People who survived severe Covid-19 infections are more than twice at risk of dying over the following year, compared with those who experience mild or moderate disease or remain uninfected, finds a study.
The study, published in the journal Frontiers in Medicine, showed that the increased risk of death was greater for patients who are under 65.
Researchers at the University of Florida, in the US, found that severe Covid-19 patients aged under 65 demonstrated a 233 per cent increased chance of dying, compared with the uninfected.
This was larger than the increased chance of dying experienced by severe Covid-19 patients aged over 65, compared with the uninfected. As these deaths frequently occurred long after the initial infection had passed, they may never have been linked to Covid-19 by the patients' families or doctors.
Moreover, 80 per cent deaths that occurred in severe Covid-19 survivors were not linked with common complications from the disease, such as respiratory or cardiovascular issues. This suggests that the patients had experienced an overall decline in their health that left them vulnerable to various ailments, the researchers said.
Mild or moderate Covid-19 patients did not have a significantly increased mortality risk compared with the uninfected, highlighting the importance of reducing the chances of severe disease through vaccination.
"Since we now know that there is a substantial risk of dying from what would likely be considered to be an unrecognised complication of Covid-19, we need to be even more vigilant in decreasing severe episodes of Covid-19,a said lead author Prof Arch Mainous of the University of Florida.
"Taking your chances and hoping for successful treatment in the hospital doesn't convey the full picture of the impact of Covid-19. Our recommendation at this point is to use preventive measures, such as vaccination, to prevent severe episodes of Covid-19."
For the study, the team tracked electronic health records of 13,638 patients who underwent a PCR test for Covid-19, with 178 patients experiencing severe Covid-19, 246 mild or moderate Covid-19 and the rest testing negative. All patients included in the study recovered from the disease, and the researchers tracked their outcomes over the next 12 months.
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न्यूयॉर्क| एक अध्ययन में पाया गया है कि जो लोग गंभीर कोविड-19 संक्रमण से बचे हैं, उनकी तुलना में हल्के और मध्यम लक्षण वाले लोगों में अगले वर्ष में मौत का खतरा दोगुने से अधिक हो सकता है।
जर्नल फ्रंटियर्स इन मेडिसिन में प्रकाशित अध्ययन से पता चला है कि 65 वर्ष से कम उम्र के रोगियों के लिए मृत्यु का जोखिम अधिक है।
अमेरिका में फ्लोरिडा विश्वविद्यालय के शोधकतार्ओं ने पाया कि 65 वर्ष से कम आयु के गंभीर कोविड -19 रोगियों में असंक्रमित की तुलना में मरने की संभावना 233 प्रतिशत बढ़ी है।
गंभीर कोविड -19 से बचे लोगों की 80 प्रतिशत मौतें श्वसन या हृदय संबंधी समस्या से होने वाली सामान्य जटिलताओं से जुड़ी नहीं थीं। शोधकतार्ओं ने कहा कि इससे पता चलता है कि रोगियों ने अपने स्वास्थ्य में समग्र गिरावट का अनुभव किया है, जिससे वे विभिन्न बीमारियों की चपेट में आ गए हैं।
हल्के और मध्यम कोविड -19 रोगियों में असंक्रमित की तुलना में मृत्यु दर में उल्लेखनीय वृद्धि नहीं हुई है, जो टीकाकरण के माध्यम से गंभीर बीमारी की संभावना को कम करने के महत्व को उजागर करता है।
अध्ययन के लिए, टीम ने 13,638 रोगियों के इलेक्ट्रॉनिक स्वास्थ्य रिकॉर्ड को ट्रैक किया था, जिन्होंने कोविड -19 के लिए एक पीसीआर परीक्षण कराया था, जिसमें 178 रोगियों ने गंभीर कोविड -19 लक्षण दिखाए थे, 246 हल्के और मध्यम कोविड -19 लक्षण दिखाए थे और बाकी के परीक्षण नकारात्मक थे। अध्ययन में शामिल सभी मरीज बीमारी से ठीक हो गए, और शोधकर्ता अगले 12 महीनों तक उनके परिणामों पर नजर रखेंगे।(एजेंसी)
यह भी पढ़े► नया कोविड स्ट्रेन 'बी.220.127.116.119' डेल्टा से भी अधिक घातक क्यों है?
About 60 per cent of people suffering stroke in India face various degrees of disability, some lifelong, said experts here.
A stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.
As brain cells begin to die in minutes, prompt treatment is crucial and early action can reduce brain damage, other complications and death.
"While the numbers of stroke patients continue to rise exponentially, like many other brain diseases, there is still a remarkable lack of awareness regarding this condition. Timely treatment in stroke will go a long way in improving a patient's quality of life, and reducing lifelong morbidity and mortality," said Pankaj Agarwal, Senior Consultant -Neurology, Head, Movement Disorders Clinic & In-Charge, Deep Brain Stimulation (DBS) Programme, Global Hospital Mumbai.
