In 2022, Shahnaz Fatima (32) noticed an uncommon white scar forming on her tongue, informs her husband, Mohammad Israr. Over time, this scar transformed into a persistent non-healing ulcer, remaining on her tongue for months. Concerned about the ulcer's persistence, the couple opted to consult local medical professionals in their hometown Sidhartha Nagar, Uttar Pradesh, seeking advice and treatment. Following consultations with several doctors, they were advised that the condition was leukoplakia. However, Israr found the diagnosis to be less than convincing and felt prompted to take his wife to Mumbai for a more thorough and accurate diagnosis. Upon reaching Mumbai, Shahnaz received a diagnosis of carcinoma at the Head and Neck Cancer Institute of India. The prognosis initially included the possibility of tongue amputation, which would have resulted in her losing the ability to speak. However, following the surgery conducted three months ago, a portion of her tongue was successfully removed, and she has since regained her ability to speak. Dr Kanav Kumar, a surgical oncologist at the Head and Neck Cancer Institute of India, along with Dr Sultan Pradhan, Dr Rajan Kannan, and Dr Mohsin Shaikh conducted surgery on Shahnaz, ultimately saving her from losing her tongue. In an exclusive interview with Midday, Dr Kumar sheds light on the symptoms, diagnosis and treatment of tongue carcinoma: Dr Mohsin Shaikh, Dr Kanav Kumar, Dr Sultan Pradhan What were the symptoms that led to the diagnosis of tongue carcinoma?Kumar: The specific characteristics of the ulcer on the tongue that led to the diagnosis of carcinoma included its non-healing nature and painlessness. Typically, malignant ulcers, such as carcinomas, exhibit a lack of healing and are initially painless. In this case, the patient had been experiencing a non-healing ulcer over the tongue for the past month, which raised concerns regarding its nature. The absence of pain initially is a common feature of cancerous ulcers, as the disease progresses and involves surrounding nerves, pain may develop as a later symptom. The combination of the ulcer's persistence and painlessness prompted further investigation to rule out malignancy. While non-malignant ulcers can also occur for various reasons, the duration of one month without signs of healing, coupled with the lack of pain, raised suspicion for carcinoma. Additionally, considering the location on the tongue, which is a common site for oral cancers, heightened the concern for malignancy. Consequently, the patient likely underwent diagnostic tests such as a biopsy to confirm the diagnosis of carcinoma and initiate appropriate treatment. What was the extent of the surgery performed to remove the cancer from the tongue and ensure clear margins?Kumar: The surgery performed to remove cancer from Shahnaz's tongue aimed to ensure complete eradication of the tumour while preserving as much healthy tissue as possible. The procedure involved excising the tumour along with a surrounding margin of approximately 1cm of normal tissue. This margin was crucial to ensure that any potentially cancerous cells were completely removed, minimising the risk of recurrence. To verify the adequacy of the resection and ensure clear margins, the excised tissue was immediately subjected to examination using a technique called frozen section analysis. This process involves quickly freezing the tissue sample and then slicing it thinly for microscopic examination. The advantage of frozen section analysis lies in its rapid turnaround time, providing results within 10-15 minutes while the patient is still in the operating room. This immediate feedback allows the surgical team to assess whether the margins are free of tumour cells and if further resection is necessary to achieve clear margins. Also Read: How this new heart procedure saved the life of a 72-year-old woman in Mumbai Were there any signs of metastasis?Kumar: During Shahnaz's surgery, lymph nodes from the same side of her neck were meticulously cleared as part of the procedure. This step was essential to assess whether the cancer had spread beyond the primary site in her tongue to nearby lymph nodes, a common pathway for cancer metastasis. Fortunately, the findings from the lymph node clearance were reassuring. Despite the potential risk of metastasis, no definitive signs of cancer spread were observed during the surgery. This initial assessment was further confirmed upon final histopathological examination of the excised lymph nodes. This outcome was particularly encouraging as the presence of metastasis in the lymph nodes would have significantly impacted her prognosis and treatment plan. The absence of lymph node involvement suggests that the cancer was localised to the tongue without spreading to other parts of the body, indicating a more favourable prognosis for Shahnaz. Side effects associated with the surgical removal of tongue cancer and lymph nodesKumar: The surgical removal of tongue cancer and lymph nodes, while crucial for treating the disease, can potentially lead to various complications and side effects. One significant concern is the impact on speech and swallowing function. Since the tongue plays a vital role in articulating sounds and manipulating food during swallowing, its removal or significant alteration can result in speech difficulties and swallowing problems. Patients may require speech therapy and dietary modifications to manage these challenges effectively. Additionally, the surgery can cause changes in taste sensation and mouth dryness, affecting the overall quality of life. Patients may experience discomfort, pain and swelling in the surgical area following the procedure. Moreover, there is a risk of infection at the surgical site, which requires vigilant monitoring and prompt treatment to prevent complications. Furthermore, the removal of lymph nodes can disrupt the normal drainage of lymph fluid, leading to lymphedema, a condition characterised by swelling in the affected area. Lymphedema management typically involves physical therapy and compression garments to alleviate symptoms. Despite these potential complications, it is essential to note that advancements in surgical techniques and post-operative care have significantly reduced the incidence and severity of complications associated with tongue cancer surgery. Moreover, in the case of Shahnaz, the absence of cancer spreading beyond the primary site to other parts of the body, as confirmed by examinations and investigations such as X-ray and MRI, suggests a more favourable prognosis and lower risk of systemic complications. Are there any factors that may affect their long-term outcome?Kumar: Following surgery, the prognosis for Shahnaz appears favourable, particularly considering the absence of cancer spread beyond the primary site and the successful removal of the tumour and affected lymph nodes. However, the long-term outcome for patients with tongue cancer can be influenced by various factors, including the stage of the disease, the extent of surgical intervention and the presence of any underlying health conditions. In her case, the early detection of the cancer played a crucial role in minimising potential side effects and improving the prognosis. Early-stage cancers typically require less extensive surgical intervention, reducing the risk of complications such as speech alteration, swallowing difficulties and shoulder stiffness. Moreover, early detection allows for more conservative treatment approaches, preserving as much healthy tissue and function as possible. Nevertheless, factors such as the aggressiveness of the cancer, the presence of any residual tumour cells and the patient's overall health and response to treatment can also impact the long-term outcome. Adjuvant therapies such as radiation therapy or chemotherapy may be recommended based on these factors to further reduce the risk of cancer recurrence and improve survival rates. Are there any lifestyle changes for such patients to reduce the risk of recurrence or further complications?Kumar: In addition to undergoing surgery and potentially adjuvant therapies, there are several lifestyle changes and precautions that patients of carcinoma need to consider. First and foremost, avoiding tobacco and alcohol consumption is paramount, as both are significant risk factors for the development and progression of oral cancers, including tongue cancer. Maintaining excellent oral hygiene is also essential in preventing oral health issues and reducing the risk of complications. Regular brushing and flossing can help remove plaque and bacteria from the mouth, reducing the likelihood of oral infections and other dental problems. Another important consideration is the use of well-fitting dentures. Ill-fitting dentures can cause irritation and trauma to the oral tissues, increasing the risk of complications and potentially hindering the healing process following surgery. Furthermore, regular follow-up appointments with medical professionals are crucial for monitoring progress, detecting any signs of cancer recurrence or complications early, and adjusting treatment plans as needed. Also Read: Indian startup develops AI-based blood test to detect 32 cancers early
