ARTICLES ON Pandemic

About 5% of Covid-19 patients suffer from the severe form of infection requiring a longer hospital stay, oxygen support and ICU admissions. The World Health Organization (WHO) last week defined ‘post-Covid’ or what is commonly known as ‘long-Covid’, a term used for Covid-19 patients who suffer from prolonged after-effects of the infection. The health agency used Delphi methodology – a structured exercise to arrive at a group opinion or decision by surveying a panel of experts. Five groups of stakeholders, including patients, patient-researchers, external experts, WHO staff and others were involved in formulating the definition. What Does the Definition State? The WHO definition of long-Covid states: “Post-Covid-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 (the virus that causes Covid-19) infection, usually three months from the onset of Covid-19 with symptoms and that last for at least two months and can’t be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new: onset following initial recovery from an acute Covid-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.” It has also clarified that a separate definition may be applicable for children. Was Such Categorisation Important? The absence of both a single terminology and a clinical case definition have been repeatedly signalled as drawbacks to advance on research and management of these patients, according to WHO. Experts say categorisation is also important for patients to accept their condition. “When there is a certain categorisation, patients learn to group themselves and come forward to seek help,” said Dr Nitin Karnik, head of medicine at the civic-run Lokmanya Tilak Municipal General Hospital in Sion. “In the absence of categorisation, patients often get lost in follow-ups. Starting of post-Covid out-patient departments (OPDs) has, therefore, been a crucial step taken by most hospitals, where patients with lingering issues can seek help,” he said. Critical care specialist Dr Kedar Toraskar from Wockhardt Hospital said that the definition is helpful, but doctors should not haphazardly label symptoms as post-Covid. “Patients may have health issues due to some underlying conditions that may not be Covid-related. Thus, a thorough diagnosis is a must before labelling the symptoms as post-Covid,” he said. Commonly, effects lingering on for more than eight weeks were identified as post-Covid by doctors. Some patients, who suffered from the after effect beyond three to six months, were identified as long-haulers. What is the Estimated Number of Long-Covid? Estimates on long-Covid vary a lot. About 5% of Covid-19 patients suffer from the severe form of infection requiring a longer hospital stay, oxygen support and intensive care unit (ICU) admissions. Patients who have moderate to severe forms of infection are more likely to have residual health issues say doctors. However, some patients with mild Covid-19 have long term lingering after-effects too. “Conservatively, I would say about 10 % patients have long-Covid, requiring follow-ups for physical and mental rehabilitation,” said Dr Toraskar, who is also a member of the Covid-19 task force of Maharashtra. While fatigue, myalgia (muscle pain), hair loss, body ache, poor appetite, muscle wastage are some of the common long-term impacts, patients also have frequent episodes of low-grade fever and effort intolerance wherein minutest efforts to walk from one room to another are not tolerated by the body. “When patients suddenly find themselves struggling to do their daily chores, they panic,” said Dr Karnik. “They need a lot of reassurance that their body will recover gradually with good diet and physiotherapy. The worst impacted are families where all members got Covid-19 and all the adults developed long-Covid. In such cases, we have seen patients struggling as there are no caregivers,” he said. Dr Karnik estimates that nearly 30% of patients suffer from long-Covid. “The long-term sequelae clear out in most patients gradually,” he said. A study published in the medical journal JAMA Network Open on Wednesday has estimated that more than half of the patients diagnosed with Covid-19 globally will experience post-Covid or long-Covid symptoms, up to six months after recovering. The study was carried out by researchers from the Penn State College of Medicine. The team conducted a systematic review of 57 reports that included data from 250,351 unvaccinated adults and children who were diagnosed with Covid-19 from December 2019 through