Along with physical and mental health, sexual health problems are also aggravated by the ongoing pandemic, a primary reason being increasing stress due to factors such as job, work life balance, financial challenges, lack of socialising and strained relationships. A recent study has revealed that Covid-19 increases the risk of developing erectile dysfunction (ED) by nearly six times.
Sexual health and wellness is defined as a state of physical, emotional, mental, social, and spiritual dimensions in relation to sexuality. Sexual intimacy is a highly stigmatised and taboo topic in India, and people are usually unwilling to talk openly about their sexuality and sexual health.
Stress directly affects our hormones and mood and can take away a person's libido, thereby affecting quality time of a couple. It can also cause one to indulge in smoking or alcohol consumption which in turn can adversely affect sexual performance. These can lead to problems such as premature ejaculation, erectile dysfunction, reduced libido, and male fertility.
Erectile dysfunction, or ED, is a common condition that can make sexual activity difficult. It may lead to a loss of intimacy in a marriage or long-term relationship, affecting the mental well-being of both partners. Some leading Indian andrologists share their thoughts on the recent study and the co-relation between the coronavirus and erectile dysfunction.
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Pramod Krishnappa, Consultant Andrologist, NU Hospitals, Bangalore tells IANSlife: "The Covid-19 pandemic has wreaked havoc on humans causing both physical and mental illness. Although the lung is the most prominent organ affected, a recent research paper from Miami has revealed the presence of Covid-19 viral particles in the most sensitive organ, penis. The authors have also hypothesised that this widespread endothelial dysfunction could lead to erectile dysfunction. An Italian survey led by Sansone also revealed that the erectile dysfunction was common among those who had Covid-19 infection in the past and very aptly commented that "Mask up to keep IT up"."
Raman Tanwar, MBBS, MS, FMAS, MCh (Urology) Gold Medallist, Department of Urology and Andrology at Uro centre, Jyoti Hospital, Gurugram adds, "Covid-19 infection leads to widespread endothelial dysfunction which means that the linings of blood vessels do not function properly once infected. For erection the optimal function of blood vessel lining is needed and many studies across the world are finding an increased incidence of erectile dysfunction in patients who are positive. Studies have also pointed that those who have ED are more likely to have Covid-19 infection."
If an individual is diagnosed with ED, the first step is to reach out to a doctor as it can be a sign of underlying health problem. Heart diseases, clogged blood vessels, high blood pressure, cholesterol, diabetes, obesity, anxiety, stress, depression and lifestyle habits like smoking and alcohol consumption are a few of the main causes of erectile dysfunction.
Vineet Malhotra, Clinical Director, Diyos Men's Health Centre shares: "The recent study conducted at the Miller School of medicine, Miami, USA notes the presence of Covid-19 in the penis even 7 months post infection. The increased risk of endothelial dysfunction can lead to a risk of erectile dysfunction in affected men."
Sanjay Pandey, Head of Uro-Andrology at Kokilaben Dhirubhai Ambani Hospital, Mumbai tells IANSlife: "Covid-19 affects different men in different ways. There is a possibility that some men might develop ED after suffering from Covid-19. So particularly for young and healthy people who abruptly develop erectile dysfunction, and especially after having Covid-19, this can be a sign of something more serious going on. This could last for long term or short term. ED is usually a symptom of another medical condition. If your health isn't great to begin with, you're more likely to have severe or unwanted symptoms from Covid-19, such as ED."
Doctors suggest that with the number of cases increasing every day and multiple studies indicating that men are more prone to Covid-19, this study makes it more imperative that men must be extra cautious in their everyday life ignoring which could affect various aspects of their lives.
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Annoyed by pimples? Here’s an ayurvedic guide you need to achieve that flawless skin By Dr. Tabassum Hasan. Do you remember the last time when you were planning to attend a wedding function? From dresses to matching shoes you took care of everything and were ready to dazzle everybody. But guess what? All of a sudden on that very day you got a new pimple on your forehead. Yes, we know how it feels. Those pesky red pimples seem to always appear before any important event in our lives. Almost every one of us suffered this embarrassing situation at some point of our existence, especially in our teenage years. But is there any solution for it? Can we avoid them? What are the causes? Let’s find out answers to all these questions.
Table of contents
• What is Acne?
