May Issue Healthcare India Magazine by akritipublishers

May 2020 Pr ice: `100

A health and wellness magazine

Meditation

Nourishing the Mind

COVID-19

Thyroid Gland

guide for Pregnancy, Cancer patients & Smokers

UP YOUR IMMUNITY THROUGH NUTRITION

Chef Sanjeev Kapoor’s

Importance of the

Karan Deol’s Fitness Mantras

easy healthy recipes TM

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This bi-monthly magazine This monthly magazine isis here to simplify your A health here to simplify your Unravelling path to health healthwith withitsits path to e r hca multidimensional multidimensional Healt e The Whole 30 loss c information bringing Health aarre weight diet decoded information, bringing c lth 7 Tai Chi Hea to realtime time to you you real stories patients, stories of patients, Aromatherapy weight with MINDFUL latest trendsinin latest trends EATING Epilepsy signs: Child medicine, doctor’s medicine, doctor’s treatment and care Nutrition The right foods for your kids insights, simple simple tools insights, tools to look look better, better 6 to better,feel feel and live healthier. better and live healthier. 18

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Contents

Letter to the Editor Dear Deepa, Thank you for sharing the online link to the magazine. I read a few articles. I want to commend the team on the vast research done on each topic and in-depth analysis. The magazine is very engaging. The topics are relevant to both genders, and across age groups. I will certainly share the link with relevant people.

Editor's Note

Speaking of the implications of the lockdown, and the extended restrictions, the editor highlights the importance of paying heed to oneâ&#x20AC;&#x2122;s mental health, as much as the physical.

Sadhguru Says

It is only by experiencing life that you can gain the wisdom needed for the liberation of your soul.

Regards,

As the pandemic gains momentum, various concerns arise, addressed in detail by our experts.

Recipes to keep you cool through summer. Innovative foods by celebrity chef Sanjeev Kapoor.

COVID-19

Bhuvana

Cook Smart

Cover Story

Nutrition/Diet

How the immune system works, and foods that enhance it. Why overeating happens, and ways to avoid it.

The age-old practice of meditation finds takers across the world, as people strive to stay calm in a world of stress and difficult circumstances. Be it in a group, or in the privacy of your home, done the traditional way, or through modern apps, meditation continues to be effective in settling your mind and redirecting your thoughts. We bring you details on meditation.

Karan Deol, of the famous Deol lineage, talks about what keeps him healthy and fit.

A young womanâ&#x20AC;&#x2122;s fight against a brain tumour. Get familiar with the kinds of thyroid disorders, and their causes. The risks posed by a fatty liver, and ways to manage it.

Feature

Wellness

Daaji talks about how to stay positive and connected with your loved ones during the period of lockdown. A diary or a journal can be your best friend when you feel the need to vent your emotions, or to simply record the events of dayto-day life. How community living can mitigate loneliness among the elderly.

Health

Beauty

The truth behind cosmetic dental treatments. The causes and remedies for yellow nails.

Fitness

Workouts for working women to stay fit. The role of technology in providing customised fitness services to the growing tribe of health conscious Indians.

Trending Now

We bring you the latest in healthcare, and a book by doctors for their patients.

72 44

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Editorial Publisher

Editor’s Note Dr Kuldeep Raizada Ph D, BCO, BADO, FAAO

Board Certified Ocularist (NEBO), USA; Board Approved Diplomat Ocularist, American Society of Ocularist, USA; Director International Anaplastology Association, USA; National Advisory Board Member, Strategic Planning, USA; Clinical Ocularist & Anaplastologist, Director International Prosthetic Eye Center, Hyderabad

Healthcare India Volume 2, Issue 12, May 2020

Lockdown Musings

Editor Deepa D. Raizada

t’s almost been a month now since the commencement of the lockdown. Like the rest of you, I have my own questions about the situation. When will it end? When shall we begin to see a decline in the numbers? And what after lockdown, or the easing of restrictions? Will there be a recurrence?

Associate Editor Sunipa Sinha

A lockdown was imperative to prevent the situation from going beyond control, and the government and various authorities are to be commended for the efforts made. On the downside, it has affected livelihoods, businesses, and of course, the economy at large. With the partial lifting of restrictions, there is undoubtedly going to be relief for some on one hand; at the same time, the need to exert caution would increase.

Consulting Editor B. Jyothi

Advisory Panel

Designer Mohammed Shakeel Ahmed

Rajiv Saxena Managing Director Blue Ocean Media Pvt. Ltd, Mumbai, Delhi, Ahmedabd

Contributors

For places where the numbers are higher, the lockdown could continue, or get stricter. These are tough times for all; for those feeling isolated or lonely, or stressed because of difficulties the situation presents, do try and find ways to stay calm. You could indulge in some quality time with family, or get into fitness routines at home, or even take up hobbies you had no time for earlier. You might even find your peace in meditation – our cover story for this issue brings you more details on the topic.

Priyanka Gupta Ajuli Tulsyan Bindu Gopal Rao Anita Raheja Heena Agarwal Namita Kamdar

Dr Ashok Kumar Grover

M.D. (AIIMS). MNAMS, FRCS (Glasgow) FIMSA, FICO, FAICO Awarded Padma Shri by the President of India

Marketing Ramki: 98846 94708 Sanaullah Khan: 93152 58330

Last, but not the least, a big cheer for our healthcare warriors who are working relentlessly in the face of this crisis. Let their efforts not go in vain; let us help them out by staying at home, following strict precautions and NOT taking this lockdown casually. With everyone’s efforts in the right direction, the numbers should hopefully, start to decline, and the recovery rate increase.

Advertising & Enquiries Connect with us: +91 91009 48787 healthcareindiamagazine@gmail.com

Dr K.S.Santhan Gopal. MD(AIIMS),FRCS(Edin),FRCOphth(UK)

Former President AIOS, Ex Hon Gen Secretary KOS Ex Secretary Bangalore Ophthalmic society, Ex Associate Editor IJO

Published by Dr Kuldeep Raizada on behalf of

As in the previous issue, this time too, we bring you articles on issues pertaining to COVID-19, to help answer any queries you may have. Do stay home, and stay safe!

Akriti Publishers and printed at Paras Offset Pvt Ltd 118-F, Kundli Industrial Area, Phase IV, Sector

Do write to us at: healthcareindiamagazine@gmail.com

56, Sector 55, Sonipat, Haryana 131028. TM

Ma 2020

Note: All images in this publication are either under Creative Commons licence, or used with permission. All opinions expressed in this issue are the writers' own.

May 2020 Pr ice: `100

A health and wellness magazine

Meditation

Prof. B.R.Shamanna

Professor, School of Medical Sciences Hyderabad

Akriti Publishers

8-1-284/OU/552, OU Colony, Shaikpet Hyderbad, Telangana 500008 Contact: 040 23569148 www.healthcare-india.org www.akritipublishers.com

Nourishing the Mind

COVID-19

Thyroid Gland

guide for Pregnancy, Cancer patients & Smokers

UP YOUR IMMUNITY THROUGH NUTRITION

Chef Sanjeev Kapoor’s

Importance of the

Karan Deol’s Fitness Mantras

Deepa D. Raizada healthcareindiamagazine@gmail.com

easy healthy recipes

facebook.com/Healthcare India Website : www.healthcare-india.org

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Healthcare 6 May 2020

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May 2020 7 Healthcare

Sadhguru Says

Get Wise Before You Get Old

When you are young, when you are healthy, when life is ahead of you, not just nuggets, a torrent of wisdom should fall upon you; and only if you let life happen to you, experiences will accumulate, says Sadhguru, Isha Foundation

t takes a lot of life’s experiences to help us realise that many things that we thought very good, turned out to be not so good. When Krishna was asked, “What is the nature of truth?” He said, “What seems to be poison is amrita; what tastes like amrita, is poison.” It takes a lot of life’s experiences to realise this. Very few arrive at this without much pain. For most, when they get there, it is too late; in the sense, that it anyway makes no difference anymore. So, the more you hasten your experience of life, the better it is, because you realise sooner that

what you thought was great, is not so great. Has it happened to you? That what you had thought was actually great when you were 16, or 30, is not so great, actually. If you don’t let the experience happen at 30, it will happen to you at 60. That is a terrible waste of life. A husband and wife were driving. There was a bit of a quarrel, as usual. In the excitement, he lost control of the car, hit the median, and the car turned over. In the next scene, they were at the gates of heaven. They walked in and found

themselves on a fabulous golf course. Nobody was there. Then the husband asked the wife, “What do you think, shall we play a round?” She said, “Okay.” So, both of them teed off and got to the green. As he was about to putt the ball, he looked around at the beautiful landscape and suddenly became a little irritated and despondent. The wife asked, “What’s the matter now?” He said, “If it was not for your stupid health food, we could have got here long ago.”

A torrent of wisdom

So many things that your body and mind carry out on a daily basis, that look like “the thing” at that moment. Later, you look back and see, and realise that they were actually not very good. You could have done better without them. There are so many things like that. And we have created a whole social hype that you are supposed to get excited about everything new, everything you do for the first time – you are not supposed to look through anything. So, like someone said, experience is like a comb that you find when you lose all your hair, or there is a vernacular saying that you find nuts to eat when all your teeth are gone. Nuggets of wisdom fall upon you when they are digging your

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Healthcare 8 May 2020

grave. No, they must fall now. When you are young, when you are healthy, when life is ahead of you, not just nuggets, a torrent of wisdom should fall upon you. If this has to happen, there is no other way than to bring clarity to your perception. If you don’t do enough work to bring clarity of perception, wisdom is an accident. If there is no clarity of perception, you will see things the way they are not. Once you see things the way they are not, unknowingly, you will live a ridiculous life. Ten people may have joined your party, all doing the same silly things, and you all may feel it is the right thing – but one day, you will know. I only hope that day is not the last day of your life. Even if you only had three days left, you could at least enjoy wisdom for three days.

Stop defending yourself against life

People are trying to gain experience. You cannot gain experience. If you live with absolute openness, experiences will happen to you. If you live with walls around you, experiences will not happen

If you don’t do enough work to bring clarity of perception, wisdom is an accident. If there is no clarity of perception, you will see things the way they are not. Once you see things the way they are not, unknowingly, you will live a ridiculous life to you. Only if you let life happen to you, experiences will accumulate. If you are guarding yourself against every little thing, there will be no experience except that of defence. Defence against what? You are defending yourself against life. That is a good strategy if you have not come here to live. But you are a piece of life – that means you have come here to live. Those of you who have lost money in the stock market, or had a tiff with your husband or wife today, if you feel like dying, just close your mouth, and hold your nose for two minutes.

Don’t conclude, try and see. There is something called experience. Don’t do what your mind says, don’t do what I say, do what the life within you says. What does it say? This being wants to live. Whatever rubbish your mind is thinking up, is not the reality. This being wants to live. It wants to live means it wants to experience the process of life, so that you can look through the process, and you can go beyond this process. If you do not look through the process, you can never go beyond it. Either you are tangled up in the process or you are insulated from it. Both will not lead to liberation. Liberation will only happen when you are able to look through the process. If the wisdom that people are expecting to happen to you when you are 60, happens to you when you are 16, you are sure to get somewhere. That means you are able to look through the process of life. You don’t have to go through all the rubbish – you look through it. That means you are a candidate for liberation. INDIA

May 2020 9 Healthcare

Covid 19 A computational approach could point toward a future treatment for Coronavirus, says this report from the Weizmann Institute of Science in Rehovot, Israel

Designing a Solution A

s the Coronavirus pandemic spreads, Prof Sarel Fleishman and his team in the Department of Biomolecular Sciences are deep into planning mode. Using a unique platform developed in their lab, they seek to address the Coronavirus problem by designing and testing millions of “nanobodies”— small synthetic antibodies that could potentially slip through the formidable defense of Coronavirus. Once the scientists home in on the most effective nanobodies, it may become possible to design a treatment capable of stopping this virus, which has already claimed thousands of lives worldwide. A structural biologist, Prof Fleishman is the developer of computer modeling tools that support the rapid and inexpensive design of customised proteins for any number of desirable properties. Much of his design work focusses on antibodies—proteins that defend the body against such disease-causing invaders as viruses and bacteria. Now he is focussed on a particular structural element in the Coronavirus—the “spike protein” that was recently characterised by scientists at the University of Texas in Austin, and which plays a key role in the infection process. His goal is to design a robust antibody that would bind to vulnerable points on the spike protein and stop infection in its tracks.

Lessons from Malaria

The potential impact of this design approach is illustrated by a recent breakthrough in TM

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Healthcare 10 May 2020

the Fleishman lab against another infectious killer: the parasite Plasmodium falciparum, which causes malaria. Prof. Fleishman’s lab invented a method that makes it possible to create computer-based models of proteins that do not exist in nature, but which, in the case of antibodies, might make them more effective or more stable, so they can be used in vaccines. The tools—which his lab made available online, and that are now used by labs around the world—embody the current understanding of how proteins fold and function. These tools also predict how specific mutations would impact protein characteristics on the atomic level, and how to combine these mutations to achieve a desired result. Two years ago, an algorithm created by Dr Adi Goldenzweig—then a PhD student in the Fleishman lab—resulted in the design of a superior anti-malarial vaccine. Not only did the synthetic proteins they designed provoke a protective immune response that short-circuited infection by the malaria parasite, they were also cost-effective to produce, and remained stable at extremely high temperatures—a significant advantage in a vaccine designed mainly for impoverished populations living in tropical climates. Successfully tested in laboratory studies by Prof Fleishman’s colleagues in the UK, the new proteins show great promise for similar success in the field and are being scaled up for

Antibodies that are perfectly primed to block Coronavirus will not be easy to design. The spikes that drive infection are shielded by particularly complex structures known as glycans. To get past this glycan shield, Prof Fleishman plans to massively expand a computational protocol already validated on a small scale in his lab

release as a commercial vaccine. Of course, antibodies that are perfectly primed to block Coronavirus will not be easy to design. The spikes that drive infection are shielded by particularly complex structures known as glycans. To get past this glycan shield, Prof Fleishman plans to massively expand a computational protocol already validated on a small scale in his lab. Using the Weizmann Institute’s infrastructure for high-performance computing, the team, including doctoral student Lucas Krauss, and Drs Ravit Netzer and Adi Goldenzweig, are not waiting to conduct further computational tests to see which of their “top-binders” should work the best. They plan to synthesise the millions of antibodies their algorithms suggest may be effective — a feat enabled by recent methods developed in the lab—and then to winnow down this massive set using experimental high-throughput screening technology. The “finalists” will be tested for their ability to neutralise Coronavirus samples—something that may lay the ground for a future treatment for COVID-19, and aid in developing a vaccine. INDIA

May 2020 11 Healthcare

Covid 19 Covid-19 and pregnancy outcomes

COVID-19 &

Pregnancy

Pregnant women are advised to avoid routine antenatal checkups if they are not in the category of high-risk pregnancy or in their last trimester, says Dr M. Swetha, Consultant Gynaecologist, KIMS SAVEERA Hospital, Anantapur

General instructions: The same conditions that apply to the general population. The most important thing to do is to wash your hands regularly and TM

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Healthcare 12 May 2020

A majority of women with COVID-19 will experience early symptoms like mild or moderate cold/flu, a new continuous cough, high-grade fevers with myalgias. More severe symptoms that necessitate immediate medical intervention include pneumonia, marked shortness of breath, patient unable to cope with the symptoms anymore. These severe symptoms are widely described in older people, the immunosuppressed, and in those with chronic health conditions like diabetes, cancer and chronic lung disease.

A study of nine pregnant women infected with COVID-19 showed that none of the babies were affected by the virus. The virus was not present in the amniotic fluid, the baby’s throat, or in the breast milk. The risk of passing the infection to the foetus appears to be very low, and there is no evidence of any foetal malformations or effects due to maternal infection with COVID-19.

Covid-19 and labour

Transmission

How can pregnant women reduce the risk of catching coronavirus?

Effects on the mother

Effects on the foetus

OVID-19, the disease caused by a new coronavirus, has spread globally quite rapidly. As this is a new virus, how exactly it affects pregnant women is not yet clear. But from the experience of corona affected patients in China, it has been found that pregnant women are more vulnerable to infection with COVID-19 than the general population. However, there have been no reported deaths of pregnant women from coronavirus till now.

The virus spreads via human to human, through respiratory droplets sent into the air when an infected person coughs or sneezes. It also spreads when someone touches a surface infected by a person who has the virus.

There does not appear to be any increased risk of miscarriage or other complications such as foetal anomalies for pregnant women who are infected with COVID-19, according to CDC. Based on data from other corona viruses such as SARS and MERS, it is noted that pregnant women who get COVID-19 may have higher risk for some complications like preterm births, but the data is extremely limited.

effectively with soap and water, or use an alcohol-based hand sanitiser as soon as you come from public places to your home or work place. Avoid touching eyes, mouth and nose frequently. If you must sneeze and cough, do so into a tissue that you discard immediately, or into your elbow.

Avoid large gatherings (>50 people at the same place). Social distancing is important to limit the spread of the virus. Do not use public transport to go to work or to public areas. Hydration and adequate rest are also important in maintaining the immune system.

A study of nine pregnant women who were infected with COVID-19, showed that none of their babies were affected by the virus. The virus was not present in the amniotic fluid, the baby’s throat, or in the breast milk. The risk of passing the infection to the foetus appears to be very low – Dr M. Swetha Newborn care

All babies of women with suspected or confirmed COVID-19 also have to be tested for the same. It is advised to have separate isolation of the infected mother and her baby for 14 days.

Breastfeeding

The main risk of breastfeeding is close contact between the affected mother and the baby, as they may share infective air droplets, leading to infection of the baby after birth.

As a precautionary approach, when pregnant women with suspected or confirmed coronavirus go into labour, they are advised to attend the obstetric unit for birth, where the baby can be monitored continuously in terms of coping with labour, and patient oxygen levels can be monitored hourly. Hence, it is not recommended to have a home birth at this time.

If you choose to breastfeed your baby, the following precautions are recommended:

There is currently no evidence to suggest that it is safer to have a Caesarean section over vaginal birth. Also, there is no evidence that affected women cannot have an epidural or a spinal block. However, if the respiratory condition of the affected person suggests that urgent delivery would be needed, a Caesarean birth may be recommended.

If you choose to feed the baby with formula or expressed milk, strict adherence to sterilisation guidelines is to be observed.

Wash your hands before touching the baby, breast pumps or bottles. Consider wearing a face mask while breastfeeding. Avoid coughing or sneezing on or near the baby.

