Guillain-Barré syndrome (GBS) is a rare neurological disorder in which the body’s immune system mistakenly attacks part of its peripheral nervous system, that is, the network of nerves located outside of the brain and spinal cord. From very mild cases with brief weakness to critical stages of paralysis that can cause a disability to breathe independently, patients can face a wide range of complications with GBS.

It has been observed that Guillain-Barré syndrome is a potentially serious hurdle associated with Covid-19 today. Many patients developed the GBS three weeks after testing positive for Covid-19. As Covid-19 is also a viral infection caused by a neurotropic virus, it can trigger this syndrome in a patient. The increase in Covid-19 cases has significantly resulted in many Guillain-Barré syndrome cases. People within the age group of 25 to 35, and 50 to 70 are most commonly affected.

It is essential for family members to keep a watch out for any of the symptoms.

Below are the indications:

1. Pricking or pins and needles sensations in the hands and feet

2. Instability and lack of coordination

3. Difficulty swallowing, speaking or chewing

4. Muscle twitching

5. Vision and eye muscle difficulties

6. Abnormal heartbeat/rate or blood pressure

7. Problems with digestion and/or bladder control.

As soon as a person notices any signs of Guillain-Barré syndrome, he or she should see a doctor for a definitive diagnosis. Early detection can aid in the treatment process and make it easier. A neurologist (a specialist who specialises in nervous system illnesses) will be involved in the treatment and may perform certain tests like nerve conduction studies (NCS) electromyography (EMG) that measures the electrical activity of nerves and muscles, lumbar puncture (spinal tap) and analysis of spinal fluid, along with breathing and blood tests.

1. Patients demonstrated considerable improvement after five days of IVIG treatment and plasmapheresis

2. If ventilator assistance is required, the patient must be admitted to an intensive care unit

3. It has also been observed that there is a residual disability at the time of discharge

Here is a list of do’s and don’ts if you are diagnosed with GBS:

1. Do understand that Guillain-Barré syndrome can be devastating because of its sudden and unexpected onset

2. Do realise that recovery isn’t necessarily quick. It might take a few weeks, sometimes months, or even years to recover from GBS.

3. Do call your health care provider if you notice muscle weakness

4. Do call your healthcare provider if you develop numbness or tingling feelings, have trouble swallowing or breathing, feel depressed or get a fever

5. Don’t be afraid to ask for social and emotional support

6. Don’t miss any follow-up appointments after being discharged from the hospital

It is essential for people to be aware of this syndrome as the diagnosis becomes more challenging when the patient visits the hospital at later stages for treatment. More awareness can indeed save lives.

The writer is a Consultant – Neurologist and Stroke Physician, Manipal Hospitals, Malleshwaram.

When a seemingly innocuous virus entered the city of Wuhan in the last month of the last decade, nobody could predict that the whole world would be paralysed for the next entire year and more! Moreover, the ordeal is far from over and the medical and healthcare fraternity world over is still struggling to find the viral antidote, pinning all the hopes on the highly anticipated vaccine. However, with the collapse of the conventional medicinal system, the general population has realised that a sturdy immune system is the best defence against any pathogen and to achieve this, natural health alternatives are being explored vigorously. 

The oldest of all medicinal systems, Ayurveda, has proved its mettle in the pandemic already! Under the guidance of the AYUSH ministry, many Ayurvedic institutions throughout the country have shown excellent results in the management of Covid-19 infections, both in acute and post-Covid phases. Numerous trials are going on and the results look promising.

The science of life, Ayurveda, has generated enormous curiosity in the last few years and many people have shifted to the Ayurvedic way of living and managing disease as it is holistic and believes in reversing the pathology without any side effects. The two-folded aim of Ayurveda is ‘prevention’ and ‘cure’ for which discrete guidelines are given in the stipulated clinical texts about aahar (healthy eating), vihara (healthy lifestyle), nidra (sleeping habits), dinacharya (daily regimen), ritucharya (seasonal regimen), and various treatment modalities incorporating scientific nutrition, thousands of herbo-mineral formulations and detoxifying treatments such as panchakarma.

