Regular exercise can keep lifestyle diseases away

April 5, 2015

Apr 5: Cardiovascular disease, diabetes, and osteoporosis - Indians are facing an unhealthy future burdened with a slew of lifestyle diseases. But instead of expensive medication and therapy, the cure lies in making exercise a compulsory part of everyday life, health experts say.

"Indians are increasingly leading a sedentary and machine-dependent life, which may seem comfortable but has extremely adverse effects on health," T.S. Kler, Head of the Department Cardiology, Fortis Escorts Heart Institute and Research Centre said.

Regular exerciseKler said with increasingly hectic lifestyles, most Indians in urban areas nowadays do not walk to the neighbourhood store but rather order groceries on phone for home delivery or drive down.

"We do not climb stairs any more, with lifts being omnipresent. Riding bicycles to work or to school is not cool in urban areas any more. Forget adults, this conditioning begins with children who prefer to stay indoors watching television or playing video games rather than spending time in the playground," he added.

"We all know that cardiovascular diseases are today a major health concern in India. They are the single largest leading cause of deaths in the country, and relatively younger people are today afflicted by coronary artery disease," the noted cardiologist said.

Various surveys done in India have shown that the incidence of coronary heart disease is 8-10 percent in urban areas and 5-6 percent in rural areas.

Kler said regular exercise can help prevent risk factors for cardiovascular diseases such as hypertension and type II diabetes. It also keeps the weight in check.

"Incidences of coronary artery disease can be reduced substantially if the entire Indian population religiously takes to physical exercise. Even 30 minutes of moderate exercise daily can be immensely beneficial. We need a national focus on this less-talked about subject," Kler said.

According to Rajeev K. Sharma, senior consultant orthopedics and joint replacement surgery, Indraprastha Apollo Hospital: "Adequate levels of physical activity decreases the risk of a hip or vertebral fracture and helps control weight. In fact, exercise is very crucial for maintaining good bone health, besides adequate intake of calcium."

"WHO estimates that globally, one in four adults is not active enough while more than 80 percent of the world's adolescent population is insufficiently physically active. This is a dreadful scenario as all these inactive people are making themselves vulnerable to several health issues," he said.

Osteoporosis-related injuries such as vertebrae fractures not only cause pain but also degrade the quality of life, curtail movement and increase dependence. Since the bone is a living tissue, it becomes stronger when subjected to exercise, Sharma said, adding that loss of bone mineral density that begins during the 30s can be curtailed by exercising regularly.

"People who exercise are found to have greater peak bone mass as compared to people who do not exercise."

According to the International Osteoporosis Foundation, the malaise annually causes more than 8.9 million fractures around the globe.

"Though exercising can, to a large extent, help in building strong bones, there is a general lack of an exercise culture in India. This needs to change. Schools, colleges and other institutions should take the lead in nurturing an exercising culture."

Harvinder Singh Chhabra, medical director and chief of spine services at Indian Spinal Injuries Centre, Vasant Kunj, said Indians generally do not realize the importance of exercising unless hit by an ailment.

"Many patients start walking regularly after back pain or osteoarthritis has already set in their bodies. We tell them they could have delayed it by being active all their lives," he added.

According to Chhabra, in the West, there is a lot of focus on physical activity and people are moving away from sedentary ways of life. "They are junking television and going for cycling, running, or adventure sports such as rock climbing. This shift is yet to take place in India."

To make exercise a national culture, apart from awareness, many enabling policy measures are also needed.

"In urban areas, several environmental factors discourage people from leading more active lives even if they want to. Lack of public spaces such as parks and grounds, safety issues on the roads, pollution and irksome traffic do not allow many people to step out of homes to run or walk. This needs to change," he said.

The latter half of the 20th century has brought substantial progress in disease control due to expansion of health infrastructure. With food and nutritional consumption also improving for a vast majority of population, life expectancy in India has gone up over the years. Experts say that deaths due to communicable diseases have decreased while those from non-communicable diseases (NCDs) have risen.

NCDs at present account for 53 percent of all deaths and 44 percent of disability adjusted life-years lost. Projections indicate a further increase to 67 percent of all deaths by 2030. Cardiovascular disease is the major contributor to this burden, attributable to 52 percent of NCD-associated deaths and 29 percent of total deaths.

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Agencies
June 24,2020

New Delhi, Jun 24: Expanding the testing criterion for coronavirus, the Indian Council of Medical Research has said it should be made widely available to all symptomatic individuals across the country.

"Since test, track and treat' is the only way to prevent spread of infection and save lives, it is imperative that testing should be made widely available to all symptomatic individuals in every part of the country and contact tracing mechanisms for containment of infection are further strengthened," it said in an advisory on 'Newer Additional Strategies for COVID-19 Testing' on Tuesday.

In its revised testing strategy for COVID-19 issued on May 18, the Indian Council of Medical Research (ICMR) had advised testing for all symptomatic Influenza-like illness (ILI) among returnees and migrants within seven days of illness.

All hospitalised patients who develop ILI symptoms, symptomatic individuals living within hotspots or containment zones and healthcare and frontline workers involved in containment and mitigation of coronavirus were also advised testing.

The apex health research body has also advised authorities to enable all government and private hospitals, offices and public sector units to perform antibody-based COVID-19 testing for surveillance to help allay fears and anxiety of healthcare workers and office employees.

The earlier advisories on rapid antibody testing advisories had focused on areas reporting clusters (containment zones), large migration gatherings/evacuees centers and testing of symptomatic ILI individuals at facility level.

Besides, the ICMR on Tuesday also recommended deployment of rapid antigen detection tests for COVID-19 in combination with RT-PCR tests in all containment zones, all central and state government medical colleges and government hospitals, all private hospitals approved by the National Accreditation Board for Hospitals and Healthcare (NABH), all NABL-accredited and ICMR approved private labs, for COVID-19 testing.

