REVISITING THE YEAR 2015

REVISITING THE YEAR 2015

Medicine is a rapidly changing field with many new researches and breakthroughs coming up every day, which shape day to day practice. The year 2015 too saw several advances in medicine and release of new and/or updated guidelines. Here is a quick snapshot of some researches that made the headlines in the year gone by. This by no means is a complete list. Our readers are welcome to add to this list…

• The landmark SPRINT or Systolic Blood Pressure Intervention Trial showed that a more intensive strategy of managing BP reduces the risk for death and cardiovascular events when compared with a strategy that lowers systolic blood pressure to the conventional target of 140 mm Hg. Treating high-risk hypertensive adults aged 50 years and older to a target of 120 mm Hg significantly reduced cardiovascular events by 30% and all-cause mortality by nearly 25%. The study funded by the National Institutes of Health (NIH) was stopped early because of the benefit of the intensive strategy.
• The FDA approved two new lipid lowering drugs, human monoclonal antibody PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors - alirocumab and evolocumab - for patients with familial hypercholesterolemia (FH) and for patients at high or very high risk for CV events who are unable to reach LDL targets despite maximally tolerated statin therapy.
• The EMPA-REG OUTCOME study, a cardiovascular-outcomes trial, for the first time, showed superiority of the diabetic drug empagliflozin (Jardiance), sodium glucose cotransporter-2 (SGLT-2) inhibitor in reducing the rate of cardiovascular death, nonfatal MI, and nonfatal stroke among individuals with type 2 diabetes and established cardiovascular disease with 38% reduction in CV death and 32% reduction in all-cause mortality.
• The US Food and Drug Administration (FDA) approved the combination tablet valsartan/sacubitril (Entresto, Novartis) for the treatment of patients with heart failure. It is the first approved agent in the angiotensin receptor-neprilysin inhibitor (ARNI) class and exerts its effect within and beyond the renin-angiotensin system. Besides reducing heart failure deaths, Entresto also reduces heart failure hospitalizations.
• A head-to-head comparison of the everolimus-eluting stent with a bioresorbable scaffold (Absorb, Abbott Vascular) against a conventional everolimus-eluting cobalt-chromium stent (Xience, Abbot Vascular) in the ABSORB III trial, the two devices yielded similar rates of target lesion failure (TLF) at 1 year; 7.8% vs 6.1%, respectively. TLF is a composite end point that included cardiac death, target vessel MI, or ischemia-driven target lesion revascularization.
• A novel oral anticoagulant (NOAC) reversal agent received FDA approval this year. The dabigatran reversal agent idarucizumab (Praxbind, Boehringer Ingelheim) is the first reversal agent approved specifically for dabigatran (Pradaxa Boehringer Ingelheim). In November, the New England Journal of Medicine published results of the factor Xa reversal agent andexanet alfa, which safely reversed the anticoagulant effect of apixaban and rivaroxaban in older volunteers.

·         The Institute of Medicine (IOM) gave a new name to chronic fatigue syndrome, systemic exertion intolerance disease or SEID, highlighting the role of exertion in aggravating the symptoms. IOM also defined clear and simpler diagnostic criteria for SEID

o   A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities, that persists for > 6 months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest

o   Post-exertional malaise

o   Unrefreshing sleep

Plus, at least one of the following: Cognitive impairment or orthostatic intolerance

