COVID 19 and Heart Disease

People of all ages can be infected by the new Novel coronavirus. But the virus poses a special threat for the people over the age of 60 and those who suffer from other medical conditions, like:

Cardiovascular disease
Hypertension
Diabetes
Chronic respiratory disease
Cancer

Like most viruses the coronavirus also spread through droplets in the air from an infected person coughing, sneezing or talkingor by touching surfaces that contain the virus, as this virus can survive for several hours or even days on surfaces such as tables and door handles.
Someone with pre-existing heart disease who becomes ill with COVID-19 may suffer a heart attack or develop congestive heart failure due to a combination of the severe viral illness, an increased demand on the heart (fever causes rapid heart rate), along with low oxygen levels due to pneumonia and increased propensity for blood clot formation. In addition to the increase in the above discussed problems, a more unusual condition called myocarditis has also been observed in COVID-19 patients.
Sometimes COVID-19 patients appear to be having a heart attack but are actually suffering from an inflammation of the heart muscle, called myocarditis. Their electrocardiograms may show changes suggestive of a major heart attack, and the blood tests also show elevated levels of troponin, a cardiac enzyme that is released when heart muscle is damaged. Due to the COVID-19 Infection the heart muscle in a heart patient becomes weaker, andthey may also suffer from Arrythmia. Thus, research shows severe injury to the heart muscle, and increased troponin levels, are associated with heart patients who are at an increased risk of death with COVID-19

Who are the people at risk?

People who are on immunosuppressants, such as transplant patients, cancer patients receiving chemotherapy or radiotherapy, patients with leukaemia or lymphoma,and people who have heart disease are at greatest risk of contracting and succumbing to the effects of the virus.
Other high-risk groups include elderly people as well as pregnant women suffering from cardiovascular disease.
Individuals with pre-existing heart conditions, such as heart failure, dilated cardiomyopathy, advanced forms of arrhythmia, patients with the obstructive form of hypertrophic cardiomyopathy and patients with congenital heart disease are at a greater risk.Sometimes due to the inflammatory effects of the virus, there is a risk of rupture of atherosclerotic plaques or fatty deposits in the coronary arteries, leading to a heart attack.

Thus, acute inflammatory response caused by the infection may worsen cardiac function and increase symptoms in patients with heart failure.
There is no evidence till now that the virus infects pacemakers and cardioverter-defibrillators or causes infective endocarditis in those with valvular heart disease.

Protocols to follow by Cardiac Patients
There are no special dos or don’ts for higher-risk cardiac patients to prevent COVID-19 exposure, but such individuals should follow the frequent handwashing and physical distancing and self-isolation. It remains vitally important to exercise at home, get enough sleep, manage stress, and eat a balanced diet. These healthy habits will not only bolster the immune system to help ward off COVID-19, but will help prevent CVD progression in the longer term.

Haemophilia: Symptoms, Diagnosis and Treatment

Haemophilia Treatment

Haemophilia is a bleeding disorder in which the blood does not clot properly. This can lead to spontaneous bleeding as well as bleeding following injuries or surgeries. It is a genetic disorder and usually inherited. In rare cases, an individual can develop haemophilia later in life. The majority of such cases involve middle-aged or elderly people or young women who have recently given birth or are in the later stages of pregnancy. This condition often resolves with appropriate treatment.

Causes of Haemophilia

When you bleed, the body normally pools blood cells together, forming a clot to stop the bleeding. The clotting process is encouraged by certain clotting factors. Coagulation or clotting factors are proteins present in the blood that help control bleeding. They are known by Roman numerals (I, II, VIII, etc.) or by names like fibrinogen, prothrombin, Haemophilia A, etc.)

Haemophilia occurs when clotting factors VII or IX are defective or missing.

Though mostly an inherited disorder, about 30% of people with haemophilia have no family history. In these people, an unexpected change occurs in one of the genes associated with haemophilia. Acquired haemophilia is a rare condition that occurs when a person’s immune system attacks clotting factors in the blood. It can be associated with:
• Pregnancy
• Autoimmune conditions
• Cancer
• Multiple sclerosis

Types

Haemophilia A (Classic Haemophilia) is caused by a lack or decrease of clotting factor VIII
Haemophilia B (Christmas Disease) is caused by a lack or decrease of clotting factor IX

Signs and Symptoms

Symptoms depend on the severity of the problem. A minor deficiency may lead to bleeding only post surgery or injury, while a more severe form can cause spontaneous bleeding. Internal bleeding can sometimes go undetected causing risk to life. Common signs of haemophilia include:
• Bleeding into the joints can lead to swelling, pain, or tightness; it often affects the knees, elbows, and ankles
• Bleeding into the skin (bruising) or muscle and soft tissue causing a build-up of blood in the area (called a haematoma)
• Bleeding of the gums and mouth, and bleeding that’s hard to stop after losing a tooth
• Bleeding after circumcision
• Frequent and hard-to-stop nosebleeds
• Bleeding after vaccination
• Bleeding in the head of an infant, especially after a difficult delivery
• Blood in the stool or urine

Haemophilia Can Result In

• Bleeding within the joints that can further lead to chronic joint diseases and severe pain
• Bleeding in the head and in the brain that can cause long-term problems, such as seizures or paralysis
• Death can occur if bleeding cannot be stopped or if it occurs in vital organs such as the brain
Tips for Prevention
• Get an annual checkup at a haemophilia treatment center
• Get vaccinated—Hepatitis A and B are preventable
• Treat bleeds early and adequately
• Exercise regularly and maintain a healthy weight to protect joints
• Get tested regularly for blood-borne infections

Diagnosis of Haemophilia

Many people who have or have had family members with haemophilia should get their babies to get tested soon after birth. It is important to note that about one-third of babies who are diagnosed with haemophilia have no other family members with the disorder. A doctor might check for haemophilia if a newborn shows certain signs or symptoms of haemophilia.

