People mostly like to have a gleaming white smile, not just for the perfect picture but also because it’s considered healthy. Various studies have suggested that whiter teeth not only help in boosting confidence but also give a competitive edge in job interviews.

Recently in India, the demand for teeth whitening has increased many folds. Growing awareness of oral hygiene, easy availability of teeth whitening OTC products, are some of the driving factors which are propelling the teeth whitening market. Sharing his views on the same, Dr Mohendar Narula, Founder, MyDentalPlan said, “We have seen a considerable surge in demand for teeth whitening services recently. With increased social media exposure and dental care awareness post Coronavirus is pushing Indians to focus on teeth whitening.”

He further added that “at least 7 out of 10 Indians have searched for teeth whitening clinics on our platform with the majority of them being adults or from the working class.” Stating the low cost of dental whitening in India, as the other reason for increased demand for teeth whitening, he said, “India offers the best dental whitening services at a nominal cost across the globe.”

The occurrence of stains and discolouration in teeth can be attributed to an increase in prolonged smoking habits, tobacco and alcohol consumption, unhealthy food habits, and higher fluoride concentrations in community water supplies.

While they are the most evident cause of stains on our teeth but they are not the only reasons. Some of the foods that we love such as coffee, colas, and even red wine can cause teeth to discolour.

Now, there is another reason that is being added to this long list, which is Coronavirus. People who have recovered from the infection have shared stories of how their teeth or gums weakened, with many complaining that their teeth have become discoloured post-infection.

There is a whole range of products that are available in the market that claim to make teeth pearly white again. However, most of these are only a temporary fix and even harm the gums and erode the teeth’ enamel. A more permanent solution that experts recommend is teeth whiting.

In teeth whitening, the colour of the teeth is lightened using only chemicals (bleach, hydrogen peroxide) or in combination with radiation (UV light or lasers). The whole process is carried out by the professional taking care that it causes minimal harm to the enamel and the gums.

Before starting with teeth whitening, it is recommended to get teeth properly cleaned and polished. It is also recommended to remove plaque and debris from the enamel and bleach to smooth the teeth surface as that helps in getting a better outcome.

Dr Mohendar Narula shed more light on the process and said, “Professional way for teeth whitening is getting them bleached in the dental clinic. The dentist applies whitening gel on the teeth surface and by using a special light or laser, the teeth get lighten by 6-8 shades. Generally, the complete process is into multiple visits and the objective is to provide best results keeping the teeth and enamel intact.”

Dr Narula added, “Another way of attaining whiter teeth is at-home bleaching. For this, the dentist fabricates customised dental trays that the patient wears at home after applying the whitening gel for a prescribed duration that lightens the teeth by three to four shades”.

It is a big myth that teeth whitening is a waste of time and money or that it can cause great harm to teeth. If done under the supervision of experts, it can help people achieve great results. In addition to this, maintaining good oral hygiene practices and regular professional dental cleanings every six months can preserve a long-lasting smile.

A new study has found that eating a diet rich in vitamin K can lower the risk of atherosclerosis-related cardiovascular disease (conditions affecting the heart or blood vessels).

The findings of the study were published in the ‘Journal of the American Heart Association’. Researchers examined data from more than 50,000 people taking part in the Danish Diet, Cancer, and Health study over 23 years.

They investigated whether people who ate more foods containing vitamin K had a lower risk of cardiovascular disease related to atherosclerosis (plaque build-up in the arteries).

There are two types of vitamin K found in foods we eat: vitamin K1 comes primarily from green leafy vegetables and vegetable oils while vitamin K2 is found in meat, eggs and fermented foods such as cheese.

The study found that people with the highest intakes of vitamin K1 were 21 per cent less likely to be hospitalised with cardiovascular disease related to atherosclerosis.

For vitamin K2, the risk of being hospitalised was 14% lower.

This lower risk was seen for all types of heart disease related to atherosclerosis, particularly for peripheral artery disease at 34%.

ECU researcher and senior author on the study Dr Nicola Bondonno said the findings suggested that consuming more vitamin K may be important for protection against atherosclerosis and subsequent cardiovascular disease.

“Current dietary guidelines for the consumption of vitamin K are generally only based on the amount of vitamin K1 a person should consume to ensure that their blood can coagulate,” said Dr Bondonno.