• The FDA announced a new policy for blood donations by gay men overturning a lifetime ban that dates to 1983. It allows gay men to donate blood and excludes only those whose last sexual contact with another man occurred in the 12 months prior to donation. But, the ban remains in place for commercial sex workers and people who use injection drugs. People with hemophilia or related clotting disorders are also still barred from donating blood for their own protection due to potential harm from large needles used during the donation process.
• The American Cancer Society (ACS) updated its breast cancer screening guidelines for women at average risk of developing the disease. ACS now recommends that women should start annual screening with mammography at age 45, not 40 as recommended earlier. At age 55, women can transition to screening every 2 years instead of annually. 
• An update of the American College of Obstetricians and Gynecologists (ACOG) cervical cancer screening guidelines recommends that women aged between 30 and 65 years and at "average risk" for cervical cancer should be co-tested with cytology and HPV testing every 5 years, or screening with cytology every 3 years. It does not recommend HPV co-testing for women younger than 30 years.
• Dirty endoscopes, particularly duodenoscopes used in endoscopic retrograde cholangiopancreatography topped the list of health technology hazards in ECRI Institute's Top 10 list for 2016. Poorly cleaned flexible endoscopes prior to disinfection can increase the risk of transmitting infections.  Outbreaks of multidrug resistant bacteria have been linked to duodenoscopes despite following proper reprocessing instructions.
• The WHO issued “Early Release Guideline” on when to start antiretroviral therapy and on pre-exposure prophylaxis (PrEP) for HIV. The two major recommendations are: Initiation of antiretroviral therapy (ART) in adults with HIV irrespective CD4 cell count, use of daily oral pre-exposure prophylaxis (PrEP) as a prevention option for people at substantial risk of acquiring HIV infection. The comprehensive guidelines are expected to be released in 2016.
• Immunotherapy has been identified as the game changer for oncology with studies demonstrating cancers like non-small cell lung cancer (NSCLC), breast cancer, multiple myeloma responding to immune checkpoint inhibitors. Earlier in the year, FDA approved Opdivo (nivolumab) to treat patients with advanced squamous NSCLC whose disease progressed during or after platinum-based chemotherapy. In October, FDA expanded the use of Opdivo to also treat patients with non-squamous NSCLC. 
• The FDA approved new formulations for delivering carbidopa/levodopa for patients with Parkinson’s disease. Rytary is an extended-release capsule formulation of carbidopa-levodopa for the for the treatment of Parkinson's disease (PD), postencephalitic parkinsonism and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication. Duopa, enteral suspension for the treatment of motor fluctuations for people with advanced Parkinson's disease and is administered using a small, portable infusion pump that delivers carbidopa and levodopa directly into the small intestine for 16 continuous hours via a percutaneous endoscopic gastrostomy procedure with jejunal extension.
• The American Heart Association (AHA) new guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC)emphasize on quick action, proper training, use of technology and more teamwork - from bystanders to dispatchers, emergency responders to healthcare providers - to increase survival from cardiac arrest. The new compression rate is 100–120 a minute, while earlier it was “at least 100.” The new compression depth is 2–2.4 inches for adults and adolescents; it had been “at least 2 inches.
• The WHO report classifying red meat and processed meat as carcinogenic created controversy and panic. The International Agency for Research on Cancer (IARC), the cancer research agency of WHO classified the consumption of red meat as ‘probably carcinogenic’ to humans and processed meat as ‘carcinogenic’ to humans. Eating 50 gm portion of processed meat daily increases the risk of colorectal cancer by 18%. However, the WHO later tried to ease the panic by emphasizing that the findings only confirmed recommendations made back in 2002, which advised people to reduce their consumption of these products to reduce the risk of cancer.
• The American Academy of Pediatrics (AAP) endorsed a recommendation for early introduction of peanut-containing foods in to the diets of infants at high risk of peanut allergies. This current consensus statement from 10 medical organizations in Europe and the United States is based on findings of the Learning Early about Peanut Allergy (LEAP) randomized trial, which found that the early introduction of peanuts into the diet of high-risk infants lowered their likelihood of being allergic to them.
• Ocrelizumab, a second-generation monoclonal antibody targeting B-cells has been a major advance in multiple sclerosis. Although not available for marketing, it has shown encouraging results in clinical trials (OPERA I and II, ORATORIO) for both relapsing-remitting and primary progressive multiple sclerosis.
• Many other guidelines have been released: pediatric pulmonary HT (AHA/ATS), pediatric perioperative anesthesia (AAP), thyroid nodule diagnosis & management (ATA), polymyalgia rheumatic (EULAR/ACR), rheumatoid arthritis (ACR)

When Europe can be free of malaria, why can't India? - IMA’s views on how NICD Coolers can help tackle the malaria menace

