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ESSENTIAL QUESTIONS ABOUT COVID-19: Dr. Mathew, a public health expert, answers

July 4, 2020 Ancy Abraham 2 Comments

The more the questions answered, the more the number of doubts about Covid-19 during the pandemic. The readers of Lifestyletodaynews.com had a plethora of essential questions about COVID-19 ranging from precautions, medication, and the long term impact of the virus. Dr. Mathew Varghese, a Public Health expert and orthopedic surgeon featured as a real-life hero by Bill Gates, was kind enough to answer the question in the mind of the readers. He spared time for an in-depth video interview about almost every issue relevant to a common man in the present scenarios.

ESSENTIAL QUESTIONS ABOUT COVID-19

Read on to find the informative answers which are educative in nature:

According to experts, the pandemic is not going to end in July, will it end?

The experts are basing their information on facts of previous epidemics and the behavior of Coronaviruses. You had SARS1; we had Middle Eastern Respiratory Disease. These are the experiences that help to guide us in our understanding of this disease.

By Mathematical models, they show that possibly by July, or maybe even August, the epidemic will reach a peak, and gradually settle.

A definite time? Difficult to answer

Historically if you look at epidemics, they have all been like this. Including the Spanish flu, which came, lasted for quite some time, and then eventually disappeared. So it is not that these pandemics will be there forever.

They will eventually be overcome by human immunity and resistance to fight against viruses. Therefore it is difficult to answer when this pandemic will end.

How long will it last?

We do not know. But usually, pandemics have a history of infecting a certain number of people and then petering out.

So there is a growth curve, which may be steep or slow, reaches a peak, and goes down.

When a large number of people have herd immunity

That growth curve starts going down, only when a certain proportion of the population gets infected, which then has the resistance to fight against it. This resistance to fight the virus is called herd immunity.

When the infection has immunized a large number of people in a community, they have herd immunity.

What is the percentage of people that need to be infected to get herd immunity?

There are experts that, until recently, have been saying 60%. But some recent reports say that even on infection reaching up to 20-30% of people gives sufficient herd immunity for the pandemic to end.

Somewhere between 20-60%

Anyone who says that this is going to end in 10 days or 15 days is all guesswork. We do not know, hopefully on reaching herd immunity of a certain proportion somewhere between 20-60%, overcome the pandemic.

Will the virus be eradicated?

In Coronavirus, we do not have a vaccine as yet. It will take about one, one and a half years at least before a vaccine comes.

Even then, if you look at the few vaccines available today, they do not provide you with permanent immunity like smallpox or oral polio vaccine.

They give you a limited period of immunity. Flu vaccines need to be given every year to protect the elderly from the effects of flu-related pneumonia.

We do not know how effective will the vaccine be for Coronavirus. We have to wait and see. Until then, we cannot answer this question, can we eradicate it or not? But looking at the past behavior of flu unlikely we can eradicate it forever.

Is there any possibility of home testing for Coronaviruses, and is that legal?

As yet, there is no home testing available, so the question of legality does not come. We do not have such a test.

At this point, we do not have any home testing

In the future, there may be, and it may be useful to test that. But at the same time, at this point, we do not have any home testing available with us.

IMMUNITY

Is immunity the biggest weapon against Coronavirus?

Yes, you know what the first virus identified was? It was a plant virus, Tobacco Mosaic Virus (TMV), in 1891. The first human disease-producing virus, you know when it was identified? 1901, it was a yellow fever virus. Remember, till today, 120 years down the line, we do not have a drug to cure virus illness.

When somebody says that I am immune, it could be because they had an infection or they have been vaccinated and become immune.

We overcome virus illnesses by the body producing antibodies that fight the viruses, kill the viruses, and we win. Those antibodies that the body produces are what give us the immunity.

When somebody says that I am immune, it could be because they had an infection, or they have been vaccinated and become immune.

We overcome virus illnesses by the body producing antibodies that fight the viruses, kill the viruses, and we win. Those antibodies that the body produces are what give us the immunity.

So is this natural immunity?

No, it is a healthy individual who can raise antibodies in sufficient numbers and strengths to fight the virus. When you say you have excellent resistance, you are saying you are a healthy person without any malnutrition, without any other illness, which may be lifestyle diseases or other diseases that make you vulnerable and immune-compromised. Therefore you are susceptible to get the infection.

It is a healthy individual who can raise antibodies in sufficient numbers and strengths to fight the virus.

How to increase immunity?

Your health is based on a balance of things—a Balance of what you eat. You have to have a balanced diet, which means a proportion of food has to be carbohydrates, proteins, and fats.

Labourers need to take a large number of carbohydrates. At the same time, inactive people take fewer carbohydrates, less fat, and more protein. Besides, you need to have a balance of physical activities also.

But that’s not sufficient.

You need to have minerals, Minerals like Zinc, Copper, various other minor elements required for your enzymes in your body for fighting and producing cells for fighting viruses. We get these elements from natural food that we take, like the vegetables, nuts, and the pulses.

We need to take a balanced diet; stay healthy and physical activity keeps our body fit. Intellectual pursuits keep our mind fit.

Physical health, mental health, well-balanced nutrition are foundations for good immunity.

So we need to have good physical health, good mental health, and proper nutrition-balanced to maintain our body health. That is the baseline foundation for good immunity.

PREVENTION

Most people have to venture out for work, essential, medical emergency, so how do we protect ourselves from being infected?

This is basic. Everyone has to remember. First, we have to understand how the virus spreads. The virus spreads from one person’s breath to another person’s breath.

The virus spreads from one person’s breath to another person’s breath.

If you are close to each other and breathing into each other’s nostrils or mouth, you are infecting each other. If a person is within your breath air distance, you are likely to get infected if the other person is infected.

How do we prevent this?

We can’t stop breathing. You continue to breathe. So we need to wear a mask.

1. The first safety step is a mask, a good mask.

A cloth mask with porous layers in it doesn’t work. It has to be a mask with multiple layers that prevent the virus. Remember, viruses are tiny particles. It can go through the pores of your cloth mask.

Therefore you need to have a mask that has a filtration capacity to filter the viruses.

Mask to protect you from the other person’s breath.

Remember, any mask is better than no mask.

So if you don’t have any masks, then use a multilayered cloth mask. At least two or three layers so that the probability of the virus entering your airway is less than normal.

2. The second safety step is to keep a safe distance.

It is debatable, whether you say one meter or two-meter or whatever.

Generally, a minimum of 1-meter distance should be kept. That is important to prevent you from getting infected from the other person’s aerosol. It is the droplets that come out of his breathe when he breathes.

Remember if you are shouting, or you are singing you bring out more aerosols. So if you are standing opposite somebody who is singing and is likely to send the aerosol down the line further, maybe 3 meters, 4 meters also, be careful. So it is essential to have the mask.

Sometimes these aerosols, small droplets, fine droplets, containing virus particles, land on your hands. And any human being touches their face at least 20 times in an hour. So from our mouth, from our nose, from our eyes, we get the viruses on to our hands. When we touch an object, we transfer the virus from the hands to the article.

When we cough without a mask, we put those aerosols on the objects around us. The objects around us are contaminated, and if somebody comes and touches those objects, we transfer the virus to the hand.

3. The third most important safety step is Hand Washing.

Regular hand washing, especially if you have touched foreign objects outside your house. Unless you are in your home where somebody is infected, and home quarantined, don’t touch any article that he has touched.

