health experts hint at a growing concern regarding liver disease among youngsters between the age group of 23-35 years old. Various conditions such as alcohol-related liver disease, fatty liver, hepatitis and cirrhosis are causing liver damage. This has led to higher mortality and morbidity rates in the youth. Timely screening and management of these fatal liver conditions are key to improving the outcome and saving the lives of youngsters battling liver disease. The liver is a vital organ that is responsible for various functions in the body. This includes functions like detoxification, nutrient processing, regulating hormones, repairing damaged tissues, functions of the immune system, and storing essential nutrients and chemicals. Currently, there’s been a significant rise in experiencing liver-related problems. Various factors that cause harm to your liver are alcohol consumption, smoking cigarettes, not drinking enough water, excessive sodium intake, viral infection and taking certain medications for prolonged periods. Health conditions like type 2 diabetes, obesity and high cholesterol levels can potentially increase the chances of developing liver-related problems. Dr Uday Sanglodkar, senior consultant hepatologist and clinical lead liver and transplant ICU at Gleneagles Hospitals Parel, said “Liver-related severe conditions like acute viral hepatitis, cirrhosis, Alcoholic hepatitis, fatty liver, and NASH (non-alcoholic fatty liver) related chronic liver diseases are significantly rising in the youngsters aged 23-35. The ratio of men and women (almost twice as high among men compared to women is 2:1).” This number has surged in the last few years because of unhealthy lifestyle practices and excess use of alcohol considered a routine social norm). The common complaints of these youngsters are jaundice which is yellowing of the skin and eyes, weight loss, nausea and vomiting, weakness, swelling over feet, enlarged spleen and fluid build-up in the stomach (ascites). In Sanglodkar’s routine practice, the numbers have gone up as compared to the last 5 years. He is seeing 1 in 5 patients to be suffering from liver disease not compared to last year but yes as compared to last 5 years. Cirrhosis is a serious condition that can potentially damage your liver and cause permanent scarring of the tissues. These scar tissues actively hijack healthy tissues present in the liver. Over time, normal liver starts accumulating fat in excess which over time results in swelling and scarring of normal liver tissue. NASH, non-alcoholic fatty liver is an excessive buildup of fat around the liver in those who drink occasionally or not at all. (it is an early stage of liver cirrhosis). Hepatitis occurs when there is a serious inflammation of the liver which can be caused by multiple factors such as viruses (hepatitis A, B, C and E) toxins, chemicals, drug abuse, drinking alcohol, genetic disorders and certain autoimmune diseases. There are various types of hepatitis such as hepatitis A (spreads through contaminated water or food), hepatitis B (spreads through being in contact with an infected person through blood contact or unsafe sex) hepatitis C (spreads through blood-to-blood contact), hepatitis D (occurs only to people who are diagnosed with hepatitis B), hepatitis E (spreads through contaminated water). It is seen those affected with hepatitis infection have not received the hepatitis vaccine. 60 percent of patients presenting for treatment with hepatitis infection have not received the hepatitis vaccine This infection can be easily prevented by getting vaccinated with a hepatitis vaccine. “Presently, we have vaccines against Hepatitis A and B which should be taken in all high-risk individuals above 18 years of age. Taking medication, eating a nutritious diet, avoiding processed goods, exercising, and quitting alcohol can keep the liver healthy. However, extreme liver damage due to cirrhosis may require liver transplantation” highlighted Dr Sanglodkar. Dr Prakash Kurane-Genenal & HPB surgeon, Apollo Spectra Mumbai adds, "The rise of liver disease among youngsters in the age group 20-36 is owing to alcohol consumption, inviting conditions like fatty liver disease and alcoholic hepatitis. Poor dietary choices high in processed foods and sugar can also cause liver damage at a younger age. Sharing of needles for drug abuse too is a drastic cause of the increasing incidence of liver disease.” Another important cause of hepatitis is the intake of medications toxic to the liver especially spurious medicines under the barb of ayurvedic medicines. In general, men have a higher incidence of hepatitis than females. However, the severity of hepatitis E-related complications is higher in pregnant females, outlines Kurane. Common symptoms of presentation of hepatitis are fever, malaise, fatigue, loss of appetite, vomiting, diarrhoea and abdominal pain. Treatment for liver disease involves adopting a healthier diet, quitting alcohol and regular physical activity. Medications may be prescribed to manage symptoms such as jaundice and abdominal pain and prevent further damage to the liver. In order to prevent hepatitis, it is essential to create awareness about the risks of liver disease in youngsters and encourage early intervention to prevent long-term complications that may necessitate liver transplants. Moreover, taking hepatitis A and B vaccines is equally important to prevent this fatal infection. By taking proactive steps, youngsters can keep liver diseases at bay.’ Also read: Your kneecap shape can signal osteoarthritis risk: Study
26 July,2024 05:07 PM IST | Mumbai | mid-day online correspondentA team of doctors in Kerala performed a five-hour heart transplant operation, giving a new lease of life to a 13-year-old girl suffering from severe cardiomyopathy -- a disease of the heart muscle. The procedure was carried out at the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), an autonomous institute under the Department of Science and Technology (DST). Paediatric heart transplants are rare due to the limited availability of donor hearts and high costs, making such treatment inaccessible to many. The young patient had been on a ventilator for two months, confined to the ICU. The breakthrough came when the Kerala State Organ and Tissue Transplant Organisation (K-SOTTO) allocated a donor heart to SCTIMST. The organ came from a 47-year-old school teacher declared brain dead following a ruptured intracranial aneurysm at KIMSHEALTH hospital. The Kerala Police facilitated a green corridor to ensure the swift transport of the organ. A multidisciplinary team led by Baiju S Dharan, from the Department of Cardiovascular and Thoracic Surgery performed the complex operation. The successful operation underscores the importance of collaboration and advanced medical capabilities, offering hope to patients with severe heart conditions. 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.
