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November 6, 2019 By Dr. Viral Thakkar Leave a Comment

Stroke: A Few Untouched Aspects

Stroke is the sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is lost by blockage or rupture of an artery to the brain. According to the WHO, it is the second leading cause of death and the third leading cause of disability. Stroke is also a leading cause of dementia and depression. For commonly known causes of stroke, please refer to the article “Stroke: Straight Dive or Pavilion” published earlier. While you might have read a number of reasons which lead to stroke, this article focuses on the importance of emotional health to prevent stroke.

There Are 2 Main Types of Stroke

Hemorrhagic Stroke: is caused by bleeding in the brain due to a weak spot in the wall of the vessel, which can cause an aneurysm (bulging of the vessel wall). The vessels can also be weakened by chronic or very high blood pressure and break from force. When the vessel breaks, blood leaks into surrounding tissue, and the brain doesn’t get the oxygen and nutrients it needs.
Ischemic Stroke: results from blocked arteries, which often occur from cholesterol build-up, called plaque. Plaques on the inside of the vessel can be fragile when blood flows past, causing the plaque to lift. But in the blood vessel, when a plaque lifts-up and the body tries to heal it, like it would scab on your arm, it makes a clot where that plaque lifted up, which blocks blood flow and can lead to ischemic stroke.

The human body is magical. When the mind perceives a threat or stress, the body releases cortisol and adrenaline to cope with it. These hormones impact the homeostasis of the body; the other parameters get deranged and affect the healing processes of the body. Now, if your personality is to take constant stress, cortisol and level of other stress hormones will be high to ensure the body deals with stress. This could cause retention of salt which might increase blood pressure. Stress also causes an increase in blood sugar, which means the vessels can’t dilate or contract to better control blood flow. Increased cortisol is also known to disrupt sleep cycles leading to fatigue.

Anyone Can Be At Risk…

…for many reasons, not just stress. Sometimes, it just how your body responds.

While there is no concrete reason to state that positive emotions, a stress-free life or a balanced psychological state will not lead to stroke. However, there are numerous research studies to indicate that there might be a relationship between negative emotions, stress & stroke. In my practice, I have usually seen stressed people holding negative emotions fall prey to issues like stress, heart ailments, etc. A University of Michigan study found that men who were more physiologically reactive to stress were 72% more likely to suffer a stroke.

Regardless of how your life or your job is, if you feel you are stressed, you most probably are.

If you’re still unsure, ask yourself these questions:

Does your significant other tell you, you seem stressed?
You tend to pick up fights and arguments with your family and co-workers more than normal?
You resort to alcohol, drugs, smoking to alleviate stress?
Do you find less joy in things that normally make you happy?
Do you find it difficult to fall or stay asleep compared to normal?
You don’t like to get up in the morning, especially on days you know you will come across stress causing situations

If the answer to the above is yes, then it’s time for you to work on yourself. Contemplate on the reason, give attention to the little things in life… It is the little things which lead to bigger changes! Some attitude changes like acceptance and forgiveness make a lot of difference!

Quick tip: Whenever you feel stress, start taking deep breaths. Mentally count till 5 & inhale, count another 5 and exhale. Make it as slow and steady as possible. Taking in more oxygen allows more oxygen to be available to the brain tissues. Some research suggests that deep breathing helps to rehabilitate the brain after a stroke. This style of breathing also helps to relax and calm the mind and whole being.

While everyone faces issues in life, it is the ability to cope with it, be in sync with one’s body which determines health!

#BeTheForce

October 23, 2019 By Vickel Dubey Leave a Comment

Understanding Patient Behaviour Towards Digital Therapeutics

Are we, as patients ready to pay for an app which is intended for Therapeutic Purpose & Helping us manage our lifestyle better?

What a Patient Thinks

Ideation of this whole article took a shape while having a discussion with my father who is a Type 2 Diabetes patient. I was actually insisting him to install an app to better manage his lifestyle specifically the dietary recommendation (Since he is a banker by profession and also manages family business, day to day life is a complete mess) given by his doctor. Initially he was in agreement but when he asked me if there is any cost associated, I nodded yes. His decision changed immediately. According to him, he knows what to eat, what not to eat and on top of it, he is taking his medication (which he often forgets) so there is no need of a digital intervention. I tried to explain to him multiple times thereafter but all in vain. According to him, it’s just a waste of money.