With the advent of the pandemic can Ayurveda turn this opportunity and redeem itself to its lost glory? Let’s explore in this article:

1. Preventive holistic aspect of Ayurveda in the pandemic – Cellular health support, Immune health support, neuroendocrine support, Nutritional support through phytonutrients

2. Covid-19 and effective Ayurvedic protocol – no side effects, decongestant and lung-protective medications, cardioprotective, immunomodulator, cellular repair, mental support, Rasayan therapy etc. There are numerous successful trials throughout the country.

3. Change in societal perception about health and disease – Recent awareness about the rise and prevalence of metabolical and lifestyle disorders like obesity, diabetes, hypertension, hypercholesterolemia etc and the limitations of conventional medicine to treat them, whereas Ayurveda successfully managing and reversing them.

4. Governmental recognition and approval – The current government with its pro-Swadesi approach has renewed its efforts in reinforcing the traditional Indian medical system. Ayurveda is being given a crucial place in the annual health budget and rigorous steps are being taken to integrate Ayurveda in the present healthcare infrastructure at the ground level.

5. Rise in popularity outside India – Worldwide, Ayurvedic medicine and products are increasing in popularity. Many students have been coming to India in recent years to learn Ayurveda and practice and propagate it back in their countries.

6. Rise in demand for Herbal supplements – With health and wellness being the biggest priorities now, the demand for nutraceuticals and immunity boosters is globally increasing. Many companies like Patanjali and Himalaya have given reports of a phenomenal rise in sales of immune-boosting supplements and respiratory medication. 

7. Refurbished standardisation protocol of Ayurvedic medications and supplements – There have been tremendous upgrades in the standardisation protocols for Ayurvedic medications and nutritional supplements making them safer for a bigger audience and an easy entry into the global market. The required regulations are under the FSSAI, FDA, Good Manufacturing Practices (WHO-GMP), ISO 9000 and Hazard Analysis and Critical Control Points (HACCAP) certifying boards.

8. India as an emerging leader in the global herbal drug market – India is currently the number 1 producer, manufacturer and exporter of herbal raw material and end products. Even the modern pharma industry relies largely on the herbal raw material supplied by India for its active ingredient extraction that is used in numerous modern medications. 

9. Vast scope for the investment in Ayurveda – Multisectoral industries like health, pharma, food, agriculture, media and trade are renewing their investment interests in Ayurveda looking at the current growth patterns in the market trends. 

10. Rediscovering and redefining marketing strategies – All that Ayurveda needs right now is an on-point marketing strategy to reach the masses and the capitalists. There have to be scientific studies, researches and relevant clinical trials that can show the documented potential of Ayurveda to the world. The preventive aspect of Ayurveda should reach the common stakeholders through proper educational channels and the various treatment modalities within Ayurveda should be researched and re-established through relevant institutions and hospitals making it easier for the common man to embrace Ayurveda. 

 The writer is the Founder of Nyrrvana Cosmetics.

Covid-19 was not known to affect children in the first wave. However, it has not been the same in the second wave, as children and youngsters have been affected by the coronavirus. Though they are experiencing mild or moderate symptoms of the infection, post-Covid complications are what worry the parents. 

COVID-19 AMONG CHILDREN

Adults were mostly affected by Covid-19 in the first wave. The immediate lockdown and closure of schools helped children to skip Covid’s radar. Though few children got infected, the symptoms among them were mostly mild or were asymptomatic. However, in the second wave, the number of children getting infected due to coronavirus has increased. The most concerning part are the increasing cases of MIS –C (Multi-system inflammatory syndrome in children). 

MIS-C IN CHILDREN

Children affected by Covid-19 in the second wave are experiencing mild or moderate symptoms. However, post their recovery from Covid within two to four weeks or in few cases even beyond, they are found to develop high-grade fever and other complications which are known as MIS-C. This Multi-system inflammatory syndrome in children affects multiple organs like the heart, lungs, and brain. A child can experience different symptoms like:

• Rash on the body

• Conjunctivitis

• Abdominal pain 

• Swelling in the neck

• High-grade fever

• Diarrhoea 

• Vomiting

• Feeling tired 

Some of the severe symptoms of the MIS-C could be trouble in breathing, pain or pressure in the chest, pale, grey or blue-coloured skin, lips, or nail beds, and severe abdominal pain. In few children, these symptoms may go to an extent of seizure or septic shock. 