• Causes and Risk Factor of Acne
• Symptoms of Acne
• When You Need to See Your Doctor
• General Tips For Acne
• What to Eat and Avoid
• Frequently Asked Questions(FAQs)
What is Acne?
In ayurvedic literature, acne has been described as yuvan pidika or tarunya pitika because it primarily affects adolescents or young people. In some texts, it is also called mukh dushika because it spreads mainly on the face of a person and has inflammation and scarring.
Acne is characterized by saruja (mildly painful), filled with meda (pus or oily secretions), shalmali (Salmalia malabarica) thorn-like eruption on the face. These pilosebaceous follicles are distinguished as comedones, papules, pustules, and scars. It mainly affects the cheek, chin, forehead, nose, and upper trunk of the body.
According to global burden of disease (GBD) study, almost 85% of young adults aged between 12-15 years get affected by this dreadful condition. Although it is not a life-threatening condition, but it impacts the social life and emotional well-being of the affected individual.
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Causes and Risk Factor of Acne
According to classical ayurvedic texts, acne is manifested due to vitiated vata dosha and kapha dosha. These doshas further vitiate rasa-raktadi dhatu, primarily rakta dhatu(blood). As result, there is excessive sweda(sweat) production, which obstructs the skin pores. This leads to local swelling and microcomedones formation. Rupture of these micro comedones leads to scarring. Vata dosha and rakta dosha also causes hyperpigmentation.
The factors which lead to all of this are mainly divided into 4 types:
• Time or age factors- young age or adolescents, summers or spring season.
• Dietary pattern- excessive sweet and spicy, heavy and oily food, milk and its products, meat and alcohol.
• Lifestyle factors- Insomnia, holding natural urges, excessive sleep, excessive sunbath.
• Psychological factors- Anger, stress, depression, and behavioral changes.
Other than the above factors, few other factors are also responsible for acne like genetics, hormonal changes, etc. Furthermore, menstrual cycle, anxiety and tension, oil-based makeup, exposure to pollution, skin allergies due to certain medication, hot and humid climate, greasy hair, and squeezing the pimples will make these conditions worse.
Symptoms of Acne
Acne is described under kshudra rogas (minor ailments) in Ayurveda. Kshudra means minimum that means these diseases happen with minimum causative factors, signs and symptoms, and requires minimum medical intervention. Acne also doesn’t have deadly symptoms but it surely affects your self-confidence. Some of these symptoms are stated below-
• Shalmali kantakakara pitika- acne resembles with the thorn of salmalia malabarica as it’s an eruption in a conical shape
• Saruja- These can be mild to moderate painful lumps.
• Ghana- The eruption is hard, thick, or indurated due to vitiated kapha.
• Medogarbha- Due to obstruction of pores or pilosebaceous glands, it is filled with pus.
• Yuna mukhe- This disease usually affects young people or adolescents.
Apart from these symptoms, some associated symptoms are also there like itching, burning, and secretions. Mental health is also affected as it has a huge impact on someone’s looks.
When You Need to See Your Doctor
Generally for acne, people prefer to have OTC (over-the-counter) products. Mild to moderate acne will calm down after the use of these gels or creams in the course of over 4 to 6 weeks. But what if these products stopped working or you have stubborn nodular or cystic acne? Then you definitely need to see your dermatologist. Also if your physical appearance is taking a toll on your mental health, a doctor will help you to combat this situation.
Also, Read► How Stress Impacts Skin: Side Effects & Prevention
General Tips for Acne
Everyone dream to have smooth, silky, and radiant skin. But having acne is a big hurdle to achieve that flawless skin. In this scenario, you can take the help of ayurvedic tips to get rid of those pimples:
• To flush out toxins (ama) in your body, you should take warm water in the morning. Mixing lemon juice in it will also give you a daily dose of vitamin C.
• To balance your body doshas, you can take Triphala. It will remove toxins and reduce your acne. Take 1 teaspoon Triphala powder with warm water.
• Shatavari is also a good ingredient to balance hormones. It will also help in pacifying pitta dosha and treat hormonal acne. You can take one teaspoon of Shatavari powder and boil it in one glass of water. When this will reduce to half, you can consume it.
• Ashwagandha is a popular herb for skin disorders. Its anti-inflammatory, detoxifying properties make it suitable for acne treatment. Take one teaspoon of ashwagandha powder and take it with water or honey.
