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World Thalassemia Day

All about Thalassemia

May 8th, 2020

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All about Thalassemia

Friday, May 8th, 2020

What is thalassemia?
Red blood cells transport oxygen throughout the body; haemoglobin is the protein in red blood cells that carries the oxygen. Thalassemia is an inherited blood disorder that affects the body’s ability to produce normal haemoglobin. People who have thalassemia produce fewer healthy haemoglobin proteins, and their bone marrow produces fewer healthy red blood cells. Haemoglobin is important because it lets your red blood cells carry oxygen to all parts of your body.

In India, every year 10,000 children are being born with thalassemia which approximately accounts for 10% of the total world incidence of thalassemia-affected children. 1 in 8 thalassemia carriers live in India.  In India, there are nearly 42 million carriers of the β-thalassemia trait.

Causes
Thalassemia is caused by mutations in the DNA of cells that make hemoglobin — the substance in red blood cells that carries oxygen throughout your body. The mutations associated with thalassemia are passed from parents to children.

Types of thalassemia
Types of thalassemia are defined by two things: the specific part of hemoglobin that is affected (usually either “alpha” or “beta”), or the severity of thalassemia, which is noted by words like trait, carrier, intermedia, or major.

Hemoglobin, which carries oxygen to all cells in the body, is made of two different parts, called alpha and beta. When thalassemia is called “alpha” or “beta,” this refers to the part of hemoglobin that isn’t being made. If either the alpha or beta part is not made, there aren’t enough building blocks to make normal amounts of hemoglobin. Low alpha is called alpha thalassemia. Low beta is called beta thalassemia.

When the words “trait,” “minor,” “intermedia,” or “major” are used, these words describe how severe the thalassemia is. A person who has thalassemia trait may not have any symptoms at all or may have only mild anaemia, while a person with thalassemia major may have severe symptoms and may need regular blood transfusions to survive.

The symptoms of Thalassemia include:

  • Slow growth in children.
  • Wide or brittle bones.
  • Weakness.
  • Pale or yellow skin.
  • Enlarged spleen.
  • Fatigue.
  • Dark urine.
  • Poor appetite.
  • Heart problems.

In some people, symptoms show up at birth. In others, it can take a couple of years to see anything. Some people who have thalassemia will show no signs at all.

Treatment
With a mild case, you may feel tired and not need treatment. But for serious cases you need regular blood transfusions. A transfusion is a way to get donated blood or parts of blood that your body needs, like haemoglobin. How often you need transfusions can vary from person to person. Sometimes, transfusions of blood cause reactions like high fever, nausea, diarrhoea, chills, and low blood pressure.

Complications
People with moderate thalassemia have an increased risk of infection and also suffer from iron overload. Some people with severe thalassemia have other health problems, like bone deformities, heart or liver disease.

Living with Thalassemia
It is possible to live a healthy life with Thalassemia. Follow these health tips to stay healthy:

  • Don’t take iron pills.
  • Ask your doctor about supplements like calcium and vitamin D.
  • Stay away from sick people and wash your hands often.
  • Eat a healthy diet to keep your bones strong and give you energy.

Myths and Facts
Myth: Thalassemia carrier couples will always have Thalassemia Major children.
Fact: That is not true. When both the partners are Thalassemia carriers there is 25 percent chance of having a Thalassemia Major child, 50 percent Thalassemia Minor and 25 percent normal i.e. not even a carrier. And if only one or none of the couple is a carrier, none of the child will be a Thalassemia Major.

Myth: Thalassemia is not preventable.
Fact: Thalassemia is 100 percent preventable. Thalassemia can be easily prevented by pre-marital screening or early pregnancy screening followed by marriage counselling and antenatal diagnosis if required.

Myth: There is no treatment for Thalassemia Major.
Fact: Thalassemia Majors can live normal life if they are given adequate blood transfusion and iron chelation therapy.

