International Day of Persons with Disabilities 2023: India’s rights groups aim to make disability inclusion more than a tick-box exercise

December 3 has been annually observed as the International Day of Persons with Disabilities by the UN since 1992.

The theme for this year’s International Day of Persons with Disabilities is "United in action to rescue and achieve the Sustainable Development Goals (SDGs) for, with and by persons with disabilities".

Chennai-based T M N Deepak is a “disability political activist” and the founder of the December 3 Movement, a 10,000-member strong disability rights association spread across Tamil Nadu. He has a physical disability owing to a polio attack at the age of two.

His brainchild, the December 3 Movement, is named after the date annually observed as the International Day of Persons with Disabilities (IDPD) by the United Nations since 1992.

“We wanted to name it December 3 to highlight that it is not a day for tokenist celebrations in our honour but one that demands recognition of us as a community with rights in the society,” Deepak said.

“It cannot be a day for tick box exercises and tokenistic ‘charity’ programmes. It is to acknowledge how much we moved or how far we are from the milestone,” he added.

Since its inception in January 2015, the disability rights association has advocated for diversity in disability to be made inclusive. “The literal English translation of unamutravar, the Tamil word for those with disabilities, is ‘alternately abled’. Yes, we are alternately abled and the human experience of disability needs inclusion,” he added.

The theme for this year’s International Day of Persons with Disabilities is “United in action to rescue and achieve the Sustainable Development Goals (SDGs) for, with and by persons with disabilities”.

The 17 SDGs under the 2030 Agenda for Sustainable Development adopted in September 2015 explicitly include the terms ‘disability’ and ‘persons with disabilities’ (PwDs) 11 times, as per the UN.

“The Agenda aims for a holistic approach to achieving sustainable development for all. We are very much part of the ‘all’. The theme mentions ‘for, with and by’ making inclusion not only a moral imperative, but a practical necessity in India,” Deepak said, highlighting the country’s 2.68 crore people with disabilities (as per the Census 2011).

About 2.2 per cent of India’s population lives with some physical or mental disability, as per the National Statistics Office report on disability released in 2019.

The UN, in its preliminary findings from the UN Disability and Development Report 2023, states that the world is “even more off track in meeting several SDGs for persons with disabilities.”

He said this year’s SDGs-related theme makes it much clearer, considering 2023 is the halfway mark to the 2030 Agenda. “Anything that has to be sustainable has to get the sanctions of all the communities. That is only possible when stakeholders ensure we are seen and heard.”

The SDGs are built on the principle of “leaving no one behind.” Delhi-based disability rights activist Arman Ali said this directly translates to rescuing the goals through the means of representation, especially when it is about a community that has been historically marginalised.

The importance of creating disability rights awareness is felt today across the board, starting from areas of governance and administration. “We have been undercounting disability and persons with disability remain underrepresented. We are still behind in adopting a holistic approach that addresses challenges and offers solutions to problems faced by the disabled community in India,” said Ali, also the executive director of National Centre for Promotion of Employment for Disabled People (NCPEDP).

Identification and convergence: In spirit, policy and action

With a disability-oriented focus on sustainable human development, the president of the Hyderabad-based Network of Persons with Disability Organizations (NPdO), Srinivasulu, who was born with a disability, said policies are not where problems begin. “It’s all on paper, but the implementation is the issue. The fight is for us to be able to live with our rights, with dignity,” he said.

Talking about accessibility, he said without an inclusive approach to collect data on disability in India, social welfare for all cannot be achieved. “Say the state and the central government are making arrangements such as ramps and lifts for me to go vote. But if they don’t start by identifying me, other factors will not align for me to reach the polling booth. This includes basics like public transport to larger factors like education,” he cited from lived experience.

Further, he mentioned that such systemic barriers can be overcome with the ‘convergence’ method wherein all sectors of society come together to support disability rights by focussing on the implementation aspects of problem-solving. “In India, where there is political will there is empowerment,” he added.

His network, like many other disability rights pressure groups across the country, continues to fight for better representation in local self-governments. Deepak’s December 3 Movement also stands by this. “Talking rights is politics,” he said, repeating his “call to action in life” and Russian revolutionary Vladimir Lenin’s quote: “If you do not talk about your politics, you will be ruled by the politics that you hate.”

Education: Beyond the ableist rubric

Education, when made accessible with a clear roadmap and milestones, leads to upliftment and empowerment, said Jayashree LV, a special educator and director of The Spastics Society of  Tamil Nadu. “Entry point could be education. But what after that? What is available and accessible to the community in terms of livelihoods and lifestyle?” she asked.

Extending the education perspective, Jayashree underscored the ableist discourse in India. ”When we talk in terms of sustainable development, the whole society which has an unconscious bias must be educated about the internalised ableism thinking,” she said, reiterating that the only way forward is to take the purposeful integration of disability inclusion one notch higher each year.

Deepak said he addresses everyone around him as “Tōḻar” (comrade in Tamil) as in, an “ally”. In line with sustainable development, here’s what experts and people with lived experiences believe those who consider themselves disability allies can do:

📌 Do not approach with a “charity mindset”. Treat persons with disabilities as equals with dignity and consider the intersectionality across caste, class and gender.

📌 “Pass the mic,” Deepak added. With the right intent, let the voices speak for themselves.

📌 Demand both public and private stakeholders to put “money where the mouth is,” Jayashree said.

📌 Look for the disability focus in development initiatives and call out tokenism. “Ask for achievable action plans. It could even be your own housing society or your constituency,” Srinivasulu said.

https://indianexpress.com/article/lifestyle/life-style/international-day-disability-sustainable-development-goals-inclusion-9051602/

Tiny ‘robots’ created from human cells might heal wounds: Study

A recent study conducted jointly by scientists at Tufts University and Harvard University’s Wyss Institute has revealed a groundbreaking development in the area of living robots created from human cells.

This research introduces tiny entities referred to as ‘anthrobots’ made from adult human seed cells, which is a departure from earlier work using stem cells. Previously, African clawed frog embryos were used to develop living robots known as ‘xenobots’.