March this year. The researchers identified many long-term health issues involving general well-being, mobility, neurological conditions, mental health disorders, lung abnormalities, cardiovascular issues, skin conditions and digestive issues among the survivors. “Our results indicate that clinical management of persistent post-acute sequelae of Covid-19 (PASC) will require a whole-patient perspective, including management tools like virtual rehabilitation platforms and chronic care for post-acute Covid-19 symptoms in conjunction with the management of pre-existing or new comorbidities,” the researchers stated in the study, further recommending one-stop multidisciplinary clinics to avoid multiple referrals to different specialists and encourage comprehensive care. Source: https://www.hindustantimes.com/cities/mumbai-news/what-do-medical-experts-from-mumbai-say-on-long-covid-definition-given-by-who-101634234872062.html

It is now known that Covid-19 survivors have to go through short and long-term complications, both psychological and physical. A recent study published in the British Journal of Dermatology has raised concerns about a condition called ‘Covid toes’ which causes inflammation in the toes and, if untreated, causes an autoimmune disorder. Dr Wiqar Shaikh, says the Covid-19 virus is a peculiar one. It has led to some unusual symptoms and manifestations such as loss of taste and smell, myocarditis (swelling of the heart muscles), kidney failure, anxiety and depression, long Covid, in which symptoms could remain for up to six months after the infection, etc. “A a rather unusual presentation of Covid-19 is Covid toes which results in chilblain-like swellings and redness of the hands and toes. A chilblain   is a condition which occurs in response to repeated exposure to cold and results in inflammation (swelling) of small blood vessels in the skin leading to skin sores or bumps on the fingers and toes.” Dr Shaikh said Covid toes have been reported from several countries in the world including Europe and North America. He quoted a study from Paris, published in the British Journal of Dermatology on October 4, in which 50 patients were studied. He said the study revealed high levels of what are called autoantibodies, antibodies produced by the body’s defence or immune system which attack the body and destroy it. Dr Shaikh said the study revealed an increase in Type 1 interferon, a key protein in the anti-viral response of the human body, which in the case of Covid infection triggers a massive response of the immune system resulting in production of IgA type of antibodies. This was found in 73% of the patients studied. This results in production of ANCA (antinuclear cellular antibodies) which lead in turn to swelling of the blood vessels of the patient, a condition called vasculitis. The entire immunological procedure is what is called an autoimmune response, in which the immune system destroys one’s body. Dr Shaikh added that there are several autoimmune diseases known to mankind, including the dreaded Systemic Lupus Erythematosus (SLE). “We could be looking at the beginning of a wave of autoimmune diseases in patients who have had Covid-19. An ominous thought and possibility,” he said. “The symptoms of chilblain-like inflammation and redness on the hands and feet, develops within 1-4 weeks of being infected and can result in swelling and hematomas on toes, and fingers also become swollen and red. Many people who have got Covid vaccines have also seen occurrence of similar conditions within 1-4 weeks of the vaccine shots, and this is attributed to autoimmune reactions caused by circulating viral antigens. This condition is self-resolving in most patients, although more widespread coagulation in vital organs will require urgent treatment with steroids”, said Dr Subhash Hira. “We have to study all post-Covid patients closely to rule out possibilities of other autoimmune diseases like SLE. Autoimmune diseases are chronic diseases and we need to educate all doctors to screen post-Covid patients for them. Also, when we see any new patient of autoimmune disease, we must ask about past history of Covid infection,” said Dr Santosh Bansode, Head of the Department, Emergency Medicine, Wockhardt hospital.  “We should educate people about these new findings so that they can take maximum precautions. Also, patients who already suffered from Covid should observe themselves for any abnormal symptoms and consult a doctor immediately,” Dr Bansode concluded. “What causes this is unknown. There is no specific treatment besides topical steroid creams which itself is debatable. Therefore, it is advisable that if any such lesions develop immediate dermatologist or physician consultation is necessary,” said Dr Ketan Vagholkar. Source: https://www.mid-day.com/mumbai/mumbai-news/article/experts-now-warn-about-covid-toes-23196099

