Some people believe that psoriasis is just a common cosmetic, skin problem. Many believe it is contagious, making it one of the most stigmatized of all skin conditions and cannot be managed. So, which is it?
Psoriasis occurs when one's immune system is overactive and attacks healthy skin tissue, causing inflammation and speeding up skin cell growth. As a result, the skin becomes itchy, painful and scaly, with inflamed red plaques (patches) or silvery scales. These can appear across the body, often on the scalp, knees, back or elbows. Still, many believe these patches cannot hurt them.
Shrichand G. Parasramani, Dermatologist, Anisha Clinic, Mumbai said, "Psoriasis is an autoimmune disease which can be controlled but has no cure. It can go into remission. Patients and their families have several misconceptions of the disease, such as it are infectious in nature and they have to live with it lifelong.
It affects the patient's quality of life to a large extent which increases his level of stress. Many patients are drawn towards alternative medicine such as Ayurveda or homoeopathy due to the failure of conventional therapy and at times high cost of treatment. This leads to irregularity in treatment, resulting in a flare-up of the disease or treatment failure.
However, patients must understand the importance of addressing the disease so as to avoid the progression of psoriasis and its underlying complications. They must be told that with newer treatment options patients can lead an almost near-normal life."
Here are 4 ways Psoriasis can worsen if not managed:
Inflammation: Psoriasis is a chronic autoimmune disease that causes inflammation. What's especially important to note is that even mild psoriasis can be a sign of significant inflammation in the body. This inflammation, in turn, can contribute to other associated health conditions.
Given that dermatologists are the key medical experts responsible for treating psoriasis, it is important to consult one to understand the condition and suitable and advanced treatment options such as biologics
Increased Risk of Health Complications: People living with psoriasis are at a higher risk of developing associated conditions or comorbidities. The most common of these is psoriatic arthritis which affects 30 per cent of psoriasis patients. It is a chronic and inflammatory disease of the joints, resulting in stiffness, pain, throbbing, swelling and tenderness in joints. If this is not treated, long-term joint damage can result.
People with psoriasis, particularly in more severe cases, are also more likely to have other inflammatory conditions, including heart attack, stroke, type-2 diabetes, and inflammatory bowel disease. Other related health issues can also include obesity, chronic obstructive pulmonary disease, metabolic syndrome, hypertension, kidney or liver disease uveitis, and sleep apnea.
Treatment to Prevent Flare-Ups: If unmanaged, psoriasis can lead to plaques and scales that continue to build and spread. Over time, these can become quite painful, causing severe itching. Without adequate treatment to prevent flare-ups, these can increase in severity and frequency. This can even happen to patients who begin medication but suddenly discontinue adhering to their recommended prescription.
It's important to remember that psoriasis can be treated. By adopting advanced therapies, such as biologics, the disease, as well as flare-ups, can be effectively managed.
Mental Health & Quality of Life: Another long-term effect of psoriasis is its effects on an individual's mental health and across one's overall quality of life. Physical symptoms, especially in commonly visible areas like the face or hands can lead to distress and affect one's self-esteem. Psoriasis, which is highly stigmatized, can be isolating or even affect social relationships.
It is also associated with psychological conditions, including depression and anxiety. These place an individual in a vicious cycle increased plaques can lead to anxiety or depression, and such stressors act as common triggers for a psoriasis flare.
By striving to address one's psoriasis, while also attempting to manage stress such as through counselling or lifestyle changes or community support groups individuals may begin noticing improvements in their overall health and well-being.
What Steps You Should Take
First and foremost, consult a dermatologist. Typically, psoriasis can be diagnosed with a simple physical examination with the doctor taking a look at one's skin, scalp and nails.
Once diagnosed, adopting a holistic treatment plan depending on the severity of one's psoriasis is key. If previously taking medication for psoriasis with limited effects, this responsiveness to treatment may also be used to find an approach more suited to the individual, especially considering recent advancements in psoriasis treatment.
