While wearing double masks, which helps create a strong barrier against Covid-19 infection spread via airborne viral particles, has become the new normal, prolonged wearing of masks can develop hydration issues or other nagging breathing troubles, health experts said on Wednesday.
There has been enough evidence through the pandemic to show the importance of masks for effective pandemic control. At the start of the pandemic, it was seen that countries (primarily Asian nations) which enforced early masking had lesser mortality rates as compared to countries in the West where compulsory mask wearing was introduced quite late.
"Prolonged mask wearing can be associated with certain problems the most common being headaches, dehydration, acne and difficulty in breathing," Radhika Banka, Consultant Pulmonologist at P.D. Hinduja Hospital & MRC, Mumbai, told IANS.
Breathing issues are "usually seen in mouth breathers and in people with underlying respiratory problems such as COPD (Chronic Obstructive Pulmonary Disease)", she added.
According to Ravi Shekhar Jha, Additional Director and HOD, Pulmonology, at Fortis Escorts Hospital, Faridabad, wearing double mask for long hours can also lead to dryness.
"It is because natural humidification of nasal mucosa gets impaired," Jha said.
There are various masks available in the market, including cloth masks, surgical masks and respirators such as N-95s.
The cloth mask has the least protection and the US Centre of Disease Control and Prevention (CDC) recommends wearing a disposable surgical mask along with a cloth mask for additional protection. For surgical masks, the knotted technique (that is knotting the ear loops to provide better fit and prevent leakage from the sides) is recommended.
But with full vaccination rolled out in most countries, are double masks still required?
"Even after double dose vaccination, people can get breakthrough infections and can still be asymptomatic carriers and spread the infection. Hence masking is important even after double vaccination," Banka said.
The health experts stated that for people living in India, double masks become more important as vaccination of children has not yet begun in the country, and asymptomatic transmission is the highest from children. Added to this is a high population density, where social distancing is not practically possible in many cases.
Most of the countries which have made masks voluntary are those in the West with low population density, where social distancing is feasible. These countries have managed to vaccinate more than 80 per cent of their population with two doses. Also, masks in these countries are still recommended in enclosed spaces, public transports, healthcare facilities etc.
"With only 48 per cent of our population being vaccinated with one dose and 25 per cent being vaccinated with two doses, I do not think India can yet take the risk of removing the mandatory use of masks," Banka said.
However, according to Jha, "A single mask, if worn properly, is sufficient."
"People who wear double masks, have this tendency of adjusting their masks repeatedly due to breathing issues, and that way the whole purpose of wearing a mask is defeated," he said.
Jha added that for someone like a healthcare worker, who is in an area with high concentration of Covid viral droplets, an N-95 mask should be worn all the time. For other situations, a normal surgical mask (single) is sufficient.
"We need to ensure that masks are worn properly, with proper seal at nose. Improperly worn masks are more dangerous. It is also important to keep in mind that a mask alone may not protect. One needs to follow hand hygiene as well as maintain social distancing," Jha advised.
Although several countries have loosened mask restrictions citing vaccine efficacy, various studies and health experts have stressed on the need for continuing wearing masks, even after being fully vaccinated, including booster shots; and following other protective measures such as physical distancing and handwashing.
A recent study led by researchers from the Monash University and the University of Edinburgh analysed more than 30 studies from around the world and found a statistically significant 53 per cent reduction in the incidence of Covid with mask wearing, and 25 per cent reduction with physical distancing. Handwashing also indicated a substantial 53 per cent reduction in Covid incidence.
Most people are able to wear masks fairly well for a few hours, but if your job requires you to wear masks for a prolonged period, it is essential to take adequate breaks to hydrate oneself and prevent any skin problems, Banka suggested. (Agency)
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With a whopping 77 million people in India living with diabetes, a simultaneous and sharp rise has been observed in the prevalence of diabetes-related preventable vision loss, particularly among the young people, say experts.
Diabetic retinopathy is a chronic, progressive retinal disease that is a leading cause of vision impairment in today's young adults, working population. It's of major concern among children suffering from juvenile diabetes (Type-1 diabetes) and especially if they have had diabetes for over 10 years.
It is estimated that approximately 1.1-crore people are suffering from retinal disorders in India and more alarmingly, about one in every three people living with diabetes have some degree of diabetic retinopathy, a diabetes complication that affects eyes.