As reported by CNN, study author Michael Levin, Vannevar Bush- professor of biology at Tufts’ School of Arts & Sciences said, “Some people thought that the features of the xenobots relied a lot on the fact that they are embryonic and amphibian.”

He also added that “I don’t think this has anything to do with being an embryo. This has nothing to do with being a frog. I think this is a much more general property of living things. We don’t realize all the competencies that our own body cells have.”

He further remarked, “While alive, the anthrobots were not full-fledged organisms because they didn’t have a full life cycle. It reminds us that these harsh binary categories that we’ve operated with: Is that a robot, is that an animal, is that a machine? These kinds of things don’t serve us very well. We need to get beyond that.”

Unlike the xenobots created previously, the anthrobots were crafted from adult human cells sourced from the trachea of anonymous donors of varying sexes and ages. The choice of these particular cells was influenced by their accessibility due to ongoing research on lung diseases, particularly linked to COVID-19.

Published in the journal Advanced Science, this study, titled ‘Motile Living Biobots Self-Construct from Adult Human Somatic Progenitor Seed Cells’, not only showcases the creation of anthrobots but also raises interesting questions about the assembly and cooperative functioning of human cells.

According to reports, the anthrobots displayed diversity in structure and behavior. Some took on a spherical shape fully covered in cilia, while others resembled a football shape irregularly adorned with cilia.

The study mentions, “morphotype 1 bots are likely to assume either non-mover behavior or wiggler behavior. This may be attributable to their spherical shape with homogeneously distributed cilia.”

The experiments outlined in this study are an early step towards focusing on the medical potential of anthrobots. To explore it further, the researchers investigated whether anthrobots could go towards or interact with human neurons grown in a lab dish. Upon deliberately "scratching" the neurons to mimic damage, they were astonished to witness the anthrobots moving towards the injured region, promoting neural growth.

The study said, “Taken together, these data reveal that Anthrobots are capable of efficiently moving across damaged tissues, and that bots that have a higher rotational tendency and or higher speed have higher degrees of unique coordinate coverage by moving across a higher percentage of the scratch interface.”

With respect to the ethical and safety concerns, CNN also mentioned “Levin said he didn’t think the anthrobots posed any ethical or safety concerns. 'They are not made from human embryos, research that is tightly restricted, or genetically modified in any way,' he said.”

https://timesofindia.indiatimes.com/etimes/trending/tiny-robots-created-from-human-cells-might-heal-wounds-study/articleshow/105679100.cms

Could lowering brain cholesterol reduce Alzheimer’s-like damage?

Clearing cholesterol ester-buildup from the brain could help prevent diseases like Alzheimer’s.

In Alzheimer’s disease, a buildup of tau protein leads to the death of brain tissue.

New research has linked this tau buildup to the accumulation of cholesteryl esters — a form of lipid that is associated with inflammation. The findings suggest that clearing out these cholesteryl esters may reduce the brain damage and behavioral changes seen in people with Alzheimer’s, at least in mice so far.

However, the researchers emphasize that the compound used in their study is unsuitable for use in people, so they are looking for other therapies that have the same clearing effect.

Alzheimer’s disease is the most common form of dementia, affecting more than 6 million people in the United States. Alzheimer’s and other dementias impact close to 60 million peopleTrusted Source worldwide. These numbers are continuing to rise, and experts estimate that by 2050, there will be more than 150 million people with Alzheimer’s and other dementias around the globe.

Symptoms of Alzheimer’s, such as memory loss, confusion, and personality changes, are thought to be largely due to an abnormal buildup of two proteins in the brain — amyloid beta and tauTrusted Source. These proteins form plaques and tangles that damage and eventually destroy nerve cells in the brain. However, what causes the buildup is still the subject of research.

Now, a study in mice from researchers at Washington University School of Medicine in St. Louis has found that tau deposits in the brain are linked to the buildup of a form of cholesterol. When the mice were treated to reduce these cholesteryl esters, their brain damage and behavioral changes also reduced.

The research is published in the journal Neuron.

How genetics affects Alzheimer’s risk

Apolipoprotein E (ApoE) is a protein in the brain. It helps regulate the transport of cholesterol and other types of fat in the blood. There are several formsTrusted Source, or alleles, of the APOE gene that controls the production of this protein. APOE ε2 may provide some protection against Alzheimer’s. Roughly 5% to 10% of people have this allele, which may delay the onset of, or even prevent, Alzheimer’s. APOE ε3 is the most common allele. It has no impact on Alzheimer’s risk. APOE ε4 increases the risk for Alzheimer’s and is associated with earlier age of disease onset. About 15% to 25% of people have this allele, and 2% to 5% carry two copies. Having two copies of this allele increases the risk of developing Alzheimer’s more than having one.

The researchers carried out the current study in mice that had been genetically engineered to accumulate tau protein in their brain. By the age of 6 months, these mice started to develop signs of neurodegeneration, and at 9.5 months, they had severe brain damage and were unable to carry out usual mouse activities, such as nest building.

They further modified the mice by removing their APOE genes. They either replaced them with human APOE ε3 or APOE ε4 — or did not replace them.

“This interesting research further elucidates the intricate link between Apolipoprotein E4 (ApoE4), a significant genetic risk factor for Alzheimer’s disease, lipid accumulation and tau pathology, in a mouse model. Discovering potential therapeutic approaches, such as enhancing glial lipid efflux, holds promise for specific interventions in Alzheimer’s, offering hope for effective treatments.” — Dr. Emer MacSweeney, CEO and Consultant Neuroradiologist at Re:Cognition Health, who was not involved in the study.

Fatty buildup of cholesterol in the brain

In the mice with the APOE ε4 allele, areas of the brain that were damaged also accumulated fatty material, particularly cholesteryl esters. Most of this fatty buildup was in microgliaTrusted Source — immune cells in the brain.