Covid-19, as we all know, shows side effects even after you’ve had the infection. It can trigger painful fibromyalgia, a rheumatic condition characterized by joint stiffness and pain, fatigue, irregular sleep patterns, and muscle aches. Read on to know more. Those who have battled Covid-19 are aware of the various complications that can arise in the post-Covid stage. From fatigue, shortness of breath, headaches, sleep troubles to low energy levels, there are so many symptoms that people have been experiencing, even after having the viral infection.  But if you’re experiencing symptoms like joint pain, memory problems, severe fatigue, or sleep problems, you could be suffering from fibromyalgia.  Fibromyalgia is a pain syndrome characterized by chronic pain, fatigue, and tenderness. It causes aches and pain throughout the body. In fact, fibromyalgia’s symptoms are often confused with arthritis or joint inflammation. However, unlike arthritis, it hasn’t been found to cause joint or muscle inflammation and damage. Dr. Bipin Jibhkate, a consultant of critical care medicine, and ICU director at Wockhardt Hospital, Mira Road, says fibromyalgia is a painful condition, and the pain is usually in the soft tissue, nerves, and muscles of your body. Pain is the most common symptom.  What are the symptoms of fibromyalgia? Dr. Jibhkate reveals that sleep troubles, muscle, and joint pain, as well as fatigue, are the major symptoms of this condition. Apart from these, this condition is often accompanied by: What causes fibromyalgia? The exact cause of fibromyalgia is unclear; there could be different causes for different people. It has been shown to be genetic. But Dr. Jibhkate says this condition can frequently become evident if you’re dealing with: These are some risk factors that can trigger the development of fibromyalgia. How is fibromyalgia diagnosed? Dr. Jibhkate says it’s not easy to diagnose the disease because there are no specific tests. But a doctor will suspect fibromyalgia based on your symptoms. And because widespread body pain is the key feature of fibromyalgia, healthcare providers will ask you to describe your pain, so that the healthcare provider can differentiate between fibromyalgia and other diseases with similar symptoms. Is fibromyalgia a treatable disease? Although fibromyalgia can affect the quality of life, it is still treatable disease. Dr. Jibhkate says that fibromyalgia is not a life-threatening disease, but the recovery of the patient can be delayed. Therefore, the patient should not miss the treatment in the middle, or else it may worsen your symptoms. It isn’t just medicine that can treat the disease, there is also a non-drug method to treat fibromyalgia, adds the expert. Here’s how to manage fibromyalgia with lifestyle changes: According to Dr. Jibhkate, there are four major triggers or risk factors of fibromyalgia that need to be kept under control, if you want to manage the condition. These are: By keeping in mind these triggers, Dr. Jibhkate shares these tips to manage fibromyalgia: 1. Modify your diet: Avoid junk and fried foods. Instead consume high-energy foods that are low in sugar such as green vegetables, fruits, nuts, and seeds. These foods can help your energy levels stay high throughout the day.  2. Stay active: Research shows that the most effective treatment for fibromyalgia is physical exercise. Carrying out gentle aerobic exercise helps with pain and fatigue symptoms. 3. Prioritise sleep: Unrelenting pain can disrupt sleep, which can lead to increased aches and fatigue, which then creates a vicious cycle. Apart from exercise, getting enough sleep is really important, when it comes to fibromyalgia. You can meditate, in order to improve your sleep pattern.  4. Limiting alcohol: Excess alcohol and caffeine intake can disturb your sleep cycle, and sleep deprivation can lead to fatigue, which can worsen the symptoms of fibromyalgia. So, limit your alcohol intake. 5. Stress reduction: When you constantly battle pain, it can place a lot of stress on your system. Finding easy ways to relieve stress can make a huge difference to your fatigue levels. You can do activities like tai chi, meditation, morning walks, breathing exercises, and gently stretch your body to reduce stress levels. So, follow these tips and manage your fibromyalgia symptoms. Source: https://www.healthshots.com/preventive-care/self-care/how-much-should-you-exercise-after-youve-had-a-heart-attack-we-asked-a-cardiologist/

