CLIMaTE - Volume 1 Issue 1

“Each and every one of us can make changes in the way we live our lives and become part of the solution”

- Al Gore

CLIMaTE

Climate Leaders In Making

Transforming Environment

Editorial Board

Chief Patron

Prof. Meenu Singh, Executive Director and CEO

Patron

Prof Jaya Chaturvedi, Dean (Academics)

Co-Patron

Dr. Pradnya

Kakodkar

Dr. Vandana

Dhingra

Chief Coordinator of Climate Change Initiative

Advisors

Dr. Bhavna Gupta

Dr. Vivek Malik Coordinators of the Climate Change Initiative

Chief Editor

Dr Oshin Puri Student

Coordinator of the Climate Change Initiative

Editors

Arnav Ranjan

Jayesh Sawarakar

Dibya Prasana Rana

MESSAGEFROM EXECUTIVEDIRECTOR

Prof.MeenuSingh

With the changing panorama of climate worldwide, healthcare has not been spared Healthcare is responsible for mitigating the impact of climate on global epidemiology and the well-being of mankind While we are striving towards making AIIMS, Rishikesh a climate-sensitive campus, it is essential to sensitive the next generation of doctors to climate change and its impact on healthcare Hence, AIIMS, Rishikesh takes the responsibility of training our future doctors as current climate leaders who take responsibility for the global environment and are ready to mitigate the impact of the incoming climate change health epidemic This newsletter is one of the many initiatives this institute of national importance will take to raise climate awareness and amplify the voices of future doctors and current climate leaders. We hope to together create ripples for global well-being

MESSAGEFROM DEAN(ACADEMICS)

Prof.JayaChaturvedi

As the Dean of the institute, I was surprised as well as impressed by the enthusiasm of our students to learn about climate change and its impact on healthcare, discuss, brainstorm, and then produce this newsletter. This newsletter is a testimony of how the youth of today are ready to lead mankind into a better future tomorrow I strongly support the efforts of the student community of AIIMS, Rishikesh to mitigate the upcoming climate crisis

MESSAGEFROM CHIEFCOORDINATOR

Dr.PradnyaKakodkar

Climate change is affecting the quality of life of the people. As per the World Health Organization Climate change is impacting health in a myriad of ways, including by leading to death and illness from increasingly frequent extreme weather events, such as heatwaves, storms and floods, the disruption of food systems, increases in zoonoses and food-, water- and vector-borne diseases, and mental health issues

MESSAGEFROM CHIEFCOORDINATOR

Dr. Vandana Dhingra

Warm greetings to the readers of this newsletter! It was an immense pleasure to organize this conference for the UG students of our college With this workshop, even I had the opportunity to learn the impact and relation of climate change with different medical specialties It not only helped us become better medico but it also helped us become a responsible citizen I am thankful to the Executive Director, the faculty, the staff and the students for their cooperation, effort and participation in making this event a success

MESSAGE FROM COORDINATOR

Dr. Bhavna Gupta

It is with great pleasure that we present to you the latest edition of the AIIMS Rishikesh newsletter, focusing on a topic of global significance - Climate Change and Its Impact As stewards of health and well-being, it is imperative for us to understand, address, and adapt to the challenges posed by climate change

MESSAGE FROM COORDINATOR

Dr.VivekSinghMalik

Climate change poses one of the most pressing challenges of our time, with far-reaching implications for human health, ecosystems, and economies worldwide As temperatures rise, weather patterns become increasingly erratic, sea levels surge and natural disasters intensify, the impacts of climate change are felt across the globe

MESSAGE FROM CHIEF EDITOR

Dr. Oshin Puri

Like every sector, healthcare too is contributing to climate change. But, unlike many, the healthcare sector has to manage the repercussions of it Hence, as we spiral down into lesser favorable climatic changes, the healthcare force in training needs to be prepared to help humanity combat its effects. Hence, sensitizing the future of healthcare - medical students of today towards Climate Change and Climateassociated epidemiological changes in the panorama of diseases will go a long way Hence, AIIMS, Rishikesh took the initiative of sensitizing a group of students who in turn took upon themselves the responsibility to educate the masses through this newsletter It gives me immense pleasure to invite you to read the first issue of our newsletter and learn more about climate change and its dynamics with healthcare

From the Chief Coordinator

DR.PRADNYAKAKODKAR

The Mind behind the Initiative

According to United Nations “Climate Change” refers to long-term shifts in temperatures and weather patterns Such shifts can be natural, due to changes in the sun’s activity or large volcanic eruptions. But since the 1800s, human activities have been the main driver of climate change, primarily due to the burning of fossil fuels like coal, oil and gas Burning fossil fuels generates greenhouse gas emissions that act like a blanket wrapped around the Earth, trapping the sun’s heat, and raising temperatures. The main greenhouse gases that are causing climate change include carbon dioxide and methane These come from using gasoline for driving a car or coal for heating a building, for example Clearing land and cutting down forests can also release carbon dioxide Agriculture, oil and gas operations are major sources of methane emissions Energy, industry, transport, buildings, agriculture and land use are among the main sectors causing greenhouse gases

With such a magnitude of health impact, the rate at which doctors encounter such patients in their clinics is also rising Hence, the medical institutes should become “Climate Aware Institute” and incorporate changes to address the climate change impact on the health of the people. These changes can be at different levels namely: Curriculum, Community Advocacy, Interdisciplinary Research, support for student-led initiatives and campus sustainability