Myth: Thalassemia cannot be cured.
Fact: Thalassemia can be cured by bone marrow transplantation but it requires HLA matched siblings. However, HLA matched donor is not always available.

Thalassemia and COVID-19

There is no evidence that thalassemia trait makes carriers more susceptible to the virus. Patients with beta thalassemia trait (or minor) have no increased risk of infection from the coronavirus, compared to other healthy individuals. Therefore it is best to follow the advice of regular hand wash and social distancing to prevent COVID-19.

Patients suffering from thalassemia major must continue with their blood transfusion schedule. Follow high levels of personal hygiene, wear a mask and practice social distancing at the hospital too. Check with your healthcare provider for the safest possible environment for receiving transfusions.

Get expert advice and treatment for Thalassemia at our specialised Thalassemia Clinic. Please find below link for more details:

https://www.kokilabenhospital.com/departments/clinicsatkh/thalassaemia.html

Stress And The Lockdown – The Warning Signs

Wednesday, April 22nd, 2020

There is the ACTUAL CONTAGION, the actual disease of the pandemic itself. And then there is the SYMBOLIC CONTAGION characterized by a blitz of misinformation, uncertainty, doubts, fear and panic, where coping mechanisms become overwhelmed. Where thoughts/emotions/behaviors become uncontrolled and the mindset switches from “Living”to “Survival”.

Faced with sudden social isolation or quarantine, individuals may react with fear and anxiety, which can then give way to depression and despair, or anger and acting out. A person may be faced with the realization that their plans for their immediate future have suddenly to be changed. They may have to be taken to an unfamiliar setting and separated from their families. They could be anxious about their own health, concerned that they could fall ill at any given time. Their anxiety may likely be worsened if they feel they are unable to conduct their routine affairs or to provide for their dependents. Similarly, from the other side of the social isolation barrier, families and loved ones of those who are in quarantine and isolation may also be very concerned both in terms of their health and capability to provide for dependents in the absence of the isolated person(s). This coupled with loneliness,boredom,anger and frustration can be an explosive combination! This may give rise to symptoms of traumatic stress resulting in Adjustment Disorders, Depression, Phobic Disorders, Panic or Generalized Anxiety Disorders, Acute or Posttraumatic stress disorders.

How to recognize early warning signs of an emotional disorder –

  • unusual decrease in energy and activity level or listlessness
  • unusual restlessness and excessive worrying;
  • having trouble relaxing or sleeping;
  • severe anxiety or panic attacks
  • change in eating patterns;
  • easily startled and feeling as-if “on the edge” daily for most of the day;
  • constant complaining or blaming others without any reason with increased irritability and anger outbursts;
  • crying frequently;
  • recurrent unexplained headaches and other bodily pains,
  • increased use of alcohol, nicotine or other drugs;
  • excessive introversion or rebellious behaviors in children
  • some signs of anxiety in children may include bedwetting, thumb sucking, worsening of tics and hyperactivity

Tips to handle stress during period of social distancing:

1. BE REGULAR – Develop a daily routine

2. EAT small, regular, well-balanced meals. Avoid over-eating or fasting for long periods.

3. SLEEP – Get plenty of sleep, at least 8 hours per day

4. AVOID excessive use of nervous system stimulants like caffeine. Strictly avoid nicotine, alcohol and other addictive drugs which can lead to symptoms of withdrawal or unpleasant cravings.

5. WORK – Schedule a regular work pattern for office (if working from home)

6. SCHEDULE HOUSEHOLD TASKS – This can be shared with other family members too, if possible. This can lead to increased family bonding. But then the work needs to be done as fun activity or shared activity, rather than a burdensome task!

7. EXERCISE – Have a daily indoor exercise schedule, e.g. like skipping and on-the-spot jogging, sit-ups and push-ups. Even dance is good form of exercise. Yogic exercises are one of the best forms of indoor exercises. You may involve other family members too in your exercise routines. This too can lead to increased family bonding.