A lot of people are wondering if drinking is permitted after getting the Covid-19 vaccine? Well, we have an answer for you! There are some people who believe there’s no harm in drinking alcohol, after a few hours of getting a Covid-19 jab. In hindsight, others say drinking after three days post-vaccination is safe. To be honest, no one is sure what to do, and that’s why there is a cloud of confusion all around. Well, worry not because this read will make it all clear. We have an expert with us, who will answer all your questions pertaining to alcohol and the Covid-19 vaccine. So, let’s begin: Can I Drink After Getting the Covid-19 Vaccine? Looks like you love your glass of sherry! If you talk about world health agencies like the Centre for Disease Control and Prevention (CDC), Public Health England or even the Health Ministry of India has not specified any guidelines on drinking alcohol before and after getting the vaccination. “There is no proof or data available when it comes to alcohol interfering with the efficacy of the vaccine. There are no studies or research to claim that alcohol affects the formation of antibodies,” says Dr. Pritam Moon, consultant physician, Wockhardt Hospitals in Mumbai. He adds, “Alcohol doesn’t have a direct association with the production of antibodies that one gets from being vaccinated. Did you know? Antibodies will take around three weeks to form, after getting jabbed. Yet, the link between alcohol and vaccination is not clear. Alcohol may not reduce the effectiveness or interfere with the vaccination. But, your immune system can take a hit after drinking alcohol and you may also get dehydrated. Too much alcohol consumption may put you at the risk of immunosuppression and your body’s infection-fighting capacity will be reduced.”  After How Many Days of Getting a Shot Can I Drink?  According to Dr. Moon, it is a good idea to refrain from alcohol for 15-20 days before and after taking the jab. Moreover, it is better to consult the doctor and only then resume drinking. “ Yes, one needs to also avoid alcohol for at least 2-3 days before the vaccination,” suggests Dr. Moon. Can it be Deadly to Drink After Vaccination? “Your health will worsen if the consumption of alcohol is too much. Anything done in excess is harmful to health,” warns Dr. Moon. Some More Precautions that I Should Take After Getting Vaccinated? You must continue to adhere to the Covid-19 protocols of masking, social distancing, and hand sanitizing. Do not venture out in crowded places, rest enough, avoid exercising for a day or two, and do not exert yourself. Stick to a well-balanced diet that consists of all the essential nutrients.  “Try to eat citrus foods like lemons, oranges, grapefruits to strengthen your immune system. Eat foods loaded with omega-3 fatty acids, and avoid the junk, oily, and processed foods. Do not forget to drink enough water and stay hydrated,” recommends Dr Moon. Source: https://www.healthshots.com/preventive-care/self-care/can-you-drink-alcohol-after-getting-covid-19-vaccine/

Doctors say it is safe to continue with exercising after taking the Covid vaccine but advise against taking up strenuous activities that the body is not used to within two to three days of taking the jab. With Covid-induced lockdowns leading to the closure of gyms and parks in most states, people again have been strapped to their couches for months like last year. To stick to their exercise routine, people have taken to working out within the four walls of their homes. However, one question that may arise is whether it is safe to exercise after getting the Covid-19 vaccine. The short answer to this question is yes. Experts told indiatoday.in there is no evidence so far to suggest exercising after inoculation can be harmful to health or affect the vaccine’s efficacy. “It is difficult to tell how a person will respond to the vaccine. There is no evidence of the vaccine being less effective owing to exercising before or after inoculation. In fact, those who exercise regularly and embrace a healthy lifestyle have enhanced responses to vaccines. Their bodies tend to create more antibodies when compared to those who are not following a healthy lifestyle,” Dr. Pritam