasing astronomically expensive diabetes medications, and they often continue to do so for the rest of their lives. Here, it is vitally important to realize that diabetes is a lifestyle issue, and that using medications will primarily serve to perpetuate the illness rather than to prevent it.

Even if they do, the method or process used won’t be natural, let alone any negative effects that might appear as the treatment progresses. Will you now want to complicate your already difficult life as a diabetic? It’s not, is it? Therefore, reversing diabetes naturally, through natural meals and workouts tailored specifically for diabetics, is preferable to all other alternatives. This article focuses on various all-natural ways to reverse diabetes, which will aid in gradually and naturally curing its consequences.

What is type 2 diabetes and how does it affect the body?

Since type 2 diabetes affects about 90% of all diabetics worldwide, we’ll first examine what type 2 diabetes is and how it affects the body before talking about natural ways to reverse this swiftly expanding and slowly debilitating condition. What exactly is type 2 diabetes then?

It is a type of lifestyle disorder defined by improper control of blood sugar levels or a spike in blood glucose levels above normal. The majority of the time, it is a result of poor eating practices, irregular exercise routines, excessive weight gain, obesity, etc. Excess body fat obstructs cell receptors, which prevents insulin from working as it should, forcing the pancreas to secrete more more insulin than usual, making the body resistant to it and leading to a host of other issues. Because type 2 diabetes is characterized by improper blood sugar control, patients are frequently sluggish, lack flexibility, and have weak muscles.

Type-2 diabetes has long been attempted to be treated with diabetes medications. There is nothing as successful as natural techniques, nevertheless, if one truly wants to reverse diabetes. Let’s move on to examine some natural diabetes reversal techniques.

How much can Type 2 Diabetes be cured naturally?

Diet and exercise are the two most crucial components of naturally curing type 2 diabetes. Let’s examine each of these components in turn.

1. Stress

Diabetes is not solely brought on by stress. However, there is some evidence suggesting that stress and the risk of type 2 diabetes may be related. High levels of stress hormones may prevent insulin-producing cells in the pancreas from functioning properly and cause them to produce less insulin, according to our study.Reversing diabetes and pre-diabetes can be aided by reducing stress. The good news is that even if stress hormones cause sugar surges and damage to the insulin receptors, the harm is temporary.

2. Diet

One of the most important factors contributing to the development of type 2 diabetes is an unhealthy diet and bad eating practices. As a result, planning a diabetic diet and visiting a diabetes expert should be done as soon as type 2 diabetes is diagnosed, as well as to prevent type 2 diabetes.

People frequently neglect or avoid eating fibre. A person with type 2 diabetes needs to consume a lot of fiber-rich foods. Fibers assist control blood sugar levels and slow down glucose absorption. A daily consumption of 30 grammes of fibre from a variety of vegetables is recommended. Type 2 diabetic diets must also contain foods high in complex carbs, such as millets, barley, whole wheat, brown rice, and others, in addition to proteins and fibres. Additionally, eating vegetables like onions, garlic, cauliflower, salad greens, green beans, broccoli, okhra, bitter gourd, fenugreek, etc. can help reverse type 2 diabetes and stop it from developing in the first place.

Additionally, it’s crucial to apply the nutritional changes gradually – start with the fundamentals, then add in juice binges and intermittent fasting to increase fat burning and aid in detoxifying. A diet that promotes muscle growth must come next, followed by a maintenance programme.

3. ExerciseAs we’ve already seen, diabetes is a lifestyle disorder caused by a lack of regular physical activity. As such, it requires diabetics to engage in regular workouts like walking, running, cycling, and swimming.But stress is another major contributor to diabetes, in addition to a poor diet and inactivity. However, stress doesn’t just affect diabetes; it also leads to a number of other issues. Exercises that defy gravity, such as stair climbing, nitric oxide dumps, resistance bands, yoga, and the best warm-up in the world, are beneficial in reducing stress and boosting muscular endurance, flexibility, and strength.

Summing Up

From the standpoint of maintaining the reversal process and avoiding becoming dependent on those pricey diabetes medications, naturally reversing diabetes is crucial. Remember that treating diabetes needs a steady process and that becoming healthier than ever demands a strong sense of self-commitment and drive. To ensure long-term success, it requires a person to modify their way of life and stick with those adjustments. To learn what works for you and what doesn’t, speak with a diabetic professional before starting a diet programme or picking an exercise to begin the reversal process.

The author is a Diet Educator & Founder, Diabexy

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Genetic testing for cancer: Why it makes sense

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The right information gives one immense power to make a wise choice. The treatment of cancer is no different. Cancer always occurs due to genetic mutations in the body, but when we say ‘genetic,’ it does not necessarily mean ‘hereditary.’ Hereditary cancer predisposition accounts for only 10-15 % of all cancers. The rest are a result of chance mutations acquired over one’s lifetime.

A genetic mutation is a disruption in the code of life written in our DNA by nature. A human cell is programmed to behave in a certain normal way throughout life. A change in the genetic code (mutation) due to several host-related and environmental influences can reprogram it to become cancerous (with uncontrolled growth).

So, the question arises: For a disease which is caused by genetic mutations, would it not make sense to perform genetic testing? Genetic testing has several important implications in the management of cancer.

Genetic testing is generally done for patients with a significant family history of cancer, or some specific patterns of presentation of cancer. If a causative germline mutation is identified, the individual’s family members are also screened for it. Thus, a cancer patient who gets suitable genetic testing done also helps save lives of family members by making them aware of any causative mutation present in their genes.

Testing for germline mutations like BRCA 1 and BRCA2 for breast and ovarian cancer, and MMR genes for colon cancer, can identify at-risk individuals. Preventive and early detection strategies can be employed in these cases to completely avoid getting cancer or treat it when it is at the earliest stage, offering more than 95% chances of cure.