When microglia accumulate a lot of lipids, they start to function abnormallyTrusted Source. They lose their ability to carry out phagocytosis (engulfing and destroying damaged tissue or pathogens), and they release pro-inflammatory cytokines, increasing inflammation in the brain.

“Microglia filled up with lipids become hyperinflammatory and start secreting things that are not good for the brain.”

— Dr. David M. Holtzman, the Barbara Burton and Reuben M. Morriss III Distinguished Professor of Neurology, Washington University in St. Louis, and senior author of the study.

Clearing cholesterol from the brain may lower inflammation

The researchers used an LXR agonistTrusted Source — one of an experimental class of drugs that lowers lipid levels in cells — to try to reduce inflammation and neurodegeneration in the mice.

Starting when the tau mice were six months old — the age at which neurodegeneration usually starts — scientists gave them the drug. Following the treatment, when the mice were 9.5 months old, they assessed them.

At 9.5 months, the mice that had been given the drug had significantly more brain volume than those that had received a placebo. In addition, they had lower levels of tau protein, fewer inflammatory cells, less inflammation, and less loss of synapses in their brains. They also retained their ability to build nests better than the mice given placebo.

On further investigation, the researchers found that the LXR agonist upregulates a gene called Abca1 that helps move cholesterol and other lipids out of cells.

“What’s exciting is that we see all these effects in an animal model that shares a lot of features with human neurodegenerative diseases. It shows that this kind of approach could have a lot of promise,” Dr. Holtzman said.

And this approach might benefit more than the brain, as Dr. MacSweeney told Medical News Today:

“Given the similarity between the mechanism driving the lipid-filled immune cells to damage the brain and the mechanism driving lipid-laden immune cells to cause vascular damage in atherosclerosis, a medication that could remove the lipid in both of these cells could have a double effect, benefiting the brain, heart, and blood vessels.”

Treatment may be toxic to the liver

Although this study shows potential, the treatment cannot be used in people as it has severe side effects. LXR agonists affect lipid metabolism in the liver and can cause fatty liver disease.

“The next phase requires a solution to render this potential type of treatment not toxic to the liver in humans,” Dr. MacSweeney told MNT.

“This could, in turn, pave the way for early human studies to discover if this early work in mice could result in a particularly sought-after treatment for people with the Apolipoprotein E4 gene, who carry the highest risk of developing Alzheimer’s disease between the ages of 65–85. And all those suffering from Alzheimer’s disease and maybe also atherosclerosis,” she added.

One alternative could be genetic methods. The research found that increasing Abca1Trusted Source levels had the same effect as drug treatment: less lipid accumulation, lower levels of tau, less inflammation, and reduced neurodegeneration.

“I think a gene therapy that increased Abca1 in the brain could have similar lipid-clearing effects,” Dr. Holtzman said.

“It’s an exciting time for Alzheimer’s research as we gain more insight into the disease and treatment pathways,” Dr. MacSweeney added.

https://www.medicalnewstoday.com/articles/lowering-brain-cholesterol-reduce-alzheimers-damage

Regular coffee consumption may help prevent IBS, but it's not for everyone

Drinking coffee may help protect against the development of irritable bowel syndrome or relieve its symptoms for some people, according to a new meta-analysis.

The meta-analysis included data from 432,022 participants across eight studies. In five of them, coffee was protective against the condition, while three suggested the opposite. Irritable bowel syndrome affects women more frequently than men.

A recent meta-analysis examining data from several studies of the same subject to determine overall trends found that consuming coffee may help prevent and relieve irritable bowel syndrome (IBS). The meta-analysis hopes to make sense of conflicting reports, and, indeed, it suggests that coffee’s protection against IBS may not apply to everyone.

According to the meta-analysis, coffee drinkers are 16% less likely to develop IBS than people who do not drink coffee. This applies to people who drink any amount of coffee regularly.

The analysis was based on eight studies that met the researchers’ standards for analysis, selected from an initial group of 187 studies identified in the EMBASE, PubMed, and the Cochrane Library databases up to March 31, 2023.

To qualify, the studies had to be randomized, controlled studies, or cross-sectional studies that focused on the correlation between coffee drinking and IBS. They also had to be in English.

The final eight studies included 432,022 individuals.

The meta-analysis posits that the contradictory findings of previous studies may have to do with coffee’s complexity. It contains over a hundred compounds, which can vary considerably based on their source, how they were roasted, types of ground, and their method of preparation. These details are not always delineated in studies.

Many of the studies also relied on self-reporting questionnaires regarding both coffee and IBS, and that this could cause misclassification and confounding issues.

The meta-analysis appears in the journal Nutrients.

What’s the link between coffee and IBS?

The authors of the meta-analysis suggest that the connection between the two has to do with coffee’s bioactive molecules.

The study’s senior investigator, Dr. Qin Xiang Ng, from the National University of Singapore, explained to Medical News Today:

“Coffee is a polyphenol-rich beverage. Coffee contains several bioactive compounds, such as polyphenols, diterpenes, trigonelline, and melanoidins.”

Gastroenterologist Dr. Babak Firoozi, not involved in this research, also emphasized that compounds found in coffee “have antioxidant, anti-fibrotic, and anti-inflammatory properties, as well as an influence on gut microbiota, bile acids, motility of the intestines, and intestinal permeability.”

“These properties can potentially have a beneficial impact on IBS,” said Dr. Firoozi.

Why coffee is not good for everyone’s gut health

Dr. Ng said that of the eight studies included in the meta-analysis, three actually found that coffee promoted IBS.

“It is important to note, however, that all three studies were cross-sectional in design, may contain several biases, and cannot establish causation between coffee consumption and the risk of IBS,” he cautioned.

Cross-sectional studies only detect associations and cannot prove a causal relationship between them.

Dr. Firoozi explained that the results of these three studies may not be so surprising, given that coffee can sometimes upset digestion.

“Coffee can also be a potent cathartic through many of these bioactive compounds. Not only can caffeine in coffee stimulate motility, but other molecules in coffee promote bowel movements through increased intestinal transit,” he explained.