Moon, consultant physician, Wockhardt Hospital, Mumbai, told indiatoday.in. Modify your exercise routine as per side effects of vaccine However, experts cautioned that one should take note of immediate side effects and modify their workout plan accordingly. Pain or swelling at the injection site, weakness, nausea, headache, and fever are some common side effects that people may experience after being inoculated. Physiotherapist Dr. Juhi Dang stressed that no new activity that one is not used to should be done soon after getting vaccinated. “Generally doctors advise against resuming exercising, but there is nothing like that. It is just a precautionary measure not to increase your pain. A heavy workout might aggravate that pain. However, if you are used to high-intensity workouts, you can continue with them. But don’t start something more intense that your body is not used to immediately after getting the jab,” Dr. Dang said. The US Centers for Disease Control and Prevention (CDC) advises people to keep their arms active to help deal with injection site pain. When should one resume physical activities if they experience side effects? Experts said one should ideally rest for a day or two post-vaccination and then resume their fitness routines. “If you notice any side effects such as fever, body pain, or nausea, then it is a good idea to take a break for two days. It is not advisable to take up any physically exhausting or intense activity if you are not used to it, a couple of days within taking the vaccine,” said Dr. Sharwari Dabhade Dua, consultant internal medicine, Rainbow Hospitals, Delhi. Strenuous workouts within 48-72 hours post-vaccination might lead to prolongation of myalgias and fatigue, said Dr. Abhishek Bansal, Director, Orthopaedics, Spine and Sports Injuries, Diyos Hospital. “It would be prudent to wait for 2-3 days post-vaccination for the muscle pains and fatigue to settle down,” he said. Echoing him, Dr. Moon of Wockhardt Hospital said, “Taking a break for a couple of days won’t hamper your workout progress. It is important to let your body recover from the side effects. Don’t be harsh on yourself; you won’t gain weight in a day.” Source: https://www.indiatoday.in/coronavirus-outbreak/story/exercise-covid-vaccine-doctors-1816444-2021-06-18

World No Tobacco Day, which is observed on May 31 every year, Tedros Adhanom Ghebreyesus, WHO Director-General said that smokers have up to a 50 percent higher risk of developing severe disease and death from COVID-19. According to experts, smoking impairs lung function, then reduces immunity, and makes it harder for the body to fight off various diseases. Health experts on Sunday warned that smoking tobacco can put you at high risk of COVID-19 by affecting your body’s immunity. So, if you are a smoker then it’s high time to crush and throw it away forever. According to experts, smoking impairs lung function, then reduces immunity, and makes it harder for the body to fight off various diseases. According to the Ministry of Health and Family Welfare, tobacco use is a major risk factor for the four main Non-communicable Diseases (NCDs) — cardiovascular disease, cancer, chronic lung disease, and diabetes. “Smoking doesn’t increase your chances of being infected by COVID-19 since the smokers are at an equal risk of contracting the infection as a non-smoking individual. However, long-term smokers suffer often from Chronic Obstructive Pulmonary Disorder (COPD) a condition that causes irreversible damage to the lungs. In such patients, COVID-19 may cause severe complications and minimize the chances of complete recovery due to the existing lung damage. International studies have shown that the Case Fatality Ratio (CFR) of COVID-19 almost triples in patients with COPD as compared to healthy individuals,” said Dr. Sudeep Sarkar, Senior Consultant, Oncosurgery (Head and Neck), Nanavati Max Super Speciality Hospital. Dr. Pritam Jain, Consultant Oncologist, Wockhardt Hospitals Mumbai Central explained: Smoking increases the risk of transmission and severity of covid 19 Smoking (cigarettes, waterpipes, bidis, cigars, heated tobacco products) causes the following: Source: https://www.healthwire.co/world-no-tobacco-day-2021-can-smoking-increase-your-risk-of-contracting-covid-19-heres-what-experts-say/