Don’t go to him closer than one meter. Don’t go to him without the mask. You have to be very careful. Any object from outside that you have touched wash your hands.

Any unknown person bringing you an object, wash your hands. Anybody giving you some items through courier, wash your hands soon after you have touched. If you have a doubt, leave the object untouched for 5-6 hours, and that is sufficient enough to be sure there are no viruses on the packet.

How to wash our hands?

I say that soap and water are enough to wash hands.

Soap and water is the best.

Why do you say that?

Washing hands with soap and water are the best way. The virus has a coating. That coating is easily washed away by soap because it has got a lipid content.

What are Lipids?

Lipids are fat-related substances. You know oils are washed only very effectively with soap. Therefore soap is more efficient than plain water or even sanitizer.

Are you not happy with sanitizers? Why?

It is expensive.
It is difficult for poor people to get sanitizers.
They finish off in no time.
Because you want to conserve the amount of sanitizer you use a small amount. You put a little bit on your palm and rub. That is not sufficient.

Use it liberally. Back, between your fingers, your thumb all have to be. And that is the same technique for washing also.

Do liberal, not thrifty use of sanitizer.

So the steps for cleaning your hands with sanitizer, washing your hand with soap and water, remain the same—every finger, front, back, thumb separately. Palms everything has to be adequately cleaned.

Soap and water are the best. But in the absence of that, you can use a sanitizer. Make a liberal use, not of a thrifty use of sanitizer.

Should we also use soaps for washing vegetables and fruits and packed groceries?

No, you don’t have to do that. We cook and eat Vegetables. Washing them with plenty of running water is sufficient. On top of that, you are cooking it. However, if you have salads that you are consuming, make sure that you have washed it thoroughly with running water.

You don’t have to use soap. I have seen people using Soda bicarb, washing soda, detergents. No. Some of the detergents will soak into these vegetables; some of these may be toxic.

Washing vegetables in plenty of running water is sufficient.

Especially washing soap, you don’t want to intake them into your body. So running water is good enough.

If you are too anxious, you may use warm water and wash these vegetables that you are going to consume raw. Or the fruits that you are going to eat, clean them thoroughly with water. Running water is good enough for you.

There is a recent report that sunlight will help you fight the virus. How useful is sunlight to fight the virus?

Sunlight has a spectrum of rays, from the very narrow spectrum to the very long spectrum – infrared to ultraviolet. Ultraviolet rays do kill viruses, but they need to lay exposed for a specific time.

If you are thinking of getting yourself sunbathed, remember Ultraviolet rays are also harmful to your skin. We do not recommend it as a method to protect yourself from the virus.

Drying and keeping objects in the sunlight for 5-6 hours may be good enough.

However, if you are thinking of keeping objects in the sunlight, which have possibly contaminated, you may keep them out in the sun, leave it. Just drying and remaining in the sunlight for 5-6 hours may be good enough.

One essential item which you may use the sunlight is for your masks. Reuse any surgical mask, which you buy, provided you dry it sufficiently.

Any surgical mask can be reused, provided you dry it sufficiently.

You take four masks, number them 1,2,3,4.

1st day wear Mask No. 1.

2nd-day mask No. 1 goes on the washing line. Leave it in sunlight and use mask No. 2.

3rd day the second-day mask goes up the washing line, and then you wear mask No. 3.

4th day, mask No. 3 goes on the washing line, and you wear mask No. 4.

5^th day, Mask No. 1 comes back, and you recycle it to a maximum of about 28 days.

You can use one set of four masks for 28 days. This method is found sufficient for the recycling of your mask. And that is the only area where I would use sunlight to sanitize the mask.

QUERIES

Curiously, some of the coronavirus positive cases have never ventured out of their houses, for six months, and followed all the precautions at home, how could that happen that they got infected?

Highly improbable that they have had no contact, and yet they got infected. The virus did not come out of thin air. It arrived through a source that was infected.

It has to be they handled some object or met somebody, coming to their house, who was infected and became positive. The chain of infection does not continue without any interaction.

The virus did not come out of thin air.

There has to be some interaction from some infected person, either directly or indirectly through objects of exchange. Maybe notes, handling notes. Perhaps some package that was given by a courier.

There have been reports of Pizzas delivered by pizza delivery boys who were infected, and they infected people.

It could be from anything that the virus landed on your body.

There is a doubt in everyone’s mind that we are already infected and healed from Coronavirus in these three months.

Yes, it is possible. Many of us had mild flu, cold, cough, and no other symptoms, and we became all right.

It is possible that you are infected, and you got cured.

That is what happened in the aircraft carrier Theodore Roosevelt where tests showed 60% of the young, healthy men were infected but asymptomatic. So you may be infected, and you got cured.

In such cases, will we be able to find out if we were infected?

Yes, there is a way to find out, and that is by testing for antibodies.

The problem with this test is that the antibody tests are not as reliable as the antigen test that we call the real-time PCR. Those are far more sensitive and far more specific. At the same time, the antibody tests are non-specific and not so reliable. The testing for antibodies will help us identify these cases.

The testing for antibodies will help us identify these cases.

What is an antibody?

The antibody, a body substance created by our cells to fight the virus, protects you from infection from the future. So if you have an infection, initially, there is no antibody because the virus is an entirely new organism that has entered your body.

The antibody is a body substance created by our cells to fight the virus.

As it enters, the body recognizes it as a foreigner and starts fighting it. As it fights, the antibody level increases until it reaches a peak, and the body wins, or sometimes the virus wins, and the body dies. Usually, the body wins. 99.5% of cases the body wins. And we can eliminate the virus. So testing for antibodies will help us identify these cases.

Are there any long term side effects for a Coronavirus patient?

Since being identified, the virus has been only six months old, causing its symptoms and the disease. It is too early for us to say if any complications are long term.

In the short term, we know what is happening. However, long term, we do not know. Only time will tell. Most viruses do not leave long term effects except for diseases like poliomyelitis, and a few other viruses that cause long term damage to the body.

Most viruses do not leave long term effects

But by and large, coronaviruses do not belong to that category, and therefore we do not expect there will be any long term effect. But time will tell. At this point, I can’t answer that question.

When primarily the elderly and those with comorbidities have succumbed to Coronavirus, some young, healthy people with no health issues died due to Coronavirus, what could be the reason?

Again difficult to answer. But in my hospital, I have been keeping track. In the 200-bed Corona ward in our hospital, we regularly treat Coronavirus patients right from the beginning of the epidemic.

What we have found is 90% plus of those patients that have died, whether they were young or they were old, were diabetics. We don’t know what happens in them. For some reason, people with diabetes have been vulnerable.

For some reason, people with diabetes have been more vulnerable.

And those that have died have shown significant changes in their lungs. Described in the lungs, earlier thought to be pneumonia, later on found to be not pneumonia, but clotting in the lungs’ vessels.

What do lungs do in our body? They oxygenate the blood. This oxygenation happens because blood is flowing through the alveoli in the lungs.

Some have what is known as ‘Cytokine Storm.’

And when the blood vessels are clotted blood flow cannot happen. Oxygenation cannot occur, and the patient dies in the absence of oxygen, because of the tissues not getting oxygen for survival. That is what happens. Some of the patients, young and dying, are described to have what is known as ‘Cytokine Storm.’

What is a Cytokine Storm?