MIS-C mostly affects children after two to three weeks of testing positive for Covid-19. It is to be noted that, MIS-C is not a life-threatening condition and can be treated effectively if it is identified early. MIS-C is considered as an immunological reaction to a past Covid infection. Children with the condition may commonly test negative for RT-PCR/antigen test and will only be antibody positive. In one-third of infected children, MIS-C can mimic another disease called Kawasaki Disease associated with inflammation of the blood vessels to the heart. While most children with MIS-C recover extremely well with no significant long term sequelae, a small proportion can develop complications related to the heart.

MIS-C can occur in children of any age, however, it is mostly seen in kids in the age group of 3 to 12 years. Babies or older children may also have the risk of developing MIS-C. 

COMPLICATIONS OF MIS-C

MIS-C is a complication that occurs due to Covid-19. Therefore, identifying the symptoms is crucial. A delay in treatment or inappropriate management can lead to severe problems to the vital organs like the heart, lungs, and kidney. In rare cases, MIS-C can lead to permanent damage to the organs or could be even fatal. 

STEPS TO BE TAKEN TO KEEP THE CHILDREN AWAY FROM INFECTION: 

• Hand hygiene –Ensure kids wash hands often with soap and water for at least 20 seconds. If soap is not available, use a hand sanitiser with at least 60% alcohol content.

• Keep children away from people who are sick –It is suggested to keep children away from unwell people, in particular, people who are coughing and sneezing. 

• Social distancing – Ensure that your child maintains social distancing when outdoors. 

• Wear face masks when in the outdoors – There is a high risk of Covid transmission when you and your child are outdoors. Make sure both of you wear a face mask that covers both nose and mouth. 

• Avoid touching your nose, eyes and mouth – Encourage your child to follow your lead and avoid touching his or her face without washing hands. 

• Cover your mouth when you sneeze or cough – Advise the kids to practice covering their mouths when they sneeze or cough to avoid spreading germs.

• Disinfect surfaces –Clean and disinfectareas of your home such as doorknobs, light switches, remotes, handles, countertops, tables, chairs, desks, sinks and toilets.

The writer is a Consultant, Columbia Asia Referral Hospital, Yeshwanthpur (A unit of Manipal Hospitals).

The pandemic can be overcome only with herd immunity — which is achieved either by everyone suffering from the disease or some suffering from it and others getting immunity from the vaccines. Ultimately when 80% of the population has either antibodies from natural disease or vaccination — we can beat the pandemic by herd immunity. To achieve this, vaccine uptake by susceptible individuals is crucial. 

Vaccine hesitancy, also known as anti-vaccination or anti-vax, is a reluctance or refusal to be vaccinated or to have someone dependent vaccinated — is becoming a problem especially in the middle of this pandemic, which can delay our fight against the pandemic.In fact, hesitancy has led to a decline in vaccine uptake and an increase in the prevalence of vaccine-preventable diseases. The Covid-19 pandemic has created a new reality where individuals are facing a previously unknown disease and its effects, providing a unique opportunity to investigate vaccine attitudes during a period of heightened disease salience. Unfortunately, there are always going to be some people who will have anxiety and uncertainty with vaccines leading to vaccine hesitancy  — but some people have been misguided to become hesitant to vaccinate due to a lot of mis/disinformation.

Vaccine Politics as I call it — for lack of better words — is politics behind the vaccine for Covid-19. If you carefully analyse the events that took place over the last 16 months, vaccine politics has played a significant role in vaccine hesitancy. Be it discrediting vaccines, spreading rumours to fuel vaccine hesitancy, frequently changing position on the vaccine distribution process, deliberately asking for the vaccine to be ‘opened up for all’ despite knowing the government was following a scientific order of priority, everything possible has been done to harm India’s vaccination drive. 

At the international level, initially, the Pfizer-Biotech vaccine was licensed in the US — as an emergency use authorisation for political reasons way ahead of schedule than completion of the trial. The initial reports of the adverse effects of the vaccine being highlighted led to a lot of conspiracy theories and vaccine hesitancy. Subsequently, AstraZeneca vaccine faced the wrath of many European countries — for all wrong reasons — as the UK had ordered enough doses first they were supplied first — leading to sanctions/highlighting the adverse effects of clotting — which affected 1:6,00,000 population as opposed to Covid-19 disease itself affecting 1:40 people. Now, in turn, the EU is trying to penalise AstraZeneca by not recognising it as a valid vaccine, especially if it is produced outside the EU? 