26 July,2024 12:15 PM IST | New Delhi | IANSBengaluru doctors successfully treated a 32-year-old woman with a rare autoimmune disease amid her pregnancy. Autoimmune disorders like Factor 13 acquired deficiency can complicate pregnancies, as antibodies generated by the mother may affect foetal development, particularly the heart. Factor 13 deficiency is exceedingly rare, occurring in approximately 1 in 2-3 million individuals, and requires specialised care. The patient, Shradha (name changed), faced multiple fertility challenges due to the autoimmune disorders, including ANA (antinuclear antibody), APL (antiphospholipid antibody), and NK cell deficiency. Despite undergoing multiple treatments like IUI and IVF, she experienced three consecutive miscarriages. It was during her second miscarriage, that Shradha was diagnosed with the rare condition, which necessitated the use of blood thinners throughout pregnancy. Shradha's pregnancy journey was fraught with complications, including frequent bleeding episodes. She conceived naturally on her fourth attempt but continued to face challenges, including spontaneous bleeding. "The rare condition of inhibitors to Factor 13 leads to deficiency. This is not inherited but can develop due to pre-existing autoimmune conditions. Managing pregnancy with Factor 13 deficiency is exceptionally rare, especially when complicated by acquired inhibitors," said Dr. Poornima M Gowda, Consultant Obstetrician and Gynecologist at Cloudnine Hospital, Benagaluru. The treatment involved regular blood transfusions to maintain stable Factor 13 levels. Despite the challenges, Shradha delivered a baby girl prematurely at 34 weeks. The baby, now over six months old, is doing well, said Dr. Poornima. The chances of the baby developing the same problem are minimal, as the condition is not genetic but will be monitored, she added. 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.
26 July,2024 11:46 AM IST | New Delhi | IANS
The ongoing Chandipura virus outbreak in Gujarat, which has also reached neighbouring states, poses a critical health risk for children below the age of 15 years. As of July 24, 23 cases of Chandipura virus were confirmed out of the total 121 cases reported based on suspected symptoms of the virus, Dr. Nilam Patel, Additional Director (Public Health) of Gujarat Health Department told ANI. Six of these cases are from other states – three from Rajasthan, two from Madhya Pradesh and one from Maharashtra. Total 40 suspected deaths have occurred due to the virus, of which 10 are confirmed cases of Chandipura. With the surge in Acute Encephalitis Syndrome (AES) cases caused due to Chandipura virus in Gujarat, the Maharashtra Health Department also issued an advisory cautioning officials and citizens to keep a check on symptoms and potential cases. According to the paper ‘Chandipura virus: an emerging human pathogen?’ published in The Lancet in 2004, Chandipura virus was first detected in 1965 in Nagpur, Maharashtra. It is reportedly named after the village where it was first detected. Since then, the virus has been reported in Maharashtra, Madhya Pradesh, Andhra Pradesh and now Gujarat. Amid this rising health concern, we speak to Mumbai-based health experts to understand the symptoms, causes, effects and possible preventative measures of the virus. What is the Chandipura virus? Chandipura is a vector-borne virus that mainly causes encephalitis. “Chandipura virus is a member of the family Rhabdoviridae, which also contains rabies. First isolated in Maharashtra in 1965 specifically from Chandipura area, this virus mainly causes encephalitis and is infamous for a high mortality rate among its victims,” explains Dr Neeraj Tulara, General Medicine and Infectious Disease Specialist, Dr LH Hiranandani Hospital, Powai, Mumbai. He adds, “This is an emerging pathogen with significant public health risks because it can cause outbreaks of rapidly progressive severe illness.”Dr Kirti Sabnis, Infectious Disease Specialist, Fortis Hospital Mulund and Kalyan, states, “The encephalitis-causing Chandipura virus is mainly transmitted by sandfly bite and leads to an inflammation or swelling of the brain.” Does it affect only children? All recent cases of Chandipura virus have been reported among children below the age of 15 years. “The Chandipura virus (CHPV) can affect adults, although it is more commonly