It is a reaction committed by the body to fight the virus, but the response is an overwhelming reaction, and that causes side effects to the patient, and the patient dies from it.

The younger people dying are usually ones who had a cytokine storm, and mostly, these are the ones with diabetics or some other major illness.

What is the precaution to be taken by pregnant women, especially while going to the hospital for checkups?

The precautions remain the same—Mask, distancing, hand wash.

Remember when you are pregnant; a pregnant mother is two lives; the mother and the child. So there is a double reason to be as cautious as possible keeping away from

Crowded outpatient areas.
Closed and poorly ventilated areas.
Poorly ventilated doctor’s chambers.

Make sure that when you go, you should have seen the clinic earlier. It should be well ventilated. The number of air chambers should be good so that your probability of getting the infection is low.

Can we accompany our child along with us?

I would not recommend that. Except in a dire situation, where no one else is at home to protect the child, to be with the child, you may carry the child.

Remember, children may be impulsive. They suddenly go and touch things, they may suddenly interact with people, and they may also pull off their mask.

Take children with you only in a dire situation, where no one else is at home to protect the child.

Therefore, because of the impulsiveness and unpredictability of children’s behavior, we do not recommend that children be accompanying pregnant mothers for antenatal care.

ADVICE TO MEDICAL PROFESSIONALS

You have directly handled patients during prime times, be it HIV+ve or Coronavirus patients, what is your advice to the medical service professionals who are directly dealing with Coronavirus patients?

My advice remains the same. If you protect yourself, you will be able to take care of your patients better. While I have seen so many patients who are Coronavirus positive, frankly infected, I have dealt with them without fear.

For the last 31/2 months now, I have been dealing with patients every day. But I take my precautions. My job as a physician is primarily a responsibility for patient care.

If you protect yourself, you will be able to take care of your patients better.

I have taken the Hippocratic Oath, and I will care for my patients, come what may. During the HIV epidemic lot of judgemental issues happened like, huge stigma against those people with HIV, and coming up with innocent victims of HIV.

We should not be judging people for an infection. We should not be stigmatizing people for their disease. Our job as professionals is to take care of these patients. We do it to the best of our ability, without any stigma. However, while we do it, we protect the patient, and we shield ourselves.

How do you do that?

Make sure that you wear a surgical mask. If it is close contact, it has to an N95 mask that you need to wear.
If you are going to do an invasive procedure, you must wear gloves.
Or you must wash your hands before and after you touch the patient.
As far as possible, keep away from the breathing area of the patient.

How do you assume that you have not got an infection from somebody? Possibly, you dont exhibit any symptoms, yet you need to wash your hands before you touch the patient. And after touching the patient, you protect yourself by rewashing your hands.

If you have to touch the face, the eyes, the nose, mouth of the patient, or any other invasive examination, make sure that you are wearing gloves. Do not do it without gloves.

Maintain distance. After using an object on a patient, sanitize before using again. Like the Stethoscope that I used for seeing the last patient with a backache, I sanitized it with sanitizer.

I am an orthopedic surgeon; you will wonder how the corona patients come to me. Yes, they come to me with a backache. Body aches are usual in viral infections.

The protocols are the same: Protecting yourself and protecting the patient.

They came to me with backaches. Neither did they know that they had corona, nor did I know that they had corona. I examined them, suspected based on some of the questions that I asked and sent them for further examination confirming them to be coronavirus patients.

We need to be careful. The protocols are the same: Protecting yourself and protecting the patient.

Hydroxychloroquine, used to treat lupus, rheumatoid arthritis and malaria, does that mean that those with these conditions can kill two birds with one?

Don’t get wrong impressions. The diseases of Lupus and Rheumatoid, these are autoimmune diseases.

What are autoimmune diseases?

These are diseases that the body’s immune system fights its cells. Usually, our immune system fights foreign cells, viruses, bacteria, allergens. But in this type of condition, Systemic Lupus Erythematosus or Rheumatoid Arthritis is Autoimmune diseases where the body fights its cells and causes illness.

You are not winning two wars at one time.

So the body’s immune system is busy fighting its cells, therefore when an invader comes, you are vulnerable. So even if you are taking Hydroxychloroquine, your invader will have the upper hand. It is just like internal strife is the right moment for an external enemy to fight and win over you.

Similarly, malaria is an external infection because of a parasite. So there is a fight between the body and the malaria parasite. So you are fighting one war inside your body. When another invader comes, even if you are taking Hydroxychloroquine, that invader has the upper hand. So that kind of cross-protection does not happen. So you are not winning two wars at one time.

Some people still believe that Coronavirus is a myth or a conspiracy. What do you have to say?

As yet, no evidence to show the creation of Coronavirus as part of bioterrorism. We do not have any reasons for that. There are hypotheses, but it has not been proven anywhere. We do not have any basis for saying that.

Coronaviruses ordinarily seen in bats, around 500 species, and some of the animals, is the only proof we have of the virus. They are a real storehouse of Coronaviruses, without any disease in them.

Bats are a real storehouse of Coronaviruses, without any disease in them.

But when it jumps from bats to human beings, you have the disease coming. Had there been an intermediary? We do not know.

Remember, when we tinker with nature too much, when we tinker with the animal kingdom’s natural habitat, in the animal kingdom, we are likely to have an interaction between the viruses in the animal kingdom and the human interface. And that is when we have diseases jumping from animal kingdom to humankind.

When we tinker with the natural habitat of these animals, that is when we have diseases that jump from animal kingdom to humankind.

So the key message in this pandemic is that we should not ruin our environment, we should not destroy our forests, and we should not unnecessarily damage our animal kingdom. Being part of an ecosystem; we need to act resposibly to protect the ecosystem for staying safe.

Concluding Message

The virus is here, it will have a natural peak, and they die down naturally. The vaccine is the way to protect it for the longer-term. But a vaccine will take a minimum of 11/2 years to come by.

Until then, the only way to protect from the virus is by preventing the spread of the infection from one human being to another.

Wearing a mask
Keeping a safe distance
Washing your hands regularly.

Stay away from places that people gather as we canoot differentiate between the infected and the not infected.

Thank you so much! Keep safe! All the best!

Dr. Mathew Varghese is a Public Health expert and Orthopaedic Surgeon. He is currently the Head of the Department of Orthopaedics, St Stephen’s Hospital, New Delhi. His work with polio patients caught the attention of Bill Gates, who named him a real-life hero who inspired him in his blog.

HEALTH, HOME

the day I stopped Google Search for Health Symptoms

March 18, 2020 Ancy Abraham Leave a comment

In this past one week, you might have Google search for health symptoms, at least once, for the term Coronavirus. Not just Coronavirus, but a few other words along with it like symptoms, remedies, and prevention. Googling for health queries is the natural tendency of everyone.

However, there are times you Google specifically for symptoms like coronavirus headache, coronavirus inflammation, coronavirus cancer…and so on. This is where I want to share the importance of E-A-T algorithm introduced by Google in 2018. I will explain later about EAT and the Medic Updates of August 2018. First I would like to share a story.

My Story of Google Search for Health Symptoms

The story begins in 2014 long before Google introduced E-A-T in SEO. I got admitted, for one month, to get ayurvedic treatment for arthritis. There were symptoms of arthritis for a year hence I was on medication.

Arthritis is a relatively harmless condition unlike deadly diseases like Cancer – that is what my family believed. That was because there were no hereditary cases of severe arthritis in my family.