“Therefore, coffee in some with diarrhea predominant IBS may not be of benefit and could actually make symptoms worse,” said Dr. Firoozi.

As a result, he said, “I don’t recommend regular coffee intake solely for IBS.”

He added that the story is different for patients with fatty liver disease. For them, he recommends at least one cup of coffee each day, including decaffeinated coffee. Coffee, he said, “has been known to reduce fibrosis in the liver. It also helps prevent gallstones.”

Meta-analysis adds to existing research on IBS

“This is a very interesting study, which lays out the potential benefits of coffee and its positive impact on IBS. That positive impact includes altering the gut microbiota, improving motility and permeability of the intestines, and reducing the sensitivity of the intestines,” said Dr. Firoozi about the meta-analysis.

“However, meta-analysis results can be incomplete and may be difficult to interpret with confidence,” he noted.

“I hope that this study will lead to a more robust, long-term longitudinal study that looks at the effects of coffee consumption not only on preventing IBS, but also as an intervention to help those people with the symptoms of IBS,” added Dr. Firoozi.

Reflecting on the importance of this meta-analysis and future research directions,

Dr. Ng told MNT:

“On the whole, the current evidence suggests a potential protective effect of coffee against IBS. We know that drinking coffee is safe at expected human consumption levels, and coffee may have health benefits for the gut that should be further studied in large prospective cohort studies.”

How common is irritable bowel syndrome?

IBS is a common gastrointestinal disorder. It causes the gastrointestinal tract to become hypersensitized and may cause bowel muscles to contract.

The result is pain in the abdomen, bloating, cramping, constipation, and/or diarrhea. IBS is also frequently accompanied by excessive gas.

However, IBS does not increase a person’s risk of developing colorectal cancer.

A 2020 studyTrusted Source of data from 34 countries, including 82,476 individuals, found that somewhere between one in 11 and one in 26 people have IBS, depending on how it is defined.

It strikes more women than men, and its incidence varies according to geographic location. There is evidenceTrusted Source that it is more common in higher-income nations.

https://www.medicalnewstoday.com/articles/drinking-coffee-may-prevent-irritable-bowel-syndrome-ibs

Telltale signs of Vitamin D deficiency in children; measures to lower the risk

Does your child often complain of muscle cramps or suffer from weak immunity? Vitamin D deficiency can lead to these signs and symptoms in kids.

Vitamin D deficiency is growing in children more so post pandemic as the little ones stayed cooped inside their houses and got fewer opportunities to play outside due to Covid-induced lockdowns. The deficiency is more common in the age group of 2-14. There are other risk factors that can lead to Vitamin D deficiency in children. Premature babies, children who do not have enough milk or those who do not get sunlight are at risk. 151.9 million children were found have Vitamin D deficiency in India in 2019, as per a report by Nature, released in October 2022. Limiting children's screen time and feeding them foods rich in Vitamin D like fish, liver oil, eggs, milk, butter, cheese, mushroom and vegetables high in vitamin D like spinach, kale, okra, and collard greens can help.

Limiting children's screen time and feeding them foods rich in Vitamin D like fish, liver oil, eggs, milk butter, cheese, mushroom and vegetables high in vitamin D like spinach, kale, okra, and collard greens can help.

"Vitamin D plays a crucial role in the development of a child. It keeps our body healthy and strengthens bones and muscles. It also helps the body absorb calcium and phosphorus from foods and supplements, safeguarding against heart disease, high blood pressure, diabetes, infections, immune system problems, cancer (colon, breast, and prostate) and multiple sclerosis. However, its deficiency may take a toll on physical and mental health," says Dr. Sanjeev Dutta, HOD and Sr. Consultant - Neonatology & Paediatrics, Marengo Asia Hospitals, Faridabad.

Causes of Vitamin D deficiency

Dr Dutta says lack of sun exposure, playtime and unhealthy diet is behind the vitamin D deficiency among children.

"Today there is a high reduction in children 's physical activities as they prefer to socialise online than outdoors. They also spend more time on screen, making them low on natural vitamin D -sunshine vitamin. Babies who are born prematurely or those who are breastfed, children who do not drink enough milk, children who spend most of their time indoors or live in a cloudy or cold climate most of the time, are prone to develop this deficiency. Obese kids are more vulnerable to vitamin D deficiency as Fat cells hold the body back from using vitamin D," he adds.

Symptoms of Vitamin D deficiency

Most common symptoms of Vitamin D deficiency reported among children include muscle weakness or cramps, slow growth, weak immunity, bone pain, osteomalacia (softening of the bones), fatigue, or depression.

"The condition is seen most in 2–14-year-old children. Owing to prolonged and severe vitamin D deficiency, Children and infants are also likely to develop rickets. The illness rickets may lead to softening, thinning, weakening and deforming of the bones that can occur in growing children. Reduced levels of Vitamin D in young children also raise the risk of hormonal imbalance like parathyroid, testosterone and progesterone. In the long term, Vitamin D deficiency can become the cause of skeletal deformities, brittle bones, frequent fractures and premature osteoporosis. Its deficiency may also hamper the mental health of a child as well," said Dr Dutta while explaining the long term and short-term implications of Vitamin D deficiency.

How to lower risk of Vitamin D deficiency

Dr Dutta shares the following tips:

To treat Vitamin D deficiency in children, Vitamin D supplements are prescribed.

Sunlight is the best source of Vitamin D therefore a daily exposure to sunlight at least 30 minutes is highly advisable.

Avoid spicy and oily food items, replace them with highly nutritious food like fish, liver oil, eggs, milk butter, cheese, mushroom and vegetables high in vitamin D (spinach, kale, okra, and collard greens).

Limit children's screen time and allow them play outside daily for at least one or two hours that will help in their physical development.

https://www.hindustantimes.com/lifestyle/health/telltale-signs-of-vitamin-d-deficiency-in-children-measures-to-lower-the-risk-101701609417828.html

What is white lung syndrome? Signs, symptoms and preventive measures of mystery pneumonia

White lung syndrome is emerging as a new health concern among children. From symptoms to preventive measures, all you want to know about the outbreak.

