from-pharmd-student-to-innovator-surya-maguluris-journey-with-litemeds-curapod

Sat Mar 28 19:13:35 IST 2026

Back when he was a doctor of pharmacy (PharmD) student, Surya Maguluri spent long hours poring over case sheets and counselling patients. Years later, that deep clinical exposure would spark an idea about using light as medicine.

As so was born Curapod, a wearable light-therapy device developed by Litemed, the startup Maguluri co-founded with Sri Velliyur. Built on photobiomodulation (a form of light therapy), the device, launched in 2023, challenges conventional approaches to pain management.

“When I started in 2008, the course (PharmD) had just been introduced in India,” he says. “There were no clear career pathways.” That uncertainty pushed him to look beyond textbooks—he would attend conferences, network with industry experts and try to understand where health care innovation was headed.

A recurring piece of advice stayed with him: find a problem and solve it.

His first attempt was not in medicine, but in tackling air pollution. He built early prototypes, including an “Ambient Air Pollution Curtailer” and a bike-based device called “Pollution Zero”. But real-world testing exposed fundamental flaws. A filter attached to a vehicle’s silencer, for instance, restricted exhaust flow and affected engine performance.

The failure forced him to rethink the very nature of solutions. “That’s when I started thinking about ‘formless’ approaches—solutions that don’t physically obstruct systems,” he says. Chemical interventions were explored and discarded. Eventually, he turned to light. “I realised that light could influence biological processes. That’s when the idea clicked—light could be used as a form of medicine,” he says.

This led him to photobiomodulation, a technology with an existing body of research but limited consumer applications. At its core, the science is straightforward: when cells are stressed—due to injury, inflammation or chronic conditions—their energy production drops, triggering pain pathways. Light, when applied at specific wavelengths, stimulates mitochondrial activity, restoring cellular respiration and ATP (Adenosine Triphosphate, the primary energy-carrying molecule) production. The result is reduced pain and improved healing.

But translating this science into a usable product posed challenges. Photobiomodulation devices typically struggle with three factors: penetration depth, coverage area and personalised dosing. Lasers penetrate deeply but cover limited areas, while LEDs offer broader coverage but typically lack depth.

Litemed’s solution, says Maguluri, lies in a proprietary approach called “constructive superimposition”, which enables deeper penetration while maintaining wider coverage.

If the science was complex, manufacturing was even more so. Moving from small batches to mass production required redesigning processes, strengthening supply chains and implementing rigorous quality controls. Shrinking the technology into a compact, wearable device without compromising performance added another layer of difficulty.

The company claims to have more than 25,000 daily users of the product—priced at 8,399—which targets over 30 musculoskeletal conditions.

The company now has a multidisciplinary team—engineers on the product side and clinicians who feed real-world insights into development. This feedback loop, says Maguluri, is critical to refining both the technology and its applications.

Looking ahead, Litemed is working on what it calls an adaptive pain management system, in which the device can personalise treatment based on factors such as body metrics and user feedback. The company is also preparing to enter global markets, and is confident of taking this Indian solution to the world.

high-five-with-jerry-pinto-balancing-diet-exercise-and-passion

Sat Mar 28 18:36:04 IST 2026

with Jerry Pinto, author and poet

1. What do you eat in a day?

I try to be as sensible as possible, so a lot of fruit and vegetables, but a lot of meat and fish as well. I try to keep my carbohydrate intake low, but I love rice and wheat, too, and in the worst possible forms, like white polished rice and maida. So I eat a lot of them, but I try to be as sensible as possible.

2. How do you stay fit?

I have a yoga routine. I do the Tibetan rites. I do some walking and I go to the gym and maybe four times a week I do some light weight training to keep my bone density up.

3. What do you do in your me-time?

My me-time is my work time. I discovered that I love writing. I love translating. I love poetry. I love all the things that I do. So, if I have free time, I do my work.

Other than that, there is a wonderful channel called Mubi. And I watch strange films from all across the world… that would never get commercial release. It is like having a film festival at your fingertips.

4. One unhealthy thing that you will never be caught doing?

I would never be caught doing drugs because I like being in control of my mind. I have no judgement against people who smoke weed or anything like that. But I don't like being out of control. I like what my mind is like right now. So, I am happy.

5. One mantra you swear by?

Lots of sleep. Lots of fruit. Lots of work that you love. Lots of love. If you have all four of those, you are fine.

when-we-support-mothers-we-support-generations-eamon-mccrory

Sat Mar 28 18:31:56 IST 2026

Interview/ Eamon McCrory, CEO of Anna Freud (a mental health charity), and professor of developmental neuroscience and psychopathology, University College London

For generations, trauma has often been understood as a single event, an incident that begins and ends in one lifetime. But as per neuroscientist Eamon McCrory, research in neuroscience, psychology and perinatal mental health shows that early adversity can recalibrate the body’s stress systems, shape attachment patterns and influence how safety, trust and intimacy are experienced well into adulthood.

Speaking on the sidelines of the Mpowering Minds Summit, held in Bengaluru, he threw light on how closely personal histories and caregiving are intertwined. In a conversation with THE WEEK, he explores how trauma echoes across generations, how resilience is built and what it truly takes to support new mothers, not just for their wellbeing, but for the generations that follow. Excerpts:

Q/ How does childhood trauma shape women’s mental health later in life? In what ways can these effects quietly pass from one generation to the next?

Childhood trauma can shape how a woman experiences safety, trust and connection across her entire life. Early adversity can recalibrate stress systems in the brain, making someone more sensitive to threat, more vigilant in relationships or more prone to withdrawal. These adaptations often make sense in the original environment, but later they can increase vulnerability to anxiety, depression or relational conflict.

The transmission across generations is often quiet. It happens through patterns, through how distress is responded to, through whether emotions are spoken about or silenced, and through hypervigilance that becomes the emotional climate of a home. Children do not only inherit stories. They inherit nervous systems shaped inside relationships. That is how trauma can echo forward without being consciously passed on.

Q/ What do we now understand about the biological and emotional pathways through which trauma is transmitted across generations, especially from mothers to daughters?

We now understand that there are overlapping pathways. Biologically, chronic stress can shape how the brain processes threat and reward. During pregnancy, maternal stress physiology can influence foetal development. There is emerging research into epigenetic mechanisms, but the evidence in humans remains complex and not deterministic.

Emotionally and relationally, attachment is central. A mother who carries unresolved trauma may find certain moments in caregiving more overwhelming, not because she does not love her child, but because her own stress system is activated. That can shape patterns of responsiveness. The good news is that these pathways are not fixed. When mothers are supported to reflect on their own histories and feel safe themselves, transmission patterns can change.

Q/ How early should we intervene to break intergenerational cycles of trauma? What forms of early support are most effective for mothers and babies?

The earlier the better. Pregnancy and the first years of life are periods of enormous brain plasticity. They are also moments when old wounds can resurface.

The most effective early supports are relational—perinatal mental health services, home visiting programmes, parent-infant psychotherapy and peer support groups, practical support that reduces isolation. What matters most is not a single technique, but whether a mother feels safe, seen and supported. When caregivers are regulated, babies benefit. Breaking cycles is not about perfect parenting; it is about consistent repair and support at the right time.

Q/ How does a mother’s mental health during pregnancy and postpartum period influence her child’s emotional development, even when the child hasn’t experienced adversity directly?

During pregnancy, maternal stress hormones cross the placenta and can influence foetal stress regulation systems. After birth, infants depend entirely on caregivers to help regulate their emotions.

If a mother is experiencing depression, anxiety or unresolved trauma, it can make responsiveness more difficult. Babies are exquisitely sensitive to emotional tone. Over time, repeated patterns of interaction shape how a child comes to experience the world: as safe or unpredictable, soothing or overwhelming.

Importantly, this is not about blame. Maternal distress is often the result of structural pressures and lack of support. When mothers receive help, children’s outcomes improve.

Q/ Culturally, mothers are often expected to be endlessly strong. How do these expectations shape women’s vulnerability to stress and trauma across generations?

The expectation of endless strength can become a burden. When vulnerability is equated with weakness, women may hide distress, delay seeking help and carry chronic stress silently.

That silence has consequences. Chronic stress affects sleep, mood, immune function and emotional availability. When a mother feels she must be invulnerable, she may have fewer opportunities for repair and reflection. Over time, daughters may internalise the same message: endure, do not disclose. That is one way cultural narratives can quietly reinforce intergenerational patterns.

Q/ What role does chronic stress—the daily, invisible kind many women carry—play in heightening trauma sensitivity in both mothers and their children?

Chronic stress is often underestimated because it lacks a dramatic event. But daily overload, caregiving strain, financial pressure and emotional labour can keep the stress system activated.

When stress is persistent, the brain can become more threat-sensitive and less reward-responsive. That affects patience, sleep, mood and relationships. Children living in that environment absorb the tone. Chronic stress does not need to be extreme to shape development. It is the accumulation that matters.

Q/ You have spoken about how love and mental illness can coexist. How can unresolved trauma affect bonding? What long-term patterns might we see in daughters when this isn’t addressed?

Love and trauma can absolutely coexist. A mother can love deeply and still struggle to regulate her own emotional responses.

Unresolved trauma may make certain infant cues feel overwhelming. It can reduce a parent’s capacity to mentalise under stress, to interpret a child’s distress accurately and respond calmly. When this happens repeatedly without repair, daughters may grow up feeling uncertain about safety in relationships.

In adulthood, that can show up as fear of abandonment, mistrust or difficulty sustaining intimacy. Again, these are patterns, not destinies. When addressed, they can shift.

Q/ In societies where maternal distress is often hidden or stigmatised, how does silence itself become a carrier of trauma from one generation to another?

Silence teaches. When distress cannot be named, children still sense it. They notice tension, mood shifts, unspoken grief. Without explanation, children often assume responsibility or develop their own narratives.

Silence can also prevent help seeking. If trauma is hidden, support is delayed. Over time, the absence of language becomes part of the inheritance. Breaking silence in safe ways can interrupt that transmission.

Q/ From your research on brain development, how might emotional inheritance shape a daughter’s ability to form secure relationships or build resilience in adulthood?

Early relational environments shape neural systems involved in threat detection, reward processing and social understanding.

If a child grows up in an environment marked by unpredictability or emotional volatility, the brain may adapt toward vigilance. That can make adult relationships feel risky.

But resilience is also relational. One stable, supportive relationship can recalibrate expectations. Protective experiences accumulate. Emotional inheritance shapes vulnerability, but relational experiences shape recovery.

Q/ If we want to truly disrupt intergenerational trauma, what structural changes—in health care, community support, and public awareness—are most urgently needed to support maternal mental health?

We need to move beyond crisis response toward prevention and relational investment. That includes universal perinatal mental health screening, accessible trauma-informed care, community-based peer support and workplace policies that recognise caregiving demands.

We also need public narratives that reduce stigma and normalise help seeking. Maternal mental health is not a private issue. It is a public health and societal issue. When we support mothers, we support generations.

proactive-ipv-detection-how-ai-is-changing-health-care-interventions

Sun Mar 29 10:13:31 IST 2026

Intimate partner violence (IPV)—abuse or aggression in a romantic relationship—is a significant yet under-discussed public health issue worldwide. The term ‘intimate partner’ includes both current and former spouses as well as dating partners. IPV can range from a single episode of violence to chronic and severe abuse that lasts over several years. It includes physical violence, sexual violence, stalking, and psychological aggression intended to harm a partner mentally or emotionally or to exert control over them.

Intimate partner violence often lead to injuries and can even be fatal. In India, IPV remains widely under-reported. Nevertheless, data from the National Family Health Survey-5 indicates that one in three married women aged 18–49 has experienced spousal violence at least once. Reports from around the world suggest that a significant share of homicide victims are killed by an intimate partner.

A team of researchers supported by the National Institutes of Health in the US has developed an AI tool that provides decision support to clinicians by predicting whether patients are at risk of IPV. Using data routinely collected during medical visits, the team trained a machine-learning model that showed high accuracy in detecting IPV among patients in a study.

As part of the study, a research team led by Harvard Medical School developed three AI models for IPV detection in health care settings and compared how well they predict risk. The study notes that many IPV cases go unnoticed, limiting chances for early intervention. Existing screening tools capture only a small share of cases, while clinical records and imaging data offer important clues. The AI works by identifying factors such as the location of injuries and signs of older trauma, and then assessing whether a patient has a high or a low risk of IPV. Radiologists, in particular, are often better at spotting patterns of injury linked to IPV.

An Indian-origin emergency radiologist, Bharti Khurana, is the senior author of this NIH-supported study. Khurana, who was born and raised in New Delhi, began working on IPV about a decade ago, initially aiming to publish a single paper exploring whether radiological scans could help diagnose IPV and raise awareness among radiologists.

As part of the study, researchers analysed several years of hospital data from about 850 affected women and 5,200 matched controls. They built two separate models—one using structured data (such as tables) and another using unstructured data from medical notes, including radiology reports. They also created a third, multimodal model that combines both data types.

All three models performed well, but the multimodal model was the most accurate, correctly identifying IPV risk 88 per cent of the time. Both the tabular and multimodal models could flag risk more than three years before patients entered hospital-based intervention programmes. While the tabular model detected risk slightly earlier, the multimodal model identified more cases overall.

According to the researchers, this AI approach aims to shift IPV detection from reactive disclosure to proactive risk recognition within routine clinical care. By analysing patterns already present in health care data, it can help clinicians initiate earlier, safer, and more informed conversations with patients.

The research team now plans to develop a decision-support tool based on these AI models, which can be integrated into electronic medical record systems to provide real-time IPV risk assessments in clinical settings.

the-humbling-truths-of-medical-internship

Sat Mar 28 18:21:29 IST 2026

Senior consultant, head and neck surgical oncology, Aster Medcity, Kochi. He is also director, Aster Head & Neck Oncology Network (Kerala cluster)

Internship humbles you.

No matter how many textbooks you have memorised, the first weeks of house surgency make one truth painfully clear: you know very little.

Suddenly, you are the junior-most person in the hospital hierarchy. Even the nurses, especially the nurses, often know more than you in practical matters. They move through procedures with an ease you are still trying to learn step by step. Postgraduates juggle admissions, emergencies, ward rounds and surgeries with a calm efficiency that feels unreachable.

Professors, once only lecturers, now appear as clinicians of another order altogether. In medical college, they were teachers. In internship, they become doctors. That distinction matters. They don’t just teach medicine anymore. They deliver it.

The postgraduates become our immediate heroes. We assist them, learn from them, try to make ourselves useful. They carry crushing workloads, and they quickly learn who they can depend on. Favourites emerge, not out of sentiment, but necessity.

For interns, the realisation comes in layers. First, how little you know. Then, the unsettling question: will I ever reach there?

You look around and see brilliance, reputation, confidence. Some people seem destined to become stars. Some quietly do their work. Some never quite find their footing. And somewhere in that landscape, you begin to wonder where you will land.

I decided early not to chase outcomes. I focused instead on the patient in front of me. Drawing blood. Inserting cannulas. Writing investigations. Giving medicines. Small tasks. But each carried its own complexity.

Finding a vein is not just technical, it is human. Thin veins. Deep veins. Anxious patients. Crying children. The art of reassurance. The patience of second attempts. The humility to ask for help. The responsibility of making someone feel safe while you are still learning yourself.

To many, these were routine. To me, they were fascinating. Each vein felt like a small challenge. Each successful cannulation, a quiet victory. Despite the exhausting hours, I genuinely enjoyed internship.

We were also lucky. Our batch had stayed together since MBBS, grouped by something as arbitrary as alphabetical roll numbers. Anatomy cadaver tables had turned into ward teams. Familiar faces became anchors in unfamiliar territory. We were not just classmates anymore. We were comrades.

But while the hospital was teaching me medicine, life was teaching me fragility. My niece was seriously ill. Phone calls came between ward rounds—about investigations, admissions, costs, uncertainty. My father had health issues. During internship, he passed away.

There was no dramatic pause in hospital schedules for personal grief. You finished your duties. You wrote your notes. You went back to the wards. Between inserting cannulas and clerking patients, I was learning what it meant to carry sorrow quietly.

At the same time, another uncertainty hovered over me: my future. Many of my colleagues were clear. “I want to be a physician,” said one. “I want to be a surgeon,” said another. Some had already chosen cardiology. Some orthopaedics. Some neurosurgery. They spoke about careers with confidence. I couldn’t.

I loved medicine—the logic, the detective work, the way diagnosis emerged from careful listening and observation. I loved surgery—the action, the decisiveness, the privilege of physically correcting what was wrong. I wanted to be both. But medicine doesn’t allow that luxury.

People had opinions. About degrees. About entrances. About which paths were “useful”. I was told more than once that an MBBS alone meant little, that specialisation was everything. I listened, nodded, and went back to work. I didn’t have the emotional space to absorb advice. I was too busy becoming.