Diagnosis includes screening tests and clotting factor tests. Screening tests are blood tests that show if the blood is clotting properly. Clotting factor tests, or factor assays, are needed to diagnose a bleeding disorder. The blood test shows the type of haemophilia and its severity.

Treatment of Haemophilia

The ideal way to treat haemophilia is to replace the missing blood clotting factor, so that the blood can clot properly. This is done by injecting treatment products, known as clotting factor concentrates, into an individual’s vein. Clinicians typically prescribe treatment products for episodic care or prophylactic care. Episodic care is used to stop an individual’s bleeding episodes; prophylactic care is used to prevent bleeding episodes from occurring.

Today, it’s possible for people with haemophilia, and their families, to learn how to give their own clotting factor treatment products at home. Giving factor treatment products at home indicates that bleeds can be treated faster, resulting in comparatively less serious bleeding and fewer side effects.

When to See a Doctor

Seek immediate care if you or your child experiences any or all of the following:
• Signs or symptoms of bleeding into the brain
• Any injury after which the bleeding isn’t stopping
• Swollen joints that are painful to bend or hot to the touch
If you have a family history of haemophilia, you may want to undergo genetic testing to see if you’re a carrier of the disease before you start a family.

Pregnancy and obesity: Know the risks

Obesity is defined as possessing an excessive amount of body fat. A measurement that is based on height and weight — known as the body mass index (BMI) — is used to determine if an individual is obese. A BMI of 18.5-24.9 is normal while 25-29.9 is overweight, 30.0-34.9 is obese (class I), 35-39.9 is obese (classII), and 40.0 and higher is extreme obesity (class III).

Can obesity affect my ability to get pregnant?

Being obese may harm fertility by inhibiting normal ovulation. Even in women who regularly ovulate, the greater the BMI, the longer it takes to conceive.

How might obesity affect my pregnancy?

Being obese during pregnancy increases the risk of various pregnancy complications for mothers, including:

High blood pressure and pre-eclampsia – a condition that develops in pregnant women, marked by high blood pressure and presence of protein in the urine
Thrombosis (blood clots) is a condition in which blood flow in a blood vessel is completely or partly blocked
Gestational diabetes is a kind of diabetes some women suffer from during pregnancy
Obstructive sleep apnoea is a disorder in which your breathing stops while you’re sleeping
PCOS (polycystic ovarian syndrome), a hormonal disorder common among women of reproductive age, is more likely to be diagnosed in obese women

Risks for your baby linked with a high BMI include the following:

Premature birth (when a baby is born before they have developed completely)
Baby having a high birth weight
Obesity and diabetes in their later life

With proper support, you can stop this cycle from being repeated.

Tips to Avoid Unwanted Gestational Weight Gain

You can limit the impact of obesity on pregnancy and ensure your health and your baby’s by adopting the following measures:

Opt for low-fat dairy products

Calcium needs generally increase during pregnancy. Most pregnant women need to consume three-four servings of dairy products each day. By choosing alternatives like skim milk, low-fat yogurt, and low-fat cheeses, you can save about half the calories.

Choose your snacks wisely

Chips, cookies, donuts, and cakes offer unwanted calories and limited nutrients. So, try to limit consuming such high-fat snacks to once a week. Also, go through the food label to choose snacks that have lesser grams of fat per servings. Some healthier options include fresh fruit pretzels, low-fat yogurt, and low-fat ice cream. Also, space your snacks evenly between meals.

Eat fiber-rich food

A fiber-rich diet keeps you fuller longer, minimizing blood sugar spikes post meals. For those experiencing constipation during pregnancy, fibers help reverse the problem. Fiber-rich foods include beans, peas, oats, fruits, seeds, lentils, vegetables, fruits, and whole grains.

Limit extra calories from beverages

Fluid needs usually increase during pregnancy. Plan to meet most of those extra fluid requirements with water instead of soda, juice or any other beverage that is high in calories and may potentially damage your developing baby.

Reduce added salt in your diet

Avoid adding salt to food while eating or cooking as it makes your body retain fluid weight.

Be physically active

Consult your healthcare provider to know about the safe ways to be physically active during pregnancy, such as walking or swimming

Schedule a preconception appointment

If you’re obese and considering getting pregnant, talk to your healthcare provider. He/she is likely to recommend a prenatal vitamin and refer you to other healthcare providers like a dietitian or an obesity specialist who can help reach a healthy weight before and during pregnancy

Seek regular prenatal care

Prenatal visits can help healthcare provider monitor your any medical condition you may have — such as diabetes, high blood pressure or sleep apnoea

And last but not least, avoid risky substances. If you are a smoker, seek help from your healthcare provider to help quit. Alcohol and illicit drugs are off-limits, too

Why Osteoporosis is More Common in Women

Osteoporosis is a disease that weakens bones, increasing the risk of unforeseen fractures. Literally indicating ‘porous bone’, osteoporosis results in an increased loss of both bone mass and strength. The disease may progress without any pain or symptoms – this is why it is often referred to as a ‘silent disease’.