8. UNWIND – Do something fun after your daily tasksare over. Read your favorite book, listen to music or play your favorite indoor game. Practice deep breathing, stretching and relaxation exercises. For those having a tub at home, have a warm relaxing bath with aromatic essential oils.

9. DEVELOP A HOBBY – Learn something new – a language or a musical instrument or even how to type fast and accurately on a computer keyboard using both hands!

10. CONNECT WITH OTHERS – Share something positive or humor (jokes, poetry, funny stories, etc.) with your friends and family. Try to avoid sharing negative views and news. Social and news media are already filled that! If necessary, only occasionally you may share only the confirmed news and facts. Show empathy towards those who may be affected.

11. BE POSITIVE – Repeatedly remind yourself of the important and positive things in your life. Keep a diary of your thoughts. Write three good things that have happened to you during the day before you go to bed. Take this as an opportunity to try and help others. Do as much charity as possible in this hour of need.

12. POSITIVE SELF TALK– Tell yourself, “It is normal for people to experience stress and feel a bit anxious or low in this period of lockdown and social distancing. All have to go through with it. I am not alone. This too shall pass.”

13. SHUN NEGATIVITY – Don’t play the blame game. Don’t entertain the victim’s role in your mind. Take charge of your thoughts and emotions. If unable to do so, seek help from your nearest mental health professional.

14. OBEY THE LAW – Last but not the least, Social distancing means social physical distancing, not emotional distancing. People can remain in touch emotionally by means of telecommunication methods in the form of video calling, conference calling and online social media.

-This blog is written by Dr. Shaunak Ajinkya, Consultant, Psychiatrist at Kokilaben Dhirubhai Ambani Hospital. Read his entire profile at: https://www.kokilabenhospital.com/professionals/shaunakajinkya.html

World Parkinson’s Day

Friday, April 10th, 2020

World Parkinson’s Day 2020 is on Saturday, 11 April 2020. Parkinson’s disease is a progressive neurogenerative disease that causes nerve cells (or neurons) in the area of the brain that controls movement to weaken and/or die. While healthy neurons produce a chemical called dopamine, which the brain needs a certain amount to regulate movement, weakened neurons produce lower levels of dopamine. What causes these neurons to weaken is currently unknown.

Although Parkinson’s disease can’t be cured, medications and therapy helps control the symptoms. Occasionally, the doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms.

Symptoms

Parkinson’s disease signs and symptoms can be different for everyone. Early signs may be mild and go unnoticed. Here are the few signs and symptoms of Parkinson’s:

  • Tremor – A tremor, or shaking, usually begins in a limb, often your hand or fingers. Your hand may tremor when it’s at rest.
  • Slowed movement (bradykinesia) – Over time, Parkinson’s disease may slow your movement, making simple tasks difficult and time-consuming.
  • Rigid muscles – Muscle stiffness may occur in any part of your body. The stiff muscles can be painful and limit your range of motion.
  • Impaired posture and balance – Your posture may become stooped, or you may have balance problems as a result of Parkinson’s disease.
  • Loss of automatic movements – You may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.
  • Speech changes – You may speak softly, quickly, slur or hesitate before talking.
  • Writing changes – It may become hard to write, and your writing may appear small.
Risk factors

One’s risk of developing Parkinson’s Disease can depend on the following factors:

  • Gender – Men are 1.5 times more likely to have PD than women.
  • Age – The risk of PD increases with age, although some people are diagnosed with early-onset PD before the age of 50.
  • Genetics – Most cases occur in patients with no familial link to PD, but some have an inheritance pattern involving certain altered genes that could increase the risk of developing Parkinson’s disease.
  • Environmental causes – Studies have shown a link between exposure to chemicals used in pesticides and herbicides – as well as metals and organic pollutants – and Parkinson’s disease.
  • Head injury – A history of head injuries can increase one’s risk of developing PD.
Complications

Parkinson’s disease is often accompanied by these additional problems, which may be treatable:

  • Thinking difficulties. You may experience cognitive problems (dementia) and thinking difficulties in the later stages of Parkinson’s disease.
  • Depression and emotional changes. You may experience feelings of depression, emotional changes, such as fear, anxiety or loss of motivation.
  • Swallowing problems. You may develop difficulties with swallowing as your condition progresses. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling.
  • Chewing and eating problems. Late-stage Parkinson’s disease affects the muscles in your mouth, making chewing difficult. This can lead to choking and poor nutrition.
  • Sleep problems and sleep disorders. People with Parkinson’s disease often have sleep problems, disturbed night sleep, waking up early or falling asleep during the day.
  • Bladder problems. Parkinson’s disease may cause bladder problems, including being unable to control urine or having difficulty urinating.
  • Constipation. Many people with Parkinson’s disease develop constipation, mainly due to a slower digestive tract.
Diagnosis

There are currently no blood or lab tests that can be used to diagnose Parkinson’s disease. Neurologists make a diagnosis based on their patient’s medical history and an examination. At least two of the four following symptoms must be present over some time for a neurologist to consider Parkinson’s disease as a diagnosis:

  • Shaking or tremor.
  • Bradykinesia.
  • Stiffness in arms or legs.
  • Balance issues.
Facts About Parkinson’s

1. The cause is unknown and there is no cure.

What causes Parkinson’s remains largely unknown. Directly inheriting the disease is fairly rare. Only about 10 to 15 percent of all cases are thought to be genetic forms of the disease. The other 85 to 90 percent of cases are classified as sporadic (or occasional).

2. People with Parkinson’s can have a good quality life.

Regular medicines, therapy, surgical therapy and lifestyle modifications, like rest and exercise, help manage the disease.

3. No two people have the same symptoms.

The progression of symptoms is often a bit different from one person to another due to the diversity of the disease.

4. Exercise helps manage Parkinson’s symptoms.

For people with Parkinson’s, exercise is a vital component to maintaining balance, mobility and activities of daily living. Exercise and physical activity can improve many Parkinson’s disease symptoms.

5. People with Parkinson’s are not always angry or sad.

Many people with Parkinson’s disease experience facial masking – reduced facial expression. They look serious or depressed but many times it’s just the disease that’s causing muscles in the face to be stiff.

COVID-19 and Parkinson’s Disease

Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. Since most people with Parkinson’s disease (PD) are in their senior years, take the below precautions to prevent COVID-19:

  • Wash your hands often with soap and water for at least 20 seconds.
  • In absence of water use a an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • Disinfect frequently touched surfaces.
  • If you notice any symptoms like cough, shortness of breath or fever seek medical help.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Stay at home.

Keep a stock of your essential medicines and keep your medical history file with your doctor’s details handy in case it is needed in event of a hospitalization.

At Kokilaben Dhirubhai Ambani Hospital we provide comprehensive care from diagnosis to treatment to surgery to rehabilitation for patients suffering from Parkinson’s disease. If you or a loved one are suffering from Parkinson’s disease, seek expert help at our Parkinson’s Clinic. Please find below link for more details:

https://www.kokilabenhospital.com/departments/clinicsatkh/parkinsonsclinic.html

World Battles COVID-19

Tuesday, April 7th, 2020

World Health Day is observed every year on the 7th of April. Let us take a look at the current global crisis – COVID-19. Global statistics show more than 13 lakh confirmed cases of COVID-19 to date and more than 72,000 deaths.

Covid-19 has spread around the planet, sending billions of people into lockdown as health services struggle to cope. The coronavirus COVID-19 pandemic is the greatest challenge we have faced since World War Two. Why is COVID-19 a pandemic? Pandemic is an escalation and refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people. Since its emergence in Asia late last year, the virus has spread to every continent except Antarctica. Cases are rising daily in Africa the Americas, and Europe.

