About 1.8 million Indians suffer from stroke every year

About 1.8 million Indians suffer from stroke every year

On World Stroke Day, it is important to create awareness on the fact that timely detection and treatment can prevent permanent disability

New Delhi, 28 October 2017: The second most common cause of death globally, next to coronary artery disease, stroke is also the most prevalent cause of chronic adult disability, reveal statistics. India accounts for more than four-fifths of all strokes with about 1.8 million Indians suffering from this condition every year. The IMA opines that stroke is not just limited to the elderly and increasingly, young Indians below 40 years of age are becoming susceptible to this condition primarily due to lifestyle factors.

A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die. It is imperative to detect a stroke early, as with every second that the disease goes untreated, about 32,000 brain cells are damaged.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, ‘Time is brain’. A patient with suspected stroke or ‘brain attack’ should therefore be shifted to hospital at the earliest and given a clot dissolving therapy. A stroke may result from a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). In others, there could be a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA).About 85% of strokes are ischemic in nature. Some common risk factors for stroke in the country include hypertension, diabetes, smoking, and dyslipidemia. These are further insufficiently controlled due to low awareness levels about the disease. Another major challenge in this direction is that treatment for stroke is still evolving in our country.”

The acronym FAST can be used to recognize the warning signs of stroke: face drooping, arm weakness, speech difficulty, and time to emergency. The disabilities caused due to a stroke can be temporary or permanent, depending on how long the brain lacks blood flow and which part is affected.
Adding further, Dr Aggarwal, said, “Stroke is an emergency and getting timely help and treatment is extremely important. Hence, it is very important to act fast to identify these patients. Early treatment improves the chances of recovery. While one cannot control factors such as race, gender, and genetic predisposition, it is possible to make certain lifestyle changes which will go a long way in reducing a person’s chances of getting a stroke at a young age.”

Some tips to prevent a stroke include the following.
Lower your blood pressure levels as a high BP is one of the leading causes for a stroke.
Losing weight can help prevent other associated complications.
Indulge in about 30 minutes of physical activity every day.
Quit smoking and drink in moderation if you must.
Keep your blood sugar levels under control.
Reduce stress through activities such as meditation and yoga. 

Childhood obesity a major public health crisis today

Childhood obesity a major public health crisis today

On World Obesity Day, awareness needs to be created on the fact that small steps at home and school can prevent obesity in children

New Delhi, 25 October 2017: Statistics indicate that India has the second highest number of obese children in the world after China. About 14.4 million children in the country are overweight as per findings. Obesity is the leading cause of many health problems and globally, about 2 billion children and adults suffer from such issues. The rate of increase in obesity among children today is alarmingly high when compared to adults, indicates the IMA.

Childhood obesity can be identified by measuring the Body Mass Index or BMI. Children with a BMI in the range of 85% to 95% are classified as being obese. Overweight and obese children are likely to stay so way into their adulthood. They also stand the chance of developing noncommunicable diseases (NCDs) such as diabetes and cardiovascular diseases at a relatively younger age.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Childhood obesity is increasing worldwide at an alarming pace. India has not been spared either. The prevalence of overweight and obesity in children is steadily increasing. A multifactorial disorder, unhealthy diet – eating foods high in fats, sugar and salt (junk food, processed food) and a sedentary lifestyle contribute significantly to this escalating epidemic. Today, TV, internet, computer and mobile games have taken precedence over outdoor sports. Childhood obesity is well-recognized as a precursor to obesity in adulthood. Most obese children grow up to be obese adults. Overweight and obesity in childhood also predispose children to other lifestyle disorders such as type 2 diabetes, hypertension, dyslipidemia, metabolic syndrome later in life. Hence, there is an urgent need to prevent and control obesity in children.”

Obese children and adolescents are more prone to bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.

Adding further, Dr Aggarwal, said, “It is important to start inculcating good nutritional habits from the beginning in children. Ensuring enough physical activity right from an early age is an equally important aspect of every child’s growth. Prevention of lifestyle diseases should start early. Schools can help in shaping the lives of students and have a very important role to play in the battle against childhood obesity. Healthy habits in childhood lay a foundation for a healthier adulthood. The IMA’s Aao School Chaleinprogramme aims at this and more.”

Here are some tips that parents can follow at home to tackle obesity and unhealthy habits in children.
• Encourage healthy eating habits right at the onset.
• Try making favorite dishes healthier. Few changes can make even snacks healthier.
• Avoid tempting children with calorie-rich food. It is okay to treat them but in moderation and by limiting high-fat and high-sugar or salty snacks.
• Make kids understand the importance of being physically active.
• Lead by example. Indulge in at least 60 minutes of moderate to intense physical activity every day.
• Reduce sedentary time. While reading is a good option, too much of screen time is not.
• Replace screen time with the outdoors and fun activities to keep children engaged.