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May 2020 13 Healthcare

Covid 19

Management of Cancer Patients during Coronavirus With the virus still spreading its tentacles around us, people with other life-threatening diseases are also being inconvenienced. How does one go for a chemotherapy session? What is the way to go for follow-up tests? Dr Anita Ramesh, Prof and Head, Medical Oncology, Saveetha Medical College and Hospital, Chennai, lists out the clinical guide for patient management during the pandemic

s doctors, we all have general responsibilities in relation to the coronavirus, and for these, we should seek and act on national and local guidelines. We also have a specific responsibility to ensure that essential cancer service care continues, with the minimum burden on healthcare. Cancer services may not seem to be in

the frontline with coronavirus but we do have a key role to play, and this must be planned.

Resources for the response to coronavirus: Cancer Patients

The most vulnerable cancer patients are more at risk of becoming seriously ill if they contract the coronavirus

infection. These include: People with cancer who are undergoing active chemotherapy or radiotherapy l People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma, who are at any stage of treatment l People undergoing immunotherapy or l

other continuing antibody treatments for cancer l People having other targeted cancer treatments l People who have had bone marrow or stem cell transplants in the last six months, or who are still taking immunosuppression drugs In addition to immunosuppression, several factors/co-morbidities are likely to be linked with a poorer prognosis with coronavirus: l Aged over 60 l Pre-existing cardiovascular disease l Pre-existing respiratory disease The more of these individual factors a cancer patient has, the more likely they are to develop a serious illness with coronavirus, especially if treated with systemic anti-cancer therapies. Clinicians may also need to prioritise treatment for those most in need. It is important that all decisions taken are done so with multidisciplinary team (MDT) input and clearly communicated with patients.

Surgical patients

General approach to prioritising patients on systemic anti-cancer therapy: l

Categorise patients by treatment intent and risk-benefit ratio associated with treatment

Urgent: Surgery needed within 72 hours

Based on: Urgent/emergency surgery for life threatening conditions such as obstruction, bleeding, and regional and/or localised infection; permanent injury/clinical harm from progression of conditions such as spinal cord compression

Clinicians will also need to consider the level of immunosuppression associated with an individual therapy and the condition itself, and patients' other risk factors.

General measures to consider

If appropriate, MDTs may consider nonsurgical options, including prolongation of neoadjuvant treatment and nonsurgical treatment if the outcomes are similar. INDIA

Treatment decisions will need to be made on a case-by-case basis

Emergency: Surgery needed within 24 hours to save a life

All elective surgeries to be postponed

Healthcare 14 May 2020

Systemic anti-cancer treatments

Categorisation of patients l

The most vulnerable cancer patients are more at risk of becoming seriously ill if they contract the coronavirus infection. These include: people who are undergoing active chemotherapy or radiotherapy; cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment

Consider alternative and less resource-intensive treatment regimes Seek alternative methods to monitor and review patients receiving systemic therapies

Categorisation of patients

Curative therapy with a high chance of success l Palliative or non-curative therapy can be delayed l

Medical Oncology

can be given in alternative regimens, different locations or via other modes of administration to minimise patient exposure and maximise resources.

1. Changing intravenous treatments

to subcutaneous or oral if there are alternatives. 2. Selecting regimens that are shorter in duration. 3. Consider using four-weekly or sixweekly immunotherapy regimens rather than two-weekly and threeweekly. 4. Dispensing longer periods of oral medications. 5. Consider deferring supportive therapies such as Densoumab and zoledronic acid treatments (except for hypercalcaemia). 6. Consider home delivery of oral medication where possible (but need to confirm the resilience of home care providers). 7. Use of GCSF as primary prophylaxis to protect patients and reduce admission rates 8. Considering treatment breaks for long-term treatments when risk of coronavirus is high. 9. Consider what supportive services are required to deliver regimens safely.

Consider whether systemic therapies INDIA

May 2020 15 Healthcare

Covid 19 Seek alternative methods to educate, monitor and review patients on systemic therapies.

Seek alternative methods to educate, monitor and review patients on systemic therapies. Identify alternative arrangements to minimise patient exposure. This could involve patients having blood tests locally or telephone/ virtual appointments

Identify alternative arrangements to minimise patient exposure. This could involve patients having blood tests locally or telephone/virtual appointments.

Radiation therapy

Categorisation of patients Priority level 1 l Patients with category 1 (rapidly proliferating) tumours, currently being treated with radical (chemo) radiotherapy with curative intent, where there is little or no scope for compensation of gaps. l

Patients with category 1 tumours, in whom combined External Beam Radiotherapy (EBRT) and subsequent brachytherapy is the management plan, and the EBRT is already under way.

General measures to consider radiotherapy

In all cases, the most clinically appropriate hypo-fractionated schedule is to be used. In some patients, a short delay for treatment may be possible without compromising outcome. General measures across all services to reduce patient contact and maximise workforce capacity Minimise face-to-face appointments Offer consultations via telephone or video consultation wherever possible l Cut non-essential follow-up visits l Accelerate adoption of stratified follow-up models l Home delivery of oral systemic agents where suitable/available l Reduce dwell time in services l For those who do still need to attend, particularly for treatment, schedule appointments to reduce waiting time l Encourage patients not to arrive early â&#x20AC;&#x201C; consider measures such as texting them when ready to see them, so they can wait in their car l l

Urgent palliative radiotherapy in patients with malignant spinal cord compression, who have useful salvageable neurological function. Palliative radiotherapy, where there is alleviation of symptoms, such as haemoptysis.

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Clinical guide for the management of cancer patients during the coronavirus pandemic

Follow broader trust actions and protocols including testing and isolation of patients with coronavirus symptoms. l If staff are required to self-isolate due to contact with a confirmed case of coronavirus, consider ways they can continue to provide care and/or support tumour board meetings. l

For example: l Virtual attendance at MDT meetings l Telephone or video consultations, especially follow-ups l Identifying vulnerable patients and making contact to discuss changes to care and treatment l Identifying patients suitable for remote monitoring/follow-up l Data entry (where remote access enabled) l Overall considerations l We should avoid unproductive attendances at hospital l Senior decision-making at the first point of contact should reduce or even preventthe need for further attendance l A decrease in elective work will allow for a greater senior presence at the front door l Clinicians may need to work in unfamiliar environment or outside of their sub-specialist areas. They will need to be supported. l No patient should be scheduled for surgery without discussion with a consultant. l The longer hours will allow ED access and help reduce crowding in waiting rooms. l The possibility of a seven-day service may need to be considered. l Consider postponing long-term follow-up patients until the crisis has passed. l Can a follow-up virtual clinic be developed with your facility? l CT scanning may be limited as it is the investigation of choice for coronavirus pneumonitis. INDIA

May 2020 17 Healthcare

Covid 19

Smokers more vulnerable to

Covid-19

he coronavirus pandemic is evolving too rapidly for conclusive evidence to have emerged on the impact of smoking on an individual’s susceptibility to COVID-19 infection. However, there is overwhelming evidence that people who smoke are at a higher risk of getting lung and chest infections, which can be caused by other respiratory viruses (such as influenza) and also bacteria (for instance, tuberculosis.) This means that it is more likely that people who smoke

have a higher risk of getting COVID-19, compared to people who don’t smoke. There is growing evidence to suggest that people who smoke are likely to be more severely impacted by COVID-19 if they do become infected, because smoking damages the lungs and they don’t work as well. For example, lungs naturally produce mucus, but people who smoke have more and thicker mucus, that is hard to clean out of the lungs. This mucus clogs the lungs and is prone to becoming infected. Smoking also affects the immune system, making it harder to fight the infection. Dr Vishal Rao, member of a highpowered committee on tobacco control, GoK, says, “We know that people who smoke are at a higher risk of respiratory tract (including lung) infections, which puts them in the most vulnerable group, having a higher risk of getting COVID-19.” He added, “We do know that exposure to second-hand smoke also damages lungs and depresses the immune system, increasing susceptibility to chest and respiratory infections. It is very important that people who smoke don’t do it in the presence of a nonsmoker. People are indoors mostly these days, and chances are they might want to smoke in front of a family member, especially kids, putting them at a higher risk of getting COVID-19. It is always a good time to quit smoking! People should take this as a 21-day challenge for quitting.”

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According to experts, people who smoke are at a higher risk of contracting the coronavirus. Instead of continuing with the habit, they should use the lockdown period to quit smoking

Speaking on the issue, Dr Prathima Murthy from NIMHANS, says, “There is growing evidence that smoking is a risk for COVID-19. Smoking worsens lung function and reduces immunity. Smokers who develop COVID-19 infection have more complications and greater risk of fatality. Even if a person is not affected by the virus, it is a good time to stop smoking. This improves immunity and can improve lung function within a few months. Apart from reducing risks from COVID-19, there are many other benefits for the lungs, heart and other parts of the body. Quit smoking and all forms of tobacco use now. If you need support to quit, get in touch with a health care provider, call the tobacco quit-line (1800112356), or give a missed call to the cessation tobacco service on 011-22901701.” Maya Annie Elias, Project Lead, Tobacco free Cities, Movement for Alternatives and Youth Awareness (MAYA) said, “People who smoke, have the tendency to share the cigarettes with each other, which puts them at higher risk of getting infected. The vendors defy the law which prohibits the sale of loose cigarettes, which is also another serious cause of concern. Enforcement officers must ensure that the ban on the sale of loose cigarette is immediately enforced.” For further details, contact:

Maya Annie Elias

Tobacco Free Cities, Movement for Alternatives and Youth Awareness (MAYA) Bangalore Ph. 9972235556

Covid 19

or the past few weeks, life has taken on an interesting twist, with us waking up and reading about the various updates on Coronavirus on social media. In the past one month, this pandemic has created havoc everywhere on the planet. Today, the world has turned to isolation as a means of stemming the spread of this disease. What is this virus.. how is it going to affect everyoneâ&#x20AC;Ś. is there a way to prevent illness... what does isolation mean -- are a few of the questions on everyoneâ&#x20AC;&#x2122;s mind. It has made a huge impact on mankind, with people panicking and even afraid to meet or greet each other. All businesses are seeing demand wane; people are worried about their jobs, and it is difficult for the curious mind to process the ongoing stress and predict the future. This anxiety and fear are causing more people to fall sick, and everyone wants immediate help. Every physician standing on the frontline is trying to help patients deal with this, while risking their own health.

Curious minds and Corona Cultivating psychological resilience In the current situation, with the global pandemic due to the Coronavirus, even though it is natural to be stressed, one must understand that this is what we need to isolate ourselves from. Our curious mind can turn out to be a harmful trigger, provoking the virus, and our psychological resilience is very crucial at this time, says Dr Shagun Bindlish, MD, FACP

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The bottom line is that there is no treatment available yet for Coronavirus, and the best option is to isolate and take basic precautions. Amidst all this

The bottom line is that there is no treatment available yet for Coronavirus, and the best option is to isolate and take basic precautions. Amidst all this anxiety, have you ever thought about how your curious mind is dealing with the global crisis?

anxiety, have you ever thought about how your curious mind is dealing with the global crisis? Are you depressed, sitting at home, or worrying whether

the virus will hit you? Or are you worried about your job or business, and what is going to happen in the future? After being stressed myself, and having a few sleepless nights, I realised we always talk about stress affecting our body and immune system. When there is too much inflammation inside our own system, the body attacks its own healthy cells, and this can, in turn, trigger an infection. In this current situation, even though it is natural to be stressed, one must understand that this is what we need to isolate ourselves from. Our curious mind can turn out to be a harmful trigger, provoking the virus, and our psychological resilience is very crucial at this time. Therefore, calm down and take the first step to isolate yourself from your own flight of fear so that your body remains healthy to fight the external triggers. Currently, the powerful and effective treatment is self-care; use this time to unwind from the daily stressful schedule and rejuvenate your soul. Our goal is to embrace the power of positive thinking. Self-isolation is not a punishment. It just means that you must do the needful to protect yourself and your loved ones. Fight fearlessly, and comfort your curious mind with positivism and resilience. Let us all become a TEAM (Together Everyone Achieves More) and help to flatten the curve.

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Covid 19

Nationwide free helpline launched on PM's appeal by a team of doctors to fight COVID 19

Contact Numbers: 1. Dr Shubhank Singh

9015909091

2. Dr Neelam Mohan

9811043475

3. Dr Bharat Singh

98960 44636

4. Dr Priyam Upadhyaya

9318395789

5. Dr Manoj Kumawat

9549982306

6. Dr Reema Verma Narang 9910498866 Amidst the nationwide lockdown, a team of doctors from different hospitals have joined hands to fight the virus

New Delhi: As we all know, the world is in the midst of a pandemic, caused by the virus called Corona. Amidst a nationwide lockdown, a team of doctors have come together and joined hands to support the people facing healthcare emergency. A nationwide helpline has been launched, where people can connect with these doctors over email, call, WhatsApp or video calls. Starting from Day 1 of the lockdown, these doctors have been selflessly helping those in need of guidance. People are panicking, and have a lot of queries which are being answered by this panel of doctors. TM

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Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. Public health expert, Dr Shubhank Singh, has taken the initiative, many other eminent doctors have later come forward to support the cause. Dr Singh says, “Our team is constantly working on an awareness drive, where they visit different places in order to make

people aware about the do’s & don’ts for the pandemic.” He also said that the best way to prevent and slow down the transmission of COVID-19 is to be well informed about the virus, the disease it causes, and its spread. It is very important to protect yourself and others from infection by washing your hands or using an alcohol based sanitizer frequently, and not touching one’s face. Despite the lockdown in the country, the virus is spreading rapidly. So, this is a crucial stage where we all need to be extra cautious and follow the instructions given by WHO and health professionals. Everyone should take

good care of hygiene, wash hands frequently with soap and water for 20 seconds, or use an alcoholbased hand sanitizer; cover nose and mouth with a disposable tissue or flexed elbow while coughing or sneezing, avoid close contact (1 meter or 3 feet) with people who are unwell. Stay at home and self-isolate from others in the household if you feel unwell. Commenting on the initiative, Dr Neelam Mohan, pediatric gastroenterologist and hepatologist, Medanta – The Medicity, who is the senior member of the team, said, “The virus spreads through droplet infection, close contact, and we have recently had an understanding that it is spreading through micro droplet infection; when you cough, sneeze or talk loudly, these drops stay in the air for some time and can give rise to infection. As suggested by WHO, there is a high probability of this virus being airborne, which we were not thinking of earlier. In addition, I would like to say that even an asymptomatic person can transmit this infection; therefore comes the role of social distancing, both outside, and as much as possible, within the house. It is the most effective way to stop or slow down the spread of infectious diseases. It means less contact between you and other people.” Dr Singh also mentioned, “We are thankful that the Honourable Prime Minister has initiated “Swasthya Bharat and Swacch Bharat Abhiyan”, where millions of people have toilets in their own house, and hand washing facilities, which are helpful in saving millions of lives in India during this pandemic situation.” The team is available 24 x 7, to help and fight the novel corona virus, because together we can fight the pandemic successfully.

7. Dr Sangeeta Subudhi

9810732330

8. Dr Shivani Deswal

9873395362

9. Dr Aashay Shah

8128938809

10. Dr Anubhuti Bhardwaj

9929771514

11. Dr Ankit Singhal

9761116274

12. Dr Avanish Singh

98894 53689

13. Dr Sabina Vij

9899932417

14. Dr Sakshi Arora

8950357666

15. Dr Nafees Ahmad

78607 36600

16. Dr Sandeep Kumar

8447783795

17. Dr Reubina KD Singh

7558095116

18. Dr Sarika Boora (Psychologist)

9810721155

19. Dr Ravinder Malik

9992963800

20. Dr Arvind Kumar Singh

9312198455

21. Dr Saraansh Bansal

81462 59139

22. Dr Pallavi Purwar

99100 81862

23. Dr Ankur Rakesh

95607 12369

24. Dr Mehul Chawla

85275 74544

25. Dr Neha

9818032536

26. Dr Danielle Dsouza

9930166262

27. Dr Sadhika Verma

9210884422

28. Dr Ankesh Rawat

9599539993

29. Dr Shailendra Bhadoriya 99103 92630 30. Dr Osho Prajapati

8076317137

31. Dr Sanjana Prajapati

9811097085

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Nutrition/Diet

How to curb Overeating Most of us love food, but some of us donâ&#x20AC;&#x2122;t know when to stop eating, especially if it is a favourite food item. When we do this frequently, the calories pile up and cause health problems. Overeating can also be due to underlying emotional problems. Dr Muffazal Lakdawala, Founder and Chief Surgeon at Digestive Health Institute by Dr Muffi, shares ways to curb overindulgence of food on a daily basis

verindulgence is eating too much at one time or excessive intake of calories. The reasons for this behaviour are multifactorial -some hormones such as leptin, ghrelin and cortisol and stress have been shown to be large contributing factors.

The hormone leptin signals the brain when food is ingested, to provide satiety. Excessive fat accumulation tends to cause leptin resistance, resulting in a decrease in the satiety signals. Ghrelin, on the other hand, is the hunger hormone; situations of stress tend to raise ghrelin levels, resulting in increased appetite and overeating. Cortisol is another hormone that is released in times of stress. Chronic stress results in the production of this hormone, commonly known as the stress hormone. Cortisol is a glucocorticoid that causes a redistribution of fat cells to the abdominal area and also causes an increase in appetite and a preference for energy-dense foods. This phenomenon is called stress eating or emotional eating. With stress eating, one eats to comfort oneself instead of the usual response to hunger. Overindulgence can be a result of stress eating/emotional eating or mindless eating. The good thing is that there are simple ways to curb this:

1. Always eat meals at a fixed place.

For e.g., all meals should be eaten at the dining table only, not on the couch, or the bed, or work table. This way, you inculcate discipline and also concentrate on your food, and are more mindful of what is going into your mouth.

2. Never eat while watching television or while on your phone. While eating, practise mindful eating tactics, concentrate on your food and nothing else. The aroma, the texture, the taste, this will bring about more satiety, and you will be satisfied with what you have eaten, thus preventing you from overeating.

3. Drinking one or two glasses of water about 20 minutes before meals helps curb appetite and reduces overall food intake. A bowl of soup or salad or fibre supplement will also result in the same effect.

4. Eat slowly and chew food

thoroughly. It takes about 20 minutes for the signal to reach your brain from the stomach, indicating a state of fullness. Keep a gap between morsels, put your fork and spoon down between each bite. This will ensure that you are eating slowly and will also help you recognise satiety.

