Category Archives: Health Wise

COVID19: DRDO’s 2-Deoxy-D-Glucose drug decoded

Dr Rahul Pandit talks about the drug that was approved for emergency use as an adjunct therapy in moderate to severe COVID19 patients by the Drugs Controller General of India early this month.

Mumbai, May 17, 2021: Adding another ammo to our battle against COVID19, the Government of India has introduced a promising anti-COVID19 drug called 2-deoxy-D-glucose (2-DG). The drug has been developed by the Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of Defence Research and Development Organisation (DRDO), in collaboration with Dr Reddy’s Laboratories (DRL), Hyderabad. The drug was approved for emergency use as an adjunct therapy in moderate to severe COVID19 patients by the Drugs Controller General of India (DCGI) early this month.

WHAT IS 2-DEOXY-D-GLUCOSE (2-DG)? 2-Deoxy-D-Glucose drug has historically been extensively tested for treating Cancer but is so far an unapproved drug. However, for COVID19, the drug shows promise. The drug comes in powder form in a sachet, which is taken orally by dissolving it in water. It accumulates in the virus-infected cells and prevents virus growth by stopping viral synthesis and energy production. Its selective accumulation in virally infected cells makes this drug unique. The Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of the DRDO, in collaboration with Dr Reddy’s Laboratories (DRL), Hyderabad, has been studying this drug in the context of radiation therapy for cancer.

The primary mechanism of the drug involves inhibiting glycolysis or one of how cells break down glucose for energy. While used to starve and kill cancer cells, this approach could also work in inhibiting virus cells too that were dependent on glycolysis for replication. When the pandemic broke out in India, INMAS, DRDO, and DRL switched their effort to explore the possibilities to use this drug to defeat COVID19. Tests at the Centre for Cellular and Molecular Biology, Hyderabad, last year indicated that the drug demonstrably killed virus cells after which it progressed to trials in people. 

2-DEOXY-D-GLUCOSE DRUG CLINICAL TRIAL: GATHERING CLINICAL EVIDENCE AND EFFICACY. In April 2020, INMAS started experimental examinations in Hyderabad with the Centre for Cellular and Molecular Biology (CCMB). After which, the Central Drug Standard Control Organisation (CDSCO) and the Drug Controller General of India (DCGI) jointly granted permission for Phase-2 trials in May 2020. Between May to October 2020, the institute started initial trials on how COVID19 patients would respond to the drug. The drug worked well with no side effects, and the patients recovered quickly. Further on, the Phase 3 clinical trial was conducted between November 2020-March 2021 in Delhi, UP, Bengal, Gujarat, Maharashtra, Telangana, Andhra, Tamil Nadu, and Karnataka. The results were favourable.

THE EFFICACY FACTOR: Clinical trial results have shown that this molecule helps in faster recovery of hospitalised patients and reduces supplemental oxygen dependence. The drug will be of immense benefit to the people suffering from COVID19. As per clinical data for efffficacy trends, the patients treated with the 2-DG drug showed faster symptomatic cure than Standard of Care (SoC) on various endpoints. A significantly higher proportion of patients improved symptomatically and became free from supplemental oxygen dependence (42% vs 31%) by day-3 compared to SoC, indicating an early relief from Oxygen therapy/dependence.

ACTING WITH RESPONSIBILITY: This drug comes when our nation is grappling to cope with the impact of the devastating second wave of COVID19, which has stressed our infrastructure and resources to its limit. I see a ray of hope, that with the availability of this drug, we may be able to reduce the burden of COVID19 and save as many lives as possible. Having said that, precaution is a must. No COVID19 medication should be taken without a doctor’s prescription. Moreover, hoarding drugs is a crime, and as responsible citizens of the nation, we must ensure that these medicines should be available and accessible to those who need it.

(Dr Rahul Pandit is Director-Critical Care, Fortis Hospitals Mumbai & Member of Maharashtra’s COVID Taskforce)

Zzz! Sound sleep was a major challenge for Indian adults during lockdown

The article was carried in all editions of The Free Press Journal on April https://www.freepressjournal.in/health/world-health-day-2021-indians-grapple-with-new-sleep-challenges

23% women in Mumbai are prone to anaemia while 27% men are predisposed to diabetes, reveals Indus Health Plus Survey

World Health Day: The study’s overall sample size in Maharashtra was 21,500 people while that for Mumbai was 2,978. These people underwent preventive health check-ups between October 2019 and February 2021.