Lack of awareness about dementia in India, says IMA

Lack of awareness about dementia in India, says IMA The problem is more in rural areas where there are not enough medical facilities available for timely diagnosis New Delhi, 01 August 2017: According to statistics from a recent research, more than 4 million Indians above the age of 60 suffer from dementia. Add to this the fact that about 1 in 16 households with an elderly person have a dementia patient. However, many people fail to recognize and understand the symptoms, says the IMA. In approximately 70% of the population in rural areas as well, dementia remains unrecognized and this can be largely attributed to limited medical facilities. Dementia is a general term for a decline in mental ability. This can become severe enough to interfere with daily life. Memory loss is an example. Alzheimer's is the most common type of dementia. Dementia is an umbrella term describing a wide range of symptoms associated with a decline in memory or other thinking skills. These can later become severe enough to reduce a person's ability to perform everyday activities. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Lack of awareness about dementia is a major reason why those who experience forgetfulness, confusion, or difficulty in doing something do not consult doctors. There are also those individuals who may not choose to talk about it considering it shameful or a normal part of the ageing process. Dementia is caused by a damage to brain cells which further interferes with their ability to communicate with each other. This can affect thinking, behavior, and feelings in those with this condition. Dementia in most cases is not reversible but medication can provide some relief to the symptoms. At times, symptoms may appear due to reversible problems like vitamin or hormone deficiencies. These can be treated with timely consultation.” While symptoms of dementia vary in people, there are some basic signs which are significant in the diagnosis of dementia: loss of memory, problems with communication and language, decreased ability to focus and pay attention, impaired reasoning and judgment, and decreased visual perception. Adding further, Dr Aggarwal, said, “Mini-Mental State Examination (MMSE) is the most widely used cognitive test for dementia. The examination takes approximately 7 minutes to complete. It tests a broad range of cognitive functions including orientation, recall, attention, calculation, language manipulation, and constructional praxis. A total maximal score on the MMSE is 30 points. A score of less than 24 points is suggestive of dementia or delirium. t is also recommended that people with dementia be screened for depression because it is a common treatable co-morbidity that may also masquerade as dementia.” Although there is no specific way to prevent dementia, following a healthy lifestyle can help lower the risk. The following steps can be taken towards this direction. • Consume a healthy diet • Maintain a healthy weight • Indulge in regularly physical activity • Do not consume alcohol in excess • Quit smoking right away • Maintain a healthy blood pressure level

Levels of awareness

Levels of awareness Doctors meet people from all walks of life and social strata in their day to day practice. And, these patients have different levels of awareness about their illnesses. Broadly speaking, patients can be classified as either “aware” or “unaware” about their illness. But, this is a very simplistic classification. There are four levels of awareness – ignorant, informed, empowered and enlightened. These levels have been defined based on the ability of the person to retain the knowledge or information that has been taught or given to them. • Ignorant patients depend on the doctor to make their decisions about the necessary interventions and treatments, with no questions asked. They are ignorant of their disease and do not participate in decision making. • Then there are informed patients. These patients have some information about their disease and will have few questions for the doctor following which they usually accept the line of management as suggested by the doctor. • The next level is empowered patients. These patients have several more questions for the doctor, they cross check facts and are an equal partner in decision making regarding their treatment. • Enlightened patients seek the opinions of many. They experiment and are only then convinced about the proposed line of treatment. Realization takes time for patients with this level of awareness. There will be multiple sessions of counselling, before these patients are convinced. Patients can also be classified on the principle of “suno – samjho – jano - karo” given by the sages. This means hearing, listening, knowing and wisdom. We should hear, listen, understand and convert it into wisdom. Hearing means that you hear anything but listening means that you should learn its meaning. Understanding means you should understand its value in your context and wisdom means you should practice it, re-practice it and learn intricacies of its implications The Bhagavad Gita has described four types of devotees comes from Bhagvat Gita where Krishna says to Arjuna (7.16) “Chaturvidha bhajante mam janah sukrtino rjuna, Arto jiijnasurarthasthi jnani cha bharatasabha”. This means that there are four types of beings who worship me: those who are unhappy, those who are desirous to have knowledge, those who desire worldly objects, and those who have acquired knowledge. In the next shloka, Krishna says that among them only those who have acquired knowledge (wisdom) are the best because they are always engrossed in worshipping me. He said those who have a knowledge love me, and I love them. A true Bhakt is a person who asks his guru the same question again and again till he understands and implements it. Rabbi Dovid Rosenfeld, a known scholar has classified four types of students in a different way. He describes them as a sponge, a funnel, a strainer, and a sifter according to their ability to retain the knowledge taught to them. • The sponge retains everything, but is unable to distinguish between correct and incorrect points or between significant and insignificant ones. He is devoid of Viveka, the power of discrimination. • The funnel brings in on one side and brings out on the other side. So, a funnel is the one for whom information goes in one ear and out the other. He has no focus on the lecture. His hearing and the mind are in different directions. • The strainer discards the wine – the significant material, and retains the lees – the incorrect or insignificant points. He’s the sort who remembers all sorts of trivial or useless details of the material he studied. Most students try to remember the foot notes of a book and forget the common things. • Finally, the sieve retains the fine flour – the significant material, and discards the dust – the inconsequential details. He is the one who understands the lecture by its main five points and remembers them in the form of sutras. There can also be three types of doctors. One, those who expect patients to accept what they say, second, who give choices to patients and ask them to choose and thirdly, there are doctors who give choices, but help the patient to choose the best option. Miscommunication is at the root of many doctor-patient disputes. When counseling a patient, the doctor has to understand the level of awareness of his patient and his level of awareness has to match with that of his patient to avoid any discordance in communication. (Inputs from Dr Ved P Mishra) Dr KK Aggarwal National President IMA & HCFI