"Stroke patients who get help from paramedics are more likely to reach hospital for care -- in India, that number is only 1.8 per cent. We need uniform emergency medical services (EMS) system and certification of stroke ready hospitals across the country so that people know where to go when they recognise the signs of stroke," added Dr P.N Sylaja, Professor and HoD, Neurology, In-Charge, Comprehensive Stroke Care Programme, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).
While traditionally stroke affects older age groups, a large number of ischemic strokes are now known to also affect young people - in their 30s or 40s. Sometimes even adolescents in their teenagers or early 20s are affected.
"Stroke affects as many as 18 lakh Indians every year, which means one Indian suffers stroke every 40 seconds. One-fourth of these people are aged less than 50 and increasingly, a large proportion of stroke patients are found in the age group of 19 to 30 years. The burden of stroke on the most productive sections of society not only affects the person and their family but leaves a cascading effect on the countrya¿s socio-economic condition," said Kamal Narayan, CEO, Integrated Health and Wellbeing (IHW) Council.
Covid has also increased the risk of stroke, particularly among the young patients between 20 and 30,as the virus triggers abnormal and severe clotting in blood. While the risk is around 1 per cent (higher if other risk factors for stroke are present), it is still life-threatening or leads to severe disability.
"In India, about 30 per cent of people suffering stroke die and a whopping 60-70 per cent people suffer various degrees of disability. The number of disabled people is more as we move into the interiors where hospitals do not even have a CT scan machine. We need to ensure they get treatment," said Prof M.V. Padma Srivastava, Head, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi.
Eating a well-balanced diet, avoiding processed foods and sugary drinks, limiting salt, alcohol, smoking, and exercising daily can lower the risk of stroke, the doctors said.
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Recent medical advances have made breast cancer a highly manageable disease, especially when detected early, as in the case of stages 0-to-II cancers.
Timely treatment also minimises disruptions to the patient's daily routine and quality of life. Advancements in digitalisation have also greatly benefited women, as they can easily access information through YouTube on how to self-examine themselves and learn about breast anatomy or changes in breast structure that should be brought to the notice of specialists immediately.
Women above the age group of 20 -25 years should examine themselves monthly, and those above 40 years of age should go for mammography at regular intervals. With earlier breast cancer detection, the survival rate increases to 80 per cent (Stage 1 and stage 2), as compared to 56 per cent in Stage 3 and stage 4.
In India, however, early treatment is the exception rather than the norm. By the time most patients are diagnosed, they are already in stage III or IV of the disease, where treatment modalities are more complex. Additionally, the stigma of living with breast cancer can hamper the patients' quality of life in physical, psychological, and social terms.
Mental health counselling, family and institutional support, and new drugs and modalities can help women at all stages of breast cancer to improve life expectancy, health, and overall happiness, thus ticking all the boxes for improved life quality.
Stigma And Suffering
One in 28 Indian women is at risk of developing breast cancer during her lifetime. As per a CII report, the median age for diagnosis is 46 years, and nearly half of all diagnosed women are premenopausal, i.e., relatively young compared to breast cancer patients in Western nations.
The concern, though, is that at the time of diagnosis, around 70 per cent of Indian women are already in stage III or stage IV (known as metastatic breast cancer, or cancer that has spread to other parts of the body). While getting screened early may seem like an evident solution, however, low awareness and culturally ingrained stigmas still prevent many women from getting the timely help they need.
Due to cultural factors and social taboos, women do not get checked for breast cancer or share their symptoms with others, thereby leading to delayed diagnosis. Unfortunately, the pandemic has only amplified the burden of our healthcare system, magnifying these delays.
A QOL-Itative Approach
Focusing on patients' QOL means helping them thrive on the physical, emotional and social parameters by improving their all-around experience of the disease. New hope has also come in the form of targeted therapies that shrink or remove tumours by disabling specific proteins on cancerous cells to block their growth.
These therapies, which can often be taken orally, allow patients to bypass chemotherapy and related harsh side effects. Targeted therapies are proving more effective than chemotherapy in extending the survival rates of patients with stage III or IV cancers up to 5-8 years even if a patient is diagnosed at a metastatic stage.
The rise of non-invasive, chemo-free targeted therapies is opening a new front in the battle against advanced and metastatic breast cancer. By reducing or eliminating frequent hospital visits and the side-effects they earlier took for granted, it is possible to enhance patients' physical and psychological well-being and to help them live longer with dignity and independence.
Breast cancer doesn't mean the end of life. Today, treatment options for breast cancer have advanced, giving hope to patients even in advanced stages. Nowadays, due to government policies (Ayushman Bharat), every woman, regardless of her social strata, can avail of world-class cancer treatment in medical facilities across the country.