14 May,2024 11:09 AM IST | Mumbai | Ainie RizviMany people who are living with obesity, suffer from dysmorphic disorder -- a condition in which a person has a distorted image of their body -- and conceal their body in their WhatsApp profile pictures, according to a study on Tuesday. People with body dysmorphic disorder feel dissatisfied with their physical appearance and may experience shame or anxiety about their bodies. Those obese and with the disorder believe they are heavier than they actually are. "This study suggests that something as simple as a WhatsApp profile picture could give doctors a valuable insight into whether someone living with obesity has body dysmorphia," said lead Antonella Franceschelli, of Unicamillus International Medical University, in Italy. In a study, involving 59 obese patients (49 females, 10 males, mean age 53 years, mean BMI 32 kg/m2), the team provided clear evidence of body dysmorphia, with 90 per cent of the men and 86 per cent of the women using profile pictures that didn't represent their physical reality. "Profile pictures of pets, family members, landscapes, flowers and cartoon characters may indicate the individual has body dysmorphic disorder," Franceschelli said. The research also found that social media exacerbates the excessive concern about physical appearance, where unrealistic standards of beauty and physical shape are often shared. "People with body dysmorphic disorder can be particularly sensitive to these influences, constantly comparing themselves to idealised images and feeling inadequate in comparison," Franceschelli said. For the study, the team involved 59 obese patients (49 females, 10 males, mean age 53 years, mean BMI 32 kg/m2), and conducted a qualitative study of their WhatsApp profile images. The results showed that the patients' profile pictures had their faces but not their bodies or used any other image like pets, family members, landscapes, cartoon characters, or objects such as flowers. Importantly, the team found that the likelihood of using a profile picture that didn't represent physical reality increased with the degree or severity of obesity. Franceschelli called for checking for body dysmorphia as a part of obesity treatment. The research was presented at the European Congress on Obesity (ECO) in Venice, Italy (May 12-15). This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
14 May,2024 11:00 AM IST | New Delhi | IANSIn a perfect Mother's Day gift, Mumbai-based Dr Rajiv Kovil helped deliver the baby of a mother with Type 1 diabetes mellitus (T1DM) with the help of a complex procedure.Type 1 diabetes mellitus (T1DM) is a chronic condition characterised by the body's inability to produce insulin. This necessitates external insulin administration to regulate blood sugar levels. For Kainaz Wadia, who was managing her T1DM with insulin, achieving optimal control becomes even more critical during pregnancy. She was instructed that the insulin may not be able to give her the kind of control required for a type 1 pregnancy, as her HbA1c and post-prandial sugars were slightly high. During pregnancy, the demand for insulin often increases due to hormonal changes, making tight glucose control paramount for the health of both mother and baby. High blood sugar levels can lead to complications such as macrosomia (large birth weight), neonatal hypoglycemia (low blood sugar levels in newborns), and pre-eclampsia (High Blood Pressure with Proteinuria). She was treated by Dr Kovil, who is a diabetologist, head and co founder, Zandra Healthcare and Rang De Neela Initiative. Kainaz's journey exemplifies the intersection of technology and determination in managing T1DM during pregnancy. While acknowledging the effectiveness of conventional insulin treatment, she embraced technology to optimize her diabetes management. She chose to utilise a high-end insulin pump (sensor augmented insulin ). But what exactly does an sensor augmented insulin pump entail? An insulin pump is a small, computerised device that mimics the function of a healthy pancreas by continuously delivering insulin through a catheter placed under the skin. This technology offers precise insulin dosing, flexibility in timing and dosing adjustments, and the ability to tailor insulin delivery to individual needs. Sensor augmented insulin pump automatically adjusts insulin delivery to your needs for an easier way to stabilise glucose levels. It features an advance level of automation for diabetes management, known as SmartGuard technology. If glucose levels are trending high, it gives more insulin. If they are trending low, it gives less or no insulin at all. Now it can even correct high glucose levels in cases where carb counts aren’t exact. For Kainaz, the insulin pump, coupled with continuous glucose monitoring (CGM) through a sensor, revolutionised her management approach. CGM provides real-time glucose readings, enabling proactive adjustments to insulin delivery based on trends and patterns, thus optimizing blood sugar control. The relationship between T1DM and pregnancy is complex and noteworthy. While T1DM is a lifelong condition, pregnancy introduces additional challenges in managing blood sugar levels effectively. Women with T1DM may face increased difficulty in regulating glucose levels due to hormonal changes and increased insulin resistance during pregnancy. Managing blood sugar levels becomes doubly challenging in such cases, underscoring the importance of advanced technology like insulin pumps. Kainaz's dedication to exercise, controlled dietary habits, and leveraging technology enabled her to achieve remarkable outcomes. Maintaining blood sugar levels within the recommended range (time in range) during pregnancy is notoriously difficult, yet Kainaz consistently surpassed expectations, achieving a time in range of over 80-85 per cent. CGMS, or Continuous Glucose Monitoring System, is a medical device that tracks glucose levels in real-time throughout the day and night. TIR, or Time in Range, is a critical metric in CGMS data analysis, indicating the percentage of time spent within a predetermined target range of blood glucose levels set by healthcare providers. This metric offers valuable insights into the effectiveness of diabetes management by revealing how well blood sugar levels are being maintained over time. The information provided about insulin pumps, CGM, and TIR is clear and concise, offering readers a comprehensive understanding of these essential tools in diabetes management. Ultimately, Kainaz's story underscores the pivotal role of technology, coupled with personal determination, in achieving successful pregnancy outcomes for women with T1DM. By embracing innovations like insulin pumps and CGM, individuals can navigate the complexities of pregnancy with greater confidence, ensuring the health and well-being of both mother and child.