At the national level, we saw how the Covaxin licensing controversy initially led people to abandon it, as they felt it was “imperfect vaccine” being hastened in licensure due to its “Made in India” issue. It was not until Covieshield (AstraZeneca) controversies in Europe — people started embracing Covaxin after that. This continued for some time and confused people. At the state level, there were accusations that BJP and non-BJP states are being discriminated against with the supply of Covaxin vs Covieshield that further confused people.  At the district/hospital levels, there were accusations that corporate chains got more vaccines allotted for various reasons than nursing homes which subsequently meant the government took control of the vaccine distribution and effectively issued a new policy from 21 June 2021.

India launched the world’s largest vaccine drive earlier this year. But even before the rollout could take place, the country witnessed many efforts that began to spread vaccine hesitancy, confuse and mislead the public about the vaccination process. In fact, after months of deliberation and discussions, the government’s advisory group for vaccines has allowed pregnant women to get jabbed. It took almost seven months, precisely on 2 July, to release an operational guideline for vaccinating pregnant women. It included details on educating them about the risks from the vaccines vs the risks of being Covid-positive. Those eligible will be able to get any of the three vaccines currently authorised in India — Covishield, Sputnik V or Covaxin. In my view, vaccinations are among the most important public health tools for reducing the spread and harm caused by dangerous diseases. Despite considerable evidence showing vaccines are safe there is increasing scepticism towards vaccination.

WHY VACCINE HESITANCY 

Here are some reasons behind vaccine hesitancy:

1. There are too many rumours about vaccine efficacy. Rumours are nothing but information that is either inaccurate or accurate – with a twisted meaning used in a different context and circulated within a network of people. Ex: Last year, so much information was circulated on social media around steam inhalation + vitamin D, and zinc supplements that it became a standard of treatment by many doctors, many not realising that zinc and vitamin D toxicity could be harmful too. Overuse of steam, inhalation has been blamed for the spread of black fungus by damaging the mucous membranes of people.

2. Misinformation – Inaccurate information. Ex: Last year before the first wave affected India, so much information was propagated about BCG and MMR protecting Indians against Covid-19 that many people came to get BCG and MMR done, only to realise that it was not correct.

3. Disinformation – The misinformation that is specifically designed to achieve an agenda. Ex: A lot of homemade drops and other unproven therapies were being projected as treatments for Covid-19 without proper studies. Ex: Ghee drops into nostrils.

4. Infodemic – What’s happening currently on many WhatsApp groups — an overabundance of information, including mis/disinformation — accompanying this pandemic. Ex: There is so much information recommending steam inhalation, vitamin C, and zinc supplementation — that almost everyone is doing it. This is similar to Hydroxychloroquine prophylaxis last year and the information was so strong that almost everyone took these to “try and protect” themselves.

5. Heuristic behaviour – Heuristics are commonly defined as cognitive shortcuts or rules of thumb that simplify decisions, especially under conditions of uncertainty. They represent a process of substituting a difficult question with an easier one. Ex: The repeated news that certain vaccines can cause a clot in the brain, without mentioning that it is rare and Covid-19 can cause that in 1:40 people, led people to avoid the vaccine.

All these issues led to already confused/infodemic loaded individuals with more confusion and vaccine hesitancy.

WAY FORWARD 

Public health leaders may wish to tap medical providers to herald in more vaccine-positive messages, the data showed. Across both vaccine-hesitant and vaccine-enthusiastic adults, clinicians will prove to be the most trusted advisor on the matter. Many hesitant people have high levels of trust in their healthcare providers, which underscores how crucial it is for clinicians to reach out to patients — especially those who have been most impacted by Covid-19 — to explain the benefits of vaccination. We need to continue to ensure that vaccination efforts shall continue to scale up in the weeks ahead and it’s critical that people receive accurate information from people they trust. Our country should adopt a multi-modal communication approach. Very few people in India have access to good quality and affordable healthcare. Many of the vaccine-hesitant adults don’t have a usual source of care (personal clinicians) and many of them are not even insured. We need more targeted outreach so that the benefits of vaccines can be understood.  