When Europe can be free of malaria, why can't India? - IMA’s views on how NICD Coolers can help tackle the malaria menace New Delhi, April 25, 2016: Dengue and Chikungunya have become important outbreak prone vector-borne diseases in the country. Outbreaks result in loss of working man-hours, long period disability in patients after initial recovery from diseases like Chikungunya, mortality in patients suffering from dengue hemorrhagic fever, which directly affect the economy of the society. The mosquitoes transmitting these viral diseases are found breeding in domestic/peri-domestic containers including desert coolers. The conventional desert coolers are being used in many parts of the country as cooling devices in houses, offices and industrial establishments during the summer months. They hold water for long period and they have become the potential breeding grounds for dangerous mosquitoes in absence of adequate control efforts. A study carried out in Delhi area revealed that these conventional coolers contribute to more than 50% of the breeding places of dengue vectors. This happens for the following reasons: The water tank of the conventional coolers is open type that attracts mosquitoes for egg laying and results in prolific breeding of Aedes aegypti mosquitoes and transmits dengue/Chikungunya viruses. Weekly larviciding or cleaning is required to prevent breeding of mosquitoes inside the cooler, which is often not practiced. Standing water in the cooler, when not in use, particularly during monsoon season, has high potential for the breeding of dengue vector mosquito and thus increases the risk of disease transmission. In order to overcome the above problems, a mosquito-proof desert cooler (NICD Cooler) has been designed in 2009. The NICD cooler is a patented item and registered with National Research Development Corporation (A DSIR enterprise, Ministry of Science and Technology). Speaking about the same, Dr SS Agarwal – National President IMA & Padma Shri Awardee Dr KK Aggarwal – Honorary Secretary General IMA said, “Eradication of malaria is a key goal of the IMA. Last week, the WHO declared the European region free of malaria with zero cases of malaria reported in the year 2015. When Europe can be free of malaria, why can't we? IMA believes that through concentrated efforts, we can fight the mosquito borne disease responsible for a large number of preventable deaths in our country. Awareness on hygiene and sanitation, disease prevention as well as community management of the disease is key. The development of unique products like the NICD coolers aimed at tackling the malaria menace must be encouraged. Together we must take a pledge to make India a malaria free country.” The NICD cooler has the following advantages over the conventional desert coolers: Water tank of the NICD cooler is completely covered to prevent the entry of mosquitoes in to the water tank for egg laying. There is thus no risk of disease transmission due to coolers. No weekly cleaning of the water tank is required. No chemical larvicide is required to kill mosquito larvae. It can be conveniently installed in high-rise buildings. Even standing water in the cooler, when not in use, has no risk of mosquito breeding.

Do not ignore transient brain dysfunction

Do not ignore transient brain dysfunction

TIA or transient ischemic attack or mini paralysis is "a brief episode of neurologic dysfunction caused by lack of blood supply to a specific area of the brain or eye, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction or brain attack", said Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA.

It is a neurological emergency; its early recognition can identify patients who may benefit from preventive therapy or from surgery of large vessels such as the carotid artery.

The initial evaluation of suspected TIA and minor non disabling ischemic paralysis includes brain imaging, neurovascular imaging, and a cardiac evaluation. Laboratory testing is helpful in ruling out metabolic and hematologic causes of neurologic symptoms.

TIA or minor non disabling ischemic paralysis is associated with a high early risk of recurrent paralysis. The risk of paralysis in the first two days after TIA is approximately 4 to 10 percent.

Immediate evaluation and intervention after a TIA or minor ischemic reduces the risk of recurrent stroke.

Risk factor management is appropriate for all patients. Currently viable strategies include blood pressure reduction, statins, antiplatelet therapy and lifestyle modification, including smoking cessation.

For patients with TIA or ischemic stroke of atherothrombotic, lacunar (small vessel occlusive), or cryptogenic type, antiplatelet agents should be given. For patients with atrial fibrillation and a recent ischemic stroke or TIA, the treatment is blood thinners. For patients with carotid blockages surgery is needed.