reported in children,” reveals Dr. Rahul Verma, Director - Neonatology & General Pediatrics, Sir HN Reliance Foundation Hospital, Mumbai. “Epidemiological studies and outbreak data have shown that children suffer severe courses of disease with higher morbidity and mortality rates compared to adults,” Dr. Tulara adds. Symptoms to look out for Early detection and intervention are key to navigate the effects of the virus. “The clinical presentation of Chandipura virus infection is acute and severe. The incubation period is short, typically ranging from 24 to 48 hours,” reveals Dr. Verma. The experts explain some symptoms to look out for. “Infection usually starts as flu-like illness — cold, sneezing, fever. It further leads to vomiting, headache, abdominal pain and diarrhoea. It can rapidly progress to seizures, confusion, and coma. The rapid progression is likely due to the virus’s aggressive attack on nervous system,” states Dr. Sabnis. Dr. Tulara states, “Stiffening, nausea, headache, vomiting which comes with sudden migraines attacks, confusion or altered mental status, attacks by seizures without warning, very high fever, sensitivity to light and drowsiness are some examples of these major symptoms. These signs clearly indicate an encephalitic condition, hence requiring urgent medical attention since their progression is rapid.” If the intervention is not prompt, the progression of these symptoms may result in a coma or even death. What are the short-term and long-term effects of the virus? Dr. Tulara reveals that the virus causes acute encephalitis syndrome with severe brain dysfunction, high fever, seizures within few hours leading to coma that may be fatal. “The long-term survivors of this disease have a range of complications such as cognitive and motor impairments while behavioral changes and neurological deficits are examples. Their quality of life is greatly affected by these lasting impacts, hence there is a need for continued medical care as well as emotional support,” he says. Is there a vaccine or treatment for the Chandipura virus? “No vaccine is available till now. It’s a sporadic disease, hence it is difficult to find a vaccine and have trials,” states Dr. Sabnis. Dr. Verma elaborates, “Supportive care remains the mainstay of treatment, aiming to manage symptoms and prevent complications.” Dr. Tulara states some supportive care measures. • Fever reduction measures include the administration of antipyretics.• Control of seizures calls for anticonvulsants.• The patient also needs respiratory assistance and maintenance of fluid-electrolyte balance. Immediate medical care remains key to manage symptoms of the virus. One must immediately visit the doctor if such symptoms arise. Has enough research been done about the virus? “Unfortunately, no definitive treatment research has been done,” remarks Dr. Sabnis. “This has not been given much attention and comprehensive studies have received less funding because it is relatively unknown outside its endemic areas where sporadic outbreaks have been witnessed. People often mistake Chandipura virus family for rabies simply because they belong to similar families, however, modes of transmission differ widely between them and their disease manifestation are in stark contrast. The main method by which Chandipura is transmitted from one person to another is via sandflies whereas rabies is typically spread through the bites of infected animals,” informs Dr. Tulara. Dr. Verma expresses hope for continued research in the domain. “With the outbreak in the news, new research is bound to happen. It should point to the infection’s treatment and the vaccine’s genesis to prevent it,” he states. What preventive measures can be taken to stay protected from the virus? Experts believe that at this point, prevention is the cure when it comes to Chandipura virus. They list down precautions to protect oneself from the infection. • Remove standing water sources and clean vegetation surrounding habitations to decrease sandfly breeding grounds. Vector control is key in preventing the virus.• Put on protective clothes, use insect repellants and fix nets or screens on doors and windows to prevent sandfly bites.• Public health education is also vital to inform communities about the risks and preventive measures. Also read: World IVF Day: How does IVF help men in overcoming infertility?