5. Include fibre rich foods and complex carbohydrates in your diet. Eat plenty of fresh vegetables, whole grains â&#x20AC;&#x201C; millets; whole wheat, as opposed TM

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to refined flour; brown rice/red rice, as opposed to white rice; whole wheat bread as opposed to white refined bread; whole pulses -- beans/ legumes/sprouts; nuts and seeds -- almonds, walnuts, pumpkin seeds, pepitas, flaxseeds, sesame seeds; whole fruits as opposed to fruit juice. Fibre increases satiety, and complex carbohydrates prevent a sharp rise and fall in your blood sugar levels that cause you to feel hungry.

6. Avoid empty calories -- carbonated

drinks, sherbets, fruit juices, alcohol, chocolates, candies, biscuits provide your body with no nutritional value and only fill you up with calories. This results in a slump of energy during the day, resulting in your overeating.

7. Eat small meals during the day rather than three big meals.

8. Avoid skipping meals, as this will

cause you to overeat later in the day, as your body is craving energy. Skipping breakfast, for example, will ultimately result in your eating a large lunch or dinner, or you might catch yourself snacking during the day, which is most likely -- biscuits, fried foods or chocolates. This is because the body is craving energy, and sugar provides it with an instant boost.

9. Eating in smaller plates/bowls, using smaller cutlery, also helps in reducing portion sizes.

10. Eat in a relaxed, calm atmosphere.

Cortisol is a glucocorticoid that causes a redistribution of fat cells to the abdominal area, and also causes an increase in appetite, and a preference for energy-dense foods. This phenomenon is called stress eating or emotional eating. With stress eating, one eats to comfort oneself, instead of the usual response to hunger 13. Avoid restricting yourself

completely; give yourself a treat once in a while. Enjoy that occasional slice of pizza or cake. If you completely cut out foodstuffs from your diet, you are more likely to overeat or overindulge.

14. If you find yourself in the habit of overeating, get some discipline in by keeping a food diary to record everything that you eat and drink during the day, with portion sizes. Research has shown that those recording their food intake are more successful at sticking with a programme or a diet plan. Nowadays, there are various apps and gadgets that can help with the same, so make use of technology. 15. Exercise regularly. Exercise helps

release feel-good hormones and reduce stress, which will go a long way in helping you avoid overindulgence.

16. Meditate, practise yoga, as it helps in calming your mind, reducing stress and promoting overall well-being.

Avoid eating in a rush -- this way you focus on your food, your satiety, and are more alert to the signals your body is giving you.

11. Serve yourself a small portion

first, and if needed, go for a second helping, but avoid piling your plate all at once, as you are then forced or tempted to finish off everything.

12. Remember to give yourself time

between two servings or two courses, as this will help you realise whether you need that second helping or not. INDIA

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Nutrition/Diet

Good nutrition is essential to a strong immune system, which may offer protection from seasonal illness and other health problems. And there are certain foods that must be consumed regularly to build immunity, says Clinical Nutritionist and Dietitian/Certified Diabetic Educator, Razia Ali

(particularly adaptive processes) in older people.

Immunity Boosting Foods T

he immune system, which is integrated into all our physiological systems, protects the body against infections and other external and internal threats by utilising three distinct layers, depending on the nature of the threat: physical (e.g., skin, TM

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epithelial lining of the gastrointestinal and respiratory tracts) and biochemical barriers (e.g., secretions, mucus, and gastric acid), numerous different immune cells (e.g., granulocytes, CD4 or CD8 T and B cells), and antibodies (i.e., immunoglobulins).

Age-related changes are compounded by certain lifestyle factors (e.g., diet, environmental factors, and oxidative stress) specific to each life stage, that can influence and modify, in some cases suppressing immune function. Accordingly, the risk and severity of infections such as the common cold and influenza (the most common illnesses in humans), pneumonia, and diarrhoeal infections, also vary over a lifetime. The first line of defence is innate immunity, which combines physical and biochemical barriers with a non-specific, leukocyte-mediated cellular response to defend against pathogens. If the pathogen manages to avoid these innate defences, a more complex, adaptive, antigen-specific response is triggered, mediated by T and B lymphocytes, which produces antibodies to target and destroy the pathogen. Both systems protect against native cells that may be harmful, such as cancerous or precancerous cells As humans age, the immune system evolves from the immature and developing immune responses in infants and children, to immune function that is potentially optimal in adolescents and young adults, followed by a gradual decline in immunity

Optimal immune function is dependent on a healthy immune system. In turn, adequate nutrition is crucial to ensure a good supply of the energy sources; macronutrients and micronutrients are required for the development, maintenance and expression of the immune response. Micronutrients have vital roles throughout the immune system, that are independent of the life stage, and it has been determined that those most needed to sustain immuno-competence include vitamins A, C, D, E, B2, B6 and B12, folic acid, beta carotene, iron, selenium, and zinc. The immune response is compromised when nutrition is poor, predisposing individuals to infections, and a poor nutritional state may be exacerbated by the response of the immune system itself to an infection. It is clear

The immune response is compromised when nutrition is poor, predisposing individuals to infections, and a poor nutritional state may be exacerbated by the response of the immune system itself to an infection. It is clear that optimal immuno-competence depends upon nutritional status

of certain infections such as diarrhoea, pneumonia and measles.

Response to Infection

The nature of the response of the immune system to a pathogen is initially dependent on whether the innate immune defences can eliminate the infectious organism. If not, previous experience with the pathogen will determine how rapidly T and B cells in the adaptive immune system are able to mount a defence against it, supported by the innate immune system.

Micronutrient Requirements

that optimal immuno-competence depends upon nutritional status. It is also recognised that micronutrient deficiencies and suboptimal intakes are common worldwide, and certain micronutrients may be more likely to be insufficient at different stages of life. This can affect the risk and severity of infection, and in fact, an individualâ&#x20AC;&#x2122;s nutritional status can predict the clinical course and outcome

The development, maintenance and optional functioning of immune cells is dependent on adequate nutrition, evident at all stages of life. Certain micronutrients play key immunomodulatory roles. Immune defences can be impaired by malnutrition, which increases susceptibility to infection. In turn, infection can cause a significant increase in the demand for micronutrients, met by endogenous or exogenous (i.e., the diet) supplies. â&#x20AC;&#x2DC;An apple a day can keep the doctor awayâ&#x20AC;&#x2122;, may have truth behind it after all. Good nutrition is essential to a strong immune system, which may offer protection from seasonal illness and other health problems. No one food or supplement can prevent illness, but you may help support your immune system INDIA

May 2020 27 Healthcare

Nutrition/Diet by including these nutrients in your overall eating plan on a regular basis. Protein plays a role in the body's immune system, especially for healing and recovery. Eat a variety of proteinrich foods including seafood, lean meat, poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds. l

Vitamin C is one of the biggest immune system boosters of all. In fact, a lack of vitamin C can even make you more prone to getting sick. Daily intake of vitamin C is essential for good health because your body doesnâ&#x20AC;&#x2122;t produce or store it. It supports the immune system by stimulating the formation of antibodies.Foods rich in vitamin C include spinach, kale and broccoli,and citrus fruits such as oranges, grapefruit and tangerines, or red bell pepper, papaya, strawberries, tomato juice, or foods fortified with vitamin C, such as some cereals. l

Zinc helps the immune system work properly and may help wounds heal. Zinc can be found in lean meat, poultry, seafood, milk, whole grain products, beans, seeds and nuts. l

Vitamin A helps regulate the immune system and protect against infections by keeping skin and tissues in the mouth, stomach, intestines and respiratory system healthy. Get this vitamin from foods such as sweet potatoes, carrots, broccoli, spinach, red bell peppers, apricots, eggs, or foods labelled "vitamin A fortified," such as milk or some cereals. l

Vitamin E works as an antioxidant and may support immune function. It is a powerful antioxidant that helps the body fight off infection. Foods rich in vitamin E include nuts, seeds and spinach. Include vitamin E in your diet with fortified cereals, sunflower seeds, almonds, vegetable oils (such as sunflower or safflower oil), hazelnuts, and peanut butter. l

Vitamin B6 is vital to supporting biochemical reactions in the immune system. Vitamin B6-rich foods include chicken and cold-water fish such as salmon and tuna. Vitamin B6 also is found in green vegetables and in chickpeas, which is the main ingredient in hummus. l

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Other nutrients including vitamin B6, B12, copper, folate, selenium and iron also support immune response l

Cook Smart

Cool Down with Melons

Priyanka Gupta brings you two easy-to-make summer coolers that are made with melons

Muskmelon Orange Cooler

Watermelon Cooler Ingredients (1 cup = 240 ml/250 gram; 1 tbsp = 15 gram; 1 tsp = 5 gram) 1. 2 cups watermelon â&#x20AC;&#x201C; peeled and cut 2. 1 tbsp lemon juice 3. 1 tsp honey 4. 2-3 mint leaves Procedure: Blend all the listed ingredients in a blender and serve chilled.

Ingredients (1 cup = 240 ml/250 gram; 1 tbsp = 15 gram; 1 tsp = 5 gram)

4. 2-3 mint leaves 5. Pinch of kala namak (rock salt) OR 1 tsp honey (depending on preference)

1. 2 cups muskmelon â&#x20AC;&#x201C; peeled and cut 2. 1 cup orange pieces 3. 1 cup coconut water

Procedure: Blend all the listed ingredients in a blender and serve chilled.

Ice cream made nutritous

Razia Ali (clinical nutritionist and dietician),shares a recipe for an oatsragi icecream

Oats Ragi Icecream Ingredients l 3 cups=750ml boiled low fat milk or boiled pasteurised milk l 250 gm roasted oats l 125 gm roasted ragi l 10-15 black raisins (soaked) l 15 dates l 4 pinches of cinnamon powder l 1 tsp vanilla extract

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Healthcare 30 May 2020

l l

A pinch of salt 5-6 finely chopped almonds for garnishing.

Procedure l Blend all the ingredients thoroughly until creamy and smooth in a mixer (a full 45-60 seconds).

l l

Pour into a churner and churn till it is a soft serve consistency. Mine took about 30 minutes. Transfer to a shallow container and freeze overnight. It takes 6-7 hours max to freeze completely. Scoop into a bowl, add toppings and enjoy. Just remove from the freezer and allow to soften for approximately 10-15 minutes before serving.

NUTRITIONAL VALUES In 1 scoop 20gm TOTAL Energy- 78.2kcal Prot- 3.65gm CHO- 17gm Fats- 1.29gm Fibre - 2.0gm Calcium- 5.1% Iron -2.8% NUTRITIONAL BENEFITS High protein High fibre High calcium High iron and folate

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Cook Smart

Foods that refresh

The well known chef, Sanjeev Kapoor, shares his recipes for a quick and easy smoothie and a salad that are perfect for summer

ORANGE AND QUINOA SALAD

GREEN SMOOTHIE WITH GRAPES Ingredients l 40-44 green grapes l 40-44 black grapes l 28-30 spinach leaves l 4 medium cucumbers l 16-20 fresh basil leaves l A few strands of wheat grass l 6 tbsp honey l A few ice cubes l 4 kiwis l 6 tbsp soaked chia seeds, drained l Basil sprigs for garnish Method 1. Halve green and black grapes and put into a bowl.

2. Put spinach leaves into a blender jar. Chop cucumbers and add. Add basil leaves, wheat grass, honey and icecubes.

3. Cut kiwis into small pieces and add to the blender jar, along with a little chilled water. Add chia seeds and blend into a smooth smoothie.

4. Pour this smoothie into the bowl of grapes. Garnish with

Ingredients l 2 oranges l 2 cups cooked quinoa l 1 medium onion, peeled l 8-10 cherry tomatoes l 8-10 roasted walnuts, roughly chopped l 8-10 red radishes, thinly sliced l Â˝ cup microgreens l Feta cheese for sprinkling For the dressing l 3 tbsp orange marmalade l Salt to taste l Crushed black peppercorns to taste l 6 tbsp olive oil l 4 lemons l 3 tbsp honey

Method

1. Peel orange and separate the segments. Remove seeds and halve them.

2. Thinly slice onion and gently separate the layers. 3. To make the dressing, take marmalade in a small jar, add salt, crushed black peppercorns, olive oil, and mix till well combined.

4. Halve the lemons and squeeze their juice directly into the jar and mix well. Add honey, place the lid on, and shake the mixture till everything is well combined.

5. Halve the cherry tomatoes. 6. Take quinoa in a large bowl, add walnuts, onion, cherry tomatoes, red radishes, micro greens and halved orange segments. Pour the dressing into it and toss lightly.

7. Transfer the salad onto a serving plate, crumble and sprinkle feta cheese on top. Serve immediately.

basil sprigs and serve chilled.

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Cover Story

M Meditation has long since been known to have positive effects that include reduction in stress levels, increased concentration, and self-healing. In these days of stress, and with the lockdown in place, practising meditation can help you stay calm, use your time productively, and improve your health in several ways. For those who don’t know how to, there are even apps that help you meditate through various methods. Healthcare India explores this age-old practice that is getting increasingly popular by Bindu Gopal Rao

editation, a practice that dates back to several centuries, is a simple yet profound gift that humanity could receive. It is the art of allowing you to connect to who yourself are, go deep within, helping you calm your mind, release tension, stress, and find balance and peace. With the growing hustle in our lives, and situations where every person is stressed for most part of their day, adding small and easy meditative practices can help bring about brilliant shifts in your mindset and lives.

Historical Routes

Meditation has been around in India for many thousands of years and dates back to 5000 to 3500 BCE. Meditation is a practice where the technique of mindfulness or focussing attention on any particular object, activity or thought is practised by an individual. This is done to get the focus and attention to achieve a clear and calm, emotionally stable state of mind. In fact, meditation as such is hard to define, as there are varying practices between traditions and within them as well. Meditation has been practised since time immemorial across religions such as Hinduism and Buddhism, and all of these have often had the same goal -- to show the path towards enlightenment and selfrealisation. The earliest records of meditation find its origins in the Hindu traditions of Vedanta. There are many popular forms of meditation including mindfulness, spiritual and focussed meditation, through movement, mantras and transcendental meditation. Incidentally, the word meditation comes from meditari, that means to think/to exercise the mind; and mederi, meaning, to heal, in Latin. It is said that it was the great saint Gyaneshwar who started teaching meditation way back in the 14th century. There are references, however, to rishis meditating in the Himalayas well before that, and there is mention in our epics, Ramayan and Mahabharat too.

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Guided meditation is a great way to start a practice. While listening to guided meditation, make sure to follow the instructions, as they are like rails that keep a train on its tracks, guiding you to your higher self or deeper self, as you may call it. Be open to the experience, without any preconceived notions or judgements. Remember, it is actually a revelation of the unknown till you finally connect with your true self

Mental Musings

“Guided meditation is a technique where you are asked to focus on a specific imagery to aid relaxation. You try to use as many senses as possible, such as smell, Karishma Chawla sight, sound and texture. Usually, this process can be aided through a teacher or a guide. Qi gong is a practice that is part of traditional Chinese medicine, and generally combines meditation, relaxation, physical movement and breathing exercises to restore and maintain balance. Likewise, a form of gentle Chinese martial art, Tai chi involves a series of self-paced

movements in a slow and graceful manner while continuing to do deep breathing,” says nutritionist and lifestyle educator, Karishma Chawla. Dr Amulya Seth, Consultant Physiatrist, Columbia Asia Hospital, Ghaziabad, avers, “Mediation is a habit to calm your mind and training it to focus. Mental and physical stress increase levels of the stress hormone cortisol that disrupts sleep, increases blood pressure, promotes depression and anxiety, and contributes to fatigue and cloudy thinking. Meditation helps control these. It also influences emotional health and helps in creating a more positive outlook towards life. It also improves sleep and attention span.” Guided meditation is a great way to start a practice. While listening to guided meditation, make sure to follow the instructions as they are, like rails INDIA

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Cover Story that keep a train on its tracks, guiding you to your higher self or deeper self, as you may call it. Be open to the experience, without any preconceived notions or judgements. Remember, it is actually a revelation of the unknown till you finally connect with your true self. If you find more calmness, relaxation, clarity of mind, and compassion towards others, then your meditation is doing its work. And you may even notice random happiness throughout the day. A correct, long-term meditation practice will help you develop a feeling of detachment from desires; you begin to perceive yourself controlling them, rather than allowing them to control you. In the words of Sri Sri Ravi Shankar, “There is no problem if you have your desires, but don’t let the desires have you. Meditation happens with the attitude, ‘I want nothing, I do nothing, I am nothing’.”

Myriad Forms

Prānāyāma is the practice of breath control in yoga that synchronises the breath with movements of the asanas, as well as distinct breathing exercises done independently and typically after the asanas. Vipassana is known to be the oldest of Buddhist meditation practices. It is a codified system of training one's mind, and entails a set of exercises that are dedicated towards making one more and more aware of his or her life experiences. Rakhee Mehta, Founder, Magicrise, says, “Vipassana is a gentle yet thorough technique of meditation. This is an inward journey that focusses on deep interconnection between the mind and body, which is realised through disciplined attention to the physical sensations. The principle of gaining focus through discipline is a very ancient practice, and can be seen in varied traditional arts such as kung-fu, tai chi, dance and the like. In the case TM

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of Vipassana, the principle of silence is applied to quieten the stir within and outside, to reach a point of balance in our fast-paced lives.” Shweta Bhatia, a registered dietitian with the Indian Diabetic Association, bodybuilder and founder of Mind your Fitness, enlists the different forms of

“Vipassana is a gentle yet thorough technique of meditation. This is an inward journey that focusses on the deep interconnection between the mind and body, which is realised through disciplined attention to the physical sensations” – Rakhee Mehta

meditation. “Mantra meditation is the easiest form of meditation, which can be easily practised by anyone. Shweta Bhatia It heals the body, mind and spirit. The Yogic Gaze (trataka) meditation technique involves using a normal candle, but depending on your choice, you can use some other object also. The candle is usually set at an arm's distance and at eye level. Then start gazing at it with open eyes. Chakra meditation involves search and activation of the chakras of the body. Raja Yoga meditation fills the heart of the practitioner with supreme joy, which is a great experience in itself. Zazen meditation was done by the Buddha. It calms the body and mind and helps the practitioner to know the nature of existence. Nada Yoga is "union through sound", where sound elevates the person at a spiritual level and undergoes inner transformation.”

