Diabetes -An Epidemic Killing India

Diabetes – “A chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces” !

In India ~70 million people are diabetic & if continue at this rate, we will cross ~100 million by 2030 according to researchers. Yes,it’s true India has become the diabetic capital of the world. Diabetes causes some serious health issues including kidney failure, blindness, stroke and heart diseases.

 

Why Indians are more prone to Diabetes:
  1. Genetic is most prevalent reason for rapid scale.
  2. The Indian diet is rich in carbohydrates and processed sugar foods. Huge consumption of soft drinks which contains large amount of sugar which leads to obesity.
  3. Urban lifestyle of people working on laptops for long hours and and less physical work.
  4. Indian adults with a lower BMI(body mass index) are at high risk of diabetes.
Besides the health risks, diabetes pushes the masses to poverty. Reports say that one-fourth of person’s income is being spent on managing diabetes and related diseases due to diabetes. Problem lies that most people are not aware that they are already diabetic. People above age of 35 are at extremely high risk of diabetes. So, it is very important for every individual above 25+ age to have a regular tests done for blood sugar.

 

Roughly ~1 million people die due to diabetes in India and we hardly have any awareness program for it. ~80% of the people above 40+ age are either already diabetic or are on verge of getting diabetic.

 

How to prevent from getting diabetic:
  1. Regular physical exercise is a must for everyone above 20+ age & maintaining an ideal body weight.
  2. Extremely less consumption of alcohol & tobacco reduces the risk of diabetics.
  3. Avoid consumption of processed sugar food and junk food which is prevalent in the name of fast food for the modern society.
  4. Regular health checks(blood sugar tests) to rule out diabetes must for everyone over the age of 30.
According to WHO report: The greatest number of people diagnosed with diabetes is between 40 to 59 years of age.Diabetes resulted in  ~4.6 million deaths in 2011 and caused ~ $465 billion in healthcare expenses in 2011 alone.

 

Roughly ~80% of the investment in health sector comes from private funds and that too from individual pockets.People with lower income are unable to handle the economic and disease burden.

Stay alert and keep your body under check by getting regular test and keep your records intact with Medimojo to stay healthy and live longer.

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Need of the hour – better health for working mothers!

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Health problems of working women haven’t been addressed properly.  Stress of work coupled with domestic responsibilities & pregnancy related problems has taken a toll not only on women’s physical health, but their mental health too, with a large number of women being afflicted by common mental disorders including depression. Faced with gender based discrimination at different stages of their lives, many find it difficult to cope with the stress they are subjected to.

The survey titled ‘Multi-tasking seriously affecting corporate women’s health’ was conducted by the Associated Chamber of Commerce and Industry to mark International Women’s Day [1] The survey that was conducted has found that about 42% of working women suffer from lifestyle diseases such as hypertension, obesity, depression, backache and heart ailments while 22% are afflicted with chronic diseases. Furthermore, there have been a severe increase in lifestyle diseases amongst women, especially working mothers’ for the past few years. 68% of working women in the age bracket of 21-52 years were found to be afflicted with lifestyle ailments. [2]

However, due to hectic lifestyles and ignorance, there is a lack of awareness regarding the diseases that are caused, especially mental ailments such as depression, anxiety amongst others.  As per World Health Organization (WHO) estimates, depression is expected to be the second largest contributor to disease burden by 2020, and with one in every three women worldwide being afflicted by common mental disorders including depression, the mental health of women is a serious issue indeed.[3] The study ‘Preventive Healthcare and Corporate Female Workforce’ also said that long hours and working under strict deadlines cause up to 75% of working women to suffer from depression or general anxiety disorder, compared to women with lesser levels of psychological demand at work[4]

WHAT CAN BE DONE?

These frightening statistics give rise to concern regarding the health of working mothers’. There is an urgent need for damage control and reducing the spread of such diseases. The health of working mothers’ does not only affect her family and her children but also the workforce of the organization they are working in. Therefore, it is beneficial for organizations to provide certain schemes that would help not just the working mothers’ but also other employees of the company. Monthly or quarterly health check-ups of the employees could be a good start.

Also, there could be a provision of psychologists or therapists in every organization, which enables employees to have easy access to any sort of psychological problem they are dealing with.  The organization should spread awareness amongst the staff regarding prevalent health risks and diseases and there should be regular awareness programs in this regard. Also, they should be provided with healthcare benefits that enables them to have hassle free access to medical facilities.

In furtherance to this, there should be policies made for working mothers’ that facilitate them to lead easier, healthier lives like providing facilities of daycare in the organization itself, flexible working hours, flexible leave policies etc.