Patient Compliance Behaviour: Medication vs Lifestyle Recommendation

This is the story of most Chronic Disease patients for whom managing their lifestyle is a crucial need. But it’s really sad to see the poor grades when it comes to be compliant of various lifestyle aspects. According to a study conducted among Indian diabetes patients, only 24.1% were aware and have been following self-blood glucose monitoring appropriately. Similarly, only 37% of the patients are adhered to the dietary prescription made by their physicians and only 35% follow up the physical exercise recommendations.

Why is it important to talk about “Patient’s Compliance Behaviour” before getting into the “Patient’s Commercial Behaviour”? The reason is that patients need a push specifically in case of chronic diseases because it’s all about care, whether it’s done by the patient himself or by a caregiver. In case of medication, the weightage is higher since it’s coming from doctors (with serious words) while in case of lifestyle, it comes as a recommendation rather than a prescription which defines the seriousness.

So, if a patient is serious enough about his disease condition and strictly follows the testing, medication and lifestyle modification, he/she doesn’t need any intervention, traditional or digital to manage his/her lifestyle but the statistics don’t reflect the same. Hence, it becomes important for patients who are not serious or moderately serious to keep engaged and motivated to adhere with the doctor’s recommendation via a push. Digital gives that push.

Now comes the commercial behaviour. There are hundreds of apps available in the market to manage your disease conditions. Some are freely available; some are coming complementary with the devices/treatment and for some, you have to lighten your pockets. Definitely the skewness is higher towards the free ones. Most of us preferred the free apps and uninstall any paid app when it asks for a payment after the trial period. But free apps have their own limitation and for better services/attributes or features, you have to pay. Same goes with the apps which are offering lifestyle management solutions for patients.

A Preliminary Investigation

To get a deeper understanding of patient’s behaviour, I conducted a small survey among diabetes patients. The survey designed on SurveyMonkey consists of 10 questions (5 open ended, 5 close ended) and shared on a few social media & chatting platforms such as Facebook, WhatsApp etc. The key questions are:

Patient’s Name
Age
Is he a diabetic patient?
If yes, is he using any online application to manage his Lifestyle?
Name of the app he is currently using
Is it a paid app?
Approximate cost of the app.
Will he pay for an app which promises to better manage lifestyle (in case the answer of Q6 is no)?
If yes, what is the approximate cost he will pay?
If no, why?

There were 43 responses received in total out of which 32 were diabetics. The outcome of the survey are as follows:

~80% of the total respondents are within the age group of 30 to 60 years
Out of total diabetes patients, only 36% are using one or another app to manage their lifestyle
Majority of the patients are using MySugar (45%) followed by Apollo Sugar (27%), GOQii (18%) and Wellthy (9%).
Only 2 out of the total patients with diabetes who are using an app have paid some amount
The approximate cost which they have paid is ~INR 2500
77% of the patients who are using an app (and answered no for Q6) are not ready to pay even if it provides a better solution, while only 23% are ready to pay.
The approximate cost which most of the patients feel comfortable to pay is INR 100-200 per month.
Free availability, YouTube videos, Advice by friends and family, waste of money etc. are some of the major reasons why people don’t want to pay for an app.

So, if we look closely, patients are quite ignorant when it comes to pay for an app. Reason, they consider it as a waste of money. This outlook needs to be changed. This perception needs to be changed. And it can only be changed when it comes as a prescription and not just a simple recommendation.

Conclusion

If a patient can spend ~INR 9,000 (from an analysis conducted by Lady Hardinge Medical College) annually for his diabetes treatment, he can definitely spend few hundred bucks to manage his lifestyle for better outcomes. But the patient also needs support from other industry stakeholders such as Pharma, Devices and payers so that the cost can be shared and patient will have to bear minimum cost burden.

August 12, 2019 By Anu Acharya 1 Comment

Nutrigenomics and You!

There are many people who feel that they are not able to achieve their health goals in spite of a conscientious diet and fitness routine. Even regular health checks do not seem to help. Is there any method to identify and bridge the gap? Nutrigenomics is the science that looks at the interaction between our diet and lifestyle habits and how they affect our DNA in terms of regulating genes responsible for metabolism, development, and overall wellness.