Mumbai, April 7, 2021: On the occasion of World Health Day, Indus Health Plus Survey revealed that people in Maharashtra are susceptible to diabetes (27%), Vitamin B12 Deficiency (23%), dyslipidemia (17%), obesity (13%) followed by heart diseases (10%) and anaemia (10%). The key non-modifiable risk factor is the genetic makeup of an individual favoured by environmental, age, gender, stress and physiology, metabolism, which increases the onset and progression of lifestyle diseases. 

The study’s overall sample size was 21,500 people who underwent preventive health check-ups between October 2019 and February 2021. From Mumbai, the total sample size was 2,978 people. It was observed that the Mumbaikars are predisposed to diabetes (25%), dyslipidemia (18%), Vitamin B12 deficiency (16%), obesity (15%), followed by anaemia (14%) and heart diseases (12%). 

Amol Naikawadi, JMD, and Preventive Healthcare Specialist, Indus Health Plus, says, “Diabetes and cardiovascular diseases are prevalent in India. These diseases tend to impact people in the most productive years of their lives and result in social and economic consequences. Another important aspect is that comorbid conditions such as diabetes, obesity, and heart diseases are high-risk conditions for COVID-19. Hence, proper management to keep them in control is vital, especially in this situation.” 

Measures to boost immunity

  • Get enough sleep
  • Eat more healthy fats and whole plant food
  • Stay hydrated
  • Take a probiotic supplement
  • Limit added sugars
  • Engage in moderate exercise
  • Manage stress
  • Maintain good hygiene
  • Avoid smoking and alcohol
  • Don’t consume excessive saturated fats

The trend report highlights that women are prone to anaemia (23%) and dyslipidemia (20%) compared to men. Men are at higher risk of diabetes (27%), Vitamin B12 deficiency (21%)and heart ailments (14%). 

The data gives us an insight into individual health needs to be taken very seriously. Health means physical, social, mental wellbeing with absence from diseases. Therefore, ensure regular health check-ups and follow-ups, personalized diet and lifestyle goals need to be set and followed, and strong immunity to protect from diseases. 

“While exposure to the SARS-Cov-2 virus remains the most decisive factor determining the chances of getting COVID-19, other possible factors may influence the response to infection. These risk factors include reduced immunity, presence of existing comorbidities, and age. The genetic variants can influence the response to COVID-19 by regulating the immune function that can make an individual less or more vulnerable than others. Therefore people must understand the value of prevention and continue to invest in timely and routine examination to monitor comorbidities and keep them at bay,” adds Naikawadi. 

The main focus of people should be on wellness and prevention of lifestyle diseases and to create a culture of healthy living among the younger generation. The best way to minimize the cost of treating lifestyle diseases is to invest in preventive healthcare, which accounts for a fraction of the money spent on corrective steps.

CATEGORYNo. of MEN: 1436 No. of WOMEN: 1542 Total: 2978
In %In %In %
ANAEMIA5%23%14%
DIABETES – F BSL27%23%25%
DYSLIPIDEMIA – TOTAL CHOLESTEROL16%20%18%
HEART PROBLEM – CT CORONARY ANGIOGRAPHY14%9%12%
OBESITY16%13%15%
VITAMIN B 1221%12%16%

Do not ignore symptoms of tuberculosis! It’s curable.

World TB Day 2021: Tuberculosis kills more number of people in India every year than the lives COVID19 has claimed over the past 12 months? Today, all we need is a surge in our actions to reduce the TB burden, tells Dr Anshu Punjabi.  

New Delhi, March 24, 2021: In the past year, the COVID19 virus grabbed much of our attention. The collateral damage that it caused in one year is very unimaginable. But did you know, Tuberculosis (TB) kills a more significant number of people in India every year than the lives COVID19 has claimed over the past 12months?

Tuberculosis continues to inflict a large quantum of socioeconomic cost on our nation. Although TB has been curable and our government has made great strides to improve diagnosis and drug delivery mechanisms, our war with this deadly disease exists. All we need today is a surge in our actions to reduce the TB burden intensely. But how is that possible?