26 July,2024 09:30 AM IST | Mumbai | Raaina JainThe conventional wisdom that a daily glass of wine is beneficial for health is based on years of flawed scientific research, revealed a study on Thursday. "There is simply no completely 'safe' level of drinking," said lead researcher Tim Stockwell from the University of Victoria in Canada. The study, published in the Journal of Studies on Alcohol and Drugs, debunks the previous studies, which stated that moderate drinkers live longer and have lower risks of heart disease than abstainers. The main issue is that these studies often include older adults without accounting for their lifetime drinking habits, Consequently, moderate drinkers are compared to "abstainer" groups, which may include individuals who quit drinking due to health issues, making the moderate drinkers appear healthier by comparison. Stockwell and his team reviewed 107 studies that examined the relationship between drinking habits and longevity. Initially, the data suggested that light to moderate drinkers had a 14 per cent lower risk of dying during the study period compared to abstainers. However, this changed upon closer inspection. Higher quality studies, which involved younger participants (under 55) and excluded former and occasional drinkers from the abstainer category, found no link between moderate drinking and longer life. It was the lower-quality studies that showed a positive correlation between moderate drinking and longevity. Stockwell highlighted the long-standing belief in the health benefits of moderate drinking, exemplified by the "French paradox" theory from the 1990s, which credited red wine for the low heart disease rates in France despite a high-fat diet. This perception remains popular, though the reality is that moderate drinking likely does not extend life and may increase the risk of certain cancers. No major health organisation endorses a risk-free level of alcohol consumption. Also Read: Mumbai hospital completes rare complex aortic valve replacement surgery on Mumbaikar; only third such case in the world 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
25 July,2024 05:01 PM IST | New Delhi | IANSIn a highly challenging and life-changing medical feat, a team of doctors successfully corrected severe scoliosis in a 14-year-old boy from Manipur. The boy had been living with scoliosis -- a condition characterised by an abnormal curvature of the spine. In a challenging five-hour procedure, surgeons successfully removed a hemivertebra, a half-formed vertebra in the spine. This intricate surgery required precise correction to align the spine properly while carefully protecting the surrounding nerves. Several major hospitals had considered the operation too risky, citing the high potential for paralysis. The surgical team's expertise was crucial in navigating the complexities of the spine and ensuring a safe outcome for the patient. "This surgery was particularly challenging due to the complexity of removing a half-formed vertebra while protecting the spinal nerves," said Himanshu Tyagi, Additional Director of Orthopedics and Spine, at Fortis Hospital Greater Noida. "Days after the surgery, the boy is walking around, climbing stairs, and showing no signs of neurological complications," said the doctor. The patient's family expressed profound gratitude to the medical team, praising their expertise and commitment. "This surgery has given our son a new lease of life," said the boy's father.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.
25 July,2024 04:26 PM IST | New Delhi | IANSAbout 236,000 lives every year, which can be 350 per day or 26 every hour, are lost due to drowning worldwide, said Saima Wazed, the World Health Organisation (WHO) Regional Director for South East Asia on Thursday. July 25 is observed as World Drowning Prevention Day to bring awareness about the leading cause of injury-related death and disability worldwide. The theme this year is ‘Anyone can drown, no one should’. “In 2019, drowning claimed 70,034 lives in the South-East Asia Region, making it the second-highest contributor to drowning deaths worldwide,” said the Regional Director. “Drowning is a sudden and silent killer, often catching victims and those around them unawares until it is too late. A few seconds may not be enough time to respond. The power is in prevention,” she added. Wazed noted that the majority of the incidents took place near homes due to lack of supervision, exposure to hazardous water bodies, insufficient awareness, and poverty. There are preventive measures that exist and are crucial to address this issue, Wazed said, adding that the global health body has outlined evidence-based, cost-effective, and scalable strategies to prevent drowning. It also comes with guidance that is tailored to different contexts. “We all have a role to play in preventing drowning. Whether by raising awareness, promoting knowledge of effective solutions, collaborating on prevention plans and policies with local or national governments, volunteering with relevant organisations, or ensuring personal and family safety around water, each of us can make a difference,” Wazed 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.