Although it is not fair, it is true: If you are a woman, you are automatically at greater risk for osteoporosis than men. Worldwide it is estimated that an osteoporotic fracture occurs every three seconds. One in three women and one in five men at the age of 50 suffers a fracture in their remaining lifetimes. In women particularly over 45 years of age, fractures resulting from osteoporosis can result in more number of days spent in a hospital compared to many other diseases, including diabetes and heart attacks.

There are several reasons why women are more prone to suffering from osteoporosis than men, including the following:

Women have smaller and thinner bones compared to men
Oestrogen, a hormone in women which protects bones, starts decreasing rapidly with the onset of menopause, causing bone loss.

Osteoporosis and young adult women

Although osteoporosis is most common in older people, it affects young people, including women who are in their 20s, 30s, and 40s. The term ‘premenopausal’ refers to women still having menstrual periods. While it is not very common for premenopausal women to suffer from osteoporosis, some women have low bone density that increases the chance of suffering from osteoporosis later during their lifetime.

Young women with a low bone density, caused by low peak bone mass, are at an increased risk of getting osteoporosis later in life. Often, when premenopausal women suffer from osteoporosis, it may be due to prolonged consumption of a medicine or underlying medical condition causing bone loss.

Osteoporosis caused by a medicine or medical condition is known as secondary osteoporosis. Premenopausal women sometimes suffer from osteoporosis for no specific reason. Such a type is called idiopathic osteoporosis where ‘idiopathic’ indicates that the cause of osteoporosis is inexplicable.

Osteoporosis and menopause

Postmenopausal women are at the greatest risk of suffering from osteoporosis and fractures due to rapid bone loss occurring with the onset of menopause. Bone mass peaks in the mid-twenties and remains more or less stable until the beginning of menopause, occurring in women between the ages 50 and 53 years in North America and Europe, and as early as age 42 in Asia and Latin America.

Oestrogen is the hormone that regulates a woman’s reproductive cycle. It also plays an essential role in keeping bones strong and healthy, in both women and men. While premenopausal women usually have more oestrogen than men, they are likely to experience dramatic drops in oestrogen production with the onset of menopause and tend to experience bone loss and osteoporosis.

Women are at an increased osteoporosis risk related to oestrogen levels if they:

Experience irregular periods or started having periods at a later than normal age
Are cancer patients
Have had their ovaries surgically removed
Are going through menopause (those undergoing menopause at an early age are at greater risk)

Women end up losing bone mass more quickly over the years immediately after menopause begins than they do at any other time during their lives.

Besides oestrogen deficiency, reduced intestinal calcium absorption, increases in urinary calcium losses, and loss of bone protective hormones affect bone health.

On the other hand, studies show that women with a higher level of oestrogen than their peers, such as women whose menstrual cycles began earlier than normal or those who consumed contraceptives containing oestrogen tend to have a higher bone density.

Essential Strategies to reduce osteoporosis

The risk of developing osteoporosis and fragility fractures is determined by many factors, some of which can be altered (e.g. nutrition, exercise, and smoking) while others cannot (e.g. age at menopause, family history, and diseases).

While peak bone mass is genetically determined, after the age of 65 genetics plays a diminishing role in bone loss and other factors like exercise and nutrition play a crucial role. Maintaining a healthy skeleton revolves around the following strategies to reduce the risk of fractures and osteoporosis:

Exercise regularly

The saying ‘move it or lose it’ is never truer than after the age of 50. At menopause, exercise becomes imperative for the maintenance of both muscle strength and bone mass.

Besides maintaining bone strength, the goal is to increase muscle mass to improve muscle function, and maintain strength and balance. Weaker muscles and poor balance contribute to more frequent falls and fractures.

Exercise for women with osteoporosis

If you have osteoporosis, your exercise programme should target balance, posture, coordination, gait, and hip and trunk stabilization. An individually targeted and supervised exercise programmes can aid recovery, prevent injurious falls, and improve the overall quality of life.

Exercises for postmenopausal women who are not suffering from osteoporosis

Overall, you must aim to exercise for about 30 to 40 minutes, at least thrice a week with some resistance and weight-bearing exercises under supervision.

2. Identify your risk factors

To enable you and your doctor to identify whether you may be at high risk of suffering osteoporotic fractures, you should be aware of the following ‘non modifiable’ risk factors:

Previous fragility fractures
Family history of osteoporosis and fractures
Early menopause
Rheumatoid arthritis
Diseases of malabsorption

3. Talk to your doctor

Menopause is the time to take action for a break free future – and that means consulting your doctor regarding your bone health. If you are encountering any risk factor, it’s important to ask your doctor for an examination which is likely to include an assessment of future fracture and bone density measurement. If you are at risk of falls, discuss fall-prevention strategies.

Depending on the results of the clinical assessment, your orthopaedic will make specific recommendations. Irrespective of risks and the treatment is prescribed, proper nutrition and an active lifestyle are essential to optimizing both your musculoskeletal and general health – and this is more important at menopause than ever before!

4. Avoid negative habits

Negative habits affect general health and also have a negative impact on the bone health, raising the risk of fractures and osteoporosis.

Smoking

Smokers and those who used to smoke in the past are at an increased risk of any fracture compared to non-smokers.

Excessive alcohol intake

Alcohol consumed moderately may not negatively impact your bone health. But long-term alcohol consumption significantly increases fracture risk in both women and men, affecting bone-forming cells and hormones and increasing risk of falls.