Well, the best approach to this is to sensitize people with the growing burden of TB and empower them enough to identify symptoms, report it early, undergo timely diagnosis, and complete adherence to treatment. So, first things first.

WHAT IS TUBERCULOSIS AND HOW DOES IT AFFECT US? TB is an infection caused by bacteria called Mycobacterium Tuberculosis and spreads through the air from one person to another when an infected person coughs, sneezes or laughs. Even though the bacteria travel easily, it’s not easy to be infected by TB. Most often, it’s spread between family members, close friends, and people who live or work together. TB most commonly affects the lungs, but it can affect other parts of the body as well, like lymph glands, abdomen, spine, joints, etc.

There are two kinds of tuberculosis (TB) infections — latent TB and active TB disease.

WHAT IS LATENT TB? In most healthy people, the body’s natural immune system kills the bacteria and there are no symptoms. Sometimes, the immune system cannot kill the bacteria but manages to prevent it from spreading in the body. You will not have any symptoms, but the bacteria will remain in your body – this is known as Latent TB. People with Latent TB are not infectious to others, and do not feel ill. It is usually happens to children. Sometimes, this dormant TB gets activated when the body’s immune system is extremely low, say in the case of HIV, cancer, diabetes, etc.

This may occur like a normal fever and can go unnoticed. In India, we do not treat latent TB, as most people would have been exposed to the bacteria at some point in time. Moreover, there is no good evidence that all these people will develop active TB disease in the future, or that treating Latent TB will prevent further reinfection.

WHAT IS AN ACTIVE TB? When the immune system is unable to kill or contain the bacteria, Active TB develops. The lungs’ Active TB disease is contagious, which means it can be spread from one person to another. It is most often spread through the air; these bacteria may enter the air when a person with TB disease of the Lungs or throat coughs. People nearby may breathe in these bacteria and get infected. People get sick from the TB bacteria that are alive and active. 

SO, WHAT ARE THE RISK FACTORS?

  • Being in close contact with a person with Active Lung TB disease is highly risky
  • If you are in contact with any groups known for passing on TB, such as the homeless, injection drug users, and persons with HIV/AIDS
  • If you are living or working with people who are at high risk for TB, such as those in hospitals, homeless shelters, prisons, slums, or refugee camps 

MAJOR SIGNS AND SYMPTOMS THAT YOU SHOULDN’T IGNORE:

  • A cough that lasts two-three weeks or more
  • Pain in the chest, with cough or at rest     
  • Coughing up blood or thick mucous
  • Night sweats
  • Feeling weak or tired
  • Weight loss
  • Not wanting to eat
  • Fever, mainly in the evening
  • Swollen neck lymph-gland(s)

The longer people wait, the TB disease worsens. Although the stigma associated with TB has gone down significantly, people need to be alert, aware, and responsible when it comes to identifying symptoms and getting treated early. TB is treatable and curable. Treatment for drug-sensitive TB is a combination of antibiotics for six months. People with drug-resistant TB will need more extended treatment with at least 5-6 drugs under expert supervision.

(Dr Anshu Punjabi is Consultant-Pulmonologist & Sleep Medicine Expert, Fortis Hospital, Mulund; Image by Wilfried Pohnke from Pixabay

Safe water means good health. Do you know why?

On World Water Day, Dr Sonali Gautam explains poor water hygiene’s impact on one’s health, especially children.  

New Delhi, March 22, 2021: On World Water Day, while we all should aim to save the most precious gift and a vital life source, we must also focus on improving water supplies and hygiene. You must be wondering why, so let me explain the impact of poor water hygiene on health. Worldwide, 2.2 billion people lack access to safely managed drinking water, and 4.2 billion people lack safe sanitation. Unsafe hygiene practices are widespread, compounding the effects on people’s health. The impact on child mortality rates is devastating, with more than 2,97,000 children under five die annually from diarrhoeal diseases due to poor sanitation, poor hygiene, or unsafe drinking water.

In India, the problem of unsafe water is a substantial public health concern. Apart from illnesses such as diarrohea, jaundice, etc., unsafe water also contributes to Hepatitis A & E. Both these diseases are associated with inadequate and unsafe water supplies, poor sanitation & hygiene, leading to infection and inflammation of the liver.