“However, there is growing evidence that intakes of vitamin K above the current guidelines can afford further protection against the development of other diseases, such as atherosclerosis,”he added.

“Although more research is needed to fully understand the process, we believe that vitamin K works by protecting against the calcium build-up in the major arteries of the body leading to vascular calcification,” explained Dr Bondonno.

University of Western Australia researcher Dr Jamie Bellinge, the first author on the study, said the role of vitamin K in cardiovascular health and particularly in vascular calcification is an area of research offering promising hope for the future.

“Cardiovascular disease remains a leading cause of death in Australia and there’s still a limited understanding of the importance of different vitamins found in food and their effect on heart attacks, strokes and peripheral artery disease,” said Dr Bellinge.

“These findings shed light on the potentially important effect that vitamin K has on the killer disease and reinforces the importance of a healthy diet in preventing it,” he concluded.

NEXT STEPS IN THE RESEARCH

Dr Bondonno said that while databases on the vitamin K1 content of foods are very comprehensive, there is currently much less data on the vitamin K2 content of foods.

Furthermore, there are 10 forms of vitamin K2 found in our diet and each of these may be absorbed and act differently within our bodies.

“The next phase of the research will involve developing and improving databases on the vitamin K2 content of foods. More research into the different dietary sources and effects of different types of vitamin K2 is a priority,” said Dr Bondonno.

Additionally, there is a need for an Australian database on the vitamin K content of Australian foods (for example, vegemite and kangaroo).

To address this need, Dr Marc Sim, a collaborator on the study, has just finished developing an Australian database on the vitamin K content of foods which will be published soon.

The research is part of ECU’s Institute of Nutrition Research. It was a collaboration with researchers from the University of Western Australia, Royal Perth Hospital, Herlev and Gentofte University Hospital in Denmark and the Danish Cancer Society Research Centre.

A recent study has linked weight fluctuations–or body mass index variability — to higher risks of cardiovascular-related problems and early death in adults with chronic kidney disease (CKD).

The findings of the study appear in the journal ‘JASN’. Body mass index variability is associated with higher risks of developing heart conditions in the general population.

Because cardiovascular disease is the leading cause of death in individuals with CKD, a team led by Dong Ki Kim, MD, PhD, Sehoon Park, MD, and Kyungdo Han, PhD examined whether BMI variability may affect the prognosis of patients with kidney dysfunction.

The study included 84,636 patients with CKD who were listed in a national health screening database in South Korea. During a median follow-up of four years, 6% of individuals died, 4% needed kidney replacement therapy such as dialysis, 2% suffered a heart attack, and three per cent suffered a stroke.

Compared with individuals with the lowest body mass index variability, those with the highest body mass index variability faced a 66% higher risk of dying, a 20% higher risk of needing kidney replacement therapy, a 19% higher risk of experiencing a heart attack, and a 19% higher risk of experiencing a stroke.

“This study showed that people who had kidney function impairment with recent fluctuating body mass index had a higher risk of cardiovascular disease or death, regardless of their current body mass index,” said Dr Kim, of Seoul National University Hospital.

“This result suggests that people with kidney function impairment should pay attention to their fluctuating weight status, and those with fluctuating weight may benefit from receiving appropriate screening and risk factor management to prevent cardiovascular disease or progression of their kidney dysfunction,” added Dr Kim.

The results were similar in the subgroups divided according to positive/negative trends in BMI during the exposure assessment period.

In addition, variabilities in certain metabolic syndrome components were also significantly associated with the prognosis of predialysis CKD patients.

Furthermore, those with a higher number of metabolic syndrome components with high variability had a worse prognosis.

‘If you have a healthy immune system but administer a trigger too soon after the first infection, your immune system will not respond as effectively as it should. Delaying it too long, on the other hand, may result in re-infection, which could be fatal. As a result, it’s best to get vaccinated three months following the initial infection, because infection during this time isn’t deemed dangerous’, AIIMS Trauma Centre Chief Dr Rajesh Malhotra explains when asked about the optimal time for vaccination of Covid recovered patients.

Following are a few snippets from the discussion with Dr Malhotra:

Q.What is the co-relation between Covid immunity and the vaccination?

The level of immunity is different in each individual and the robustness of the response may vary across ages, comorbidities, sex, etc. Natural infection mounts immunity and vaccination but the immune response mounted by the vaccine is much more robust because the infection manipulates the immune system to thrive in the body, as per a study conducted by a University in London. 