After the outbreak of mystery pneumonia among China's paediatric population, a similar illness has been raising child hospitalisation cases in Ohio, US. Referred to as the White Lung Syndrome, the illness is characterized by white patches all over the lungs and children affected by it have been experiencing symptoms such as cough, fever and fatigue. Kids under five may reportedly have sneezing, a stuffy or runny nose, watery eyes, wheezing, vomiting and diarrhoea. Health officials in Ohio feel the current outbreak isn't due to a novel respiratory virus and could be due to Covid, flu, RSV, or mycoplasma. Experts have advised to get children vaccinated in order to prevent them from the outbreak apart from healthy lifestyle measures like balanced diet, physical activity and good sleep.

What is white lung syndrome?

"The term was coined to describe a mysterious respiratory illness that began to be seen among patients in China primarily with pneumonia-like symptoms. In China, it was found to be due to a combination of various respiratory illnesses, including influenza, SARS-CoV-2 (Covid-19), Respiratory syncytial (RSV), and mycoplasma pneumoniae. Although it's not considered a new disease, the world which has still not forgotten Covid-19 is in a state of alert! And rightly so, as the number of cases has seen a huge spike," says Dr Ravi Dosi, Consultant, Pulmonary Medicine at Kokilaben Dhirubhai Ambani Hospital, Indore.

"White lung syndrome is emerging as a new health issue of global concern. The term was first associated with an outbreak of a respiratory illness in China. It now describes a similar wave of pneumonia that is affecting children across the U.S. Since August this year, around 150 paediatric pneumonia cases have been reported especially in Warren County, Ohio, mirroring a similar outbreak in China. This is once again raising concerns among health officials globally and the exact cause of this outbreak is currently under investigation by health authorities," says Dr Dosi.

"It's a respiratory infection caused by multiple microorganisms (influenza, mycoplasma etc) leading to development of pneumonia.

On CXR it appears as white patches in lungs. Since it's a sudden outbreak (in China) and rapidly spreading, hence the name white lung syndrome is coined to identify this outbreak quickly," says Dr S Vidya Nair, Sr. Consultant, Pulmonology, Marengo Asia Hospitals, Faridabad.

Symptoms of white lung syndrome

"In this, white patches in the lung are formed all over the organ. It can be called as a white lung pneumonia or white lung syndrome. At the moment, we are seeing this in China. Many of the children are having both lungs' involvement because of pneumonia and the symptoms start from upper respiratory infection and then it moves to lower respiratory tack that is lung. Patient start having infection, fever, cough, other symptoms, sore throat, watery eye skin rash or symptoms like diarrhoea," says Dr Vikas Maurya, Director and HOD Pulmonology, Fortis Shalimar Bagh.

"The most common symptoms among affected children include cough, fever, and fatigue. We must visit a doctor promptly as early medical intervention helps to ensure proper diagnosis and treatment," says Dr Dosi.

"The clinical symptoms and signs are similar to previous respiratory infections caused by influenza and other atypical pneumonia causing bugs. The symptoms start with flu like symptoms and then progressing to cough, wheezing breathlessness and development of pneumonia," says Dr Maurya.

"White lung syndrome is emerging as a new health issue of global concern. The term was first associated with an outbreak of a respiratory illness in China. It now describes a similar wave of pneumonia that is affecting children across the U.S. Since August this year, around 150 paediatric pneumonia cases have been reported especially in Warren County, Ohio, mirroring a similar outbreak in China. This is once again raising concerns among health officials globally and the exact cause of this outbreak is currently under investigation by health authorities," says Dr Ravi Dosi, Consultant, Pulmonary Medicine at Kokilaben Dhirubhai Amabani Hospital, Indore.

Treatment

The treatment is mainly focused on addressing the symptoms of pneumonia and ensuring the respiratory health of the patients. Medicines are given to alleviate symptoms like cough and fever. overall monitoring must be done and oxygen therapy provided if necessary.

"In the US, this is the flu season, one more factor leading to more worry. It is important to take preventive measures not just in the US, but also for us here in India. These include following personal hygiene such as hand washing, covering mouths when coughing, staying at home if ill, and ensuring that we take the flu vaccinations that are available today. With the year-end festivities coming up, we must be careful to take all precautions especially when attending any gathering, where the risk of contracting a respiratory infection is higher," says Dr Dosi.

"Precautions like hygiene, mask, physical distancing can decrease the risk of respiratory infections including virus or micro plasma like bacteria. Vaccination is also very important. That said if you get the vaccine for influenza, it will not take care of all the viruses but yes will take care of at least influenza," says Dr Maurya.

"Stay at home in case of any flu like symptoms and consult a respiratory specialist. All chronic respiratory patients must strictly continue the medications/inhalers prescribed, any change in symptom warrants review consultation," says Dr Nair.

https://www.hindustantimes.com/lifestyle/health/what-is-white-lung-syndrome-signs-symptoms-and-preventive-measures-of-mystery-pneumonia-101701606304045.html

4 shame-based trauma responses seen in Complex PTSD

From over-sharing to over-apologising, here are four shame-based trauma responses seen in people with Complex PTSD.

Complex post-traumatic stress disorder is the condition where a person experiences the symptoms of PTSD along with additional symptoms such as severe difficulty in controlling their emotions and feeling a sense of distrust for the world. Complex PTSD also causes people to respond to trauma situations in an extreme manner. Shame-based trauma responses in the case of Complex PTSD can depend on the past experiences of the person concerned. "The walk of recovery. Building self-esteem when you have C-PTSD is a layered process. It's not just about feeling good in the moment; it's about creating a strong foundation for long-term emotional well-being," wrote Therapist Linda Meredith. 

Here are four shame-based trauma responses seen in people suffering with Complex PTSD:

Over-apologising: Often Complex PTSD happens to people who have dealt with situations and experiences where they have been treated like a scapegoat. This further makes them use the survival skill of over-apologising and avoiding conflict at any cost. They feel that staying away from arguments will make people like them and this can protect them.