The students enrolled in the first-year medical school should be sensitized about climate change A cohort of interested students can form a team mentored by the faculty of the college “Catch them Young” should be the tagline This cohort is the Future Doctors and the Present Climate Change Leaders”

The objectives of this group will be:

1 To sensitize the student community about climate change by undertaking different activities

2 To suggest sustainability changes at the campus and student levels

3 To research to find sustainable solutions that will reduce the impact of climate change

4. To undertake community advocacy programs.

5 To collect baseline data on human health affected by climate change

6 To identify evidence gaps, systematically collect information and synthesize evidence to help the policymakers in making laws

Climate Change is real, and its changes are visible. There are 3 levels of prevention where we can act: Primary Level (Health Promotion and Specific Protection ), Secondary Level (Early Diagnosis and Prompt treatment) and Tertiary Level (Disability limitation and Rehabilitation) The student’s cohort can take up activities at any one of the three levels Role of the Climate Change aware Institute in supporting Student-Led activities

The institute should conduct a brain-storming session to identify health areas that are impacted by Climate Change. Collect data on patients with those unique features caused due to Climate change Conduct seminars, trainings and conferences with the theme of Climate Change Inviting guest speakers to sensitize the students and faculty Identify areas that can be transformed at the institution level Identify areas in the curriculum that can be integrated horizontally without having to make any extra time and space for the climate change information Nominate active and interested faculty to be mentors for the students-led group. Motivate students to take up research projects in the area of Climate Change Motivate students to undertake community participation and advocacy activities Sustainability measures at the institution can also be undertaken

Finally to conclude: The young future doctors can be the present climate change leaders They have been with the institute for five-plus years and during this time they can undertake several environmentally friendly activities which are helpful to the community at large Everyone has a moral obligation towards the family, community, and the world at large Each small step taken at the individual level by each person can collectively sum up to a great achievement Each doctor can and should aim at reducing the Climate change effects

Advisor’s Insights

Dr. Bhavna Gupta

The escalating climate crisis poses significant risks to our well-being, affecting every aspect of our lives, from the air we breathe to the food we eat and the stability of our communities. Extreme weather events, such as heatwaves, floods, and hurricanes, are becoming more frequent and severe, leading to direct health impacts, including heatrelated illnesses and injuries Our mental health is also at stake, with climate-related stressors contributing to anxiety, depression, and other psychological issues Vulnerable populations, including children, the elderly, and those with preexisting health conditions, are disproportionately affected.

In response to these challenges, it is imperative that we adopt both mitigation and adaptation strategies Reducing greenhouse gas emissions, transitioning to renewable energy, and implementing sustainable practices are crucial steps. Additionally, enhancing public health infrastructure, improving early warning systems, and fostering community resilience will help us adapt to the changing environment Healthcare professionals play a vital role in this endeavor, not only by treating affected individuals but also by advocating for policies that prioritize environmental sustainability and public health We encourage everyone to engage in local initiatives, educate others about the health impacts of climate change, and contribute to building a healthier, more sustainable future.

Together, we can make a difference

Empowering

Climate Change

Leaders: The One Health Cadet Corps Awareness Model

Dr. Vivek Singh Malik

Climate change poses one of the most pressing challenges of our time, with far-reaching implications for human health, ecosystems, and economies worldwide As temperatures rise, weather patterns become increasingly erratic, sea levels surge and natural disasters intensify, the impacts of climate change are felt across the globe Recognizing the urgency of this issue, the One Health Cadet Corps awareness model for youth engagement in One Health has the potential for climate change action, offering a multifaceted approach that addresses the interconnectedness of human, animal, and environmental health

Through the One Health Cadet Corps awareness model, which includes activities like One Health Selfie, One Health Walk, Health Detectives, and Health Debates, youth develop One Health literacy, fostering a deeper appreciation for the environment and cultivating research skills and effective communication as climate change leaders to drive positive change toward a sustainable and interconnected world through education and advocacy

Building on the success of previous health literacy initiatives targeting children and youth, such as those outlined in the Editorial "Empowering Children for One Health Measurement: The Role of One Health Cadet Corps in One Health Index" published in the Journal of Medical Evidence, the One Health Cadet Corps model offers a novel approach to climate change education and advocacy

Central to the model is the development of a personalized One Health Index, through collaborative partnerships with stakeholders from government, academia, and civil society, children and youth have the opportunity to advocate for evidence-based solutions to climate change and participate in decision-making processes that affect their futures

THE FACULTY PANEL

Front Row: (Left to Right) - Prof. Smriti Arora; Dr. Padnya Kakodkar; Prof. Minkashi Dhar; Prof. Shailendra S Handu; Prof. Girish Sindhwani; and Dr. Vandana Dhingra.

Second Row: (Left to Right) - Dr. Sriloy, Dr. Bhavna Gupta; Dr. Anindya Das; Dr. Rohit Gupta; Dr. Ruchi Dua; Dr. Prasan Kumar Panda; Dr. Amit Kumar Tyagi; Dr. Latika Chawla ; Dr. Riti Bhatia; and Dr. Kalyani Sridharan.