Such benefits and policies will not only help improve the health of working mothers’ but will also prove to be an incentive for mothers’ to work

Breast Cancer: the deadly crab !!

Lifestyle change in India has impacted women adversely. Women have become increasingly

vulnerable to cervical and breast cancer. The latest trend pattern point towards younger

women contracting breast cancer, whereas the average age of contracting the disease till a

decade ago was from 45-55 years of age, as stated by the doctors at AIIMS1.

According to the recent reports, 17% of the total world population suffering from breast

cancer is from India. Furthermore, according to the experts from AIIMS, breast cancer is the

second most common cancer that the people suffer from. It has been roughly concluded that

for every 2 women newly diagnosed with breast cancer, one lady is dying of it. 2

Even though the statistics provide a rather grim scenario, fortunately the survival rate of

people suffering from breast cancer is estimated to be around 85% or more. Therefore, if

awareness is spread regarding the disease and there is early diagnosis then death due to breast

cancer can significantly reduce.

RISK FACTORS

In order for an early deduction, symptoms and causation of breast cancer have to be

recognised.

The risk factors that are present in breast cancer are divided into further sub-categories, (i)

Non-Hormone related risk factor, (ii) Hormone related risk factor.

(i) Non- Hormone related risk factors are: Hereditary breast cancer- People who have

(ii) Hormone related risk factors: Action of estrogens on breast. Breast tissue is

a history of breast cancer in their family are more prone to contracting breast

cancer. Other factors that affect are- Gender, females are prone to breast cancer.

Out of every 100 cases of breast cancer, only 1 may be in a male.

 Age is also considered to be one of the leading factors. Chances of developing

breast cancer increases, as the age increases. Presently, the peak period is

between the ages of 40 years-60 years.

 Stress, Obesity, taking of oral contraceptives and lack of exercise are also

considered to be few of the major risk factors.

responsive to the hormone estrogen, and prolonged action of estrogen on the

breast is not desirable; in a majority of breast cancers, estrogen is responsible to

‘drive’ the cancer cells.3

1 http://www.newindianexpress.com/nation/India-has-17-Percent-of-the-Worlds-Population-Suffering-from-

Breast-Cancer/2015/01/28/article2640991.ece

2 http://www.breastcancerindia.net/statistics/stat_global.html

3 http://www.breastcancerindia.net/bc/risk01.html

 If a women has disorder that affects that affect menstrual cycles, the likelihood

of risk of getting affected by breast cancer increases.

 Reproductive history of a woman is also a determining factor. If a woman has

a child after the age of 30, has an increased risk of developing breast cancer.

And so for the lady, who has never borne a child.

 Early menarche (The age when the first menstrual cycle occurs) and late

menopause (The age of the last menstrual cycle) are considered to be risk

factors. 4

SYMPTOMS

A person can perform a self detection in order to find out whether they have the

symptoms of breast cancer or not. If the following abnormalities are found, they

can go to a professional for further check-up and help.

(i) A change in how the breast and nipples feel: – If there is any tenderness or

any sort of lump near the breast or the underarm area.

 If there is any change in the skin texture or an enlargement of pores in the skin

of the breast.

 If there in any lump in the breast.

(ii) Any change in the breast or nipple appearance: – If there is any sort of

change in the size of the breast, either swelling or shrinkage of breast.

(especially if only on one side)

 If there is any redness or change in the texture resembling skin of an orange.

(iii) Any nipple discharge: – if there is any sort of milky discharge from the

nipple, when a woman is not breastfeeding can also be one of the

symptoms of breast cancer.

These are some of the common symptoms of Breast cancer. It is highly encouraged for

women to perform self examination at least once a month. Forty percent of diagnosed breast

cancers are detected by women who feel a lump, so establishing a regular breast self-exam is

very important. 5 It is also highly recommended for women to go for mammography at

regular intervals during the age of 40-60, in order for early detection.

TREATMENT IN INDIA

To fight breast cancer it is imperative to spread awareness regarding it. The term ‘cancer’

itself stems a foreboding feeling amongst most of us, it is important to understand that cancer

4 ibid

5 http://www.nationalbreastcancer.org/breast-self-exam

is curable. Breast Cancer has a very high chance of survival, hence if detected at an early

stage and with proper treatment it can be completely cured.

There are hospitals and healthcare facilities dedicated solely to cancer. The standard

treatment methods include- surgery, chemotherapy and radiation therapy. There are hospitals

providing the high-end treatment for breast cancer. But it is expensive, unaffordable and

inaccessible to people. The process of cancer treatment can be a long and tedious one,

spanning over years at times. For most people living in towns and remote areas, it means

uprooting their lives in order to get the treatment.