What is Hepatitis A and E? Hepatitis A and E viruses are RNA virus, which primarily infects the liver, causing inflammation of the liver (Acute Hepatitis). Infection with Hepatitis A & E is usually self-limiting.

How is the infection acquired? Hepatitis A or E is spread primarily through food or water contaminated by faeces from an infected person (feco-oral route). It enters the liver from our gut and is then excreted again by our gut into the stool, thus completing the infection cycle.

Who are at risk for Hepatitis A or E? Not everyone who’s infected will have any evidence of this disease, as it may go unnoticed (asymptomatic disease). But still, these people can excrete viruses in their stool and continue to infect others (carriers).

Asymptomatic disease: India being a developing nation with poor sanitation conditions, more than 95% of children below five years of age are usually infected with these viruses, with an asymptomatic course. Thus, in India, antibody to Hepatitis A virus is nearly universally detectable by adolescence, and antibody to HEV increases during young adulthood to reach about 40% in adults.

How does it spread? Hepatitis A is usually spread person-to-person through food or water contamination. An infected person’s hands can become the source of infection after using the bathroom. The virus then spreads by direct contact or by food, beverages or other objects that the infected person handled. An infected individual can transmit the virus to others as early as two weeks before the symptoms begin to appear.

Symptomatic disease: International travellers to India, children from high-income families are at risk of developing Hepatitis A or E infection because they do not eat much from the streets and have not developed the required antibodies resulting in fever, stomach-ache and jaundice.

What are the symptoms of Hepatitis A or E?

  • Fever
  • Tiredness
  • Stomach upset
  • Loss of appetite
  • Dark yellow urine
  • Diarrhoea
  • Yellowish eye & skin called jaundice

Why is it dangerous? Unlike Hepatitis B & C, Hepatitis A does not cause Chronic Liver Disease and is rarely fatal. But it can cause debilitating symptoms and Fulminant Hepatitis (Acute Liver Failure), which is often fatal. Fulminant Hepatic Failure leading to death is seen in 1.8 % adults, and 10% in pregnant ladies.

Most people with Hepatitis E get better within a few months. Usually, it doesn’t lead to long-term illness, or Liver damage like other forms of Hepatitis do. But Hepatitis E can be dangerous for pregnant women or anyone with weak immune systems, including the elderly or ill.

How to prevent it? The best approach is to take all precautions to avoid Hepatitis and ensure safe drinking water for all. Make sure that your water source is clean and well maintained. Apart from this, follow this:

  • Hand sanitation: Frequent handwashes before meals and after using the washroom.
  • Avoid eating outside, especially if you are pregnant.
  • Hepatitis A vaccine: Vaccinate your children below six years (consult a paediatrician about this).

If you identify any of the above symptoms, kindly meet your Gastroenterologist for timely treatment and care to resolve the infection with expected full recovery.

(Dr Sonali Gautam, Consultant-Gastroenterology, Hiranandani Hospital, Vashi, a Fortis network hospital; Image from Pixabay)

Care for your oral health to keep cancer at bay

On World Oral Health Day 2021, Dr Hitesh R Singhavi tells us why oral hygiene is a must.

New Delhi, March 20, 2021: Did you know that people whose inner cheek, teeth and gums are in poor condition may be more susceptible to mouth and throat cancers? Well, here is what you should know. Oral cancer is one of India’s most common cancers amongst men (11.28% of all cancers), the fifth most frequently occurring cancer amongst women (4.3% of all cancers). The causes attributed to oral cancer are mainly tobacco chewing, areca nut, alcohol consumption, and poor oral hygiene (POH). We often associate poor oral hygiene with dental caries, Gingivitis, Periodontitis (gum disease) and foul smell. Still, poor oral hygiene, in the long run, can give rise to fatal diseases, including cancer. A British study has shown that patients with poor oral health index have an overall higher mortality rate (they die prematurely) compared to others. Let’s take a look at the frequently asked question related to poor oral hygiene and oral cancer.

WHAT ARE THE FACTORS CAUSING POOR ORAL HYGIENE? There are numerous common factors leading to poor oral hygiene, including tobacco chewing, alcohol, areca nut chewing, infrequent dental visits, immunocompromised status, low socio-economic status, and lower education level. Studies have shown that all these factors significantly deteriorate oral hygiene.