People who developed immune response after getting infected by SARS in 2003 carried circulating Antibodies in their bodies in 2020. Therefore, some people may carry the immunity against coronavirus for a lifetime whereas some may get reinfected due to their weak immune system. Another cause for recurrence is the variant, which goes unidentified by the body. The third reason could be if a person’s immune system is fully compromised and has got the persistent infection for months together, the virus inside his body may mutate and come out as a variant which can cause a reinfection. Fortunately, these possibilities are rare.

Q. Can someone who has developed a mutation spread the infection while in the recovery stage?

A healthy person can recover from Covid in 14-17 days but may spread a virus that is dead cannot multiply. On the other hand, an immunocompromised person who has a virus multiplying in his body can spread a live virus. They may also land up with a mutant due to its prolonged stay because it is a known fact that mutations occur during the prolonged stay of a virus.

Q. What should the immunosuppressed person do in such a condition?

They must wear a mask at all times as they may shed mutants. Secondly, they must get vaccinated and if they are vaccinated, various agencies have recommended a booster response to control the infection. But the most effective way out is early administration of monoclonal antibodies which can mitigate the persistence of the virus and also the emergence of the variants in their bodies. They should also be isolated from their family members and the family should be vaccinated which will cause an important epidemiological intervention.

Q. Is it the right approach to get vaccinated right after the recovery?

The right approach is to get vaccinated which reduces the risk of infection by half. The period between two infections is roughly around a hundred days which means that the safe time to get vaccinated is within three months of recovering from the first infection.

I would not worry about antibodies in immunocompetent people. The other fact that people forget is that T-Cells are the most important among the four forces that fight the infection (Antibodies, B-Cells, T-Helper Cells, and Killer T-Cells), while antibodies are only ammunitions.

Q. Are you saying that a recovered Covid patient need not get an antibody test right away and can wait 90 days before getting vaccinated?

There are no such drugs that can counter the virus, just some drugs that reduce replications. If you have a competent immune system and give a trigger too early after the first infection, the response will not be as robust as intended. On the other hand, delaying it too long may cause re-infection that may be fatal. Thus, it is ideal to get vaccinated after three months of the first infection because having an infection in this period will not be considered harmful.

Q. Everyone is talking about the third wave. What is the status actually, is it still impending or is it already here?

The pandemic has not checked off. Secondly, the virus has not been conquered. There is always a risk that it could come back in a way that it could escape the immune system and the vaccination. The UK and US are going through the fourth wave, Japan is going through the fifth wave while many countries like South Africa and Bangladesh are suffering from the third wave. Many states of India, like Kerala, are already going through the third wave. Think globally, nationally, and locally. Every area and state needs to have its own plan of action but keep a check on what is happening in other nations and learn from their experience. Nobody should feel secure depending on the number of cases in their states and the strategy should be locally relevant.

Q. Is the healthcare infrastructure of India prepared to face a similar number of cases like the second wave?

I would agree that each hospital is better prepared because there are very competent healthcare professionals in our country. Every state is making a position for ICU care, thrust on pediatric care and augmenting their healthcare infrastructure. 

Herd immunity is being approached, which is why we may not have such a huge surge. We were caught off guard during the second wave because, after the first wave, serosurvey showed high seropositivity. Firstly, since we did not have vaccines at that time, the natural immunity weened off gradually. Secondly, the variant emerged causing a huge distinction between the first and second waves. 

On the contrary, now we have vaccines as a boost. The variant strain will be kept in mind. A lot of people who are vaccinated or immune due to the previous infection can develop asymptomatic or minimally symptomatic re-infection and thus become spreaders. Hence, it is being insisted to follow the Covid protocols.

Q. How important it is for children to get vaccinated?

We keep on saying that this virus will eventually become endemic like HIV AIDS. Its mortality will reduce. In the coming times, children will get Covid vaccination like any other vaccine. About now, only children with serious comorbidity should be protected. It is now being said that the Delta variant is as contagious as chickenpox or measles and as you know children cannot comply with masks in schools or social distancing. They may therefore spread it rapidly among themselves and people as well, which is why we are encouraging vaccination among children. Although, the mortality is very low among them.