In rural areas, there is a severe lack of awareness and screening process for early process. The

lack of facilities and technology in rural areas makes it incredibly difficult for people living

in those areas to get the treatment. Locally, there are hardly facilities available to do the

simple mammography.

Therefore, there is an urgent need to firstly, spread awareness on breast cancer. It calls for

complete evaluation of National Cancer Control Program (NCCP) with strong emphasis on

educating the public about the common symptoms and signs and the importance of early

diagnosis and treatment. This can be achieved through educating the individuals involved in

health care i.e. doctors at primary health centre, pharmacists, health workers (male and

female), anganwadi workers etc. The next level includes the educated and respectable persons

in the villages i.e. school teachers, sarpanch, ward members and active youths. 6

Participatory workshops and training sessions by the non government organizations(NGO),

municipal, district and state health administration, structured training and field activities by

medical colleges and regional cancer centres, participatory programs on radio and television

i.e. mass media, descriptive articles in newspapers and magazines, exhibitions and public

lectures etc. Well-illustrated audiovisual educational materials are extremely useful for

literate as well as illiterate populations. The other programs like reproductive and child health

programs can be utilized as opportunities to educate the public about the presentation and

early detection of cancer. Community-based educational intervention can increase

community awareness about cancer and can yield a positive change in the practice of strategy

for early detection of cancer. 7

Various strategies that have been given in order for cancer prevention are:

 Clinical breast examination by trained personnel in the rural areas like female

health workers has been suggested to be a viable screening option considering

the socio-economic condition and the unavailability of facilities at the remote

places.

 In the present scenario where a number of programs are being conducted on

the national basis under National Rural Health Mission (NRHM), organizing

6 http://medind.nic.in/jat/t10/i3/jatt10i3p299.htm

7 Sharma V, Giri S. Cancer control in India- A sorry state. Indian J Cancer 2009;46:340.

training and education for the health workers regarding clinical breast

examination can be achieved.

 Proper screening at the root level can definitely improve the present scenario

of presentation at an advanced stage in breast carcinomas. The availability of

treatment option at least at the district level is also essential as the

economically poor people differ to go for treatment to a far off place which is

the major cause for late presentation.

 A breast cancer pilot project can be initiated with establishment of diagnostic

facilities with trained staff for early diagnosis and treatment of breast cancer

patients at an early stage.8

If these steps are taken, if extensive awareness is spread amongst the people regarding the

disease and care and screening is made available at the very primary level then Breast Cancer

can be prevented before it gets fatal.

The Caring Parent – Prevent your kid from catching common cold

This is that time of the year , where you as a parent get cold at the thought of your child catching the common cold.

Do you know that most kids get infected with cold for 9 times or more in a year. This roughly amounts to once every month. Common Cold is the most common infectious disease among kids in many countries. We know you care for your kids and the following simple tips will help you beat the cold this time round and always.

So just follow them for a worry free enjoyable season :

1.

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Wash your kid’s hands regularly and thoroughly, and teach them to do so after and before eating and after coughing or sneezing.using a sanitizer every time would be of added benefit.

2.

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Prevent your child from being in the company of anyone who has a cold or is a smoker . Virus particles can travel up to 12 feet through the air when someone with a cold coughs or sneezes, and secondhand smoke can make your child more likely to get sick.

3.

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Clean & Disinfect the towel that you use on the child or still better use only disposable tissues /towels and discard them out of reach.

4.

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Make sure that your child drinks out of a fresh cleaned glass or water bottle every time she is drinking water or any other fluid.

5.

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Disinfect frequently touched surfaces, and objects such as toys and doorknobs. Using a household cleaner that kills viruses, such as phenol/alcohol may help to reduce viral transmission.

 

Sandhya’s Story :” I could have saved my husband “

Sandhya's Story

Sandhya’s Husband Satish was this  great guy, and he was hilariously funny. By 33 years of age he has already been seen as a bright performer and has recently been elevated to the role of an AVP , in his organization where he has been working for 3 years.

One day at office he  started to feel sick – tired at first , which he has been feeling with increased frequency in the last few months . His doctor had told him he had hypertension. And that was what making him feel sick often

But this time it was more serious as he was in a lot of pain, so much that he went to the emergency room. He was given pain medications and sent home.

The pain never went away. Two months later , it got so bad that he had to taken to the emergency where some pain medication and test done to ascertain the rise in BP a sure sigh of hypertension. The test results showed nothing abnormal to the presenting conditions and Satish was discharged with a range of Blood reports  , MRI etc and pain & hypertension management medication.