THE AUTHORS

Arpita Subhashree

“All we can to do is adapt or change, so choose judiciously!”

Aditya Bhandari

“At this level of insanity in the human population, there is no wonder that climate change will cause the sixth mass extinction!”

Chintu Das

“A changing climate needs a changing mindset”

Arpit Bansal

“Climate change isn’t just about saving the planet, it is about saving ourselves.”

Rishita Aggarwal

“I believe that Climate change must be cured at its root cause over symptoms”

Asmita Sharma

“We’re living on a ticking time bomb of worsening climate triggered by our own ignorance.”

Ananya Patel

“The effects of climate change can no longer be neglected. We need to act together to protect our planet.”

Devanshu Agnihotri

“Resonate to this catastrophe and reciprocate like a mother.”

THE AUTHORS

Tanmaydeep Singh

“If you really think that the environment is less important than the economy try holding your breath while counting your money”

Ridhima Choudhary

“Climate change is already communicating itself , it's the solutions that we need storytelling.”

Dr Kanak Tara Dubey

”Climate change is a critical issue that requires urgent, collective action to safeguard our planet and ensure a sustainable future for all.”

Pranav Dayanand

“The earth is our canvas, let’s paint it green”

Sonal Bhatia

“Climate change could be controlled when each individual thinks the mother earth as their own responsibility. EACH EFFORT DOES MATTER!!”

Arnav Ranjan

“Climate change devastates lives, leaving scars on generations to come."

Jayesh Sawarkar

“Climate change is nothing but a disorder of the earth. We, the citizens of the Earth must cure it.”

Climate

Climate

Climate

Climate

FUTURE DOCTORS AND CURRENT CLIMATE CHANGE LEADERS

The workshop “Future Doctors and Current Climate Change Leaders” was held on 14th March 2024 in the telemedicine department of the college Chaired by our very own Dr Meenu Singh ma’am and moderated by Dr Pradnya Kakodkar, the event is planned to raise awareness in society by educating and enlightening the MBBS students of AIIMS Rishikesh about climate change The workshop was guided by the belief that the youth is the foci of society and that any change in the output of society can be achieved by targeting the youth Every participant in the workshop was given a medical specialty and was asked to present the relation of that specialty with climate change A total of 13 presentations were presented ranging from Psychiatry to Geriatric Medicine. The workshop also included role plays and climate board-making to promote teamwork amongst the participants

Climate change has now become a grave reality and is causing physiological changes in the body both directly or indirectly It was therefore important to dissect the relation of climate change with different medical specialties to ensure optimum body functioning in the changing environment The association of climate change with the medical specialties helped the students explain problems and concepts such as the gut-brain axis, cardiovascular diseases, obesity and the basis of mental health

The faculty and the students found the workshop helpful as it helped them not only identify the problems caused by climate change but also helped them find solutions to it.

AdityaBhandari,MBBSBatch2022

CLIMATE CHANGE AND INFECTIOUS DISEASES

RishitaAggarwal,MBBSBatch2021

Climate change amplifies the complexity of infectious disease dynamics by altering ecological systems, disrupting natural balances, and exacerbating health disparities Climate change poses significant challenges for microbial epidemiology by altering their interactions with hosts, vectors, and the environment, ultimately impacting human health and disease outcomes

The key outcomes and statistics associated with the impact of climate change on pathogens include:

1 Altered Vector Habitat: Rising temperatures and changes in precipitation patterns can expand the geographic range and prolong the activity periods of disease-carrying vectors

2 Vector-Borne Disease Transmission: Climate change can accelerate the development of pathogens within vectors, shorten the incubation period of diseases, and increase vector feeding rates, contributing to higher transmission rates

3 Waterborne Diseases: Changes in precipitation patterns (frequent and intense rainfall events) can lead to flooding and contamination of water sources with microbial pathogens increasing the risk of waterborne diseases like cholera, typhoid, etc

4 Foodborne Illnesses: Rising temperatures can impact food safety by promoting the growth of bacteria like Salmonella and Vibrio in food supplies, potentially leading to contamination of food with pathogens and increasing the risk of foodborne illnesses

5. Emerging Infectious Diseases: Climate change can create conditions conducive to the emergence and spread of new infectious diseases

6 Impact of Socioeconomic Factors: Populations living in low-income communities or areas with inadequate access to clean water, sanitation, and healthcare are disproportionately more affected by climate-related health risks

At the individual level ensuring personal protection (like using insect repellent, practicing proper hygiene, drinking safe water, properly storing and cooking food, etc.), proper vaccination, and participation in community-based surveillance and reporting systems can be effective

Some strategies institutions can adopt include strengthening their healthcare infrastructure to effectively respond to climate-related health risks, implementing vector control programs, upgrading water treatment and distribution systems, improving sewage disposal and hygiene promotion campaigns

At the regional level, a coordinated approach includes establishing an integrated surveillance system for monitoring disease trends, developing early warning systems and capacity building and training

At the national level, governments and public health authorities can play a crucial role, by promoting intersectoral collaboration, enacting and enforcing public health policies and legislation, and developing and implementing national climate change adaptation plans, to mitigate the impact of climate change on infectious diseases

At the international level, strengthening international partnerships, agreements, frameworks and collaboration is essential for leveraging resources, expertise, and political commitment to address climate-related health risks.