Mind Matters

Meditation is best known for reducing stress and anxiety, and there has been a study that has indicated that mindfulness and Zen like meditation can significantly reduce stress when practised over three months. Another study revealed that meditation literally reduces the density of brain tissue associated with anxiety and worrying. Dr Vivek Chandel, Wellness Manager, Fazlani Natures Nest, says, “Mindfulness meditation increases your psychological functioning, and in the process, improves your sense of wellbeing. Loving kindness meditation enhances brain areas associated with mental processing and empathy, and hence is based on compassion. It also increases your sense of social connectedness. Meditation basically also improves memory and your ability to make decisions.” The cornerstone of The Art of Living programmes is the healing breath, known as the Sudarshan Kriya. This unique breathing practice is a potent energiser, where oxygen enters each of the cells and removes negative emotions from the body and releases tensions, frustrations and anger, clears anxiety, depression, and lethargy, giving relief to both, the mind and body. With regular practice, one becomes calm and centered, with a clearer mind. A sense of joy in the moment prevails, and one is able to smile from the heart. Gurudev Sri Sri Ravi Shankar has said, “In ancient times, meditation was used for enlightenment: to find the self. And meditation is a way to overcome problems, as well as any unhappiness. Meditation is also a way to improve one’s abilities. The social ills of today, the stress and tension, calls for one to meditate. The more responsibility you have in life, the greater is the need for meditation. People who have nothing to do, may not need meditation as such. The busier you are, the less time you have, the greater desires you have, that much more you need meditation. It relieves you of stress, and helps you better accomplish your tasks and ambition.”

The cornerstone of The Art of Living programmes is the healing breath, known as the Sudarshan Kriya. This unique breathing practice is a potent energiser, where oxygen enters each of the cells and removes negative emotions from the body and releases tensions, frustrations and anger, clears anxiety, depression, and lethargy, giving relief to both, the mind and body. With regular practice, one becomes calm and centered, with a clearer mind Yogic Concentration

Shiv Yog meditation is a deep state of physical, mental, and emotional relaxation, which allows an individual to access one’s subtle body. It was popularised by Dr Avdhoot Shivanand, a celebrated Himalayan Yogi, spiritual scientist, and social reformer from India. “Through this process, one can fill all their subtle bodies with powerful cosmic energy. Every cell down to atomic and sub-atomic levels, fills up with this cosmic energy, resulting in raised frequencies. It is possible to experience raised frequencies through the body that ensues. A deep sense of calm, peace, and tranquility descends upon the person meditating. In this state, it is likely that any trauma of the past could be recollected at the conscious level. However, on the state of deep calm, it is possible to witness the incidents without emotionally reacting to them. This is also how healing happens, as the person is able to distance themselves from the

situation and look at it impartially. One can unlock the key to happiness, joy, prosperity and perfect health through the sacred science of Shiv Yog,” says Dr Prakash Kalmadi – Founder and Director at KARE Ayurveda and Yoga Retreat (KARE). Dr Sukeshini Ramteke, Consultant Physiotherapist and Sport Physiotherapist, AXIS Hospital, Mumbai adds, “As an individual becomes regular with practising meditation, there is a visible increase in joy, peace, and enthusiasm. This happens because of the increased prana (life force energy) in the body. Meditation can reduce high blood pressure as well as the blood lactate level, and reduce anxiety attacks. It can also help lower any tension-related pain and increase serotonin production that improves mood and behaviour, strengthens the immune system, and increases energy levels. Meditation brings an alpha state into the brain, that aids and promotes healing, while making the mind fresh and beautiful.” INDIA

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Cover Story Health Plus

According to research, meditation helps to activate the 'natural-killer cells' which kill bacteria and cancer cells. It reduces anxiety Shweta Bhatia and stress, increases blood circulation and lowers blood pressure, improves concentration and sleep quality, helps in post-operative healing and cures chronic ailments like allergies and arthritis. “There is a lot already spoken about meditation and its co-relation to anxiety and depression. Besides that, there are

“As an individual becomes regular with practising meditation, there is a visible increase in joy, peace, and enthusiasm. This happens because of the increased prana (life force energy) in the body. Meditation can red2uce high blood pressure as well as the blood lactate level, and reduce anxiety attacks” – Dr Sukeshini Ramteke many more benefits of meditation such as being more present in this moment. One of the biggest losses we don’t realise is losing the moment we have in front of us because we are constantly thinking of the past or the future. Regular practice can train the monkey mind to be in the present. It also relaxes the nervous system and regulates cortisol (stress hormone), that can directly impact the immune system, sleep, fast aging, and even lead us to chronic diseases,” says Certified Health Coach Nipa Asharam. TM

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App Fix

As with everything else now, you can also use apps to help you meditate, and integrate it into your daily life. Calm is a heavily-marketed mindfulness app that has a mix of spoken meditation sessions and calming music and nature sounds. Unlike other apps, you can also download meditations to listen to them offline. There are also dedicated sessions for children, as well as stretches to help relax your body. Another app called Headspace has an animated feel, but with a calming effect; it starts you off with a personal ‘get-to-know-you' quiz, but is fairly limited in its choice of responses. The app called Simple Habit denotes a simple way to inculcate meditation in our lives. It has a clean interface, with lots of options for sessions that are designed to suit most of your needs. Smiling Mind is a personalised meditation app that can help you practise mindfulness in various sectors of your life. Indian meditation apps include Sattva meditations and mantras, Isha chants, Chakra meditation, Yoga Nidra, Let’s meditate, and AOL- meditation among others. In addition, there is the Heartfulness App by Ramakrishna Mission which helps with not just meditation and relaxation, but yoga and spirituality too. Meditation apps work for people who do not have the time to practise. These apps can be used at home for at

of meditation, one’s brain lets go of the flight and fight mode, and moves from the preservation mode to the rest and digest mode -- leading to a more relaxed and peaceful state, stimulating gut health, and thus allowing the body to function in a restorative state.

According to research, meditation helps to activate the 'natural-killer cells' which kill bacteria and cancer cells. It reduces anxiety and stress, increases blood circulation and lowers blood pressure, improves concentration and sleep quality, helps in post-operative healing, and cures chronic ailments like allergies and arthritis least an hour at a time. These, however, are quick fixes that work temporarily. One can stay away from stress, and boost efficiency by practising meditation regularly. This positive addiction will have a long-term impact on your body, mind and emotions.

Vipassana

The retreats at Vipassana are for at least 10 days; they include 10 hours of daily meditation, completely cutting off the outside world. Vipassana follows the age-old technique of focussing on your breath by staying in one position (lotus position preferably) as long as you can to achieve concentration. Once the meditator has gained his concentration below his nostril area, he starts working on inner awareness of his breath. He starts moving his concentration to various parts of his body, from top to bottom, and then the other way around. It begins first through the face, followed by the neck, arms, upper body, and legs. It is very important to routinely

do at least one hour of meditation everyday to achieve the benefits. Also, one is not allowed to speak at all, so there is a period of complete silence in the person’s life for 10 days. Darshana Gupta, Freelance PR Consultant, meditation, yoga and dance enthusiast, and an avid solo traveler, says, “After going through two 10-day Vipassana meditation courses and now practising it regularly, I feel more in tune with nature. It helps to improve one’s health by reducing stress levels, stay at peace, and be compassionate toward others. There is higher awareness, and getting angry is rare, since you are aware of what is happening, and you have the capability to switch.”

“You can try different ways of meditating. Deep breathing 8-10 times, four times a day, or playing some meditative chants or mantras and trying to focus on one’s breath. The frequency and vibration of the music help soothe the brain. Even spending time in nature and allowing one to process feelings, thoughts and emotions, or sitting down to write one’s emotions and feelings, can count as meditation. You can also do pranayam and chant Om, practise guided meditations under a spiritual teacher, or practise gratitude each day by writing a few things you are grateful for. All of these are some ways to meditate.”

Science of Meditation

It has been scientifically proved that meditation increases grey matter and even retain it as you grow older. It has also been scientifically proved to create more gamma brain waves (we usually create more alpha brain waves). Gamma brain waves are the ones associated with universal love, forgiveness, letting go, so on

Choose your Meditation

Tiesta Duggal, an internationally certified workshop leader and life coach, opines, “There are various meditative practices and spiritual ways to meditate, and numerous institutions and meditation centres coming up around the globe to help people develop a better connect with themselves. To start with, meditation can be as simple as taking a few minutes out of one’s busy schedule and taking a few deep breaths to allow their minds to calm down and restore. Today, science has increasing proof about the benefits of meditation, as during the process INDIA

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Cover Story and so forth. Monks create very high gamma waves, so our brain can be compared to theirs to see this clearly. Studies indicate that meditation has both, physical and mental impact. This includes resolving problems like irritable bowel syndrome, posttraumatic stress disorder, fibromyalgia, psoriasis, anxiety and even depression. There are some important aspects like depression, chronic pain and anxiety that are typically solved in any mindful meditation programme, with effects similar to other existing medical treatments. Speak to your doctor before replacing pharmacological treatments. Dr Shweta Gaonkar, Mercure Goa Devaaya Retreat, avers, “Meditation reduces the depression causing chemicals in the brain. The stress hormone named cortisol, and adrenaline levels, are reduced in the blood, which are factors of disturbed sleep and stress. People who meditate can produce more antibodies (immunity cells) than others. Meditation impacts neuronal plasticity and decreased activity of default mode network, and the activation of brain regions involved in cognitive and emotional control.” Dr (HC) Shashi Kumar T. N., Founder of Nirvana Yoga Shala and Osho Glimpse, Mysore, says, “Backed by scientific research, meditative practices are known to be effective methods of relaxing. Regular meditation has shown to reduce anxiety attacks by lowering levels of blood lactate; prevent/reduce stress and stress-related muscle tension; lower blood pressure and cholesterol levels; boost the functioning of the immune system, manage chronic pain; increase exercise tolerance in heart patients, and even reverse heart disease.

Tools and More

One can take the help of musical instruments, music per se, or other elements that can aid meditation. From creating a calm ambience with scented candles and crystals to playing soothing music, there are several options available.

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“Meditation reduces the depression causing chemicals in the brain. The stress hormone named cortisol, and adrenaline levels, are reduced in the blood, which are factors of disturbed sleep and stress. People who meditate can produce more antibodies (immunity cells), than others. Meditation impacts neuronal plasticity and decreased activity of default mode network, and the activation of brain regions involved in cognitive and emotional control” – Dr Shweta Gaonkar

Tibetan bowls, candles, fragrances, music, beads, guided meditation apps and games, crystals and lights are some of the tools that aid meditation; also Buddhist Malas, also known as yoga beads, prayer beads that are used for counting breaths and Japa. Zen meditation music is specifically composed in order to promote relaxing brainwaves, and to calm the mind. Muse Meditation Assistant is a truly unique and wonderful mindfulness tool. It is modern and a little futuristic,

but definitely a good piece of meditation equipment to buy. Muse works as a personal assistant. When you put the muse headband on and start the app, it plays relaxing music, designed to calm the mind. You can then focus on those sounds. It measures whether you are calm or stressed, and uses that information to change the sounds it is playing. When calm, you hear more intense sounds, that remind you to relax. The Buddhist Gong is specifically designed to create frequencies that help us meditate, by entering the brain into a meditative state. Crystals are some of the most age-old and beautiful objects that help in meditation, and they all have different spiritual properties, so choose wisely.

In Conclusion

Meditation has known to improve sleep patterns as well, and a recent Indiawide study has indicated that people in their 60s could sleep as well as the people in the 40s. This goes to show that meditation can have a positive impact on physical as well as mental wellbeing. New age modern and fast lifestyles have a lot of stress and dayto-day tension that can be remedied with simple and active Meditation,

which can make anyone attain a meditative state. Walking, reading, cooking, bathing or even just watching your breath is a form of meditation. The art of extending awareness and breathing can create meditation within you. Meditation begins by being separate from the mind, by being a witness; and therein lies its true power. It not just relaxes and rejuvenates your mind but also helps you heal yourself. That is certainly reason for you to start meditating. After all, your health is in your hands, and meditation is the path to achieve it and more.

Celeb Speak

Sri Sri Ravi Shankar — “Meditation is the art of doing nothing and letting go.” Dalai Lama — “If every eight-year-old in the world is taught meditation, we will eliminate violence from the world within one generation.” Sadhguru — "You cannot do meditation but you can become meditative. Meditation is a certain quality. It is not a certain act." Eva Mendes — "Meditation really helps create not only a sense of balance… but serenity and kind of a calm state of mind." Ellen DeGeneres — "It feels good. Kinda like when you have to shut your computer down, just sometimes when it goes crazy, you just shut it down and when you turn it on, it's okay again. That's what meditation is to me." Hugh Jackman — "Meditation is all about the pursuit of nothingness. It's like the ultimate rest. It's better than the best sleep you've ever had. It's a quieting of the mind. It sharpens everything, especially your appreciation of your surroundings. It keeps life fresh." Deepika Padukone — “I meditate.

We bring you some of the best apps that help you meditate Calm: One of the most popular of all meditation apps, Calm also has specific programmes to tackle issues like anxiety, lack of sleep, and stress. Available on the Apple Store. UnPlug: This app has over 700 meditation videos, ranging from one minute to one hour. Many options of customisation are available, and sessions are filmed live. Available on Apple Store and Google Play. Headspace: If you want to improve focus and get temporary relief from daily activities, Headspace can help. With quirky illustrations, there are also sessions that can help you sleep well through the night. Available on Apple Store and Google Play. 10% Happier: Like the New York Times best-selling book by the same name, this has a free version and a premium one that has a library of 500 plus guided meditation videos. Available on Apple Store and Google Play. Insight Timer: This is an entirely free App that has over 30000 pre-recorded guided meditation sessions, an in-app progress keeper, and guided sessions led by wellknown yogis and mental experts. Available on Apple Store and Google Play. Relax Now: This app is a tool to help your body relax, as it has recordings from a certified hypnotherapist, David Ridgeway D. Hypn. This is a free app, and you have options that can energise or calm you, with a range of customised background music options. Available on Apple Store and Google Play. Pzizz: An app that can primarily help users sleep, there is music, voiceovers and sound effects that can help you go to a Zen-like mode. If you are looking to get more work done, check out the focuscapes section as well as the cooldown section to get back into your space. Available on Apple Store and Google Play. The Mindfulness App: If you are aware of the basics of meditation and are not looking for guided exercises, this app can help. You can also create a custommade session with flexible time periods. Available on Apple Store and Google Play. Aura: If you are looking to self-reflect, based on the mood you are in, this is the app for you. You can track your meditation time, moods, and set reminders to practise mindfulness to improve your moods. Available on Apple Store and Google Play. Simple Habit: Focussed on daily stress relief, this app has five-minute sessions that you can do on the go. There are motivational guides and bedtime stories also on the app. Available on Apple Store and Google Play. INDIA

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Cover Story and then seeing its benefits in everyday life. l

Do not get anxious or start reacting when you are not able to focus on your breath. It happens a lot that while meditating for a certain time, you are unable to focus, as your mind is wandering, and your body gets restless. Just keep moving on by focussing on your breath, time and again.

COVID-19 and Meditation

I breathe out what I can't control and focus on the positives.” Rajinikant — “Meditation is the key to energy.”

Kinds of Meditation

Vipassana meditation Mindfulness meditation l Sudharshan Kriya from AOL l Transcendental meditation l Shambhavi Mudra kriya by ISHA FOUNDATION l Buddhist form of meditation l ZEN form of meditation l Chakra meditation l l

Do it Right l

Meditation is not about having no thoughts – so don’t try to make that your objective; it is training the monkey mind to be present with what is in front of us. Meditation does not mean that you need to sit in one place. In fact, you need to be in a meditative experience through the day with whatever activity you are doing. TM

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Meditation is not a religious activity. It is a mindful activity, so do not confuse the two; just keep it simple. Do not expect immediate results; your mind will deviate, and that is normal. The point is daily practice,

In the current times of the COVID-19 pandemic, there could not be a better way to keep your sanity in check than through meditation. With social distancing and quarantining becoming the new norm, we live in a changed world, where things are completely different from what was normal earlier. And this is where you can keep your mental health in perfect condition by meditating. A simple way to do this is to close your eyes and calm your mind – do this anywhere and anytime. You can focus on your breath or on any object, and relax your mind. This is when you have much free time, so start with small steps and take charge of your life – you are bound to come out of this stronger and happier.

Feature The latest Deol scion to rise on the horizon is Karan Deol. He is the son of popular actor, Sunny Deol, and the grandson of legendary actor, Dharmendra. He made his debut with the film, Pal Pal Dil Ke Paas, last year. Karan loves to work out, eats healthy, and is big time into music. The good-looking young actor who also writes poetry and raps as a hobby, discusses his fitness fundas with Anita Raheja and Heena Agarwal

Are you happy with your current health and diet regimen?

Yes, I am very happy with my diet and fitness regimen. It ranges from functional to weight lifting to stretching; I do a variety of things and try to mix it up, and not let my body get used to one style of training. I am not much into junk food and don’t indulge in diet supplements either. My diet was decent in 2019, but that is something I have to improve this year.

What is your new year resolution as far as diet and exercise are concerned?

I plan to eat less sweets. I eat moderately and healthy most of the time but sweets are something I can’t resist once I begin. I already exercise a lot but will try to increase my tolerance levels. Exercising in the morning is beneficial, so I will stick to the morning routine. If I am unable to do so, I will make up for it during the day.

“I can bake a good cake.”

Do you subscribe to outdoor activities like running, jogging, golf, or do you prefer sports like badminton, tennis and squash? Sport is good for body and mind. I like all types of activities, whether it is outdoor or indoor. I enjoy running and jogging, I have played badminton, tennis and squash, but my first love will always be football. Running on a treadmill, weight training, or any other gym activity is also good.

Do you keep changing your format of exercise?

Yes, I keep changing my format of exercise because once your body gets used to a certain routine or a certain kind of training, the growth stops. It is always better to switch to different TM

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Make it a point to do something related to fitness, whether it is walking or going to the gym...some form of workout is important for a fit body and peace of mind. Once you get used to it, you will feel motivated to exercise everyday. Exercise uplifts your mood training forms, trying something new in a bid to shock the body. It keeps the body flexible and injuries at bay.

Did you have interest in athletics from your schoolgoing days?

Yes, from my school days, I have been very fond of playing football. The football ground was my place to have fun after a tiring day. I also play with

my friends and watch a lot of sports, especially tennis and football.

How do you feel when you go to the gym and when you skip a gym session? If I don’t work out, I feel guilty. I feel good, motivated and refreshed after a good workout.

What is your fitness motto?

Never stop pushing yourself. If you feel like you’re going to give up, everything is going to fall apart around you. If you keep pushing yourself, you will only get better.