Follow your heart ... Realize your dream

Follow your heart ... Realize your dream 

 Dr KK Aggarwal, Editor in Chief eMedinewS and IMA News in conversation with Dr HS Bhanushali, Consultant General & Thoracic Surgeon, Thane.

Dr HS Bhanushali has been honored with Dr BC Roy National Award for the year 2009 under the category of ‘Best Talents in encouraging the development of Specialties in different branches of Medicine’.

How does it feel being conferred one of the most prestigious awards in the medical field?

I feel extremely delighted and at the same time humbled to have received this prestigious award. I am grateful to the President and Members of the award committee to have selected me for this award.

Tell us about your journey so far.

I was born in a small hamlet in Shahapur Taluka, Thane district in a poor family. As there was no secondary education available in my village, at the age of 12, I left home to join school at Shahapur 16 miles away. Every day, I had to cross a river just to be able to get to my school.

In those days patients from in and around my village had to travel to the big cities for medical treatment. Looking at their plight, I decided to become a doctor and dedicate my life to serving the underprivileged. When I completed MS, I was offered prestigious jobs in India as well as abroad. But I was determined to offer my services in an area where medical facilities were not readily available. I renounced all the lucrative offers coming my way and started practice at a small rental place in Thane. Eventually I built a 25-bedded private hospital in Thane. It was one of the first hospitals in Thane. We had patients coming in from all the surrounding villages for treatment.

It has always been my mission to make quality treatment available to all. With that I mind I developed the “Kaushalya Medical Foundation Trust Hospital” in Thane, in 2002. It is a 110-bed hospital with over 150 consultants and a state of the art technology which caters to the working class population of Thane. It was my dream to make medical treatment available at affordable costs to all strata of society and to achieve it, I spent my life’s savings in constructing this Hospital.

What were the early challenges faced by you in your career? How did you manage to overcome them?

When I started my practice in the 60s, health awareness was practically zero in the rural areas. To increase health awareness and for early diagnosis, I used to travel to the rural areas every weekend and conduct health camps, providing free check-up, for years together. During these camps I realized that tuberculosis was a looming problem, which was widespread and severely affected the quality of life of the patients. The lack of knowledge and awareness regarding TB and the social stigma associated with the disease also compelled me to work towards tackling the problem of TB. In 1968, I formed the “Thane District TB Association.” From 1968 -1975, I covered the whole of Thane district and arranged TB, BCG and medical check-up camps every weekend. I examined approximately 4-5 thousand patients each week, took mass mini X-rays and administered BCG vaccines to small children. Nearly 3.5 lakh kids were administered BCG vaccine during these camps. These camps were not only aimed at treating patients but also trying to increase the awareness about TB.

The TB patients, who required surgery, were admitted to either MT Agarwal (Mulund) or Sewree TB Hospital, both Municipal run and I used to perform surgery on them, free of cost. From 1966-1993,I performed over 4600 chest surgeries for Pulmonary Tuberculosis and nearly 12000 general surgery operations in municipal general hospital.

At that time I also realized that the resources for learning advanced surgical techniques in India were limited. So I went abroad, mastered advanced techniques like highly selective vagotomy and thoracoscopic surgery and brought them back to treat our ailing population.

Tell us about your family. How important has been the role of family in your journey?

My wife Dr Mrs Asha Bhanushali, a gynecologist by profession has been my biggest pillar of strength in my professional as well as personal life. She has played various roles over the years from being a good surgical assistant during my initial practice, to an excellent gynecologist, an able hospital administrator to a wonderful working mother. I could chase my dreams because she took care of things around me. My son Dr Amol has continued in my chosen field and has taken it to the next level of Advanced Thoracoscopic surgery.

What would be your message to the community?

Have patience, tolerance and faith in the medical system. Early diagnosis is critical, so do not procrastinate and consult a doctor at the right time. Also, the community needs to bring back the change in relationship from doctor-consumer to doctor-patient.

Given a chance, what changes would you like to bring about in health policies.