13 May,2024 11:55 PM IST | Mumbai | mid-day online correspondentIn a remarkable medical feat, a team of specialists led by Dr Mazda Turel, neurosurgeon at Wockhardt Hospital and ENT Specialist Dr Nipah, achieved a ground-breaking success in treating a highly unusual case of sinonasal malignancy. This extraordinary case, which involved a 30-year-old male patient Mr Sachin Kesharwani, showcased the power of collaboration and innovation in modern medicine. The patient initially presented with persistent headaches, nosebleeds, and bulging eyes—a distressing combination of symptoms that signalled a severe underlying condition. An MRI revealed a tumour nestled within the nasal cavity, eroding the base of the skull and infiltrating the brain, leading to the displacement of orbital structures and causing the patient's eyes to protrude. Dr. Turel and his multidisciplinary team, including ENT specialist Dr. Neepa Vellimuttam, consultant ENT & Endoscopic Skullbase surgeon, embarked on a comprehensive treatment strategy. The procedure was complex and extensive, requiring meticulous planning and execution. Dr. Nipah skillfully excised the tumor from the nasal cavity, while Dr. Turel performed a delicate cranial surgery to remove the tumor extension into the brain. Further mentioning the details of the surgery, Dr Turel said, “One of the most critical aspects of the surgery was the meticulous repair of the skull base. We utilised a combination of autologous tissue from the patient's thigh, along with synthetic materials, to seal the defect and prevent cerebrospinal fluid leakage—a potential complication that could lead to severe infections.” However, on the success of this critical surgery, an elated Turel mentioned, “Following the successful surgery, the patient experienced a remarkable recovery. His debilitating headaches subsided, his vision improved, and the position of his eyes returned to normal, marking a significant milestone in his journey to recovery.” However, the joy of this success was tempered by the biopsy results, which revealed the tumor to be a highly malignant sinonasal carcinoma. Despite this setback, the patient's resilience and the unwavering commitment of the medical team remained steadfast. The subsequent course of treatment involved a rigorous regimen of chemotherapy and radiation therapy, aimed at targeting any remaining cancer cells and preventing recurrence. The patient endured numerous sessions of therapy, demonstrating immense courage and determination throughout his ordeal. Dr. Turel emphasized the rarity and complexity of this case, underscoring the unique challenges posed by the intricate connection between the nasal cavity and the brain. Despite the inherent risks, the successful outcome serves as a testament to the expertise and innovation within the medical community. This extraordinary case exemplifies the transformative potential of modern healthcare, where collaboration, cutting-edge technology, and unwavering determination converge to defy the odds and restore hope to those facing life-threatening illnesses.
13 May,2024 06:24 PM IST | Mumbai | mid-day online correspondentAn 18-year-old girl from Haryana gave a new lease of life to four critically-ill patients after her tragic death. In a deeply moving generosity, Joginder Pal Singh and Pinky Rani, the parents of the 18-year-old girl, chose to donate their daughter's organs. The girl was declared brain-dead at Alchemist Hospital, Panchkula, on Saturday. On April 29, she met with an accident. The donated organs were harvested, and the liver was sent to Max Hospital at Saket in Delhi. The pancreas and one kidney were sent to PGIMER, Chandigarh, and one kidney was donated to a critical kidney failure patient at Alchemist Hospital, Panchkula, near here. For timely transportation of organs, green corridors were created on Sunday between Alchemist Hospital, Panchkula, to Max Hospital Saket, Delhi, and PGIMER as well. Neeraj Goyal, associate director (kidney transplant), Alchemist Hospital, said the significance of organ transplantation in restoring health and vitality to patients. While emphasising the importance of awareness regarding organ donation, Medical Superintendent Paramjit Maan said many precious lives could be saved through transplantation. Director General of Health Services (DGHS) Randeep Singh Punia commended the family for their noble gesture while emphasising the life-saving importance of organ donation. With the coordination of Deputy Commissioner of Police Himadri Kaushik and Haryana Police, the organs reached their destinations on time, ensuring that the life-saving transplant surgery could proceed without delay. This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
13 May,2024 05:55 PM IST | Chandigarh | IANSDoctors in Delhi have given a new lease of life to a 50-year-old woman with a rare appendix cancer. The woman was presented at MASSH Super Specialty Hospital, with symptoms of right lower abdominal pain and nausea that persisted for 15 days. Upon evaluation, the doctors found a 14.3 x 13.8 x 8.5 cm tubular, thick-walled cystic mass that extended from the base of the caecum (a pouch connected to the junction of the small and large intestines) to the right adnexa in the pelvis, indicative of Mucocele of the appendix. "Mucocele of the appendix is a rare clinical entity, and its treatment requires meticulous care and precision, with no spillage technique. Mucocele of the appendix poses diagnostic and therapeutic challenges due to its rarity,” said Dr. Sachin Ambekar, Director of Minimal Access Surgery, Surgical Oncology & Medical Director at MASSH, on Monday. It is so uncommon and occurs in only 0.07-0.63 per cent of all appendectomy cases. The team resorted to 3D laparoscopy to ensure precise visualisation and meticulous dissection. During the procedure, adhesions were visualised in 360-degree depth perception not seen in conventional laparoscopy, and meticulous dissection was carried out without any mucinous spill. A cystic mass of the appendix (14.3 x 13.8 x 8.5 cm), with inflamed walls but without perforation was located in the right iliac fossa. Notably, no lesions were found in the peritoneal cavity. "3D Laparoscopy played a crucial role in this operation by enabling us to visualise and dissect with never before seen 360-degree in-depth precision. This technology offers significant advantages over conventional laparoscopy, particularly in delicate procedures such as this," Dr. Ambekar said. Remarkably, the patient experienced no complications during the postoperative period and was discharged from the hospital on the second day, the doctor said. This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever.