Who is your sports idol?

My sports idol is Paul Scholes from Manchester United. I am a huge fan of Paul and don’t miss any of his matches.

What importance does fitness play in your life?

Fitness is very important in my life. If I don’t go to the gym at least once in a INDIA

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Feature Who, according to you, is the Bollywood actress with the fittest body? Disha Pattani.

What is your advice for health watchers in 2020?

Make it a point to do something related to fitness, whether it is walking or going to the gym...some form of workout is important for a fit body and peace of mind. Once you get used to it, you will feel motivated to exercise everyday. Exercise uplifts your mood. A good exercise routine is a must to feel good about yourself.

Which are your favourite restaurants and cuisines? My favourite restaurant is Izumi in Mumbai. I like all types of foods; I’m a big foodie. I like South Indian, as well as Italian and Japanese. I try and eat local food while travelling; I love experimenting with new cuisines.

Which are your favourite sweets and desserts?

There are many -- chocolates, cakes, brownies and cookies, to name a few. I can eat a lot of them, but I restrain myself.

What is your diet preference – vegetarian or non vegetarian? I love both, vegetarian and non vegetarian food.

Which is your favourite non vegetarian dish? My favourite food item would be butter chicken.

Can you cook? If yes, what do you excel at? day, I feel like my day is not going right. I don’t feel good. A fitness routine is like meditation; it helps me stay focussed. Fitness is good me-time. Since everybody in my family is into fitness, it has been inculcated in me from an early age.

What is your fitness regimen?

My fitness regimen is not rigid. I keep on switching; either I do weight lifting or something functional; if I’m not doing functional, I try to do little bit of boxing or a little bit of other outdoor activities, or play a sport.

Which is the first gym you went to? Who inspired you to work out?

The first gym I went to is the gym in my house, and I was so lucky that I have one. Thanks to my dad (Sunny Deol), my chacha (Bobby Deol) and my dada TM

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A fitness routine is like meditation; it helps me stay focussed. Fitness is good me-time

What is your daily diet from morning to night?

As a child, I saw them working out in the gym, and would join them at times.

When I wake up, I have a warm glass of lime water with honey, and four or five almonds, then I go to the gym. After finishing the gym routine, I have two egg whites, and one whole egg and half an apple. For lunch, I have some chicken, with a salad. For an evening snack, I have a cup of coffee with a couple of biscuits, and later in the night, I generally have fish, with a salad.

What are the supplements you take?

Which is the body part you hate training?

Dharamendra, since they are all health enthusiasts.

I don’t take any supplements. I just have a vegan protein powder. I believe in a holistic approach, and hence get my nutrition from natural resources. Since we have a farmhouse, a lot of our veggies come from there. Since you can get almost all nutrition from natural resources, there is no need to rely on supplements.

There is no body part that I hate training... I love to exercise but I don’t overdo any particular exercise.

Who, according to you, is the Bollywood actor with the fittest body?

Tiger Shroff. You can see his flexibility in his action and dance sequences.

I can cook a little bit. I can make an omelette and bake a cake. In fact, I can bake a good cake.

What was your favourite food as a child?

I relished pasta and I still do. Both, with red and white sauce.

What is your idea of a romantic meal?

I would like to order a pizza at home, sit down, and watch Netflix.

Which is your favourite beverage? Coconut water.

Which is your favourite vegetable? Broccoli.

Which is your favourite fruit? Chikoo.

Which is your favourite dish? Aloo paratha.

Who is your favourite person in the family who cooks really well?

My favourite person in the family who cooks really well is my daadi. Her makke ki roti and sarso ka saag is yummy. INDIA

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Wellness

Emotional connection at a time of distancing O ur lives are undergoing a lot of change at the moment. And it is not all bad! For a start, our mother Earth is having a chance to breathe for the first time in many years. And most of us are having to slow down and remember what it’s like to appreciate the little things in life.

Kamlesh D. Patel (Daaji), Spiritual Guide of Heartfulness, talks about the lockdown, social distancing, and how to strengthen our emotional connections during this stressful time

There is another very potent form of communication at our disposal, however, and that is our ability to connect heart to heart. The beauty of the heart-to-heart connection is that it works across any distance. We can send love from wherever we are to anyone, anywhere and at any time

As we prepare ourselves and our families to weather the COVID-19 pandemic, many of us are being cautious, and limiting our interactions with the external world to survival needs. Anything more would be foolish. The effect of the virus has also added new words to our vocabulary, but they are not just words – they symbolise an associated shift in lifestyle:

We have been told to practise social distancing, and it simply means to maintain a distance with others, whether they are affected by the virus or not. In fact, it is not social distancing we are being asked to do, but physical distancing, and it does not mean that our social connections need to disappear. We can maintain a physical distance while also maintaining a social and emotional connection. We have to disentangle the two things.

Self-isolation. Quarantine. Lock-down. Social distancing. Physical distancing. Travel ban. Work from home. School shutdown. Border closure.

Physical distances have always been there, with family members living on different continents and travelling, and we have learnt to stay connected

What matters is how we are coping with all this. Are we anxious, stressed, panicked and fearful? Or are we going about our daily lives with an attitude of poise and care? Whatever we do will radiate out, affecting others. COVID-19 is a great equaliser – it does not discriminate according to race, gender, culture, class or nationality. We are all in the same boat, and we will only survive if we are as concerned for others as for ourselves. This tiny virus is already teaching us about generosity of the heart, as we realise the need to be kind and compassionate to everyone. TM

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through technology. Even before that, people would write letters to each other. So, what is so different about this current situation? No doubt we are all worried about our loved ones, and look forward to seeing them again. Maybe we also feel helpless about elderly parents on the other side of the world, or dearly want to comfort a friend who is ill. Whatever our individual circumstances, all of us are facing new challenges every day. So, what can we do to help lessen the stress? How can we practise social distancing while enhancing our emotional connection? How can we enrich our sense of community without physical contact?

First, we have a rare opportunity to pause, slow down, and witness our lives as if under a magnifying glass – to discover how we interact with even the smallest of things. For example, how do we care for the food we have in our kitchen cupboards? And our cooking utensils? The way we take care of things tells us a lot about ourselves. In our busy lives, we’re not so used to examining ourselves in such close proximity, as our attention is more focussed outward. We are social creatures, seeking fulfilment in connection with others around us. This pause gives us a chance to ask: What brings such calamities to our human species, which is already suffering? Is it a wake-up call for us to do more, to be more aware? Our basic instincts are to hug our loved ones, to shake hands, and to touch our faces. Now we have to retrain ourselves to behave differently and limit our physical connections. Being separated from loved ones at a time like this can be scary and threatening. There is another very potent form of communication at our disposal, however, and that is our ability to connect heart to heart. The beauty of the heart-to-heart connection is that it works across any distance. We can send love from wherever we are to anyone, anywhere and at anytime. Here is a simple way to connect: INDIA

May 2020 51 Healthcare

Wellness partners, and developing appreciation for our children as they embrace this new world that is facing them. At times like this, we have an opportunity to strengthen family ties, which we often take for granted.

Sit comfortably and gently close your eyes. Bring the person you wish to send love to in front of you. Feel your heart connecting to their heart. Gently send love and care to the person from your heart to their heart. Feel connected. After you have done this for a few minutes, see if you feel more peaceful within yourself, and if the other person also feels more peaceful. Even turtles maintain such a mental contact with their family members. When a mother turtle wants to lay her eggs, she swims from her place at sea to a certain beach, and lays her eggs in the sand, covering them for protection. She then swims back to her particular place in the ocean. After two months, when the baby turtles hatch, they run down the beach and swim out to their mother. If turtles can maintain such contact, why not us? We may have no choice but to be isolated from our loved ones, so let’s see if we can stay connected at a deeper level. If we cannot meet outside, we can certainly meet within. The news is currently full of stories of conflicts between spouses, and tension between children and parents, and between the elderly and their family members. How can we face the cabin fever we experience in close quarters together? Here is a sweet story that TM

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may shine some light on this important aspect of family. Once upon a time, there was a family of porcupines, and in case you didn’t know, a group of porcupines is called a prickle! One day, one of the youngest porcupines was completely fed up. He was so tired of being poked by the quills of his larger family members that he decided to try his luck alone. As soon as he left the group, however, he found himself shivering with cold! No longer was he protected from the elements by his parents, aunts, uncles and older cousins. He soon understood that he would not survive outside his prickle, and he rushed back inside, not caring anymore about the uncomfortable quills.

Do the jabs of the quills in our families have to feel so bad? Perhaps we are being given an opportunity to spend time with each other, learn to accept each other’s imperfections and taunts, and develop greater emotional connections than we normally would because of the stress of our busy lives. These days, our human community is global, and even viruses don’t respect national boundaries, and yet many of us are lonelier than ever.The beauty and silence of being alone has been replaced with the anxiety and sadness of loneliness. Maybe we can grow emotionally stronger while staying at home – building stronger bonds of friendship, nurturing the love for our

In earlier times, children started learning at home long before they went to school. Grandparents, parents, aunts, uncles and family friends, all shared their knowledge with the young ones growing up. It was common to tell them stories, read books with them, and teach them skills. We can do the same today – read a chapter of a book aloud together, understand the contents, and have a discussion. One book a week becomes 50 books a year, and 500 books in ten years. We have time now to work on our lifestyle choices. Why not try to live without constant screen time by having more family time? Internet-based technologies are very important for us to stay connected right now, but we can also benefit by taking breaks from screen time and the associated radiation. Reach out to others in simple ways. Whether it is enjoying a song together, or a meditation, watching a movie, sitting down to meals, or telling each other jokes, the liveliness, joy and humour we will feel will dissolve the pain. While we are all affected by the suffering around us, do we need to sink into a black hole? And will it help us and others if we do? There is another way: When we stay connected in our hearts, in a prayerful mood, our prayers will join with the echoes of the prayers of others and create a vibration of love all around us. When we maintain the inner purity of our consciousness, it will also help to dissolve the negative thought pollution that surrounds us. I am not trying to deny or downplay the severity of the current pandemic. It would be foolish to live in denial – we need to accept reality and act accordingly. In fact, the more we accept, the sooner we will adapt to the

need of the moment. I am only offering a way forward.

while being careful to prevent the spread of the virus.

There are so many simple habits we can adopt that will help sustain us for longer periods, such as conserving groceries, fasting, and being careful about finances. It also helps not to resort to panic buying. We can help our elders, and those who are less fortunate. We can be kind to others, and volunteer in our communities,

There are also many household tasks that we normally never find time for, like cleaning out cupboards. We can write, draw, paint, dance, sing, cook new dishes, sew clothes for loved ones etc. We can create healthy lifestyle habits, like cooking meals at home, doing breathing exercises to build immunity, meditation, and yoga asanas. Spend time with your loved ones, and learn some new skills. Maybe you will find a new sense of satisfaction and inner fulfillment as a result. Even in these days of lockdown, a regular daily routine will be so beneficial. Try it. Use this time to experiment with lifestyle choices.

Reach out to others in simple ways. Whether it is enjoying a song together, or a meditation, watching a movie, sitting down to meals, or telling each other jokes, the liveliness, joy and humour we will feel will dissolve the pain

And if you would like to experience inner stillness, peace and joy every day, become an expert in the Heartfulness practices. Take refuge from the craziness of our current crisis within your heart. Your heart is the doorway to a vast inner universe – a place of wonder and wisdom, of feeling and connection. Heartfulness practices offer a protection in your energetic structure, and this is important for balance, even if it is not a remedy for everything. Let this unusual time be an opportunity: Practise for yourself, for your loved ones, and for all humanity. INDIA

May 2020 53 Healthcare

Wellness So why journal?

The practice of

journaling Dear Diary,

. ough it’s a Sunday day today, even th sy bu ty et to pr a ed en It’s be ily chores. Manag finished all my da y -- cleaning Woke up late and agenda for the da nt rta po im t os m ganising complete my t the afternoon or en Sp s. rd oa pb cu my drawers and ings from the ing all unwanted th ov m re d an t, se the clo et made this d a relaxed minds an ic us m od Go drawers. interesting. tedious task quite today. See ya. Well, that’s all for

Namita Kamdar, a writer and yoga practitioner, explains why journaling can become a daily ritual, why it is important, and how it can become one’s safe haven and happy place

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Healthcare 54 May 2020

he few lines mentioned above are an example of what a ‘diary entry’ or a ‘journal entry’ contains. To define it simply, a journal is a notebook or document on the computer where a person records information of a personal nature. Regularly recording events of the day is called journaling. Initially, it takes a while to record information frequently, but once it becomes a practice, it’s called the practice of journaling.

For many people, sitting down to record events of the day in a book might seem quite amusing. Well, you can’t blame them. In our daily lives, to find a few minutes to record information in a book can seem quite unnecessary, especially when we’re trying to constantly juggle between maintaining a healthy work-life balance. Plus, there’s also a kind of discipline that comes with journaling. All this might just seem too much when there’s no visible benefit.

In times that we live in, stress, anxiety, and depression have become more commonplace than ever. We all know someone in our vicinity who has suffered from one or all of these ailments. At such times, to have a place that you can blindly go to, is reassuring. A journal can become that safe place for everyone, irrespective of whether they are struggling with mental health issues or not.

Some reasons to begin journaling:

1) It helps you focus: One of the basic requirements of journaling is solitude. Any kind of writing requires focus and attention. Especially when it comes to your emotions, feelings and thoughts. Journaling requires you to tap into your own mind, life, experiences, and note things down from your perspective. The whole process of thinking, writing, expressing, gives the mind something to focus on, improving concentration and reflection. 2) Helps to be honest with yourself: Journaling is all about you! Your life, your experiences, your emotions, feelings, relationships, travels etc. In this big entity that is you, there are bound to be a lot of happy, sad, confusing, disturbing moments. Writing them, getting clear and honest about them, is at the heart of what emotional journaling is. It’s all about being honest about you to you, without the fear of others.

3) A catharsis: Catharsis means to release your emotions, in any way that is preferred. Any kind of pent-up emotion when given space to release, brings about relief. Journaling gives the space to share anything and everything. On days when there is that ‘low feeling’ or ‘bad mood’, taking a few moments to write it down can really help drive that mood away and clear the head. I like to call journaling, ‘an emotional haven’. 4) Promotes better articulation of feelings and emotions: The adage, ‘practice makes perfect’, holds true for everything in life. Similarly, when it comes to sharing emotions and feelings, a lot of people find it difficult to ‘express themselves’. Maintaining a journal where feelings and emotions are expressed freely and regularly, without fear, helps to get clear about them. 5) Paving the path for nostalgia: Once the practice of journaling has set in, there is a tendency to just keep writing ahead. Every once in a while, stopping by to read and reflect over the old entries helps to bring back memories, emotions and experiences.

In our fast-paced lives, there are a hundred thoughts that flow through our brain. Some good, some bad, some happy and some sad. These thoughts affect our emotions, feelings and actions, in turn impacting our positively or negatively. When we journal, we pause, give time to ourselves to slow down, observe those thoughts, and write them down. We allow the mental narrative, the conversations we have with ourselves, to present itself on paper. This ‘slowing down’ is essential, to bring a sense of clarity and peace to the mind. Pause every once in a while, to not just read through the journal entries but also to reflect upon life. It’s not time wasted, it’s peace and clarity earned. I remember my yoga teacher once telling us in a class - the human body is designed to evacuate all waste matter and toxins on a daily basis to maintain health of the body. But what about the mind? The mind does not have any outlet for evacuation. Evacuating the mind of waste matter is as important as evacuating your lungs, kidneys etc.! Journal your way through life so that in the process of evacuating your body every day, you do not forget to evacuate your mind as well. INDIA

May 2020 55 Healthcare

Wellness

Positive Ageing L

oneliness and social disengagement have a direct and palpable effect on an individual’s physical and mental health. If one were to search the web for “loneliness and ageing”, one would find a number of studies done across geographies, with the same findings – a direct causative relationship with health issues that adversely impacts longevity and wellbeing. Some studies have gone so far as to say that loneliness and its impact on the physical and mental health of an individual, may, in fact, be more harmful than being overweight or having a sedentary lifestyle. The National Poll on Healthy Ageing conducted by the University of Michigan found that individuals suffering from loneliness rated themselves two to six times worse off on physical and mental health parameters, as compared to socially engaged individuals. It is erroneously assumed that the key differentiator between communities designed for senior citizens and those occupied by mixed-families lies in product attributes such as wider corridors or grab-bars in bathrooms. It is true that product design of senior living communities is now a well-researched and practised science. A well-designed community will ensure that the building and its facilities remain accessible, practical and usable for all residents, even as TM

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their physical abilities change over time. The real differentiator lies in the wellness and well-being programmes that are built into the day-to-day activities of the communities. A welldesigned programme will ensure that residents work together to remain physically fit, mentally alert, and intellectually engaged for longer.This is best achieved in an environment that allows them to remain socially active and engaged in various activities with different peer groups. Physical well-being amongst seniors is a function of four distinct aspects, these being strength, stamina,

Mohit Nirula, CEO, Columbia Pacific Communities, talks about how senior citizens can stay engaged through various activities with others their age, even while living alone

flexibility and balance. These are inter-linked, and must be worked on individually and collectively. Decline in one of these aspects starts to impact the others, resulting in accelerated reduction in physical fitness. A scientifically designed fitness programme will aim to engage residents and work on each of the four aspects in group sessions. Specially trained physiotherapists can also customise sessions for individual residents that address their specific needs or areas of improvement. Social interaction and the opportunity to meet and interact with peers with varied interests and hobbies is one of the distinct advantages of being a part of a community designed for seniors. It is not

uncommon for an individual to be a part of separate and diverse groups, with different members, united only by their common interest. Residents can go for a morning walk with one group, and participate in yoga thereafter with a different group. This may be followed by breakfast with a different couple, who may be their neighbours, followed by a newspaper reading and discussion on sport or politics with another set of people. The afternoon may see one playing bridge in a foursome, followed by a drink in the evening while watching an IPL match with a few cricket aficionados. When one’s community and neighbours consist of 250–300 people of a similar age group, who have gone through school, college and professional life in the same years/decades, it is only to be expected that such a group will share many of the same interests and passions. This is especially so, as their exposure to music, films, sport, politics and culture overlap, and hence, they have much in common. It has been seen that seniors living on their own become increasingly dependent on a host of “external” resources to remain socially engaged. This includes a retinue consisting of maids, handymen, chauffeurs, security guards, gardeners etc. to look after the day-to-day chores. As seniors age, their “geographical range” of social engagement keeps reducing. Various factors such as increasing traffic, decreasing parking spaces, lack of last-mile connectivity and poor public transport, the fear of jostling with crowds, all conspire to limit seniors to their homes.