Herd immunity is the most decisive route to freedom from Covid-19. Thanks to the unprecedented efforts of the scientific community, we finally have a solution: safe and effective vaccines. Experts are estimating that up to 90% of the population need to have antibodies to achieve herd immunity. To reach it, we must see society trusting medical professionals and governments to accept vaccination. We need greater transparency on data and consistent messaging on safety.  Despite the science, there is still a section of society that perceives vaccination to be a bigger threat than Covid-19. And India is full of quacks, a lot of people depend on the knowledge of these quacks and suffer. As the Covid-19 pandemic continues to surge worldwide, recent approvals of Covid-19 vaccines raise hope for a light at the end of the long and dark tunnel. In my view, Covid-19 vaccination programs can affect meaningful resolution only with sufficient participation rates to achieve herd immunity. 

The writer is Founder Chairman & Neonatologist, Cloudnine Group of Hospitals, Bengaluru. He is also a healthcare delivery graduate from Harvard Business School.

About a few years back, the only conversation that was happening around menstrual hygiene was about the performance of the sanitary pads/napkins. All the big FMCG brands, that are still the biggest brands in India, were talking about parameters like absorption capacity, length of the sanitary pad, dryness of the pad, so it was all performance-based. Everything in performance was indirectly related to a brand offering something that will prevent staining. With modern start-ups entering the menstrual hygiene space, the conversation has radically shifted from performance to comfort. Women started asking if performance guaranteed comfort. Since then, a lot of startups have started offering natural sanitary pads, nobody was talking about natural and organic sanitary pads before, because the conversations earlier were not on comfort, but now the discussions are also on what is my pad made of, how comfortable am I feeling while I am wearing it, how soft it is, do I feel like I’m wearing a diaper? While it prevents staining, but am I really comfortable doing my everyday work wearing it, moreover is it rash proof? 

Another major observation that perplexed me and was one of the main reasons I started this company is the whole convenience aspect of using period products and nobody was talking about that. And as I said earlier, it was all about performance, but women wondered about the post-use convenience, disposal aspects. Also, these days there is a lot of focus on product packaging and providing a holistic experience to the end-user. With the new entrants, brands have become conscious and are striving to deliver an overall experience. The shift has also been to make sure that the customer experience is at par with other personal care products that the customer is using because she’s a young, mature woman making better choices for her body and the brand needs to deliver an experience that stands and pairs with her lifestyle. 

One more significant change that we are observing today is that personal hygiene is no longer limited to sanitary pads; people are exploring many more options to take care of their menstrual hygiene, which is directly related to the fact that women are becoming more knowledgeable or conscious about menstrual hygiene. Pantyliners, tampons, menstrual cups, and intimate cleansers, were all non-existent more than a decade ago. Today, however, women are actively seeking information on these products, reading up on them, trying them and asking questions about them, so it’s not only about sanitary pads, women are actively looking for better options, more convenient and comfortable solutions. Sustainability is not a new concept, but sadly, few individuals in India base their purchasing decisions on picking a product because it is sustainable. While sustainability isn’t a deciding factor for many women today, it has become a criterion that women are becoming more cognisant of.

Even though many women seem to be hesitant to try this because of the mental barrier, the concept of inserting something inside the vagina is a daunting task. Conversations around period positivity are catching up actively through multiple initiatives on various platforms aimed at creating awareness about the menstrual cup which can be cleaned and reused. To build a society that is more inclusive and kinder, it is important to raise awareness on issues that are important to women. Menstruation is one such subject that doesn’t get the attention it deserves. Apart from the societal taboos associated with menstruation, menstrual hygiene products do generate a lot of plastic waste that is detrimental to the environment. Hence, we need to choose wisely.