HOW DOES POOR ORAL HYGIENE CAUSE ORAL CANCER? POH is strongly associated with oral cancers. It aids the carcinogenic potential of other known carcinogens, like tobacco and alcohol. It causes easy conversion (faster endogenous nitration) of tobacco metabolite into cancer causing products (nitrosamines), leading to cancer development. POH also reacts with alcohol to form Aldehyde-also a class I carcinogen (Class I carcinogen are the product which can independently cause cancer).

HOW CAN YOU PREVENT ORAL CANCER BY MAINTAINING GOOD ORAL HYGIENE? One should not consume tobacco or tobacco products, which is one of Gingival Recession’s major causes (loss of gums), leading to loosening of teeth and the formation of a pre-cancerous lesion. Similarly, avoiding alcohol consumption may help maintain good oral hygiene, as evidence shows that an alcohol consumer has higher chances of foul-smelling mouth, more tar burdened teeth, and a greater possibility of bleeding gums.

WHICH ARE THE PARTS OF ORAL CAVITY YOU SHOULD LOOK FOR CANCEROUS LESION ASSOCIATED WITH POOR ORAL HYGIENE? Buccal Mucosa (inner cheek mucosa) is the most common oral cavity cancer site when POH is associated with tobacco chewing habit. When POH is associated with alcohol, then under the tongue’s surface, the floor of the mouth is the most common site.

CAN SHARP TOOTH OR ILL-FITTING DENTURE CAUSE ORAL CANCER? Chronic mucosal trauma due to a sharp tooth or ill-fitting dentures can cause oral cancer. A study conducted by Tata Memorial Centre (Singhavi et al) has concluded that chronic mucosa trauma has higher chances of developing oral cancer. It’s not an uncommon finding to have oral cancer in non-habitual patients, especially tongue cancers. Chronic mucosa trauma and poor oral hygiene are the front runners in such cases.

Evidence that ascertains the link between poor oral hygiene and oral cancer: Level 1 (direct causation) evidence to determine poor oral hygiene as the primary etiological factor of oral cancer is lacking. However, studies have shown that maintaining good hygiene reduces the chances of oral cancer by 200%. Also, 93 relevant articles published in the literature until the year 2020 concluded that poor oral hygiene contributes to oral cancer causation, in one way or the other. However, for more information, refer to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414580.

Thus, on the occasion of World Oral Health Day, which is observed on March 20th, 2021, let’s pledge to spread the word and educate people on the significance of oral health and sensitise people that maintaining good oral hygiene is a must to stay away from oral cancer.

(Dr Hitesh R Singhavi is Consultant, Head and Neck Surgeon, Fortis Hospital, Mulund; Image by Daniel Albany from Pixabay

107-year-old man becomes the oldest person in India to get COVID vaccine at Fortis Hospital

At 105, he was the oldest patient in the world to undergo Carotid Artery Stent Implantation to remove a major blockage in the artery supplying blood to the left half of his brain to prevent a major stroke and paralysis.

New Delhi, March 15, 2021: Kewal Krishan, age 107 years plus, became the oldest person in India to be vaccinated against COVID under the supervision of his cardiologist Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute. Two years ago, he was the oldest patient in the world to have undergone stenting to the artery of left side of brain by Dr Ashok Seth to prevent a major brain stroke.

Dr Ashok Seth, Chairman, Interventional Cardiology, Fortis Escorts Heart Institute, with 107-year-old Kewal Krishan while he was getting vaccinated.

Dr Ashok Seth, Chairman, Interventional Cardiology, Fortis Escorts Heart Institute, said, “It is really a heartening moment to see that Mr Kewal Krishan has got vaccinated safely and will continue to lead a good quality of life in safety. This is important especially because two years ago Krishan started having repeated small strokes and was threatening a major stroke leading to paralysis. He had a 95% calcified left carotid artery stenosis (blockage in the main artery supplying blood to the left half of brain). The blockages were very hard, torturous and angulated. It took us two hours to treat it via a non-invasive Carotid Artery Stent Implantation. I am happy to say that he improved and that day we prevented him from having a major stroke and today he is well, lead a quality of life and therefore took the vaccine to remain well and enjoy his life with his family. He is an example for many other elderly patients to keep a positive attitude to life and wellbeing.”