Standardization of quality of healthcare and indirectly that of medical education is the need of the hour. I would also like to see a larger number of well-structured screening programs being implemented for e.g. a better program for awareness, detection and treatment of TB, especially DRTB. Lastly, the medical insurance system should be more patient-friendly as well as hospital-friendly.

What advice would you give to youngsters?

My advice would be to follow your heart. If you have a dream, set no stone unturned to realize it. Be committed to your profession and have good work ethics; name, fame and money will follow.

Common symptoms that may indicate calcium deficiency: HCFI

Common symptoms that may indicate calcium deficiency: HCFI

New Delhi: June 18, 2016: Calcium is important for maintaining strong bones. It also helps in blood clotting, early developmental growth and muscle contraction and relaxation. Calcium can be easily obtained from natural food sources like leafy vegetables, yoghurt, nuts and cheese. However, the majority of the Indians, specifically in the age group of 14-20 years suffer from calcium deficiency due to lack of efficient absorption. “Calcium deficiency disease, also known as hypocalcemia, occurs when you don’t get enough calcium. It is crucial that people are educated about the effects of calcium deficiency on the overall health and wellbeing of people in the long run. Those suspected of suffering from calcium deficiency should not self-diagnose and treat themselves by consuming large amounts of calcium supplements. Instead, it is important that they consult their doctor and together devise a healthy eating plan supported by supplementation,” said Padma Shri Awardee Dr KK Aggarwal – Honorary Secretary General IMA & President Heart Care Foundation of India (HCFI) The natural ageing process can cause calcium deficiency disease. Most of the calcium in your body is stored in your bones. As you age, your bones begin to thin or become less dense, increasing your daily calcium requirement. It’s important that women, in particular, get their calcium levels checked in their middle age and take necessary supplementation for the decline in the hormone estrogen during menopause causes a woman’s bones to thin faster. Other causes of calcium deficiency disease include malnutrition (starvation), hormone disorder hypoparathyroidism, premature delivery and malabsorption. Malabsorption is when your body can’t absorb the vitamins and minerals you need from the food you eat. A few signs and symptoms of calcium deficiency that everyone should be aware of include: - Muscle cramps: Despite an adequate level of haemoglobin and sufficient water intake, if you suffer from regular muscle cramps, it could be a sign of calcium deficiency. · Low bone density: Calcium is required for mineralisation of bones to keep them strong, as we grow old. Therefore, low calcium levels directly affect the bone density and increases susceptibility to osteoporosis and fractures. · Brittle nails: Our nails need calcium deposits for maintaining their strength. Lack of calcium can make our nails brittle and weak. A · toothache: Given that about 99% of our body’s calcium is stored in our bones and teeth, calcium deficiency is bound to cause toothache and decay. · Menstrual cramps: Women suffering from calcium deficiency may face high levels of pain during menstruation given the crucial role played by calcium in muscle contraction and relaxation. · Low immunity: Calcium helps maintain a healthy immune system. The deficiency of calcium reduces body’s resistance against pathogen attack. · Neurological problems: Lack of calcium can cause neurological problems such as seizures and headaches that occur due to excess pressure on the head. A deficiency in calcium may lead to neuropsychiatric symptoms like depression, insomnia, personality changes and even dementia. · Palpitation: Calcium is required for your heart to function properly and in case, of a deficiency; your heart palpitation will increase to an abnormal speed and result in uneasiness too. Calcium helps the heart pump blood and enables the heart to contract well too. If you are suffering from any of these symptoms, it is important to consult your doctor who will then advise a blood test to determine your body’s calcium levels. The cure to calcium deficiency includes consuming a high calcium diet and supplementation.