All hospitals, laboratories and state governments intending to perform the point-of-care antigen tests need to register with ICMR to obtain the login credentials for data entry.

"ICMR advises all state governments, public and private institutions concerned to take required steps to scale up testing for COVID-19 by deploying combination of various tests as advised," the advisory added.

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Agencies
June 19,2020

While coughing, fever and difficulty in breathing are common symptoms of COVID-19, a new case study has found that pink eye is also a reason to be tested for the disease.

The study, published in the Canadian Journal of Ophthalmology, determined that conjunctivitis and keratoconjunctivitis can also be primary symptoms of COVID-19.

The researchers noted that in March, a 29-year-old woman arrived at the Royal Alexandra Hospital's Eye Institute of Alberta with a severe case of conjunctivitis and minimal respiratory symptoms.

After the patient had undergone several days of treatment with little improvement -- and after it had been determined that the woman had recently returned home from Asia -- a resident ordered a COVID-19 test.

The test came back positive, according to the researchers.

"What is interesting in this case, and perhaps very different to how it had been recognised at that specific time, was that the main presentation of the illness was not a respiratory symptom. It was the eye," said Carlos Solarte, an assistant professor at the University of Alberta in Canada.

"There was no fever and no cough, so we weren't led to suspect COVID-19 at the beginning. We didn't know it could present primarily with the eye and not with the lungs," Solarte said.

Academic studies at the outset of the pandemic identified conjunctivitis as a secondary symptoms in about 10 to 15 per cent of COVID-19 cases, he said.

Since then, scientists have gained greater knowledge of how the virus can transmit through and affect the body's mucous membrane system, of which the conjunctiva -- the clear, thin membrane that covers the front surface of the eye -- is an extension.

While the finding provides important new health information for the public, it also makes eye exams more complicated for ophthalmologists and staff, the researchers noted.

"The patient in this case eventually recovered well without any issues. But several of the residents and staff who were in close contact with the patient had to be under quarantine," said Solarte.

"Fortunately, none who were involved in her care also tested positive," he said.

Patients coming into an eye clinic with conjunctivitis and keratoconjunctivitis are now treated as potential cases of COVID-19 and extra precautions are taken by staff, according to the researchers.

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Agencies
July 15,2020

The first COVID-19 vaccine tested in the US revved up people's immune systems just the way scientists had hoped, researchers reported Tuesday -- as the shots are poised to begin key final testing.

No matter how you slice this, this is good news, Dr. Anthony Fauci, the U.S. government's top infectious disease expert, told The Associated Press.

The experimental vaccine, developed by Fauci's colleagues at the National Institutes of Health and Moderna Inc., will start its most important step around July 27: A 30,000-person study to prove if the shots really are strong enough to protect against the coronavirus.

But Tuesday, researchers reported anxiously awaited findings from the first 45 volunteers who rolled up their sleeves back in March. Sure enough, the vaccine provided a hoped-for immune boost.

Those early volunteers developed what are called neutralizing antibodies in their bloodstream -- molecules key to blocking infection -- at levels comparable to those found in people who survived COVID-19, the research team reported in the New England Journal of Medicine.

This is an essential building block that is needed to move forward with the trials that could actually determine whether the vaccine does protect against infection, said Dr. Lisa Jackson of the Kaiser Permanente Washington Research Institute in Seattle, who led the study.

There's no guarantee but the government hopes to have results around the end of the year -- record-setting speed for developing a vaccine.

The vaccine requires two doses, a month apart.

There were no serious side effects. But more than half the study participants reported flu-like reactions to the shots that aren't uncommon with other vaccines -- fatigue, headache, chills, fever and pain at the injection site. For three participants given the highest dose, those reactions were more severe; that dose isn't being pursued.

Some of those reactions are similar to coronavirus symptoms but they're temporary, lasting about a day and occur right after vaccination, researchers noted.

Small price to pay for protection against COVID, said Dr. William Schaffner of Vanderbilt University Medical Center, a vaccine expert who wasn't involved with the study.

He called the early results a good first step, and is optimistic that final testing could deliver answers about whether it's really safe and effective by the beginning of next year.

It would be wonderful. But that assumes everything's working right on schedule, Schaffner cautioned.

Moderna's share price jumped nearly 15 percent in trading after US markets closed. Shares of the company, based in Cambridge, Massachusetts, have nearly quadrupled this year.

Tuesday's results only included younger adults. The first-step testing later was expanded to include dozens of older adults, the age group most at risk from COVID-19.

Those results aren't public yet but regulators are evaluating them. Fauci said final testing will include older adults, as well as people with chronic health conditions that make them more vulnerable to the virus and Black and Latino populations likewise affected.

Nearly two dozen possible COVID-19 vaccines are in various stages of testing around the world. Candidates from China and Britain's Oxford University also are entering final testing stages.

The 30,000-person study will mark the world's largest study of a potential COVID-19 vaccine so far. And the NIH-developed shot isn't the only one set for such massive U.S. testing, crucial to spot rare side effects. The government plans similar large studies of the Oxford candidate and another by Johnson & Johnson; separately, Pfizer Inc. is planning its own huge study.

Already, people can start signing up to volunteer for the different studies.

People think this is a race for one winner. Me, I'm cheering every one of them on, said Fauci, who directs NIH's National Institute of Allergy and Infectious Diseases.

We need multiple vaccines. We need vaccines for the world, not only for our own country. Around the world, governments are investing in stockpiles of hundreds of millions of doses of the different candidates, in hopes of speedily starting inoculations if any are proven to work.

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