Even in advanced stages, families should not lose hope, as newer drugs such as molecular therapy treatment have proven effective for patients suffering from hormone-positive breast cancer, which is the most common form of cancer among Indian women. As many as 60 to 90 per cent of patients respond to these advanced treatments positively, enabling them to lead an enhanced quality of life. With such innovations, cancer can be viewed as a chronic disease that needs management.
Awareness-building and sensitisation are key. Educating women and girls in urban and rural contexts about breast cancer, the importance of regular self-monitoring, and de-stigmatising medical examinations and advanced treatment options, so that they can maximise their chances of identifying and beating the disease.
It would also help address psychosocial impacts like anxiety, depression, or fear by making therapy or psychiatry facilities accessible, affordable, and un-stigmatised for patients. This would also include teaching families and communities to support patients by accompanying them for treatments, helping with chores, spending time with them, and not letting them feel like a "burden".
The late American writer John Diamond said that cancer is "a word and not a sentence". However, for lakhs of women, breast cancer is a life-changing reality. While conventional treatments for breast cancer are constantly evolving and their efficacy is undeniable, life after a breast cancer diagnosis is about more than survival (extending the patient's life) or pain management (alleviating physical discomfort). What's required is a holistic approach towards improving the quality of the patient's life and this is being understood today. (Padma Shri Pankaj Shah, Medical Oncology Haematology, Zydus Hospital, Ahmedabad)
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Although India has, for a long time, battled the incidence of cancer, latest estimates pegs them to be rising at significantly higher rate. Once thought of as an old age disease, cancer is now a cause of concern also among the youth and children.
National Cancer Awareness Day is observed every year on November 7 in India, to increase awareness about cancer prevention and the need for its early detection.
According to the Indian Council of Medical Research (ICMR), there will be an estimated 12 per cent rise in cancer cases in India in the next five years.
Longer life expectancy is a major contributor to the overall cancer incidence. As people grow old, their bodies have longer time to allow faults to build up and the body accumulates more of these faults in the genes, considerably increasing the risk of cancer.
"Larger proportion of older individuals is the first cause of increased cancer numbers. The higher the proportion of older age in the population, the higher is the chance of cancer," Wesley M Jose, Clinical Associate Professor, Medical Oncology, Amrita Hospital, Kochi, told IANS.
Further, males (52.4 per cent) are more prone to the risk of all cancer cases compared to females (47.4 per cent). Tobacco use is the major reason comprising 48.7 per cent of cancers among males and 16.5 per cent among females.
A recent report states that the number of cancers associated with tobacco use in 2025 would be 4,27,273 contributing to 27.2 per cent of India's total projected cancer cases. Initiation of tobacco, known to contain at least 69 cancer-causing agents, in the youth is a contributory factor to the increased burden of cancers associated with tobacco use in India.
"Tobacco cessation will reduce the cancer burden by about 25 per cent. The major contributing factor being tobacco and ghutka consumption that directly accounts for 27 per cent of cancers in India," Murad E. Lala, Oncologist at P.D. Hinduja Hospital & MRC, Mahim, Mumbai, told IANS.
"We all know that oral and lung cancer that affects our male population to the maximum can be prevented by curbing smoking and tobacco consumption. We need to start thinking of some unhealthy foods similar to what we think about tobacco unnecessary, addictive, and harmful," said Anil Heroor, Director-Advanced OncoSurgery Unit, Fortis Hospitals Mumbai.
Apart from tobacco, alcohol, obesity, a sedentary lifestyle and environmental factors also contribute to the increase in cancers.
"The overall living circumstances of the Indian population have improved and that have also led to a larger sedentary workforce, which has access to a high-calorie diet. These factors indirectly have affected the rise in numbers," Jose said.
"Nearly six types of cancers are linked to obesity and are slowly on the rise among people under 50. These are cancers of the colon or rectal, pancreas, kidney, gallbladder, uterine (also called endometrial cancer), and multiple myeloma. These Cancers are often not discovered in younger people until the disease is advanced and harder to treat," Heroor said.
Childhood cancer is also seeing an increasing trend, mainly of leukemia and lymphomas. Childhood (0-14 years) cancers constitute 7.9 per cent of all cancers, according to ICMR.
"The common types of cancers in children are leukemias, lymphomas, CNS tumours, retinoblastomas and Wilm's tumours. While most of the childhood cancers are curable if detected early and treated appropriately, children in India have limited access to tertiary centres that treat childhood cancers. This delay in treatment causes the survival rate to drop," Jose said.
The cancer burden in the country can be reduced by strengthening the government health systems, making universal health coverage, health education, treatment compliance, and early detection centres at the community level.