Elevated temperatures induce the risk of heat-related illness like heat exhaustion, characterized by persistent high body temperature below 104 °F This exhaustion can severely lead to heat strokes (body temperature above 104 °F) progressing to inflammation and organ malfunction Classical heat strokes are triggered in conditions of elevated core body temperature due to the loss of thermoregulatory centers This differs from the epidemiology of exertional heat stroke caused by excessive physical exercise in prolonged heat exposures

CLIMATE CHANGE AND GERONTOLOGY RECOMMENDATIONS

DevanshuAgnihotriandArnavRanjan, MBBSBatch2022

The elderly population, being one of the most vulnerable groups to climate change, is more susceptible due to altered physiology These individuals, in most cases, are associated with multiple comorbidities including renal, cardiovascular, and dermatological disorders. Impaired thermoregulatory centers, thirst centers, and thermal perception exaggerate the scenario

Phenomenons like heat waves, air pollution, vector-borne diseases, and psychological events affect the population adversely. Mainly focusing on dehydration, heat exhaustion, and heat stroke Involving extreme weather events, water scarcity, and water pollution, pose the threat of dehydration to this vulnerable group

At an individual level we could bring about changes by taking small initiatives towards sustainable development and promote hydration among individuals around us

At an institutional level we could hold camps and events promoting healthy lives and how to help elderly people around us With awareness about Heat stroke and it’s impacts on our Health

At a national level policies which promote research and development towards a greener and cleaner future for the benefit of the nation and the people living within it

At an international level BRACE (Building Resilience Against Climate Effects) is an initiative that combines atmospheric data and epidemiological analysis for a better response against climate change On community levels hydration awareness campaigns, climate resilience infrastructure, and building support groups are highlights

CLIMATE CHANGE AND PULMONOLOGY

ArpitaSubhashree,MBBSBatch2021

Problem statement

Effect of climate change on pulmonary physiology

Initially, airway obstruction is restricted to smaller airways, resulting in a decreased ratio of time to peak expiratory flow: total expiratory time (Tpef:Te) and decreased ratio of forced expiratory volume at 1 second to forced vital capacity (FEV1:FVC) Eventually, as larger airways start getting blocked, mid-maximal expiratory flows (MMEF) also get reduced

Effect of climate change on pulmonary pathology

On acute exposure, airway inflammation is predominated by neutrophil that aggravates responsiveness to irritants Chronic airway inflammation (mediated by monocytes and lymphocytes) enhances cellular proliferation and extracellular matrix reorganization Furthermore, reduced particle clearance substantially increases the probability of tissue injury beyond inflammation resulting in morbidity and mortality.

Foreseeable future

Environmental studies have been revealing a general increase in both the incidence and the prevalence of respiratory diseases including allergic rhinitis (hay fever), asthma, and COPD During the last 60 years, there has been an increase in the epidemic prevalence of allergic disorders, which is expected to reach up to 4 billion in the 2050s. A global study found that >50% of annual asthma emergency room visits globally could be attributable to O3 and particulate matter

RECOMMENDATIONS

IndividualsAdopt sustainable practices

Use the air quality index (AQI) to avoid outdoor exposure in unhealthy zones Wear a mask if necessary

InstitutionsUse renewable energy sources and advanced filtration systems

RegionalImplement strict emissions standards

NationalInvestin research and innovation for developing new technologies to control particulate pollution

InternationalCollaborate with international organizations and governments to address transboundary particulate pollution

CLIMATE CHANGE AND DERMATOLOGY

Climate change refers to long-term shifts in temperatures and weather conditions Such shifts can be natural, due to changes in the sun’s activity But since the past few years, human activities have been the main driver of climate change, primarily due to the burning of fossil fuels Burning fossil fuels generates greenhouse gas emissions that act like a blanket wrapped around the Earth that traps the sun’s heat and raises the temperatures.

Climate change affects all aspects of the environment and also affects humans in very harmful ways, especially in the dermatological aspect, and may lead to widespread diseases How our planet’s climate is changing will influence the frequency of dermatologic conditions, especially those associated with infectious etiologies, sun exposure, environmental irritants, and aquatic transmission The incidence of skin disease is already shifting due to climatic conditions that favor microbe propagation, with a trend toward broadening geographic distributions of cases

Global populations are at an increased risk of skin cancer due to the earth’s diminished ozone layer, which is likely a result of human activities leading to climate change With the increase in the concentration of chlorofluorocarbons in the atmosphere there has been an exacerbation in damage to the ozone layer leading to a perpetual cycle of ozone depletion accompanied by their regeneration, with an increase in ozone depletion there are increased chances of harmful UV rays being able to reach the Earth’s surface which otherwise would not been able to reach due to the presence of the ozone blanket

These UV rays are very harmful carcinogens and mutagens and can lead to DNA damage associated with a variety of skin cancers like squamous cell carcinoma, melanoma, basal cell carcinoma, and various skin diseases like atopic dermatitis. These harmful rays damage the normal anatomical structure of the epithelium creating a breach in it through which antigens can enter and cause inflammatory reactions The damage can range from sunburn to malignancy. So this is a major topic of concern

RECOMMENDATIONS

In the foreseeable future, there will surely be an increase in incidences of skin cancer and all the other skin-related problems if the present rate at which climate is changing does not stop That’s why we need to eliminate its root cause, which is

To stop the release of chlorofluorocarbons by reducing the use of refrigerators and air conditioners, and other human practices that are damaging Mother Earth

On institutional level, we all can promote various activities that will raise awareness about this issue among the youth like plantation drives, less use of motor vehicles, etc

So before doing something on big levels, let's first take small individual steps to fulfill our common motto which is to stop climate change and make this earth a better place to live in

CLIMATE CHANGE AND ENDOCRINOLOGY

This article aims to provide an insightful exploration into the multifaceted realm of climate change and its impacts, shedding light on the interplay between hormones, nutrition, and the environment.