According to the ayurvedic doctor, there are about 5000 variations of arthritis. Furthermore, the ancient Sanskrit texts on Ayurveda say that a doctor cannot claim to completely cure four diseases, out of which arthritis is the foremost.

Only when my health condition got out of control did I decide to undergo proper ayurvedic treatment. There were excruciating pain and trouble in walking.

Ayurveda is a holistic treatment; therefore as the treatment began there was more pain and inflammation. Furthermore, for the first in my life, I came to know how functional every part of my body was. The situation is like taking the car for servicing and the mechanic finds a number of faults with the car, which you had never imagined.

Every day I used to clear all my queries with the doctors. Some replies were unsatisfactory. There were too many queries. Besides you cannot pester a doctor with ludicrous queries.

Therefore, to get more information I searched Google Search for Health Symptoms. The disease crippled and brought to a halt my speedy lifestyle. I had scores of queries for Google.

I was searching Google for arthritis and life span, arthritis and cancer, arthritis and degeneration, arthritis and deformation, arthritis and gingivitis. There were search results for every query. In case the answer was no satisfactory I would modify the question until I got satisfactory answers.

On the contrary, there were stories of many arthritis patients – a young lady in her twenties, a mother with three kids and a single mother with two grown-up children – all depended on their family to fulfill their daily routines. There were no positive motivational stories.

After reading all the articles I thought I was either going to die or remain bedridden forever. Thinking about my kids’ future, one night I was in a frenzy and loss of breath.

The next day Doctor told me that Rheumatic Arthritis is reversible. He showed me two of his staff who came there crippled with Rheumatoid Arthritis, now they were free of the disabilities and working like others.

Then I went to my room and searched Google for Arthritis reversal. There were many articles and inspiring stories on arthritis reversal. Those stories gave me the motivation to approach arthritis positively and to expect a recovery very soon, On a positive note, that day I stopped searching for health queries regarding arthritis.

That day…..

That day I got the answer for the query for my cardinal question ‘Can I live a normal life once again’? Five years after the severe arthritis attack, I now live a normal life. Like the doctor said arthritis is not completely curable. By following certain food and lifestyle changes, the disease has come under control.

Google Search and Coronavirus

At this time when Covid-19 is spreading, faster and wider than wildfire, I would like to tell you how to make good use of the August 1, 2018 Medic update introduced by Google. To ensure quality content in sensitive topics like health and money google brought in the EAT ( Expertise, Authority, and Trustworthiness ) algorithm.

To be ranked high on google, the author of the post must be able to establish Expertise, Authority, and Trustworthiness about the topic. Now the question is how can a reader understand the EAT of the post that he or she is reading.

Here is how you can decide on the EAT of the post:

The Bio of the Author

When you read a health post check the credentials of the author. In the above example, the claims of the author have been reviewed and verified by a Doctor. That gives authority and trust to the post.

Read the comments

The comments of the readers are very important in asserting the trustworthiness of a post. In the above comments, the readers are doubtful about the genuineness of the post. In such cases, the author’s replies are very important.

Medical claims backed by science

Every medical claim that the author makes must be backed by science. In the above example, the author quotes from WHO. The quotes make the article authoritative and trustworthy.

Tips on how to search google for health topics from my personal experience

Listen to the Doctor

Some doctors have put posters outside their consultation rooms asking the patients to leave their google knowledge outside.

Listening to the doctor with an open mind is very important. A doctor gets his medical degree after years of hard work. They are those multitalented, studious, disciplined classmates who chose medicine as a profession with a passion to serve humanity. They have to clear tough exams to qualify for medical studies.

Listening and following what the doctor says is very important. In addition, Google can provide information and clarity about the disease. What a doctor says about your health condition and what you think about your health issue may be entirely different. The doctor is always right. There should be mutual trust between the doctor and the patient to get proper healing.

From my personal experience, I understand that we end up with the wrong information when we search for health issues we feel we are suffering from. For instance, now you are doubtful whether you got COVID-19 because of an irritation in the throat. The search results for your queries on COVID-19 and throat irritation might either give you jitter or false hope.

Yesterday a Volgger apologized for spreading false information on Coronavirus. She had said in her vlog to drink hot water so that coronavirus goes from the throat to the stomach and thus dies. Now she says her claims were a mistake.

Therefore, I would say that you should not overdo google search. Google for Coronavirus symptoms or Coronavirus Cure and the top search results are from the renowned health organization from the world over. Trust what they say.

Search for the disease, not symptoms

You must search for a specific disease like Coronavirus. Then you get the proper search results when you Google Search for Health Symptoms. If you search for symptoms, you get confusing search results. If you google ‘cold, cough, sneezing’, then these are the symptoms for the common cold, flu, coronavirus and even cancer. Weight loss is a symptom of cancer, liver disorders, and many other diseases. Therefore you should google for disease in general instead of symptoms in particular.

Top Search results are most credible

To conclude, according to Marie Haynes, a renowned SEO consultant, the top three Google search results have a Wikipedia page. Which means those are from credible sources that have Expertise Authority and Trust.

PS: This post was written with an intention to give a proper direction to everyone who searche about Coronavirus. Maintain social distancing, wash your hands always and stay safe until coronavirus in contained.

FITNESS

8 Fitness trends in the United Kingdom in 2018

August 31, 2018 Guest Post Leave a comment

While living in such a fast-paced world Fitness trends can be really hard to be up to date. New research is being done every day putting pressure on all of us to stay in the loop.

It is not so different in the fitness world. New training routines and methods are introduced every month. So today I’m going to talk about fitness trends in the UK in 2018 and hopefully give you a better idea of what might be suitable for you as an individual rather than a mass user.

Ballet Fitness

Ballet fitness is a unique fitness class to improve your grace, posture and fitness level. Classical ballet moves incorporated in challenging fitness routine. Which helps to connect your body and mind as well as challenge your physical ability. Ballet classes usually combine Ballet, Stretching and Pilates. Some classes can be very fast paced while others are slower. Also, some classes offer more technical ballet while others concentrate on fitness with just a few ballet elements.

I would highly recommend you to do very good research beforehand. Having a ballet fitness class in your routine once a week can really improve your flexibility and even confidence!

Small Group Training Studios

While for the past couple of years a big hit was low bugged big gyms, this year the new hit is small fitness studios for classes exclusive.

City centres, as well as suburbs, are full of small studios for classes. The range for these studios can be really wide. From cycling or circuit training to pilates, yoga, dancing or even meditation. The place usually comprises a very small space which can accommodate a max. of 20 people, creating a secure and exclusive place for training. They usually have a fixed timetable and quite a strict booking system. Prices can vary from £20 to £30 per session. As many studios are opening at the moment, every studio is trying to be as exclusive as possible, offering unique classes which are great for the user.

Hiit

Yes, HIIT training is still very big in the UK!

What is it? High-intensity interval training is one of the most popular training styles to lose fat. HIIT trend started back in 2014 and now it is so popular that almost every gym offers a class.

HIIT class includes very fast pace followed by slow pace interval. These classes are very popular at lunchtimes as they usually last only for about 20-30 minutes. I usually incorporate HIIT Style in my workouts. And most of my clients find it the hardest part of the workout!

Fitness Trackers

It all started with £2 pedometers and progressed to £10000 diamond encrusted iWatches!

Wearable technology got extremely popular this year in the UK. Probably every other person has got one. It comes in different sizes, colours, shapes and technical profiles.