IMA and FOGSI join hands to create awareness about contraception

IMA and FOGSI join hands to create awareness about contraception Dr KK Aggarwal, National President IMA Dr RN Tandon, Hony Secretary General IMA Dr Rishma Pai, President FOGSI 2017 Dr Hrishikesh Pai, Secretary General FOGSI 2017 Today is World Population Day, a day earmarked by the United Nations to create awareness about population issues worldwide. The importance of family planning is one such very important issue. In a momentous occasion, 3 lakh doctors of the Indian Medical Association (IMA) and 37,000 doctors of FOGSI, the Federation of Obstetric and Gynaecological Societies of India, have joined hands to create awareness about a paradigm shift in contraception in a bid to empower women with choices available and help them to make the right choice for themselves. There is now a basket of choices available in our country, from the irreversible tubectomy to the reversible long-acting spacing methods of contraception such as the intrauterine device (effectiveness lasting for 3-year duration or 10-year duration) and the implants. Injectable contraceptive has recently been added as a new contraceptive choice. The various methods of contraception can be categorized into three groups based on their effectiveness. • Most effective: These include the long-acting reversible contraception and sterilization, which is a permanent method. The pregnancy rates are the lowest because their effectiveness is minimally influenced by the actions of the user or adherence. • Effective: In this category, the injectable contraceptives have the highest effectiveness. Other options are the oral contraceptive pills, transdermal patch and the vaginal ring. But their effectiveness rests on the user and incorrect or irregular use is associated with higher pregnancy rates. • Least effective: Diaphragms, cervical caps, sponges, male and female condoms, spermicides, periodic abstinence and withdrawal are associated with much higher pregnancy rates. Contraceptive counseling also involves informing the woman about the various choices available in the country today along with the associated risks and benefits in addition to educating them about contraception, their present and future contraceptive needs and the risks of unintended pregnancy so that she can balance the advantages of each method against its disadvantages and side effects and decide on a preferred method. Emergency contraception is another important option that young adults should be aware of including the right way to use it to prevent an unplanned pregnancy. For individuals at risk of sexually transmitted infections, the use of condoms is recommended. Instead of the doctor taking a decision alone on behalf the woman, the two should together decide on what would be the best method of contraception taking into consideration the personal preferences, social and cultural factors along with the efficacy, safety and side effects of different contraceptives. A judgment of the UK Supreme Court in 2015 in the case of Montgomery vs Lanarkshire Health Board changed the law on informed consent in the UK. According to the judgement, when counseling the patients about the benefits and risks of various treatment options, doctors are now required to ensure that “the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments”. And, to consider whether “a reasonable person in the patient’s position would be likely to attach significance to the risk, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it." Data show that women prefer the long-acting reversible contraception as a first choice of contraception over sterilization. It is a highly efficient method with failure rates equal to or better than the permanent method; moreover, it is non-surgical, cost-effective and reversible. Instead of opting for irreversible tubectomy, there is now an alternate choice of reversible long-term contraception. Women who request a sterilization should also be counseled about the long-acting reversible contraception as a method of choice of contraception marking a paradigm shift from permanent method to the long-acting reversible contraception. Dr KK Aggarwal National President IMA & HCFI