Endocrine physiology and nutrition are closely intertwined as hormones play a crucial role in regulating the various aspects of metabolism, digestion, and nutrient utilization in the body. Adequate nutrition is essential for maintaining proper hormone function, as deficiencies or excess of nutrients can disrupt hormone levels and lead to metabolic imbalances Such metabolic imbalances are reflected in different forms of malnutrition such as obesity and undernutrition These problems are often accelerated in groups that are said to be food insecure

Food insecurity is the lack of regular access to enough safe and nutritional food which is required for the normal growth and development of an individual Severe food insecurity is said to occur when a person runs out of food resources or at the extreme, has gone days without eating This leads to undernutrition, a scenario where the individual suffers from a severe lack of nutrients and daily caloric requirements On the other side, moderate food insecurity paradoxically leads to obesity This is due to insufficient money or resources for a healthy diet and thus increased consumption of highly energydense processed foods due to their affordability

Climate change is a rising concern and poses a serious threat to food security because it influences food production and the agro-ecosystem It favors the spread of pests and increases foodborne and waterborne diseases by changing the microbial communities and species interaction

Global warming is seen to destabilize the ecosystem by lowering crop yields, livestock production, and fish catch The elevated levels of CO2 have been shown to decrease the protein concentration in cereals This decreases the availability of nutritious food which is a major cause of malnutrition Increasing temperature also affects fruit and vegetable production, leading to increased prices and therefore a shift towards cheaper processed food and beverages, which in the long run can lead to obesity

Thus it needs to be realized that obesity, undernutrition, and climate change are three interconnected pandemics, termed a ‘Global Syndemic’, and must be tackled together to create a transformative and lasting change

RECOMMENDATIONS

Triple duty actions must be adopted where all three issues are addressed simultaneously An example of transportation shift can be used to elicit this model

At individual level, we can choose to cycle or walk shorter distances instead of using motor vehicles. This would be beneficial for one’s health as well as for the climate

At the institutional and regional level, marathons and cyclothons can be organised

At the national level, odd even rule for vehicles and car pooling should be implemented to reduce the pollution load

At the international level, efforts should be made to develop green energy fuels.

AnanyaPatel,MBBSBatch2022

CLIMATE CHANGE AND CARDIOLOGY

ChintuDas,MBBSBatch2021

Problem statement

Climate change poses a significant risk to heart health Poor air quality from particle pollution or extreme heat increases the chances of heart attacks, congenital heart disease, strokes, and atherosclerosis, particularly for those already at risk One of the most important factors for congenital heart disease(CHD) is maternal ambient heat exposure during pregnancy Specific CHD classes affected included congenital malformations of cardiac septa and congenital malformations of great arteries Certain CHD subtypes were also impacted by atrial septal defect and patent ductus arteriosus Elevated maternal body temperature due to fever during the initial trimester of pregnancy is linked to an increased risk of congenital heart defects in the baby These defects can significantly impact fetal development. Heat stress during pregnancy can lead to maternal dehydration, elevated core body temperature, and changes in placental blood flow These factors collectively influence fetal growth and organ development, including the heart A reduction in particulate matter (PM) 2 5 levels has been linked to a decrease in the progression of carotid intima-media thickness This evidence supports the association between long-term exposure to PM2 5 and the burden of atherosclerosis in humans

Foreseeable future

In the foreseeable future, the incidence of cardiovascular disease is expected to rise A study projected that by midcentury, the number of heat-related cardiovascular deaths in the U.S. could increase by up to 233%. This alarming rise is attributed to climate change intensifying extreme heat events

RECOMMENDATIONS

To address the impact of climate change on cardiology at different levels requires taking initiative at different levels and involves collaborative efforts and actions tailored to each level:

At the Individual Level, adopting a healthy lifestyle with regular exercise, a balanced diet, stress management, and supporting sustainable practices can be helpful

At the Regional Level, promoting active transportation options, like cycling and walking, establishing green spaces, and urban planning strategies that prioritize health and well-being should be done

At the National Level, enacting legislation to regulate emissions, promote clean energy initiatives, incentivize sustainable practices in healthcare systems, and Invest in research and development to understand the specific cardiovascular impacts of climate change can be effective

At the International Level, Collaborating with other countries to share practices, technologies, and resources for combating climate change and promoting cardiovascular health on a global scale can be done

By taking comprehensive action at individual, regional, national, and international levels, stakeholders can address the multifaceted challenges posed by climate change to cardiovascular health and promote resilience and adaptation strategies for communities worldwide