For people with high-risk mutations, several strategies are used to completely prevent or detect cancer early. These include risk-reduction mastectomies (removal of breast tissue), risk-reduction oophorectomy (removal of ovaries), and hormonal therapy with simple drugs like Tamoxifen and screening MRIs.

Genetic testing is not only useful in prevention and early detection of cancer, it is also extremely important during treatment. Genetic alterations such as EGFR, ALK, ROS1 and MET in lung cancer; BRCA in breast, ovarian and prostate cancer; RAS, B-RAF and MSI in colon cancer, and B-RAF in Melanoma (skin cancer) are some examples where therapies which target these driver mutations, or act via pathways dependent on these mutations, improve survival as well as quality of life of patients.

Micro-satellite instability, higher tumour mutation burden and mutations like POLE can help inform decisions regarding using immunotherapy in suitable patients. One such example was the recent Dostarlimab study in rectal cancer which showed unprecedented responses in those with microsatellite unstable tumours. Genomic risk scores can help decide the need for add-on chemotherapy after surgery in early hormone-positive breast cancer.

For patients with blood cancer, mutations like BCR-ABL in CML and JAK2 in other myeloproliferative neoplasms (MPNs) are not only diagnostic but also confer sensitivity to targeted drugs like Imatinib (and similar drugs like Dasatinib, Nilotinib and Bosutinib) and Ruxolitinib.

Targeting FLT3 mutation in acute myeloid leukaemia (AML) has changed the outcome significantly for FLT 3 Mutated AML. Similarly, IDH inhibitors and Menin inhibitors are impacting the treatment of AML immensely in those with certain genetic mutations.

Genetic testing for blood cancers helps in stratifying these cancers into a favourable v/s unfavourable biology, helping doctors take decisions whether a particular patient will benefit with more treatment like allogenic stem cell transplant. Thorough testing can identify the reason why certain patients with acute lymphoblastic leukaemia do poorly despite otherwise having no high-risk features.

Testing hundreds of mutations together by a strategy called Next Gen Sequencing has increasingly become more and more accessible and affordable in India. Based on such ‘comprehensive genomic analysis’ where several different mutations are taken into account, approaches that utilize combinations of targeted drugs and chemotherapy/immunotherapy are sometimes able to elicit responses in relapsed / refractory cancers where routine treatment has failed. Several such strategies are currently being tested in clinical trials.

Genetic mutations are also used after treatment to monitor disease and detect recurrence or change in disease biology early, such as minimal residual disease testing in AML, T790M in lung cancer and T315I in Chronic myeloid leukaemia.

Overall, genetic testing is now an integral and essential part of treatment of cancer which guides risk reduction, screening strategies, prognosis as well as treatment and follow up.

The author is a Senior Consultant, Medical Oncology/Hematoncology/BMT, Amrita Hospital, Faridabad. View are personal. Views are personal.

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Digital health technologies transforming traditional family doctor-patient relationship

Representational image. News 18

In India, chronic diseases are on the rise due to changing lifestyles, putting a heavy burden on specialty doctors. According to the LASI report, high cholesterol, diabetes, and physical inactivity were key risk factors for rising incidents of cardio-vascular diseases. Further, India is becoming the diabetes capital of the world and the associated comorbidities diseases pose a major threat.

Medical cases, especially in rural Bharat are reported at a very late stage of the disease, leaving doctors very little room to help patients. A proactive approach to prevention, early diagnosis and screening is becoming increasingly important. However, there is very little coverage of specialists across the country.

In this scenario, the role of traditional Family Doctors is seeing renewed interest. The concept of family doctors or physicians has been around for long, but their prominence in the healthcare space had seen a decline. Generally, family doctors know a patient’s entire medical history as well as life events that may influence his or her health. But traditionally this has been managed in an offline manner.

Living in a complex world of diseases, doctors today need the power of digital tools to drive better health outcomes and enhance their relationships with their patients. A well-informed doctor can better manage a family’s health if they have access to updated health information and working relations with specialty doctors. In many cases, doctors need to rely on tech innovations to be able to find answers to complex treatment situations and drive better health outcomes.

An Electronic Medical Record system (EMR) is one such example. EMRs are essentially electronic versions of patient health information collected over time. They can be used across diverse healthcare settings and across all specialties of doctors.

Technological capabilities coupled with the longitudinal view of patient health information made available through EMR can enable the family doctor to set a strong foundation for prevention and early detection of diseases in their patients.

EMRs also enable the doctors with Insights dashboard, prescription summaries, and pre-defined templates that help in the effective structuring of patient information. This digital approach trumps the traditional hand-written prescriptions and equips the family doctors today to handle a complex health crisis while reducing incidents of misdiagnosis / medical errors.

When it comes to doctor-patient relationships, EMR enables doctors to communicate effectively and regularly with their patients in the language that they are most familiar with. Studies have shown that this two-way approach to managing one’s health has led patients to be more involved in their care. Some industry reports also suggest that EMRs have improved the work lives of family doctors, by making quality health systems and sources of information readily available, anywhere, and anytime. Increased productivity, operational efficiencies, and turn-around-time (TAT) to come up with analytics based on historical information are indicators of the transformational role an EMR plays in doctors’ life.

Compared to western countries, India was at a nascent stage in adopting EMR. Thanks to healthcare programs like Ayushman Bharat Digital Health Mission (ABDM) by Govt of India, the scenario is changing rapidly. From large hospitals to individual single doctor clinics, the adoption of technology in general and EMR in specific is growing in India and is playing an important role in transforming doctor patient relationships.

The author is the head – of sales (Doctor Growth) HealthPlix Technologies. Views are personal.

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