The last thing that I would like to point out is that this segment specifically was restricted to the offline space, no education, no awareness, just selling your products. All the education and awareness was just on product features and performance. But today with consumers demanding information and awareness, not just on the product but how can I take care of my body. With access to social media, information on Google, YouTube, Instagram, Facebook, brands are adopting a strategy of education on menstrual hygiene and we can see that consumers are relating more with brands who are actively contributing to awareness, not just to the product but also overall issues like why does heavy bleeding happen, what is the menstrual cycle, what are causes of concern, what are issues like PCOS, PMS, etc. Brands that are actively engaging in distributing information like this, making their consumers more aware about all these issues, nobody was talking about PMS and PCOS even though one in every five women in India goes through it in India. There is a very high percentage, 50% to 70% of women are facing PMS symptoms and nobody is talking about it. So the whole game has shifted from just selling the product to offering transparency and awareness and actively educating consumers. People have also started associating more with brands that are actively contributing to this information and being more transparent and taking initiatives to make the consumers aware and speak in a way that’s bold and relatable and not hushed. This also propelled the brands in the FMCG space who are not focused on digital at all to actively start doing campaigns on empowering the users and telling users it’s not something to hide.   These have been some of the major changes in the women’s hygiene space over the last decade and it’s great to see women embracing their bodies and wanting to understand the other aspects of menstruation as opposed to just worrying about the performance of their period product.

The writer is Founder & CEO, Carmesi.

Monsoon is cherished by people as it brings that much-needed relief from the scorching heat. But, with the monsoon season, not just rain, even notorious eye infections such as conjunctivitis, dry eyes, and stye will be at one’s doorsteps. Here, personal hygiene can play a vital role in managing eye infections. Don’t forget to follow these essential tips to take care of your peepers. 

The eyes are one of the vital and sensitive organs of the body that are prone to infections in the rainy season. Enjoying the monsoon and getting drenched is blissful, right? However, the monsoon season brings along a plethora of infections and diseases as the air becomes a commuting medium for bacterias and viruses. Along with waterborne diseases and allergies, even eye infections can steal your peace of mind. Neglecting eye hygiene can turn into a nightmare for you.

Beware of these common eye infections during monsoon

You will be shocked to know that conjunctivitis (pink eye) is an inflammation or swelling of the conjunctiva (the transparent membrane covering the outer surface of the eye and the inside of the eyelids) commonly seen during monsoon. It is an infectious disease and spreads from one person to person due to increased moisture in the air. The symptoms of conjunctivitis are redness of the eye, swelling, discharge, eye itching, and pain. The moisture content in the air during monsoons creates a favourable condition for the viruses to grow and multiply, and one may get a corneal ulcer that is the wound on the surface of the cornea. The symptoms are red eyes with eye discharge, and blurry vision. When the eyes are not able to provide adequate moisture owing to insufficient tears then the eyes can become dry. It happens because of the dust and pollutants during the monsoon. A stye is a bacterial infection seen in monsoon and can be worrisome. Don’t delay in seeking the treatment once you notice these eye problems.

Make sure that you prioritise your eye health and follow these vital tips during monsoon:

• Wash your hands and avoid hand-to-eye contact to keep eye infections at bay. Do not rub your eyes with your fingers as they contain germs and can lead to an infection.

• One should avoid using common towels, napkins, or handkerchiefs to clean their eyes as could lead to conjunctivitis.

• One using the lenses should clean them frequently, wipe the spectacles with a clean cloth and use eye drops on the recommendation of doctors.

• Avoid rubbing the eyes, regularly wash your eyes with the help of cold water to protect them from dust particles.

• Avoid eye make-up if you are having eye pain or an allergy. 

• If you notice unusual symptoms such as blurriness, itchiness, and eye pain, avoid using over-the-counter medication and consult the doctor.

• Blinking often will help you keep the eyes feeling fresh, clean, and hydrated and tackle dry eyes problem. Drink plenty of water, and follow the 20-20-20 formula that is after every 20 minutes, take a 20-second break to focus the eyes on something 20 feet away to relax your eyes.

• Debris in the eye can irritate the eye and invite infections, use glasses when exposed to wind or dust.

• Wearing contact lenses without cleaning causes major eye infections during the monsoons. Clean them properly before wearing and carry an extra pair when you are out. Do not share your lenses with anyone.

• Avoid using a swimming pool during monsoon as doing so will raise your risk of bacterial eye infections or use an eye mask while swimming.

The writer is MS Ophthalmology, Apollo Spectra Karol Bagh, Delhi.