Over-trusting: People with Complex PTSD keep believing that people will love and care for them. Hence, they become vulnerable and emotionally connected to everyone. This further sets them up for heartbreak when they realise that they have been betrayed.

Over-thinking: The cycle of thinking of the past trauma and trying to connect the dots with the present happenings keep people with Complex PTSD in a constant loop of thought. This further causes anxiety and depression as they try to unravel the happenings and think of the worst-case scenarios. This can mentally and emotionally drain them as well.

Over-sharing: People with Complex PTSD try to fast track intimacy and emotional connection by over-sharing information and connect based on trauma. Sometimes, over-sharing is done to push people away as well.

https://www.hindustantimes.com/lifestyle/health/4-shame-based-trauma-responses-seen-in-complex-ptsd-101701664502418.html

Liver specialists want you to minimise alcohol drinking right away; here’s why

The liver is a resilient organ, capable of regenerating and repairing itself, but even this remarkable ability has its limits, said Dr Ram Chandra Soni, chairman, gastroenterology and hepatology, Accord Superspeciality Hospital, Faridabad

Liver specialist Dr Saurabh Sethi encountered a patient in his 50s who was diagnosed with liver cancer. The sole risk was alcohol abuse and in the man’s case, it resulted in the blockage of the bile duct. “To relieve the obstruction, I did an ERCP (Endoscopic retrograde cholangiopancreatography) and placed a plastic stent into the duct to relieve his jaundice. The surgery was successful but unfortunately, the patient’s prognosis is bleak. I highly recommend to minimise alcohol consumption,” he said in a post on his Instagram.

Addressing concerns about addiction, Dr Sethi said that while it is tough to break the habit, he shared that many of his patients had succeeded given there are aids like counselling and support groups. “Please talk to your doctor,” he said.

Taking a cue from his message, we decided to ask experts why alcohol is toxic to your body and ways to give up the addiction.

Addressing the connection, Dr Ram Chandra Soni, chairman, gastroenterology and hepatology, Accord Superspeciality Hospital, Faridabad shared, “In my whole career, I have met and treated many patients, and if there’s one thing I can confidently attest to, it’s the alarming connection between alcohol consumption and liver diseases.”

The liver is a resilient organ, capable of regenerating and repairing itself, but even this remarkable ability has its limits, remarked Dr Soni. “Excessive alcohol intake pushes the liver to its breaking point, leading to a cascade of problems that can be devastating. Regular and heavy drinking can lead to fatty liver disease, cirrhosis, and even liver cancer.

The liver processes alcohol, breaking it down into harmful byproducts that can damage its cells. Over time, this damage accumulates, causing inflammation, scarring, and a loss of function. It’s a slow, insidious process that often remains unnoticed until it’s too late,” explained Dr Soni.

It’s not just the quantity of alcohol; the frequency matters too. “Binge drinking or regular moderate drinking can also take a toll on the liver. What many don’t realise is that even a single episode of heavy drinking can trigger a severe form of liver inflammation, known as alcoholic hepatitis, which can be life-threatening,” said Dr Soni.

As a gastroenterologist and hepatologist, he implores people “to listen to your liver’s silent cries”. “Quit alcohol now, or at least drink in moderation. Your liver is a precious organ, working tirelessly to keep you healthy. It’s time to return the favour and take your liver’s health seriously. Don’t become another statistic in the growing number of liver disease cases caused by alcohol,” said Dr Soni.

Medications and therapy may be necessary for those with severe alcohol dependence, said Dr Mukesh Nandal, consultant, gastroenterology, Narayana Hospital Gurugram. “Surround yourself with a supportive network and set realistic goals. Remember, the journey to sobriety is a path to a healthier, happier life,” said Dr Nandal.

https://indianexpress.com/article/lifestyle/life-style/liver-specialists-want-you-to-minimise-alcohol-drinking-right-away-heres-why-9018678/

Can diabetes lead to hair loss?

Poorly controlled diabetes can also trigger telogen effluvium, where hair prematurely enters the resting phase, resulting in increased shedding, said an expert

High glucose levels, a hallmark of diabetes, can significantly affect hair health, experts urge. Keep in mind that your lifestyle impacts your hair quality too.

High glucose levels in diabetes can contribute to hair loss through various mechanisms. Dr Gaurav Jain, senior consultant, internal medicine, Dharamshila Narayana Suprspeciality Hospital mentioned that elevated blood sugar levels can lead to poor circulation, affecting blood flow to the hair follicles. “This diminished blood supply hinders the delivery of essential nutrients to the hair, impairing its growth and strength,” said Dr Jain.

One of the most noticeable impacts is alopecia areata, an autoimmune condition more common in those with Type 1 diabetes, leading to patchy hair loss, said Dr Anantharaman, consultant – endocrinology, Chinmaya Mission Hospital, Bengaluru.

Poorly controlled diabetes can also trigger telogen effluvium, where hair prematurely enters the resting phase, resulting in increased shedding. “The reduced blood flow due to damaged blood vessels in diabetes slows hair growth and leads to thinner hair,” stressed Dr Anantharaman.

Furthermore, diabetes can cause hormonal imbalances, including increased levels of dihydrotestosterone (DHT), a hormone linked to hair loss. Dr Jain said that DHT can shrink hair follicles, leading to a shorter lifespan for each hair strand and eventual thinning.

Moreover, people with diabetes might experience heightened susceptibility to fungal infections and conditions like seborrheic dermatitis, adversely affecting the scalp and hair. Inflammation is another factor; diabetes often involves chronic inflammation, which may negatively impact hair follicles. “This inflammatory environment can disrupt the normal hair growth cycle, pushing more follicles into the shedding phase,” said Dr Jain.

In summary, the intricate interplay of impaired circulation, hormonal imbalances, inflammation, and complications associated with diabetes can collectively contribute to hair loss. “Managing blood sugar levels, adopting a healthy lifestyle, and seeking medical advice are crucial steps in mitigating this potential complication,” Dr Jain said.