‘If you have a healthy immune system but administer a trigger too soon after the first infection, your immune system will not respond as effectively as it should. Delaying it too long, on the other hand, may result in re-infection, which could be fatal. As a result, it’s best to get vaccinated three months following the initial infection, because an infection during this time isn’t deemed dangerous’, Dr Rajesh Malhotra explains when asked about the optimal time for vaccination of Covidrecovered patients.

Following are a few snippets from the discussion with the AIIMS Trauma Centre Chief:

What is the co-relation between Covid Immunity and the vaccination?

Dr. Rajesh Malhotra: The level of immunity is different in each individual and the robustness of the response may vary across ages, comorbidities, sex, etc. Natural infection mounts immunity and vaccination but the immune response mounted by vaccine is much more robust because the infection manipulates immune system in order to thrive in the body, as per a study conducted by a University in London. 

People who developed immune response after getting infected by Sars in 2003 carried circulating Antibodies in their bodies in 2020. Therefore, some people may carry the immunity against coronavirus for a lifetime whereas some may get reinfected due to their weak immune system. Another cause for recurrence is the variant, which goes unidentified by the body. Third reason could be if a person’s immune system is fully compromised and has got the persistent infection for months together, the virus inside his body may mutate and come out as a variant which can cause a reinfection. Fortunately, these possibilities are rare.

Can someone, who has developed a mutation, spread the infection while in recovery stage?

Dr. Rajesh Malhotra: A healthy person can recover from Covid in 14-17 days but may spread virus which is dead cannot multiply. On the other hand, an immunocompromised person who has virus multiplying in his body can spread live virus. They may also land up with a mutant due to its prolonged stay because it is a known fact that mutations occur during the prolonged stay of a virus.

What should the immunosuppressed person do in such a condition?

Dr. Rajesh Malhotra: They must wear mask at all times as they may shed mutants. Secondly, they must get vaccinated and if they are vaccinated, various agencies have recommended a booster response in order to control the infection. But the most effective way out is early administration of monoclonal antibodies which can mitigate the persistence of the virus and also the emergence of the variants in their bodies. They should also be isolated from their family members and the family should be vaccinated which will cause an important epidemiological intervention.

Is it a right approach to get vaccinated right after the recovery?

Dr Rajesh Malhotra: The right approach is to get vaccinated which reduces the risk of infection by half. The period between two infections is roughly around hundred days which means that the safe time to get vaccinated is within three months of recovering from the first infection.

I would not worry about antibodies in an immunocompetent people. The other fact that people forget that T-Cells are the most important among the four forces that fight the infection (Antibodies, B-Cells, T-Helper Cells and Killer T-Cells), while antibodies are only ammunitions.

Are you saying that a recovered Covid patient need not get an antibody test right away and can wait 90 days before getting vaccinated?

Dr Rajesh Malhotra: There are no such drugs that can counter the virus, just some drugs that reduce replications. If you have a competent immune system and give a trigger too early after the first infection, the response will not be as robust as intended. On the other hand, delaying it too long may cause re-infection that may be fatal. Thus, it is ideal to get vaccinated after 3 months of the first infection because having an infection in this period of time will not be considered harmful.

Question: Everyone is talking about the third wave. What is the status actually, is it still impending or is it already here?

Dr Rajesh Malhotra: Epidemic has not checked off. Secondly, virus has not been conquered. There is always a risk that it could come back in a way that it could escape the immune system and the vaccination. UK and USA are going through fourth wave, Japan is going through the fifth wave while many countries like South Africa and Bangladesh are suffering from third wave. Many states of India, like Kerala are already going through the third wave. Think Globally, Nationally and Locally. Every area and state needs to have its own plan of action but keep a check on what is happening in other nations and learn from their experience. Nobody should feel secure depending on the number if cases in their states and the strategy should be locally relevant.

Is the healthcare infrastructure of India prepared to face the similar number of cases like the second wave?

Dr Rajesh Malhotra: I would agree that each hospital is better prepared because there are very competent healthcare professionals in our country. Every state is making position for ICU care, thrust on pediatric care and augmenting their healthcare infrastructure. 

Herd immunity is being approached, which is why we may not have such a huge a surge. We were caught off guard during the second wave because after the first wave, serosurvey showed high seropositivity. Firstly, since we did not have vaccines at that time, the natural immunity weenedoff gradually. Secondly, the variant emerged causing huge distinction between the first and second waves. 

