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?
- Stomach upset
- Loss of appetite
- Dark yellow urine
- 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)
New Delhi, February 5, 2021: Having a headache or a sore throat or indigestion, how many times have you turned to the internet to get a diagnosis? Do you have the habit of searching the internet at the first sign of a niggle? Well, you might be suffering from cyberchondria. The term was coined by a British newspaper in the early 2000s as a play on the word hypochondria. Like hypochondria, cyberchondria refers to a person’s anxiety about their health that is created or exacerbated by using the internet to search for medical information.
The digital revolution has changed many aspects of our lives, especially in the way we source health-related information, as it is easily and freely available. In the earlier times, 1 out of 10 patients used to seek health information on the internet, but today, that number has changed to 9 out of 10 people seeking health information online before visiting a doctor. Many even believe that the internet has all the answers to their health problems. Ironic indeed! But that is how people surf the world of web, in pursuit of a definite health solution or a diagnosis.
A recent Google trend report on how Indians surfed the web in the past year has some shocking revelation. According to Google trends, “How to make coronavirus vaccine at home? And how to improve immunity against COVID?” were some of the top trending searches on the internet in India, followed by questions around food to eat to build immunity, plasma therapy, COVID symptoms, home remedies for COVID, etc. This indicated that people are all willing to take a chance on self-treatment and self-diagnosis. But is this worth the shot?
RISK OF MISDIAGNOSIS, OVER-DIAGNOSIS OR UNDER-DIAGNOSIS: More often than not, self-diagnosis on the internet always points towards something more frightening. It can lead to misdiagnosis or over-diagnosis. For example, if you search for ‘headache’, you are likely to find around 20 results showing the different interpretation of headaches, each scarier than the other. There are chances that your headache may be something small, but the internet search shows signs of a cancerous tumour or some other neurological problem. In the bargain, you will freak out, and this may cause a high level of stress. Moreover, self-medication involves pharmacological risks that can result in severe adverse reactions. Sometimes, you would even under-diagnose yourself, which could have a severe long-term impact on the quality of life or worse, death.
SYMPTOMS OF A CYBERCHONDRIAC: According to experts, lately, cyberchondria is becoming a growing problem as people resort to finding out what the internet has to say about their health and wellbeing. People having cyberchondria tend to misinterpret regular bodily changes and minor physical symptoms as signs of severe illness or disease. For many people living with health anxiety, fear can become so severe that it interferes with work and relationships.
SEEKING HELP FROM A MEDICAL PROFESSIONAL IS THE RIGHT WAY: Many times, we come across patients with a whole list of questions about their symptoms and medical condition. Some patients come with a diagnosis they have already arrived at by using the internet. And some, come with lab reports and medical investigations, also a result of online searching. Of course, we would call them empowered patients, but quite often, these people display a lack of trust in the health advice offered by doctors. We must understand that no technology or internet search can completely replace professional medical help. By doing so, you are inadvertently putting yourself at risk of anxiety and incorrect diagnosis and will spend more money on healthcare.
‘SEARCH IT’ THE RIGHT WAY: Using search engines to gain knowledge about health topics is not wrong but checking the source of information is very important. Information on these websites and apps should be viewed very cautiously as they don’t know your medical history or actual symptoms. The suggestions they make are not made by medical practitioners but are actually key-word based.
Remember, the internet is just a channel through which you can gain information, but the actual empowerment comes when you use that information wisely and not rashly.
(The article has been authored by Dr Sanjay Shah, General Physician & Dr Pradip Shah, General Physician, Fortis Hospital, Mulund.)
Dr Kirti Sabnis
The concept of wellness is not new, but the pandemic really compelled us to take the time to focus on our health. Instead of working out to the point of exhaustion, people have taken a more holistic approach to their overall wellbeing. From how we work out, what we eat, what we drink, the products we put on our bodies and faces, the way we rest, everything has changed — and the impact of these changes will be felt into 2021 and beyond.