13 May,2024 05:42 PM IST | New Delhi | IANSThe scorching heat in Mumbai is not only causing dehydration, gastric problems, and muscle spasms in people but also skin-related diseases. A majority of people have started experiencing skin problems such as sweating boils, rashes, itching and burning of the skin, hyperpigmentation, acne, and pimples. It is the need of the hour to consult a dermatologist and take utmost care of your skin. The scorching heat. Dermatologists share more details. Common skin diseases during summerDr Shareefa Chause, dermatologist and cosmetologist, Shareefa's Skin Care Clinic said, “During the pandemic, the citizens were home-bound due to lockdown and there was no surge in skin-related diseases. However, after the pandemic, people have resumed their daily routine like going to the office, social gatherings and parties, and vacations. This has led to a significant spike in contagious diseases in the skin. There is a 40 per cent rise in skin diseases from April due to soaring temperatures.” Also Read: Yeast infection, UTI and Jock itch: Common infections of intimate areas and prevention tips According to Chause, people from all age groups are complaining of sweat boils, fungal diseases, psoriasis and eczema flare-ups, rashes, acne, itching and burning of the skin, hyperpigmentation, pimples, ringworm (tinea corporis), athlete's foot. These skin conditions often have symptoms such as redness, itchiness and cracked skin between the toes, toenail fungus, yeast infections, skin dryness due to dehydration, and genital rashes. “The body tends to sweat profusely when there is increased heat and humidity outside. As the sweat gets trapped in the body, one is susceptible to various skin diseases. The sun is so harsh during summer that it can cause red patches and rashes that burn. Even tanning is another problem that is commonly seen in a large number of people. Apart from ringworm, athlete's foot, rashes, acne, pimples, and boil, bacterial infections can also steal one's peace of mind. Bacterial skin infections such as cellulitis, impetigo, and folliculitis are seen due to Staphylococcus and Streptococcus bacteria. Children and adults are the vulnerable populations affected by skin infections,” adds Dr Surbhi Deshpande, dermatologist, Zynova Shalby Hospital. Also Read: Beauty treatments in summer: Experts weigh its pros and cons, share tips to get started Tips to keep skin infections at bayChause says, ‘‘Shower twice a day. If bathing is not possible then wipe the body with a damp cloth. Change the sweaty clothes and dry your body immediately after a swimming or workout session. Maintain good personal hygiene, and use dusting powder for rashes or other products such as moisturisers, lotions, and creams only after consulting the doctor. Antifungal creams, ointments, gels, sprays, or powders can be used for ringworm and athlete's foot.”Wear sunscreen of at least SPF 30 for hyperpigmentation, remove makeup before sleeping, and wear full-sleeved cotton clothes to prevent tanning and sunburns. To minimise the impact of tanning, one can take help of the procedures like laser skin rejuvenation, chemical peels, with a skilled and certified dermatologist. To tackle acne and pimples, opt for creams and face washes recommended by the experts. Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.