Maintaining a healthy weight

Being underweight is associated with increased bone loss and risk of fracture. For instance, individuals with a BMI of 20 kg/m2 will have a two-fold increased risk of fracture compared to those with a BMI of 25 kg/m2. Hence, it is imperative to ensure that the meals provide the necessary nutrients and enough caloric intake to maintain healthy muscles and bones.

For further details, request an appointment with an orthopaedic doctors.

Thyroid Gland: Facts, Diseases, and Treatment

Thyroid Gland Treatment

The thyroid gland is shaped like a butterfly, and is located low on the front side of the neck. It is below Adam’s apple, along the front of the windpipe. There are two side lobes in the thyroid, and they are connected by a bridge (isthmus) in the middle. We usually cannot feel our thyroid when it is in its normal size.

The thyroid is richly supplied with blood vessels, and is brownish-red in colour. Certain nerves that are important for our voice quality also pass through the thyroid. Several hormones, collectively called thyroid hormones, are secreted by the thyroid. Thyroxine, also called T4, is the main hormone. Metabolism, growth and development, and body temperature are all influenced by thyroid hormones. Adequate thyroid hormone is essential for brain development during infancy and childhood.

What Are the Common Thyroid Problems

Goiter: Swelling of the thyroid is termed Goiter. This can be harmless or may indicate iodine deficiency or a condition called Hashimoto’s thyroiditis, which is associated with thyroid inflammation
Thyroiditis: A viral infection or autoimmune condition can result in inflammation of the thyroid called Thyroiditis, which can be painful, or be completely asymptomatic
Hyperthyroidism: This is usually caused by Graves’ disease or an overactive thyroid nodule, and results in excessive thyroid hormone production
Hypothyroidism: Low production of thyroid hormone is Hypothyroidism. The most common cause of hypothyroidism is thyroid malfunction caused by autoimmune disease
Graves’ disease: Overstimulation of the thyroid due to an autoimmune condition, causing hyperthyroidism, is called Graves’ disease
Thyroid cancer: Though it is an uncommon form of cancer, thyroid cancer is usually curable. Treatment options are surgery, radiation, and hormone treatments
Thyroid nodule: These are very common and refer to small abnormal mass or lump in the thyroid gland. Few can be cancerous. They may either secrete excess hormones, causing hyperthyroidism, or cause no trouble at all
Thyroid storm: This is a rare form of hyperthyroidism where extremely high levels of thyroid hormone cause severe illness

Thyroid Tests

Anti-TPO antibodies: Sometimes, proteins mistakenly attack the thyroid peroxidase enzyme, which is used by the thyroid to make thyroid hormones. This is called the autoimmune thyroid disease
Thyroid ultrasound: When a probe is placed on the skin of the neck, the reflected sound waves can identify abnormal areas of thyroid tissue
Thyroid scan: In this test, a small amount of radioactive iodine is administered through the mouth to get thyroid gland images
Thyroid biopsy: A small amount of thyroid tissue is removed with a needle, and tests are done, in order to look for thyroid cancer
Thyroid stimulating hormone (TSH): TSH is secreted by the brain, and regulates the release of thyroid hormone. High TSH found in a blood sample indicates low levels of thyroid hormone (hypothyroidism), and low TSH suggests hyperthyroidism
T3 and T4 (thyroxine): These are the primary forms of thyroid hormone, and the levels can be checked with a blood test
Thyroglobulins: The thyroid secrets this substance, and it can be used as a marker of thyroid cancer. It is usually checked in follow-up in patients with a history of thyroid cancer. High levels of Thyroglobulins indicate recurrence of the cancer
Other imaging tests: If tests indicate that thyroid cancer has spread (metastasized), further investigations like CT, MRI, or PET scans can help identify the extent of spread

Thyroid Treatments

Thyroid surgery (thyroidectomy): Thyroidectomy is carried out for thyroid cancer, goiter, or hyperthyroidism, where surgery removes all or part of the thyroid
Antithyroid medications: The overproduction of thyroid hormones (hyperthyroidism) can be slowed down through medications
Radioactive iodine: This can be used in low doses for testing the thyroid gland or destroying an overactive gland. Cancerous tissue can be destroyed if large doses are used
External radiation: Over many appointments, a beam of radiation is directed at the thyroid, and these high-energy rays help kill cancerous cells in the thyroid
Thyroid hormone pills: This daily treatment in the form of thyroid hormone pills, helps to replace the amount of thyroid hormone one is unable to make. The pills treat hypothyroidism, and also help prevent thyroid cancer from coming back after treatment

If you have any of the abovementioned thyroid problems, do not leave it untreated. Consult an endocrinologist as soon as possible.