It is erroneously assumed that the key differentiator between communities designed for senior citizens and those occupied by mixed-families lies in product attributes such as wider corridors or grab-bars in bathrooms. It is true that product design of senior living communities is now a well-researched and practised science This ease of social interaction allows residents to participate in group activities and to follow their hobbies and interests. Such pursuits keep residents mentally engaged. The brain, like the heart, is a muscle, and the more one exercises it, the stronger it becomes. This, in turn, helps individuals remain alert,

and ward off mental ailments such as Alzheimer’s, Parkinson’s and dementia. It is a biological fact that the body slows down with time. Positive ageing is about working with one’s fellow residents, participating in scientifically designed wellness and well-being programmes that keeps one healthier for longer, thereby ensuring that one’s best years are spent pursuing life’s passions and interests that had been on hold, in the company of likeminded friends and neighbours.

On the contrary, being part of a community designed for seniors, residents stay with their friends, and the next social get-together is only an elevator or a buggy ride away.

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Health

A life changing experience

from bad to worse. A hammering headache followed by severe weakness; in fact, there were times when I would start to collapse during situations of acute mental or physical stress. My weakness was evident, and even walking stairs seemed like mountain climbing. Then in June 2019, my world came tumbling down; my vision started deteriorating, and every day thereafter, I saw less. Reading became next to impossible, which was very unfortunate, as I am a bookworm. There came a time when I could barely see 10-15% at night, and ended up tripping over things or banging my head on closed doors and walls. My fainting attacks, too, increased manifold.The situation was definitely grave and could not be ignored anymore. The headaches continued; now they lasted more than 15 days at a stretch, unbearable, with no respite at all. Paracetamol did not help even a wee bit. Noise, arguments, and loud music played havoc on my system.

Ajuli Tulsyan talks about how her life changed when she was diagnosed with a benign brain tumour; and winning the battle

oday’s chaotic lifestyle, erratic food habits and high stress levels have made us vulnerable to many ailments. Many a times, we even tend to ignore nagging symptoms, hoping they will get better on their own eventually. But here is a story that clearly states that no symptom should be ignored and TM

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nothing is more important than one’s health. A mere headache could actually be hinting at something more serious and should not be left unattended.

The Symptoms

I’d always had headaches and they’d been a constant, along with low immunity levels. Having consulted doctors all across the country, nothing

concrete was ever diagnosed, though there were multiple suggestions and thereafter, experimental medication. While one doctor felt it was a case of acute migraine, the other was of the opinion that excessive exposure to the computer was the sole cause of my headaches. Nothing seemed to work, and the headaches only started getting

The tests confirmed that 80% of my right eye was damaged and 30% of my left eye. I had become partially blind, and the process was irreversible, as the optic nerve had got affected during my surgery. My entire hormonal system had gone for a toss. And today, I am going through a hormone replacement therapy. And very thankfully, my biopsy report confirmed my tumour to be benign

The Diagnosis

We thought perhaps my eye power had drastically changed, and so went to an ophthalmologist; I went to Dr Prasad Reddy at Amma Eye Care Hospital, Vanasthalipuram. He too was taken aback by my condition. A thorough checkup indicated no alteration in my power whatsoever. But Dr Prasad insisted I consult a neurophysician and referred me to Dr Srinivas Deshmukh at Deccan Hospital, Somajiguda. We lost no time in doing so. After discussing all my symptoms and condition, Dr Deshmukh advised me to go for an MRI of the brain immediately. At that time, we started cribbing under our breath about how money-minded the medical profession has become, that for a mere headache, an MRI was being suggested. But we went ahead…and thank God for that! The result left us shell shocked -- I had a grape sized tumour perched

stubbornly on my pituitary gland. How could this happen, and why me? Dr Srinivas Deshmukh confirmed it to be a case of Pituitary Macroadenoma and suggested we immediately consult a surgeon, Dr Manas Panigrahy, at KIMS Hospital, Secunderabad. Getting an appointment with Dr Panigrahy is very tough but thankfully, we knew someone who got us an appointment for the very next day. Our fears were

re-confirmed. It was an advanced case of brain tumour, that needed to be operated upon immediately. Pre-operative tests were carried out, and I was diagnosed with high blood pressure as well. So, this had to be brought under control. Apart from this, my cortisol level was astonishingly low. Dr Panigrahy put me on steroids, as my body desperately needed cortisone to sail through the critical surgery. INDIA

May 2020 59 Healthcare

SPECIAL OFFER!

Health A week’s dosage helped balance my cortisol levels, and by then, the BP medicine got my pressure under control as well.

D-day, 11th July 2019

As my family waited outside the OT, I was wheeled inside. An operation that was supposed to take 90 minutes, took five and a half hours. Dr Manas told my family that I was brought in the nick of time; yes, my tumour had started haemorrhaging. A part of the grape sized devil was sent for autopsy and I was sent to the ICU. When all the doctors and the family went back that night, I suddenly started feeling very uneasy, and breathing became difficult. I was shivering, and the doctors on duty ran to my rescue. My BP had dropped to 50, temperature -- below 70, pulse below 40; and I was feeling extremely cold. Suddenly, I remembered my cortisol deficiency, and in that critical condition, I started murmuring, “Give me cortisone.”

Sept ber

em 2019

2019

We went back to the ophthalmologist, Dr Prasad Reddy. He conducted a field test and other tests to get a complete picture of my eyes’ intricate details. The

www.healthcare-india.org gust

My life started getting back on track, but after three or four months postsurgery, my previous symptoms started resurfacing. My vision was affected, and reading was tough again. Thankfully, there was no headache but the vision problem left me confused. This should not happen; after all, the culprit had been removed.

The next complication was my hormonal system...Since the tumour had been sitting on my pituitary gland, which is the master gland of the body, my entire hormonal system had gone for a toss. And today, I am going through a hormone replacement therapy. But very thankfully, my biopsy report confirmed my tumour to be benign.

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The Complications

/ 9 9 2 . s R

2019

I am also a follower of Nichiren Buddhism, a philosophy that helps to cope with any adverse situation by showing the light of positivity even in moments of acute darkness. In this philosophy, we chant, and those following the philosophy become family. Each one dedicatedly chanted for my wellbeing, took turns babysitting my little one, and never let me fumble. Yes, I remained perennially in a high life condition.

April

With the unwavering support of my family and friends, I slowly and steadily started recuperating. My three-year-old daughter was my biggest strength, and

my motivation to recover at the earliest.

t s u j r sues fo

tests confirmed that 80% of my right eye was damaged and 30% of my left eye. I had become partially blind, and the process was irreversible, as the optic nerve had got affected during my surgery. But the good news was that the central vision wasn’t much affected, and the damage was more towards the peripheries.

2019

The Recovery

The result left us shell shocked -- I had a grape sized tumour perched stubbornly on my pituitary gland

June

The learning here -- one needs to be thoroughly updated on his or her health condition. It is not wise to be ignorant. The doctors will definitely do their duty, and the patient should not interfere in any treatment. But sometimes, it just happens that the patient knows her/ his body better, and at times, intuition works best.

y l h t n 6 mo

Ma y 20 19

While two doctors on duty asked me to relax, saying the best was being done and I would recover soon, the third doctor took me seriously and minutely went through my case file. I was right, cortisone could definitely help, and he asked the nurse on duty to immediately give me an intravenous dosage of cortisone. Slowly, my condition started to improve and miraculously, I had saved my own life.

FOR DIGITAL COPY

May 20

Today, I feel blessed for having got a second life. My profession concerns my eyes, and having become partially blind has made it difficult, but it has in no way deterred me from carrying on in life; this article is proof. An article that used to take me 20 minutes to pen down, today takes me an hour and a half; but so what? I can still carry on with double the zeal and the motivation to go on till I can. Inner strength is the biggest strength that helps us fight any adverse situation.

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Health

The malfunction of the thyroid gland can cause several other health issues and disorders. Positive Homoeopathy brings you details about the thyroid gland, and what happens when it shows an imbalance

ALL ABOUT THYROID PROBLEMS S tress is not only an aggravating factor for many chronic illnesses, but can also precipitate many psychosomatic disorders. Hormonal imbalance is one of the most common disorders in the present scenario of stressful living, and the commonest among these are thyroid problems. Emotional conflicts often precipitate imbalances in the thyroid, and thyroid disorders are, in turn, responsible for mood swings, anxiety and other psychological problems. So, there is a marked relation between the mind, body and the thyroid gland. The thyroid is one of the largest endocrine glands in the body, and is not to be confused with the parathyroid glands. The thyroid gland is found in the neck, below the thyroid cartilage. TM

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The thyroid controls how quickly the body uses energy, makes proteins, and decides how sensitive the body should be to other hormones. So any disturbance in the thyroid gland function results in suffering and symptoms in almost all the organs of the body. Diseases of the thyroid gland can result in either production of too much (overactive thyroid disease or hyperthyroidism); too little, known as underactive thyroid disease or hypothyroidism; thyroid hormone; thyroid nodules; and/or goiter. Thyroid problems are more prevalent in women than in men.

Hypothyroidism may be caused by several reasons.Treatment of hyperthyroidism by radioactive destruction of thyroid tissue or surgical

removal of the thyroid tissue can result in hypothyroidism. Anti-thyroid antibodies may be present in people who have diabetes, lupus, rheumatoid arthritis, chronic hepatitis, or Sjogren's syndrome. These antibodies can cause decreased production of thyroid hormones. Hypothyroidism can be present from birth, leading to physical and mental retardation called cretinism. Hashimoto's thyroiditis occurs when there are defects in the production of the thyroid hormone, resulting in an increased amount of TSH. The increased TSH results in goiter, and the enlargement of the thyroid gland itself can be seen as an obvious swelling in the front of the neck. Some medications, particularly lithium, may cause drug-induced hypothyroidism.

Similarly, a hyperactive thyroid may be caused by several factors. Grave's disease is a thyroid condition that results from an abnormal stimulation of the thyroid gland by a material in the blood, termed the thyroid stimulating immunoglobulin (TSI). TSI overstimulates the thyroid, causing goiter. It also causes Grave's eye disease, characterised by a bug-eyed look and frightened stare. This can progress to severe eye pain or eye muscle weakness, causing tearing and double vision. It also causes raised, thickened skin over the shins or the feet, called Myxoedema. Thyroiditis is an inflammatory disorder of the thyroid gland, which includes such conditions as de Quervain's thyroiditis or Hashimoto's thyroiditis. In these conditions, you may have periods of increased thyroid hormone release due to the inflammation, causing a hyperthyroid state. As thyroid failure occurs due to the inflammatory response, hypothyroidism may occur. Pituitary adenoma: This tumour of the pituitary gland causes independent TSH production, leading to overstimulation of the thyroid gland. The other common disorders of thyroid are goiter or nodules. Most of the time, thyroid nodules and thyroid goiters do not cause any symptoms. Some goiters are found because of the thyroid hormone overproduction or underproduction from the thyroid gland. Some nodules are found because a patient or doctor identifies a lump in the

Hand tremors, nervousness, feeling excessively hot in normal or cold temperatures, frequent bowel movements, losing weight despite normal or increased appetite, and excessive sweating are the symptoms of hyperthyroidism

neck. There are only two conditions that cause thyroid enlargement and nodules: external radiation exposure, or iodine deficiency. Often, several members of a family will have an enlarged goiter, as the condition can be inherited. Thyroid cancer is the rarest form of thyroid, which when detected, can be cured, if diagnosed in the early stages. Hypothyroidism can be suspected if a person suffers from dullness,

dizziness and unexplained weakness, associated with weight gain, dry skin and hair, loss of hair and other symptoms. Later symptoms are poor appetite, deeper, hoarser voice, puffiness around the eyes, depression, irregular menstrual periods or lack of menstrual periods. Poor tolerance to cold temperatures, constipation, and carpal tunnel syndrome, can at times, indicate hypothyroidism.Symptoms of hypothyroidism in children include excessive fatigue, poor growth, and under-par performance at school. Hand tremors, nervousness, feeling excessively hot in normal or cold temperatures, frequent bowel movements, losing weight despite normal or increased appetite, and excessive sweating are the symptoms of hyperthyroidism. Insomnia , scanty menstrual flow, joint pains, difficulty concentrating, eyes seeming to be enlarging, may point to hyperthyroidism. Homoeopathy offers curative treatment for thyroid disorders; the allopathic mode of treatment prescribes for a lifelong supplementation and therapy. Homoeopathy considers the individual as a whole and treats the person in disease, not the disease in the person. So, the gland is stimulated, and starts to function normally after a course of time. After withdrawing medicines through tapering of doses, these can be stopped permanently through the constitutional therapy given in homoeopathy. INDIA

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Health to insulin resistance, other risk factors include obesity (BMI >23), abdominal obesity (waist circumference >80cms in women and >90cms in men), history of impaired fasting glucose/ diabetes, hypertension (blood pressure >130/85mmHg), triglycerides >150mg/ dl, low high-density lipoprotein â&#x20AC;&#x201C; cholesterol (good cholesterol) may predispose to NAFLD of primary origin [1, 5]. Certain medical procedures, surgeries and hepatotoxic drugs may also lead to fatty liver, known as secondary NAFLD [8].

Dr Kuhu Roy, an independent Nutrition Consultant, talks about the symptoms and preventive measures for this lesser known, silent liver disease

A sedentary lifestyle, coupled with over nutrition resulting from an energy dense diet containing excessive calories coming from simple and refined carbohydrates, fructose (fruit sugar), total fats, saturated fats, cholesterol, higher omega 6 fatty acid consumption, deficient or excessive protein intake, deficiency of n-3 polyunsaturated fatty acids, vitamins D and E, become the sowing seeds of NAFLD [9, 10, 11, 12].

What are the signs and symptoms of NAFLD?

Non-alcoholic

fatty liver disease

he liver is the biggest organ inside the human body, tasked with digesting and metabolising the macronutrients (carbohydrates, proteins and fats), and plays a significant role in detoxification, among many other crucial biological functions. Unfortunately, the liver does not get as much attention as it deserves. Liver health in India is usually not looked beyond viral hepatitis, given the magnitude of its burden. That is where a silent health bomb ticks, termed as nonalcoholic fatty liver disease.

What is non-alcoholic fatty liver disease?

Non-alcoholic fatty liver disease (NAFLD) is a condition wherein fat deposition (in the form of triglycerides) occurs in the liver cells of individuals who are either teetotallers or consume non-significant amounts of alcohol [1]. It is globally the most common liver disease [2, 3]. In India, it is postulated that one in four urban Indians maybe having NAFLD [4]. The number of NAFLD cases are escalating, in tandem with the prevalence of obesity, diabetes, and other risk factors that predispose to NAFLD [1, 5].

What are the risk factors for NAFLD?

Genes, a faulty diet, and a sedentary lifestyle create a complex web, to give rise to NAFLD. Asians, particularly of Indian origin, are at a higher risk of developing NAFLD [5, 6, 7]. They develop visceral obesity (fat deposition in the abdomen) even at lower degrees of body mass index (BMI). The presence of visceral fat gives rise to insulin resistance, wherein insulin is unable to produce the desired normal response to glucose, which is seen as a universal phenomenon in NAFLD [1, 3]. In addition

It is asymptomatic in nature, until cirrhosis sets in [1]. Symptoms like right upper quadrant pain, present in few, often conflict with the symptomatology of other ailments. Swelling in the liver (hepatomegaly) might be felt upon physical examination [6]. Mild or moderate elevation in liver enzymes might be observed in some, otherwise the liver enzymes may continue to remain in the normal range even in advanced disease, as they are poor surrogate markers [1, 2].

How is NAFLD diagnosed?

Ensure to rule out significant alcohol intake (> 7 standard alcoholic drinks/ week (70g ethanol in women and > 14 (140g in men), exclude the presence of other co-existing liver ailments, and confirm the presence of fat deposition in the liver through an imaging technique (ideally an ultrasound) or liver biopsy [13]. In fact, many have an accidental diagnosis of NAFLD upon appearing for an abdominal ultrasound for other health issues. Though a liver

Though a liver biopsy is the best means to diagnose and identify the stage of the disease [1], it has many demerits because of which it fails to be a good screening tool for NAFLD biopsy is the best means to diagnose and identify the stage of the disease [1], it has many demerits because of which it fails to be a good screening tool for NAFLD.

What if NAFLD is ignored?

It is a multi-system disease, the neglect of which predisposes to risk of death due to cardiovascular disease, possibility of contracting chronic kidney disease, osteoporosis, and deterioration in liver status by advancement to fibrosis, cirrhosis and even hepatocellular carcinoma [2, 3, 14, 15].

What is the treatment for NAFLD?

There is no treatment approved for NAFLD, although several trials are underway that may hold promise in the future [1, 3]. Current treatment guidelines address the risk factors

present in association with NAFLD, discontinue the use of hepatotoxic drugs, and introduce sustainable changes in the lifestyle aimed at weight loss through diet and physical activity [1, 9]. Weight loss (3-5%) helps reduce liver enzymes and fat deposits in the liver, improves glucose control and the sensitivity of insulin for its better utilisation, and delays the progression of NAFLD to more advanced forms [9, 11, 16, 17].

Is there a diet for NAFLD?

There is no standard NAFLD diet [11, 16] but it is advisable to stick to lowfat diets that are heart-healthy and effective in the long run. The following pointers can help manage NAFLD better: Choose good (complex) carbohydrates found in cereals, millets, pulses, legumes, fruits and vegetables. They

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Health contain good amounts of dietary fibre, vitamin B complex, among other vitamins, minerals and antioxidants [10, 16]. Likewise, keep refined carbohydrates at bay (products containing refined wheat flour, semolina, sugar). Consume fruits in moderation. Shun sweetened beverages [18]. Reduce the intake of foods containing saturated fat (butter, ghee, mayonnaise, red meat, high fat dairy products, fried foods), cholesterol (eggs, liver, cake, biscuits), avoid trans-fat (bakery products, fried foods, processed foods or those prepared in reheated oil) but increase the intake of n-3 polyunsaturated fatty acids (flaxseeds, chia seeds, walnuts, spinach, salmon, tuna, sardines, mackerel) and monounsaturated fatty acids (olives, almonds, walnuts, avocados) in the diet

[10, 19]. It will help reduce the risk of heart disease associated with NAFLD. Meet protein needs through optimum intake of pulses, legumes. Nonvegetarians may incorporate lean meat and fish in addition to plant protein, and shun red and processed meats at all costs [16, 19]. Foods containing vitamin A (all yellow-orange fruits, dark green leafy vegetables), vitamin C (citrus fruits and vegetables), vitamin E (nuts, dark green leafy vegetables) should be included as they are rich in antioxidants [16]. Engaging in physical activity (resistance training or aerobic exercise) for at least half an hour on most days of the week will help reduce liver fat [1, 20].