Why is it Important to Understand Nutrigenomics?

Common dietary elements can act on our DNA, either directly or indirectly, to alter gene expression or structure. For example, dietary fat/carbohydrate intake affects genetic activity, metabolism rates, adiposity and thereby, a likelihood of weight gain (obesity).
Sometimes, for some of us, diet can be a serious risk factor for many diseases. For example, carriers of MTHFR gene variants may have lower enzyme activity and hence a higher risk for developing folate deficiency. In such instances, a reduced intake of Vitamin B6-containing foods may trigger clinical manifestation — screening can help implement dietary changes to manage health better.
The impact of diet on the balance between healthy and diseased states depends on our DNA. For example, variation in the SOD2 gene can alter the the antioxidant activity and increase the risk for excessive oxidative damage. Individuals who carry such variants need to ensure richer portions of antioxidants in their diet. Exercise routines can be planned with adequate rest between heavy workouts for repair/recovery.
Some diet-regulated genes (and their common variants) can affect the onset, incidence, progression, and/or severity of chronic diseases.
Chronic diseases can be prevented, mitigated, or addressed through dietary intervention based on the knowledge of nutritional requirement, nutritional status, and genotype. For example, certain gene variants can increase the likelihood of developing gluten intolerance. Genetic screening can help identify such risk factors for dietary intervention if required. This can have a positive impact on health, overall wellness, as well as athletic performance.

What Can You Learn From Nutrigenomics?

Your power to absorb vital nutrients required for a healthy body and mind
The impact of nutrients on various organs and pathways
Nutritional factors that can protect your genome from damage
Impact of genes on your lifestyle, diet, fitness, habits, etc.

When Is The Best Time To Get A Test?

The answer is NOW! Nutrigenomics are once-in-a-lifetime tests that are noninvasive. From newborns to nonagenarians, anyone can take this test. Whether you are starting your wellness journey or a veteran health and fitness expert, these tests can help you get to know yourself better.

How Can You Use It To Improve Quality Of Life?

Nutrigenomics can be the game-changer that empowers you on your wellness journey or enables you to achieve your fitness goals. Here’s how it works:

Genetic tests are available online — you order one and receive the sample collection kit, along with a health history questionnaire.
Once you send the sample, your DNA is extracted and analyzed for several key markers associated with diet, fitness, well-being, disease risk, and more.
The genetic counselor correlates genetic findings with health history to offer personalized nutrition, fitness, and wellness advice.
Your nutritionists and personal trainers can also be part of the genetic counseling session in order to design diet plans and fitness routines that work for you.

Sharing her views on the importance of Nutrigenomics, Pooja Ramachandran, India’s pioneering genetic counselor says, “The need for personalizing nutrition was seen soon after the conclusion of the Human Genome Project and the ensuing impact of personalized medicine. Nutrigenomics is poised to be a powerful tool for nutritionists, dietitians, doctors as well as any healthcare professional in using nutrition therapy for the treatment of disease. More importantly, Nutrigenomics may facilitate the prevention of diet-related diseases, and help design individualized nutritional strategies based on anticipated adverse or beneficial impacts of specific food or nutrients for a particular individual.”

August 10, 2019 By GOQii Leave a Comment

Why Fake Health News is Dangerous For Your Mind and Body!

“Eating 30 mangoes a day can cure diabetes”

“Eating 1 tsp of Methi Seeds every day for 30 days can cure diabetes”

These were some of the claims made by patients to GOQii’s very own Dr. Akshat Chadha. In fact, we even came across a 2016 article that received around 1.4 million shares on Facebook that was titled, “Dandelion Weed Can Boost Your Immune System and Cure Cancer”.

Now before you begin stuffing yourself with mangoes and Methi Seeds or begin a quest to get a hold of Dandelion Weed, take a step back and analyse these claims.

Dr. Chadha asks a very valid question, “If it is that simple, why is the world suffering from diabetes?”

How Fake Health News Works

What is the first thing you do when you experience an unusual fever, intense pain in a body part or several of them? You turn to Dr. Google! At some point, we all have typed in “Quick ways to lose weight” or “How to build muscle quickly”.

While this may be out of general curiosity or to find an easier way out, it is certainly not the right thing to do. Most of Google searches related to illnesses end with either cancer or some other godforsaken illness that no one has heard of. Is Google even reliable?