25 July,2024 04:11 PM IST | New Delhi | IANSMumbaikar Kapil Gala is a relieved man after the successful completion of a complex aortic valve replacement surgery earlier this month. Gala, a 39-year-old had achondroplasia, was treated Jaslok Hospital & Research Centre by a team of doctors who came together to address only the third such case in the world, according to the city hospital. Born with achondroplasia, commonly referred to as dwarfism, Gala had multiple leg deformities and underwent eight surgeries on his feet to enable independent walking. Employed in the financial industry and managing a family independently, he faced a sudden onset of paraplegia a year ago, threatening his mobility and independence. The Mumbaikar was then admitted under the care of spine surgeons Dr Raghvendra Ramdasi and Dr Manish Kothari, Dr. Nihar Mehta, associate director of the Structural Heart Department at the hospital. Gala was diagnosed with severe aortic stenosis during the pre-operative workup for spinal surgery. His bicuspid aortic valve, a congenital defect, necessitated urgent intervention before any spinal surgery could be considered. Speaking to mid-day.com, Gala said, "I have faced many challenges due to my health conditions since childhood. However, this aortic stenosis would give me dizziness, blackouts which unbalanced my regular routines as well. At Jaslok Hospital, Dr Nihar and Dr Upendra along with Heart team gave me the right option of open heart valve surgery ensuring me a good quality life." A multidisciplinary team, including Dr Mehta, Dr Anand Bhabhor (additional director- Critical Care), Dr Upendra Bhalerao (consultant-Cardiovascular & Thoracic Surgery), Dr. Rajashri Agaskar (consultant- Cardiac Anaesthesiology), Dr Kothari (consultant - Spine Surgery & Endoscopic Spine Surgeon), and Dr. Purnima Shah (Consultant- Neurology & Neuromuscular Specialist), came together to discuss the best course of action after Gala came in for a spine surgery. However, in a press conference with the media, Dr Kothari said as they do a health checkup before the surgery, they found that Kapil had a weak heart. After a thorough review of echocardiograms, blood tests, CT scans, and MRI reports, the team identified several key concerns during the consultation. Kapil's bicuspid valve lacked the necessary calcium for a minimally invasive TAVI procedure. Additionally, contractures and small arteries in his feet made TAVI a less suitable option. His lung function, however, was deemed capable of handling surgery with pre-surgery exercises. Anaesthesia posed significant risks; extending his neck for intubation could lead to spinal compression and quadriplegia. Furthermore, the surgical team faced the challenge of operating without affecting his spine or legs, necessitating continuous monitoring of muscle and nerve signals throughout the procedure. The team concluded that an open-heart surgery to implant a mechanical (metal) valve, which could last approximately 15-20 years, was the safest and most effective option. Dr Mehta performed a coronary angiography to ensure no blockages were present. With careful planning and the use of a flexible video laryngoscope and conscious sedation Patient was anaesthetised. The Aortic valve replacement surgery was successfully conducted by Dr Bhalerao. Commenting on this case, Dr. Nihar Mehta said, "Our primary concern was the patient's safety and long-term health. We knew that TAVI was not the best option due to the anatomical challenges. It was crucial to provide a solution that ensured his survival and quality of life. We are delighted that Kapil trusted us and chose to proceed with the open-heart surgery." Dr. Upendra Bhalerao added, "Performing open-heart surgery on a patient with such unique challenges required meticulous planning and execution. This was high risk surgery and posed considerable technical challenges due to anatomical variations and neuromuscular deformities. The successful outcome is a testament to our team's dedication and expertise." Dr. Manish Kothari remarked, "It was a complex case, but seeing Kapil recover and regain his mobility is incredibly rewarding. His journey exemplifies the importance of interdisciplinary collaboration in medicine.” Jaslok Hospital is honoured to have played a part in enhancing Mr. Kapil’s quality of life. This case exemplifies the dedication and compassion of our medical team and reaffirms our commitment to delivering exceptional patient care." Elated with his progres, Gala said, “Dr Nihar was like a brother to me who gave me the correct advice of not getting a TAVI done despite being a TAVI specialist to ensure my safety and long-term quality life. Dr Upendra Bhalerao, Dr Manish Kothari, nurses and entire team of Jaslok Hospital treated me as a family. I am standing so comfortably today because of their hardwork.” The doctors have said Kapil's surgery was a success. He was off life support within 12 hours, walking with crutches by the second day, and discharged on the seventh day. The doctors said it further helped because Gala had a positive attitude and trust in the medical team were pivotal to his recovery. He continues to support his family and live a fulfilling life. The new valve will not hinder any future surgeries, including potential spinal surgery to further improve his mobility. While Gala's surgery has been successful, does every person suffering from dwarfism and suffering from achondroplasia need such a surgery or is this a special case? Speaking to this writer, Dr Mehta explained, "Achrondroplasia is not associated with Bicuspid aortic valve stenosis. The combination is exceptionally rare Bicuspid aortic valve itself implies that our aortic valve has two leaflets from birth instead of the naturally occurring three leaflets. This exposes the valve to stressors of flow throughout the life and leads to leakages or choking of the valve between ages of 50-60 (or even older). For our patient to have achrondroplegia with cervical myelopathy with aortic stenosis was exceptionally rare which is why it needed a combination of specialists , a team based decision , out of the box planning and meticulous execution for a successful outcome." This is a very very rare case where a person suffering from dwarfism and achondroplasia with cervical myelopathy has developed aortic stenosis. Only two cases are reported in scientific literature so far. The couple faced two major challenges. Firstly, the life threatening problem where aortic stenosis was causing him fainting attacks and chest pain so that he can't do his daily activities. But now, after heart valve replacement, he is doing everything without any symptoms. Secondly, the risk of being bedridden and losing power in all four limbs causing loss of earning and becoming dependent on someone if he develops any issues in surgery, . However, we could avoid all complications because of meticulous planning and team work," Dr Bhalerao concluded.