Living with a Congenital Heart Defect

“Your baby has a heart defect”
Words no new parent expects to hear. Yet those were the words of Priya’s doctor soon after she was born. And those words changed everything.
Unlike most newborns, Priya did not cry much. She also seemed to have no interest in feeding. Her parents started getting a little worried when relatives and friends began commenting that she looked pale. When six-week-old Priya was taken to her paediatrician for routine shots and she cried so hard that she turned blue, they became really alarmed. The next day, the doctors listened to Priya’s heart. The couple’s worst fears had come true. Their first child had a type of congenital heart defect called the Tetralogy of Fallot. People with this condition have four defects in their heart: a hole in the wall that divides the chambers, a thickening of the pulmonary artery, a thickening of the ventricular walls, and an overriding aorta. “Although the doctor explained everything to us, we heard little beyond, your baby has a heart defect”.
They were referred to a paediatric heart surgeon who told them surgery was the only way to repair their child’s heart. What followed was the most difficult period in the lives of Priya’s parents. After numerous tests, the date of the surgery was fixed. “Handing our child over to the surgeon on the day of the surgery was the toughest thing we have ever done,” Priya’s mother said. The parents knew that Priya would be in great hands, but even that couldn’t guarantee a positive outcome. When the doctor and his team emerged almost eight hours later and informed them the operation was a success, it was like their child was born again!
When finally Priya came home after discharge from the hospital, her parents heard something that they had not heard before from their daughter, a loud, hearty cry. Priya also began to feed properly. Soon, she was acting like a normal, healthy baby.
‘Congenital heart defect’ is another way of stating that your heart had a problem when you were born. It could be a hole in the heart, a valve defect, narrowed arteries, or a problem in the heart’s rhythm. Not all conditions are serious, and in some cases, no treatment may be required. Some conditions are, however, serious and maybe life threatening and could require either prolonged medical or surgical treatment.

What Are the Various Types of Congenital Heart Defects

The number of congenital heart defects is vast. Some of the more common defects include:

Septal defects where there’s a hole between the two chambers of your heart. It’s commonly known as “hole in the heart”
Coarctation of the aorta where aorta, the main artery of the body, is narrower than normal
Pulmonary valve stenosis where the pulmonary valve that controls the flow of blood out of the lower right chamber of the heart to the lungs is narrower than usual
Transposition of the great arteries where the pulmonary and aortic valves and arteries they are connected to have swapped positions
Underdeveloped heart is that part of the heart that doesn’t develop properly, making it difficult to pump enough blood

Why It Happens

In most cases, there is no obvious cause of congenital heart diseases. However, some things increase the risks of the condition, including:

Down’s syndrome – a genetic disorder affecting a baby’s normal physical development and leading to learning difficulties
The mother suffering from certain kinds of viral infections, such as rubella, during pregnancy
The mother taking certain medications during pregnancy
The mother drinking alcohol or smoking during pregnancy
The mother suffering from poorly controlled type 1 or type 2 diabetes
Other chromosomal defects, where genes may be altered from normal or inherited

Symptoms of Congenital Heart Defects

Congenital heart diseases may have several symptoms, especially in children, including:

Rapid heartbeat
Rapid breathing
Swelling of the tummy, legs, or around eyes
Extreme fatigue and/or tiredness
A blue tinge on the skin (cyanosis)
Tiredness and rapid breathing when being fed

These problems may become noticeable right after birth, although mild defects might not cause issues until later in life. If you notice the abovementioned signs as a child or in your children, it is essential to see a paediatric cardiologist immediately.

How Can Congenital Heart Defects Be Treated

Today, there’s good news for those babies who are diagnosed with congenital heart defects. Most of these defects can be either treated or helped through medicines, special devices such as artificial valves and pacemakers, or surgeries.
Heart transplants are often a possibility. These advances have helped millions of children all over the world with heart defects to survive to adulthood. Many of these surgeries have been performed before the age of two.
What About a Future With Congenital Heart Defects
Research is continuously being conducted regarding both the cause and the treatment of congenital heart defects. Several kinds of congenital heart defects may be repairable like in the case of Priya. Eight years later, Priya is living a normal life of a second-grader. She still has to be monitored, and she’s had surgery to insert an occluder septal device into her heart. But she runs around with her friends, her brother, and her pet dog. Priya embraces what she calls her “special heart”—and explains the reason for her scar to whoever asks her.
In many cases, however, these defects don’t have a long-term effect on a child’s health and in some cases, may not even be identified until adulthood. It’s essential to understand as much as you can about the CHD and the problems it may cause. The following guidelines provide recommendations on how to take measures to live the most normal and healthy life possible.

Ask questions. Learn the name(s) of your CHD
Be aware of your medical history thoroughly, including surgeries you may have undergone
Learn the risks you are likely to face as an adult
Know how to identify signs of a new heart problem
Maintain a list of any medications you’re taking, their dosages, and what they are for
Ensure that any diagnostic tests, medical procedures, and surgery for complex ACHD are performed by your ACHD centre
Exercise—but discuss the exercise programme with an ACHD cardiologist to know the ones that are appropriate for you
Consult your doctor to know what forms of birth control are safe—and check with an ACHD specialist before you become pregnant

Coronavirus: What We Do and Don’t Know

A rapidly evolving health news broke in late December 2019 with a novel illness originating in Wuhan, China. Reports of the number of infected people rose swiftly, and isolated cases of the new coronavirus — referred to as 2019-nCoV — have appeared in several countries. At this writing, about 2,000 new cases were recorded in China in the past 24 hours, raising the worldwide total to nearly 9,800, according to Chinese and World Health Organization (WHO) data.
With information about the coronavirus changing so quickly and news reports about the originating illness seeming to raise the stakes, you’re likely to be wondering how worried you ought to be. Here’s a primer on what we know about the virus and what it means for you. While there’s much we don’t yet know about the virus, medical experts, public health officials, and scientists are collaborating to provide more information.

What is a coronavirus?
Per the WHO, coronaviruses or CoV belongs to a large family of illness-causing viruses, ranging from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome or SARS-CoV and Middle East Respiratory Syndrome or MERS-CoV. A novel coronavirus or nCoV is a new strain that hasn’t previously been identified in humans.
Coronaviruses are zoonotic, indicating that they are passed on between animals and individuals. Recent research suggests that SARS-CoV was transmitted from civet cats and MERS-CoV from dromedary camels to us, humans. Several known coronaviruses are circulating in animals that have not yet infected us.