CLIMATE CHANGE & GASTROENTEROLOGY RECOMMENDATIONS

ArpitBansal,MBBSBatch2022

When we consider the effects of climate change on human physiology, the cardio-respiratory system comes to mind as the primary victim, but its effects on the gastrointestinal(GI) system are also emerging as a significant area of concern From altering water quality to intensifying foodborne illnesses, its effects on GI health are both immediate and far-reaching

When we talk of gastrointestinal health, the enteric infections play a major role in altering its health. Climate change has been seen to show its effect on these infection-causing pathogens also by various ways in the form of increasing their distribution, multiplication, and resistance to the environment Extreme weather conditions, like floods and excessive rains, also lead to an outbreak of these enteric infections in the affected areas

Seeing the increased incidences of enteric infection in the public, the WHO and UNICEF, along with many govt. Non-govt. the organization has taken the initiative to Water, Sanitation, and Hygiene(WASH), which can be defined as a collective term encompassing the interrelated elements of access to safe drinking water, adequate sanitation facilities, and good hygiene practices This initiative has played an important role in controlling the spread of such infections

Though the government is taking part in controlling the spread of such infections, the main problem of climate change still needs to be addressed We, the public, along with the government, should start taking action against such climate change By making small changes, in the form of vigilant use of electricity, reducing the use of bikes/cars for small distances, and promoting the use of bicycles and carpooling

The government can also devise policies for mitigating the emission of climate change-causing greenhouse gases through these concerted efforts, we can navigate the challenges posed by climate change and safeguard against enteric infections and many other effects of climate change on the body

At Individual level, one could be vigilant to use of electricity; limit the use of motorized vehicles for small distances

At the Community level, people should start practicing carpooling, using public transport services instead of personnel vehicles.

The Government can devise policies for mitigating the emission of harmful greenhouse gases, promote use of eco-friendly and sustainable practices, etc

Through these concerted efforts, we can navigate the challenges posed by climate change and safeguard against the many harmful effects on our body

CLIMATE CHANGE AND ENT

ArnavRanjan,MBBSBatch2022

As the world grapples with the far-reaching consequences of climate change, its effects extend beyond rising temperatures and extreme weather events. One often-overlooked consequence is the impact on ear, nose, and throat (ENT) health. WHO has labeled it as ‘The single biggest health threat facing humanity’ and could be the leading cause of death in the foreseeable future. Climate change has a crucial impact on ENT disorders which have been growing over the past few decades

For instance, increasing temperatures and changing vegetation patterns lead to prolonged allergy seasons, exacerbating allergic rhinitis and sinusitis. Similarly, shifts in precipitation can create favorable breeding conditions for mosquitoes and other vectors, increasing the transmission of diseases such as malaria and dengue fever, which can manifest with ENT symptoms. There is an increase in Upper respiratory tract infections like Chronic Rhinosinusitis and nonallergic rhinitis due to an increase in Particulate Matter and Air pollution The increase in Noise pollution has led to the induction of Hearing loss with air pollutant toxins causing sensorineural hearing loss These adverse conditions cause innumerable effects on human health by affecting sleep patterns, increased chances of cutaneous malignancy especially of the head, neck, and exposed skin areas, and multiple other adverse effects.

To take up initiatives individuals can raise awareness, adopt sustainable practices, and seek medical advice Institutions should integrate climate change into medical education, conduct research, and advocate for policy change

At regional levels, surveillance systems and public health interventions are crucial, along with fostering community engagement

Nationally, policies prioritizing climate change adaptation in healthcare, resource allocation, and cross-sector collaboration are essential

Internationally, global cooperation, support for vulnerable populations, and promotion of sustainable development are key Achieving carbon neutrality could be one of the major steps that can be taken towards the cause By taking collective action, we can mitigate the effects of climate change and build a healthier future

CLIMATE CHANGE AND NEPHROLOGY

PranavDayanand,MBBSBatch2022

An alarming issue pressing the current generations is climate change and its effects on healthcare A particularly troubling issue is the continued burden of global warming on the renal system Increased heat stresses lead to impaired or hyperstimulated renal feedback mechanisms presenting in the form of Acute Kidney Injury Persistent AKI leads to Chronic Kidney Disease. CKD associated with Heat stress nephropathy is known to be one of the first epidemics due to global warming and has no known cure, highlighting its severity

A seemingly unexpected effect of climate change in recent times is the increased prevalence of Urolithiasis in various regions of the US An increase in the spread of high-risk zones in the country is estimated by the linear and non-linear models This results in an increased burden on healthcare

The future predicts an increased burden of global warming on renal functioning Increased healthcare costs and poor patient drug compliance are the major issues to be tackled CKD is estimated to become the fifth most severe cause of death by 2040 The percentage of the population living in high-risk zones of urolithiasis is predicted to grow from a mere 40% in 2000 to 70% in 2095 representing a 30% increase The healthcare incurred costs would be $0 9–1 3 billion annually representing a 25% increase over current expenditure. RECOMMENDATIONS

An effective way to tackle this issue would require interventions at multiple levels We must start at an individual level and inculcate sustainable practices in our everyday lives

At our institutional level, raising awareness of this crucial issue becomes imperative, the formation of clubs and societies promoting climate change awareness and bringing to light the concept of kidney health is essential

As a society, we need to look into reducing our carbon footprint and effective utilization of resources