• Apart from these, blood purifiers told in classical ayurvedic literature like sariva, manjishtha, draksha, and neem are also beneficial for acne treatment. You can include them in your daily routine to purify the blood and balance your doshas. They also have anti-inflammatory and anti-bacterial properties.
• Drinking amla juice daily can help you as amla helps in balancing your doshas. Amla also contains vitamin C which is a potent anti-oxidant. This will reduce harmful free radicals and will keep acne at bay.
• Fennel seeds and coriander seeds concoction is also a good option as it will cool down your body heat. Take one teaspoon of both and boil it in one glass of water. When it will reduce to half, take it after it cools down.
• As clogged pores are the cause of acne, you should wash your face at least twice a day. Use gel-based mild cleansers according to your skin type.
• Avoid touching your face as your fingers usually have bacteria on them. Touching your face can lead to transfer of those bacteria to your face and this can result in infection.
• You should avoid squeezing the pimple. Yes, we know that you have a strong urge to pop that pimple. But always remember that it will lead to more scars.
• Always use a broad spectrum SPF if you are stepping out of your house. Even inside your home, you should at least wear sunscreen of SPF 30.
What to Eat and Avoid
As the saying goes, what you eat appears on your face. This is definitely true in the case of acne. Our skin health says a lot about the way we eat. So if you are someone whose diet is full of junk food and sweetened beverages, then you need to reconsider your food choices. Follow these dietary rules to get rid of your skin ailments and for a healthier complexion-
• Always eat homemade fresh food. Make it light and less spicy.
• Amaranth, barley, oats, rice are healthy grains for you. Include them in your diet.
• Fresh vegetables like bitter gourd, leafy greens, cauliflower, peas, okra, bell peppers are good for your skin and health.
• Soaked almonds and nuts are also a good option as they contain healthy fats that your body needs.
• Eat fruits like apple, oranges, mango, watermelon, dates, figs, pineapple, cherries, grapes, and lime.
• Turkey, salmon, and freshwater fish are the best options if you are a non-vegetarian.
• Always avoid refined grains and sugars like white bread, pasta, noodles, sodas, and artificial sweeteners.
• Heavy and spicy diets create an imbalance between doshas, so try to avoid them.
• Consuming dairy products is also not advised if you are suffering from acne.
• Fast foods like burgers, chowmein, French fries, nuggets, and soda drinks are a big NO if you want to have good and healthy skin.
• Avoid meat (especially red meat) and alcohol consumption as these create havoc on your skin.
Other than that you should keep track if you are allergic to any particular food, foods that may cause bloating or increase inflammation in your body. Just follow these simple rules and you will start noticing a positive difference in your skin soon.
Frequently Asked Questions(FAQs)
Q1. How acne scars can be removed?
Ans. In Ayurveda, there are several local applications for acne scars like haldi, sandalwood, multani mitti. However, in modern medical treatments like microdermabrasion, chemical peeling, micro-needling, fillers, punch excision, and laser resurfacing are prescribed for different types of lesions. Topical treatments like antibiotics (clindamycin and erythromycin), benzoyl peroxides, and vitamin A acid derivatives like tretinoin are also helpful for mild to moderate scars.
Q2. Why acne occurs on the face?
Ans. Acne occurs when your pores get clogged by oil, pus, dead skin, or bacteria. It's like a small red protuberance with pus at its head. This can happen on your shoulders, back, and chest too.
Q3. Which acne cream is best for oily skin?
Ans. Creams with active ingredients like neem, tea tree oil, aloe vera, turmeric are best suitable for acne. In Ayurveda, there are different types of face masks for acne. Some of those are vachaadi lepa, dhanyakaadi lepa, lodhraadi lepa, jayaphalaadi lepa, manjishthaadi lepa and kumkumaadi taila etc. Other than these, you can look for ingredients like bakuchiol, Centella asiatica, honey, colloidal oatmeal, willow bark extract, and resveratrol in your acne products.
Q4. Can acne scars be removed permanently?
Ans. Most of the acne scars get faded over time. As our skin gets renewal after almost 5-6 weeks. That means dead skin cells get replaced by new skin cells. So our scars naturally go away. But in the case of severe scarring, one should get treatment by a dermatologist. They can surely help you to reduce the appearance of your scar.
Q5. Can acne scars be removed naturally?