"With the growing incidence of diabetes, it has been estimated that diabetic retinopathy affects one in three people with diabetes and remains the leading cause of blindness in young working-aged adults," Dr Mahipal Sachdev, Medical Director and Chairman, Centre for Sight Group of Eye Hospital, told IANS.
"Approximately 7-10 per cent of young diabetics will go on to develop diabetic retinopathy, of which 2-4 per cent will have vision threatening sequelae if not taken proper treatment." added Dr. Aditya Sudhalkar, M.S. Ophthalmology, Consultant Vitreoretinal Surgeon.
The most common form of diabetic retinopathy is Diabetic Macular Edema (DME) which arises when the damaged blood vessels swell and flow into the macula of the retina causing visibility issues in the normal vision.
According to Dr. Chaitra Jayadev, senior vitreo-retinal consultant, Narayana Nethralaya Eye Institute Karnataka, studies have shown that the prevalence of DME and diabetic retinopathy is higher and more severe in young diabetics with a longer duration of diabetes.
"Diabetes in the younger is a distinct pathological entity characterised by a more aggressive presentation and manifestation. An earlier onset of diabetes leads to a longer exposure to insulin resistance and hyperglycemia. This gives rise to a greater propensity for developing long-term microvascular and macrovascular complications," Dr. Jayadev said.
Thus, screening for diabetes is of utmost importance, even if one is "young" and has no symptoms. It becomes more crucial if one has risk factors such as family history, obesity, sedentary lifestyle, or on long term steroid medications.
Dr. Sudhalkar said that in India, there is a general reluctance towards attending clinics and nearly 25 per cent of young patients with DME come late for diagnosis.
"It's important to know, only 11 per cent of diabetic retinopathy patients can actually reverse vision threatening sequelae once they set in. The rest continue to progress even with strict glycemic control," he noted.
"Retinopathy, unfortunately, is the most neglected complication of diabetes. We see so many patients come to OPD where eyes have not been checked for. So the screening, also known as Funduscopy, should be done at the time of diagnosis of Type-2 diabetes, in adults, and in children, five years after the onset of diabetes, and thereafter annually," Dr Dheeraj Kapoor, HOD, Endocrinology at Artemis, Gurugram, told IANS.
If diabetes occurs near puberty, then funduscopy should be checked for potential retinopathy.
"It is important because the condition poses no symptoms in the initial days. And once symptoms set in, such as bleeding in the eye, red vision, sudden loss of vision, it's too late," Kapoor said.
The doctors advised to adhere to the treatment and maintain a healthy lifestyle to effectively manage diabetes and to prevent the onset or progression of eye diseases.
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While Covid-19 spared none, people with diabetes were among the hardest hit. The infectious disease not only raised the risk of severe disease progression and death among diabetics, affecting even the recovery, it also contributed towards the burden of diabetes in the country.
World Diabetes Day is observed annually on November 14 to raise awareness on the high blood sugar condition and related consequences.
India, known as the diabetes capital of the world, is home to one in six diabetics in the world. The country has also suffered significantly from Covid-19.
While on an average, diabetes reduces life expectancy by 4-10 years increasing the risk of death due to other comorbidities, which include heart attacks, kidney failures and infections, Covid infection fast forwarded that among people with diabetes.
Diabetes increased inflammatory response among Covid patients, spiking their blood sugar levels. It then complicated the course of Covid, resulting in excess morbidity and mortality, as well as posing severe challenges in the recovery of patients.
"During Covid patients were succumbing to it, not because of the original disease, but because despite all other efforts their glucose levels remained high. Thus recognising glucose as a vital sign very similar to blood pressure and pulse rate, respiratory rate, became more necessary during the pandemic," Jothydev Kesavadev from Jothydev's Diabetes Research Centres, Kerala, told IANS.
"Studies from all over the world show that the majority of the deaths from Covid were linked to high glucose values, and this includes both patients with no diabetes and with the new onset of high glucose," he added.
Further, the use of steroids, to control the serious manifestations of Covid-19, worsened the glucose levels in the patients.
High blood sugar levels, coupled with increased use of steroids, also led to other complications such as an unprecedented surge in cases of mucormycosis, commonly known as black fungus. It is a fungal infection, which occurs by inhalation of spores and can disseminate to various organs rapidly.
According to a recent study, published in Diabetes and Metabolic Syndrome: Clinical Research and Reviews, more than 86 per cent of mucormycosis or black fungus cases related to Covid in India, had uncontrolled glucose values.
"While the Covid cases are closely related to diabetes, mucormycosis is also very closely related to diabetes in Covid. Whenever the glucose is high, there is a deranged immune mechanism and in the presence of an infection it is persuaded rapidly," Kesavadev said.