25 July,2024 02:08 PM IST | Mumbai | Nascimento Pinto
Infertility is a growing concern worldwide, affecting roughly 1 in 6 couples according to the World Health Organization (WHO), with male factors contributing to around 50% of these cases. While the focus often falls on women's health, a significant portion of infertility cases involve male factors. Beyond celebrating the incredible strides in assisted reproduction, World IVF Day, marked annually on July 25th, serves as a vital reminder that male fertility is just as crucial for conception as female fertility. Often, the conversation surrounding infertility focuses on women's health. However, this day brings the spotlight to the significant role men play in family planning. On World IVF Day, Dr. Kshitiz Murdia, CEO and co-founder of Indira IVF and Dr Priyank Kothari, consultant andrologist and assistant professor at B.Y.L Nair Ch Hospital, Mumbai delve into fertility challenges faced by men, and the benefits of assisted reproductive technology. Prevalence and causes of male infertility in India“We are facing a pandemic of non-communicable diseases in India, with a manifold rise in diabetes, hypertension dyslipidemia and other environmental and lifestyle-related illnesses. Infertility is among these and it is estimated that 15 to 20 per cent of couples in India suffer from infertility. Infertility in a couple can be due to either male factors, female factors or both. Male infertility contributes to 40 to 50 per cent of all cases. Exposure to environmental toxins such as lead and mercury, age, lifestyle factors such as smoking, obesity, drug and alcohol abuse and lifestyle stresses are the main causes of decline in male fertility over the past decade,” explains Dr Priyank Kothari.Comprehensive diagnosis and understanding of male infertilityUnfortunately, despite the high prevalence of male infertility in India, there is still a lack of awareness about the condition and its causes. “The 1st step in evaluating a couple for infertility should be a Semen Analysis and any couple unable to conceive after 12 months of unprotected intercourse can be labelled infertile and needs to consult an expert for evaluation,” poses Kothari.He elaborated, “The diagnosis of the male factor contributing to infertility is confirmed by a semen analysis done after 2 to 3 days of abstinence. At least 2 semen samples a month apart are usually required for an accurate estimation as there is considerable physiological variation in the semen parameters of a normal male. There can be a decrease in count, Concentration (Oligozoospermia), motility (Asthenozoospermia), quality of sperms (Teratozoospermia), or a combination of factors. The cause can be due to hormonal deficiency, testicular dysfunction, or external factors. Varicocele can be a very common cause of poor counts and motility (dilated veins above the testis signifying poor blood flow) and is a surgically correctable cause of male infertility. In 10 % of men with sub fertility there can be a complete absence of sperms in the ejaculate (Azoospermia).”Murdia adds, “ART employs a range of diagnostic tools, including semen analysis, DNA fragmentation testing, hormonal evaluations, and genetic screening. These tests provide comprehensive insights into sperm quality, quantity, and genetic integrity, as well as potential structural or hormonal issues. This thorough approach enables fertility specialists to develop tailored treatment plans and select the most appropriate ART techniques for each case, maximising the chances of successful outcomes.” Targeted and effective treatment optionsThe advent of assisted reproductive techniques like IVF (In Vitro Fertilization) and ICSI (Intracytoplasmic sperm injection) in the past two decades has revolutionised the treatment of male infertility. Murdia tells us about the range of targeted treatments tailored to address specific male fertility issues identified during the diagnostic phase. He shares, “Intracytoplasmic Sperm Injection (ICSI) is a notable procedure that assists men with low sperm count or poor sperm motility. ICSI involves the direct injection of a single sperm into an egg, significantly increasing the likelihood of successful fertilisation. Studies have shown that ICSI results in fertilisation rates of 80-85 per cent demonstrating its efficacy in overcoming many barriers to natural fertilisation.”.How can we know the parameter of being fertile? Kothari answers, “Fertile men usually have counts in the range from 15 – 100 mill/ml and motility of 40 per cent or more(forward movement of sperms under the microscope). In men with borderline decrease in count ( > 10 million) with good motility IUI(Intrauterine Insemination) is an option. In IUI the semen sample is purified and concentrated using various laboratory techniques and a high-quality aliquot is injected at the time of ovulation(egg rupture) into the uterus as a simple side room procedure.”He goes on to stress how the motility of sperm is important for the success of Intrauterine Insemination(IUI). “IUI is also beneficial for female factor infertility or when women have PCOS and irregular menstrual cycles. Men with very poor counts of less than 5 million/ ml sometimes even less than one million(occasionally a very few live sperm) in the ejaculate, where natural conception hasn’t taken place after years of attempting unprotected intercourse need advanced techniques like IVF or ICSI to be able to father a biological child.”Kothari briefly explains the most well-known ART, “IVF entails harvesting oocytes from the ovary under ultrasound guidance at the appropriate time in the women’s cycle and adding the sperms to the media containing the egg. The media resembles the physiological fluid present in the uterus facilitating the formation of an embryo (1st few cells of a newborn) which is then incubated (at optimal temperatures) till it reaches a stable form and is transferred back into the uterus (womb) at an appropriate time in the cycle. The embryo then implants into the uterus and further grows as a fetus in the women achieving successful pregnancy which then continues as usual process of 8-9 months followed by childbirth. Thus, even 15- 20 sperm can be used for IVF and a successful pregnancy is achieved. Men with low counts who haven’t benefitted from other conservative measures are advised for IVF after appropriate evaluation of the female partner. Benefits of assisted reproductive technology for menART has