British people are obsessed with sharing their progress with friends as well as challenging each other. This is a great way to be fit and motivated. Some bands or watches will send you a reminder if you have been sitting for too long. I always recommend my clients to get one to stay on top of their fitness.

Races

While obesity alarm rises really high, the UK is trying to fight this really hard! This year, particularly, it has been really active regarding races. Charities, companies, schools, universities, associations and communities are pulling themselves together and organizing group events. From 3km walks to triathlons, we’ve been busy! Being a part of a running club or getting ready for a fitness event is now extremely popular. It’s so much easier to get motivated when you are in a group with others. People are encouraged to also involve their family and friends. Even sedentary people are trying to get involved.

Why not start with something along the lines of a 2k walk for your favourite charity? Doing things for a particular purpose really motivates people. Personally, I love this new trend.

Personal Training

As a personal trainer in the UK, I’ve learnt quite a few things throughout the last years. I can confidently say that fitness and exercising have become a really big trend in the recent years. With so much information available online people sort of became confused and started seeking professional help and advise.

Personal training is really big at the moment in the UK. You can hire a personal trainer to come to your home or any desired location including parks and squares. Some PTs do not train outdoors or do not travel – they have a base where they work from, like an exclusive personal training studio or a simple public gym.

Personal training is a luxury service and can be very pricey. Making sure that you have the right trainer is very important! My advice is that you do your research and go through a couple of consultations before signing up.

The 24h Gym

You might be wondering who would be going to the gym at night… You might actually be surprised!

The 24hour gym can get very busy during the night hours. Many night goers are students as well as shift workers. When for some people it seems like madness to train in the middle of the night, for others this is the only way they can fit in a workout within their busy schedules. You should be aware that most 24h gyms are unsupervised during the night and for security reasons changing rooms might be locked.

Unfortunately, there are no classes available during the night and I’m not sure if there are any PTs who would be willing to work at night. You might want to make sure that you have a workout plan in place. You can easily find a 24h gym near you. They are very popular in suburban areas within cities.

Online Training

The growing popularity of social media has had a huge impact regarding online training and its development. A lot of personal trainers and coaches are calling themselves ‘influencers’ and ‘online couches’. Online personal training is very ‘price-efficient’ but it comes with its cons too.

Usually, online personal training means that the trainer is sending you a monthly programme, which means no face-to-face training. Do you really have to rely on your own expertise for correct posture whilst performing exercises?

Some trainers offer nutrition supervision along with the exercises. Doing good research is highly recommended here. Not all online trainers actually hold a fitness qualification. Some of them have just been training for years themselves and therefore think that they can also train others.

Be very careful and make sure your online coach not only looks good but do actually know what they’re talking about. Ideally, they would have fitness qualifications, talk to them and ask them where do they get their knowledge from. You want to make sure you’re in the hands of a professional when it comes to training and your health.

Conclusion

So many fitness trends around might leave you feeling confused… You might want to know where to start, so I’ll give you very simple but helpful advice.

Experiment and find what works for you in terms of your body and mind. Some people might like classes because it feels like working as part of a team. Others prefer personal training because they’re working on a one-to-one basis. Endurance training or HIIT training can be a good mixture to start with if you like cardiovascular activities.

A lot of my clients now want to concentrate on the way they move as well as getting rid of pains and aches. If you can feel that your posture is not correct or you’re having chronic pain then it might be good to start with some mobility work.

Sometimes not being part of the trend is also a good thing. As long as you can find what suits you, you should not feel the need to follow something just because it is popular!

About Justina

Justina Triasovaite is a certified female personal trainer in London and also runs justinatraining.com, a site with useful information for those who are interested in general fitness and body transformation. A committed health and fitness fanatic, Justina is very passionate about helping people transform their lives.

The content is the views of the author. Does not repesent the perspective of Lifestyletodaynews.com

GREEN LIVING, HOME

What happened when fashionable footwear became common in Kerala?

August 1, 2018 Ancy Abraham Leave a comment

I don’t know when footwear became so common in Kerala. Because if you google ‘Kerala 1970’ or ‘Kerala 1975’ you will see that there are very few images of people in footwear. But one thing is sure that before the 90’s Keralites used to buy only water resistant rubber or plastic footwear.

In Kerala rain is unpredictable and in the bygone days, people had to walk a lot. There was no way to protect the shoes from getting wet. So in earlier days, people used to buy, water-resistant, rubber or plastic chappals.

And there was no compulsion for children to wear shoes to school because rain is unpredictable in Kerala.

When we went for the vacation during our childhood, to Kerala, we used to carry clothes that dry fast, and water-resistant footwear.

In the 1980’s, for instance, there were fewer private transports. People had to walk for 15-20 minutes, mostly on unpaved roads, to reach the bus stops. On rainy days there were potholes and puddles. That required durable footwear rather than fashionable footwear.

Since water resistance and design does not go together it was hard to find fashionable footwear in Kerala. If someone wore a fashionable shoe all eyes would be on those shoes.

From the 90’s there was an emerging fashion sense of footwear. Pointed and flat heals have become common. Sneakers and leather shoes are used as daily wears in the rain prone Kerala

Nowadays, everyone has a collection of shoes for various occasions. Yes, they own a pair of shoe for the rain too. But not the lacklustre plastic or rubber chappals of the yonder years. Now there are fashionable rainy shoes. And durability is not the issue. What is more important is the good looks.

The 90’s is an important time period because it was in 1989 that an ad company gave Kerala the tile of ‘God’s own country’. The title changed the image of Kerala. And slowly Kerala became one of the sought after tourist destinations in the world. 1990 was also the beginning of globalisation and privatization.

A large number of Keralites started travelling aboard for work. People started getting exposed to other culture and there was more income. Also, a growing number of Indian and foreign tourists were visiting Kerala.

Keralites whether they were in Kerala or abroad, got exposed to other cultures. Cultural shock was reduced. The quality of life improved for Keralites. There were changes in the dressing also. Half sarees and sarees were replaced by salwar kameez. Rubber and water resistant plastic footwear were replaced by leather and designer footwear.

Own vehicles to travel

When you wear costly leather shoes, that can get spoiled in rain. Naturally, your concentration will be towards protecting the shoes from the rain. Most Keralites own vehicles like a car or a two-wheeler. Now there is no need to walk to the bus stands.

Front yards paved with tiles

And the front yards are decorated with paved tiles. So there are no more puddles in front of the house. You can walk on the tiled pavements which are attractive and prevent the shoes from getting soiled.

Waterproof Houses

The houses and public buildings are now built rainproof. Not a single drop of rainwater enters the houses. And the car parking is covered. you can get into the car without the shoes and clothes getting wet in the rain.

No space for rainwater to penetrate underground

The worrying factor is that when you cover the ground in front of your house with tiles, you are not allowing the rainwater to penetrated underground. When we use engineering and design to beautify the surrounding and protect ourselves from rain, do we play a role in the flood that hit Kerala?

Watching rain without getting wet

Before 1990’s people did not like to visit Kerala during the rainy season. Because the rain hampered the tour programme. But now people enjoy coming to Kerala because they can watch the rain, without getting wet, by sitting in the balcony or while travelling in an Airconditioned Car.

We think of rain as a spoiler when we visit Kerala to enjoy the lush green landscape. We forget that rain is responsible for the lush green landscape.