A team of doctors at Wockhardt Hospital successfully performed surgery for post-Covid mucormycosis on a 60-year-old woman to save her eyes. Nagma Sheikh (Name changed), a housewife who is a resident of Mira Road, contracted Covid-19 in April and was admitted to a hospital for Covid treatment. Apparently, due to excessive use of steroids, the patient soon noticed symptoms such as intolerable headaches and blackish nasal discharge, nasal congestion, and swelling of the left eyes. She consulted various hospitals in Mumbai, but nothing seemed to provide her that much-needed relief. Finally, she was successfully treated at Wockhardt Hospital, Mira Road where she underwent surgery for the deadly black fungus. The surgery was performed by a team headed by Dr Sheetal Radia and Dr. Chandraveer Singh, Consultant Otorhinolaryngologist and Head & Neck Onco Surgeon. Dr. Singh said, “On arrival in an emergency, the lady exhibited the symptoms such as blackish nasal discharge, nasal congestion, headache, and swelling of the eyes. By KOH mounting frozen section and MRI, it was confirmed that it is mucormycosis.” Mucormycosis: Causes And Risk Factors   Mucormycosis or black fungus is a rare infection that occurs after exposure to mucormycetes mold. It affects paranasal sinuses, the base of the skull, eyes, lungs, and brain, and is common in people suffering or recovering from COVID-19 due to excessive use of steroids. This black fungus is seen in those with low immunity, irrational use of steroids, having high diabetes and other comorbidities, using dusty humidifiers, having prolonged hospital stay, and ones on medication that lowers their ability to fight germs and viruses – Dr. ChandraVeer explained. According to the doctor, the woman’s infection had invaded the nose, base of the skull, eyes, and could have led to blindness, loss of body tissue, and damaged to the other vital organs of her body. Hence, the patient was scheduled to undergo surgery as soon as possible. “The surgery involved removing the engulfing tissue where the cribriform plate of the base of the skull was removed and the Orbit medial wall was removed to remove the edema of an eye. Mucormycosis from all sinuses and base of the skull and medial wall of the eye was removed too. The mucormycosis is removed with debris tissue in 2 hours,” Dr. ChandraVeer elaborated. Source: https://www.thehealthsite.com/news/post-covid-mucormycosis-prompt-surgery-saves-eyes-of-60-year-old-woman-with-deadly-black-fungus-815487/

As a deadly second wave of COVID-19 continues to ravage India, the medical fraternity in our country is not only concerned about this contagious virus but also other complications that are being reported by the patients. Cases of Mucormycosis, commonly known as the black fungus-a debilitating and life-threatening infection are being reported among COVID-19 patients and survivors.   Dr. Siddhartha Saoji, an endoscopic ENT surgeon at Wockhardt  Hospitals quoted “Mucormycosis, a life-threatening infection, is promulgating in these people especially patients who have diabetes. If  left untreated, this can result in blindness/ Decreases vision/ double vision and even deterioration Of general condition.” For a patient’s infection with the fungus, the clinical deterioration may start not In the span of the day but in the span of just a few hours. Consequently, the post-COVID patients, as advised by health experts, should remain very vigilant in looking for the early symptoms. If someone has contracted the Mucormycosis (black fungal) infection, there are a few warning signs they Can look out for, like pain around the eyes/nose, facial swelling, double vision, decreases vision, loosening of teeth ache, headache, fever, and even nose bleed. The case of Mucormycosis is alarmingly rising. A certain category of people is more prone to get infected by this fatal infection. People having diabetes, especially diabetic ketoacidosis, cancer organ transplant, Stem cell transplant, Neutropenia  (low number of white blood cell), long-term corticosteroid use, Injection drug use, too much iron in the body (iron overload hemochromatosis), Skin injury due to surgery, burns, or wounds, Prematurity and low birth weight are more to get an infection post-COVID infection. The diagnosis of this is mainly based on a clinical evaluation by an ENT surgeon. A diagnostic endoscopy with visualization of the typical blackish lesion is usually followed by a biopsy to confirm the presence of fungus. Imaging with contrast MRI (or contrast CT if MRI is not feasible) is essential to understand the extent of involvement and should be done as soon as possible. As far as the treatment is concerned all these patients require surgery, regular debridement, management