According to studies, people across the world have adopted fitness routines and immunity-boosting diets, making health as their first priority. Here are a few tips on how you can ensure your wellbeing in the new year.
FOCUS ON COMMUNITY CARE: The pandemic has compelled us to focus on community care rather than being self focused – a growing awareness that is helping propel people towards a greater pathway to happiness. Scientific researchers say that people are prioritizing giving back, donating their time, skills, and using their power to address systemic issues that are present in their own lives, workplaces, and communities.
BUILD STRONG METABOLIC HEALTH: With the adverse effect of COVID19 on one’s health, one of the most noticeable effects were weakened metabolic strength. People suffered from the disease because they could not fight the virus. The eating and lifestyle patterns have never been of much concern until this year. Now, everyone is concerned about what they eat, and whether their body has the strength to fight the disease. Food with all the vital elements to provide balanced nutrition to our body is now on everyone’s priority list. Green leafy vegetables, eggs, fruits like berries, apples, citrus fruits, Melon are good for metabolic strength and will become must-have’s in 2021.
MENTAL WELLBEING IS PARAMOUNT: For years together, the issue of mental wellness didn’t get much needed attention. However the pandemic changed this, and for good. In India, there is a surge in telemedicine services for mental health consultations, especially from tier II and III cities as well. People have now understood the relevance of caring for oneself and for the community too. There are newer technologies and wearable devices that now share alerts on your mental wellbeing. Coming year, you will see more devices with built-in alerts to remind you to stop and breathe when it measures that your heart rate is up.
SEEK OUT FOR VIRTUAL FITNESS TRAINING & EXERCISE MODULES: With fitness centers only opened in a limited capacity, many trainers have turned to virtual classes. This has created more access for fitness training for those who didn’t have the time or capacity to go to a gym. There are several platforms that offer holistic virtual programs. Also, trainers are leveraging social media to offer free classes. This trend will picked momentum this year.
MONITOR SLEEP PATTERNS: Not getting the recommended hours of sleep is linked to weight gain and obesity, high blood pressure, diabetes, depression, heart disease, stroke, and a greater risk of death. Furthermore, sleeping for less than seven hours a day leads to impaired immune system, decrease in cognitive performance, and an increased risk of accidents. There are several apps that track your sleep and give you important insights into your sleep patterns. These apps are designed to help you improve your sleep patterns and help fight insomnia.
MINDFUL EATING HABITS: The trend of ‘eat fresh, eat local’ has been gaining strength in India. Moreover, people will continue to turn away from restrictive diets, especially those that completely demonize certain macronutrients, such as carbohydrates. I also believe there will be an increase in people embracing food in all its forms through the trend of upcycling food, which means that strange-looking vegetables and wasted food scraps can be turned into delicious meals and snacks. It is a step toward a healthier, more sustainable, and more conscious future.
BUILDING IMMUNITY: An optimally functioning body and a nutritious diet is the key to keep your immune system on track. A healthy immune system can safeguard the body from any disease, even fight COVID19. The awareness among people for immunity-boosting nutrients has now taken a peak, and everyone is now looking for health supplements or food with rich immunity-boosting elements. The immunity booster supplements whether it’s Green Tea or fruits rich in Vitamin C are now part of every household. This is something that has drawn maximum people’s attention and will be practiced in 2021 as well.
While the above mentioned wellness trends are significant for complete wellbeing of mind and body. It is equally important to seek expert guidance for all medical needs. Adhering to precautionary measures such as maintaining social distancing, sanitizing hands and wearing masks are key. Patients are recommended to follow treatment guidelines in managing chronic diseases such as diabetes, obesity, cardio-vascualr diseases, cancer especially in the elderly to ensure health and safety of everyone around us.
(Dr Kirti Sabnis is Infectious Disease Specialist at Fortis Hospital, Mulund and Kalyan)