The US remains the country with the most reported confirmed cases, with more than 337,000, followed by Spain (more than 131,000), Italy (more than 128,000), Germany (more than 100,000) and France (more than 93,000). India has recorded more than 4200 cases so far.

Most cases in India are of people who had a travel history to coronavirus infected countries or had come in contact with a person who had recently travelled abroad, this is called local transmission. As per The Indian Council of Medical Research (ICMR), India has still not reached the stage of community transmission of coronavirus.

Important things to note about COVID-19
  • There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
  • The best way to prevent illness is to avoid being exposed to this virus.
  • Whilst the virus infects people of all ages, there is evidence that older people (60 and over), and those with underlying health conditions (such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer), are at a higher risk.
  • COVID-19 may be spread by people who are not showing symptoms.
How is COVID-19 spread?

The virus is thought to spread mainly from person-to-person.

  • Between people who are in close contact with one another (within about 6 feet).
  • Through respiratory droplets produced when an infected person coughs, sneezes or talks.
  • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
  • A person can get COVID-19 by touching a surface or object that has the virus on it and then touching their mouth, nose, or possibly their eyes.
Protect yourself from COVID-19
  • Everyone should frequently wash their hands with soap and water and scrub for at least 20 seconds. Use an alcohol-based sanitizer in the absence of water.
  • Cover your nose and mouth with a disposable tissue or flexed elbow when you cough or sneeze.
  • Stay at home.
  • Don’t touch your eyes, nose, or mouth if your hands are not clean.
  • Avoid close contact with people who are sick.
  • Practice social distancing.
  • Everyone must wear a cloth face cover when they have to go out in public, to buy essentials.
  • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, mobile phones, handles, desks, keyboards, etc.
Suspect COVID-19?

People with COVID-19 usually have mild to severe respiratory illness with symptoms of fever, cough, shortness of breath. Some people may have symptoms like muscle aches, headache, sore throat, or diarrhoea. These symptoms may appear 2-14 days after exposure. If you suspect you have COVID-19 follow these steps:

  • Stay at home and rest.
  • Contact your nearest healthcare provider for testing and further action.
  • Do not visit the hospital without informing in advance.
  • Separate yourself from other people in the home as much as possible.
  • Use a face mask at all times.
  • Ask family members to self-quarantine themselves for 14 days.
  • You can dial the government helpline number 011-23978046 or email to ncov2019@gmail.com for further details on coronavirus.
How is India fighting the pandemic?

The COVID-19 infection rate in India remains relatively low as compared to its 130 crore population size. However, India has acted fast and taken some strict measures at the earliest. India is the world’s second-most populous country and has large numbers of poor living in crowded, unsanitary conditions. Here are the measures taken by India to help contain the spread of coronavirus in the country:

  • All international and domestic air travel is suspended.
  • PM Narendra Modi has declared a 21-day nation-wide lockdown to stop the spread of coronavirus.
  • All schools, colleges, government and private offices are closed.
  • All inter-state bus services and metro services across India are suspended.
  • Everyone has been advised to stay at home.

Strict adherence to lockdown, regular handwashing, and effective measures for social distancing will help contain the spread of this pandemic. We are all together in this fight against coronavirus. Let us support each other. Stay at home and stay safe as doctors, nurses and other support staff work endlessly to fight coronavirus.

World Tuberculosis Day

Monday, March 30th, 2020

About one-quarter of the world’s population is infected with tuberculosis (TB) bacteria. Only a small proportion of those infected will become sick with TB. People with weakened immune systems have a much greater risk of falling ill from TB. A person living with HIV is about 20 times more likely to develop active TB.

What is Tuberculosis?

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects your lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.

Once rare in developed countries, tuberculosis infections began increasing in 1985, partly because of the emergence of HIV, the virus that causes AIDS. HIV weakens a person’s immune system so it can’t fight the TB germs. Many strains of tuberculosis resist the drugs most used to treat the disease. People with active tuberculosis must take several types of medications for many months to eradicate the infection and prevent the development of antibiotic resistance.