One day, a fellow intern needed blood investigations—recently married, likely pregnancy-related. She also needed an IV cannula. Her veins were faint and fragile, and despite being a doctor herself, she was quietly afraid of how much it might hurt.

Naturally, everyone suggested anaesthesia residents. Some suggested senior nurses experienced in cannulation. That was the standard route. She listened quietly and said, simply, “No.” Then, in front of everyone, she said, “Shawn will do it.”

I was taken aback. I wasn’t an expert. I was still learning. And here she was, choosing me over seasoned anaesthesia residents. It was a small moment. But it mattered.

I examined her veins. Not easy. My first attempt failed. I punctured the vein. I paused. Adjusted. Tried again. The second time, the cannula slid in smoothly. She didn’t flinch. Later, laughing with friends, she said, “It was hard to see. But it was the right decision. Even Shawn punctured.”

Everyone laughed. So did I. But inside, something shifted. She probably forgot that moment soon after. I didn’t. Because at a time when my father was gone, my future uncertain, and my confidence fragile, someone had trusted my hands.

Medicine will give you critics. Life will give you competition. People will question you, compare you, test you. That seems inevitable. But once in a while, someone does the opposite. They lift you. Often without realising it.

That day, she gave me more than procedural practice. She gave me belief. And I learned something important: we grow not just through mentors. Sometimes, we grow through peers. Through shared exhaustion. Through quiet faith. Through colleagues who say your name when easier options exist.

I learned early that courage doesn’t arrive suddenly in operating theatres. It begins quietly, sometimes with a cannula in a crowded ward.

co-sleeping-dangers-why-doctors-advise-room-sharing-for-your-baby-safety

Sat Mar 28 18:14:24 IST 2026

It was a standard 2am wake-up call. I blinked and squinted at the clock, as I began the instinctive mid-sleep search for the warm, swaddled bundle that was supposed to be tucked safely beside me.

My hand hit empty sheets.

Panic struck! I sat bolt upright, only to find her at the other end of the bed. It was a relatively large bed—about six feet wide—and luckily, it was pushed against the wall. She was only about three months old then, and I never imagined a human that small was capable of inchworming her way across the bed as if in a cross-country race.

Sleep was her absolute priority from day one. I would often pause and stay still for hours after she finally drifted off, terrified that even a twitch would ruin the hard-won silence. I am sure mothers everywhere curse the noise that leaves their little ones' sleep ruined. Don’t even get me started on the aunties who would just turn up to wake them up—“She has been sleeping for too long, hasn't she? It is okay to wake her now.” Uff!

As is the way in our families, I was looking forward to the snuggles and the ‘emotional bond’ of having her sleep next to me, but she had other plans. My ‘Lady Gaga’ was never one for snuggle sleeping; she wants her space, and more often than not, she can be seen curled up in a corner of the bed, far from my skin. Seeing this girl care less about my snuggles than Beth Dutton (Yellowstone series) walking into a boardroom she is about to set on fire has kept me up many nights.

But then, is contact sleeping the benchmark for bonding with your child? If you think that sleeping next to your child is the popular, and therefore correct, method, doctors may have some news for you.

Co-sleeping, the kind where the mother sleeps next to the baby on the same bed, is not recommended by doctors. It carries many risks, including Sudden Infant Death Syndrome (SIDS). Room sharing is the recommended alternative, where the baby sleeps separately in a crib or bassinet in the same room as the mother.

“Evidence has shown that co-sleeping increases the risk of SIDS,” said Dr Geeta Gathwala, head, paediatrics and neonatology, Amrita Hospital, Faridabad. “So, if the mother is co-sleeping with the baby, especially in situations where the baby is a pre-term or born with low birth weight, the risks of SIDS are higher.” She added it is a risky time for babies till they are four to six months old.

Though room sharing is commonly seen as a western practice, doctors point out that the recommendations are backed by evidence and it applies to India as well.

The Indian Academy of Pediatrics and the American Academy of Pediatrics recommend room sharing. Though SIDS cases are rare in India compared to the west, cases do emerge.

Gathwala recalls a case around 11 years ago, when a newborn, sleeping next to the mother in bed, was found dead.

“The initial days after birth, mothers would be extremely tired and in deep sleep,” explained Dr Rojo Joy, head of neonatology, Lourdes Hospital, Kochi. “Any mishap can happen. Maybe a hand coming on top of the baby can lead to smothering and hamper the baby’s breathing.”

Then, there is the question of emotional bonding. Should you worry that your baby may not bond with you if she sleeps at a distance? Not really. Bonding occurs during breastfeeding and physical contact when both the mother and the baby are awake and alert. “The baby can be kept close when they are awake. During sleep, as per recommendations, it is better to practise rooming in, not bedding in,” added Joy.

Seven months ago, Joy recalls a case where a two-and-a-half-month-old baby was brought dead to the hospital. That morning, the mother, on waking up, found the baby lying next to her unresponsive. No one knows what happened during the night.

Doctors advise that pillows, soft bedding and unnecessary clothes around the baby on the bed can also increase the risk of SIDS. There is also the risk of babies falling down from the bed.

“Parents should ensure that their baby always sleeps on its back and not tummy,” said Gathwala.

Ultimately, every baby is different, and a mother is usually best equipped to make the final call. Still, it is a lot to ask of a mother to navigate these high-stakes choices when she is already depleted and vulnerable. Sometimes, the bravest thing we can do is follow the safety guidelines even when our hearts—and our traditions—are pulling us toward the snuggle.

surviving-dengue-a-survivors-account-of-recovery-and-resilience

Sat Feb 21 17:04:55 IST 2026

Life can change its course like a ship in the blink of an eye with hard starboard or hard port. I had always prided myself on leading a disciplined lifestyle, with two hours of daily exercise, a balanced diet and a belief that these would be enough to keep a 58-year-old biological body shipshape, ready to weather any storm. Little did I imagine that I would one day drop anchor in a hospital bed.

Alas! I was caught in a perfect Tropical Revolving Storm named Dengue. When I was admitted to the Command Hospital, I found myself in a place that ran like a taut ship—professional, compassionate and precise. The doctors and staff worked in seamless coordination, navigating patients through their darkest hours with calm assurance.

Yet, despite the hospital’s efficiency, my mind was anything but calm. As I lay in that bed—my body drained of strength, my thoughts adrift—I realised how fragile even the most well-maintained vessel can be when one small standard operating procedure fails. I had been meticulous in taking preventive measures against dengue season. But somewhere, somehow, a single lapse allowed the enemy to board my ship.

A hospital bed is a curious place for introspection. Like a ship anchored in turbulent sea, it rocks gently between wakefulness and sleep, between memories and the starkness of reality. Time slows down. Hours become days. Hunger fades. Sleep eludes. You find yourself yearning for the mundane—a simple walk, a hearty meal or just a peaceful night's sleep.

Dengue, often called haddi tod bukhar in Hindi (bone-breaking fever) is caused by a virus transmitted through the bite of infected mosquitoes. It brings with it high fever, unbearable pain in the joints, back and legs, and a deep sense of fatigue that drains both body and spirit. While many recover within a few days, severe dengue can quickly become a medical emergency.

On the fifth day of fever, I found myself in such a crisis. My face was drained of colour, gums had started bleeding, red spots appeared on my legs and my platelet count had plummeted to 13,000—dangerously low. I was like a ship battered in a tempest, struggling to stay afloat. It was then that my wife forced me to get admitted in hospital.

When my platelet count continued to fall, the doctors decided to transfuse platelets. I learned then that these vital components of blood have an incredibly short lifespan—barely seven to nine days—and are constantly replenished by the bone marrow. In other words, my own body had to start producing enough platelets to save itself. It was a battle that no medicine could fight for me—my body had to take command once again. And, slowly, it did. Day by day in the hospital, the tide began to turn. My platelet count started an upward journey, my strength began to return slowly and I could finally sense the storm easing. I was allowed to leave the hospital with strict instructions to take rest, replenish and stay hydrated for the next 10 to 15 days. Recovery, like sailing after a storm, brings a new perspective.

As I lay in that hospital bed, grateful for the doctors, nurses, and the quiet resilience of the human body, I realised how fragile and precious health truly is. No matter how disciplined we are, life always finds a way to remind us of our vulnerability. But it also reminds us of our strength—the power to endure, heal and to rise again. The ship that weathered the TRS Dengue now sails again—humbled, wiser and more grateful than ever.

The writer is commander, Coast Guard Region (northeast).

how-ayurveda-supports-bodys-defences-against-neurodegeneration

Sat Feb 21 17:00:27 IST 2026

India is witnessing a silent neurological shift—a stroke every three minutes, a doubling of Parkinson’s cases, and dementia in the 40s and 50s. These numbers point to a deeper truth. Brain health cannot rely solely on emergency interventions or imaging; it demands metabolic stability, daily rhythm, digestive governance and personalised prevention. Ayurveda brings this perspective through agni (innate metabolism), ama (inflammation) and swasthya (good health). It has consistently supported better vitality and functional gains in stroke rehabilitation while helping slow down the trajectory of Parkinson’s and dementia by aligning diet, lifestyle and individualised treatment.

Erratic lifestyle—including irregular meals, late nights, processed snacking and continuous cognitive load—weakens agni. When agni diminishes, ama forms. This metabolic residue silently blocks microchannels, influencing mood, clarity, memory and sleep. Strengthening agni therefore becomes essential for neuroprotection. Efficient digestion ensures proper nutrient assimilation, stable hormones and balanced immunity. Ayurveda positions these functions as prerequisites for long-term neurological health.

How ayurveda can help in promotive, preventive and adjuvant care in these conditions.

Stroke: Act fast with FAST and support with ayurveda

A stroke hits because blood flow to a part of the brain is interrupted. In the beginning, patients may notice abrupt weakness on one side of the body, imbalance, blurred vision, difficulty in speaking, or a sudden inability to understand simple sentences. These early changes occur because the affected brain cells lose oxygen within minutes, disrupting movement, speech and coordination almost instantly. This is why recognising a stroke quickly is critical.

The FAST signals:

1. Face drooping: A smile appears flat on one side

2. Arm weakness: Arms drift downward when raised.

3. Speech difficulty: Slurred or confused words.

4. Time: Rush to hospital, as every minute saves brain cells.

After the emergency treatment, ayurveda can play a crucial role in strengthening the body’s resilience through everyday habits. Warm, timely, easy-to-digest meals support agni, while avoiding late-night eating and processed-heavy combinations can prevent ama formation. Keeping blood pressure, blood sugar and inflammatory markers stable through routine and moderation further protects vascular health. Light daily movement and mindful breathing reduce sympathetic overload, and tracking swasthya indicators like digestion, sleep and mood helps in catching early deviations. All these behaviours build a stronger baseline and support smoother recovery without disrupting ongoing medical care. These micro-habits won’t replace emergency care, but they strengthen your brain’s defences and support recovery.

Parkinson’s and dementia: The slow rise with co-morbid drivers

Compared with many other conditions that are highly symptomatic, Parkinson’s and dementia do not announce themselves loudly. They surface gradually through subtle tremors, the slowing of daily movements, shrinking recall, disturbed sleep, irritability, difficulty with multitasking and changes in digestion. These conditions rarely act alone; they unfold faster when supported by metabolic and lifestyle co-morbidities. For example, diabetes and insulin resistance impair cellular fuel supply, hypertension reduces cerebral blood flow, and anxiety or depression shifts neurochemical balance. Sleep disruption, alcohol and nicotine load, sleep apnoea and chronic inflammation further strain neuronal systems. Gut dysbiosis (an imbalance in the gut microbiota like bacteria, fungi and viruses) alters the signalling between the gut and the brain, adding another layer of vulnerability. Ayurveda reads these disturbances as systemic shifts that require whole-person correction, not isolated symptom management.

A real-life illustration of when life moves faster than health

Let’s step into a moment many of you may recognise. After four hours of fragmented sleep following a late call, an early flight awaits. Your mind is already scattered across tasks, while hypertension, borderline diabetes and low-grade inflammation simmer in the background. Breakfast is skipped, caffeine becomes the first intake of the day and screens dominate the time before boarding.

Ayurveda instantly reads this situation not as carelessness, but as a predictable point where agni falters, ama accumulates, and the mind slips into a rajasic, hyper-reactive state. Even here, ayurveda offers stability. Having something warm and a light meal before travel prevents the metabolic dip. Avoiding caffeine on an empty stomach calms the system and sipping warm water through the journey reduces ama build-up. A short breathing pause before boarding drops sympathetic overdrive, and postponing high-stakes decisions prevents errors born of fatigue. Reducing sensory noise from screens stabilises attention. These adjustments protect the physiology in environments where disease often begins. These are not elaborate rituals. They are micro-decisions, your way of staying centred amid unpredictability.

The foundation for neuroprotection

1. Daily digestion-first living: A neuroprotective lifestyle begins with simple metabolic discipline, like avoiding incompatible combinations such as milk with fish or fruit-heavy smoothies as they prevent metabolic overload. Eating warm, freshly prepared meals at consistent times stabilises digestion. Keeping dinner light and having it early supports natural detox cycles, while leaving adequate gaps between meals helps the body reset. Regular observation of bowel patterns reinforces gut health, and sleeping by 10pm aligns the body with natural hormonal rhythms. Small practices such as intentional breathing, reducing screen overload, and short post-meal walks help regulate glucose and calm the nervous system. Ayurveda also encourages exercising within capacity, roughly half of one’s strength, to avoid fatigue that weakens agni. These choices collectively prevent ama accumulation and maintain metabolic clarity.

2. Ingredients to include in your diet: It is important to nurture the body with ojas (innate immunity) through nourishing and vata-balancing foods. Kushmanda, brahmi, ksheer, sarpi and shankapushpi, along with fruits like avocado, pomegranate, banana and vegetables like ash gourd, beetroot, carrots, sweet potato, spinach and drumstick collectively support long-term cognitive resilience.

3. Swasthya checklist: A brief self-check each morning helps detect early imbalances. A steady appetite, comfortable elimination, a sense of physical lightness, mental clarity, restful sleep, emotional stability, absence of bloating and natural energy indicate balanced physiology. Any variation in these patterns is an early sign of agni disturbance and rising ama. Addressing it promptly prevents deeper disruptions.

The takeaway

Stroke, Parkinson’s and dementia demand precision diagnostics and systemic correction. Modern medicine promotes acute management, monitoring and pharmacological support. Ayurveda strengthens the terrain by restoring metabolic balance, aligning circadian rhythms and personalising diet and lifestyle to support long-term neurological function.

This dual approach creates a pragmatic path where emergency medicine offers rapid intervention and disease control, while ayurveda ensures that the underlying physiology remains stable enough to support recovery, prevent progression and sustain cognitive vitality.

The writer is chief medical officer, Apollo AyurVAID Hospitals

magictouch-how-an-indigenous-innovation-is-redefining-heart-care

Wed Mar 18 17:40:16 IST 2026

A stable job is every middle class family’s dream. So when Manish Doshi, born into one such family, decided to quit a campus placement job in the late 1980s, it left his parents and siblings anxious and disappointed. India was yet to open up its economy, and walking away from a stable job was widely seen as reckless. Doshi, however, was determined to break free from that mindset, trusting his intuition and inventive spirit to chart his entrepreneurial path. A textile engineering graduate, he began his journey in chemical trading. Over the next three decades, he would evolve into a visionary medtech entrepreneur, building innovative, life-saving medical technologies in India for the global market.

It was in the late 2000s that Doshi began pursuing the challenge of developing a drug-coated balloon that used sirolimus, an immunosuppresant that also prevents abnormal cell growth.

The need was undeniable. Heart disease remains one of the world’s leading killers, driven largely by coronary artery disease, in which fatty deposits narrow or block blood vessels supplying the heart. While stents and conventional drug-coated balloons have transformed care, they are not without limitations. Metal stents permanently cage the artery, impairing its natural movement and sometimes triggering late complications such as restenosis (re-narrowing of the blood vessel) or thrombosis (clotting). Earlier drug-coated balloons, largely reliant on paclitaxel, act quickly but lack sustained biological effect. These shortcomings are particularly acute in small vessels, complex lesions, bifurcations and in-stent restenosis—precisely the cases where physicians need better, implant-free solutions.

It was this unmet clinical gap that led Doshi to found Concept Medical and develop MagicTouch, the world’s first sirolimus-coated balloon. The philosophy behind the technology marked a fundamental shift: treat the disease inside the artery without leaving anything behind. Instead of relying on a permanent scaffold or a short-acting drug burst, MagicTouch aimed to trigger biological healing of the vessel itself—allowing the artery to recover its natural function once the therapy was delivered.