Ans. Several home remedies like lemon juice, potato juice, turmeric powder, aloe vera, and gram flour are used for ages to remove hyperpigmentation and scars.
• Acharya Sushruta, SushrutaSamhita,AyurvedTatva Sandipika Hindi commentarytranslated by Ambika Datta Shastri, Chaukhamba Sanskrit Sansthan Varanasi, Reprint edition. Nidanasthana, 1995;1(13/38):287.
• Acharya Sushruta, SushrutaSamhita, Acharya YadavjiTrikamji, Choukhambha publication, Varanasi. Edition 2005, Nidanasthana 2005;13/ 39:323.
• Acharya Vaghbhata, Astanga Hrdayam, Dr. Brahamanand Tripathi. Chaukhamba Sanskrit Pratishthan, Delhi, Reprint edition, Sutrasthana, 2009;1(25):19.
• Agnivesh, Charak Samhita, revised by Charak and Dridhabala with Ayurveda Deepika commentary, by Chakrapani Datta, edited by Vd. Yadavaji Trikamaji Acharya, Chaukhamba Surbharati Publications, Varanasi, reprint 2002, Sutrasthana 18/24, S S11/49.
• Lad, Vasant. Textbook of Ayurveda: Fundamental Principles. Albuquerque: The Ayurvedic Press, 2002
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Mandi, June 14 (IANS) A team of researchers from IIT Mandi has identified the underlying biochemical relationship between the consumption of excessive sugar and the development of afatty liver', medically known as Non-Alcoholic Fatty Liver Disease (NAFLD).
NAFLD is a condition in which excess fat deposits in the liver. The disease starts silently, with no overt symptoms for as much as two decades. If left untreated, the excess fat can irritate the liver cells, resulting in scarring of the liver (cirrhosis), and in advanced cases, can even lead to liver cancer. The treatment of advanced stages of NAFLD is difficult.
One of the causes for NAFLD is the overconsumption of sugar -- both table sugar (sucrose) and other forms of carbohydrates. The consumption of excess sugar and carbohydrates causes the liver to convert them into fat in a process called hepatic De Novo Lipogenesis or DNL, which leads to fat accumulation in the liver.
The molecular mechanisms that increase hepatic DNL due to overconsumption of sugar, which is is key to developing therapeutics for the NAFLD, have not been clear yet, said lead scientist Prosenjit Mondal, Associate Professor, School of Basic Sciences, IIT Mandi.
The team used a complementary experimental approach involving mice models, and identified the unknown link between the carbohydrate-induced activation of a protein complex called NF-KB and increased DNL.
"Our data indicates that the sugar-mediated shuttling of hepatic NF-KB p65 reduces the levels of another protein, sorcin, which in turn activates liver DNL through a cascading biochemical pathway," explained Mondal. The findings are published in the Journal of Biological Chemistry.
The team showed that drugs that can inhibit NF-KB can prevent sugar-induced hepatic fat accumulation. They have also shown that the knockdown of sorcin reduces the lipid-lowering ability of the NF-KB inhibitor.
The finding that NF-KB plays a key role in lipid accumulation in the liver opens up a new avenue of therapeutics for NAFLD. NF-KB also plays a role in other diseases that involve inflammation, such as cancer, Alzheimer's disease, atherosclerosis, IBS, stroke, muscle wasting and infections.
The research comes at a time when India has included NAFLD in the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).
India is the first country in the world to identify the need for action on NAFLD and with good reason. The prevalence of NAFLD in India is about 9 per cent to 32 per cent of the population, with the state of Kerala alone having a prevalence of 49 per cent and a staggering 60 per cent prevalence among obese school-going children.
The study has conclusively shown that excessive sugar intake leads to a fatty liver. This should offer incentive to the public to reduce sugar intake to stop NAFLD in its early stages, the team said.
Lifestyle disorders are a major cause of death in almost every country now. The occurrence of these problems is not a one-day process; people suffer due to long-time ignorance of their health care. Some of the lifestyle disorders are obesity, diabetes, cardiovascular diseases, cancers, strokes, Chronic Obstructive Pulmonary Disease (COPD), arthritis, and mental health issues.