Do not compromise with standards

Dr KK Aggarwal, Editor in Chief eMedinewS and IMA News in conversation with Dr Yash Gulati, Sr Consultant Joint Replacement & Spine Surgeon, Coordinator Division of Joint Replacement, Apollo Hospitals, New Delhi. Dr Yash Gulati has been honored with Dr BC Roy National Award for the year 2008 under the category of ‘Outstanding Services in the field of Socio-Medico Relief’. How does it feel being conferred one of the most prestigious awards in the medical field? I feel humbled. Gives me energy to work with greater gusto and to work with dedication and integrity. Tell us about your journey so far. जुसतजु हो तो सफ़र कहाँ ख़त्म होता है वरना हर मोड़ पेमँजिल का ग़ुमा होता है I am an alumni of prestigious Maulana Azad Medical College, Delhi. I did my MCh (Orthopedics) from University of Liverpool, England and Diploma in Sports Medicine from Royal College of Surgeons, Dublin, Ireland. I super specialized in Minimally Invasive Spine Surgery, Microdiscectomy for Slip Disc and correction of Spine Deformities. After having worked for number of years in England and Republic of Ireland and doing fellowships in different countries, I returned to India to join Apollo hospital right from its inception. I popularized the Gyroscope-based Pin Less Navigation for knee replacement in India, a technique which allows accurate positioning of implants with less chances of embolism and blood loss. The shelf life of knee replacement is also likely to increase because of accurate placement, especially in complex cases. Another contribution of mine is setting up of the Dept. of Spine Surgery in medical college, Aligarh Muslim University where tremendous work is being done now. I also have the honor of being the first Indian orthopedic surgeon to have done Endoscopic Disc surgery for Slipped Disc in India. I have contributed a number of scientific papers both in the Indian and Foreign journals and have the largest series cases in India for Total Hip Replacement in Sickle Cell Disease. I have also been a teaching faculty for numerous Orthopedic Conferences in India and abroad. Along the way, I have held various positions as the President of Delhi Orthopedic Association and Chairman, Implants Committee, Indian Bureau of Standards, Honorary Consultant to Indian Armed forces, Honorary Consultant to Border Security Force and was Adjunct Professor, Indira Gandhi national Open University (IGNOU). I have travelled to more than 20 countries to promote “Medical Tourism” in India and encourage people to come to India for treatment especially for complex problems. In 1999, I anchored a popular talk show on Doordarshan called “High Tech Surgery – Dr Yash Gulati Health Show”. This was the first time that a medical show in India had live audience participation, questions on telephone and demonstration of high tech surgeries. In my role as Trustee for the “Varishth Nagrik Kesri Club”, a well-known social organization, I have been involved in spreading awareness about medico-social problems in elderly. I have been Senior Consultant at Division of Joint Replacement & Division of Spine surgery, Orthopedics, Apollo Hospital, New Delhi for 18 years and Advisor Orthopedics, Apollo Group of Hospitals. I am also a visiting Senior Specialist Orthopedic Surgery at RAK Hospital, United Arab Emirates. I was awarded the Padma Shri by President of India in the year 2009. I started from a humble background. And, coming so far is like a dream come true. What were the early challenges faced by you in your career? How did you manage to overcome them? There were a few hiccups, but otherwise no major problems. Settling in private practice and to keep up with academic activities was a bit of a challenge, but it was important to do both and with God's grace, I was able to do it. Tell us about your family. How important has been the role of your family in your journey? My wife Dr Renu is an Associate Prof. Institute of Home Economics, University of Delhi and teaches Human Development. She has been extremely supportive and without her support I could not have progressed. She is also an Advisor to Delhi Public School Society, Vice President of Varishtha Nagrik Kesri Club for elderly and is doing voluntary work with Delhi Police Woman Welfare Society. My daughter Nitya is doing Fellowship in Pediatric Heme-Oncology at Memorial Sloan Kettering, New York. My son, Sukrit, did his Engineering and Masters in Finance from University of Illinois at Urbana-Champaign, USA and is now working with KPMG, India. My son-in-law, Jas Karan, is doing his MCh Cardiothoracic Surgery from Sion Hospital, Mumbai. My parents, Smt Padma (School teacher) and Shri Jai Diyal Gulati (government servant ... Administrative Officer) retired from service long ago and are socially active. What would be your message to the community? My message to the medical community..... Do good work and maintain dignity of the profession. My motto ... ‘Do it Right’. Given a chance, what changes would you like to bring about in health policies? Some changes that I would like to bring about in health policy are: • Health Insurance for all • Less duty on imported medical instruments, implants and drugs • Incentivize indigenous manufacture of medical equipment and implants • Do not discourage doctors from going abroad for training. No bonds (they serve no useful purpose)… some may not come back, but still support families here. And, those who come back after training, add quality. It’s a win-win situation for the country. This is the policy for engineers, other professions ... So why should it be different for the medical profession? • Strict vigil on standard of private medical education. They are welcome to earn money but must bring out doctors at par with international standards. • Common entrance exam for UG and PG medical courses. This will bring up the standards and is good for national unity!!! Let people move between states. In fact, this should happen for types of higher education. Let everybody be eligible in every college in the country. What advice would you give to youngsters? • Have integrity • Maintain dignity. • Do not compromise with standards. • Do good work - Money will follow. It cannot be the other way round! जो अपनी फ़िकर* को ऊँची उड़ान देता है खुदा भी उसे खुला आसमान देता है * thought process / aim.