Mr Anil Vinayak, Group COO, Fortis Healthcare, said, “Fortis is committed to supporting the Government in this mammoth vaccination drive. At Fortis Healthcare, we have administered more than 60,000 doses till date across 21 of our network hospitals pan India. It is extremely encouraging to see the increase in the vaccination numbers with each passing day.”

COVID19 vaccination: 20 points to keep in mind

Go ahead and get the jab for yourself and your loved ones, says Dr Rahul Pandit

New Delhi, March 13, 2021: We have entered the second phase of the world’s largest immunization program. However, several looming questions could hamper the success of this program and weaken the fight against COVID19.

Only people who have an Anaphylaxis (allergic reaction) to any of the vaccine contents, should NOT take the vaccine.

Yes, vaccination is the most effective tool to fight the COVID19 pandemic, and help us succeed in our mission to restore normalcy! Having said that, the COVID19 vaccination drive in India has seen much momentum since day one. With an enthusiastic push from the civic bodies, we are slowly but steadily approaching our target goals. After successful round of vaccination for the healthcare providers and frontline workers, we have now moved to vaccinate and protect seniors above 60 years of age, and those above 45 years with comorbidities.

Here’s a guideline to help proceed with vaccinating yourself and your loved ones:

1.       All adults should take the COVID19 vaccine and encourage others to take it as well.

2.       You should have had your meals, and be well hydrated for your vaccination.

3.       Only people who have an Anaphylaxis (allergic reaction) to any of the vaccine contents, should NOT take the vaccine.

4.       All approved vaccines including Covishield and Covaxin have:

  • 100% efficacy in preventing death due to COVID19
  • Very high efficacy against severe COVID19
  • High to moderate efficacy (60%-95%) against symptomatic COVID19
  • Poor efficacy only against asymptomatic COVID19

5.       Vaccinating the high-risk vulnerable population – above 60 yrs and above 45 yrs with co-morbidities will bring down the mortality rate to ‘very low’, as currently, this group forms almost 90% of patients who succumb to the disease. Therefore, we must encourage people in these age groups to be vaccinated.

People with previous COVID19 infection should take the vaccine only after 8-12 weeks of recovery from COVID 19.

6.       People with previous COVID19 infection should take the vaccine only after 8-12 weeks of recovery from COVID 19.

7.       A person who has received Plasma Therapy to treat a previous COVID19 infection should wait for 8-12 weeks before taking the vaccine.

8.       Vaccine is safe in patients with hypertension, diabetes, renal failure, and heart disease, amongst those who have undergone bypass, post-angiography, and those on dialysis.

9.       In pregnant women, if the benefit outweighs the risks of the vaccine, then you may take the vaccine. For example, a frontline pregnant worker should take the vaccine.

10.   There is no data on how long pregnancy should be avoided post-vaccination. However, as it is an inactivated or dead virus it should be safe after 6-8 weeks of vaccination to conceive.

People on anti-platelet agents like Aspirin and Clopidogrel
should take the vaccine without stopping their medication.

11.   Vaccine is safe amongst those with a food allergy, drug allergy (other than the vaccine components) and common allergic conditions such as asthma, allergic rhinitis and allergic dermatitis. But consult your doctor before enrolling yourself.

12.   People on anti-platelet agents like Aspirin and Clopidogrel should take the COVID19 vaccine without stopping their medication.

13.   Patients on blood thinners like Warfarin or newer anticoagulation agents have a small risk of injection site swelling. Patients who are on these newer agents can skip their morning dose, take the vaccine and continue the next regular dose.

14.   Patients with neurological complications like stroke, Parkinson’s, dementia should take the vaccine as it is safe for them.

15.   Patients on immunosuppressant’s (i.e. patients who’ve undergone organ transplants) of any type can safely take the vaccine. However, immune response may not be complete. Check with your doctor before enrolling.

A simple Paracetamol can be taken post-vaccination if required, and most symptoms would be well controlled.

16.   It is false that alcohol is not allowed post-vaccine or that vaccine causes impotency or that vaccine will change the DNA of a person.