Building boundary walls, blocking rainwater

We build boundary walls around our property without leaving an outlet for the flood water to drain. In this way, we are preventing the rainwater from flowing and draining into the rivers.

Building houses inspired by the West

When we model our houses like those in Western countries, we must understand that those countries do not get rainfall like Kerala. When we build houses and public buildings, we must take into consideration the geography of the area.

What are the possible solutions?

Do not build houses on paddy fields

During this flood, many people were complaining, in television interviews, that the flood water cannot drain into the rivers or seas because their route is blocked by the manmade constructions. Some houses are built on the paddy fields, whereby the flood water cannot go underground in those places.

Do not block the route of the rainwater

There is a saying in Hindi “Paani apna rastha nahi bhoolta”. Which means water does not forget its route. If the water knows the way, the human being in the area also must be knowing the way the rainwater flows to drain in the river or sea.

Ensure that rainwater is able to penetrate underground

When we construct roads and houses, or hardscape the front and back yards, we must ensure that the rainwater is given its due space to seep underground or flow into the river.

Do not ignore rain and rainwater

We cannot live in Kerala by ignoring the rain. If there is too much rain then there is the flood. If there is a scarcity of rain then there is drought. A few months ago Kerala government was planning to produce artificial rain by cloud seeding because of the scarcity of water in some regions.

The manmade constructions are one of the many reasons for the flood. If we make some correction in the constructions of houses and public building, and it’s surroundings, we can prevent flood to some extent.

There is a saying in Malayalam, “Annaan kunjum thannaal aayathu.” which means “every little help”. The proverb comes from the story of the little squirrel that helped Lord Rama in building the bridge. Lord Rama blessed the squirrel by stroking on the back. Which caused three striped to form on the squirrel. And Lord Rama said that the service of the small one also matters in the completion of a big project.

I feel that our houses are the smallest block of development in Kerala. We must provide options in our homes for rainwater harvesting and also for the excess water to flow into the river. Our small action helps in increasing the water table levels in our area.

In television interviews, you can see the flood victims blaming the government. We forget that we are also part of the Government. Some things we can also do. Instead of waiting for the Government to do something, we must take ownership of developing our village in an environment-friendly manner.

We are indebted to nature. In a State like Kerala, which is Nature’s bounty, you cannot ignore Nature and her fury and carry on development.

In this flood, the water was around 5 ft high. A bigger flood had happened in 1924. The flood which is known as the great flood of 99 Malayalam Era (ME) is said to have risen to 12 ft. The flood killed thousands and washed away a rail line. Even in that flood the reason for the flood was said to a manmade construction – the breaches in the Mulleperiyar dam.

Find a rain friendly fashion

Nowadays we wear leather chappals that get spoiled in rain. And jeans that take a long time to dry. We must find an alternative fashion which is rain friendly. The design of our homes and garments must be rain friendly. We must enjoy getting wet and dirty in the rain.

When in Kerala blend with rain

When you are in Kerala, instead of finding methods to protect yourself from rain, blend with nature. Give rain the utmost priority in all your activities.

FITNESS

10 reasons Why you must bicycle today, on world’s first ‘World Bicycle Day’

June 3, 2018 Ancy Abraham Leave a comment

Today, June 3 has been declared as, the first, ‘World Bicycle Day’ by the UN. According to the UN declaration, one of the benefits of cycling is that “the synergy between the bicycle and the user fosters creativity and social engagement and gives the user an immediate awareness of the local environment”.

There is more to Cycling………….

Cycling is beneficial in improving your health, reducing pollution and increasing your understanding of your surrounding.

Feeling One with Nature

The oneness that you feel with nature is unique and cannot be experienced by using any other means of transportation. You cannot feel the experience even by walking.

Science-fiction are just fictions

We read so many science-fiction about the future where people will be far-removed from nature. They live in a technological habitat, surrounded by the gadgets and with little interaction with nature or fellow humans. Go cycling to change your perception. Man can coexist with nature even when they are immersed in technology.

Return to Nature

Now there is a change in perception. People are understanding the importance of Nature. There are many ‘back to nature’ and ‘sustainable development’ activities. The interest that people show in the kitchen garden, home cooking and nature tours are an indication that we understand that for the existence of the human species we need to live in tandem with nature.

Striving to Co-Exist

Understanding nature and striving to co-exist with the natural environment is a necessity. Nowadays most of us take a break from our city life, permeated by technology, and travel to places that are almost untouched by the automation.

Balancing Nature and Technology

We go back to nature because we know nature has much to offer to our existence. We get rejuvenated in our health by spending some time with the environment. We tend to be more creative when we are closer to nature. Preserving the environment is a selfish need of the human species. So we have the Nature movements and the Sustainable development models.

Cycling for Sustainable Development

When you cycle you will feel the breeze. You will see all the flora and fauna and humans around you. As you are travelling in the open space, not in a closed vehicle, you will feel one with nature. That feeling of oneness is the beginning of your positive outlook towards the environment and other species.

Feel the Surrounding

Yes, you can feel the nature with your five senses. When you travel in a car you are in a closed environment and artificial air conditioning.

Less pollution

There two types of pollution that happen when you Cycle. Since Cycle does not run on fuel, you are saving the environment from gas emitted from fuels. On the other hand, your body becomes more immune to pollution. Your lungs and internal organs are healthier because of more intake of oxygen.

According to the UN cycling has ‘has a positive impact on climate”. If more people use cycle then there will less pollution.

Health Benefits

When you cycle your cardiovascular fitness increases. There is the movement of joint and muscular flexibility. A number of diseases are prevented or becomes less severe by cyclings like diabetes, some cancers, arthritis and diseases.

Perfect transportation during traffic jams

On a day when there is a traffic jam, you can speed through the traffic. There is o excuse for being late to work.

In many countries, there are depots where you can rent a cycle and go the office. There is the twin benefit; you are following a fitness regime on a working day as well as having a pollution free commutation.

According to UN “The bicycle can serve as a tool for development and as a means not just of transportation but also of access to education, healthcare and sport”.

Enjoy bicycling today and share your experience in the comment box.

HEALTH

Alternative ayurvedic treatment for Knee Replacement

April 24, 2018 Ancy Abraham Leave a comment

There is a general perception that Ayurvedic treatments are for rejuvenation, or ‘to get refreshed’. And not for treatments like knee replacement. However, in my recent visit to an Ayurveda hospital, I discovered that ayurvedic treatments heal several diseases.

Many patients, who were rejected by the mainstream doctors, found successful recovery through ayurvedic treatments for diseases like cancer, skin diseases and knee replacement surgeries. Today I would like to share some of the anecdotes about patients. They came there in search of alternative ayurvedic treatment for knee replacement.

ayurvedic treatment for knee replacement

They came in search of a last resort to escape undergoing knee replacement surgery, or to escape the huge financial expense incurred in the surgeries.

Forty years of knee osteoarthritis and still going strong

A nun used to take care of the elderly during her younger days. She used to carry the bed-ridden old people on her shoulder. As a result, she developed pain in her knees when she was around 40 years old. She consulted an orthopaedic doctor and he said that he can only prescribe painkillers for this disease so she should better go for ayurvedic treatment.

So she consulted an Ayurveda doctor and started taking ayurvedic internal medicines and external oil application. Only after she turned sixty, she opted for complete ayurvedic therapy of three weeks followed by 45 days of internal Medicine and oil massage.