It is important to remember to treat psoriasis as a chronic condition with longer-term implications, as opposed to one with temporary treatment solutions. The main aim of psoriasis treatment is to reduce inflammation and plaques. Currently, there are newer, advanced and innovative treatments, including biologics to safely and effectively treat and manage psoriasis. These work by blocking reactions in the body that cause psoriasis and its symptoms.
Biologics are important treatment options, particularly for people with moderate-to-severe psoriasis. While they may believe their condition cannot be improved or are distressed about other treatments failing, biologics can have life-changing impacts, especially in controlling one's symptoms. (Shrichand G. Parasramani, Dermatologist, Anisha Clinic, Mumbai)
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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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Sleep is an essential function that helps in recharging our bodies and minds. Moreover, healthy sleep also helps the body in remaining fit and it staves off any diseases. When we do not get enough sleep, our brain does not function properly and it can impair our abilities to concentrate, think clearly and process memories. An adequate amount of sleep that an adult requires ranges from seven to nine hours.
However, work schedules, day-to-day stressors, a disruptive bedroom environment and medical conditions can prevent us from receiving adequate and peaceful sleep. Hence, a healthy diet and good lifestyle habits can ensure a good amount of sleep each night. However, for some people chronic lack of sleep may be a sign of a sleep disorder.
Sleep reflects one's state of mind and overall health in general. A good sleep is one which is age appropriate in duration, qualitatively divided into various sleep stages of adequate periods and which eventually makes a person feel refreshed in the morning and through the day. Although there is a wide variation in the amount of total sleep required by healthy adults to maintain a good daytime function, it is widely accepted that a good, consolidated 8 hours of uninterrupted night-time sleep is essential for majority of adults.
An adequate amount of sleep duration is extremely important to maintain good mental and physical health. A sleep deprived person often experiences decline in cognitive function, poor memory, inability to concentrate on tasks at hand and easy irritability with frequent mood swings. Even if the sleep duration is adequate, an interrupted and disrupted sleep with poor sleep quality devoid of deep sleep is also associated with excessive daytime sleepiness with declining cognitive function.
Lack of good sleep, both in terms of duration and quality, can adversely affect the physical wellbeing with such individuals being more prone to develop both infectious as well as lifestyle related diseases. With the millennial generation adopting a 24-hour lifestyle without any defined periods of sleep, increase in the total screen time during COVID-19 lockdowns due to exponential increase in online classes and meetings, and poor sleep hygiene, have all resulted in a variety of sleep disorders.
Ultimately, this very important aspect of keeping people healthy is not only being ignored but also leading to abuse of sleeping pills, alcohol and smoking. With rising stress levels and a constant pressure to meet deadlines, it is extremely important to maintain a work life balance and give oneself adequate opportunity and time to have a good night sleep. If anyone experiences any kind of sleep related issues, these should be brought to the immediate notice of the sleep physicians and expert opinion must be taken for timely diagnosis and management.
All in all, sleep is good and necessary. For adults, getting at least seven hours of sleep ensures proper daytime functioning which involves being alert for the day and being able to concentrate and not moody and tired through the day. Creating a night time routine that ensures that your mind and body are relaxed can be helpful in ensuring a good sleep for all individuals.(By Ayush Gupta)
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After a sombre year, people all over the world are finally ushering in the festive season with more joy and hope. For many, it will also be the first time they see their extended families and loved ones in over a year. Family gatherings obviously come with feasting, food and drink, however, if you are breastfeeding your baby, then there are some foods that you might want to steer clear of.
The key to a good breastfeeding diet is simply to be on a nutritious and healthy meal plan. After the rigorous process of watching what they eat, new mothers can finally relax and eat almost everything they had to give up for nine months. But this must be done in careful moderation because a newborn baby's diet is still entirely dependent on their mother's milk. Hence, it is important to make sure that mothers eat meals that are rich in nutrients, vitamins and minerals such as iron, calcium, potassium, Vitamin A and Vitamin D.
The list of foods to avoid during pregnancy is long, but thankfully breastfeeding moms can eat almost anything as long it is in moderation. The following foods should be consumed in small amounts if a woman is breastfeeding.