On the contrary, now we have vaccines as a boost. The variant strain will be kept in mind. A lot of people who are vaccinated or immune due the previous infection can develop asymptomatic or minimally symptomatic re-infection and thus become spreaders. Hence, it is being insisted to follow the Covid protocols.

How important it is for children to get vaccinated?

Dr Rajesh Malhotra: We keep on saying that this virus will eventually become an endemic like HIV AIDS. It’s mortality will reduce. In the coming times, children will go for Covidvaccination like any other vaccine. About now, only children with serious comorbidity should be protected. It is now being said that Delta variant is as contagious as chickenpox or measles and as you know children cannot comply with mask in schools or social distancing. They may therefore spread it rapidly among themselves and people as well, which is why we are encouraging vaccination among children. Although, the mortality is very low among them.

Change is the only constant that drives our life towards growth. Looming in the coronavirus pandemic, the healthcare system of India has been on a transformative journey over the last couple of years. The competency of healthtech proved itself for the first time during the pandemic. When hospitals and local clinics became life-threatening zones due to skyrocketing Covid cases, the people who were suffering from other illnesses turned to telehealth.

When people were locked in their homes, fighting their own battle against all those pathogens, the healthtechsector attempted to connect them with the fragmented medical community. The fact that India is the 3rd largest smartphone market in the world has been a big support for the healthtech system to grasp a strong foothold. The current significant role played by digital devices in people’s lives became the means to reimagine a virtual healthcare management system. The ever upgrading digital healthcare is completely revolutionizing the healthcare system for the betterment of people and the nation as a whole.

The patient-centric approach

The on-demand healthtech system has made people more oriented towards their health. With all their health data at their fingertips and the option to consult doctors online — anytime, anywhere, people have become focused on self-care more than ever. There is a noticeable decline in the number of cases where patients would avoid consultation, as now it can be arranged as per their comfort.

The 24/7 availability of doctors is now enhancing the scope of preventive care while minimizing the chances of diseases reaching their severe stages. With patients becoming more conscious of the quality and cost of healthcare, hospitals and other healthcare providers have begun to emphasize delivering more personalized treatments.

Expanded reach of the healthcare

Limited medical facilities and insufficient manpower had always forced patients from remote areas to travel to metropolitan cities in search of quality treatments. The huge crowd in the premises of AIIMS hospitals has been a clear proof.

Healthtech has strengthened the care delivery system in such rural areas where doctors’ availability was a huge challenge. It has prominently improved the situation for patients who are aged or suffering from chronic conditions by furnishing in-home patient monitoring services. Additionally, technology has also been a boon for doctors, from the standpoint of obtaining case management support by specialists. One-click case history of patients is the easiest means to share data and get suggestions from peers.

Sensors, wearables, and implantables came with the biggest advantage

These electronic devices help doctors monitor patient health and keep track of vital signs via smartphoneconnectivity. Empowering medical professionals to keep a real-time update on a patient’s situation and providing timely remote care has been a successful change for the healthcare industry.

AI is shaping the future of medicine

Human intelligence has come together with artificial intelligence to create a healthcare system that releases the burden of doctors from administrative tasks and promotes precise diagnosis. Complimenting the efforts of doctors, AI-enabled care helps to define and decide the treatment regimes for patients suffering from complex diseases. The databases generated out of the entire AI integrated system have the potential to shape the foundation of predictive healthcare.

The present growth of the telehealth sector is just the beginning of many more advancements which are yet to revolutionize the healthcare industry.

Docty, a Telehealth Startup is helping people access integrated healthcare — regardless of their geography, through online consultations. Keeping the patient’s safety at core, this platform aims to strengthen the three pillars that are the biggest concerns of our healthcare system, i.e., Availability, Affordability, and Accessibility.

Improving transparency while maintaining quality healthcare has been the motto of this data-driven human-centric telehealth platform. The purpose is to serve convenience in healthcare appointments and digitizing records. With a customizable search function, the portal allows patients to explore and find the best-suited doctor for themselves instead of compromising with the locally available medical professionals. Docty has embraced the smarter way of healthcare and it has been an uphill climb of success for its users as well as the doctors associated with the platform.

Dr Priti Shukla (MS, MCH, Plastic Surgery) is the founder of Hyderabad’s Ambrosia Clinic, and a perpetual user of the Telehealth App, Docty