According to Dr Anantharaman, to mitigate these issues, maintaining optimal blood sugar control is crucial. “However, since hair loss can stem from various factors, a comprehensive evaluation by a healthcare provider is advisable for personalized advice and treatment,” said Dr Anantharaman.

https://indianexpress.com/article/lifestyle/life-style/high-glucose-levels-diabetes-hairloss-hormonal-9037559/

 

Signs of Analysis Paralysis we should be aware of

From overthinking about the consequences to second-guessing ourselves, here are a few signs of Analysis Paralysis we should know about.

Analysis Paralysis is the condition where we get so overconsumed by the thoughts of consequences that we are not able to take decisions without having severe anxiety and worries about the same. "Such a situation can lead to prolonged decision-making, as you become fixated on minor details, hindering your progress. To conquer analysis paralysis, a blend of self-reflection, planning, and action is key," wrote Therapist Carolyn Rubenstein. Here are a few signs of Analysis Paralysis that we should be aware of.

We focus on the minor details so that that we keep dwelling on smallest of mistakes and overburden ourselves with that.

We always feel that the decision we take will have grave consequences and we will be responsible for the same – this causes us to have more anxiety.

Overthinking of the potential negative consequences makes us replay the outcomes in the head and think of the scenarios that can happen.

We often get overconsumed with the thought of the topic in hand and research it for hours before arriving at a decision about it.

Even after taking a decision, we are never confident about it – hence, we second-guess ourselves and feel dissatisfied. 

https://www.hindustantimes.com/photos/lifestyle/signs-of-analysis-paralysis-we-should-be-aware-of-101701363611674.html

Robotic liver transplant: When and who should do it?

Not aware of the robotic liver transplant? Here's what exactly it is, who can opt for it, how the patient is prepared for it and the benefits.

A robotic liver transplant is a great option when compared to conventional liver transplant surgery where typically, surgeons execute liver transplants to substitute a malfunctioning or injured liver due to liver failure with a healthy one but in a robotic liver transplant, the replacement procedure is carried out using automated arms rather than the surgeon's hands or laparoscope. This approach renders the surgery significantly less invasive compared to other types of liver transplant surgeries, enhancing surgical precision and results.

When and who should do a robotic liver transplant?

In an interview with HT Lifestyle, Dr Gaurav Chaubal, Director of Liver, Pancreas, Intestine Transplant Program and HPB Surgery at Global Hospitals in Parel, answered, “These high-precision surgeries, often regarded as a soothsayer for complex hepatic ailments, are most effective on those grappling with disorders including hepatocellular carcinoma (liver cancer), cirrhosis (scarring of the liver), and biliary atresia that may lead to serious liver impairment. Deciding when to undergo a robotic liver transplant can be tricky but is typically suggested for patients who are at stage 3 or higher in chronic diseases or mostly guided by serious or life-threatening damage inflicted upon the patient's liver functions.”

How is the patient prepared for this type of transplant?

Dr Gaurav Chaubal revealed, “Before undergoing a liver transplant, your doctor will review your health history and conduct various tests. If you are deemed healthy enough, a compatibility test may be carried out if the organ is from a live donor to avoid any potential rejection. The doctor will instruct you to abstain from eating at least 6 hours prior to the operation. On the day of the procedure, the expert team of doctors will explain it in detail and take note of your recent meal intake. Also, the heart rate, blood pressure, and respiration rate will be monitored before being transferred into the operating room.”

How is a robotic liver transplant is carried out?

According to Dr Gaurav Chaubal, “Liver transplants are only considered for individuals suffering from incurable complications such as cirrhosis due to end-stage liver diseases. The healthy liver required for the procedure can be obtained from a deceased (cadaveric or non-living) donor or a living person. Robotic liver transplant surgery involves the use of mechanical arms that create smaller cuts than traditional open or laparoscopic surgeries. This method is employed to remove the liver from the donor (a process known as hepatectomy) and implant it into the recipient (the transplant process). Initially, surgical markings are made on the abdomen of both parties involved, after which minor incisions enable the insertion of instruments by mechanical arms.”

He added, “These incisions also allow for a camera arm's movement, providing a three-dimensional view of the operation area. With these arms' help, he/she meticulously detaches the diseased liver from surrounding blood vessels, organs, and structures before securing it. The mechanical arms then extract this damaged organ and replace it with a healthy one, reconnecting them to nearby structures and blood vessels. Once blood circulation is reestablished and any remaining bleeding has ceased, sutures are used to close up incisions before applying sterile dressing at the operation site. Post-operation monitoring takes place over several days to ensure there's no infection while also evaluating whether or not the body has accepted its new organ.”

The benefits:

Dr Gaurav Chaubal explained, “Gone are the days when liver transplant surgeries required large incisions, led to longer hospital stays, and came with significant risks of complications. The advent of robotic liver transplants is revolutionizing this space offering a plethora of benefits that contribute towards better patient outcomes and improved quality of life post-surgery. Robotic liver transplants ensure precision.”

He elaborated, “This technology-driven approach provides surgeons with unparalleled 3D visualization which opens up the avenue for more precise movements. Moreover, less intrusion into the body means fewer chances for infection, reduced pain levels, and lightning-fast recovery times. Patients can get back on their feet sooner than expected and reclaim their livelihoods swiftly and smoothly.”

Follow-up and recovery after the transplant:

Dr Gaurav Chaubal concluded, “You will be required to go for regular check-ups and follow-ups as suggested by the hospital. The doctor will explain to you about when to eat solid food. Even after recovering, you will have to follow a well-balanced diet, abstain from alcohol, smoking, or illicit drugs, sleep well, maintain an optimum weight, and take medications prescribed by the doctor only.” 

https://www.hindustantimes.com/lifestyle/health/robotic-liver-transplant-when-and-who-should-do-it-101701334863026.html

Anaemia in India: Impact on reproductive health and tips to prevent it

Understanding Anaemia in India, how it impacts reproductive health and tips to prevent it

Our body contains red blood cells (RBC), which are disc-shaped cells that transport oxygen to the various organs and tissues and a person with a low count of RBC is said to have anaemia. The human body requires a good oxygen supply to perform its functions adequately and when a person suffers from anaemia, they experience symptoms like fatigue and shortness of breath, resulting from poor oxygen delivery to the vital organs and tissues of the body.