At the core of MagicTouch is nanolute technology, a proprietary drug-delivery platform designed to overcome sirolimus’s known challenges. Sirolimus, long considered the gold standard in interventional cardiology, offers controlled inhibition of abnormal cell growth, reduced inflammation and support for natural healing. “However, sirolimus is unstable and poorly lipophilic (washes out quickly), making it hard to deliver. Even today, among 20–30 drug-coated balloons globally, only two use sirolimus,” notes Doshi. “We reduced the drug particle size from about 90 microns to 0.35 microns, studied arterial tissue porosity and delivered the drug deep into the vessel wall, where it acts as a reservoir. We also developed an excipient that improves drug binding and bioavailability.” With this engineered solution, the artery itself becomes a drug reservoir, enabling sustained release long after the balloon is removed.

“By 2009, we had completed our first animal studies for what later became MagicTouch. Between 2008 and 2009, I filed patents aggressively to avoid repeating past mistakes. Today, 132 patents are granted globally, giving us full freedom to operate,” says Doshi.

Today, Concept Medical’s drug-coated stents and related drug-delivery technologies are commercially available and used in over 80 countries. “Our innovation earned major milestones: Concept Medical became the first Indian medical device company to receive five Investigational Device Exemption (IDE) approvals—required for pivotal clinical trials—from the US FDA. Clinical trials are currently ongoing in the US. MagicTouch’s commercial entry in Japan is expected this year, and the US commercial launch is projected for 2028,” says Doshi.

Doshi asserts that in percutaneous coronary intervention (PCI)—the procedure used to restore blood flow to the heart without open-heart surgery—drug-coated balloons represent the future. “In India, 90 per cent of PCI procedures still use stents,” he says. “In Europe, nearly 30 per cent have already shifted to balloons. Market studies suggest that by 2034, 70–80 per cent of PCI procedures will be implant-free.”

Doshi himself underwent a stent-free angioplasty using MagicTouch four years ago. “MagicTouch already addresses most coronary problems,” he says, adding that Concept Medical is expanding its application into other critical areas, including below-the-knee vascular disease, erectile dysfunction, carotid artery disease, ischemic stroke and urethral strictures.

us-withdrawal-from-who-an-opportunity-for-india-to-take-leadership-in-global-health-lawrence-gostin

Sat Feb 21 16:06:37 IST 2026

Interview/ Lawrence Gostin, director, World Health Organization Collaborating Center on Public Health Law & Human Rights at Georgetown University

With the United States officially leaving the World Health Organization, concerns are mounting over what this could mean for global health cooperation, and for countries like India that rely on WHO for disease surveillance, technical guidance and emergency coordination.

The US has historically been one of WHO’s largest funders and most influential political actors, and its exit comes at a time when the world remains vulnerable to pandemics and emerging infections.

Lawrence Gostin, director, World Health Organization Collaborating Center on Public Health Law & Human Rights at Georgetown University, tells THE WEEK how the US withdrawal weakens WHO’s capacities, why densely populated countries such as India should be concerned, and why this moment could also open the door for India to step into a larger leadership role in global health.

Does the US withdrawal weaken WHO’s authority, or primarily its financial and political leverage?

The US withdrawal primarily weakens WHO’s financial position. Stopping US funding has resulted in about a 20 per cent reduction in WHO staffing and capacities. It means that the WHO has to cut back on vital programmes such as pandemic preparedness and response, including surveillance in key areas like influenza and measles. Technically, the US withdrawal should not weaken WHO's authority because it gains its authority through the WHO constitution and World Health Assembly, which won't change. But politically it will make it much harder for the WHO to leverage its influence if the United States is not on board, or worse, if the US is actively opposing WHO initiatives.

How could this decision affect countries like India?

WHO will be in a weaker position to offer technical and scientific assistance and guidance to middle-income countries like India. WHO is losing scientific and other experts and is stretched thin without US funding and participation. The absence of scientific expertise from the US Centers for Disease Control and Prevention is especially concerning.

Is there a risk that global disease surveillance and early-warning systems could be weakened? What would that mean for densely populated countries such as India?

Much of the reductions in financing and capacities will occur in the areas of disease surveillance and outbreak detection and response. For a densely populated country like India, this is of grave concern, as there are heightened vulnerabilities to infectious diseases.

Does the US withdrawal set a concerning precedent for other countries to disengage from multilateral health institutions?

As a matter of law, the US is the only country that is permitted to withdraw under the WHO constitution. This is due to a joint resolution of the US Congress that grants the US the power to withdraw but only if it pays its existing dues. President Donald Trump has not paid his current financial obligations.

How might this reshape global health governance going forward?

The US has been highly influential in global health governance and diplomacy. The US withdrawal will certainly weaken overall governance and international negotiations.

What could this shift mean for India’s role and influence within the organisation?

I would make a plea for India to see the US withdrawal as an opportunity to assert its influence in global health policy. India should significantly increase its funding of WHO and become reenergised in WHO policy and governance. This is a unique opportunity for India to take leadership in global health. It makes sense as India is one of the world's most accomplished scientific powers, including in the manufacturing of vaccines and medicines. I would rather see India leading on science, health and equity at WHO than China.

what-is-epstein-barr-virus-and-why-is-new-research-so-important

Fri Feb 27 14:08:04 IST 2026

While the world debates the shocking allegations and criminal details in the ‘Epstein files’, the medical research community has shed new light on a highly contagious virus that also bears the Epstein name. The Epstein-Barr virus (EBV) is named after two scientists—Michael Anthony Epstein and Yvonne Barr—who discovered the tiny herpes-family viral particles in 1964 while studying a rare African childhood cancer called Burkitt lymphoma. EBV—the first virus linked to human cancer—is also one of the most common human viruses and spreads through body fluids, primarily saliva. Most people are infected at some point in their lives, usually in childhood, and experience no symptoms. In that sense, EBV behaves like a long-buried story: it can remain unnoticed for years, only revealing itself when conditions allow it to reactivate.

Interestingly, Epstein identified the virus only three years after obtaining the biopsy samples he suspected might contain it, and largely by accident. In 1961, after attending surgeon Denis Burkitt’s lecture on a mysterious “jaw tumour” common in equatorial Africa, he suspected a viral cause and secured tumour samples, but found no viral particles.

The breakthrough came in late 1963 when a flight carrying a sample from Uganda was delayed, extending the transit time. By the time it arrived, the specimen looked cloudy and nearly contaminated and was close to being discarded. Instead, Epstein examined it and found free-floating tumour cells that had loosened during the long journey and began growing in culture. Working with Barr and pathologist Bert Achong, he used electron microscopy on these cultured cells and, in 1964, observed the EBV for the first time.

Those with weakened immune systems are more prone to EBV reactivation. When that happens, symptoms can vary in severity, ranging from sore throat and fatigue to skin rashes, swollen lymph nodes and an enlarged spleen or liver. If viral genes begin altering the growth cycle of infected cells, they can also contribute to cancer.

Recently, a landmark study by AstraZeneca and Memorial Sloan Kettering Cancer Center, published in Nature, identified 22 genetic variants that influence how effectively the immune system controls persistent EBV levels in the blood. Using large genomic and health-data libraries alongside innovative computational methods, the researchers measured EBV levels across hundreds of thousands of individuals and found that certain genetic differences—many in immune-related genes—make it harder for the body to keep the virus in check. People carrying these variants are more likely to have higher viral loads, which are linked to increased rates of chronic disease.

This latest finding, too, echoed the virus’s own accidental discovery. Because the team analysed fragments of genome-sequence data that are usually discarded in routine human genetic studies and turned them into meaningful insights at an unprecedented scale. After publication, Caleb Lareau, principal investigator at Memorial Sloan Kettering Cancer Center, described the approach as turning “trash into treasure”.

high-five-with-anuja-chauhan-why-getting-off-the-internet-is-the-best-self-care

Fri Feb 27 14:08:38 IST 2026

1. What do you eat in a day?

I eat papaya, dal, chicken/paneer, veg stir-fry or light sabzis, roti, rice, peanuts and dahi.

2. How do you stay fit?

I do yoga and lift weights mostly.

3. What do you do in your me-time?

Doing things that get me off the internet. Wandering around the garden with a mug of coffee, checking every morning for new leaves and new buds, weeding, pruning, training creepers on to walls and fences is pure, rejuvenating bliss. I also paint walls and furniture—the smell of water-based paint is lovely. It costs so little and yet a new lick of paint literally wipes the slate clean and is so therapeutic for a cluttered mind. Chatting with my grown-up children is great, too. They are living the life I used to live long ago—with clients and bosses and love interests. It is very interesting to see the adult world through their Gen Z lens.

4. One unhealthy thing you will never be caught doing?

Drugs!

5. One mantra you swear by?

Never overeat or over-imbibe alcohol on holiday—it is the fastest way to totally ruin your much-anticipated vacation.

why-doctors-say-no-to-sugar-and-salt-for-babies

Sun Feb 22 12:09:17 IST 2026

Dipped in honey and sugar, my mother-in-law’s fingertips edged closer towards my ‘Lady Ga Ga’s' lips. She was five months old when we finally made the trip to my husband’s home for the first time after her birth.

Excitement was in the air. Gates swung wide open, welcoming the little bundle of joy. Uncles, cousins and aunts all made a beeline to sweep her away. That was when mom-in-law entered with the sugary delight. My husband saw the fingertip right before it touched the baby’s lips, and almost instantly, he grabbed her hand with a resounding ‘No!’

The excitement drained from his mother’s face as he tried to politely explain. “Why not? It’s just a few grains.” The question sounded innocent.

In Indian culture, sweets are often the language of love. It is tradition to serve sweets when something auspicious such as this happens.

My mother-in-law’s question was sincere. Yes, it is only a grain, but sugar is an out-and-out villain, especially for little people like a five-month-old—a fact that is either little known or often ignored.

New mothers, or let’s say, parents, live in a state of constant conflict with ‘harmless’ traditions. We are constantly reminded at every turn of how things were done ‘back in the day’. If it is not our parents, it is the neighbour aunty popping up with a load of wisdom. “We started solids at three months,” or “We used kajal, and their eyes were fine,” or the rotating menu of jaggery, palm sugar and refined sugar for the kids to eat ‘properly’.

The list is exhausting. I have heard new parents saying that they don’t give sugar to their kids at home, but it is difficult to say no to grandparents.

In this ‘smart’ world, a new mother’s job isn’t just raising a child; it’s constantly suiting up for a battle against outdated advice and bursting myths.

Doctors strongly recommend avoiding sugar and salt until two years of age. “A baby’s first foods set the taste standard for life. If early food is very sweet, plain food later feels boring. If the early food is salty, normal food later feels tasteless,” says Dr Chhaya Shah, a paediatric physician in Jabalpur.

Experts stress that the world our kids are growing up in is far different from how we were raised. Back then, chocolate was a rare luxury—something that only appeared when ‘Dubai uncle’ or visiting aunt arrived with a suitcase full of treats. But clearly, the times have changed.

Shah says that treats, sweet or salty, are readily available now. “You name it, and it is only a click away or stacked up in the kitchen,” says Shah. “Every household will have some sweets in the fridge. Once children get the taste of them, they will prefer them to the healthy food they are having, and it gets difficult to control them.”

Why sweeten a puree when there is absolutely no benefit to be found?

Experts warn that once a child develops an early preference for sugar or salt, they begin to link flavours with emotions, and they won’t be able to self-regulate them later on. (You might have come across kids throwing tantrums at malls and shops for just a bar of chocolate or ice cream and screaming until their parents buy it to calm them.)

The truth is, babies already get all the salt and sweetness they need from breast milk or formula. An infant’s kidneys simply are not developed enough to process extra salt. Therefore, doctors recommend delaying it as much as possible, for at least 18-24 months.

Also, studies point out that an early start on salt is linked to hypertension later on. “The risks are real. Early exposure to sweets and junk food sets a path towards obesity. When extra salt is given, it causes fluid retention, and it increases the blood pressure,” says Dr Sohail V. Seyad, a paediatrician based in Kochi.

Shah recalls a case: “A 16-year-old walked into my clinic weighing 92kg with a blood pressure of 160/120—numbers you’d expect in an elderly patient, not a child. The culprit? A heavy habit of instant noodles. They are loaded with salt. It was a convenience that cost his health dearly.”

The Indian Academy of Paediatrics (IAP) highlights that many junk foods have poor nutritional quality owing to high carbohydrate and fat content. This nutritionally imbalanced diet often leads to severe illnesses in the long run, including diabetes and heart disease.

Seyad adds that dental issues, too, are quite common among young kids now due to high sugar intake. “Also, early introduction of salts and sugars may trigger allergies in some kids as well. Even giving honey before 12 months should be strictly avoided as it could lead to botulism,” he says.

Seyad remembers a two-year-old who had to undergo six root canals because of excessive sweet consumption! Another baby, an 18-month-old, weighed 19.8kg as the parents used to feed him sugary stuff right from when he was seven months old, he adds.

“The whole idea is to not let children develop a preference for sweet food,” says Seyad. “Studies have revealed that early high intake of sugar or salt can cause cholesterol, cardiovascular issues and diabetes in the long run. Kids don’t require [added sugar] during the early stages; strictly none until 12 months.”

keralas-tech-revolution-how-advanced-healthcare-is-fuelling-medical-tourism

Sat Jan 24 15:23:07 IST 2026

For decades, Kerala has set the benchmark for public health care in India—anchored in a robust public health care infrastructure, a strong focus on primary care, and effective last-mile delivery. Today, driven by a strategic embrace of cutting-edge medical technologies, the state is steadily transforming into a global destination for advanced health care.

Over five lakh international patients are estimated to visit Kerala each year, drawn by high-quality, cost-effective treatment. Notably, a growing share of these patients seek technologically advanced procedures that rival—and in some cases surpass—those offered by traditional global health care hubs, both in quality and delivery. In Kochi’s private hospitals, medical tourism currently accounts for up to 30 per cent of revenue, underscoring the sector’s expanding influence on health care economy.

Strengthening Kerala’s appeal is its rapid adoption of advanced medical technologies, including robotic-assisted surgery, 3D printing, and augmented reality (AR) in surgical planning.

Robotic-assisted surgery

The wider adoption of robotic-assisted surgery has become one of the most significant advances in Kerala’s health care landscape. State-of-the-art technologies such as the da Vinci system are now routinely used across specialities including urology, gynaecology and oncology. These systems enable surgeons to perform complex procedures with far greater precision, reduced blood loss, and minimal postoperative pain. Features such as 3D high-definition vision and wristed instruments enhance surgical accuracy by offering superior depth perception and greater dexterity compared to conventional surgical techniques. The proven effectiveness of robotic procedures has also encouraged more surgeons to pursue specialised training, helping the technology gain a firm foothold across the state, both in government as well as private hospitals.

Patients, particularly those from overseas, are increasingly seeking out these procedures because they offer faster recovery, fewer complications and better outcomes. This rising demand has strengthened Kerala’s reputation for advanced, high-quality care and created a supportive ecosystem for robotic-assisted surgery. Equally assuring is the end-to-end care, from advanced pre-operative diagnostics to structured post-surgical rehabilitation.

Alongside robotics, emerging innovations like 3D printing for customised implants and prosthetics, and augmented reality for surgical planning are increasingly being integrated into treatment protocols. These tools allow doctors to personalise care, particularly in complex cases such as spinal surgery, tumour removal and facial reconstruction. With digital models and virtual simulations, surgeons can anticipate challenges and ensure the best possible care for patients expecting world-class results.

The global opportunity ahead

Kerala’s medical value travel industry currently generates around 40 crore in hospital revenue a month. By placing a stronger focus on technology and specialised care, we could witness this figure increase significantly, even triple.

Stronger partnerships between the government, private hospitals and academic institutions can help strengthen Kerala’s position as a leading destination for medical tourism. Joint research initiatives and training programmes not only improve the quality of care, but also equip the next generation of doctors and surgeons to use advanced technologies with confidence.

By continuing to combine medical expertise with advanced digital tools and a patient-centric approach, Kerala has the potential to compete with international health care hubs like Singapore and Turkey. It can also set a new benchmark for affordable care that is accessible to patients from around the world.

Dr Moopen is the founder chairman & MD of Aster DM Healthcare.

how-a-paediatricians-relentless-fight-got-fake-ors-drinks-banned

Tue Jan 27 16:18:36 IST 2026

In 1978, Lancet called oral rehydration salt/solution (ORS) “potentially the most important medical advance of this century”. Discovered by Indian scientist Hemendra Nath Chatterjee, its usage was eventually developed and used across the world. It is estimated that ORS has so far saved more than 50 million children. As part of their global diarrhoeal disease control programme, the World Health Organization and UNICEF standardised ORS in 1975 and further popularised its use.

India’s population made it a major beneficiary of ORS. However, its wide use bred a commercial version. In 2003, Bengaluru-based Jagdale Industries made a sugary drink that tasted like ORS, named it ORS-L, and marketed it as a rehydration drink for children. Sold almost like a medicine, it earned an estimated Rs100 crore annually for Jagdale and was bought for Rs750 crore by Johnson & Johnson in 2014.