The executive must pass laws that are environmentcentric and must strive for a balance between financial growth and environmental stability

AsmitaSharma,MBBSBatch2022

Food shortages caused by climate crises lead to undernourishment in mothers, which poses a high risk of malnutrition in newborns. This could lead to metabolic and developmental disorders in the children Unsafe drinking water is also a major problem caused by the changing climate, which could lead to severe diarrhea and dehydration in the mother Heat shock and increased transmission of vector-borne diseases also prove to be gargantuan threats to maternal health

CLIMATE CHANGE AND REPRODUCTIVE HEALTH RECOMMENDATIONS

Fetal health problems can lead to low birth weight, preterm birth, and even infant mortality in severe cases The emergence of a large number of cases of childhood asthma has also been attributed to the effects of the ever-changing climate. Not just this, we’ve also discovered that the transmission of sexually transmitted diseases has increased manifold in recent years, and it has been majorly correlated to climate change Increasing salinity in the coastal areas has been correlated to increasing uterus-related disorders in women

Socially, it has also been tied to the increasing gender and sex-based violence, especially against women, due to the rising resource crunch It has also led to the perpetuation of social prejudices against LGBTQIA+ people who face increasing threats to their limited safe spaces and discrimination in the face of natural calamities

In the foreseeable future, these ailments caused by the rapidly changing climate are expected to rise manifold if we fail to take necessary actions against them Due to the expanding social disparities along with rising temperatures, the future remains bleak, aided by the mushrooming population problem Reproductive health of the masses is sure to deteriorate if strong interventions are not made in an effective and prompt manner

Making global efforts and providing affordable and accessible antenatal and postnatal care are of paramount importance if we want to ensure climate resilience Taking ecology-sensitive steps like family planning, usage of ecofriendly sanitation products, etc could lead to the dawn of a sustainable future for all of us sharing the magnificent planet Earth.

CLIMATE CHANGE AND NEUROLOGY

SonalBhatia,MBBSBatch2022

As increasing temperature has become a serious concern in September 2021, 220 Medical journals published a joint editorial calling it a national urgency to keep the average global temperature from rising below 1 5 °C A study in Portugal indicated the increased risk of mortality by 52 % just by residing in extremes of cold or hot climates Low temperature by vasoconstriction, increase in thrombogenic activity, and increasing demand of O2 of the brain

On the other hand High temperatures cause dehydration leading to an increase in blood viscosity

The next rising highlight of the decade is the airborne pollutants which not only affect the respiratory and cardiovascular systems but have significant neurological manifestations

Now you might think why should it concern us?

The gravity of this could be understood that 30% of all the strokes caused globally are contributed by these airborne pollutants These numbers of deaths are 16 times more than that a war could cause and 3 times more than deaths combined due to AIDS, TB, and malaria could cause together

Now the next leading question arises how do these micro, nano particles cause such serious injuries?

These particles cause imbalances in NO levels which generates ROS ROS then alters the permeability of the bloodbrain barrier and causes inflammatory responses which leads to uncountable neural dysfunction including loss of sensorium, seizures, dysarthria, paresis, and a lot more.

Summarising it all the effect of temperature and humidity on cerebrovascular diseases is complex and multifaceted Further research has to be made to fully elucidate their impact No doubt that reducing air pollution is the need of the hour but further research is needed to uncover the underlying mechanism and develop effective intervention

RECOMMENDATIONS

On an individual basis, one could reduce the use of motor vehicles which are a major source of particulate emissions

On an institutional one could go on with carpooling or using a bicycle as an eco-friendly alternative Use of vehicles with natural gas instead of diesel

On international level a more focus on sustainable development can prevent the rise of temperature to extremes of conditions

CLIMATE CHANGE AND PSYCHIATRY

AdityaBhandari,MBBSBatch2022

Climate change induces a stress response in the form of emotional, cognitive, physiological, and behavioral changes These changes over some time affect the physiological and psychological functioning of the brain and therefore cause an effect on mental health

Climate change has been associated with the following effects on the psychological functioningIncreased global temperatures over the past few years have led to an increase in aggression Criminal behavior is on the rise during the summer months 1

Usage of antipsychotics with increased temperatures has led to a higher chance of developing a heat stroke

The anticholinergic property of antipsychotics leads to lesser secretomotor function As a result, less sweating and secretions lead to improper heat loss.

Climate disasters like floods and hurricanes increase the chances of one to develop anxiety disorders like PTSD

Migration as a result of climate consequences like the submergence of coastal areas increases the susceptibility to psychiatric disorders of all types 4.