Another study, published in the same journal showed that people with Type-2 diabetes who also suffered Covid-19 were more likely to experience severe fatigue than those who did not have the infectious disease, emerging as a major roadblock in the recovery of patients infected with SARS-CoV-2.
Moreover, among diabetes patients, those with increased fatigue level post Covid-19 also had increased postprandial blood glucose levels.
Covid also contributed to new onset of diabetes in many people, particularly the young. On one hand, Covid-induced lockdowns increased diabetes cases as people spent more time indoors, while eating more and exercising less.
On the other hand, Covid also contributed to nearly 25 per cent rise in diabetic patients in the country, according to an analysis of OPD data from a private hospital in Delhi.
Doctors found that among patients with confirmed Covid-19 infections, there was nearly 25 per cent of new onset of diabetic patients. Stress induced hyperglycemia -- high blood sugar -- was seen in 10 per cent of patients who had Covid-19 infection.
"The younger population is increasingly affected. We have seen that happening during Covid-19 epidemic. Increasing number of young people with more severe diabetes are now being seen," Dr Anoop Misra, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, told IANS.
As per a recent study, among the younger generation in India, below the age of 30 years, there is a rapid increase in the occurrence of diabetes over the last 10 years.
"For these, diabetes as a disease will result in complications after 10 to 15 years. Imagine a situation where more and more people are developing diabetes at the age of 25 years or 30 years, which means even during the productive age group, by the time they are 35 years or 40 years, they will start developing complications. if the disease is not treated properly," Kesavadev said.
"There is an urgent need to decrease the screening age of diabetes to 25 years, from the current 30 years, in India," Dr Misra said, adding that "there is increasing urgency to ensure that young people follow correct lifestyle practices including more exercise, correct food choices, and maintenance of weight to normal, or even leaner category".
While diabetes cannot be treated it can be controlled and reversed by adopting a healthy lifestyle, diet and having proper sleep, as well as exercising for at least half an hour every day, suggested the experts. (Rachel V Thomas)
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Chronic inflammation caused by obesity may trigger the development of cells that break down bone tissue, including the bone that holds teeth in place, finds a new research.
The study, completed in an animal model, found that excessive inflammation resulting from obesity raises the number of myeloid-derived suppressor cells (MDSC), a group of immune cells that increase during illness to regulate immune function.
MDSCs, which originate in the bone marrow, develop into a range of different cell types, including osteoclasts (a cell that breaks down bone tissue).
"This research promotes the concept that MDSC expansion during obesity to become osteoclasts during periodontitis is tied to increased alveolar bone destruction," said researcher K.H. Kwack from the University at Buffalo.
"Taken together, this data supports the view that obesity raises the risk of periodontal bone loss," Kwack added.
Bone loss is a major symptom of gum disease and may ultimately lead to tooth loss.
Also known as periodontal disease, gum disease affects more than 47 per cent of adults 30 years and older, according to the Centers for Disease Control and Prevention.
For the study, published in the Journal of Dental Research, the team examined two groups of mice fed vastly different diets over 16 weeks -- one group, a low-fat diet that derived 10 per cent of energy from fat, the other group a high-fat diet that drew 45 per cent of energy from fat.
The investigation found that the high-fat diet group experienced obesity, more inflammation and a greater increase of MDSCs in the bone marrow and spleen compared to the low-fat diet group.
The high-fat diet group also developed a significantly larger number of osteoclasts and lost more alveolar bone (the bone that holds teeth in place).
Also, the expression of 27 genes tied to osteoclast formation were significantly elevated in the group fed a high-fat diet.
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An immediate challenge today is the prevention of Diabetes among the youth and pregnant women, Union Minister of State Dr. Jitendra Singh said on Sunday.
The minister, also a renowned Diabetologist, called for a mandatory diabetes test in all maternity hospitals and for every pregnant women, adding that more than 70 per cent of India's population is below 40 years of age.
Calling for an integrated and holistic approach to fight Diabetes, Singh said: Covid has prompted us to discover new norms in adversity and underlined the importance of combining traditional Indian management modalities with the Allopathic System."
"Diabetes is a growing epidemic globally and more so in India. A total of 88 million adult populations in India has diabetes in 2019 as per the latest International Diabetes Federation (IDF) estimates and this is projected to rise by almost 74 per cent to 153 million by 2045, giving India the dubious distinction of becoming the diabetes capital of the world," Singh said.