17.   There are currently no trials available on children, hence vaccination for those below 18 years can be delayed for now.

18.   Patients with cancer and those undergoing Chemotherapy should consult their doctor and seek an appropriate window for vaccination between the Chemotherapy cycles. Ideally, the patient should wait for at least four weeks post-chemotherapy to take their vaccine.

19.   Fever, body ache, dizziness, headaches are common symptoms post-vaccination.

20.   A simple Paracetamol can be taken post-vaccination if required, and most symptoms would be well controlled.

Do not believe in rumours, the best way to get the right information is to speak to doctors at medical centres who are offering the COVID19 vaccination. Remember, vaccine-induced immunity is as important as herd immunity. It is the current and the only way to tackle the growing menace of the virus. Let’s all come together to fight back and end the pandemic once and for all.

(The article has been authored by Dr Rahul Pandit, Director-Critical Care, Fortis Hospitals Mumbai & Member-Maharashtra’s COVID Taskforce) 

(Images from Pixabay by Wilfried PohnkeGerd AltmannAlexandra_Koch; fernando zhiminaicela)

)

Things you should do to manage your PCOS/PCOD

Statistics state that one in every five women in India suffers from Polycystic Ovarian Syndrome or Polycystic Ovarian Disease and cannot live a healthy life. PCOS and PCOD bring along complications that deteriorate the quality of life.

New Delhi, March 5, 2021: Ever since Lata entered puberty, she has had difficulty in managing her weight. She craved carbohydrates and even skipped dinner, but her weight increased at a faster rate month over months. Apart from her weight problem, she faced acne and Hirsutism issues (male-pattern facial hair growth). She also has visited her primary care physician on several occasions, complaining of dizziness, feeling shaky, and irregular menses. Her doctor started her on birth control pills to regulate her periods but in vain. Later, she was detected with Hypoglycemia; her physician and her family encouraged her to follow a strict diet and exercise regimen.

Lata is now married for two years and plans to begin a family but cannot conceive. She continues to struggle with severe Hypoglycemia, has elevated serum triglyceride levels and feels miserable. However, recently when Lata visited a reproductive Endocrinologist, she was diagnosed with Polycystic Ovarian Syndrome (PCOS).

Like Lata, many young women suffer from Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Disease (PCOD) and cannot live a healthy life. These conditions bring along complications that deteriorate the quality of life among young women. Statistics state that one in every five women in India suffers from PCOS.

DIFFERENCE BETWEEN PCOS AND PCOD: In women with PCOS, their ovaries produce higher levels of androgen than usual, which interferes with the development and release of the eggs. Some of the eggs develop into cysts – which are the little sacs filled with liquid. Instead of being released during ovulation, these cysts build up in the ovaries and even get enlarged. PCOD (Polycystic Ovarian Disease) is a condition where the ovaries release many immature or partially mature eggs, which eventually turn into cysts. Some common symptoms are abdominal weight gain, irregular periods, male pattern hair loss, and infertility. In this condition, the ovaries usually become enlarged and secrete large amounts of androgens that can cause havoc with a woman’s fertility & her body.

Symptoms of PCOS/PCOD.

EFFECTIVE WAYS TO MANAGE PCOD AND PCOS: Obesity is recognized as an important contributory factor in these conditions. So, diet control, exercise, and monitored weight loss are the first line of treatment. Even 10% weight loss helps quite a lot for hormone imbalance management and in bringing body mass index <25. This also improves menstrual disorders, infertility, insulin resistance, Hirsutism, and acne.

Hormonal management with combined Oral Contraceptive Pills (OCP) is effective in reducing Luteinizing Hormone and Testosterone Hormone. PCOD/ PCOS is not a disease; it is a hormonal imbalance where male hormones increase, so we can control these hormonal changes with OCPs. Insulin resistance is associated with Diabetes Mellitus, central obesity, Dyslipidemia and Hypertension, which can be managed.

Hormonal changes cause abnormal uterine bleeding, prolonged menses, and anovulation (absence of ovulation), for Endometrial Hyperplasia, sometimes endometrial biopsy has to be done. For young females presented with infertility, ovulation induction is done with hormones. Sometimes if the person is not responding to medicine, then Laparoscopic Ovarian Drilling is done. There are rare cases where if weight loss is not possible with diet and exercise, then bariatric surgery is prescribed. Anti-androgen medicines are used for cosmetic purposes in Hirsutism patients. Laser is also used for hair removal.