On the other hand, fake health news forwarded via WhatsApp or shared on Facebook are mostly prevalent because people are looking for an easier way out. Eating Banana Peels or a spoonful of Methi seems easier to do than to actually eat the right food and exercise.

Even the allure of alternate medication over traditional medication seems intriguing for the simple fact that someone would rather experiment with something as absurd as Dandelion Weed, than go through Chemotherapy for Cancer treatment.

Is the tone of authority that claims – “Cure <insert illness here> instantly”, “100% guaranteed weight loss”, or “Build a 6 pack in 3 days” to be blamed or is it our willingness to click on something like this without asking questions to be blamed? At the end of it, these articles only lead you to a website where someone is trying to sell you something or keep you from buying something else.

Apart from the reasons above, why fake articles get so much traction is simply because they deliver quick and easy to read content and headlines as opposed to research documents which are full of tables and scientific jargon that provide evidence.

More so, there’s this crushing need to believe something we wish were true. If someone who loves sweets were to come across an article that read, “Eating a lot of sweets is good for your health”, wouldn’t you click on it even if the claim isn’t backed by a legitimate study?

The Need to Eliminate Fake Health News

With more people buying into these fake health news and tips, it becomes difficult for doctors as most of their consultation time goes in myth-busting rather than treatment. If an expert is to reject fake news or tip, the patient is often not convinced.

Fake articles and our willingness to believe in them can do more harm than good. Especially if you go for alternate or self-medication cited from these fake articles which can make your condition worse!

Fortunately, the anti-vaccine brigade hasn’t made its way to India with their disputable content. Thanks to them, Measles made its return in 2016 in the United States. Who knows, if we begin here, we’d be welcoming Polio with open arms.

How to Identify Them

Keep an open mind but not open enough to passively accept any false piece of information which claims to be true. Here’s what you can do:

Check the Source: Always check if the article is backed by proper study. If the giant breakthrough in cancer treatment hasn’t been spoken about by the American Cancer Society or other reputable sources consisting of experts on the subject, it probably isn’t true.
Look for More Sources: Don’t rush to the fields to pick out Dandelion Weeds based on a single article. Always look for more sources, more studies have reached the same conclusion. If you can ask multiple people how you look in your new dress, taking multiple opinions on medication and health shouldn’t be that difficult.
Be Sceptic: If you watched WWE in the 90s, the legendary Stone Cold Steve Austin probably gave the most genuine advice ever – “Don’t Trust Anybody!” If it is too good to be true, it probably is. Just because a “research”, “Study” or “Claim” falls in line with what you’re already doing, doesn’t make it authentic. Awaken your inner sceptic and doubt everything! There is no shortcut to getting healthy and fit.
Talk to Your Doctor: If you tell your doctor or even your nutritionist about eating banana peels to lose weight, we’re sure they’d crack up! Any credible data, analysis or information is useless if not interpreted by an expert. Verify these so-called “facts” with your doctor, nutritionist or expert. The person on the other side of the table didn’t spend years of their life getting a degree in medicine or certification just for show.
Get a Second Opinion: Not convinced with what your doctor, nutritionist or trainer has to say? Get a second opinion. No one is 100% accurate all the time. They are human, they can make errors. It’s best to get a second opinion if you’re not convinced. Just avoid Googling your issue because search engines and social media channels aren’t allotted degrees on healthcare, medicine, nutrition and fitness.

It is imperative to bust fake health news, tips and myths to avoid injury, illness and in a worst-case scenario – death. Be well-informed with the right knowledge from the right people. In an attempt to curb the epidemic of false news, GOQii in association with Akshay Kumar and a team of experts is out to bust these myths for good with the GOQii India Health Quiz (IHQ).

The GOQii India Health Quiz aims to elevate over 130cr Indians by giving them the right knowledge and busting myths via live hourly quizzes within the GOQii App. All you need to do is download the app, watch LIVE classes on GOQii Play, participate in the quiz and earn points. These points can be redeemed for prizes such as Cellphones, Fitness Trackers and a grand cash prize of Rs. 5 lakh.

Remember, that the first step towards a healthy lifestyle begins in the mind. Train yours and until then, in the words of Akshay Kumar, “Gadhe Mat Bano!”