with anti-fungal drugs and other allied medical treatment as per protocol and long time follow up. Timely diagnosis and intervention result in a better outcome and prevent the spread of infection to the eyes and brain. Dr. Saoji informed the most of the patients arrive late when they are already losing vision, and doctors have to surgically remove the eye to stop the infection from reaching the brain. In some cases, it can require surgery; it can lead to eventual loss of the upper jaw sometimes even an eye. Here’s Guide for Do’s and Don’t’s Do’s-  Don’t’s- So keep your eyes peeled for any signs and symptoms and report immediately in case you experience them!! We at Wockhardt Hospitals are trying to keep our nose to the grindstone and help the community fight the covid 19 pandemics. Source: https://thelivenagpur.com/2021/05/16/another-dark-side-of-covid-mucormycosis/

The month of May is considered as Maternal Mental Health Awareness Month. Mid-Day.com spoke to two Mumbai-based experts to understand the impact of the pandemic on new mothers and pregnant women, and what can be done to help them Coronavirus has caused an indelible impact on everyone’s mental health. New mothers and women who are pregnant have been one of the most vulnerable groups during this pandemic. Psychiatrist Dr. Sapna Bangar, who is also the head of Mpower, Mumbai, says that the pandemic adds an overwhelming feeling for pregnant women and new mothers. She says, “For a woman, feeling stressed during pregnancy is common with worries about the wellbeing of her baby.” Along with this, the stress of the pandemic has affected the mental health of pregnant women and new mothers — causing excess worry, fear of contracting the virus, being isolated, having to go through the birthing process, and the challenge of taking care of a newborn especially for first-time mothers without extended support, she says.  The month of May is observed as Maternal Mental Health Awareness Month. The aim is to raise awareness and end the taboo attached to maternal mental health. According to a report published on the NCBI website, an estimated percentage of women — 10–35 percent — around the world including India suffer from depression during pregnancy and postpartum. And, due to the uncertainty surrounding Covid-19, it has been observed that there have been “higher levels of depression among women during and after pregnancy.” India is currently in the middle of an intense second wave of coronavirus pandemic. While it is hard for everyone to cope with such uncertain and grim situations, it is comparatively harder for pregnant women and new mothers because they have to be careful about themselves and also have to be cautious about their newborn or yet-to-be-born child.  Speaking about the impact of the pandemic on new mothers and pregnant women, Dr. Sonal Anand, psychiatrist, Wockhardt Hospital, Mira Road, says, “Pregnant women are known to be susceptible to emotional ups and downs and stress. Due to the effects of the suppression of T cell activities and other physiological body changes pregnant women are more prone to changes in the immune system. Lack of sleep and increased daily stress can give rise to various mental health issues like anxiety, depression.” She adds that new mothers already experience anxiety related to their responsibility. The fear of the pandemic, isolation, and lack of social support adds even more pressure as most of them are already bogged down by “haywire timetables and acceptable levels of post-partum blues.” Both experts have noticed the most common maternal mental health issues to be anxiety, depression, and sleep issues. Dr. Anand says, “Fear of contracting the virus, fear of getting very sick, and fear of losing someone are the issues that are being seen. Sleep disturbances and unnecessary negative thinking are affecting mental health adversely.” While there are no concrete data or research yet on the long term effects of the pandemic on maternal mental health, Dr. Bangar opines that any mental health issues in parents, especially mothers, stress or depression leads to an increased risk of attachment disorders, behavioral problems, social difficulties, neurodevelopmental disorders such as ADHD and conduct disorders in children.  