Migrant populations have a higher chance of getting schizophrenia

RECOMMENDATIONS

In the foreseeable future, climate change is expected to get harsher and therefore cause a higher risk of psychiatric disorders Climate change over some time will increase the genetic susceptibility along with the already present environmental susceptibility towards developing a psychiatric disorder If climate disasters keep on increasing in magnitude, they will continue to cause the loss of people, homes, and resources which will lead to increased incidences of not only anxiety disorders but also disorders such as substance use because of the inability to cope

Coping mechanisms - Therefore, to live better in the future, we must learn to cope with the increasing changes Cultivation of resilience to climate changes at the community level is essential as it will lead to a better mental response to climate stressors

Improving emotional processing, practicing mindfulness, acknowledging change, and encouraging creative practices will improve our coping mechanisms

Climate solutions in the form of cycling, green exercises, etc lead to positive mental health benefits They promote better stress tolerance and therefore must be promoted from both an individual’s and a society’s point of view

Team-1: Our role play touched upon the topic of climate change and its effect on the GI system It was centered in an OPD setting and showcased an interaction between a doctor and a patient presenting with abdominal pain for the past 2 days Upon enquiry history of excessive binge junk eating and lack of exercise Food intake from various unhygienic sources was also brought to light This brought upon the topic of urbanization and lack of healthy food options and the contrary the ease of access concerning unhealthy food. A history of an altered sleep-wake cycle affecting the body’s natural circadian rhythm was also given Climate change and its effects on food production and availability and its primary effects on the eating habits of the general population were the prime highlights of the role play T E A M 1

T E A M 2

Team-2: Climate change changes the overall lifestyle making them more prone to cardiovascular, respiratory, obstetric and psychiatric issues. While assessing a couple for obstetric problems the physician determines the major reason to be climate change caused due to migration of the family from Uttarakhand to Delhi, two years back The inability to fertilize was due to the pollutants and sedentary lifestyle, attributed to changes in the environment Their child also presented with complaints of lethargy decreased attention, obesity and GI issues The elder people in the family had cardiovascular, respiratory and psychiatric disorders He mainly complained about the situation he was put in by being in Delhi for the past two years In the end, the physician explains that climate change is the root cause behind all the disorders The objective was to learn that excess smoke, sedentary life, noise levels, quality of food and water etc increase the risk of all such diseases

Team-3: Living in times when coastal areas are under massive threat, our role play aims to highlight the impact of increased temperatures on tourists in the coastal state of Goa. With the setting in a dermatologist's clinic, Mr Tan and his friend Mr Ban present to the doctor Me Tan has sunburn because of his trip to Goa around 6 months back Mr Ban too had symptoms of sunburn, but they subsided soon after the trip. The doctor says that Mr Tan might have skin cancer and asks him to get a few tests done. Mr Tan and Mr Ban are surprised because such an outcome was never expected Residing in a place such as Ahmedabad, Mr Tan and Mr Ban expected their trip to Goa to be forgiving to their skin The doctor asks them if they had applied a Sunscreen for sun protection Replying in the affirmative, they say that they have been applying for it for a very long time since their place of residence also is a very hot place However, the doctor says that places like Goa need sunscreen with higher SPF because they have a higher temperature and sun exposure She also added that the increase in temperatures over the last few years has added to increased incidence of sunburn and skin cancers in coastal areas such as Goa. T E A M 3

Our role play focused on climate change and the effects it has on endocrinology We see that the rising temperatures and other adverse effects of changing climate patterns lead to devastating consequences for our health In this play, we see a girl of 16 years approaching a doctor presenting complaints of fainting, weakness, and hot flushes History-taking reveals that she regularly helps her father with field work as he’s a farmer. She continues this even during the summers and during the afternoon hours. The doctor recommends loads of rest and breaks in between the fieldwork in which she can cool down in the shade The doctor also notices that the BMI of the girl is below the recommended BMI for girls of her age. She is showing some symptoms of malnutrition. The doctor explains to her how she’s more susceptible to experiencing the ill effects of rising temperatures The girl further enquires why this is happening to her as her parents had also worked similarly during hot weather and not suffered severe consequences The doctor explains that she is bound to feel the effects more because of her increased susceptibility and the changing climate The doctor also prescribes her a diet of fruits and vegetables The next patient presents with a higher BMI and deficiency of essential vitamins She has adopted a vegan diet and has not supplemented her diet with vitamins The doctor prescribes her multivitamins and recommends exercise to her This goes to show that climate change-induced insufficient nutrition presents both emaciation and obesity T E A M 4

The workshop educated all the climate change leaders about the impact of climate change on vulnerable populations and various body systems in a healthy individual Focusing primarily on the initiatives to be taken, a poster was designed. Starting from individual to global levels, several steps can be taken Maintaining good hydration status, using cycles for short distances, switching off unnecessary electrical appliances, green goblin drives, establishing rainwater harvesting systems, segregation of waste, using solar water heaters, WASH Program, and BRACE initiatives were the major initiatives suggested In private clinics using primary, secondary, and tertiary prevention schemes, creating green clinics, and using informative posters were also highlighted

C H A R T 1

The workshop concluded with a poster-making event, aimed to summarize the minutes of the conference in an easy-to-grasp, pictorial and informative manner The systemic issues faced due to climate change and the rise in global temperatures were depicted Corresponding solutions that came up in the conference after each presentation were also mentioned These included proper waste management, using alternative energy sources and so much more The solutions ranged from an individual to a global level The chart also involved some fun artistic elements depicting the global change before and after implementing the solutions Finally, the posters were presented and explained to the faculty C H A R T 2

V

The workshop was brought to a conclusion by a valedictory ceremony held in the presence of Prof. Meenu Singh, Dr. Vandana Dhingra and Dr Pradnya Kakodkar

Prof. Meenu Singh ma’am explained to the participants about her concern for climate change She invited suggestions for climate change that can be implemented at a college level Following this, all the participants of the workshop were awarded a certificate and goodies The supporting staff involved in the smooth operation of the workshop were also felicitated