Missing Medical Record Delays Care

Sandhya Says  “ My husband’s conditions only worsened from here !”

He was referred to a bigger hospital where the doctors asked for Satish’s  previous reports and medication history

“I wish I had them organized and arranged “ feels Sandhya  regretfully.

Fighting for Access to Records

In the following 2 days, “ I went to the hospital & my consulting doctor “ –thankfully many of these reports could be  arranged but most of the prescription from the doctor could not be found as there was no record kept whatsoever.”

“ however unfortunately the doctors at the new hospital found these records  to have not bee updated or not kept in the standard format which further delayed the care”

“Finally with  the record., and some new tests, the new doctors, had a bigger shock in store for me”

“ Satish has been diagnosed with stage IV Kidney cancer.”

My world seemed crashing down “ when doctors made the astounding revelation that the previous health records were filled with actionable data that would have impacted Satish’s care and created a better living condition for him, and for both of us .

My husband came home to die. Recounts Sandhya – ” It was hard. But, I had access to the data, and I had his record that I could refer to, so I could take care of him for the next 2 years whereas the doctors had given him only 4-6 months.”

Sandhay feels” Other people don’t have to suffer like he did. I really believe that access to your medical record can change your life, can save your life, and can make you happier.

Medimojo : Your Health dashboard

Dashboard HQ (1)

All of us have owned , seen or known how a motorized vehicle works. Our Car in life has a pride of place and it is something which draws our collective fantasies. We take  great pains in ensuring the regular upkeep and maintenance of our car.

We very well know how a car functions and what are its vital “techno-markers” for a smooth trouble free functioning. The “techno-markers” significant for a smooth uninterrupted functioning of a car are its – clutch oil , break oil , engine oil , coolant etc.

As owners of car we are always mindful of these “techno-markers” , always being in the healthy zone .Being in that healthy zone ensures that the machine of our fantasy always stays in the peak of its performance and delivers uninterrupted service.

The car has a fancy dashboard , which keeps us informed any time and every time how these “techno-markers” are behaving and thus , how the machine is performing or may perform in the future. Every-time any of these “techno-markers” are likely to  affect the performance and smooth functioning the dashboard shows alerts for us to act and take immediate corrective measures.

What if there was a similar dashboard for a human body to alert occurrence of any avoidable event and ensuring a non stop healthy living without the interruptions caused by unforeseen illnesses.

Like the car Dash Board and its “techno –markers” what if there was a alert system to correct any such interruption before they happen.

What if that advance alert system could  detect or predict such events early and preventive action be taken just like in the case of your car.

Everytime we engage with the players of health/medical systems , we create a medical event in our life. In each such event there is a lot of data generated about our health which may have significant bearing not just for that occasion but for future well being as well.

Each doctor engagement creates a prescription which has vitals about our health life , BP , BMI , symptoms and medication history. Every blood report that you get done there are 3-4 pages of report with many different values and multiple parameters which are your “Bio-markers”.

The Consultant may explain some of these to you if you have a presenting problem relevant to the presenting conditions. However , many of the other parameters go unnoticed and unexplained and eventually get lost as they are not relevant to the presenting conditions.

It is in these data that the “Bio-markers” for your uninterrupted disease free healthy living  exists .

These is where the digitization of health records become significant and tracking and analyzing them makes impactful difference to a healthy happy living. If recorded & analyzed over time , the data available in the prescription and the Bio-Markers” in the various diagnostic reports  become the alerts for the health Dashboard, much like the system that your car has.

Digitization of health records not just enables its storage , access and future perusal but also gives insights and alerts which can keep you and your loved ones avoid episodes of prolonged illness and avoid costly hospitalization expenses.

So Digitize every health record and get dashboard for tracking your and your family’s health and pave the way for a healthier , happier illness free living.

India, among most depressed nations in the world

According to a report published in BMC medicine (BioMed Central), an average of 12 percent people in China go through a major depressive episode. In addition, countries like Netherlands, France and The USA reported more than 30 percent people who had gone through depression. But the crown for the depression capital of the World goes to India. For a country that stigmatizes mental illness, the report in BMC medicine is a harsh awakening. As per the report a total of 36 percent people in India have gone through or are going through depression. And this isn’t even the worst news.

In the list of the top diseases that affect corporate executives, depression (42%) ranks at the top, followed by obesity (23%), high blood pressure (9%) and diabetes (8%). Roughly half the respondents in a survey conducted by ASSOCHAM, admitted to feeling exhausted too often, over a quarter said  that headaches were a common feature of their working lives. What’s more worrying is the age distribution of the respondents. Over half (55% to be precise) were under the age of 30 and a quarter were between 30 and 40 years.