13 May,2024 03:35 PM IST | Mumbai | mid-day online correspondentIncreasing tobacco smoking rates among women is a significant contributor to early menopause, which poses a significant health risk, warned doctors on Monday. Premature menopause is the cessation of menstruation before the age of 40 and can have profound implications for a woman's health and quality of life. Jaishree Gajaraj, Senior Consultant, Obstetrics and Gynaecology, MGM Healthcare, told IANS that smoking accelerates premature menopause, which further raises the risk of developing osteoporosis, cardiovascular diseases, cancer, and psychological issues like depression and anxiety in women. Nicotine, a primary component of tobacco, exerts detrimental effects on ovarian function by reducing the number of viable eggs and hastening the decline of ovarian reserve. This premature depletion of follicles leads to an earlier onset of menopause. It not only impacts fertility but also contributes to the overall decline in ovarian function. "Oestrogen has cardio-protective effects, and its abrupt reduction can lead to adverse changes in cholesterol levels, blood pressure, and vascular function," Dr Jaishree said. Research shows that women who smoke go into menopause about a year earlier than non-smokers and as much as two years earlier for heavy smokers. "It has been observed that smokers who are currently smoking will experience a younger menopause than smokers who have never smoked," Vidyashri Kamath C, Consultant Obstetrics & Gynecologist, KMC Hospital, Mangalore, remarked. The doctor noted that "smoking by-products decrease the quantity or quality of the ovarian follicles; it also causes changes in reproductive hormone levels during reproductive years; and smoke exposure during the intrauterine period may also affect the follicle pool and influence menopausal timing." "Smokers are 35 per cent more likely to break a hip after menopause than non-smokers. Former smokers have a 15 per cent greater risk of hip fracture. How long you smoked will affect your risk of fracture more than how much you smoked," said Sophia Rodrigues, Consultant - OBG, Manipal Hospital, Goa. A recent study showed that women who enter menopause before the age of 40 are more likely to die young. Premature menopause is a critical issue and underscores the urgent need for comprehensive education and awareness, the experts said. Also Read: Must combat dual burden of smoking & smokeless tobacco This story has been sourced from a third party syndicated feed, agencies. Mid-day accepts no responsibility or liability for its dependability, trustworthiness, reliability and data of the text. Mid-day management/mid-day.com reserves the sole right to alter, delete or remove (without notice) the content in its absolute discretion for any reason whatsoever
13 May,2024 02:00 PM IST | Mumbai | IANS“Madhi, Badmash bachcha! Come and say hi,” hollers the Parel-based mother and autism activist – Mugdha Kalra at her son. After minor resistance, her son arrives and waves at this writer through the computer screen on a video call. While he avoided making eye contact, his greeting was heartfelt and topped with warmth. Madhav (14), son of Mugdha was diagnosed as being on the autism spectrum when he was 4. While Mugdha has spoken extensively about bringing up a neuro-diverse child, she is now onto raising awareness about the importance of building a community of parents who can support each other. To help autistic children, she has co-founded Not That Different – a child-led movement that focuses on inclusion and understanding neurodiversity. The project is the outcome of a collaboration between Mugdha and Nidhi Mishra, founder of Bookosmia. It comprises a comic strip, in which Bookosmia’s 12-year-old persona Sara introduces her readers to her new friend, Madhav, a child on the autism spectrum. Through Sara’s journey of meeting and accepting someone a little different, one can understand what being neuro-diverse entails. “Autism is a developmental difference that influences a person’s worldview and their social engagements. However, what one fails to realise is how society’s understanding and acceptance can positively impact the lives of autistic children and their families,” Mugdha shares with Midday. Also Read: Health cover denial sparks mother's advocacy for autistic son Systemic issues that affect the growth of autistic children“The government does not prioritise the creation of specialised policies for individuals with invisible disabilities, indicating a lack of recognition for their needs and challenges," opines Mugdha. Over a period of time, she has set 4 goals that she is primarily tackling to help the development of neurodivergent children: Curriculum crisis: In India, there is currently an absence of a tailored curriculum specifically designed for functional academics catering to children with special needs. This gap continues as there are no educational reforms to enforce the diverse learning requirements of these children. Lack of awareness on therapy: Is there a system by which the government is giving any kind of license to practice to the number of people who have now mushroomed in the name of therapy – questions Mugdha, highlighting the grave issue of self-anointed therapists that are emerging. How does one get to know which therapy center or which professional is qualified to be doing what they are doing? No health cover: Autism and Down's Syndrome fall under the category of intellectual disabilities as per the Rights of Persons with Disabilities Act, 2016. This Act obligates the central and state governments to design schemes ensuring inclusive insurance coverage for persons with disabilities – however, insurance companies breach these regulations by refusing coverage or denying claims of individuals living with neurodivergence. Disability certification: It requires 14 sittings spanning over 3 months to obtain the Unique Disability ID (UDID) Card. Usually, these sessions get extended leaving parent and their special-needs children harassed by the inefficient ways they are carried (elaborated later in this article). Data deficit for policy formationRegrettably, Mugdha sees little hope for progress, particularly because this disability is invisible, making it less likely to receive attention. Despite the recent efforts of the National Health Scheme to conduct a survey, it appears that individuals with invisible disabilities may not be adequately accounted for in the data collection process. “Any matters concerning invisible disabilities or disabilities in general remain overlooked. Without a specialised census focused on data collection for individuals on the spectrum or those with invisible disabilities, they'll never be important enough for the government. So why do you see today blind association or the blinds in the country have the most solid presence?” asks the autism activist Mugdha. Indeed, the visibility of blindness makes it impossible to conceal, and since individuals who are blind typically do not have cognitive impairments and are functional, they tend to receive the most support. Similarly, those who use wheelchairs often receive significant assistance. However, individuals with invisible disabilities face stigma and taboo, which complicates their access to support and understanding. The issue primarily lies in the lack of acceptance, remarks Mugdha. “Parents often hesitate to openly acknowledge that their child has an invisible disability. Consequently, accurate