What are the common symptoms of coronavirus?
The common symptoms include cough with fever and in some cases, shortness of breath. There are reports of non-respiratory symptoms like vomiting, nausea, or diarrhoea. Many people easily recover within a few days. However, the elderly, very young, or people with a weak immune system may develop a more serious infection, such as pneumonia or bronchitis.

Are antibiotics effective in preventing/treating the coronavirus?
No, antibiotics don’t work against viruses. They can only fight bacteria. The new coronavirus is a virus and, therefore, antibiotics can neither be a means of prevention nor treatment. However, if hospitalized, you may receive antibiotics to prevent bacterial co-infection.

How is it treated?
Scientists are striving to understand the virus. Currently, there aren’t any approved antivirals for the coronavirus. For patients suffering from this illness, specialized, extensive care in an intensive care unit (ICU) can be lifesaving.

Can pets at home spread the coronavirus?
So far, there’s no evidence that pets like cats or dogs can be infected with the coronavirus. However, it is a good idea to wash your hands after contact with pets. This provides protection against common bacteria like Salmonella and E.coli that can pass on from pets to humans.

Should you worry about catching this virus?
Unless you are or have been in close contact with an individual who has the coronavirus — which right now, means a traveller from Wuhan, China (the epicentre of the outbreak) who has the virus — chances are that you are safe. So far, most cases are in people who have been in Wuhan, family members of those infected, or medical workers. India reported its first positive case of novel coronavirus on Thursday (30 January 2020). The patient is a student at Wuhan University and is now in isolation in a hospital in Kerala.
While we do not yet understand how the virus spreads, coronavirus is generally passed through droplets that contain large particles that can typically be suspended in the air for three to six feet before dissipating. By contrast, measles or chickenpox spread through smaller droplets over greater distances. Some coronaviruses have been found in the stool of some people.
So, it is likely that sneezes or coughs from an infected person are likely to spread the virus. It is too early to confirm whether yet another means of transmission, faecal-oral contact, is also capable of spreading coronavirus.
WHO’s recommendations for the public to reduce transmission of a range of illnesses, including the coronavirus, are as follows:

Clean your hands frequently with hand wash or soap and water
Cover mouth and nose with flexed elbow or tissue – throw away the tissue immediately and wash your hands when coughing or sneezing
Do not stay in close contact with anyone who has fever and cough
Seek immediate medical care and share travel history with the healthcare provider if you have cough, fever, and difficulty when breathing
Avoid unprotected contact with animals and those surfaces that are in contact with animals when visiting areas experiencing cases of coronavirus
Don’t indulge in the consumption of raw or undercooked animal products
Handle milk, raw meat, or animal organs carefully to avoid cross-contamination with uncooked foods

Given the current spread of this virus and the pace of international travel, the number of cases is likely to increase. The Chinese government has put Wuhan into virtual quarantine to stop further spread of the virus. A number of foreign governments have advised against non-essential travel to China and are flying their citizens out of Wuhan. As more information about the virus becomes available, public health organizations like the Centers for Disease Control (CDC) and WHO will be sharing information and strategies worldwide.

Nutrition: What Is It and Why Is It Important

Malnutrition is a complex problem to solve but, as levels of undernutrition and obesity rise, something must be done.

– Dr. Francesco Branca, leading food health expert, WHO.

What is Nutrition and the Importance of Nutrition?

Nutrition, aliment, or nourishment is the supply of materials – food – required by organisms to stay alive. Our food choices affect our health and this is why they say — we are what we eat.
Good nutrition forms an important part of a healthy lifestyle. Combined with physical activities, our diet can help us maintain a healthy weight, reducing the risk of developing chronic diseases and promoting our overall health.

What is the Impact of Nutrition on Your Health?

Millions of people are suffering from different forms of malnutrition. According to WHO, currently, in India, 1.9 billion adults are overweight or obese while 462 million are underweight. Among children, 52 million under-fives are suffering from wasting, where they have a low weight for height.

As mentioned earlier, nutrition is a critical part of our health and development. Malnutrition, in any form, poses threats to human health. Today the world faces a double burden of malnutrition that includes both undernutrition and overweight, especially in low- and middle-income countries.

Better nutrition is directly related to improved maternal, infant, and child health, better immune systems, safer pregnancy and childbirth, reduced risks of non-communicable diseases (like diabetes and cardiovascular diseases), and enhanced longevity. Healthier children learn better. Individuals who get adequate nutrition are usually more productive.

Thus, the link between good nutrition and healthy weight, lowered risk of chronic diseases, and overall health are too important to ignore. By taking steps to eat healthily, you’ll be ensuring that you have access to the nutrients your body needs to stay active, healthy, and strong. As with physical activities, making small changes in your diet can go a long way, and it is easier than you think!

How Can I Eat a Healthy Diet?

The easiest way to follow a healthy diet is to eat a balanced diet that fulfils all of a person’s nutritional needs. Humans require a certain amount of nutrients and calories to stay healthy. A balanced diet provides the nutrients an individual requires without crossing the recommended daily calorie count. A nutrition food chart is a visual guide that displays the recommended daily intake of essential nutrients and helps individuals make informed choices about their diet. According to WHO, the following are the keys to a healthy diet:

Eat a Variety of Foods

Eating a variety of whole, unprocessed, and fresh food every day helps both children and adults to obtain the right amounts of essential nutrients. It also helps them avoid a diet that is high in sugars, fats, and salt which can lead to unhealthy weight gain (i.e. overweight and obesity) and acquiring non-communicable diseases.