Himanshu Rai, Chief Dietician and Nutritionist at Think You shares some of the leading causes of lifestyle disorders:
If your eating habits are linked to skipping meals, overeating, oily-fried-sugary meals, then you could be in the trap of lifestyle disorders. As per the WHO, "A healthy diet helps to protect against poor nutrition in all its forms and lifestyle-related health issues such as diabetes, heart diseases, strokes, cancers and brain disorders also." Eating healthy meals, not skipping meals and food that contains ingredients from all the major food groups (cereals, legumes and pulses, milk and meat, fruits and vegetables, fat and sugar) would be helpful to protect you from lifestyle disorders.
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Lack Of Physical Activity
Lack of physical activity may lead to obesity or being overweight and it may lead to several other disorders such as cardiovascular diseases, diabetes, cancers and various others. The WHO suggests regular physical activity is very helpful for the prevention of diseases and improves the overall quality of life. As per WHO, adults should do 150 - 300 minutes of moderate-to-intense physical activity every week to provide significant benefits to overall health.
Lack Of Sleep
According to CDC (Centers for Disease Control and Prevention), poor sleep has been linked to diabetes, cardiovascular diseases, depression and obesity. In the case of diabetes, it has been linked to poor control of blood sugar levels. Whereas, in cardiovascular diseases, persons with poor sleeping are found to be at increased risk of high blood pressure, stroke, coronary heart diseases and irregular heartbeats. In obesity, short sleep duration results in metabolic changes, which are linked to obesity. Sleep disturbances for a long time have been one of the important symptoms of depression also.
As per Mayo Clinic, long-term stress puts the body on over-exposure to cortisol hormone and other stress hormones, which affects your body's normal health process. Overexposure to stress results in heart diseases, weight gain, depression, anxiety, digestive problems, sleep issues, headaches and memory issues. Stress management is very important to keep away from the different health issues.
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Smoking affects almost all the organs in a bad manner. Direct smoking may lead to different serious health concerns such as cancer, heart diseases, diabetes, stroke, lung disease, COPD (Chronic Obstructive Pulmonary Disease), etc. Whereas second-hand smoke causes stroke, coronary heart diseases, lung cancer, etc in adults. In children, second-hand smoke causes sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth.
Excess Alcohol Consumption
Excess alcohol drinking in the long term may lead to chronic diseases such as heart diseases, stroke, liver diseases, cancer, mental issues, digestive issues and several others. Whereas in short term, it causes accidents, violence, alcohol poisoning, risky sexual behaviours, miscarriage and stillbirth in pregnant women.
Mahatma Gandhi once wrote, "Instead of using the body as a temple of God we use it as a vehicle for indulgences, and are not ashamed to run to medical men for help in our effort to increase them and abuse the earthly tabernacle."
This statement is well connected to today's lifestyle disorders also; it means we are neglecting the power of prevention, doing excess and inviting lifestyle disorders.
Lifestyle disorders can be easily prevented with the help of eating nutritious meals on time, proper physical activity, proper sleep, stress management and avoiding alcohol and smoke.
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<br>With a 1.1 million population (2011 census), India's second least populous state Mizoram is the only state where out of the 11 districts, only four districts -- Aizawl (27), Serchhip (1), Kolasib (1) and Saitual (1) -- have reported 30 deaths due to Covid-19.The state's Health and Family Welfare Department Secretary R. Lalramnghaka said that the Mizoram government has recently formed a team comprising medical experts and scientists to conduct a scientific study on all aspects of the spread of Covid-19 in the state.The team comprises experts from the Integrated Disease Surveillance Programme (IDSP), Indian Medical Association, Principal of the Zoram Medical College and Hospital (ZMCH) and professors from Mizoram University."After studying all the aspects of the Covid-19 and its related effect, the team would submit a detailed report with their findings and recommendations to the government for taking further course of steps," Lalramnghaka told IANS over phone.Mizoram's Health and Family Welfare Minister R. Lalthangliana has in a meeting with members of the study team asked for an in-depth study and research on the spread of the coronavirus specially the second wave of Covid-19 as it is different from the first wave.Of the 1.1 million population in Mizoram, tribals constitute around 95 per cent, the highest proportion of tribals among the Indian states.Though Mizoram and a few other northeastern states had once suffered from malaria leading