Symptoms

Although your body may harbour the bacteria that cause tuberculosis (TB), your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between:

  • Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn’t contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB.
  • Active TB. This condition makes you sick and in most cases can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later.

Signs and symptoms of active TB include:

  • Coughing that lasts three or more weeks.
  • Coughing up blood.
  • Chest pain, or pain with breathing or coughing.
  • Unintentional weight loss.
  • Fatigue.
  • Fever.
  • Night sweats.

Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, signs, and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

Causes

Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.

Although tuberculosis is contagious, it’s not easy to catch. You’re much more likely to get tuberculosis from someone you live with or work with than from a stranger. Most people with active TB who’ve had appropriate drug treatment for at least two weeks are no longer contagious.

Risk factors

TB can happen to anyone everywhere. Certain risk factors highly increase your chance of getting TB. These factors include:

Weakened immune system

A healthy immune system often successfully fights TB bacteria. However,a number of diseases, conditions and medications can weaken your immune system, including:

  • HIV/AIDS.
  • Diabetes.
  • Severe kidney disease.
  • Cancer treatment, such as chemotherapy.
  • Cancer.
  • Drugs to prevent rejection of transplanted organs.
  • Malnutrition.
  • Very young or advanced age.
Preventing the Spread of TB

If you have active TB of the lungs, you can infect other people. For that reason, your doctor will tell you to stay home during the first few weeks of treatment, until you’re no longer contagious. During that time, you should avoid public places and people with weakened immune systems, like young children, the elderly, and people with HIV. You’ll have to wear a special mask if you have visitors or need to go to the doctor’s office.

If you have active TB, keep your germs to yourself. Follow these tips to help keep your friends and family from getting sick till you become infection-free:

  • Stay at home.
  • Ventilate the room.
  • Cover your mouth while coughing sneezing.
  • Wear a surgical mask.
Finish your medicines

This is the most important step you can take to protect yourself and others from tuberculosis. When you stop treatment early or skip doses, TB bacteria have a chance to develop mutations that allow them to survive the most potent TB drugs. The resulting drug-resistant strains are much more deadly and difficult to treat.

Vaccinations

Infants often are vaccinated with bacillus Calmette-Guerin (BCG) vaccine because it can prevent severe tuberculosis in children.

Tuberculosis in India

According to the latest report released by the World Health Organisation (WHO) India accounted for 27 per cent of the total TB cases, followed by China with 9 per cent, Indonesia at 8 per cent, Pakistan (6 per cent) and Bangladesh (4 per cent). As per the report 10 million people had TB in 2018. While 26,90,000 people had TB in India, out of which 19,90,000 were notified. According to the report, TB kills 1.5 million every year and is the leading killer of people living with HIV/AIDD and a major cause of deaths due to anti-microbial resistance.

Myths and Facts for Tuberculosis

1. Myth: Tuberculosis happens only to smokers.

Fact: Smokers are predisposed to developing respiratory diseases. However, TB is caused by the bacterium Mycobacterium tuberculosis. So smoking increases the risk for developing tuberculosis.

2. Myth: TB is a poor man’s disease.

Fact: In reality, tuberculosis has broken all barriers and can affect anyone irrespective of their socio- financial background and living conditions.

3. Myth: It can be fatal.

Fact: If a patient follows the complete treatment module, then the disease is fully curable.

4. Myth: Tuberculosis is hereditary

Fact: Tuberculosis is NOT hereditary. TB is an airborne disease that is spread when a person with active TB coughs, laughs, sneezes or sings, breathing out tiny infected particles into the air. The particles may then be inhaled by others nearby.

Are you suffering from persistent cough or any other Tuberculosis symptoms? Consult experts at our Department of Pulmonary Medicine for more assistance. Please find below link:

https://www.kokilabenhospital.com/departments/clinicaldepartments/pulmonarymedicine.html

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