The American brand sensed the business opportunity, rooted in a genuine health need. It renamed the brand ORSL and pushed it aggressively, onboarding medical stores, supermarkets, e-commerce websites and even doctors, especially paediatricians. But, one paediatrician understood the danger and took up the fight.

“In one case, the parents followed every instruction precisely—correct food, correct fluids—yet the child did not get better,” said Dr Sivaranjani Santosh. “The diarrhoea persisted and dehydration worsened. One day, one of the parents asked me if ORS and ORSL were the same. I said they could be, but also asked them to bring the tetra pack they were using. When I examined the label, it was not the WHO-recommended ORS at all.”

In paediatric medicine, few principles are as firmly established as ‘diarrhoea rarely kills, dehydration does’. If dehydration is prevented, a child usually survives. “Even glucose cannot be given directly to sick children; it needs the right amount of sodium and water,” said Sivaranjani. The balance ORS should have is measured in osmolarity (concentration of a fluid). It is key because, in the body, water always moves from a diluted fluid to a concentrated one. When ORS has the right osmolarity—about 0.245 osmoles per litre (osm/l)—it is lower than blood (0.275-0.295osm/l), and water flows from the gut to the body, improving hydration. But, when so-called ORS drinks have high osmolarity—often 0.300-0.600osm/L—water is pulled from the body to the gut, speeding up dehydration and worsening diarrhoea.

“I realised it after observing cases and eventually heard from other paediatricians of how the sugary drinks failed to provide rehydration and caused dehydration among the sick children,” said Sivaranjani. These sugary drinks are “hyperosmolar”—they are dangerously skewed in terms of composition (see table).

Around 2015, Sivaranjani realised ORS was not being diluted by medical ignorance, but by commercial confusion. The massive marketing machine continued its blitz, until, owing to increasing objections from the medical fraternity, J&J started printing the warning: “Do not give during diarrhoea”—in tiny font.

Sivaranjani intensified the awareness effort. In campaigns at schools, she warned parents about the sugary drinks. In 2017, she posted her first YouTube video on the difference between ORS and ORSL.

Meanwhile, other companies entered the space with brands like Rebalanz VITORS (launched in 2018) and ORSFIT (2019). These were sold to unsuspecting parents across the country, mostly through medical stores.

Sivaranjanai escalated the issue in 2021, writing multiple letters to the Central Drugs Standard Control Organisation. The CDSCO first asked for proof, then said that the problem did not fall under its jurisdiction as the drinks were not drugs. So, she filed a complaint with the Food Safety and Standards Association of India in February 2022. Following the efforts of Sivaranjani and other paediatricians, the FSSAI barred sugary drinks from using the term ORS on labels in April 2022.

It was a decisive win, but it did not last long. In July, the authority reversed course—allowing ORS terminology with the diarrhoea disclaimer.

The FSSAI took cover behind the Controller General of Patents, Designs and Trade Marks, Mumbai, stating it was the CGPDTM that granted trademarks such as ORSL. “This flip-flop was devastating,” Sivaranjani said. All through, she was also flagging the issue to the Union health ministry. She complained several times on the Prime Minister’s Office website, too, but there was no response.

The FSSAI and the health ministry maintained communication with Sivaranajani, but the officials were mostly asking for more proof or continued the inconsequential talk. “I could see no action; it was truly baffling,” she said. “Despite medicine, public health and ethics on our side, the government agencies refused to act.”

When contacted, neither the FSSAI nor Kenvue, which was spun off from J&J in 2023 and currently owns the rehydration product, responded. Former FSSAI CEO Pawan Agarwal said: “Though it was a drink and the issue fell under the FSSAI’s purview, ORSL was a trademark. So, at the time, the best FSSAI could do was to highlight that it was not ORS as per WHO standards. The recent decision to ban the use of ORS in trademarks was prompted by medical shops selling ORSL when the customers asked for ORS.”

In September 2022, fed up with the lack of response from the FSSAI and the health ministry, Sivaranajani filed a public interest litigation in the Telangana High Court. “As the case dragged on, I felt isolated,” she said. “I wondered why the judiciary was taking so much time on the topic that was so clear from the beginning.”

Then, before the first hearing, she posted a video on social media requesting people to wish her luck. The response was staggering. It may have started with concerned parents amplifying her message, but it was soon taken up by Anchor Ravi, a well-known TV personality in the Telugu states. Actors Samantha Ruth Prabhu and Nani took the campaign to the next level. Dozens of paediatricians and scores of social media influencers joined the movement. The campaign spread rapidly across south India. The public scrutiny shifted the balance.

Meanwhile, the Endocrine Society of India and Women Pediatricians Forum joined her case. The ESI’s petition was accepted while the WPF’s was denied.

Finally, the FSSAI banned the use of ORS in brand names on October 14, 2025. But, within two days, the Delhi High Court asked it to respond to JNTL Consumer Health (India) Pvt Ltd, a Kenvue subsidiary. JNTL had told the court that stock worth Rs180 crore was in the market and calling it back could cause reputational damage. “I could not understand how the FSSAI agreed to this,” said Sivaranjani. “This was taking the public’s health for granted and playing with the childrens’ lives.”

The response from FSSAI was slow, prompting the Delhi High Court’s Justice Sachin Datta to remark the order was intended to give the regulator two to three days to act and that he might not have granted it if he had known the FSSAI would take longer. Eventually, the FSSAI upheld its earlier ban, calling the drinks a public health hazard. Though Dr. Reddy’s, which owns Rebalanz VITORS, tried to challenge the ban, the Delhi High Court did not entertain the plea. It also reiterated that it will not interfere in the FSSAI’s ban as people could mistake the branding for ORS, leading to a public health hazard.

However, despite the ban, the drinks remain on the market. The FSSAI has conducted raids across the country and seized stock in some states. But, the issue persists. ORSL has even rebranded to ERZL (the ‘e’ designed to look similar to ‘o’ and the ‘z’ to ‘s’). Sivaranjani is reaching out to the ministry of commerce and industry and the FSSAI to not allow the rebranding.

Meanwhile, the case in the Telangana High Court is still active, with the prosecution seeking a court directive to the companies to obey the FSSAI’s ban. Sivaranjani also wants all stock recalled and distribution stopped. Amid her battles for public health, she still wonders how products endangering millions of children stayed in circulation for so long.

why-younger-people-are-getting-cataract-causes-symptoms-and-treatment

Sat Jan 24 14:48:06 IST 2026

Deepali R., a Mumbai homemaker, thought menopause was her only worry as she approached her late 40s. Little did she know that she would soon join her septuagenarian uncle in wearing post-cataract surgery spectacles. She experienced persistent haziness in vision, but thought it was stress-related and ignored it. “It was a jolt,” she says. “I hadn’t even greyed fully. But thankfully, my vision has been revitalised.”

Cataract, the gradual clouding of the eye’s lens, has always been a part of the ageing process. But today, people in their 40s are signing up for surgery. “Previously, the approach to cataract surgery was to delay it till blindness set in or until there was a sudden dramatic depletion in vision,” says Mumbai ophthalmologist Dr Himanshu Mehta. “Cataract never happens suddenly. Technology, too, wasn’t developed back then.”

EMERGING AWARENESS

Mehta believes people today, especially professionals, feel a more pressing need for excellent vision. Earlier, elderly members of a household who didn’t need to read or see much ignored the symptoms. “A 50-year-old corporate guy facing vision problems might find it a hindrance at the workplace, not being able to clearly read presentations,” he says. “‘I can’t see’ is no excuse.”

Delhi-based perfumer Mukul Gundhi, 54, believes that along with a sound nose, a good pair of eyes is a non-negotiable to his livelihood. He couldn’t afford gradually depleting vision while handling daily customers, reading online orders and maintaining accounts at his heritage perfumery. Following successful cataract surgeries for both eyes, he now enjoys an improved quality of life.

“The cataract concept has changed over the years,” says Delhi ophthalmologist Dr Rajib Mukherjee, who operated on Gundhi. “In the 1980s and 1990s, people waited until the cataract completely matured, which could take decades. That era was devoid of computer and phone screens. Today’s visual demands are far greater. Can you sacrifice identifying things on your phone? Today, we don’t look at mature cataracts, but rather at lifestyles.”

EARLY INDICATIONS

“More than even screens, early diabetes causes early cataract,” says Dr Ronnie Jacob George, senior ophthalmologist at Chennai’s Sankara Nethralaya. “The number of young Indians with diabetes has sadly increased over the years.”

Fluctuating blood sugar level causes imbalances in the intraocular (in the eyeball) fluid, leading to swelling of the lens. “When the concentration of sugar increases, the lens tends to absorb water and swells,” says George. “The lens is clear due to the proteins being arranged in a particular way. In this case, the protein arrangement is changed and vision becomes hazy.”

Uncontrolled blood sugar, extensive exposure to ultraviolet radiation, smoking and tobacco consumption of any kind, he says, affect eye health. “Farmers, for instance, are known to suffer from early cataract due to continuous UV exposure,” he says. “That’s why wearing sunglasses is essential. Airline pilots always do, considering intense UV exposure at high altitudes.”

Although cataract and ageing are directly connected, many babies are born with the condition, too. “If the mother suffers from infections like rubella during the second trimester, the child can be born with cataract,” says Mehta. While his oldest cataract patient was 108, his youngest was just two.

FROM ‘SODA GLASSES’ TO SAFE AND SMOOTH

“At the outset, the term ‘surgery’ gave me jitters,” says Gundhi. “However, after the first eye’s cataract was smoothly removed, I was completely fearless for the second.” The post-operative pain, he says, was like a needle-prick during a blood test.

With technical advancements, cataract surgery is no longer painful, cumbersome and stressful. “Earlier, sandbags were placed on either side of the head [to restrict movement] while the patient lied down,” says Mehta. “There was risk of infection. Many lost eyes. There was no lens replacement, but instead ‘soda glasses’ (thick lenses) with convex lenses of a whopping +30 power. With those, everything looked magnified. While crossing the street, one experienced a ‘jack in the box’ phenomenon (an optical illusion). A car would appear, then disappear only to suddenly reappear, causing confusion and often accidents.”

Today, with evolved technology, things look brighter. “Modern techniques include phacoemulsification surgery that began in the 1990s,” says Mehta. “It involves a ‘phaco machine’ which, through a tiny ultrasonic needle, breaks the cataract at a high speed and suctions it out. No stitches are involved.”

Laser surgeries, however, are the most advanced and near-painless, he says, especially FLACS (Femtosecond laser-Assisted Cataract Surgery). “Even when we perform a laser surgery, the fragments are finally removed by the phaco machine. The robot makes it more precise and perfect. Laser is a safe procedure and hence consistently repeatable,” he says.

Comparatively, phacoemulsification without femtosecond laser (a precise infrared laser) is more affordable and not many Indian centres are equipped with the latter. “Less than 5 per cent of patients choose femtolaser. For them, an iPhone is more important than the eye,” says Mehta with a chuckle.

PRICELESS PRECISION

“Cataract is the most frequently performed surgery globally,” says George. “Around 40 years ago, surgeries involved opening the eye to remove the cataract and lens replacement wasn’t common. Today, sophisticated procedures are performed with high-end technology. Eye drops have replaced injections and stitches. Incisions are as minute as 2.2mm.”

There are also highly precise algorithms to estimate the patient’s lens power. “Error rates have decreased,” he adds. “Along with providing the power your eye needs, we can also correct your spectacle errors, even cylindrical ones, to enable you to be as spectacle-independent as possible.”

The most commonly implanted artificial lenses during cataract surgery include monofocal (allows you to see only at one particular distance), multifocal (vision at multiple distances), toric (to correct astigmatism) and extended depth of focus (continuous range of vision).

SURGERY AND RECOVERY

At the outset, the pre-operative ‘workup’, Mukherjee explains, involves examining the health of the eye structure. “The eye is shaped like a globe. We have to observe it from front to back,” he says. “If, for instance, the patient has a weak cornea, the surgical plan would be designed accordingly, to make it safer.”

The second step, he says, is lens selection based on the patient’s lifestyle and the outcome the lens offers.

Cataract surgeries usually take between 10 and 30 minutes, depending on how complicated the case is. The anaesthesia administered can either be local or ‘topical’, an advanced method that involves just eye drops. An echocardiogram and a series of blood tests are ordered before surgery.

“Today, immediately post-surgery, the patient is ambulatory (can walk),” he says. “I encourage them to enjoy life with their renewed vision.”

For safety, a pad is placed on the patient’s eye for a couple of hours after surgery. Many ophthalmologists recommend post-operative clear spectacles to avoid infections; some don’t.

“Many misleading advertisements promise an immediate return to office following surgery,” says Mukherjee. “We have to consider patient safety and long-term outcomes.” After surgery, medication includes eye drops for at least six to eight weeks. The patient has to keep water from entering the eye for about five days.

“Recovery has many indicators, like the patient’s mobility and reasonably improved vision from the first day after surgery,” he says. “They can go out after a few days of being home-bound.”

Bilateral cataract surgery (operating on both eyes together) is often practised abroad. “Our situation in India is different,” says Mukherjee. “Patient safety is prioritised. It pays to leave a gap of around a week between the surgeries.”

Mehta recommends a simple, regular home test—cup each eye (even with spectacles on) to test the vision of the other. “Cataract is a once in a lifetime surgery,” he says. “Once removed, it never recurs."

high-five-how-to-combat-a-sedentary-lifestyle-with-this-simple-health-mantra

Sat Jan 24 17:06:54 IST 2026

With Dr Manan Vora, orthopaedic surgeon

1 What do you eat in a day?

I am going to answer this question by saying I personally eat 1,700 calories a day with 1.6g per kg of protein. The reason I have answered like this is because everything that I put in my mouth is measured to the T on a food weighing scale and my protein is accounted for. So I would much rather answer it like this to let people know principally that this is something they should consider doing.

2 Your fitness regime?

Ninety minutes a day of strength training four days a week. One hour in the evening is either football or racket sport. And I do not sleep till my smartwatch shows I have completed 10,000 steps a day.

3 What do you do in your me time?

I am not too proud of it, but I am addicted to my phone. So, I am watching Shark Tank videos on YouTube or a suspense thriller show on Netflix. That's what I do in my me time. I am counting this as me time, apart from following the Indian cricket team or my favourite football team. But I am guilty that my me time does involve a screen.

4 One unhealthy thing that you will be never caught doing.

I have never tried alcohol, not a sip. I have never tried vaping, smoking, hookah and I don't think I would ever touch any of these. I am very proud of that.

5 One health mantra you swear by?

Constant movement. In today's day and age, because of sedentary lifestyles or people crossing a certain age, [they] think that they have to just stay in bed or sit all day, I do not agree. And the number of patients I am seeing with back and neck pain, knee issues, because they have sedentary lifestyle, is so high. So one thing I would strongly promote and advocate is just every hour, get up, move your body, challenge your body. You will be surprised how capable it is to move and be functional when you move it, and try to gain more and more muscle. So the answer is movement.

cribsheet-a-mothers-guide-to-preventing-bone-loss-and-calcium-depletion

Sun Feb 01 19:51:40 IST 2026

Until that day, all I had seen—and felt—were tiny feet kicking in my belly. She kicked a lot, tangoing with the clatter of my keyboard. But, on June 19, by midday, she stopped playing footsie and finally decided to greet the world.

I caught only fragments of hushed talk about a tangled umbilical cord, and panic set in. I saw the doctor reaching for the forceps. She was out—but the cord was wrapped around her neck twice.

For a second, she didn’t cry—a silence that stretched into a heart-stopping eternity. Then, a sweet, sharp wail pierced the stillness. I thought the hard part was over. I was wrong.

Despite being a natural marvel, motherhood remains wrapped in mystery, myth and superstition. We glorify it, cloak it in divinity and grace—yet the science that sustains it often remains hidden.

Even in the 21st century, a mother can find herself learning something entirely new from an Instagram reel, despite having grown up surrounded by the idea of motherhood.

A popular myth suggests that once delivery ends, struggle gives way to the serene ease of feeding a newborn. But how many of us know that our mother’s hips and spine may have disintegrated to produce enough calcium-rich milk?

Yes—if a mother does not get enough calcium from her diet, her body treats her skeleton like a calcium bank, withdrawing what it needs to enrich breast milk for the baby.

My daughter was an SG baby—small for gestational age. I had to help her gain weight quickly, but I was not even sure I was lactating. Enter Sister Elsy, the hospital’s lactation coach—a much-needed breath of calm. She reassured me that I was producing enough colostrum, the nutrient-dense fluid secreted in the first few days after birth. A sliver of order amid the chaos.

Often called liquid gold, colostrum is rich in antibodies and white blood cells—essentially a baby’s first vaccine. The milk begins to arrive by the third or fourth day after delivery.