significantly advanced fertility treatment for men, leading to numerous successful pregnancies through its combination of cutting-edge techniques and personalised care. The benefits of Assisted Reproductive Technology for men are extensive and impactful. From accurate diagnosis and targeted treatments to advanced retrieval techniques and fertility preservation, ART offers comprehensive solutions to address male infertility. As technology and medical expertise continue to advance, theprospects for men facing fertility challenges will only improve, offering them greater opportunities to achieve their dreams of fatherhood.Advanced sperm retrieval techniques“For men with conditions such as non-obstructive azoospermia, where no sperm is present in the ejaculate, advanced sperm retrieval techniques like Micro TESE (Microdissection Testicular Sperm Extraction) offer a viable pathway to fatherhood. This surgical procedure involves extracting sperm directly from the testicular tissue, enabling men with severe fertility issues to produce viable sperm for fertilisation. Data indicates that Micro TESE can successfully retrieve sperm in approximately 50 per cent of cases, providing hope for men previously deemed infertile,” says Murdia.Fertility preservation strategiesART also plays a crucial role in fertility preservation for men, highlights Murdia. He elaborates, “Sperm cryopreservation, or the freezing of sperm, is an invaluable option for men who may undergo treatments or face conditions that could compromise their fertility in the future. The success rate of sperm cryopreservation and subsequent use in ART procedures is well-documented, with live birth rates comparable to those using fresh sperm. By preserving their sperm, men can ensure the possibility of fathering biological children at a later date, offering peace of mind and strategic family planning options.”Psychological and emotional benefitsThe psychological and emotional impact of infertility on men can be profound, affecting self-esteem, relationships, and overall well-being. ART provides not only medical solutions but also emotional support and hope, as per Murdia. “The advancements in ART offer men concrete options and a sense of control over their reproductive futures, alleviating some of the stress and uncertainty associated with infertility. Studies have shown that successful ART treatments can significantly improve psychological well-being and relationship satisfaction among couples facing infertility,” concludes the expert. Also Read: The monsoonal blues: Navigating mental health in the season of rain
25 July,2024 12:25 PM IST | Mumbai | Maitrai Agarwal
The arrival of the monsoon season brings a welcome respite from the scorching summer heat. However, for a significant portion of the population, this climatic shift coincides with a decline in mental well-being. “Research and anecdotal evidence suggest a significant correlation between the onset of the monsoon season and mental well-being, often referred to as 'monsoon blues.' Fluctuating weather conditions, including heavy downpours, lightning, thunder, and flooding, contribute to feelings of uneasiness. The varying humidity levels during monsoons can disrupt body temperature regulation, leading to feelings of heat, reduced energy, and fatigue. Higher humidity levels can also affect mood, causing lethargy, lack of motivation, and irritability due to physical discomfort like excessive sweating and sticky skin,” explains Janvi Rathore, therapist at The Mood Space. She goes on to list the varied challenges that come along. “The moisture in the air may exacerbate breathing difficulties, asthma symptoms, and allergies. The rapid temperature shifts common in monsoon can trigger headaches or migraines, further impacting mood and energy levels. Challenges such as excessive flooding, prolonged commute times, and traffic congestion make navigating the outdoors daunting.” Recent research indicates a rise in the prevalence of depression, anxiety, and seasonal affective disorder (SAD) during these months. The mental health expert delves into the reasons, “Reduced sunlight exposure during rainy periods can contribute to Seasonal Affective Disorder (SAD). Overall, rain limits outdoor activities, dampens spirits, disrupts routines, and fosters feelings of boredom or restlessness due to decreased social interactions and outdoor enjoyment.” This disruption, coupled with the limitations on outdoor activities and potential changes in routine, can negatively impact mood, energy levels, and social interaction. However, by practising self-care practices, exploring mindful activities, and understanding when to seek professional support, we can take control of our mental health. The therapist delves into the impact of monsoon on mental health, seasonal affective disorder, and lists practical tips for individuals to navigate the monsoon season with resilience. Demystifying Seasonal Affective Disorder “Seasonal Affective Disorder (SAD) is a subtype of major depressive disorder characterised by recurrent depressive episodes linked to specific seasons, such as winter or monsoon periods. Symptoms include persistent low mood, loss of interest, fatigue, and disrupted sleep patterns lasting for at least two consecutive years and impairing daily functioning,” explains Rathore. Norman Rosenthal, a physician who noticed his productivity decline during winters, pioneered research on SAD alongside Al Lewy and Tom Wehr, highlighting the effectiveness of bright light therapy in managing seasonal mood changes. Rathore tells us that SAD arises from reduced sunlight exposure during certain seasons, disrupting the body's circadian rhythm and serotonin production, which regulates mood. She adds, “Geographically, it is more prevalent in regions with distinct seasonal variations and fewer daylight hours, especially at higher latitudes. Women are more commonly affected than men, with young adults, particularly those aged 18 to 30, at higher risk.” Enhancing well-being in seasonal transitions: Holistic treatments for seasonal affective disorder Seasonal Affective Disorder (SAD) symptoms often improve with seasonal changes, but effective treatment strategies can help manage its severity. “Light therapy, involving exposure to bright light mimicking sunlight for 20-30 minutes daily, helps regulate hormones and alleviate depressive symptoms associated with SAD. Regular physical activity for 30 minutes daily can also mitigate symptoms