Take home message

NAFLD is gradually making its presence

felt in India, and it might just be the tip of the iceberg, given its silent nature. The need of the hour is to spread awareness about NAFLD, as it is still an alien term to many. Screening of high-risk individuals for early diagnosis and management will help avert a huge burden on the public health system. NAFLD can be kept at bay by following a balanced diet and engaging in regular physical activity. Non-alcoholic fatty liver disease (NAFLD) is a condition wherein fat deposition (in the form of triglycerides) occurs in the liver cells of individuals who are either teetotallers or consume non-significant amounts of alcohol. It is a multi-system disease, the neglect of which predisposes to risk of death due to cardiovascular disease, possibility of contracting chronic kidney disease, osteoporosis,

and deterioration in liver status by advancement to fibrosis, cirrhosis and even hepatocellular carcinoma.

References

Leoni S, Tovoli F, Napoli L, Serio I, Ferri S and Bolondi L. Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis. World J Gastroenterol. 2018. 14; 24(30): 3361–3373. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment PharmacolTher 2011;34: 274-285. Younossi, Z., Anstee, Q., Marietti, M. et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev GastroenterolHepatol 2018;15, 11–20. Misra A, Misra R, Wijesuriya M, Banerjee D. The metabolic syndrome in South Asians: Continuing escalation & possible solutions. Indian J Med Res 2007; 125: 345-354. Dharel N, Fuchs M. Nonalcoholic Fatty Liver Disease – A Major Public Health Challenge for the 21st Century. JSM GastroenterolHepatol 2014; 2(2): 1018. Puri P, Sanyal AJ. Nonalcoholic Fatty Liver Disease: Definitions, Risk Factors, and Workup. Clinical Liver Disease 2012; 1 (4): 99-103. Duseja A. Nonalcoholic fatty liver disease in India: A lot done, yet more required! Indian J Gastroenterol 2010;29:217-25. Kneeman JM, Misdraji J, Corey KE. Secondary causes of nonalcoholic fatty liver disease. Ther. Adv. Gastroenterol. 2012; 5: 199–207. Schwenger KJP, Allard JP. Clinical approaches to non-alcoholic fatty liver disease. World J Gastroenterol 2014; 20(7): 1712-1723.

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Yasutake K, Kohjima M, Kotoh K, Nakashima M, Nakamuta M, Enjoji M. Dietary habits and behaviors associated with nonalcoholic fatty liver disease. World J Gastroenterol 2014; 20(7): 1756-1767. McCarthy EM, Rinella ME. The role of diet and nutrient composition in nonalcoholic Fatty liver disease. J AcadNutr Diet 2012; 112: 401-409. Jian-Gao Fan, Hai-Xia Cao. Role of diet and nutritional management in nonalcoholic fatty liver disease. Journal of Gastroenterology and Hepatology 2013; 28 (Suppl. 4): 81–87. Wong VW, Chan WK, Chitturi S, Chawla Y, Dan YY, Duseja A, Fan J, Goh KL, Hamaguchi M, Hashimoto E, et al. Asia-Pacific Working Party on Nonalcoholic Fatty Liver Disease guidelines 2017-Part 1: Definition, risk factors and assessment. J GastroenterolHepatol. 2018;33:70–85. Bhatia LS, Curzen NP, Calder PC, Byrne CD. Non-alcoholic fatty liver disease: a new and important cardiovascular risk factor? Eur Heart J 2012; 33: 1190– 1200. Byrne CD, Targher G. NAFLD: a multisystem disease. J. Hepatol. 2015; 62(1Suppl): S47– 64.

Conlon BA, Beasley JM, Aebersold K, Jhangiani SS, Wylie-Rosett J. Review. Nutritional Management of Insulin Resistance in Nonalcoholic Fatty Liver Disease (NAFLD). Nutrients 2013; 5: 4093-4114. Bhat G, Baba CS, Pandey A, Kumari N, Choudhuri G. Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease. World J Hepatol. 2012; 27;4(7):209-17. Colak Y, Tuncer I, Senates E, Ozturk O, Doganay L, Yilmaz Y. Nonalcoholic Fatty Liver Disease: A Nutritional Approach. Metabolic Syndrome And Related Disorders 2012;10 (3): 161-166. Zelber-Sagi S, Ratziu V, Oren R. Nutrition and physical activity in NAFLD: an overview of the epidemiological evidence. World J Gastroenterol 2011; 17: 3377-3389. Bacchi E, Negri C, Targher G, Faccioli N, Lanza M, Zoppini G, Zanolin E, Schena F, Bonora E, Moghetti P. Both Resistance Training and Aerobic Training Reduce Hepatic Fat Content in Type 2 Diabetic Subjects WithNonalcoholic Fatty Liver Disease (the RAED2 Randomized Trial). HEPATOLOGY 2013; 00:000-000. Pg1-9. INDIA

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Beauty Cosmetic dentistry has come a long way in the range of treatments it offers. Dr Meghna Dang of We Smile, Paediatric Dentistry, Implant Surgeries, Laser Surgeries and Cosmetic Smile Makeovers, Mumbai, busts some commonly held misconceptions regarding this option of improving one’s looks and teeth

extraction or root canal treatment. In most cases, patients feel a mere discomfort and nothing beyond that. Additionally, the usage of anaesthesia helps in eradicating the pain factor.

Restricted to aesthetics

Cosmetic dentistry does not simply focus on improving one’s appearance, but also aims at restoring the mouth’s natural functionality. It eliminates bacteria hiding within cracks and cervices, protects the jaw bone from deterioration, and positively impacts chewing capacity, amongst other benefits. For instance, dental veneers are not only used for smile beautification, but also to resolve the troubles of thin enamel. Enamel erosion can cause the affected teeth to be more susceptible to chipping or cracking, as well as lead to sensitivity, which can cause sharp shooting pain, with worsening of the erosion. In these cases, veneers can be very useful.

Whitening damages teeth

Myths about Cosmetic Dental Treatments A

n individual’s smile is said to be their most beautiful and valuable asset. However, several people feel uncomfortable whilst smiling in public due to damaged teeth. Unhealthy teeth do not always mean cavities; it can be an outcome of a plethora of other reasons like – misalignment, discolouration, chipping and others. These have a drastic effect on one’s appearance and steal the glamour from a person’s smile. Cosmetic Dental Treatments came into existence with the sole purpose to resolve these dental problems and add to the beauty of one’s smile, consequently boosting confidence. However, people have pre-set notions pertaining to these solutions, which stop them from opting for the same. TM

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Here are some myths around aesthetic dentistry that now stand busted Expensive

Technological advancements in the field have worked wonders in terms of cutting down costs. Dentists are able to procure material easily, and are enabled to perform procedures with increased efficiency. For instance, new designing techniques allow them to structure and mill dental crowns in their office, enhancing the efficacy of the process and bringing down the treatment time— from multiple visits to a single sitting. Treatments that entail extensive work are deemed to be costly. However, in order to curb the same, a large number of pocket-friendly payment plans have come into the picture.

Weakens teeth

A common perception is that even though cosmetic dentistry improves one’s appearance, it adversely affects the wellness of an individual’s teeth. A healthy smile is a highlighting feature behind aesthetic treatments, but it does not mean jeopardising teeth strength. Furthermore, procedures like dental implants prevent a multitude of oral problems like tooth movement, bone loss, and difficulty while chewing or speaking.

Painful process

Pain is subjective, and has different implications for different people. The main motive of cosmetic dentists is to ensure comfort and ease during the treatment. Studies have proved that on an average, these procedures are much less painful than a simple tooth

Whitening kits available in the market, if used inappropriately, can damage one’s teeth, as they are made of harsh ingredients. However, professional treatments are safer and provide absolute results. One can experience significant improvement right away, and there is no need to apply strips or trays for a long period. Dentists use a specialised gel that breaks down the stains on teeth when exposed to scientifically controlled light, leading to a sparkling and brighter smile.

Involves extensive procedures

Despite common beliefs, cosmetic dentistry does not always entail major procedures that result in drastic changes. Processes like teeth whitening or dental bonding, which are used to remove stains or fix a chipped or broken tooth, are minor treatments that do not significantly change an individual’s appearance. On the other hand, elaborate methods like dental crowning work towards restoring one’s smile rather than completely changing a person’s look.

Results look fake

Modern times have witnessed great technological developments that have transformed the face of aesthetic dental treatments. Orthodontic professionals use porcelain materials that resemble natural teeth, and as components, come in a variety of colours, which can be further developed and fabricated to match the shade of one’s existing teeth. This new-age technique leaves behind a natural and beautiful smile.

Crowns don’t require any maintenance

Dental crowns require a healthy brushing and flossing regimen, just like natural teeth. It is further suggested that one should regularly rinse their mouth with a mouthwash and visit a professional for cleaning, at least twice a year. If good oral hygiene is not maintained, the risk of cavities increases. The tooth underneath the crown is prone to decay, and harmful bacteria can shorten the lifespan of the crown.

Dental bridges are the only way to replace a missing tooth

These have been used for several years to combat the issue of a missing tooth. However, it is not the sole method to resolve this trouble. Dental implants are deemed to be a better choice for replacing one or more missing teeth, as they resemble natural teeth, and are stronger and easier to clean. They can also be used to anchor dentures or partial dentures. INDIA

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Beauty

Are Yellow Nails a Big Concern? Dr B. L. Jangid, dermatologist & hair transplant surgeon at SkinQure Clinic, New Delhi, explains why yellow nails occur and how to treat them

ave you ever noticed your nails turning yellow? If yes, then stay careful, as it can be a matter of concern. Yellow nails may be a sign of some serious health conditions, namely â&#x20AC;&#x201C; anaemia, iron deficiency, thyroid, diabetes, lung problems, and so on.

Why do yellow nails occur?

Those with yellow nails might be familiar with the trouble that comes along with it. Not only does it hamper the physical appearance of your nails, but it can also be associated with some serious health issues. If you are unaware of what could cause nails to turn yellow, below are some pointers to explain the same. Frequently changing nail paint: It might sound weird but it is true. When you frequently change your nail paint, the enamel of your nail turns weak and starts breaking. Therefore, try changing your nail paint once a week for healthy nails. TM

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Being a chain smoker: Another prime reason for yellow nails can be smoking addiction. Smoking is not only harmful for your lungs but also results in nails yellowing. So, if you have a habit of smoking, try reducing it. It can be hereditary: You can be a victim of yellow nails due to your hereditary factor as well. Someone in your family might be suffering from yellow nails, passed on to you via heredity. You can either opt for some medication, professional consultation, or try home remedies for curing it.

Treat the cause

suggestion is to treat the cause first. If you are applying something on the nails which is resulting in the yellowing, consider avoiding it for some time. You can also ask for nail care for getting rid of yellow nails.

Easy tips to get rid of your yellow nails

Apply tea tree oil: If your nails are getting discoloured, you can apply some tea tree oil on them. The oil helps in getting rid of any bacterial infection or fungus that might be responsible for discolouration. Try mixing the tea tree oil with a carrier oil such as olive oil, coconut oil, or jojoba oil, and apply the mixture on the affected nail. Use baking soda: Fungus infections usually occur in an environment where the pH level is mostly acidic. In such a case, try dipping your nails in hot water mixed with baking soda that can prevent the fungus from spreading, allowing you to have beautiful nails.

Important things to keep in mind

Like any other body part, your nails also require proper attention and care. Remember that healthy nails can restrict any nail-related disorders that can create trouble for you. For example, always be particular about nail hygiene. Try cleaning and trimming them on a regular basis. Be careful about the products used if visiting a spa or a salon. Ensure that the manicurist is using a new kit for your manicure. It is also recommended not to constantly use nail paint remover. Try using it once a week, to avoid cracked and broken nails.

Dip your nails in oregano oil: Utilising oregano oil for treating yellow nails is by far the most popular and effective home treatment available. Oregano oil can help to moisturise, and maintain good, strong, and attractive nails. Add vitamin E to your diet: Vitamin E is known to help cells retain moisture and make nails look healthier. In fact, your skin, nails, and hair -- all take on an appearance of vitality when you have plenty of vitamin E. Moreover, the consumption of vitamin E is regarded as one of the successful treatments for combating yellow nail syndrome. Since vitamin E stimulates healthy nail growth, it can either be applied topically or taken orally for helping your nails grow quickly.

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Fitness line, from the shoulders to the knees. Take a break for three to five seconds— pressing your glutes firmly all through the workout—then lower yourself back to the position from where you started.

Easy Exercises for

working mothers Sailendra S. Raane, Director - Fitness Division, RESET-Holistic Living Concepts, shares some easy exercise routines for busy working mothers

e often witness women on television shows who are forever killing it at the work zone; they attend uncountable business dinners and yet manage to have svelte bodies. Of course, in real life, working mothers who are constantly juggling demanding professions and other responsibilities like home and motherhood, often end up struggling for sufficient time to work out on a regular basis. Due to following a faulty fitness regimen, women may fall prey to various lifestyle

ailments like obesity and diabetes. Proper exercise and diet are indispensable, and women should try and find a way to prioritise these. The fact that it is challenging does not necessarily mean that it is impossible. Below are a couple of simple yet effective physical movements and full-body workouts which will facilitate working women to stay fit and in the pink of health.

Abs: Mountain Climber, with hands on Swiss Ball

This physical movement is one of the simplest, yet most functional ways to firm up your abdomen. In fact, you will hardly be required to move a muscle. How this exercise is performed: While exercising, you must assume a push-up position, with your arms placed totally straight, but you must place your hands on a Swiss ball instead of the floor. All through the workout, your body must form a straight line, right

Quadriceps: Offset Dumbbell Lunge

from your head to your ankles. Tighten up your core and hold it in the same way for the entire duration of the workout. Lift one foot off the ground and gradually elevate your knee as close to your upper torso as you can, without altering your lower back position. Then replicate the moves with your other leg. Alternate back and forth for about 30 seconds. If you find this too challenging, place your hands on a flat surface or a bench.

How to perform it: Begin the exercise by lying on your back on the ground, with your knees bent and your feet flat on the ground. This should be followed by bracing your core, squeezing your glutes, and elevating your hips in a way that your body forms a straight TM

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Your palms should be facing outwards, but turned slightly inward. Place your right hand on your abs and then lower the dumbbell to the side of your torso. Take a break, then press the weight back to the starting position. Repeat replications, then duplicate on your right side.

Biceps: Split Stance Dumbbell Curl

Glutes: Hip Raise

This exercise targets the muscles of your rear, which can facilitate in making your stomach flatter. This is because when you have weak glutes, which is very common in females, the top portion of your pelvis tends to tilt in the forward direction. This will not just put stress and strain on your lower back, but can also cause your stomach to stick out— even if you don’t have an ounce of extra fat.

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As you hold a weight on just one side of your body, it surges the demand placed on your core to keep your body steady. The result is that your abs and hips are required to work much harder, and you will also increase your balance. Most importantly, you will burn down tons of calories.

How to perform it: To perform offset dumbbell lunge, you must hold a dumbbell in your right hand next to your shoulder, with your arm being slightly bent. Now step forward with your right leg and lower your body till your right knee is bent at least at 90 degrees, and your left knee touches the ground. Then push yourself back to the preliminary position. This becomes one rep. Perform all the remaining reps, then replicate with your left leg, while holding the weight in your left hand.

Torso: Single-Arm Dumbbell Chest Press

This physical movement helps to efficiently work your glutes and abs, as it works your upper torso and triceps. Hence, the move will enable you to strengthen your core and hips as you effectively tone your upper body. How the workout can be performed: To perform the exercise, hold a dumbbell in your left hand and lie flat on your back on an even bench. Hold the dumbbell over your chest, with your arms straight.

By placing one foot in front of you on a bench, this physical movement forces your hips and core muscles to work harder in order to maintain body stability. That way, you are able to engage more muscles and burn down more calories than you would do if you performed the workout in a regular standing posture.

How to perform the movement: Grab a pair of dumbbells and place one foot in front of you on a bench or a step that is a little higher than the knee level. Allow the dumbbells to hang at arm's length next to your sides, while your palms face the forward direction. Without moving your upper arms, slightly bend your elbows and curl your dumbbells towards the direction of your shoulders. Take a break, then gradually lower the weights back to the start position. INDIA

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Fitness Over the years, it has been fascinating to witness the shift in the cognisance and consumption pattern of individuals towards fitness. The fitness industry in India is witnessing tremendous growth and is poised at an inflection point. With a large number of people switching towards a healthier lifestyle, the demand for gyms and fitness studios is at its peak. The need to look their best and feel stronger is one of the biggest driving forces that is contributing to shaping the fitness industry globally.

The Fitness Industry and Preventive Healthcare Market

: 0 2 0 2 n i y r t s u d n i s s e n t Indian fi T S A F G N GROWI India is fast emerging as a modern community that sees the importance of health and wellness. The current landscape is a combination of products and services that are helping individuals lead a healthy life. The future sees many fitness centres emerging as solution-oriented service providers, says Dhara Tanna, Senior Vice President, Fitternity

ill only a few years ago, the fitness industry in India was in an extremely fragmented state. There were vast gaps between the supply and demand in the market, owing to it being an almost entirely unorganised sector. In addition to that, Indians were sitting on the fence due to conventional business models of gyms since smaller sachets of TM

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memberships were not available. With the largely unorganised service offerings becoming a core concern to new entrepreneurs in the segment, the decade witnessed a rise in the game changers to bring about a structure. The supply and demand in this industry is slowly but gradually maturing. To observe the market from the suppliersâ&#x20AC;&#x2122; standpoint, the age-old functioning

pattern -- the selling of services at a non-standardised rate and focussing on the customer relationship as a short-term sales goal â&#x20AC;&#x201C; was observed. The pattern that emerged was selling services at an X rate to customer A; however, if customer B negotiates better, he gets a huge discount on the X rate.

The fitness and preventive healthcare industry is large and is growing exponentially. The over 27M monthly Google searches that led to an inability to discover fitness online, was due to 96% gyms/studios not having a website. The report also stated that 30 million Indians will utilise fitness services in 2023.