Sharing the concerns about of Diabetes that is making fast inroads in rural India with huge economic bearing on poor families, Singh said that there is a need to popularise Telemedicine to provide easy and affordable access to the ailing population.
Talking about the National Digital Health Mission, Singh said it can revolutionise healthcare in India as citizens will be issued a health card that will have all their medical information.
He said, the details of medical tests, illnesses, doctors' prescriptions and medical reports will be on a single identity card and will be the first of its kind in the world.
The Union Minister was speaking at a webinar on diabetes on the occasion of World Diabetes Day, jointly organized by Swami Vivekananda Yoga Anusandhana Samasthana, S-VYASA, Bengaluru and Central Council for Research in Yoga and Naturopathy, CCRYN, New Delhi.
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Heartfulness meditation, a simple heart-based meditation practice aimed at attaining a balanced state of mind, helps in reducing stress and improving the quality of sleep, revealed a study.
The mixed-method study was conducted by US researchers during the Covid-19 pandemic and was published recently in the International Journal of Environmental Research and Public Health, said Heartfulness Institute, which has its global headquarters in Hyderabad.
Heartfulness meditation was associated with significant reduction in perceived stress and improvement in the quality of sleep of participants who completed the online-based meditation programme.
Kamlesh Patel, also known as Daaji, the guide of Heartfulness meditation, underlines the need to immediately address stress in one's life.
"The simple focus of life is to become better and better each day. To achieve this we need to be in a state of complete awareness about our self and raise our consciousness in tune with our true nature. Stress is the modern day ill created by our inability to focus on things that matter. Stress and its negative impact on our overall wellbeing has slowly but steadily taken control of every individual," he said.
"While we know Covid-19 as the pandemic, the build-up of stress and its ill impacts is the bigger pandemic and equally a bigger health crisis. Stress needs our urgent attention as well and in consistent practice of meditation we have the most effective vaccination to ward off stress and is the visa for living your life in joy," he added.
The study was conducted by Dr Kunal Desai, Dr Priti Parikh and Dr Alpa Desai of the Department of Internal Medicine, Boonshoft School of Medicine at Wright University, Ohio, and Prof Dr Pratibha Gupta, Food Nutrition and Health Agricultural Research Development Programme, Central State University, Ohio.
Stress and lack of quality sleep are considered serious public health challenges despite modern lifestyles, comforts, and technological advances. The Covid-19 pandemic has genuinely brought attention to this pre-existing stress problem by making it significantly worse.
The study aimed to investigate whether using a virtual heart-based meditation program is associated with improved stress levels and quality of sleep. The researchers enrolled 63 participants to receive an eight-week virtually conducted Heartfulness meditation program. Of these, 36 (57 per cent) completed the entire eight weeks of the Heartfulness meditation programme.
The participants were recommended to attend a minimum of two out of a total of eight virtual trainer-guided group Heartfulness relaxation and meditation sessions each week. These sessions, conducted by one of the authors and a Heartfulness trainer (KD), included 5-7 min of relaxation followed by 20 min of meditation.
They were also provided instructions on using the phone application called 'HeartsApp' on their phones. They could connect as an anonymous seeker with a Heartfulness trainer through the application and meditate without any audiovisual interaction. They were also suggested self-practices to the best of their abilities.
"Our study showed that following Heartfulness meditation practice, PSS and PSQI improved significantly in the participants from different parts of the United States. About 31 per cent were healthcare professionals, and the entire programme was conducted virtually. Based on these observations, we propose that meditation programmes offered via virtual platforms can offer a convenient, helpful, and easily accessible tool to a large community at once to help improve the psychological wellbeing of individuals," said Dr Kunal Desai, who led the study.
"The results of qualitative analysis in our study bring a unique perspective to this aspect as we were able to show that the participants' subjective experiences strongly supported the results of the survey findings. Thus, these results enhance our understanding of how Heartfulness meditation practice helps reduce stress and improve the quality of sleep. Our qualitative analysis suggests these effects could be because a simple heart-based meditation brought a 'calming effect' in our participants, resulting in an 'inner peace'. Such an effect also resulted in inner changes in our participants, including positive thinking, accepting and empathic attitude, and an increase in awareness of one's own emotions and the needs of others."
This study adds to the existing literature supporting the benefits of Heartfulness practice, as reported by some previous studies showing the benefit of Heartfulness relaxation and meditation to reduce stress, burnout, loneliness, and improve the quality of sleep.
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