To produce milk, the body functions like a biological refinery, drawing glucose, amino acids and proteins directly from the mother’s bloodstream. If her diet falls short, the milk does not suffer—the body compensates by dipping into its own reserves. A growing baby requires roughly 300-400ml of breast milk per day. If dietary intake is inadequate, calcium is withdrawn from trabecular bone—the spongy, honeycomb-like structure found abundantly in the hips, pelvis and spine. So, the next time that persistent back pain refuses to fade, it may not be just post-delivery strain. It could be your bones quietly paying the price.

That breastfeeding could be ‘harmful’ to the mother is never talked about. Even women are unaware of it. A friend, mother of two, was as surprised as I was. “Oh! Maybe that’s why the back pain and aches never end,” she said, clutching her hips. Another friend continued to breastfeed her child until the child turned four. She told me mother’s milk is the best food for the baby—which is partly true. So, where do we draw the line?

Studies show that many mothers function in a state of chronic calcium deficit. Experts caution that without proper supplementation, this can raise the risk of osteoporosis—extreme bone loss that can lead to vertebral fractures.

“From 14 weeks of pregnancy to six months post-delivery, a woman should consume 1,000mg of calcium daily. Since studies have found that most Indians don’t meet this requirement through diet alone, supplements are essential,” said Dr Bipin Theruvil, head of arthroplasty, Medical Trust Hospital, Kochi. Neglect can also lead to osteomalacia (condition causing soft, weak bones), stress, fractures and severe muscle cramps, he said.

The situation becomes even more precarious for mothers caught in the trap of restrictive food trends—or for those battling conditions like rheumatoid arthritis, where inflammation further complicates an already demanding biological process.

Dr Teena Anne Joy, gynaecologist at Aster Medcity, Kochi, said prolonged breastfeeding has limited nutritional value. “Feeding a four-year-old serves more as a pacifying mechanism. We recommend exclusive breastfeeding for six months, and continued breastfeeding, along with solids, till two years,” she said. However, she cautioned against blaming breastfeeding alone for aches and pains. “Nutritional deficiencies, posture, and the constant bending and lifting involved in infant care all contribute. Annual check-ups are crucial, but often ignored,” she said.

"During the first year postpartum, hormonal shifts cause temporary bone mineral loss. Adequate calcium, vitamin D, weight-bearing exercise, and avoiding calorie restriction below 1,800kcal are essential for bone health and long-term recovery," said a board-certified lactation consultant in Gurugram.

The daily grind of breastfeeding is a test of endurance—made harder by pumping schedules and the anxious arithmetic of not wasting a single drop.

It is messy. It is beautiful. It is a struggle. Still, dear mother, trust science. Let your ‘Ga Ga’ create music in your home with ‘Ca’.

migrions-the-secret-viral-packages-that-make-infections-more-severe

Fri Feb 27 14:17:32 IST 2026

A group of Chinese researchers has found that viruses are using a technique strikingly similar to the Trojan Horse—unknown until now—to infiltrate and spread within the body.

At different stages of evolution, viruses have developed diverse strategies to spread and survive. How efficiently a virus moves from one cell to another plays a major role in how severe an infection becomes. The two main ways viruses spread are cell-free diffusion—virus particles are released into the space outside cells and go on to infect new ones—and direct cell-to-cell spread, which helps viruses evade the host’s immune system.

Now, a new and more dangerous viral path has been discovered. Researchers found that a newly identified cellular structure called migrasomes forms specifically during cell movement and that the vesicular stomatitis virus can package its genetic material and proteins inside these migrasomes. In effect, viral cargo is cleverly hidden and discreetly loaded in structures linked to cell migration. These virus-like packages, named migrions, are made not only of viral components but also of the host cell’s own material.

When viruses spread using migrions instead of individual virus particles, they grow much faster in newly infected cells. This happens because migrions deliver multiple copies of the viral genetic material at once, allowing replication to begin immediately and in parallel. Therefore, they are far more infectious than free virus particles. When viruses enter the body hidden inside migrions, the disease becomes significantly more severe. Experimental mice developed serious infections in the lungs and brain, often leading to encephalitis and death.

Although Odysseus devised the idea of the Trojan Horse outside the gates of Troy, it was the city’s residents who unwittingly carried the enemy inside. Similarly, viruses appear to be exploiting the body’s migratory machinery to move efficiently, infect cells and survive.

people-think-carefully-about-food-they-also-need-information-diet-yuval-noah-harari

Fri Feb 27 14:18:29 IST 2026

With Yuval Noah Harari, historian and philosopher

1 What do you eat in a day?

I eat mostly vegetarian food. Usually, for breakfast, I eat fruits and porridge. For lunch, probably rice with vegetables or dal, or something similar. In the evening, usually salad and bread. I don’t have a very specific diet.

I would say, though, that the same way people think very carefully about food, they also now need an information diet. You know, information is the food of the mind. Too much food is not good for the body; too much information is also not good for the mind. We need small amounts of high-quality information, and then we need time to digest it. Like with food, you eat for an hour, two hours a day, and then most of the day you just digest the food.

So it is with information as well. You read a book, you watch the news, you have a conversation. Then you need time—you don’t take more information in. You just think and meditate on the information you got; you digest it. And digestion is often the most important part of the entire process.

2 Your fitness regimen?

I try to meditate two hours a day and do some kind of exercise—walking, yoga. I would say that, with regard to both exercise and food, that it is very dangerous to take the regimen of somebody else and adopt it for yourself, because every person is different.

Every person has a different body, a different occupation, lives in a different country. So, if you live in a very cold country and you eat something, and then somebody in a very hot country hears about your diet, eating the same thing may not be good.

I would say people should experiment with food, with exercise, and see what makes them personally feel better, healthier, and then do that instead of trying to copy the exercise regimen or the diet of somebody else.

3 How do you unwind when you are alone?

I meditate—that is one very important thing. I start the work day with an hour of meditation, and at the end of the work day, I do another hour. I spend a lot of time with friends. I watch television. At night, if I want to just completely shut down the mind—not think about anything—I watch some TV series.

4 How do you decide what information to ingest and what not to take?

Yes, first of all we need to develop the ability to tell the difference between reliable and unreliable information, because we are flooded with too much information. The key question is, what is the evidence on which the information is based?

Science is all about evidence. Something can be very attractive, interesting or exciting, but there is no evidence that it is true. So, this is like junk food. It is very tasty, but it does not really do good for your body. So the question is, what is the evidence that this story, article or book is really telling me the truth?

Most information is like junk food; most information is not the truth. The truth is costly. It takes time, money, energy to do research, to gather evidence, to write the truth. Whereas fiction and fantasy and lies, they are very cheap. You just write anything you want. You don’t need to invest anything. So this is why most information is not the truth.

Also, the truth tends to be complicated because reality is complicated. Whereas fiction can be made very, very simple.

5 Fiction is bad?

People prefer simple stories over complicated ones. And the truth is often painful. There are many things we don’t want to know about ourselves, our nation, our world. Fiction can be made very, very flattering. So again, it is all like junk food. It is very tasty, very cheap, but it is not good for your body.

how-a-new-endocannabinoid-could-revolutionise-stroke-pain-treatment

Fri Feb 27 14:19:15 IST 2026

Humans have been using cannabinoids—the active compounds found in the cannabis plant—for medicinal and ritual purposes for at least 5,000 years, with some archaeological evidence suggesting an even longer relationship with the plant. Compounds like THC and CBD—found in cannabis and known as exogenous cannabinoids—have some cousins in the human body. These cannabinoids, produced by our bodies, are called “endocannabinoids”, and since the evolution of the human race, they have been modulating a wide range of physiological and pathophysiological responses. The neuromodulatory network they form, in fact, helps maintain homeostasis—the body’s internal balance.

There are two primary endocannabinoids, and one of them—anandamide—is named after the Indian philosophical concept of ananda, a metaphysical condition related to profound stillness. Often called the “bliss molecule,” in its natural form it is highly unstable and breaks down almost immediately after being produced. The second, 2-arachidonoylglycerol (2-AG), is found abundantly in the body and plays a key role in regulating immune responses and pain signalling. If exogenous cannabinoids like THC and CBD are like a flood that hits every receptor in the brain at once, endocannabinoids are like a precise “surgical strike”: they are released only where and when they are needed and break down quickly.

Now, a group of researchers from Northeastern University in the US has created the first synthetic endogenous cannabinoid compound that would not produce a “high,” but is more potent and stable. The researchers made a strategic modification to the endocannabinoid structure to ensure that it binds to cannabinoid receptors while also blocking the enzymes that would normally break down cannabinoid molecules. The precision of this modified structure also allows the compound to trigger the body’s natural analgesic (pain-killing) pathways without crossing into areas of the brain that produce psychoactive effects. Researchers say that the molecule they developed will have a wide range of applications, and they have begun testing it for protection from strokes and even the “reversal” of stroke effects. It will also be tested soon for pain-relief applications in inflammation, cancer, and neurodegenerative diseases.

indias-mental-health-crisis-how-wellness-gurus-on-social-media-are-fuelling-a-ticking-time-bomb

Sat Jan 03 14:57:22 IST 2026

In a nation of over 1.4 billion, India's mental health landscape is a ticking time bomb. Nearly 197 million Indians—one in seven—live with some form of mental disorder, according to the Global Burden of Disease study.

Depression and anxiety top the list, worsened by rapid urbanisation, economic pressures and the lingering psychological scars of the pandemic. Yet, access to professional help remains a distant dream for most.

India has 0.75 psychiatrists per one lakh people, far below the World Health Organization's recommended three per lakh—although this picture is rapidly changing.

With approximately 9,000-11,000 psychiatrists in India against a required 36,000, it means more than 80 per cent of those with severe mental illness receive no formal care. Stigma, high costs and an acute shortage of professionals have resulted in treatment gaps ranging from 70 to 92 per cent—leaving millions vulnerable.

This vacuum has been eagerly filled by a burgeoning army of self-proclaimed wellness gurus. Social media platforms, such as Instagram, TikTok, and YouTube, are teeming with influencers promising quick fixes for mental anguish. From celebrity life coaches to viral “healers", these people capitalise on desperation, peddling unverified advice in a market projected to reach trillions globally.

In India, where traditional healing blends with modern digital trends, the allure is particularly strong. Beneath the glossy reels, however, lies a perilous underbelly: dubious methods, with little or no scientific backing, often leading to delayed treatment and intense suffering.

Wellness gurus urge followers to "visualise" their worries away, drawing from the law of attraction—a pseudoscientific idea popularised by self-help literature.

Proponents claim positive thoughts alone can rewire the brain to eliminate anxiety disorders. This narrative ignores well-established neurobiological mechanisms such as dysregulated serotonin pathways and chronic stress responses.

Studies show no empirical evidence supporting manifestation as a standalone treatment; instead, it can foster self-blame when it fails—deepening feelings of inadequacy.

In India, influencers with millions of followers promote this through daily affirmations, charging for premium "manifestation workshops" that promise an end to panic attacks without therapy.

A similar oversimplification is seen in the promotion of gratitude journaling as a panacea for depression. Writing down three things one is thankful for each day is often sold as a way to “overcome” clinical depression. While acknowledging positives can serve as a minor adjunct in therapy, it is no substitute for addressing underlying causes such as genetic vulnerability, chronic stressors or unresolved trauma.

Research from leading psychology bodies shows that such simplistic tools lack robust evidence for treating moderate to severe depression—potentially trivialising the condition.

Fads are rampant: crystal healing, where amethysts are said to "absorb negative energy" for better mood; essential oils, claiming to cure insomnia without side-effects; or eating an orange in the shower to "reduce anxiety" through sensory distraction.

These ideas emerge from the wellness industry's scrutiny-free wonderland, blending ancient and modern practices. Beyond these are more dangerous claims—dubious trends include "quantum healing" suggesting consciousness alone heals mental problems, or, the promotion of unregulated supplements as "natural antidepressants”.

In India, social media influencers—often without medical qualifications—push these ideas, creating an infodemic of misinformation.

A recent investigation found that over half of popular mental health content on social media platforms contained inaccuracies or outright falsehoods, frequently promoting quick fixes and questionable products.

Celebrity coaches blend spiritual anecdotes with self-help, but critics question the authenticity and efficacy, labelling it “self-hype".

The government has stepped in, mandating influencers to disclose qualifications when giving health advice, yet enforcement lags.

The perils of these self-sprouting gurus are manifold. First, they exploit vulnerability, using fear-mongering against "big pharma" or fostering dependence through gated online communities.

This erodes trust in science, steering people from evidence-based care. In India, where stigma already deters professional help, such misinformation delays treatment, allowing conditions to worsen—sometimes with tragic consequences.

A recent Gallup snapshot revealed nearly 30 per cent of Indian workers face daily stress, with half considering quitting their jobs, amplifying the crisis. Wellness toxicity also triggers burnout; the pressure to maintain "perfect" habits, like endless journaling, can induce anxiety, turning self-care into a trap.

Financially, it is exploitative: premium courses, apps, and products drain resources without results. Worse, some methods harm—unregulated supplements can interact dangerously with medications, and ignoring symptoms risks severe outcomes. As one expert notes, these influencers are often conspiracy-adjacent, blending wellness with extreme views.

Exposing these charades is crucial, but so is highlighting paths forward. True mental health promotion rests on evidence-based methods—grounded in rigorous research. Cognitive Behavioural Therapy (CBT), for instance, is a gold standard for anxiety and depression, teaching skills to reframe negative thoughts with proven efficacy in reducing symptoms by 50-60 per cent in trials.

Schemes like the National Mental Health Programme should integrate CBT into primary care on a larger scale.

Medication, when prescribed by professionals, plays a vital role; antidepressants have strong evidence for moderate-severe cases, under supervision.

Lifestyle interventions shine, too: regular physical activity, such as 150 minutes of moderate workouts weekly, lowers depression risk by 20-30 per cent.

Quality sleep—7-9 hours every night—regulates mood hormones, while a balanced diet supports brain health.

Social connections are pivotal; evidence shows strong relationships buffer stress, reducing mental disorder onset.

The need of the hour is to evolve a community-based model involving local personnel to promote wellness through peer support. This will help in decreasing distress in rural areas.

Mindfulness-Based Stress Reduction (MBSR), with roots in meditation but backed by Randomised Controlled Trials (RCTs), alleviates anxiety without pseudoscience.

School-based mental health programmes build resilience through evidence-driven education, fostering literacy and coping skills.

Workplace interventions—including stress management training—yield returns: for every rupee invested, up to four are saved in productivity.

Digital tools, when evidence-based, offer accessible therapy modules.

Prevention is key—addressing determinants like poverty and gender inequality through policy can avert disorders.

To bridge the gap, India must invest in training more professionals, de-stigmatise help-seeking, and regulate influencers rigorously.

Dr Alok Kulkarni is senior consultant psychiatrist at the Manas Institute of Mental Health, Hubli.

how-to-control-your-genes-the-science-of-epigenetics-explained

Sat Jan 03 14:49:55 IST 2026

For decades, we believed our health, lifespan and disease risks were fixed at birth—sealed within the double helix of our DNA. Now, that idea has been overturned. The science of epigenetics—the study of how chemical ‘switches’ control gene activity—has reshaped how we and research scientists understand life. If the DNA helices are the hardware in us, then epigenetic switches are the software that control the hardware. This software influence shows that genes are not static codes, but dynamic instructions that respond to our environment, lifestyle and even our emotions. The epigenetic switches—similar to on/off switches—don’t rewrite the instructions in the DNA manual, but they control which parts are to be read and how much, as well as which are to be skipped for effective gene expressions.

So, our biology listens to the life we lead, the thoughts we harbour and the emotions we feel. The prefix ‘epi’ means ‘above’, so epigenetics refers to what happens above our genes. Chemical modifications that decide which genes are switched on or off are mostly: DNA methylation, histone modifications and chromatin remodelling. These affect how tightly the DNA is packed in the cell. When a gene region is tightly wrapped, it’s silent; when it’s open, it’s active. This control system shapes how cells work, how our body ages and even how our brain adapts to stress or trauma.

Think of your DNA as a library of books, each containing instructions for one body part—heart, skin, brain or immune system. But your body doesn’t read every book at once. The epigenetic switches act like bookmarks or sticky notes that tell the cell which pages and which part of the page to read and which to skip. These sticky notes change as life progresses, taking in its fold impacts of all the changes and events we go through. What you eat, how much you move, how you sleep, the air you breathe and even the thoughts you think—all can rewrite these molecular bookmarks. A poor diet or stress can blur or move them, silencing protective genes. Healthy living, meditation and prayer, on the other hand, can add new notes that activate genes promoting repair and resilience. In other words, healthy habits are molecular conversations with our genome to improve it for a better life experience. Our lifestyle, in a very real sense, writes notes on the margins of our DNA to shape our stories.