Growing Population and Consumer Spending Potential

The population of India is fast growing, and a large part of it consists of individuals below 40 years of age. Hence, the expenditure amount, on average, increases every year. In the earlier days, when spending money on fitness used to be considered a luxury, today, it has become a vital aspect in the lives of people. With growing urbanisation and the rise in the number of middle class (working class) people, the increasing disposable incomes are boosting the need for gyms and studios. Moreover, young adults who are leading a sedentary life are now becoming more conscious about the need for a healthy body.

Growing Popularity of a Fitness Culture

With fitness becoming a conscious lifestyle choice, the fitness culture is gaining

With fitness becoming a conscious lifestyle choice, the fitness culture is gaining tremendous popularity. Modern cardiovascular and resistance equipment, specialised fitness training styles, and new-age workout programmes, are some of the things that have attracted a new kind of audience to the studios

tremendous popularity. Modern cardiovascular and resistance equipment, specialised fitness training styles, and new-age workout programmes are some of the things that have attracted a new kind of audience to the studios. The public awareness towards fitness and wellness has increased the promotion of new offerings by fitness centres/ studios.

Rise In Budget-Friendly Fitness Services While the gyms and studios often have a membership offering that is of a minimum duration of three months, a game changing platform offers a variety of fitness services that are easily accessible and also customisable, based on their preference.

Personalised Consumer Offerings

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InFitness the Spotlight satisfaction within multiple fitness service providers, giving customers the power to decide where and when they would like to work out. It has enabled them to choose as per their preference and not be confined to one option, as was the case a few years ago. Not only does this break the monotonous workout pattern that has been ongoing for years, but it is also light on the pocket to avail. Consumers can view pictures and videos online and choose after having an informed perspective.

Consumer Centric Focus

Various fitness centres are building their offerings to be more consumer centric. They are focussing more towards providing human intensive services through a humanised approach based sale. This kind of service has an extensive reach, which can serve as an optimal solution to cater to the growing demand and need for wellness solutions, and build on the customer satisfaction aspect as well.

more about their progress or about their body-fat percentage or sleep analysis, can now have technology help them keep a tab on it all.

Technological Advancement

Technology is increasingly finding a place within the routines of individuals. With various kinds of apps to wearable technology,You to a don't discovery booking democracy. have and to have a platforms, technology has it the pedigree, the opportunity tomade become easier for people to you. identify the right king is wide open to kind of workout/training session and avail as per their to preference. Notvery only So theitopportunity become the is the use of existence technology the fitness centre of the is in always wide industry convenient, butcall it also open to you. In yoga, we thehelps spine

the merudanda, which means the axis of existence, because if you generate your energies sufficiently, you can sit here being the very axis of existence. This science of getting there, this dimension of making this happen to yourself is what we are referring to as yoga. But the reason why it looks so distant for many people is simply because they have tied their boat to one shore but are working hard to get to the other shore. It is a very hard job that way. If you cut the rope, even the breeze may take you there. You may just float around and get there. If you row hard,

The human body is the most sensitive and capable in making the consumers aware of the instrument on this latest advances in the segment. Fitness enthusiasts are curious know planetwho â&#x20AC;&#x201C; there is tono other instrument like this you will definitely get there very quickly, but if you row hard without cutting the rope, it is an endless, thankless job. This has been the main problem with people on the spiritual path. People don't cut this rope but they want to get to the other shore. It is a simple understanding, a simple intelligence that if you want to go from this shore to that shore, if you want to make

Hence, the fitness market scenario in India seems to be positive as multiple factors are contributing to its expansion. India is fast emerging as a modern community that sees the importance of health and wellness. The is a combination acurrent journeylandscape from the physicality to a of products and services that are helping dimension beyond the physical, unless individuals healthy future you cut this lead rope,ayou won'tlife. getThe there. seesismany fitness centres emerging as This simple, common sense. solution-oriented service providers, and hence friendlier their So we are askinginyou to approach, bend your rather body, thanyour harsh and business focussed. hold breath and do these things

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because slowly, it will cut the ropes of the physical and create a distance between you and the physical. Once there is a distance, rowing your boat away is very simple; just the current or the breeze may take it. Even if you sleep, it may still make it to the other shore, but the important thing is that you have to create a distance from the physical. You have to just keep a little distance from whatever enhances and reinforces the physicality in your life. You identify all those compulsive aspects of the physicality and stay away from them. In a small way, this is going beyond the limitations of the physical.

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May 2020 2019 Healthcare 14 76 November Healthcare TM

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November 2019 15 Healthcare

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Artificial intelligence and related technologies have already become a major draw in the healthcare industry, with the potential to transform patient care as well as administrative processes by automating tasks and achieving faster results, says Sanjay Jha, Director, ColMed

rtificial intelligence (AI) systems are evolving at a breakneck pace, and have already made remarkable advances in successfully replicating repetitive and complex tasks, offering unique insights, making it possible for product developers to focus on the more nuanced aspects. AI based programmes can acquire information, sort and process the data logically, use known variables to form solutions, recognise the mistakes, and correct them, improving the quality of product design. Artificial intelligence and related technologies have already become a major draw in the healthcare industry, with the potential to transform patient care as well as administrative processes by automating tasks and achieving faster results. According to a report by Zion Market Research, Global Artificial Intelligence (AI) in the healthcare market is likely to reach USD 17.8 billion by 2025. Algorithms in disease diagnosis, clinical trials and predictive analysis for disease outbreaks have the potential to

dramatically change the way healthcare is planned, executed and delivered. The medical device industry is no exception. AI can not only be used to design and test new devices, but also for diagnostics, surgery, and as a therapeutic aid. Diagnosis: Artificial Intelligence already has a considerable presence in diagnostic medicine. AI technologies reduce the diagnostic workload for physicians, most of whom are overworked to the point of complete exhaustion. It helps bring down the rates of wrong diagnosis. If algorithms can diagnose medical maladies with complete accuracy in just half of the patients, professionals can end up saving a lot of time. Medical device manufacturers should keep up with the integration of AI in diagnostics. Wearable devices powered by artificial intelligence have a wide variety of applications, from medical imaging and gene sequencing to studying drug interaction and presurgical planning. The better patients are able to monitor their vitals and have the information delivered to doctors and specialists, the more it eliminates the need to visit a clinic or hospital. This will help bring down overhead healthcare costs and reduce the load on overburdened healthcare facilities. l

complicated equations, help refine modeling, and improve product testing. Algorithms can help generate hundreds of product designs, based on parameters such as weight and size, raw materials, and the intended functionality. From there, it can provide suitable candidates for the purposes of testing. Add 3D printing into the mix, and the possibilities become more obvious. The entire product pipeline can be AI driven, beginning with building multiple models, rapid prototyping using a 3D printer, and testing multiple variants at the same time. Device manufacturers can also embed sensors and trackers into the 3D printed devices, broadening the durability, ergonomics, and usefulness of these designs. Robotics and monitoring: Automated surgery is also fast becoming a ubiquitous reality. It might be a little difficult to convince the public at large to hand over the surgical duties to a robot, but once they are made to understand how much more efficient it is, they will be more than convinced. AI has a big role to play in next generation robotic surgery. They can help augment the perception capabilities and dexterity of surgeons using machine learning algorithms. Surgeons will be able to make use of such systems to make more well-informed decisions. AI-based surgical systems will also reduce surgical variations, eliminate inefficiencies, and improve the patient outcomes. l

Disruption of distribution

Let us also take a broad look at how artificial intelligence will impact the distribution of medical devices. It allows device manufacturers from becoming order takers to order makers. Demand forecasting will be significantly better due to disease state forecasting. Based on the pattern of disease state and previous purchases, AI software can be used to suggest medical supplies before the end user runs out of stock. Even distributors stand to gain from the use of artificial intelligence due to availability for consumption forecast. Artificial Intelligence will help identify when products need to be sent to distribution centres and when the products with low shelf life need to be promoted to reduce inventory waste. In short, an artificial intelligence equipped distribution manager can help optimise the inventory, as well as the supply chain management.

The future looks bright

With the government signaling its intention to institute a separate body for the regulation of medical devices, the competition in the industry is only set to go up. The quality of manufacturing is also set to get better, and device manufacturers will have to do everything they can to stay ahead of their peers. If they fail to embrace technologies like artificial intelligence that improve the state of healthcare delivery, then they are going to find it difficult to stay relevant in the market.

Invention: Technologies that are built using artificial intelligence can help refine the development process of medical devices. AI software can solve l

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Trending Now native tissue to the affected chest wall, either as a loco-regional flap or as a part of a larger micro-vascular surgery. There is an additional option of having silicone implants. Although the expertise of breast reconstructive plastic surgery is available in selected centres in India, not many women opt for this procedure. There are, however, many women who opt for an external breast prosthesis, either by choice, or because of other factors like age, comorbidities, or affordability.

Options for Breast Reconstructive Surgery

The external breast prosthesis is an artificial breast form (either cotton or silicon) that is used to replace the natural breast after complete or partial removal. It aims at providing symmetry and a natural shape to the body, although it may remain a compromised solution for the lost breast.

Dr Arvind Krishnamurthy, Professor and Head, Surgical Oncology, Cancer Institute (WIA), Chennai, addresses the unmet need of breast reconstruction and rehabilitation among Indian women with breast cancer

reast cancer is currently the leading cause of cancer among all women worldwide, including India. There were about 2.1 million reported cases of newly diagnosed female breast cancer in the year 2018, accounting for almost 25% of all women cancers. The vast majority of the cases of breast cancer (90%) are sporadic and only about 5-10% of the cases have a hereditary and genetic pre-disposition, including a personal or family history of breast/ovarian cancer, or harbouring high-risk hereditary and genetic factors, including a personal or family history of breast or ovarian cancer and inherited mutations like the BRCA1 and BRCA2. Historically, almost all the women (early stages as well as locally advanced stages) of breast cancer used to necessarily undergo complete removal of the affected breast, known as a mastectomy. However, over the past four decades, the option of breast conservation (removing only a part of TM

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the breast, instead of the whole breast) is available for some of the women, especially for those with early-stage breast cancer. Breast conservation therapy (which usually includes further radiation therapy) provides equivalent long-term survivals and much better cosmetic outcomes than the mastectomy approach. There is, however, a wide geographical variation in the acceptance of breast conservation among women, globally. Women from North America were less likely to undergo breast conservation than their counterparts in Europe or Asia. The trend of breast conservation seems to be much lower among Indian women, ranging from 11-60% across various centres. The reasons for the under-utilisation of the breast conservation approach are complex and manifold, which include the physicianâ&#x20AC;&#x2122;s perception, as well as the patientâ&#x20AC;&#x2122;s preferences.

Mastectomy causes not just a physical change in the appearance of the women, but can also bring about enormous psychological trauma, leading to a major effect on a woman's self-esteem, with a decreased sense of femininity. With relatively higher rates of mastectomies among the Indian women with breast cancer, there is a definite need for a comprehensive reconstruction and rehabilitation programme, which includes counselling and education about the various forms of reconstruction (Including plastic surgery and external breast prosthesis). The options for breast reconstruction include plastic surgery, which entails a transfer of the patientâ&#x20AC;&#x2122;s

Most external breast prostheses are custom-made (available in various sizes) and are made of a soft silicone gel. The outer surface feels soft and smooth, and usually includes a nipple outline. The external breast prostheses are available in two forms, i.e., the adhesive and the conventional ones. The adhesive prostheses are attached to the woman's skin with an adhesive strip, whereas the conventional prostheses are worn inside the bra, which has a special pocket to hold the prosthesis.

The external breast prosthesis is an artificial breast form (either cotton or silicon) that is used to replace the natural breast after a complete or partial removal. It aims at providing symmetry and a natural shape to the body, although it may remain a compromised solution for the lost breast An earlier study from India reported that more than half of the women who undergo a mastectomy, do not undergo any form of reconstruction. The lack of awareness about the various forms of breast reconstruction may be a major reason for the above trend. Among the women who do opt for a breast reconstruction, the vast majority of the women use crude custom-made prostheses like cloth and cotton. Only about one-fifth of the women who opted for rehabilitation, used the external breast prosthesis. Education, age, and urban living were among the various factors which influenced the use of the external breast prosthesis.

Women < 50 years, and especially those who were educated, were more likely to opt for the external breast prosthesis. Furthermore, many of the prosthesis users felt that there is a need for developing better prostheses, which are more user-friendly and affordable. The Cancer Institute (WIA), hence, on the occasion of World Cancer Day, February 4, 2020, organised a programme of providing the option of external breast prosthesis, free of cost, to all the deserving women who had undergone a mastectomy, during the course of their management of breast cancer. This was made possible due to the CSR support of the HCL Foundation. All other forms of reconstruction and rehabilitation for breast cancer among other cancers are also available at the Cancer Institute (WIA), Chennai. The wearing of external breast prostheses can help women undergoing a mastectomy restore their body image, posture, and confidence. There is, however, a need for research for better understanding the myriad complex issues surrounding the breast reconstruction and rehabilitation, especially among Indian women.

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Link to buy: https://www.abccart.com/product/nutriorg-aloevera-juice/ Aloe Vera is a multifaceted medicinal plant. Its medicinal value makes it superior to most. It is believed to be a miraculous plant for treating numerous health problems. In Ayurveda, it is often referred to as the â&#x20AC;&#x2DC;silent healerâ&#x20AC;&#x2122;, and finds mention in the Ramayana, the Bible and the Vedas. It is known by many names, such as Dhratkumari, Gwarpatha, Kwargandal, Kumari or Ghee Gwar in Hindi. After years of research, it has been concluded that there are 300 types of Aloe Vera, out of which 284 types of Aloe Vera have 0 to 15 % medicinal value; 11 types of Aloe Vera are poisonous; of the rest, the one known as Aloe Barbadensis Miller, is 100% medicinal.

1. Female urination device (Pack of 20): Gives women the freedom to stand and pee in unhygienic toilets. 2. Toilet seat covers (Pack of 20): Creates a barrier for protection from germs on toilet seats. 3. Intimate wipes (Pack of 40): To keep intimate areas clean. 4. A face mask to prevent breathing in germs/ viruses.

The Aloe Vera plant goes back to over 5000 years; people have used it for various medicinal purposes in the past. From Cleopatra to Mahatma Gandhi, many have preached its health benefits. No doctor can overlook the medicinal values that this plant possesses. TM

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Healthcare 82 May 2020

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Doctor-Patient Relationships Dr Debraj Shome and Dr Aparna Govil Bhasker have compiled a book titled Dear People, with Love and Care, Your Doctors, which is a first of its kind in the country, highlighting the relationship between doctors and patients

octors, patients, health and healthcare involve all humans. Every one of us has fallen ill at some point or wanted to be a doctor at another. In good times, the relationship between a doctor and patient is an epitome of belief, love and care; in times of illness, doctors can acquire the status of demigods and epitomise hope. In recent times, though, the doctor-patient relationship has suffered from a lack of trust and perhaps empathy, and the connection seems to be weaker than it used to be. While earlier, doctors used to be treated as god, these days, there are unfortunate instances of conflicts between doctors and society. In fact, even the incidence of violence against doctors has increased. Today, patients have access to information that makes it easier for them to secondguess their doctors, as the internet allows them to do their own research, diagnosis, and treatment. This desire for immediate treatment has also contributed to the disturbance in the sanctimony of the relationship, and the development of a distance between patients and doctors.

world, including Dr Mohammed Rela, Dr Pradeep Chowbey, Dr Ravi Wankhedkar, Dr Nitin Kadam, Dr S. Natarajan, Dr Lalit Kapoor, Dr SubramaniaIyer, Dr Jesse Berry, Dr Wolfgang Gubisch, Dr Gabriela Casabona, Dr Kamal Mahawar, Dr Marcus Ranney, Dr Dheeraj Mulchandani and many others. Dr Debraj Shome, eminent Facial Plastic and Cosmetic Surgeon, and Co-founder and Director, Debabrata-Auro Foundation, said, “We often hear discouraging stories of doctors being abused and hospitals vandalised. The narrative is gradually turning negative -- a dismal reality for both doctors and patients. But we tend to forget that there are many medical miracles occurring all over the world owing to the cutting-edge technologies, which have transformed the healthcare industry. The life expectancy all over the world has more than doubled in the past few decades, due to the wonders of modern science.”

It is vital to revive and strengthen the bond of trust to foster better communication and healthcare decisions. Dr Debraj Shome and Dr Aparna Govil Bhasker have compiled a book titled Dear People, with Love and Care, Your Doctors, to give a sneak peek into the world of medicine, and motivate millions to maintain faith in the doctor-patient relationship.

He added, “The book aims to bring back the focus on the unshakeable foundation of doctor-patient relationship through inspiring stories from the diaries of 30 doctors and five patients. These are stories of triumph, empathy, positivity, loss and, sometimes, failure. Likewise, it goes one step ahead, and captures the experience of people who surround a doctor -- the mother of a doctor, a surgeon's husband, and an acid attack survivor. These stories underline that a doctor too, is a human being, after all. Hence, these stories are a source of motivation for everyone.”

Written in a Chicken Soup for the Soul kind of format, this easy-to-read book contains short stories written by patients and doctors about their experiences with health and healing. The book contains chapters from some of the best doctors in India and the

Dr Aparna Govil Bhasker, well known Bariatric Surgeon, and Co-founder and Director, Debabrata-Auro Foundation, said, “Once upon a time, doctors were considered akin to god. The stethoscope was revered, and their healing touch was discussed far

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and wide. But the scenario has changed now; the doctor-patient relationship bond has been altered by technological interference, and there is a widespread distrust between both, as people are at war with their healthcare providers.” She added, “This book can be an answer to what may have gone wrong in a profession, which, from time immemorial, has remained one of the most respected ones, and may just inspire both, the doctors and the rest of the world, to restore the beautiful relationship. It is for the first time that there is a manifesto of doctors’ rights being shared, along with patients’ rights. This is a book of human interest stories, based on the doctor-patient relationship. It's an easy read, and is touching and empathetic, and doctors and patients will connect with it.” So, whether you are a doctor or a patient, whether you have benefited from or suffered at the hands of the healthcare system, this book gives you a great chance to get an inside peek into the world of healthcare. Riveting and unputdownable, this must-read should be a part of your reading list. This book is published by Bloomsbury, and has been blessed by His Holiness, the Dalai Lama with the foreword, and has been acknowledged by Vinod Tawde, Higher and Technical Education Minister of Maharashtra, Ranjit Patil, state minister of home, law and justice, Ms Shaina NC, and many renowned doctors. The book provides a sneak peek into the world of medicine and healthcare.