So, eating the right foods and avoiding certain carbohydrates & fat helps manage the symptoms. Try to consume whole foods which are free from sugar, hormones and preservatives; fruits, vegetables whole grains and legumes should be preferred. Moreover, plant-based proteins and unprocessed high carbohydrates can improve insulin sensitivity. Try to consume more fibre in your diet, reduce the consumption of coffee. Soy, Turmeric, Cinnamon, Vitamin-D3, Calcium, Zinc, Primosa oil, and Cod liver oil should be added to your diet.

(Text by Dr Sushma Tomar, Consultant Obstetrics and Gynecology Fortis Hospital, Kalyan; Images by Soleha Shaikh, Mumbai-based nutritionist and certified diabetes educator, and calligraphy artist.) 

Five misconceptions about contraceptive pills busted

Dr Neha Bothara explains how the birth control pill is safe, affordable and effective when used correctly.

There are many risks that myths and misconceptions around oral contraceptive pills can bring along. For example, unfounded concerns or false perceptions deter men and women from using a particular contraceptive method or contraceptive altogether. It can ultimately lead to unwanted pregnancies and unnecessary physical as well as mental harm to the woman. However, with the right amount of education, women can easily have a healthy sexual and reproductive life.

The biggest advantage of oral contraceptive pills is that they are effective and have a very low failure rate when used correctly; other benefits include regular menstrual cycles and lighter flow. However, taking one pill daily can seem tedious for some women and can also lead to missed pills which add to the failure rate. Therefore, women need to take responsibility for their reproductive health while consuming contraceptive consciously and carefully. All women must consult a gynaecologist before starting any new contraceptive, especially pills.

Learn the truths about 5 contraceptive myths that you should not believe:

ALL CONTRACEPTIVE PILLS LEAD TO WEIGHT GAIN: First generation contraceptive pills caused some temporary weight gain related to fluid retention in the body. However, newer formulations do not cause weight gain, rather they help with weight loss in patients who have Polycystic Ovary Syndrome (PCOS) along with other benefits.

CONTRACEPTIVE PILLS LEAD TO ACNE OR ABNORMAL HAIR GROWTH: Newer contraceptive pill formulations with different progesterone components, reduce testosterone concentration and reduce the incidence of acne in patients with PCOS.

IT IS ALL RIGHT TO MISS ONE OR MORE PILLS IN THE CYCLE: Missing pills during the cycle should not be taken lightly. It can lead to unexpected pregnancy due to contraception failure. Moreover, it can also cause spotting or mid-cycle bleeding to begin. One must always consult a gynaecologist if one or more pills have been missed to learn about what all precautions are to be taken in such an instance, and how to make sure unexpected pregnancies do not happen.

CONTRACEPTIVE PILLS DAMAGE FERTILITY: There is no evidence that contraceptive pills have an adverse impact on fertility. They only prevent ovulation and pregnancies.

BIRTH CONTROL PILLS CAN BE STARTED WITHOUT ANY PRIOR EVALUATION OR RISK ASSESSMENT: Birth control pills are generally safe, but some people who have certain risk factors like having a genetic tendency for blood clot formation, or those who are obese or who smoke might not be suitable candidates for contraceptive pill use. Hence, one must always consult a doctor and get a risk evaluation before starting Oral Contraceptive Pills (OCP). Having said that, lots of confusion information is available on the internet, it tends to create fear among women. Here is what you can do to debunk these doubts.

  • Getting the right information about contraceptives is crucial. The best way to get the correct information is through a medical resource coming from government websites, from international health organizations or from a hospital website.
  • Discuss your concerns with your Ob-Gyn about the use of any contraceptive method. Not every method suits everyone, and making an informed choice helps in finding the best fit for you and your partner.
  • Many of the myths associated with the birth control pill do not apply to every person. Each one of us is different, and only you and your doctor can determine whether the pill (and which pill) is right for you. Be sure to ask your doctor any questions you have and discuss your concerns.

(Dr Neha Bothara is Consultant Gynecologist & Obstetrician, Fortis Hiranandani Hospital, Vashi).