Lack of awareness impediments treatment of Parkinson's disease

Lack of awareness impediments treatment of Parkinson's disease Disease causes 60% to 80% of dopamine-producing cells to become damaged New Delhi, 25 June 2017: According to a report published in the International Journal Of Nutrition, Pharmacology, Neurological Diseases out of every 1, 00,000 people in India, 70 have Parkinson’s disease. What is alarming is that the brain has already lost more than half of its dopamine-producing cells, by the time the characteristic symptoms develop in patients. The symptoms of this disease are so subtle that it can remain undiagnosed for years. Parkinson's disease is a neurodegenerative disorder that is chronic and progressive. It occurs when the nerve cells in the brain stop producing dopamine, a chemical which helps in controlling movement. Dopamine helps in the smooth transmission of messages to different parts of the brain and regulates body movements in healthy adults. When a person develops this disease, about 60% to 80% of the dopamine-producing cells get damaged. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "The main impediment to managing Parkinson's is the lack of awareness about this condition. This disease generally affects those who are above the age of 60 and the risk increases with age. The symptoms can vary from person to person. Some early stage symptoms include very slight shaking of hands, difficulty in walking and/or postural imbalance. The four key motor symptoms of Parkinson’s disease include tremors (hands, arms, legs, jaw); stiffness or rigidity (arms, legs, trunk); slowness of movement; and postural imbalance (poor balance and coordination). This is a progressive disorder but not life threatening. However, people with Parkinson’s disease may be unable to perform daily movement related functions and eventually stop working due to progressively disabling symptoms." Diagnosis of Parkinson's can be done through a 99mTc-TRODAT-1 SPECT scan of the brain. Early detection is very important in minimizing dopamine loss in the brain and maintaining muscle function. Adding further, Dr Aggarwal, said, "While there is no cure for Parkinson's disease as yet, treatment can definitely help people live a good quality life, provided the diagnosis is done at the right time. The decision to start taking medicine, and which medicine to take, varies from person to person." Tips for people with Parkinson's disease • Simplify daily tasks and set realistic goals. • Plan activities such as household chores, exercise, and recreation well in time. Distribute them throughout the day. • Take some rest before and after any activity. • Do not plan activities right after a meal. Rest for 20 to 30 minutes after each meal. • Divide your work among friends and family. Do not hesitate to ask for help. • Get proper sleep and elevate your head when sleeping. Avoid extreme physical activity or lift heavy objects.

“Baar baar poocho” urges IMA on the occasion of the upcoming World Health Day

“Baar baar poocho” urges IMA on the occasion of the upcoming World Health Day 10% of the population suffers from depression at any given time Urgent need to raise mass level awareness about the intrinsic role played by the medical fraternity, family and peers in helping overcome depression New Delhi, April 8, 2017: As per the WHO, 1 in 4 persons will suffer from a mental disorder in their lifetime and 10% of the population suffers from depression at any given point. Unfortunately unlike other diseases with evident physical symptoms, people living with depression do not get the necessary help given the strong social stigma attached to the condition. The need of the hour is to raise mass level awareness about how the medical fraternity, caregivers and peers can help mental health sufferers. In a clinical setting, there are often crowded rooms and physicians get little time to interact with each patient. Sharing private and sensitive information in such an environment can seem overwhelming for the patients. Even if they are willing to divulge the details, they may hesitate to do so in the first sitting itself. With this background, IMA has launched its “Baar baar poocho” campaign aimed at educating its 3-lakh doctor members on how they can help identify and help mental health patients. The campaign warrants that the physician should politely question patients regularly and multiple times, about sensitive information related to depression, alcohol use, smoking habits, drug abuse, and sexual needs and preferences. "A General Practitioner (GP) is the first point of contact for a patient and must be sensitized on ways in which they can diagnose signs of depression amongst patients and help them seek appropriate care. This program is in line with the MCI’s (Medical Council of India) new guidelines that state that 10% of all medical education programs should focus on mental health” said Padma Shri Awardee Dr. K.K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA. IMA has also highlighted the role that the government can play in dispelling the stigma around mental health issues. “First and foremost it is crucial that the treatment of depression and other mental health disorders is included in insurance cover. Presently, chronic patients often do not openly come out and talk about their issues out of the fear that their mediclaim may get rejected”, Dr KK Aggarwal added. IMA also stressed on the need to find a solution to the shortage of mental health care professionals in our country. The Indian government estimates that 6-7% of the country’s population lives with major to minor mental health concerns. This amounts to approximately 70 million Indians, with the number increasing every year. Despite the large number of people who require mental health attention, India has only 6,500 trained psychiatrists and even fewer psychologists. The need of the hour is to arm doctors with the resources required to help patients receive appropriate medical attention. On World Health Day, let us take a pledge to educate people that depression is like any other chronic physical ailment. It is no different from diabetes, heart disease, and hypertension. All these conditions are treatable and manageable by necessary lifestyle changes, therapy and medication.