Remarkably, epigenetic switches can also be inherited and passed on to future generations. The lifestyle choices, mental stress and even the generational experience of famine/drought/social injustice, may influence not only our health, but that of our children and grandchildren, too.

Despite this progress in genetics, we must know that we are only beginning to understand the complexity of the epigenome—the collection of all the epigenetic marks on the DNA in a single cell. Its cell-specific patterns and constant environmental interplay make it one of biology’s most intricate systems.

The science of epigenetics can have a massive real-life impact on public health recommendations by confirming the molecular mechanism of environmental effects. For example, a mother's diet during pregnancy—like adequate folic acid/B vitamins—can impact the child's lifelong risk for diseases like heart disease and diabetes by influencing DNA methylation patterns in the foetus.

Even more exciting is the research area where scientists are learning to “reprogram” the epigenome. Studies show that epigenetic editing can slow biological ageing, repair damaged tissues and even treat/reverse cancer-related changes. There are FDA-approved drugs (histone methyltransferase inhibitors, DNA methyltransferase inhibitors, to name a few) that modify the chemical switches on DNA in patients to “reprogram” a cancerous cell back towards a more normal state or make it sensitive to other treatments.

The diseases that have shown proven clinical results through epigenetic interventions are myelodysplastic syndromes, types of leukaemia, T cell lymphomas and sarcomas.

As this field advances, we are stepping into a new era of medicine, where health and even destiny become choices we can shape. Epigenetics is finding intriguing parallels in ancient Indian philosophy. It shows that our inner and outer worlds continuously shape our biology. Indian spirituality has long held that consciousness governs matter.

The idea of karmic or Akashic records, which hold impressions of all thoughts and actions across lifetimes, finds a poetic mirror in the concept of epigenetic inheritance. Just as experiences can leave molecular imprints on genes passed to future generations, our spiritual traditions teach that karmic patterns influence the soul’s journey.

Empowered with the knowledge of epigenetics, we can now imagine a world where ageing is not inevitable, where cancer risk is reduced by restoring healthy gene function, and where mental wellbeing can be strengthened by nurturing our inner environment. Epigenetics is making this vision real. It shifts biology from being about fixed letters to being about annotations, edits and rewrites—a living script that evolves with every breath, meal and emotion. The epigenome is rewriting the story of life, and for the first time we understand that the pen is in our hands.

The writer is a pathologist and an author.

ditch-the-plank-why-standing-ab-exercises-are-your-new-core-go-to

Sat Oct 25 16:48:36 IST 2025

If you wince when you think of ab workouts, you’re not alone. Pilates enthusiasts aside, most of us don’t enjoy working our core muscles with exercises like planks and crunches, which is why standing ab exercises come in so handy.

Not only can you avoid sweaty gym floors or getting up close and personal with your living room carpet, but they are also the best core exercises to do at home, says Kate Rowe-Ham, a certified personal trainer, women’s fitness coach and strength specialist, who is also the founder of the fitness platform Owning Your Menopause.

“Standing ab exercises train your core in a way that mimics how you use it every day—upright, moving, twisting, rotating and stabilising, so they are more functional than planks,” she explains.

Want to give them a try? Here, Rowe-Ham reveals her favourite three standing ab exercises and how to do them.

What are standing ab exercises?

These are designed to target the core muscles, including the abdominals and obliques, from a standing position. Doing these not only boosts strength in the trunk, but also has benefits for the entire body. “They improve posture and balance while being easier on the wrists, shoulders and lower back,” says Rowe-Ham. “This makes them a brilliant alternative for anyone who struggles with a plank.”

You can do standing ab exercises as part of a dumbbell core workout or a bodyweight workout for beginners, depending on your current fitness levels.

How to do standing ab exercises

Standing wood chop

“[This is a fantastic, full-core move that mimics how we actually move in everyday life, reaching, twisting and lifting,” says Rowe-Ham.

“It builds rotational strength, targets the deep core muscles (like the transverse abdominis), and teaches your body to generate and control force, a skill we use for everything from putting on a seatbelt to carrying shopping bags. It’s powerful, functional, and satisfying.”

How to do it:

Stand with your feet shoulder-width apart and clasp your hands together.

If you’re doing it with a dumbbell or medicine ball, hold it securely.

Start with your arms raised diagonally above one shoulder.

Rotate through your torso and “chop” down across your body towards the opposite hip.

Return to the starting position with control and repeat.

Standing side bend

Don’t underestimate this one, Rowe-Ham warns. It may look easy, but it “directly targets the obliques, improves side-to-side movement and supports better posture and spinal alignment”.

“It’s brilliant for strengthening the muscles around your waist, which help protect your lower back,” she says.

How to do it:

Stand tall with feet hip-width apart.

You can do it with your hands behind your head (bodyweight version) or by holding a dumbbell in one hand down by your side.

From there, slowly bend your torso to one side, as if you’re trying to reach your rib towards your hip.

Squeeze through your obliques to come back up.

Keep your hips square and avoid leaning forward or backwards.

Standing side crunch

We promised no planks, but crunches are still on the menu, and standing side crunches are one of the best. “It’s a brilliant way to fire up both the obliques and the lower abs while also working your balance, coordination and hip mobility,” says Rowe-Ham. “Because you’re moving dynamically, your heart rate lifts, too, so it gives you a little cardio boost alongside core strengthening.”

Here’s how to do a standing side crunch:

Start standing tall with your hands lightly behind your head.

Drive your right knee up towards your right elbow, crunching through the side of your waist.

Lower back down and repeat on the same side before switching, or alternate sides throughout.

To make it harder, hold a light dumbbell or small ball overhead as you bring your elbow and knee together.

Not keen on crunches? You could always try shoulder taps or leg raises instead to fire up your obliques and lower core muscles.

Do standing ab exercises really work?

Yes, they are a great way to improve your core strength and boost full-body stability, mobility and balance, says Rowe-Ham. “They train your core in the way it’s actually designed to function. Unlike floor-based movement, where you’re braced against the ground, standing work forces your muscles to stabilise you against gravity while you move,” she explains.

But the benefits don’t stop there. “They also activate the deep stabilisers, like the transverse abdominis, obliques and muscles around your spine and hips,” she says. “These are the muscles that keep you upright, protect your lower back and help you resist unwanted twists or wobbles when you’re walking, lifting or even just carrying a shopping bag.”

How often should you do standing ab exercises?

Little and often is the key to building a stronger core with standing ab exercises, says Rowe-Ham. “Just 10 to 15 minutes, two to three times a week can make a real difference to your strength, posture and stability,” she says. “The trick is consistency. Try a set of side bend while the kettle’s boiling, a few standing side crunches after you’ve been sitting at your desk for a while, or some wood chops while you’re waiting for dinner to cook.”

It’s the little bursts like this that add up over time, she notes, so you can train your core muscles and reap the benefits without having to spend dedicated time on a dumbbell core workout, for instance.

Standing ab exercises versus plank

Comfort: As Rowe-Ham notes, standing ab exercises don’t put pressure on the lower back, wrists or shoulders like regular planks do, which can make them a great alternative for those with existing discomfort in these areas.

Functionality: Standing ab exercises are functional fitness exercises as they so closely mirror everyday movements, like picking things up off the floor. There’s very little in life that mirrors the classic plank. This makes standing ab exercises one of the best exercises for longevity, too.

Versatile: Both planks and these standing movements are versatile enough to add to a plethora of workouts, whether that’s sessions on the treadmill or traditional weight training. You can also do them anywhere, with no equipment.

Making them harder: It’s a lot easier to make standing ab exercises harder with equipment like cables, resistance bands, dumbbells or kettlebells. The easiest way to make a plank harder is by holding it for longer or balancing a weight plate on your back, but this can lead to injury, and most people will need to do it at the gym.

understanding-alzheimers-disease-symptoms-causes-and-treatment

Sat Oct 25 16:40:18 IST 2025

Alzheimer’s disease is named after Dr Alois Alzheimer, a German psychologist and neuropathologist. His assessment of a female patient with symptoms of pre-senile dementia (those under 65), along with the findings of an autopsy of her brain, led him to two neurological substances—senile plaques and neurofibrillary tangle. These two would later be recognised as markers of the disease.

Alzheimer’s is the most common type of dementia, an umbrella term for conditions that occur when the brain no longer functions properly. While there is no cure for it, symptoms can be alleviated. The average life span after symptoms first appear is eight years.

Understanding Alzheimer’s

A disease that gradually destroys brain cells. Patients eventually lose some cognitive abilities, such as memory and language. This is different from the minor effects on memory that ageing can have.

The most affected

This and other varieties of dementia become more common with age, affecting one in every 14 people over 65.

Comparison with dementia

While dementia is a broad term, Alzheimer’s is a specific condition. It first affects the area of the brain responsible for learning, so early signs may include abnormalities in memory, thinking and reasoning abilities.

What families should look out for

Early in the condition, people might find it difficult to recall recent events. Memory deteriorates over time, accompanied by other symptoms. Non-memory components such as finding the proper word, difficulty interpreting visual imagery and impaired thinking, might indicate early stages.

Symptoms and progression

Alzheimer’s typically begins slowly and worsens over time. It eventually spreads across the majority of the brain. The condition can affect memory, thinking, judgment, language, problem solving, personality and movement.

Behavioural changes

Moodiness, apathy, personality changes, unsocial behaviour and linguistic difficulties are all possible indications of the condition.

Comprehending confusion

Patients might be forgetful and struggle to keep up with conversations. They may grow agitated because of this. Noise, speech, crowds and movement can be overwhelming.

Causes

A combination of hereditary, lifestyle and environmental variables that work together to alter the brain over time. Alzheimer’s is caused by unique genetic abnormalities in less than 1 per cent of the population.

Amyloid plaques and tau (neurofibrillary) tangles

The disease is thought to be caused by an abnormal build-up of proteins in and around brain cells. One of the proteins involved is amyloid, which accumulates in plaques (clumps) around brain cells. The other protein is called tau, whose deposits form tangles within brain cells. These are visible only under a microscope during autopsy.

The risk of misdiagnosis

Vitamin B12, folate, vitamin D deficiency, thyroid problems, depression, sleep disorders, infections and drug side effects can all mimic Alzheimer’s symptoms. Proper testing is necessary to avoid misdiagnosis.

Women more at risk

They are twice as likely as men to develop Alzheimer’s because of biological or genetic variations, as well as societal conditions associated with gender, such as education level, occupation and sexism. (The last includes lower economic and social status, higher levels of stress due to greater caregiving burdens, masking of symptoms, etc.)

Disease progression in women

They have a faster cognitive decline, lose their freedom earlier and spend more time with a higher level of disability. The reasons are most likely biological and societal.

The menopause connection

According to research, fluctuating and declining oestrogen levels following menopause may predispose women to Alzheimer’s disease.

Diagnosis

There is no single test to tell if someone has Alzheimer’s. Physicians use diagnostic methods such as neurological exams, cognitive and functional assessments, brain imaging and cerebrospinal fluid or blood testing, in conjunction with medical history. Current tools detect changes years before symptoms, yet accuracy varies.

Treatment and management

Mainly involves the use of cholinesterase inhibitors (that prevent the breakdown of a specific neurotransmitter, leading to improved communication between nerve cells). These drugs may help improve cognitive ability and memory and maintain capability to carry out daily activities, but they do not stop the disease from progressing. The effectiveness of these medications is variable.

Early diagnosis and treatment make maximum impact; however, most people will need ongoing assessment and dose adjustment.

Lifestyle changes

Regular physical activity helps with blood flow to the brain and may decrease neurodegeneration. A diet rich in antioxidants, omega-3 fatty acids and low in processed food supports brain health. Cognitive stimulating activities, such as completing puzzles, reading books and learning new skills, strengthen neural connections. While lifestyle changes will not cure Alzheimer’s, they can help preserve function, postpone symptom progression when combined with medical management, and improve overall wellbeing.

Occupational therapy or social engagement in care

Occupational therapists—who help patients with daily activities—create individualised schedules and approaches to help sustain independence in daily life. Social interaction through family engagement, support groups or planned activities benefits emotional health and decreases feelings of loneliness, depression and anxiety.

New treatments and research

Focused more than just on symptom relief. Disease-modifying treatments, speci fically monoclonal antibodies directed against amyloid-beta proteins, can slow the neurodegeneration. Non-invasive brain stimulation, gene therapy and stem cell mediated repair of neural circuits are being researched. Additionally, clinical trials are examining anti-inflammatories, neuroprotective agents and personalised treatment approaches. Although this research is still largely experimental, it has the potential to change the trajectory of the disease.

Caring for loved ones

Support independence by creating recognisable routines that lessen confusion and anxiety. Dividing tasks into easy-to-follow steps alongside visual cues and gentle assistance promote independence. Supporting participation in chores, interests or self-care supports confidence. Positive redirection and patience are important, as is balancing supervision with independence.

Managing agitation

Learn the possible triggers, provide reassurance and use distraction or other activities like listening to music or walks. Creating safe spaces, minimising communication and creating regular routines can help reduce frustration and limit challenging behaviours from being exacerbated.

Difficult situations like sundowning

Minimise noise, reduce bright lighting and utilise familiar cues to alleviate confusion or sundowning (feelings Alzheimer’s patients get when the sun sets). Soothing words, familiar routines, plenty of fluids and rest help promote soothing. Avoid arguing, and let them take their time to process information to alleviate agitation and anxiety.

Home safety modifications

Ensure lighting is bright, remove items that could lead to falls and use floor mats. Install door-locking hardware, label rooms, keep medications in a safe place and place sharp objects out of reach.

The impact on relationships

People with Alzheimer’s could become more irritable and impatient, making it difficult for those around them. Caretakers of Alzheimer’s are more likely to experience worry, depression and a lower quality of life than other caretakers.

Use support systems

Adult day care services provide day-to-day help. These choices offer short-term care for a person with dementia while allowing the caregiver to take a break. Day-to-day support may include supervision, home-delivered meals and/or transportation.

The numbers in India

Around 88 lakh people over the age of 60 suffer from dementia; the prevalence is projected to double by 2050.

The rural-urban divide

A study found that the prevalence of dementia was greater in the rural elderly (30 per 1,000) than in seniors in urban areas (20 per 1,000). Lower education level, poorer income and co-morbidities such as diabetes and cerebrovascular illness were the most commonly identified risk factors.

Indian family structures

Joint family systems in India often ensure the care of the elderly with Alzheimer’s or dementia as responsibilities are divided among family members. But traditional gender roles still influence this experience. Women, especially daughters-in-law, have been taking on the lion’s share of this work, which adds to the emotional and physical burden.

Challenges in India

There is a general lack of awareness and understanding of Alzheimer's, which leads to undetected or misdiagnosed cases. This delays therapy. There is an overall stigma associated with mental health. Rural areas have limited access to health care institutions and specialised Alzheimer’s care.

Indian initiatives

The National Dementia Strategy and National Mental Health Programme seek to promote disease awareness while also improving patient treatment and access to mental health services. Memory clinics and dementia day care centres have been established in multiple locations. Furthermore, the Ayushman Bharat initiative includes financial help for Alzheimer’s patients’ treatment.

can-digitoxin-be-a-breakthrough-for-pancreatic-cancer

Fri Feb 27 14:20:32 IST 2026

Could the clue to a future cure lie in the past? It may sound like a philosophical musing, but a group of drug researchers in Sweden is exploring exactly that question—testing whether an archaic drug—digitoxin—could offer new hope in treating pancreatic cancer, one of the deadliest forms of the disease.

The story of digitoxin began not in a laboratory but in ancient and folk medicine, where the foxglove plant (Digitalis purpurea)—from which digitoxin is derived—had been used for millennia. In traditional European herbalism, foxglove leaves were brewed into teas for various ailments. However, its potency often led to accidental poisoning, earning it a reputation as a dangerous “witch’s herb”.

In 1775, William Withering, an English physician and botanist, encountered this folk remedy from ‘Mother Hutton’, an old lady from Shropshire. Mother Hutton’s secret herbal tea, which contained about 20 ingredients including foxglove, was reportedly successful in treating ‘dropsy’—a condition we now recognise as congestive heart failure caused by fluid retention. Intrigued, Withering began experimenting with foxglove extracts on his patients around 1776.

He systematically tested dried foxglove leaf powder, documenting doses, effects and side effects in over 150 cases. Soon, Withering found that foxglove could reduce fluid buildup by strengthening the heart’s contractions, and he also identified the most effective dosage range.

After a decade of trials, Withering published his seminal work in 1785, An Account of the Foxglove and Some of Its Medical Uses: With Practical Remarks on Dropsy and Other Diseases. This book introduced digitalis to mainstream western medicine, standardising its use while warning of its toxicity. Withering didn’t isolate specific compounds—he worked with crude leaf extracts, which contained a mixture of cardiac glycosides (sugar-bound steroids), including digitoxin.