statistics on the prevalence of these disabilities are lacking. Without this data, the government may perceive this demographic as a small and insignificant group.” When disabilities are approached collectively, progress tends to be limited. However, when specific conditions like autism are individually addressed, significant strides can be made. It's essential to recognise the prevalence of various special needs children across the country and have accurate data to inform decisions regarding school placements and government support. Without precise numbers, appropriate interventions become challenging to implement. This highlights a significant gap in addressing discrimination, particularly between visible and invisible disabilities.Also Read: Catch autism early: Key steps for early intervention Obtaining UDID remains a complex taskDespite the government setting in place certain policies to address the needs of autistic children, it takes a lot of time and harassment to get the benefit of those policies, shares Mugdha. For example, obtaining her son's disability certification required 14 sessions spanning over three and a half months. While some may consider this relatively quick, it's worth noting that it typically involves a longer process. “Now, just imagine taking your specially-abled child to a government hospital, which may not have public bathrooms, which, in the same room is also, evaluating your son along with inmates of your local jail. You are made to wait in lines for two to three hours for 14 different sessions and you are not even based in Bombay,” Mugdha sheds light on the plight of parents and children who have to come from far off to obtain a UDID card. Also Read: How bureaucracy is failing the applicants of Unique Disability ID While the disability certificate indeed provides benefits such as access to writers or readers during examinations, additional time and permission to use a calculator, obtaining it is far from straightforward in our country. Mugdha and Madhav’s journeyWhen Madhav was diagnosed with autism, Mugdha was completely unaware of the developmental condition. It took her about three to four years to grasp the concept of autism and truly understand the needs of her differently-abled son. “Our journey began in Bangalore, which proved to be excellent in terms of therapy options. Following this, we relocated to Bombay, where his academic intervention began.” While Madhav began to make progress in academics, it was albeit slow. Regarding schools, Mugdha has exclusively turned to special needs schools to support her child, as mainstream schools, even those claiming to be inclusive or integrated, often lack the resources to adequately meet the needs of autistic children. Instead, the family embarked on a journey focused on special needs education and enrolled him in specialised schools. Now, at the age of 14, Madhav continues to attend a special needs school and is passionate about fitness and is progressing at his own pace, focusing on functional academics. Mugdha’s career as a broadcast journalist has been instrumental in her efforts to create acceptance around neurodivergent children. Apart from raising awareness, Mugdha actively engages with parents of children with intellectual disabilities, equipping them with valuable tools to support their special needs. On raising a child with a developmental difference, Mugdha opines that the initial difficulties are always there till you do not fully accept the fact that you have a differently abled child who perhaps is not neurotypical. Once that acceptance takes shape, you are ready to embrace the new life as new avenues open up. “I've been very open with my friends and my family and my neighbours and my collegiate society about the fact that my son is autistic and that he has different needs and that he is going to occupy his deserving space in the world,” says Mugdha who is indifferent to the opinions hurled at her. She concludes by saying: In India, everyone will have an opinion on your parenting style. Everyone will have an opinion on why in the first place you have a special needs child. So the only way to deal with it is to accept that your child is autistic and raise them by prioritising their needs and at all times being prepared to give back answers when tough questions are put to you and fighting for your child's rights! Also Read: Our expert answers some common questions about Autism
13 May,2024 11:06 AM IST | Mumbai | Ainie Rizvi
Geetha VM’s son Om, was 10 when he was diagnosed with pneumonia in February 2020. To avail medical treatment, the Bengaluru boy was hospitalised and his family was promised insurance coverage by Care Health (formerly Religare) Insurance company. However, later they were denied health cover on account of Om’s autistic condition, which the parents were not aware and hence did not reveal at the time of purchasing the policy. Shortly after Om was admitted, a representative from the insurance company arrived at the hospital, demanding Geetha sign a declaration that Om has Autism Spectrum Disorder (ASD) and specify the age at which he was diagnosed. In an interaction with Midday, Geetha tells us: “When we bought the insurance policy, Om had developmental delay, and autism wasn't diagnosed by the government doctors. The health experts claimed that he only had developmental delays with academic and learning difficulties. Moreover, when you buy insurance, the agents usually check for underlying conditions like thyroid, cancer, and those kinds of pre-existing illnesses.” She continues, “In our case, they never highlighted or checked with us whether Om had intellectual disabilities or any such condition within the family. So, we took it for granted and didn't read all the rules.” What followed was an email from the insurance company stating that Om's policy 'was subject to cancellation due to non-disclosure of material facts regarding pre-existing ailments.’ Upon learning this, Geetha and her husband were taken aback. They didn’t expect that the medical cover for pneumonia would be declined owing to his underlying developmental delay/autistic condition which was not revealed. After several emails pointing out that Om’s ASD had no bearing on his physical illness, the family was met with disappointment. They had to pay all the treatment bills with the help of Om's husband's company corporate insurance. While Geetha believes it’s her fault for not disclosing that Om is under ASD, the question remains – why are insurance companies denying health coverage for people with intellectual and developmental disabilities? Also Read: A guide to navigating social relationships for individuals with bipolar disorder What does the law state? Autism and Down's Syndrome fall under the category of intellectual disabilities as per the Rights of Persons with Disabilities Act, 2016. This Act obligates the central and state governments to design schemes ensuring inclusive insurance coverage for persons with disabilities. The Niramaya Health Insurance Scheme, under the National Trust Act, 1999, stands as the only government program offering comprehensive health cover for individuals with intellectual disabilities. This scheme grants an annual reimbursement-only insurance cover of up to Rs 1 lakh, which includes hospitalisation, outpatient department fees, ongoing therapies and transportation costs for those with valid disability certificates. However, as per Geetha, insurance companies breach these regulations by refusing coverage