217709-depression-1311688503-189-640x480In a recent article by a popular news broadcaster, it was stated that 64% of the college students living in Delhi had shown symptoms of depression and inane mood fluctuations. The number of suicides in the last few decades had tripled in the age groups of 15-24. For a nation, that claims its strength from its youngsters, this is dark news. Studies from India have also shown that life events during the period preceding the onset of depression play a major role in depression. Studies on women have also shown the importance of identifying risk factors like interpersonal conflicts, marital disharmony and sexual coercion.

While depression is a simplistic word to throw around for many, it is responsible for around 850,000 suicides a year. To put that in perspective, imagine a World War taking place every 3 years. 120 million people are affected by depression worldwide. It is an illness far greater, than mankind has faced.

In a country like India, where going to psychologist means you need a trip to the loony bin, the social stigma regarding mental illness in particular is crippling. Most social stigma against mental health arises from people who have never been directly in contact with people in need of mental aid or who have based their worldview on the narrow belief of popular public opinion and misleading pop culture.

As per the American National Institute of Mental Health, the following are the most common symptoms of depression-

a) Persistent sad, anxious, or ‘empty’ mood

b) Feelings of hopelessness, pessimism, guilt, worthlessness

c) Loss of interest or pleasure in hobbies and activities once pleasurable

d) Appetite and/or weight changes

e) Persistent headaches etc.

There are various factors which can cause depression such as biological brain changes, traumatic life events, hormonal changes etc. In the language of the common man, our body contains chemicals that help control our moods. When we don’t have enough of these chemicals or when our brain doesn’t respond to them properly, we may become depressed. Depression can be genetic (meaning it can run in families). Abusing drugs or alcohol can also lead to depression. Some medical problems and medications can lead to depression.

If a person feels he is depressed it is of paramount importance that he seeks help. Friends and family members can act as guides to assist the people going through depression. They can notice irregular behavior and assist counselling.

The stigmatization of mental illness is another reason for the lack of preventative measures taken in

India in regards to depression. Many people working in corporate offices refuse to speak openly about their issues, thinking that it will cause social isolation. Employers should conduct enrichment programs to help employees with psychological issues and to assist them in better integrating with the workplace.

The government can further the cause of treating mental illness by releasing advertisements and social awareness campaigns like it has done for Polio and Tuberculosis.

If a person feels that he is depressed for any reason, he should not delay an appointment with a psychiatrist. Ignoring depression can lead to other mental conditions. For people suffering from depression, a variety of treatments are available.

The first and foremost treatment is that done through medication. The most common types of medicines are serotonin reuptake inhibitors (SSRI’s) and tricyclic antidepressant1.

However a few individuals might require Psychotherapy, Electroconvulsive therapy, and cranial magnetic stimulation. Scientific studies have shown that short term courses of therapy are often helpful in treating depression. Cognitive therapy helps change negative thinking and behavior that may contribute to clinical depression. In addition, psychotherapy involves interpersonal therapy, which focuses on dealing more effectively with other people, working to change relationships that can cause or worsen clinical depression.

In the past few years, herbal therapy has gained momentum in the field of mental science. Hypericum Perforatum2 is an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest around the world.

Prevention of course is better than the cure. While a lot of research has not taken place India regarding the prevention of depression, Sethi, a renowned scholar in the field of medicine and others proposed a prevention model for depression focusing on improving social network and educational programs, designed to educate the public with regard to the risks inherent to change of jobs, residence, pattern of living as well as how to protect against them and removal of malnutrition and infections.

Help can be found throughout the country in various clinics and hospitals. In addition, Ayurvedic treatment can be found throughout the country. Counseling can also be found on the internet for those who do not have the abilities or find it stressful to go to a doctor. The self-stigmatization of depression can cause major problems for the one who is depressed and can even cause obstacles in the treatment.

Depression is an invisible illness. Since it shows no visible marks, it is easier for people to trivialize the effect that it can have. But just because the disease is invisible, doesn’t give us the right to turn a blind eye towards those who suffer. It is our responsibility as active members of the society to build a better understanding towards depression and mental illness in general.

1 WebMD, “How Different Antidepressants Work” (2015) <http://www.webmd.com/depression/how-different-antidepressants-work&gt; accessed 21 December 2015.
2 Shelton RC, “St John’s Wort (Hypericum Perforatum) In Major Depression. – Pubmed – NCBI” (Ncbi.nlm.nih.gov,2015) <http://www.ncbi.nlm.nih.gov/pubmed/19909690&gt; accessed 21 December 2015.