Common symptoms that may indicate calcium deficiency: HCFI

Common symptoms that may indicate calcium deficiency: HCFI

Calcium is important for maintaining strong bones. It also helps in blood clotting, early developmental growth and muscle contraction and relaxation. Calcium can be easily obtained from natural food sources like leafy vegetables, yoghurt, nuts and cheese. However, the majority of the Indians, specifically in the age group of 14-20 years suffer from calcium deficiency due to lack of efficient absorption.

“Calcium deficiency disease, also known as hypocalcemia, occurs when you don’t get enough calcium. It is crucial that people are educated about the effects of calcium deficiency on the overall health and wellbeing of people in the long run. Those suspected of suffering from calcium deficiency should not self-diagnose and treat themselves by consuming large amounts of calcium supplements. Instead, it is important that they consult their doctor and together devise a healthy eating plan supported by supplementation,” said Padma Shri Awardee Dr KK Aggarwal – Honorary Secretary General IMA & President Heart Care Foundation of India (HCFI) 

The natural ageing process can cause calcium deficiency disease. Most of the calcium in your body is stored in your bones. As you age, your bones begin to thin or become less dense, increasing your daily calcium requirement. 

It’s important that women, in particular, get their calcium levels checked in their middle age and take necessary supplementation for the decline in the hormone estrogen during menopause causes a woman’s bones to thin faster.

Other causes of calcium deficiency disease include malnutrition (starvation), hormone disorder hypoparathyroidism, premature delivery and malabsorption. Malabsorption is when your body can’t absorb the vitamins and minerals you need from the food you eat.

 A few signs and symptoms of calcium deficiency that everyone should be aware of include:

- Muscle cramps: Despite an adequate level of haemoglobin and sufficient water intake, if you suffer from regular muscle cramps, it could be a sign of calcium deficiency.

· Low bone density: Calcium is required for mineralisation of bones to keep them strong, as we grow old. Therefore, low calcium levels directly affect the bone density and increases susceptibility to osteoporosis and fractures.

· Brittle nails: Our nails need calcium deposits for maintaining their strength. Lack of calcium can make our nails brittle and weak.
A · toothache: Given that about 99% of our body’s calcium is stored in our bones and teeth, calcium deficiency is bound to cause toothache and decay.

· Menstrual cramps: Women suffering from calcium deficiency may face high levels of pain during menstruation given the crucial role played by calcium in muscle contraction and relaxation.

· Low immunity: Calcium helps maintain a healthy immune system. The deficiency of calcium reduces body’s resistance against pathogen attack.

·  Neurological problems: Lack of calcium can cause neurological problems such as seizures and headaches that occur due to excess pressure on the head. A deficiency in calcium may lead to neuropsychiatric symptoms like depression, insomnia, personality changes and even dementia.

· Palpitation: Calcium is required for your heart to function properly and in case, of a deficiency; your heart palpitation will increase to an abnormal speed and result in uneasiness too. Calcium helps the heart pump blood and enables the heart to contract well too.

If you are suffering from any of these symptoms, it is important to consult your doctor who will then advise a blood test to determine your body’s calcium levels. The cure to calcium deficiency includes consuming a high calcium diet and supplementation.