In 1875, German pharmacologist Oswald Schmiedeberg isolated and named digitoxin using chemical fractionation techniques. His work enabled laboratory testing. By the late 1800s, digitoxin was being commercially produced and used worldwide to treat heart conditions.

In 1904, German physician Albert Fraenkel demonstrated its antiarrhythmic effects. However, digoxin (isolated in 1930 from a related plant) later supplanted digitoxin because it was easier to manage clinically. Until recently, the therapeutic efficacy of digitoxin in patients with heart failure and reduced ejection fraction had not been conclusively established in clinical trials. That changed in August 2025, when a trial presented at the European Society of Cardiology Congress showed that digitoxin improves outcomes in advanced heart failure.

Now, researchers are investigating whether digitoxin can be repurposed to treat pancreatic cancer. Laboratory studies have shown that digitoxin can disrupt cancer cell metabolism, interfere with calcium balance and, in some cases, induce cell cycle arrest or cell death.

If these findings hold up in clinical trials, it could mark the rebirth of a centuries-old drug with a new purpose.

how-to-identify-address-and-overcome-burnout-workplace-stress

Sat Oct 25 15:58:11 IST 2025

Burnout is a buzzword which is often bandied about when we feel a bit tired at work and overwhelmed by life. In fact, it is a syndrome with clear symptoms, including exhaustion and feeling cynical about your work, which was recognised by the World Health Organization (WHO) in 2019. It not only affects workers’ lives, but also the economy.

It is not a modern phenomenon, either. Graham Greene’s 1961 novel—A Burnt-Out Case—is about an architect worn down by his job. In 1974, Bob Dylan sang about being “burned out from exhaustion”.

In the same year, Christina Maslach, a professor of psychology at the University of California, started to research the phenomenon. She says: “Someone told me, ‘lawyers call it burnout’ and that term captured the feelings people were expressing to me.”

If you are exhausted, feeling negative and your performance has dropped at work, you may well be suffering from burnout—but how can you get back on track?

What is burnout?

The WHO defines burnout as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed”.

Prof Maslach, who is also the author of 2022 book The Burnout Challenge, explains: “Burnout is a stress response to those chronic job stressors. A stress response is a normal human response to threats or challenges, and it’s a good thing usually. That’s how we cope. But recovery is the issue.”

“When you run a marathon, you recover. Chronic job stressors—we liken them to pebbles in your shoes—are the daily things that are always in the way. But the optimistic note in the WHO definition is that stressors can be managed,” Prof Maslach adds.

Symptoms of burnout

The three main symptoms of burnout are:

1) Exhaustion

2) Feelings of negativity or cynicism towards your occupation

3) Reduced professional efficacy including difficulty processing information or making decisions

Prof Maslach describes the latter as the feeling of, “‘What’s wrong with me, why can’t I do it?’ Burnout is the trifecta of stress, disliking the job and yourself.”

Jacky Francis Walker, burnout specialist and psychotherapist, adds, “You feel more exhausted and lacking in energy as time goes on. It becomes an everyday experience. You are bone-tired—different to fatigue, you feel under temporary stress.”

“Secondly,” he says, “you feel disillusioned about your job and lose your motivation and engagement. There’s a sense of detaching from your commitments to your role. Finally, you might notice you are not as sharp mentally and it’s harder to process information or make decisions. You might work less effectively so you work longer hours.”

Stages and types of burnout

According to Prof Maslach the typical employee profiles are:

* Those who are engaged

* Those with burnout

* Those who are experiencing one of the three symptoms who may be on the road to burnout

In 2022, the American Psychological Association found 26 per cent of workers had a lack of motivation, 32 per cent emotional exhaustion and 44 per cent physical fatigue. According to Mental Health UK’s Burnout Report, 20 per cent of workers in the UK had to take time off work in 2023 due to occupational stress.

Research also suggests there may be differing types of burnout relating to different types of work environment.

1) Frenetic—marked by work overload and often experienced by highly involved, ambitious individuals

2) Underchallenged—experienced by those working in roles with no personal development

3) Worn-out—which occurs in a rigid, hierarchical organisation where workers may have a lack of control or recognition.

Steps towards burnout recovery

It is not as simple as writing up a self-care list. While there are steps the individual can take, workplace stressors need to be sorted too as ineffective coping mechanisms can exacerbate burnout, causing both physical and mental health issues.

Follow these steps:

1 Acknowledge burnout

The first step to recovering from burnout is acknowledging it. But that can be easier said than done when we are hard-wired to keep going.

“There is denial around burnout and we can lose insight the more burned out we become,” says Walker. Look out for early warning signs like:

Short-temperedness

Irritation with colleagues or frustration with small tasks

If you are in a caring profession, you may feel emotionally detached

“You can feel as if your batteries have been depleted: I say to clients you are not the famous brand of batteries which keep on going, you are the competitor,” adds Walker.

2 Remove stressors

Try to identify your workplace stressors, and remove “the pebbles”.

“Having recognised there is a problem and something needs to change, assess what is possible to change—what is the low-hanging fruit?” says Walker.

The stressor may not be the job per se. In her book The Burnout Challenge, Prof Maslach cites the following factors contributing to the perfect environment for burnout:

*Increased workload

*Lack of control

*Inadequate reward systems

*A toxic community

*Lack of fairness

*Opposing values

Work constructively with colleagues and management in addressing these. Prof Maslach says: “Can you say, ‘[Let’s] make this better?’ Can you make suggestions and be constructive? Can you say, ‘We don’t need patting on the back all the time, but occasionally let people know they have done something well?’”

According to the Mental Health UK survey, 43 per cent of workers cite having a supportive line manager as an effective measure in beating burnout. By law, employers are obliged to identify any risks to your health and must take steps to help prevent or reduce workplace stress.

3 Put boundaries in place

Walker says, “Knowing what your normal time boundaries are at work—when you start, when you finish—helps your brain understand, ‘This is when I normally switch off.’ There might be days when we need to push the boat out, but you need to know what your normal is.”

Being more disciplined about when we stop and start being in work mode, putting an out of hours response on emails, or switching off the work phone, can help.

4 Reassess goals

You may have to have some hard conversations with your employer about what is actually achievable, or with yourself, about the goals you have for your career.

A 2022 review into burnout states, “The expectations that employees have regarding their work are related to the level of burnout, such that higher expectations and higher goal setting lead to greater efforts and thus higher levels of emotional exhaustion and depersonalisation. This mismatch between expectations and realities can lead to frustration and burnout in workers.”

Walker says, “When someone is nearing recovery we look at what brought them to this place and what to put in place to make [their job] more sustainable. Often we need to address their attitude to their expectations of what they should do, would like to do, or ought to do.”

5 Focus on looking after yourself

Here are some tips:

* Eat healthily on and off the job

* Eat regularly, and not skipping meals

* Stay hydrated

Try cardiovascular exercise and yoga, according to a 2015 study both are effective in combatting stress and emotional exhaustion.

* Try meditation or mindfulness

* Try getting eight hours

* Try to have social contact with friends, co-workers, and family

* Try being out in nature and spending a day a month taking yourself out of your usual environment

* Switch off screens (maybe one day a week)

But these measures will not change your stressful situation. Prof Maslach says, “There are coping strategies out there: meditating, mindfulness, doing exercise, getting eight hours of sleep, and being more healthy, which don’t change the stressors, but help you be more rested.”

Remember that taking time out on sick leave or holiday may be a short-term way to cope with burnout, but it is not a long-term path to recovery.

Instead, Walker advises focusing on sustainable recharging strategies: “Start to put some healthy habits in place. Establish what is the non-negotiable bare minimum time away from work you need each week for you to sustainably function and give you enough respite.”

6 Seek professional support

In extreme cases of burnout, seek a therapist.

Cognitive behavioural therapy (CBT) can be effective in reducing burnout, it is a problem-focused talking therapy which gives people tools to cope with current situations and negative thinking patterns. A 2019 study of 60 nurses experiencing burnout showed CBT had an impact on feelings of negativity surrounding both the job and individual performance.

The strategy to overcoming burnout

Try the following techniques:

* Take back control

There is no hard and fast rule as to how long it will take to overcome burnout. Some people recover in three months and others may take years. But evidence shows those who acknowledged they were ultimately in control of their own lives recovered successfully.

A 2015 Finnish study of 12 people who attended a rehabilitation course after suffering burnout noted that, “The entire process of self-recovery represents a shift in clients’ perceptions from denying their burnout symptoms to a realisation they are ultimately in charge of their own physical and mental wellbeing.”

* Make changes to your lifestyle

According to Walker, changes we can make to create that “buffer zone” such as reading, exercising and switching off from workplace and online stress are a key part of a burnout recovery strategy. “We are bombarded with emails with expectations of responding immediately and also with visual stimuli, adverts and social media. It takes up mental load. Our buffer zone has been taken away from us,” he says.

Be careful that relaxation strategies such as socialising—which can be beneficial—do not fall over into negative habits such as self-medicating with alcohol or drugs to cope.

Prioritise quality sleep

Prof Maslach says, “The notion of that eight-hour workday, eight-hour personal time, eight-hour sleep—which is how the 24 should be divided—is actually how we as human beings function.”

A Mental Health UK survey found that 64 per cent of working adults thought that poor sleep was a contributory factor in burnout. Also, a 2021 study found nurses with burnout suffered from daytime sleepiness and poor sleep quality.

Make sure you wind down before bed. Walker says, “If your mind is overactive and you haven’t switched off, it will be hard to sleep. I call it the always-on brain. Build in at least 10-15 minutes before bed where you regroup, and perhaps make a note of what’s floating around in your head [such as worries or priorities for the following day].”

Prioritise activities you love

“Some people might like to go to the gym, cycle or do a hobby, or simply spend time with the family,” says Walker. In a Mental Health UK report, 71 per cent of people cited having a supportive social network as helping to prevent burnout.

Learn stress-management techniques

Walker suggests, “Take mental time out. Whatever works for you, like reading offline material including newspapers or simply closing your eyes, is fine.”

“You may have regular practices like mindfulness which helps you immerse yourself in another world for a period of time,” she adds. A 2023 study showed that diaphragmatic breathing—taking four deep breaths a minute—could improve negative reactions to stress.

If you have lost your commute to work, be mindful you might also have lost a key stress-management technique.

How to avoid burnout in the future

In extreme circumstances, some people with burnout may choose to leave their job. Ideally, you won’t have to take the nuclear option.

If you do, then the key to avoiding burnout in a new workplace is to:

Make sure there is a match between your values and theirs.

Ask sensible questions about the culture and specific examples like, ‘What’s the company’s approach to helping employees have a work-life balance?’

If you have experienced burnout and decide to stay in your job, then be aware of the triggers that led to it last time. “You may feel you have recovered and you are back to normal, but you start to put yourself under the same load, and you go down again,” says Walker.

Remember that it can be a two-way street between employee and employer. A 2020 study examined how employees could contribute to reduce burnout risks. Among these were: seeking out tasks that energise; socialising with co-workers; reducing work-home conflict—especially relevant with the rise of hybrid and flexible working.

No one wants to be stuck in a cycle of repeated burnout, but with collaboration, on both sides, it can be avoided.

medical-research-bias-women-gender-gap-health-feminism

Sat Sep 27 16:42:59 IST 2025

We often think of health as a gender-neutral subject, but in reality, the difference between the sexes in medicine is almost as stark as in athletics. Feminism in health today is a basic need, and not a privilege; it is about questioning systems that disadvantage women.

For decades, medical research has largely been conducted on man (and even male animals), treating male bodies as the ‘default’ model. As a result, the clinical presentation of many diseases, drug dosages as well as side effects and even adverse reactions of surgical implants in women at times vary from the listed ones or the established norms after a study/ trial.

Avoiding the female body in studies has its own reasons—makes the work easier since the hormonal fluctuations in women in various stages of life and a month are complex and any trial taking these variables into consideration is a time- and effort-intensive process.

It is necessary to bridge the gender gaps in the current or past trials, as medicines from past trials are in use today. The studies that were done with remarkable gender imbalance should be identified and re-examined in order to rectify the potential variations in women.

The US Food and Drug Administration did not mandate the inclusion of women in drug trials/ clinical research until the 1990s. The repercussions of that are evident even today. Also, there is no regulatory body mandate for equal participation of both genders, and sex disaggregated data submission is still not an acceptance criterion for a clinical study/trial.

A meta-analysis of data from thousands of medical journals, published in Journal of Clinical Medicine in 2022, found that women are likely to experience adverse drug reactions twice as often as men. They develop higher blood concentration levels and longer drug elimination times, leading to higher degree of side effects.

Here are a few examples to help understand cases of misapplied medicine in women:

The most burning instance is the insomnia drug Zolpidem, which has slow pharmacokinetics (how the body reacts with a drug over time) in women, leading to complications. This drug concentration was higher (three-fold) in women and stayed in blood beyond the morning after its use, leading to drowsy office hours and worse, vehicular accidents. It was only in 2013, after 30 years of its availability in the market, that the FDA halved the recommended dose for women.

So is the case with antidepressants and antipsychotics. As any human anatomy book will reveal, women have higher body fat percentage, so the fat-soluble drugs (like SSRIs, antipsychotics) are stored and released differently, leading to varied or increased side effects.

When it comes to cardiovascular disease, a ‘classic’ symptom documented is chest pain radiating down the arm. But in women, the common symptoms are jaw pain, fatigue, nausea or even back pain. Moreover, aspirin—recommended for heart attack prevention—was found to reduce risk of stroke but not heart attack.

Also, more often clinicians treat chronic pain and even chest pain in women as psychological issues rather than investigating a physical source of the pain.

The story is similar, if not worse, in medical device usage. Since women have different hip angles, bone density and joint sizes, the hip implants tested on men presented with more adversities in women.

In cardiac pacemakers and defibrillators, women have been receiving fewer benefits. Women mostly have smaller heart, and the metabolism of electrical signals generated in these devices often differ in women. A JAMA (2009) meta-analysis reported women being less likely to benefit from intra-cardiac devices (ICDs), and face more complications during or post ICD implantation.

The size and design of artificial heart valves put women more at risk of mismatch between valve size and cardiac anatomy. As per research studies in Circulation (2014), women were at higher risk while undergoing transcatheter aortic valve replacement. Also, women’s smaller coronary arteries make stent placement riskier, with higher chances of restenosis (narrowing of artery) and complications. A study in European Heart Journal (2016) confirmed that women had worse outcomes post stenting.

Also, the clinical system today reflects a poor understanding of menopause—a landmark phase in a woman, with about 40 per cent of her life ahead. Menstruation and mental health around hormonal fluctuations are areas lagging in mainstream care-giving.

Now is the time to revisit stereotypes and ensure prudent policies for both genders. The solution approach to gender discrepancy in health care is enforcing inclusive clinical studies or trials and mandating sex-disaggregated data in every study. Those funding studies and journals publishing them should make this a mandatory requirement. The other best practice would be to include hormonal and life-stage variables in studies, tracking menstrual cycle, stages of pregnancy and menopause and influence of hormone therapy, which alter pharmacokinetics.

Most important, medical education needs reforms to sensitise budding doctors to such gender-related differences in physiology, pathology and in treatment protocols.

Gender equality and equity in health is a matter of scientific accuracy and also justice. Modern medicine has always presented itself as neutral, objective and universal, but it is time to add a female perspective in every research/ trial. This will address historical disparities and ensure well-being of half the world’s population.

The writer is a pathologist and an author.

how-marbles-healths-ease-tdcs-offers-new-path-for-depression-anxiety

Mon Sep 29 16:50:01 IST 2025

John (name changed), 30, was struggling with low mood, crying spells, anxiety and sleep disturbances. Since he had previously experienced serious side effects from psychiatric medication, he was unwilling to take that route again. So when he visited Dr Avinash Desousa, senior consultant, psychiatry, at Sir H.N. Reliance Foundation Hospital, Mumbai, and director of the Desousa Foundation, the doctor had an alternate approach. He turned to a neuromodulation device called EASE, developed by the Indian health-tech startup Marbles Health. The brain is an electrochemical organ: psychiatric drugs act on its chemical messengers, while neuromodulation targets its electrical signals.

EASE, which employs the proven technique of transcranial direct current stimulation (tDCS), is the first licensed neuromodulation device of its kind to be created in India. “[For John], we suggested a trial of tDCS: 10 sessions, five days a week for two weeks,” says Desousa. “If he felt better, we would extend it to 30–40 sessions, followed by maintenance sittings.” The patient eventually underwent 30 sessions, after which he continued maintenance tDCS twice a week, later reducing to once a week. “Now he is stable and doing well. Importantly, the treatment was combined with psychotherapy,” says Desousa.

Witnessing loved ones struggle with mental illness pushed tech entrepreneurs Ramya Yellapragada and Lakshay Sahni to build this device. “We know very little about the brain and what truly works for it,” says Yellapragada. “Pills aren’t always the best or safest option. A huge part of brain function runs on electrical signals, so the question was, how do we harness that to heal?”