Besides, vaccination for virus-related cancer like liver and cervix, and improved physical activity, stricter tobacco and alcohol laws can also help, the experts suggested. (IANS)
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इंडियन काउंसिल ऑफ मेडिकल रिसर्च (आईसीएमआर) द्वारा तैयार की गई एक रिपोर्ट में कहा गया है कि 2012-19 के बीच कैंसर के कुल मामलों में से 7.9 फीसदी 14 साल से कम उम्र के बच्चों में पाए गए। 'क्लिनिकोपैथोलॉजिकल प्रोफाइल ऑफ कैंसर्स इन इंडिया : ए रिपोर्ट ऑफ हॉस्पिटल-बेस्ड कैंसर रजिस्ट्रीज, 2021', नेशनल कैंसर रजिस्ट्री प्रोग्राम (एनसीआरपी) के तहत 96 अस्पताल-आधारित कैंसर रजिस्ट्रियों की अवधि के दौरान एकत्र किए गए डेटा को समेकित करता है। डेटा देशभर में इन केंद्रों को रिपोर्ट किए गए पुष्टिकृत विकृतियों के सभी निदान और इलाज के मामलों से संबंधित हैं।
देश में 2012-19 के दौरान कैंसर के 13,32,207 मामले दर्ज किए गए। इनमें से 6,10,084 को डेटा की पूर्णता और गुणवत्ता के आधार पर विश्लेषण के लिए शामिल किया गया था।
बचपन के कैंसर वैश्विक स्तर पर बचपन की बीमारियों के प्रमुख कारण के रूप में नौवें स्थान पर हैं, विकलांगता समायोजित जीवन वर्ष (डीएएलवाई) के 11.5 मिलियन के लिए जिम्मेदार है।
भारत में, एनसीआरपी की एक हालिया रिपोर्ट के अनुसार, सभी आयु समूहों में कैंसर के सापेक्ष बचपन के कैंसर (0-19 वर्ष) का अनुपात 1 से 4.9 प्रतिशत के बीच पाया गया।
दिल्ली में लड़कों में 203.1 प्रति मिलियन और लड़कियों में 125.4 प्रति मिलियन की उच्चतम आयु-समायोजित घटना दर (एएआर) दर्ज की। ल्यूकेमिया 0-14 वर्ष आयु वर्ग में दोनों लिंगों में सभी बचपन के कैंसर के लगभग आधे के लिए जिम्मेदार है (लड़कों में 46.4 प्रतिशत और लड़कियों में 44.3 प्रतिशत)। लड़कों में अन्य सामान्य बचपन का कैंसर लिम्फोमा (16.4 प्रतिशत) था, जबकि लड़कियों में यह घातक अस्थि ट्यूमर (8.9 प्रतिशत) था।
बचपन के कैंसर दो आयु समूहों के लिए प्रस्तुत किए जाते हैं : 0-14 वर्ष और 0-19 वर्ष राष्ट्रीय और अंतर्राष्ट्रीय तुलना को सक्षम करने के लिए और बचपन के कैंसर के अंतर्राष्ट्रीय वर्गीकरण के अनुसार वर्गीकृत किया जाता है।
रिपोर्ट में कहा गया है कि बचपन के कैंसर के अलावा, तंबाकू के उपयोग से जुड़े कैंसर में पुरुषों में 48.7 प्रतिशत और महिलाओं में 16.5 प्रतिशत कैंसर शामिल हैं।
थायरॉइड कैंसर (महिलाओं में 2.5 प्रतिशत बनाम पुरुषों में 1 प्रतिशत) और पित्ताशय के कैंसर (महिलाओं में 3.7 प्रतिशत बनाम पुरुषों में 2.2 प्रतिशत) को छोड़कर, साइट-विशिष्ट कैंसर का सापेक्ष अनुपात महिलाओं की तुलना में पुरुषों में अधिक था।
सभी कैंसरों में दूर के मेटास्टेसिस का उच्चतम अनुपात फेफड़ों के कैंसर (49.2 प्रतिशत पुरुष और 55.5 प्रतिशत महिलाओं) के रोगियों में देखा गया, इसके बाद पित्ताशय का कैंसर (40.9 प्रतिशत पुरुष और 45.7 प्रतिशत महिलाएं) और प्रोस्टेट कैंसर (42.9 प्रतिशत) का स्थान है।
रिपोर्ट ने सुझाव दिया कि कई कैंसर के लिए कीमोथेरेपी अभी भी सबसे विशिष्ट उपचार पद्धति थी, भले ही प्रस्तुति में रोग की नैदानिक सीमा कुछ भी हो, जिसमें यकृत, पित्ताशय, पेट, फेफड़े और बचपन के कैंसर शामिल हैं।
यह भी पढ़े► कैंसर और हार्ट अटैक से ज्यादा खतरनाक हो जाएगा सेप्सिस: शोध