Every five years she undergoes the three-week massage therapy that includes various bolus applications administered by masseurs. Now she is above eighty and she is as active as an eighty-year-old should be. She says her timely switching to Ayurveda saved her. She has witnessed many of her friends, who did not treat the disease properly, die of arthritis and rheumatic pain.

Saved the money

A fifty-year-old man, instead of depositing Rs 4 lac for knee replacement surgery, consulted a doctor friend who in turn introduced him to an ayurvedic doctor. The doctor prescribed weeks of ayurvedic therapy followed by 45 days of internal medication and external oil application. After three months of ayurvedic treatment, he completely recovered with no requirement of knee surgery.

Knee replacement postpone for 5 years

A sixty-eight-year-old lady when recommended to undergo knee replacement surgery consulted the ayurvedic doctor. The ayurvedic doctor also recommended knee replacement surgery. But the lady did not have a huge amount to spare so she wanted to undergo Ayurvedic treatment so that she can postpone the surgery for some more time. After undergoing the ayurvedic treatment, the doctor has guaranteed her another five years without going under the knife.

A US journal, Arthritis and Rheumatology, has found that 30% of the knee replacements in the US might have been unnecessary. In India also the condition doesn’t seem to be any different. Consulting an ayurvedic doctor before going for a knee replacement surgery may save money. Also, will help in escaping from going under the knife.

FITNESS

EMS technology for complete health and fitness

March 16, 2018 Ancy Abraham Leave a comment

To remain fit and healthy one needs to exercise regularly and maintain a healthy diet and in addition use gadgets like EMS technology. In India, 90% of the population do not follow any health and fitness regime or a healthy diet, although, we are aware of the benefits of exercise and diet.

But we are unable to follow a health and fitness regime for a long time. There are many reasons to why we cannot follow a fitness regime:

India is not a sporting nation.
Health and fitness come last our list of priorities of our daily routine.
Most people leave early in the morning for office and come late in the evening, so there is the time constraint.
Exercise and walks make you feel tired, thereby making you cut short some other daily routines.
There is no time to exercise after the daily chores.

Benefits of EMS fitness training

EMS technology, used at ZYNK Fitness Studio, gives you fitness and health by just working out for 30 minutes, every week, in their fitness studio.

How the EMS technology works

Electro Muscle Stimulation (EMS) technology stimulates the muscles in the body just as in workouts. The movement of the muscles, known the contraction, wherby the fitness achieved from exercise depends on the number of contractions of the muscles. The EMS technology used at Zink produces 3600 contractions in 30 minutes , a task not achieved even by two hours of Gym exercise.

In a normal gym routine, on every done by the muscle the message reaches the brain. Thus the process becomes tiring. In the EMS technology, every contraction produced by the electrode is effective as 10 contractions in a normal gym workout. By the time the information of one contraction reaches the brain, the muscle has already done 10 contractions with the EMS. Therefore we feel relaxed while doing an EMS fitness routine.

The Zynk fitness trainers say that during a normal gym routine some of the muscles do not get exercise. But in EMS training, 90% of the body muscles are activated.

The person is made to wear a specially made jacket with EMS electrodes. The size of the jacket varies from person to person. The EMS used at Zynk fitness is wireless.

Who can do the workout using EMS

Athletes

This technology has been used by professional athletes like Usain Bolt, Karim Benzema, and many others. Athletes do EMS training for more strength, more endurance, more speed and more flexibility. EMS shot into prominence when YohanKots, a Soviet Scientist, revealed that EMS could boost strength by up to 40% in elite athletes.

Weight loss

According to Vani Trivedi, of Zynk Fitness, “For 48hours after workout body in on a weight loss mode.” With a proper diet and EMS training, you can lose weight in 90 days.

Sitting job complications

For those who suffer from neck and back pain due to continuous sitting jobs, EMS therapy is very effective. EMS technology used in rehabilitation and training for people under physiotherapy.

Post pregnancy

EMS helps to tone the body and helps achieve the original weight and tone. It supports the regeneration of deep muscle fibres and connective tissues affected by pregnancy.

Benefits of using EMS

All areas of the muscles are covered

In the gym, all areas are not covered. But with EMS 90% of the muscles are covered. Electrode works all over the body.

Improves skin tone

EMS is very effective for skin. The skin glows after undergoing the training. As one gets older skin gets sagging, and it not toned and tight. Your skin tone improves with EMS training.

Keeps you young for longer

Growth hormones are responsible for our looking younger. Celebrities do botox to look younger. By EMS training you can boost growth hormones well. It will keep you younger for longer.

Keeps you fit and healthier

When you age, size of bone gets weaker and smaller. EMS does systematic work of bones and muscles and not joints. You feel oiling happened in every bone. Every bone feels fresh and light. Therefore your confidence increases.

There is an overall improvement in health and fitness because of deep tissue strengthening, improvement in the cardiovascular system and improvement in blood circulation.

Why at zynk Fitness?

There are over 1000 similar centres around the world, this is the first EMS fitness studio in India. You can workout without being tired. Even after having a long day’s works you feel rejuvenated after the Zynk fitness training.

Besides if you come for the Zynk fitness session before going to the office, you can have a shower and look fresh. As there is negligible sweating you feel relaxed after the workout.

The is no pain of exercise and you do ten times more of fitness training. The trainers at Zynk say that EMS works on the muscles and bones, and not on the joints. Injuries happen when there is overload on the joints.

According to the Zynk fitness trainer, the EMS workouts produce long-lasting results using simpler workouts.

FITNESS, HOME

What is the behavioural approach used in ADHD? (ADHD Part -IV)

October 2, 2017 Ancy Abraham

What is the behavioural approach used for treating ADHD?

The behavioural approach, for instance, is to increase the attention span of the child. In mild to moderate only behavioural management is needed. It could be in the form of a game, depending on the age of the child. Depending upon the developmental level of the child we give them tasks to improve their attention skill:

Games and Activities

We prescribe certain games and activities where the child can sit and persist with the task. That will improve the child’s attention span.

At School

For the classroom instruction, we sometimes give a letter to the teacher suggesting where he should be seated. The teacher should have proximity to the child. Seat given to the child should not be near the window side, door side or outskirts. The child should be given aisle seat so that he can have eye contact with the teacher. These will help him focus on activities in the classroom. The teacher should be monitoring the child so that his attention doesn’t wander. They should examine the notebooks frequently so that the books are complete. The child should be called his or her name. If he is called by his name, his attention span will persist.

Appreciation and Rewards

The parents and teachers are instructed to reward the child whenever he behaves well. Usually, his hyperactivity or impulsive behaviour is judged as indiscipline in the school. He is scolded and not much of positive comments are obtained by the child. Parents and teachers are asked to look out for even the smallest good behaviour. He must be praised and rewarded with gifts. He must be given small responsibilities in the class like carrying the books to the staff room so that he feels that he is worthy. In this way, his behaviour is likely to improve.

At home

Parents are asked to give clear instruction to the boy to keep his shoes, bags and toys in its proper place. Thus his life will become more structured. Whenever he complies with the parents’ expectation of the kind of behaviour they expect from him he can be rewarded.

Nurturing their Abilities

When we assess the child we assess their potential. Some of them are good at sports. So encouraging them in sports is part of the behavioural therapy. Some may be good in arts or electronics, so channelizing their ability will help them.