In an interview with HT Lifestyle, Alok Khettry, COO India Business at Bharat Serums and Vaccines Limited (BSV), explained, “RBC also contains haemoglobin, an iron-rich protein that binds oxygen to the lungs and allows the cells to transport it throughout the body. To diagnose a person with anaemia, a healthcare professional will measure the amount of haemoglobin they possess in their blood. According to the National Family Health Survey 5 (2019-21), the prevalence of anaemia in India is 25 percent in men (15-49 years) and 57 percent in women (15-49 years).”

What causes anaemia in a person?

Alok Khettry revealed, “Each RBC has a lifespan of 100-120 days and is produced by the bone marrow. On average, the bone marrow produces two million RBC each second, while the same amount is removed from circulation. In this regard, balancing the production and removal of RBC is critical, as any adverse effect on this process can cause anaemia. This means that in a person suffering from anaemia, either the production of RBC is too low or the destruction of RBC is too high.”

He added, “Decreased red blood cell production: Most factors that lead to reduced production of RBC fall in either of the two categories, namely acquired or inherited. Acquired factors that can decrease RBC production include an imbalanced diet that lacks iron, vitamin B12, and folate, which are essential for RBC production, kidney disease, some types of cancer like leukemia and lymphoma, autoimmune diseases, HIV, tuberculosis, hypothyroidism, certain types of medications or treatments, particularly chemotherapy and radiation therapy for cancer and exposure to toxins, such as lead to name a few.”

Pointing out that genetic conditions like Fanconi anaemia, Schwachman-Diamond syndrome and congenital dyskeratosis can also cause anaemia in individuals, Alok Khettry said, “Increased red blood cell destruction: These conditions can also be acquired or inherited. Some acquired factors include blood loss because of accidents or injuries, surgery, heavy menstrual bleeding, childbirth, endometriosis, and gastrointestinal lesions, such as ulcers or those due to IBD or cancer. It can also be caused by hemolysis, which occurs when the RBC breaks down too soon due to various reasons like autoimmune activity, certain infections, medication side effects, and exposure to toxins.”

Additionally, conditions like an enlarged spleen, liver diseases such as hepatitis or cirrhosis and infections like malaria can also cause anaemia. Some inherited causes of increased red blood cell destruction include sickle cell disease, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and thalassemia.

How does anaemia affect reproductive health?

During pregnancy, a woman can be diagnosed with various types of anaemia, which can cause both short-term and long-term complications to her reproductive health. According to Alok Khettry, the specific reason behind the anaemia is generally dependent on the type - Anemia of pregnancy: During pregnancy, the blood volume increases substantially. This means the iron and vitamins needed to make this higher RBC also rise. If the pregnant woman doesn’t consume enough iron-rich food, it will lead to anaemia. This is not considered abnormal unless the RBC count is too low.

Iron-deficiency anaemia: During pregnancy, the unborn baby uses the RBC of the mother for its growth and development, especially in the last three months of pregnancy. If a pregnant woman has extra red blood cells stored in her bone marrow before she gets pregnant, her body will use these stores during pregnancy. However, if a woman does not have enough iron stores, they can suffer from iron deficiency anaemia during pregnancy. This is the most common type of anaemia in pregnancy. Good nutrition, both before and during pregnancy, is vital to help build up these stores.

Vitamin B-12 deficiency: Vitamin B-12 is another critical mineral for making RBC and haemoglobin. Eating animal-based food like milk, eggs, meats, and poultry helps prevent vitamin B-12 deficiency. Women who eat vegetarian meals are at a higher risk of contracting vitamin B-12 deficiency. During pregnancy, these women may need vitamin B-12 shots to avoid complications.

Folate deficiency: Folate (folic acid) is a B vitamin that works with iron to ensure cell growth. If pregnant women do not consume enough folate during pregnancy, they could get iron deficiency. In addition, folic acid reduces the risk of having a baby with congenital disabilities of the brain and spinal cord, especially if it is consumed in the early periods of pregnancy.

How can anaemia be prevented?

Alok Khettry suggested, “Besides spreading awareness about the complications and impact of anaemia on the reproductive health of women, screening tests must be conducted at hospitals and healthcare facilities across the country. Good nutrition before and during pregnancy can also be vital in preventing anaemia and building a rich nutritional store in the body. A good, balanced diet will help women deliver healthy babies and recover faster from the process of childbirth as well.”

He highlighted, “Some good food sources of iron include meats including beef, pork, lamb, liver, and other organ meats, poultry including chicken, duck, turkey, and liver, especially dark meat, fish including shellfish, sardines, anchovies, clams, mussels, and oysters (all should be well cooked and avoid fish with high mercury content), types of cabbage including broccoli, kale, turnip greens, and collards, legumes like lima beans, green peas, canned baked beans, yeast leavened whole wheat bread and iron-enriched white bread, pasta, and cereals.”

Collaborative Solutions for a Healthier Future

Alok Khettry concluded, “In the collective effort to understand and address anaemia's impact on reproductive health, collaboration is key. Healthcare professionals, community leaders, policymakers, and individuals can work together to foster a culture of open dialogue and proactive health measures. Through combined efforts, we can script a narrative of resilience, health, and hope for future generations.

In essence, understanding anaemia in India and its effects on reproductive health requires a collective acknowledgment of its prevalence, breaking cultural barriers, emphasizing nutrition, and advocating for systemic changes. By addressing these facets, we can pave the way for a healthier and more informed tomorrow.”

https://www.hindustantimes.com/lifestyle/health/anaemia-in-india-impact-on-reproductive-health-and-tips-to-prevent-it-101701353463341.html