Dr. Anand concurs, “It is difficult to comment on the long-term effects of this pandemic as there is not sufficient data yet. However, we know that chronic stress predisposes to rise in mental health issues.” But like everyone, even new mothers and pregnant women do have to make an effort to take care of their physical and mental health. Dr. Anand suggests practicing mindfulness and gratitude can help keep negative thoughts at bay. “Stay away from stressful news and disturbing posts on social media. Focus more on the positives. Music and art can uplift the mood. Focus on healthy eating and adequate sleeping,” she says.  “Being part of support groups helps to exchange information and resources. It is important to stay connected with family and friends so as to not feel isolated. You can always seek professional help,” suggests Dr. Bangar.  It is not just these women who have to take care of themselves, their caregivers and loved ones also have an important role to ensure that they are in a good mental space. Being available to them, even if that means remotely, to comfort the pregnant or new mothers to offer support, give advice, share experiences and provide reassurances makes a huge difference. “It can be very daunting especially in India as culturally the pregnancy and early days of birth and newborn care have always been supported by parents or parents-in-law or extended family. So caregivers can help by instilling confidence and reassuring the new mothers. Having virtual contact on a regular basis is important to prevent isolation and feeling overwhelmed and respecting their wishes and decisions about themselves and they are newborn,” says Dr. Bangar.  Caregivers have to communicate well and also be good listeners. According to Dr. Anand, they must listen to the worries, acknowledge them and give answers with realistic reasoning. “Letting the woman know that she has supported is all that matters. Keeping the environment happy and stress-free is what caregivers should abide by,” she says.  While we all are doing our best to get through a difficult period, it is important that we put extra effort to ensure that our own mental health as well as that of people around us is taken care of. Professional help should be taken whenever necessary and we all should do our bit to remove the stigma around mental health, especially maternal mental health.  Source: https://www.mid-day.com/lifestyle/health-and-fitness/article/how-does-the-pandemic-impact-maternal-mental-health-experts-explain-23172305

The coronavirus, despite having been around since 2019, is still an unknown entity on all of the symptoms and risks it and its mutations entail. The vaccine for it, which has been brought about after a speedy R&D, is also something people are wary of. But as the government, scientists, and medical fraternity have been saying time and again, there is nothing to be scared of with the vaccine. Everyone eligible should register and get vaccinated! With the registrations opening up for the 18 to 45 age bracket too, one question that has arisen amongst the younger women is whether the vaccine affects one’s menstrual cycle. Here’s what these expert doctors have to say. “There are myths floating online that the COVID-19 vaccine will affect the menstrual cycle. This is a myth and needs to be debunked,” says Dr. Mangala Patil, Consultant Obstetrician, and Gynaecologist, Wockhardt Hospital, Mira Road. “There was a message circulating on social media which said that menstruation ‘lowers’ the immunity of a woman. Taking a vaccine, five days before, during, or after your periods won’t be safe and may not garner a sufficient response. This is a rumor,” clarifies Dr. Surabhi Siddhartha, Consultant, Obstetrician & Gynaecologist, Motherhood Hospital, Kharghar. Dr. Vaishali Joshi, a senior Obstetrician & Gynecologist at Kokilaben Ambani Hospital, Mumbai, adds, “COVID infection itself doesn’t affect menstrual cycle or flow. Any viral illness unless it is severe or critical usually doesn’t affect periods or hormones.” The “COVID-19 vaccine is safe for menstruating women in every manner. There is no study or claim to validate that the vaccine is harmful to women during their periods. Millions of women have already gotten vaccinated and didn’t record any reactions. The vaccine safe and should be taken. Also, avoid rescheduling vaccination if you are on your period. Avoid falling prey to these fake posts,” Dr. Siddhanta asserts. To that, Dr. Patil adds, “Women above 18 irrespective of their period cycles and hormonal status should get vaccinated, apart from pregnant women who aren’t listed to get vaccinated. Periods have nothing to do with your immunity.” Source: https://www.femina.in/wellness/gynaec/does-covid-vaccine-affect-menstruation-193654.html