or denying claims of individuals living with these conditions. “I did my research and spoke to senior parents of autistic children. They told me that companies don’t provide cover when you mention autism. You have to be secretive and discreet to avail health insurance for children diagnosed with autism,” shares Geetha. Her anger is in place. When the Insurance Regulatory and Development Authority of India (IRDAI) has clearly stated that intellectual disabilities, including autism, down’s syndrome and other intellectual disabilities or neurodivergence should be mandatorily covered, why are insurance companies denying the claim? “There may not be enough data or clinical experience of long-term risks to design the product appropriately,” wrote a senior manager of Care Health Insurance to Geetha. The manager insisted that despite IRDAI mandating health cover, we don’t have to give you a policy necessarily. He added, “If we provide a policy but then prevent you from making claims, you could file a lawsuit against us. However, we haven't issued a policy to you, and we're unable to do so.” Though Geetha had, later, provided them with his disability certificate which indicated he has a mild to moderate Autism Spectrum Disorder. Geetha tried her level best to convince the manager. She also suggested that a panel of doctors can speak to the underwriting team stating that autism is not an illness or a disease, but it's more like a a lifelong neurological condition and doesn’t impact the physical condition of a person. To her apathy, the insurance company denied all her requests. Also Read: Bipolar disorder advocates demand action for improved mental health care If Covid-19 can be covered, why not autism? Currently, Geetha is on a mission to expose the inefficiencies of the system. “I've been reaching out to numerous insurance companies, and I've even asked many parents to do the same for research purposes, almost like cold calling. Initially, these companies promise attractive premiums, covering amounts like 1 crore or 50 lakh for the entire family. They send us detailed emails with all the information. However, as soon as we disclose that only our son has Autism Spectrum Disorder, things take a different turn.” “The representatives handling our inquiries often lack sufficient knowledge. They quickly classify it as an "Intellectual Disability" and state that it cannot be covered. When we press them for more information, they struggle to provide satisfactory answers due to their limited understanding. Even when we escalate the issue to their managers, we're met with a similar response. They claim that their underwriters are still researching and trying to figure things out.” When the unheard viral illness, Covid-19 made an outbreak, insurance companies saw it as a lucrative opportunity to devise timely products. Despite the ambiguity and rapidly evolving situation, insurance agents promptly decided to include Covid-19 coverage overnight without knowing if Covid-related expenses would amount to 1 lakh, 2 lakh, or even 6 lakh. Geetha’s frustration stems from this swift action to cover Covid-19, an unfamiliar and terrifying phenomenon. While today Covid-19 is well understood and accepted as a part of our lives, back then, it was an unprecedented threat affecting the entire globe. Nevertheless, insurance companies readily embraced the need to cover it, recognising its importance for the well-being of the entire population. No space for disability Here is a minority group, persistently seeking answers for years, yet receiving no response. Is it because of prejudice towards individuals with disabilities or an indifferent mindset? Disabled children don't have the power to vote—does their absence from the voting demographic render their needs insignificant? However, Geetha hesitates to solely blame politicians, as the government, through the IRDAI, has unequivocally directed insurance companies to provide coverage. Although there are a few insurance companies, like Star Health Insurance, that offer coverage, the amount they provide is paltry—just Rs 3 lakh. This amount proves insufficient, especially when considering medical expenses for conditions like pneumonia, which necessitates hospitalisation for a mere 48 hours. Even for such a short duration, the medical bill can range from Rs 40,000 to Rs 60,000, considering inflated medical costs and other expenses. This inadequacy is glaringly evident and leaves much to be desired in terms of support for individuals with disabilities. Also Read: Lok Sabha elections 2024: Even in MVA, ticket for a Muslim a distant dream Furthermore, their coverage only extends up to 25 years of age. When Geetha inquired with her health insurance provider about extending coverage for her son, she learnt that they will not cover up beyond the age of 25. However, Care Health Insurance reached out to her with an alternative policy. “At that time, my son was only 12 years old, and I expressed concerns about what would happen if he encountered health issues before reaching 18, even common ailments. To this, they reiterated that coverage would only commence after he turns 18, and even then, it would be limited to Rs 5 lakh. Additionally, they required me to pay a significantly higher premium, almost double the standard rate, for this extended coverage,” Geetha tells Midday. Similarly, there are a few insurance companies—just a handful—that offer very low coverage. Some individuals are forced to pay high premiums for this limited coverage, which is completely unjust. Geetha opines that it's simply not right to exclude a significant portion of the population like this. Take the case of pneumonia, for instance. Anyone can fall ill with pneumonia; it's not something that discriminates based on age or any other factor. What frustrates Geetha even more is that there are insurance covers for things like pet animals, houses and cars, but why not for human beings? Why are insurance companies denying coverage to a significant portion of the population? This discrepancy is concerning and highlights the need for greater inclusivity in insurance coverage. What’s next for Om? People with Autism Spectrum Disorder are normal individuals and citizens of India, deserving of equal rights and access to essential services like health insurance. As a parent and advocate, Geetha is raising her voice to demand inclusivity and justice for our children. Geetha’s resilience knows no bounds. She has taken to social media to raise awareness on the institutional inefficiencies when it comes to health cover for children with special needs. “It has to go to the insurance companies, the IRDA, to the right people for it to click. And it's just been 2-3 days since I started this whole thing, maximum 48 hours.” For Geetha, the goal isn't about going viral and amassing 1000+ views. Even if it's just three views, the content must reach the right target audience, namely the decision-makers within insurance companies. It sheds light on the burning negligence when it comes to covering children with developmental conditions and serves as a stark reminder for the IRDAI to question insurance companies about their failure to adhere to the regulations. To conclude, Geetha adds, “I am appealing to insurance companies and the public alike: my son, along with countless others on the autism spectrum, deserves proper health insurance coverage. We are willing to pay premiums for fair coverage that reflects their needs and ensures their well-being.”