to many deaths, most tribals due to their healthy and traditional food habits (mostly boiled food) and lifestyle remained unaffected from many diseases compared to the mainland states. However, in recent years, due to the use of tobacco products and drugs, prevalence of cancer and HIV/AIDS is rising in a few northeastern states including Mizoram, Manipur and Meghalaya.Health officials in different northeastern states said that unlike in the first wave children below 15 years are also being tested for Covid-19 in reasonable numbers during the second wave in Mizoram, Manipur, Tripura, Meghalaya, forcing the governments of several states to constitute panels of paediatric doctors.As the nature and intensity of the second wave of Covid-19 are diverse, physician Pradip Bhowmik has suggested forming study groups for an in-depth study of the disease."It is witnessed in the second wave that during the post-Covid period many patients are being affected by pneumonia and mucormycosis (black fungus)."Unlike in the first wave, a large number of young people and children are being infected by the coronavirus. In the second wave the recovery rate is very slow and the death rate is higher," Bhowmik told IANS.He said that it is being observed that Indian strains of the virus are more dangerous then the UK and Brazilian variants.Bhowmik, who is an expert in Hepatitis disease and has worked on the disease in the northeastern states and Bangladesh, said that genetically tribals' immunity is always better but they are also falling prey to Covid-19, necessitating a serious study.<br> <br>Around 10,024 positive cases have been detected in Mizoram so far, while the state's active caseload stood at 2,473 on Saturday evening.A 50-year-old man, who had returned to Aizawl from Amsterdam in the Netherlands via Delhi and Guwahati on March 16 last year, tested positive for the novel coronavirus in Mizoram on March 24 last year.A 62-year-old man died of Covid-19 on October 28 last year at the ZMCH in Mizoram registering the first Covid related mortality in the Christian dominated state, bordering Myanmar and Bangladesh.<br> <br>The victim had comorbidities.<br> <br>(Sujit Chakraborty can be contacted at email@example.com)--IANS<br>sc/bg/ksk/
New Delhi, May 20 (IANS) Hypertension and tobacco are the top most causes of premature mortality and people consuming tobacco in any form are at high risk of many diseases, as nicotine is solely responsible for constricted arteries, heart failure, inflammation, many types of cancers, blindness, and gangrene, while it also complicates existing hypertension.The above was mentioned by noted interventional Cardiologist Dr. (Prof) (Col.) Shekhar Kashyap while speaking at a webinar on 'Hypertension, COVID-19 and Tobacco – A Deadly Triad'. Kashyap is the former Head of Department (Cardiology), Army's Research & Referral Hospital in New Delhi."Although the tobacco lobby promotes that nicotine does not cause hypertension, it affects all the organ systems. Tobacco consumption in any form be it cigarettes, chewable, and nicotine gum, causes increase in blood pressure and elevates the heart rates. Nicotine cessation can help immediately. Within 20 minutes of cessation, blood pressure returns to normal and 15 years of cessation eliminates all hazards of smoking," added Kashyap.Hypertension is the most widely prevalent vascular disease among the low and middle income group countries. It is also one of the biggest causes of premature deaths in the world. Today, one in every four men and one in every five women today are suffering from hypertension."Those who consume tobacco have poorly controlled hypertension. It is a myth that smokeless tobacco or non-combustible tobacco has no ill-effects. There are ample studies to prove that these cause many diseases," Kashyap said, adding that tobacco blunts the effects of medicines taken to stabilise blood pressure.Kashyap said persons with cardiometabolic factors face a higher risk of severe Covid-19 condition along with complications and mortality. Chewing tobacco can increase the risk of Covid-19 as the person does not wear a mark, the hand to mouth contact increases, salivating and spitting puts others at risk, and sitting together to drink and smoke leaves no room for social distancing, thereby increasing the risk of spreading the infection."To counter the threat of Covid-19, it is imperative to combat the misinformation campaigns. The studies that purportedly claim consumption of alcohol or smoking can prevent Covid-19, may be manipulated and, therefore, as a vigilant society, there needs to be a high index of suspicion around such studies, he added. Kashyap advised that people should rely on information and guidelines from credible sources such as the WHO, US CDC, Ministry of Health and Family Welfare and ICMR.He said that there is a lot of ground that needs to be covered, which can begin with sensitising kids at the kindergarten level about the harmful effects of tobacco on our health. Further, surrogate advertisements promoting the use of tobacco in any form should not be allowed in the vicinity of schools or other educational institutions.--IANSksk/