Eat a combination of different foods, including staple foods like cereals, such as barley, wheat, rye, or rice, or starchy tubers and roots such as potato, legumes like beans and lentils, vegetables, fruits, and food from animal sources like egg, meat, fish, and milk.

Include Plenty of Vegetables and Fruits in Your Diet

Fruits and vegetables are essential sources of vitamins, dietary fibres, minerals, plant protein, and antioxidants. People who follow a diet rich in vegetables and fruits are at a significantly lower risk of obesity, diabetes, heart disease, stroke, and certain types of cancer.

Eat a wide variety of vegetables and fruits
Opt for raw vegetables and fresh fruits when snacking, rather than foods that are high in fat, sugar, or salt
Avoid overcooking vegetables and fruits as this leads to the loss of essential vitamins
When buying dried or canned fruits and vegetables, go for varieties without added sugar and salt

Consume Moderate Amounts of Fats and Oils

Fats and oils are concentrated sources of energy. Consuming too much fat, especially the wrong kind of fat, will turn out to be harmful to health. For instance, people on a diet that comprise saturated fat and trans-fat are at greater risk of suffering from heart diseases.

Use unsaturated vegetable oils, such as olive, corn, sunflower, or soy oil, in place of animals fats or oils high in saturated fats like ghee, lard, palm, and coconut oil
Choose white meat (e.g. poultry) and fish, which are low in fats, over red meat
Limit the intake of processed meats as these are high in salt and fat
Whenever possible, choose low-fat or reduced-fat versions of dairy and milk products
Avoid baked, processed, and fried foods that contain industrially produced trans-fat

Reduce the Intake of Salt and Sugar

People whose diets are high in sodium, including salt are at a greater risk of getting high blood pressure, which increases the risk of heart diseases and strokes. Similarly, those on a high-sugar diet have a greater risk of becoming obese or overweight, and a risk of tooth decay. People who reduce the amount of sugar reduce the risk of non-communicable diseases like heart diseases and strokes.

For a healthy diet, sugar should ideally represent less than 10% of total energy consumption. Reducing further to about 5% will result in additional health benefits
Choosing fresh fruits instead of sweet snacks like cakes, cookies, and chocolates may help reduce sugar consumption
Limiting the consumption of soda, soft drinks, and other drinks high in sugar also helps reduce sugar intake

How Can I Make Healthy Choices When Shopping for Food?

You must thoroughly go through the Nutrition Facts Food Label on canned, frozen, and packaged food items. This label:

Lists the items that by law need to be listed on food products
Shows what a serving size of a food is, and how many calories and fat grams are in a serving, as well as how many calories of the food come from fat
Tells some important vitamins and minerals that the food provides

What if I Have More Questions About Nutrition?

Consult a doctor or dietitian

Your Liver needs the right care

The liver is an important organ and it produces clotting proteins that are necessary for the blood to clot, and for removing toxic substances that can be harmful to the body, such as drugs. The liver also plays an important role in regulating the supply of glucose and fat that the body uses as fuel. In cirrhosis the liver cells’ ability to add or remove substances from the blood are diminished or destroyed. Bile produced by liver cells has two main functions: to aid in digestion and to remove/eliminate toxic substances from the body. Due to Cirrhosis the liver is not able to eliminate toxic substances normally, and they accumulate in the body. Thus, Cirrhosis is the scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.

Symptoms of Liver Cirrhosis

Cirrhosis often has no signs or symptoms until the damage is extensive. Common signs and symptoms of cirrhosis may be:

Fatigue & Weight loss
Easily bleeding or bruising
Loss of appetite
Nausea
Swelling in your legs, feet or ankles (oedema)
Itchy skin
Yellow skin and eyes (jaundice)
Fluid accumulation in your abdomen (ascites)
Spiderlike blood vessels on your skin
Redness in the palms of the hands
Loss of periods in women not related to menopause
For men, loss of sex drive, breast enlargement or testicular atrophy
Confusion, drowsiness and slurred speech

Causes of Liver Cirrhosis

There are a number of diseases and conditions that can damage the liver and lead to cirrhosis.

Some common causes include:

Chronic alcohol abuse
Chronic Hepatitis B, C and D
Nonalcoholic fatty liver disease
Iron buildup in the body
Cystic fibrosis
Copper accumulated in the liver (Wilson’s disease)
Poorly formed bile ducts
Alpha-1 antitrypsin deficiency
Inherited disorders of sugar metabolism
Genetic digestive disorder
Liver disease caused by your body’s immune system (autoimmune hepatitis)
Destruction, Hardening and scarring of the bile ducts
Infection, such as syphilis or brucellosis
Medications, including methotrexate or isoniazid

Risk factors

Excessive consumption of alcohol
Obesity increases the risk of conditions leading to Cirrhosis, like nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.
Chronic hepatitis may be one of the world’s leading causes of liver disease

Complications

Liver Cirrhosis may lead to complications like:

High blood pressure in the veins Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood to the liver from the intestines and spleen.
Swelling in the legs and abdomen Increased pressure in vein can cause fluid to accumulate in the legs and in the abdomen (ascites). Edema and ascites also result from the inability of the liver to make enough of certain blood proteins, like albumin.
Enlargement of the spleen (splenomegaly) Increased pressure in the veins can also cause changes to and swelling of the spleen, and trapping of white blood cells and platelets. First sign of cirrhosis may be decrease white blood cells and platelets in the blood
Bleeding Strained by the extra pressure, these smaller veins can burst, causing serious bleeding. High pressure in veins can also lead to bleeding in the esophagus or the stomach and can be life-threatening. Continuous bleeding will happen if the damaged liver is not able to make enough clotting proteins
Infections Having cirrhosis, may make it difficult for the body to fight infections. Ascites can also lead to bacterial peritonitis, a serious infection.
Malnutrition Cirrhosis makes it difficult for the body to process nutrients, leading to weakness an weight loss.
Buildup of toxins in the brain Once, a liver is damaged by cirrhosis, it is not able to clear toxins from the blood as well as before. These toxins, when they build up in the brain may cause mental confusion and difficulty concentrating which can progress to unresponsiveness or coma.
Jaundice Jaundice occurs when the diseased liver isn’t able to remove bilirubin, a blood waste product, from your blood. It causes yellowing of the skin and whites of the eyes and darkening of urine.
Bone disease People with cirrhosis lose bone strength and are at greater risk of fractures.
Increased risk of liver cancer liver cancer is common among amongst people who have pre-existing cirrhosis.
Acute-on-chronic cirrhosis. Researchers believe that many people end up experiencing multi-organ failure while suffering from Cirrhosis.

Ways to prevent

Here are a few ways to care for your liver:

Avoid alcohol if you have cirrhosis
Eat a healthy diet that’s full of fruits and vegetables, whole grains and lean protein instead fatty and fried food
Maintain a healthy weight and create a weight-loss plan if you are obese or overweight.
Stop sharing needles, having unprotected sex to reduce the risk of hepatitis B and C. Get vaccinated for hepatitis

Stomach Pain? Could be Ulcerative Colitis

Ulcerative colitis is a chronic disease that causes inflammation/irritation and sores called ulcers on the inner lining of the large intestine or the colon. Here the lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucous. Usually the cells and proteins that make up the immune system protect one from infection. In people with inflammatory bowel diseases, however, the immune system mistakes food, bacteria, and other materials in the intestine for foreign or invading substances. During such situations the body sends white blood cells to the lining of the intestines, where they produce chronic inflammation and ulcerations. Temporary inflammation is caused by the immune system to combat an illness or infection, and then the it is reduced but in people with ulcerative colitis, however, this inflammation can persist long after your immune system finishes its job.

Thus, Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal (GI) tract, and is also called inflammatory bowel disease (IBD).

Causes of Ulcerative colitis

The exact cause of ulcerative colitis remains unknown. Diet and stress were previously suspected for it, but now doctors know that these factors may aggravate but don’t cause ulcerative colitis. One possible cause for it could be an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.

What are the risk factors of Ulcerative colitis?

The exact cause of ulcerative colitis is unknown. The following factors may play a role in causing ulcerative colitis among people:

Ulcerative colitis may begin before the age of 30. It can occur at any age, and may even occur in people at the age of 60.
Race or ethnicity. It can occur in any race but Jewish descent people, have a higher risk
Family history. One is at a higher risk if you have a close relative, such as a parent, sibling or child, with the disease

Symptoms

Ulcerative colitis symptoms may be different for different people and may also depend on the severity of inflammation and where it occurs. Signs and symptoms may include:

Diarrhoea, accompanied by blood or pus
Abdominal pain and cramping
Rectal pain & bleeding
Urgency to defecate
Inability to defecate despite urgency
Weight loss & Fatigue
Fever
failure to grow in children
Anaemia

Diagnosis of the disease

In order to confirm a diagnosis of ulcerative colitis, you may have to undergo one or more of the following tests and procedures:

Blood tests. Blood tests may be done to check for anaemia, a condition in which there aren’t enough red blood cells to carry adequate oxygen to your tissues or to check for signs of infection.
Stool sample. The presence of white blood cells in the stool can indicate ulcerative colitis. A stool sample can also help rule out other disorders caused by bacteria, viruses and other infections.
Colonoscopy. Here the doctor views your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, small samples of tissue (biopsy) can be taken for laboratory analysis which may help to confirm a diagnosis.
Flexible sigmoidoscopy. A slender, flexible, lighted tube is used to examine the rectum and sigmoid, the last portion of your colon. For a severely inflamed colon, this test may be performed instead of a full colonoscopy.
X-ray. In severe cases X-ray of your abdominal area is done to rule out serious complications, such as a perforated colon.
CT scan. A CT scan of your abdomen or pelvis may be performed to reveal how much of the colon is inflamed.

CT enterography and MR enterography. These noninvasive tests may be prescribed to exclude any inflammation in the small intestine and are better than the conventional imaging tests. MR enterography is a radiation-free alternative

Treatment

Ulcerative colitis can be treated in different ways depending upon the severity of the situation.

Anti-inflammatory drugs are often the first step in the treatment of ulcerative colitis
Immune system suppressors reduce inflammation, and suppress the immune system’s response that starts the process of inflammation
Other Medication like antibiotics, pain relievers and iron supplements can be used effectively
Surgery can often eliminate ulcerative colitis. But that usually means removing your entire colon and rectum (proctocolectomy).Your surgeon may create a pouch from the end of your small intestine. The pouch is then attached directly to your anus, allowing you to expel waste relatively normally. In some cases a pouch is not possible and surgeons create a permanent opening in your abdomen (ileal stoma) through which stool is passed for collection in an attached bag
Since for such patients the risk of Colon Cancer increases, it is essential to be on constant follow up