13 May,2024 10:59 AM IST | Mumbai | Ainie Rizvi
A prickly itch in your naughty bits, especially in public places, makes for an extremely uncomfortable and embarrassing situation. The constant urge to scratch your private parts is an indication of you not taking your intimate hygiene seriously and that you might just be suffering from skin infections in your private areas. Such infections in intimate areas are exacerbated during hot and humid summers. With the mercury hitting 40 degrees Celcius, ensuring optimal intimate hygiene is paramount. Although regular baths and the use of talcum powders might be a summer routine for most of us to keep infections at bay, taking care of private parts requires much more than just that. We contacted experts to get you a complete guide on how to keep those nasty red rashes and wet disgusting infections from coming at you. Dr Rohan Palshetkar, head of Unit Bloom IVF, professor, department of OBGY, DY Patil School of Medicine tells Mid-day.com that infections of the intimate areas are common in summer. “Sweating in the genital area can create a warm, moist environment that promotes the growth of bacteria and yeast, leading to infections. Further, dehydration can cause vaginal dryness, making it easier for bacteria to enter the vagina and cause infections,” says Palshetkar. Also Read: How social media addiction has given rise to popcorn brain in young adults Dr Shefali Trasi Nerurkar, consultant dermatologist, Dr Trasi clinic and La Piel skin clinic adds, “Lack of personal hygiene and improper clothing also make the patients more prone to these infections.” Further, Dr Trishna Gupte, clinical cosmetologist and trichologist, founder, The Cosmo-Square clinic, ISCA also highlights, “Excessive sun exposure on intimate skin can lead to sunburn, skin cancer, and premature ageing. The fragile skin in intimate locations of the body is frequently more sensitive to harm than other sections of the body. Hence ensuring proper hygiene is extremely crucial.” Which infections of intimate areas are common in summer? Palshetkar: Heat, sweat, and dehydration can make your intimate areas prone to several issues such as: Yeast infections: They are a common side effect of summer on the vagina. The hot and humid weather can create an ideal environment for yeast to thrive, leading to vaginal itching, burning, and discharge. It presents with a white curdy discharge from the vagina or penis and is treated with anti-fungal medications. Bacterial vaginosis: It is a condition caused by an imbalance of bacteria in the vagina. Symptoms of bacterial vaginosis include vaginal discharge, itching, and a foul odour. It presents with a foul-smelling, greenish discharge. It is commonly seen in women and treated with oral antibiotics. Urinary tract infections (UTIs): UTIs are more common in the summer due to dehydration and sweating, which can irritate the urinary tract and lead to an infection. Patients usually complain of a burning sensation while passing urine. The treatment provided is hydration and antibiotics. Taenia: Constant moisture due to sweat can give rise to wetness that causes superficial skin infections like taenia. Some also have extremely dry skin that can become dryer in summer due to dehydration or a lack of hormones, particularly for those in the peri-menopausal age group. Patients usually complain of dry itchy skin with patches. Intertrigo: It is a condition of the skin in the stomach fold, groin and under the breasts. It causes rash which is sore and itchy. It happens when areas of moist skin rub together. Bacteria and yeast can grow in this environment, leading to an infection. Intertrigo looks like a red, raw rash on the skin. It may feel sore or itchy, and it can sometimes ooze. It can develop in any fold of the skin. The most commonly affected areas of the body include the neck, under the breasts, the abdomen, the groin, the back, the upper leg, behind the knees, between the buttocks, in the webs of the fingers, and in the webs of the toes. Intertrigo may develop in one or more of these places Also Read: Vital organ damage to death: Mumbai doctors share tips to protect yourself from heatstroke in summer Gupte: Other infections common in men include: Jock itch: Symptoms include redness, itching, and a rash in the groin area. Treatment involves antifungal creams with a recovery time of one to two weeks. Balantis: Symptoms include redness, swelling, and pain on the head of the penis. Treatment involves antifungal or antibiotic creams with a recovery time of one to two weeks. Prostatitis: Symptoms include pain in the pelvic area and difficulty urinating. Treatment includes antibiotics with a recovery time of two to six weeks. What kind of risk does exposure to direct sun hold for intimate areas? Gupte: Excessive sun exposure on intimate skin can lead to sunburn, skin cancer, and premature ageing. The fragile skin in these locations is frequently more sensitive to harsh sunlight than other parts of the body. Seek shelter during peak solar hours – which are usually between 10 am and 4. Wear protective gear, such as lightweight and breathable fabrics that cover the skin. How should women maintain intimate hygiene in summer? Nerurkar: Women can do the following to ensure proper hygiene in intimate areas: 1. Take cold or lukewarm water baths regularly. 2. Use intimate cleansers for washing intimate areas. These cleansers are pH skin-friendly and anti-septic. 3. Always use anti-fungal or cooling dusting powders to help absorb the skin's sweat and keep that area dry. 4. Change underwear regularly, especially if you sweat excessively. 5. Drink lots of water and consume cooler foods to keep the body’s temperature cool. 6. Don’t share clothes and towels with other family members. 7. Since swimming is a preferred hobby in summer, ensure you take a shower after you take a swim. Gupte: Additionally, practise excellent wiping practices by wiping from front to back after using the restroom to prevent the spread of bacteria. Avoid douching or using harsh soaps and scents in the vaginal area as these can alter the natural pH balance and cause infections. How should men maintain intimate hygiene in summer?Nerurkar: Men too should follow more or less the same tips but some additional hygiene care involves: 1. Use loose boxers or shorts at home to allow easy breathing of groin skin. 2. Shave the hair from intimate areas for better hygiene. What kind of undergarments must men and women wear during the hot season? Palshetkar: Unless you are looking to dazzle, stick to breathable fabrics as they’re less likely to irritate and cause yeast and bacterial infection. Cotton prevents sweating to a great extent and thus is the right fabric to opt for. Gupte: Tight underwear should be avoided since it might increase heat and moisture in the groin area. Instead, boxer briefs made of moisture-wicking fabric are advised. Lightweight materials such as cotton are recommended because they allow for improved airflow and sweat absorption, keeping the body cool and dry Finally, choosing undergarments that prioritise breathability, moisture management and comfort will help men keep cool and comfortable during the summer. Also Read: Greasy and itchy skin in summer? Here is an easy guide for healthy skin during the hot season Which skincare products must be used to prevent infections in the intimate areas? Gupte: Women can use intimate washes with gentle ingredients like aloe vera to maintain pH balance. Men can opt for talc-free powders to keep the groin area dry and prevent chafing. Palshetkar: In case of itching and rash please visit a dermatologist, gynaecologist, or urologist. Suggest some easy home remedies for such infections Gupte: For summer-related skin issues, aloe vera gel can soothe irritated skin, and wearing breathable fabrics can help maintain dryness in intimate areas. Nerurkar: Drink lots of water and eat fresh fruits and salads to keep the body and skin cool. What common mistakes should be avoided in case of an infection in a private part? Nerurkar: Avoid wearing synthetic clothes and innerwear. It leads to a moist environment in the intimate area. Do not wear tight clothing. Strictly keep the groin region dry. Wipe the intimate areas with cloth or tissues and keep the area dry. Gupte: One common error is failing to use sunscreen, which results in sunburn and skin damage. Another mistake is over-washing your face, which can remove natural oils and alter the skin's moisture balance. Also, both genders should avoid using heavy, oil-based moisturisers in the summer, since they can clog pores and worsen sweat-related outbreaks. Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.
13 May,2024 10:35 AM IST | Mumbai | Aakanksha AhireADVERTISEMENT