All food items with alcohol and caffeine content should be kept to a bare minimum. Alcohol especially is tricky, because even after having waited for 2-3 hours after the consumption of a drink, a baby can be exposed to it through breast milk, and this could potentially harm an infant's development, growth, and sleep patterns. And as for caffeine, while it is much safer than alcohol, it is recommended that nursing mothers limit their intake to about 300 milligrams per day.
Chocolate can be included back in the diet, as long as it is consumed in small quantities. This is because chocolate does contain theobromine, which is a stimulant and there is a small possibility of it leading to a breastfed infant being restless and fussy. Since any nutrient from the food the mother consumes gets transformed into breast milk, care should be taken to consume avoidable food items in very small amounts.
Stress producing foods or high calorific foods should be avoided: Carbonated beverages, Caffeine, packaged fruit juices with excess sugar, Peppermint or gums, salad dressings with high sodium should be completely avoided. Processed foods are quick and easy to prepare especially when you have a baby.
However, these foods contain preservatives and additives that are toxic for the baby which should be avoided. An expecting mother is suggested to get proper rest and keep stress at bay. While postpartum stress affects many new mothers, experts suggest that managing stress and anxiety is crucial to the well-being of both the mother and her infant. Stress may lead to reduced lactation and breastfeeding issues.
Avoid binge-eating during this time, despite the erratic hours that new parents are bound to experience. Carbonated drinks and junk food cravings should be substituted with healthier food options like nuts and fruits.(Rohit Shelatkar, VP at Vitabiotics, Fitness & Nutrition Expert)
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Many people believe that heart disease typically affects men. Unfortunately, this is far from the truth. Coronary heart disease is the leading cause of mortality not only among men, but also among women. But women are actually at greater risk if not detected early, and this exacerbates the issue.
Signs of poor heart health do not appear as visibly in women as it does in men. What this means is that if a man has a heart issue, there are specific symptoms like angina which can be spotted easily and the right course of action be recommended. The same issue in a woman may not result in a sign or symptom that can be easily spotted. So often, their symptoms go ignored or unrecognised and they do not receive timely intervention to correct the problem. The issue is so acute that today 1 in 3 deaths among women is due to coronary heart disease.
There is also a significant lack of self-awareness among women about risk factors and the prevention of CVDs. Women don't only attend to matters of the home, but they hold positions at leading companies, and continue to rise to the occasion and meet impossible demands on their time. Through all of this, they take care of the emotional needs of their family members and loved ones; and still culturally are predisposed to putting the needs of others before their own. The stress they experience, among other common risk factors, often goes unnoticed by those around them. And stress has a greater influence on CVD risk in women vs men. Along with stress, other factors like diet quantity and quality also have a greater influence on CVD risk in women vs men. Additionally, women are also impacted by female-specific risk factors for CVD like polycystic Ovarian syndrome PCOS, preeclampsia, pregnancy induced hypertension and gestational diabetes.
In such a situation where symptoms of a heart problem do not manifest visibly, it is extremely important for women to be aware of their own risk factors and adopt proactive measures to take care of their heart health. For example, one risk factor, stress has been linked to a greater intake of energy and nutrient-dense foods, mainly sources of sugar and fat, and to poor diet quality. Women can take simple steps like reducing unhealthy fats and products with high content of sugar and salt to improve the quality of their diet. Choose ingredients that are good for the heart, like oatmeal, wholegrains, fiber rich vegetables, blended oils with the right balance of fatty acids, legumes, soy products, and the like. Regular and consistent exercise, adequate sleep, and other such lifestyle modifications can help maintain heart health in the long term.
Furthermore with signs of poor heart health not manifesting visibly in women, it is crucial that they get regular health check-ups done to assess their risk proactively. Self-awareness and early identification of cardiovascular risk factors can lead to better prevention of CVD in women.
This World Heart Day, let's choose self-care. Get a simple heart check-up done and encourage other women in yourselves too, to get the same done. Take proactive steps for heart health today.
(By Brajesh Kunwar)
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