‘Time Out’ Method

Parents are trained to deal with impulsive behaviour. Sometimes they have to set limits when the child is exceeding certain limits. In very severe situations parents may be asked to keep the child in a room so that anger comes down. It is not a punishment but a principle of ‘time out’. This principle has to be applied only sometimes.

Dr. Varghese Punnoose specilaised in Child Psychiatry. He is an MBBS and MD in Psychiatry from Government Medical College. He is currently Professor and Head of Department at Government Medical College, Kottayam, Kerala.

He authored a book ‘Manorogangal’, in malayalam, about Pshycatric disorders. There is one chapter on ADHD also.

Is Medication for ADHD (Attention Deficit Hyperactivity Disorder) child necessary? (ADHD Part -I)

What is ADHD (Attention Deficit Hyperactivity Disorder)? (ADHD Part -II)

How ADHD is diagnosed?(ADHD Part -III)

HEALTH, HOME

How ADHD is diagnosed?(ADHD Part -III)

October 2, 2017 Ancy Abraham Leave a comment

How is ADHD diagnosed?

On a simple physical examination, you will not find anything abnormal. MRI or CT scan will not show any abnormality. If you do a functional brain imaging you may find that these circuits are dysfunctional.

A simple physical examination will not reveal anything abnormal.

Usually, we do not diagnose ADHD when the child is 3 or 4 years unless it is a very severe condition. We wait till the child is 5 or 6, by the time the child will go to school and some external discipline will come.

Who Defines criteria for Diagnosis of ADHD?

Authorities like International Classification of Diseases (ICD) by World Health Organisation (WHO), American Psychiatric Association(APA) and Diagnostic and Statistical Manual of Mental Disorders(DSM) are the world authorities that define criteria for diagnosing ADHD.

What is the process of Diagnosis?

Diagnosis of ADHD is not based on any laboratory test. We do not have a lab test or a scan to Diagnose ADHD. It is based on the history provided by the parents and teachers and the direct observation of the child by a trained professional. It is a clinical diagnosis. Functional brain imagery is available only in research labs.

What is the next step after ADHD is diagnosed?

So once you diagnose ADHD, the next step is to educate the parents and teachers. We take collateral information from teachers also. In our centre, there is a form called ‘teacher’s observation report’ about the child. The teacher fills information about child’s behaviour in school and class. We also ask them to bring their notebook because that may show some careless mistakes which are common in ADHD.

Parents and teachers might think that the child is only an indisciplined, overprotected and pampered child.

We collect information from other sources if available. All those assessments are taken into account and if the assessment satisfies for ADHD, we teach and educate the parents about the problem. And after completing the assessment we talk to the parents. We need to educate the parents. They might think that the child is only indiscipline, overprotected and pampered child. We talk about options to manage the problem. And see whether he is able to cope with the management procedures.

When do you finally Confirm that a child has ADHD?

We have to check for any medical conditions that are like ADHD. For instance, some may have epilepsy or anaemia. So there has to be a physical examination. The next step is to examine for some conditions that occur with ADHD. For instance dyslexia, a specific learning disorder (SLD) which is known as a learning disorder.

There are two approaches to manage the disorder- behavioural approach and pharmacological approach.

Almost two-thirds of the children with ADHD also have SLD along with it. ADHD is rated as mild, moderate and severe depending on the number of symptoms present and the functional impairment it produces. Mild cases may not require medication. In moderate and severe cases the option of medicine is given to the parents.

What are the procedures to manage the disorder?

After all the assessment we call a section once again with the parents. Education is given to them, explaining the problems and giving them management options.

We teach the parents, give suggestions to the teacher and encourage the child is the behavioural components of ADHD.

There are two approaches for managing the disorder – behavioural approach and pharmacological approach.

Dr. Varghese Punnoose specilaised in Child Psychiatry. He is an MBBS and MD in Psychiatry from Government Medical College. He is currently Professor and Head of Department at Government Medical College, Kottayam, Kerala.

He authored a book ‘Manorogangal’, in malayalam, about Pshycatric disorders. There is one chapter on ADHD also.

What is ADHD (Attention Deficit Hyperactivity Disorder)? (ADHD Part -II)

October 2, 2017 Ancy Abraham Leave a comment

What is ADHD (Attention Deficit Hyperactivity Disorder)?

Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder. Some say that there is no such disorder, which is incorrect. It is a worldwide accepted condition. It is a brain development disorder occurring in about 5 to 7 percent children.

It is a brain development disorder occurring in about 5 % to 7% children.

In certain brain development disorders, the physical features are visible. In Cerebral Palsy and Down Syndrome, for instance, the physical features are evident and hence these are accepted as real disorders. But, when you look at a child with ADHD they may not have any visible physical anomaly. And therefore it is not recognized as a medical condition. The behavioural manifestation of ADHD could be passed on as a naughty behaviour of a normal childhood, or even smartness. In these children there are no physical abnormalities, they have behavioural problems.

What are the mental functions that are affected in ADHD?

Attention deficit

The ability to focus attention is the function of the brain. As far as a school child is concerned he should have approximately 30-40 minutes of attention span. There should be a coordination of eyes, hands and mind. Brain should be able to focus these functions. That varies from person to person, but with children with ADHD, attention holding function is very grossly impaired.

What happens is that the child will not be able to persist with the task. In the classroom, he will not be able to pay attention for a long time, and this will affect his academic performance.

Hyperactivity

Generally, a five or six-year child is able to sit quietly and keep calm when they are engaged with some serious activities. But children with ADHD will not be able to control their action. They will be very fidgety, restless, squirming on the seat and moving around. In addition to the distractibility, if the student is restless he can disrupt the whole class. The energy might be considered as the smartness of the child; however, it is an illness. It is “Disruptive” overactivity. Normally school going children are active and exuberant. That is not hyperactivity. Disruptive overactivity is called hyperactivity.

In addition to the distractibility, if the student is restless he can disrupt the whole class. The energy might be considered as the smartness of the child; however, it is an illness. It is “Disruptive” overactivity. Normally school going children are active and exuberant. That is not hyperactivity. Disruptive overactivity is called hyperactivity.

Impulsivity

Impulsivity means they are unable to hold their responses. Whenever they are angry they may use bad words. They may be talkative in class and they may find it difficult to wait for their turn in group activities. They may blurt out answers even before questions are finished. They are unable to hold their emotions. Impulsivity can land them in trouble.

When attention deficit, hyperactivity and impulsivity combine that produces this syndrome called ADHD.

What can be the reason for ADHD?

The exact reason cannot be pointed out. The genetic factor could be a reason for ADHD. Many parents say that the father also was hyperactive in his childhood, but in those days, no one realized that it was ADHD. Nobody is sure why it happens in some children.

Nobody is sure why it happens in some children. Basically, there could be some genetic influences.

Basically, there could be some genetic influences. It could be some infection or toxins that the mother carried when she was pregnant. Many a time we are unable to pinpoint that this is the cause, but these are the possibility. Scientific research has shown that the circuits in the brain that control the motor activity – brain circuits which control the impulsive reactions – these circuits are dysfunctional.

Dr. Varghese Punnoose specilaised in Child Psychiatry. He is an MBBS and MD in Psychiatry from Government Medical College. He is currently Professor and Head of Department at Government Medical College, Kottayam, Kerala.

He authored a book ‘Manorogangal’, in malayalam, about Pshycatric disorders. There is one chapter on ADHD also.