by boosting mood. Maintaining adequate Vitamin D levels through supplementation or sunlight exposure positively impacts mental health overall,” says Rathore. Regulating sleep patterns is beneficial, as disrupted sleep is common in SAD. She also bats for Cognitive-behavioural therapy (CBT) and other psychotherapeutic approaches, “They assist in developing coping strategies and challenging negative thought patterns associated with SAD. Mindfulness practices such as meditation and deep breathing reduce stress and enhance emotional resilience, complementing other treatments effectively.” In summary, combining light therapy, regular exercise, Vitamin D maintenance, sleep regulation, and psychotherapy significantly aids in coping with Seasonal Affective Disorder, promoting better mental health during affected seasons. Navigating mental health during monsoon: Risks and resilience While monsoon showers bring relief there are also many ways it can be detrimental to one’s mental health. “Weather conditions and uncertainties associated with heavy rains and storms during the monsoon season can worsen anxiety and can result in Generalised Anxiety Disorder (GAS). For individuals experiencing Social Anxiety Disorder, the changes in daily routines and outdoor activities due to heavy rains may increase their tendency to isolate themselves and avoid social interactions, potentially exacerbating their symptoms,” shares Rathore. She poses that monsoon-related disasters such as floods, landslides, or property damage can amplify symptoms of Post Traumatic Stress Disorder (PTSD) in individuals who have previously encountered traumatic events. “The upheavals in daily routines, shifts in lifestyle, and challenges brought about by the monsoon season can precipitate Adjustment Disorders, marked by emotional and behavioural symptoms that significantly impact the well-being,” says Rathore. Weathering the storm: Practical tips for boosting well-being The seasonal shift brought by the monsoon, while refreshing, can present challenges for mental well-being. This period calls for prioritising positivity and emotional resilience. The expert shares some practical tips to navigate the season with a sunny disposition: Embrace the power of nature • Nature walks: Take a moment to appreciate the natural beauty surrounding you. A walk in the gentle drizzle or simply sitting by the window to enjoy the calming sound and sight of raindrops can significantly uplift your spirits. • Indoor greenery: Enhance your living space with indoor plants or create a small herb garden. Bringing elements of nature indoors can improve your mood and create a more nurturing environment. Stay active and connected • Indoor workouts: Combat feelings of isolation and boost your mood with indoor activities. Consider yoga, home workouts, dance routines, or following fitness videos. Exercise helps release endorphins, improve mood, and enhance overall well-being. • Virtual connections: Limited outdoor activities during the monsoon shouldn't mean isolation. Stay connected with friends, family, and colleagues through video calls, messaging apps, and social media. These virtual connections alleviate loneliness and maintain strong relationships. Fuel your body and mind • Nutrient-rich diet: Prioritise foods rich in antioxidants, vitamins, and minerals. These nutrients play a vital role in supporting mental well-being and emotional resilience. Embrace indoor activities and hobbies • Creative pursuits: Engage in activities that bring you joy and a sense of fulfillment. You can also explore hobbies like reading, cooking, painting, playing music, or learning new online skills. These activities are not only mentally stimulating but also provide a sense of accomplishment and enjoyment. Structure and mindfulness for peace • Daily routine: Establish a daily routine. This provides structure and purpose, helping maintain stability and reduce feelings of loneliness. A routine also ensures you prioritise activities that are important for your well-being. • Mindfulness practices: Integrate mindfulness techniques like meditation, deep breathing exercises, or progressive muscle relaxation into your daily routine. These practices significantly reduce stress, enhance emotional resilience, and promote a sense of calm and well-being. By incorporating these tips into your monsoon season routine, you can effectively combat the "monsoon blues," prioritise mental health, and embrace the season with a positive outlook. Remember, practising self-care and self-compassion is crucial. Taking proactive steps to nurture your mental and emotional health is key to managing isolation effectively. Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.
25 July,2024 11:23 AM IST | Mumbai | Maitrai AgarwalThe shape of a person's kneecap may indicate their risk of developing osteoarthritis - a common and debilitating joint disease, suggested a study. Researchers from the Australian National University (ANU) in Australia focussed on potential differences in kneecap shape between men and women, given that women with knee osteoarthritis often experience more severe symptoms. The team made use of CT scans to analyse the kneecaps of healthy individuals and patients awaiting knee replacement surgery. They employed advanced image analysis techniques to create 3D models of the kneecaps and measured the surfaces’ shapes. While the study “did not find distinct differences in kneecap shapes between sexes, it revealed that individuals with osteoarthritis exhibited more pronounced variations in kneecap surface shapes.” These differences became more significant with increasing disease severity, said the team led by Associate Professor Laura Wilson from ANU. She noted the unexpected nature of the findings, highlighting that the “changes in kneecap shape varied across different joint surfaces as osteoarthritis progressed.” The study is published in the journal Osteoarthritis and Cartilage. The researchers now plan to investigate whether these shape differences appear early in the disease's development. If the early onset of these changes can be confirmed, kneecap shape could potentially be integrated into disease prevention models, aiding in the early identification of individuals at higher risk for knee osteoarthritis. This could lead to targeted early interventions for those at risk, the researchers 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
24 July,2024 03:13 PM IST | Mumbai | IANSADVERTISEMENT