Neuromodulation, which involves sending small currents to specific brain areas, emerged as a safe and effective solution. “Licensed technologies already exist and are highly effective, but they are priced in crores,” says Yellapragada. “Most hospitals, especially psychiatric clinics, cannot afford them. That’s what pushed us to create solutions that are effective, affordable and scalable—starting in India, but designed for the world.”

EASE has been designed as a portable, wearable headband. Sahni notes that the upper part delivers tDCS neuromodulation by sending gentle impulses to the brain, while the lower part monitors brain activity using electroencephalogram. “The upper part is therapeutic; the lower part helps with diagnosis,” he explains.

Alongside this, the device also provides an option for Cognitive Emotional Training (CET), which improves cognitive functions. “When you do these training activities while being stimulated, the [therapeutic] effects are compounded,” says Sahni, adding that their medical device has been designed to be operated by mental health professionals or doctors.

Desousa says he is using EASE to develop treatment modalities for managing depression as well as resistant hallucinations in schizophrenia. “Psychotherapy or medication can be combined with tDCS. But in some patients with mild to moderate depression, it can even be used as a stand-alone treatment,” he explains.

Sahni adds that in their trial in India, patients showed a 63.8 per cent decrease in illness scores within two weeks of use, without any adverse side effects.

Yellapragada notes that EASE has also shown strong promise across a range of other psychiatric conditions, including anxiety, obsessive compulsive disorder, phobias and addiction disorders, as well as neurological conditions such as aphasia and mild cognitive impairment. The team is also exploring neuromodulation’s potential in areas from stroke rehabilitation to dementia care. “We have seen doctors themselves identify new areas—where the same brain networks are involved—in which the device could be used,” says Sahni.

The validation study for EASE was conducted at AIIMS Delhi with 25 patients, each undergoing around 20 sessions. Marbles Health founders say it took more than four years to develop EASE, and since its pilot launch earlier this year, they have partnered 40 leading hospitals and clinics in India, delivering thousands of sessions. They have also signed MoUs with the NHS in the UK and are conducting joint studies with two major Indian hospitals.

The founders emphasise that the current version of EASE is about 35 per cent cheaper than foreign alternatives. “We are also developing a further affordable version of the device,” says Sahni. “Our long-term vision is similar to how BP machines moved from clinics into households. One in seven homes worldwide faces a mental or neurological condition, and we hope our device will eventually be used—under medical supervision—in these homes.”

why-cannot-stop-scrolling-phone-infinite-scroll-addiction

Tue Oct 07 11:59:21 IST 2025

Before our thumbs learned the reflex of swiping up and our eyes adjusted to a feed with no end, there was just a small design experiment—and a young designer named Aza Raskin.

In 2006, Raskin was working at a small software company called Humanized. Back then, the internet felt slower, more deliberate. Every time you reached the bottom of a page, you had to stop, move your mouse and click ‘Next’. It was a small interruption, but it broke the spell. Raskin wondered: what if the page didn’t stop? What if it just kept going?

He wasn’t thinking about addiction or attention spans, just a smoother, more seamless web. But that one tweak would cause a ripple across the internet, quietly reshaping how billions of us now spend our days and nights. We call it the infinite scroll.

For many people, scrolling is no longer a conscious decision. It is a reflex—something your hand does without waiting for your mind to catch up. And once you start, you rarely notice how deep you have gone.

Every night, Delhiite Shreya Arora, 27, tells herself the same lie: just five minutes. Ninety minutes later, she is still lying in the dark, the pale blue glow of her phone casting across her face, her thumb moving like it has a mind of its own. “It is like my brain checks out,” she says quietly. “But my hand keeps going.”

Across town, HR manager Rohit Sharma, 43, calls it “time theft”. “I didn’t choose to waste that time,” he says. “It is like the app chose it for me.”

From students delaying assignments to parents grabbing a rare moment of quiet, millions of us are caught in the same loop. What starts as a quick peek turns into an hour. Or two. Or more.

One evening, Tarun Katyal, 38, a finance analyst in Gurugram, came home tired. He dropped on to the sofa, phone in hand, and opened a short video “just to unwind”. One reel turned into five. Five turned into 30. When he finally looked up, two hours had slipped by. His dinner sat cold on the table, his head was pounding, and he felt empty. “I didn’t even like what I was watching,” he says. “I just couldn’t stop. It was like I had been hypnotised.”

Vartika Mehra, 25, who lives in Lucknow, knows the feeling all too well. After a breakup, she felt hollow—no energy for friends, no words for therapy. So she turned to her feed. One ‘glow-up’ reel became another. Sad songs. Healing quotes. Strangers crying into their cameras.

At first, it felt like comfort, as if someone out there was hurting alongside her. “It felt like therapy,” she says. “But then it just felt like nothing. I wasn’t crying anymore. I wasn’t feeling anything. I was just gone.”

Akshay Jain, 17, from Noida doesn’t even pretend anymore. Most nights, he watches ‘study with me’ videos instead of studying—strangers working in cafés with soft background music. It looks and feels productive, but it isn’t.

It might feel like you are making those choices—opening the app, swiping, tapping—but much of it was decided for you long before your thumb moved. The truth is, the scroll isn’t just a habit. It is design.

The design that never lets you stop

“This isn’t happening by chance,” says Prof Mohit Bhardwaj, head of user interface (UI)/user experience (UX) at the Indian School of Design and Innovation in Mumbai. He explains that infinite scroll is a powerful mechanism that turns scrolling into a low-effort, almost mindless activity while algorithms quietly curate what you see. “The feed never ends, so your brain never gets the message that it is time to stop,” he says.

He points to a UX principle called progressive disclosure—revealing information gradually in small, easy-to-digest chunks so your brain doesn’t have to work too hard. Because there is no natural break in the feed, there is nothing to slow you down. “No friction means no pause,” he says.

Bhardwaj also talks about completion bias—our urge to finish things to get closure. “Unfortunately, here there is no finish line,” he says. It is like a story with no last page, keeping your brain waiting for an end that never comes.

In his classes, Bhardwaj starts with what not to do—dark patterns, manipulative prompts and design tricks that trap people. Only after that does he move to accessibility, inclusion and ethical design. “Users are people, not just numbers on a dashboard,” he tells his students.

If Bhardwaj focuses on the “how” of infinite scroll, Manish Goyal, UX Designer-1 at Onething Design Studio, zeroes in on the feeling it creates.

“Vertical scrolling feels natural to the brain,” he says. “It takes less mental effort, it feels smooth, and it keeps the content coming. But that sense of control you think you have? It is an illusion—the system is choosing what you see next, not you.”

Personalisation, he explains, is another powerful hook. Algorithms learn what makes you pause and feed you more of it, creating the impression that the app truly knows you.

“Wellness tools exist—time-limit pop-ups, usage dashboards—but they are buried deep in the settings menu,” says Goyal. “The tools that keep you engaged? Those are the defaults.”

For him, ethical design isn’t a fantasy. He points to examples already in play: LinkedIn lets you mute updates and even reach the bottom of your feed. Brave Browser blocks trackers without fuss. Notion sends you summaries without dangling endless notifications. Even Instagram offers time-limit reminders—though, as Goyal notes, most people never turn them on.

And it is not just designers who notice. Developers see it happening in real-time. For Bhumik Virmani, a full stack developer team lead at EchoWave Media, it comes down to friction, or rather the lack of it. “The fewer clicks or taps you need, the longer you will stay,” he says. “Auto-play starts the next video before you have even decided if you want to watch it. Pull-to-refresh works like a slot machine—a skeuomorphic design that mimics the motion of pulling a lever. That unpredictability keeps the brain curious.”

And the loop is only getting tighter. Instagram is now testing an auto-scroll toggle for both reels and regular posts, so the feed keeps moving without you even swiping—the design does the scrolling for you.

Virmani is quick to point out that ethical alternatives exist. Snapchat, for example, now offers in-app mental health resources when certain topics are searched. “It is proof,” he says, “that you can design for engagement without trapping people.”

Those design choices work because they tap into something deeper—the brain’s own built-in reward system, where psychology takes over from design.

The mind’s own slot machine

“Scrolling and tapping on social media have a similar effect on the nervous system as slot machines or spin wheels,” says Dr Jyoti Kapoor, senior psychiatrist and founder of Manasthali. “As you scroll, anticipation builds for what might come next. Each tap triggers a release of dopamine—a short burst of pleasure—and you repeat the process to feel it again. It is not what you see, but what you might see that keeps you hooked.”

Most people, she says, don’t realise they are in this loop until someone points it out and, by then, the habit is well-worn. “Like any addiction, compulsive social media use replaces activities that truly build you up—reading, creative work, conversations with family, exercise, even quiet moments alone. Social media doesn’t relax you; it overstimulates you. That leads to burnout and a lower tolerance for stress.”

The toll isn’t just mental. Hours hunched over a phone strain the neck, shoulders, thumbs and fingers. Blue light throws sleep cycles off balance, which in turn makes you more likely to pick up your phone late at night, restarting the loop. She points to research showing a rise in anxiety, mood disorders and even suicide among teens and young adults over the past two decades. “The correlation,” she says, “is hard to ignore.”

Kapoor’s prescription is simple but firm: start with awareness, track your usage, set alarms, replace scrolling with screen-free hobbies, prioritise face-to-face interactions, create a phone-free bedtime routine and switch off the internet for a few hours each day.

There is also an emotional side to the scroll—one that psychologist Dr Shweta Sharma, founder of Mansa Global Foundation, calls “intermittent reinforcement”, the same pattern that makes gambling addictive. But it is not just about dopamine. “Scrolling often works as a buffer against discomfort: boredom, loneliness, anxiety, fatigue. It feels like movement, but it is really avoidance.”

Over time, explains Sharma, that avoidance dulls emotional rhythms, scatters attention and weakens impulse control. For younger users, it can even replace the ability to sit still and process emotions. “If you have never learned to just be with your feelings, scrolling becomes your go-to escape.”

That kind of emotional avoidance, says Prachi Saxena, clinical psychologist and cofounder of The Emotional Wellness Initiatives, can also show up as a “flight” response—the brain’s way of dodging difficult emotions. “Instead of sitting with them, we grab the phone and flood ourselves with something that hooks us instantly,” she says.

She explains that platforms know this and use “primitive cues” to exploit it—red notification dots, bright animations and sounds that mimic alerts from the natural world. The human brain, she warns, “is not designed to be constantly bombarded with irrelevant information”. Processing it all “drains your mental energy, making you less able to solve problems or adapt.” Blue light from screens, she adds, disrupts the brain’s natural rhythms, leaving people physically tired but mentally wired.

Her advice is simple: get comfortable with a little discomfort. “Set a short timer before you start scrolling, and stop when it goes off,” says Saxena. When boredom creeps in, call a friend. When you crave something new, step outside and let your senses wake up—notice the air, the sounds, the colours around you. And when anxiety is what’s driving you to reach for your phone, put pen to paper. Writing it down activates the same parts of the brain that help regulate emotion. Little by little, you take back control from the scroll—one pause, one choice, one word at a time.

Some people only notice this pattern when it is broken, often by accident. That’s what happened to Shreya Arora. The turning point came one night when her phone died mid-scroll. She stared at the black screen in her hands and realised she couldn’t remember the last time she had just sat with her thoughts. Since then, she has been taking pauses—walking without headphones, switching her phone off before bedtime. She still scrolls, but now she notices when she is doing it. “Sometimes,” she says, “that’s enough.”

Bhardwaj calls these moments “breaks in the loop”—brief interruptions that allow people to see the system for what it is. “The design is built so you never reach the end,” he says. “When you stop, even for a minute, you notice yourself again.”

And one last thing: It’s okay to still scroll

You’re not weak for scrolling—these platforms were built to keep you here. Remember it is by design, and it hasn’t changed much since that tweak in 2006. But you have—now you know how it works. And sometimes, that’s all it takes to choose when to stop.

Healthy scroll habits to break the loop

• Set a 20-minute scroll timer—pause before continuing

• Move social apps off your home screen to reduce temptation

• Log out after use to add a moment of reflection

• Replace scroll breaks with grounding activities—walk, stretch, journal

• Use built-in tools: ‘You’re All Caught Up’ nudges, screen time limits

• Let boredom breathe—don’t fill every quiet moment with a swipe

94.2% of internet users (ages 16–64) access the web via smartphones

11.3% of social media users globally meet clinical criteria for addiction

Users spending 3+ hours/day are 4.7x more likely to face relationship issues

Children under 5 years spend 2.2 hours/day on screens, twice the recommended safe limit: ICAN study

female-cardiovascular-risks-women-heart-attack-symptoms

Sat Sep 27 15:58:27 IST 2025

A woman’s heart may be deep in feeling, but anatomically it is smaller than a man’s. Its walls are thinner and its blood vessels finer, even when body size is matched. Functionally, women have a faster heart rate and a higher ejection fraction (the proportion of blood pumped per beat), but their overall cardiac output—the total volume of blood pumped per minute—remains lower than in men.

Female hearts are not simply scaled-down versions of male hearts; differences in wall thickness and chamber proportions mean many features do not reduce proportionally with body size. Women’s hearts also show greater contractility, and sex hormones shape their response to stress and regulate calcium, producing distinct rhythm patterns and metabolism. These differences influence how men and women experience, present, and are diagnosed with heart disease. In India, men show a higher prevalence of heart disease, particularly ischaemic heart disease (IHD), and are affected at younger ages. In women—especially post-menopause—heart disease carries higher mortality rates and worse outcomes after cardiovascular events.

Most common conditions: For both sexes, these are IHD, valvular heart disease, and congenital heart disease. IHD, also known as coronary artery disease, occurs when cholesterol builds up in the coronary arteries. Severe obstruction deprives the heart muscle of oxygen, causing angina (chest pain). A rupture and a blood clot results in a heart attack. Valvular heart disease arises when one or more of the heart’s four valves do not function properly, either because of birth defects or childhood infections.

Heart attacks in women: Half of the women have atypical symptoms. Instead of the classic chest pain, they may experience excessive sweating, palpitations, nausea, vomiting, epigastric discomfort, backache, breathlessness, or extreme fatigue.

The risk of misdiagnosis: Women’s symptoms are frequently mistaken for gastritis or psychological symptoms. Greater vigilance is crucial: tests like ECG and echocardiography and treadmill tests should be done to catch early signs.

Cardiac arrest vs heart attack: The first is the condition where heart stops functioning totally. Heart attack occurs when the coronary artery is totally obstructed and causes decreased blood supply to the cardiac muscle. Heart attack can lead to cardiac arrest.

A time of increased vulnerability: Women become increasingly vulnerable to heart disease after 40-45 years, especially post-menopause. Women with diabetes and uncontrolled hypertension are prone to heart problems at a younger age. With menopause and the resultant lowering of oestrogen, women become more prone to heart problems than men.

The oestrogen connection: Oestrogen is beneficial for metabolism and increases good cholesterol. It also dilates the coronary blood vessels, improving the circulation to the heart. So women in their reproductive years are protected from heart problems because of oestrogen. But this shield is lost if they have diabetes and hypertension.

Differences in recovery: When treated early, women recover as well as men. But if treatment is delayed, outcomes become relatively poor. Smaller vessel size and more advanced disease at presentation also makes cardiac procedures like coronary angioplasty or bypass surgery less successful.

The menopause connect: As oestrogen levels come down, cholesterol levels go up. Those with high blood pressure and onset of secondary diabetes are at increased risk of heart problems. Reduced oestrogen and increased cholesterol level causes blood vessels to stiffen further, putting the heart at greater risk.

Effect of birth control pills: Use of these, especially in post-menopausal women, has yielded conflicting results. If you use these long term, they can cause an increase in clotting tendencies and cause blood clotting in the limb vessels, which can go to the lungs and cause pulmonary embolism. But contraceptive pills with low oestrogen and progesterone have been shown to have fewer detrimental effects.

Hormone replacement therapy: HRT initiated early after menopause, that is within the first two years, can benefit patients with definitive indication of heart problems. Women aged 60 and above are found to have more cardiovascular complications with HRT.

Pregnancy and heart health: Most women do not exhibit heightened heart problems during pregnancy. But those who have valvular or congenital heart disease can have complications because of the increase in volume of the heart and other physiological changes during pregnancy. Those who have narrowed valves can develop signs of heart failure in the second trimester. They should have regular evaluations to catch early complications.

Peripartum cardiomyopathy: This is a variant of heart myocardium, which is seen during the later stages of pregnancy (about 28 weeks) and up to six months post-delivery. This occurs when the heart muscle becomes weak, decreasing the heart’s pumping ability to pump. It can cause signs of heart failure or arrhythmia (irregular heart beat). Women who fall pregnant very early (before 20) or late are at greater risk.

As women age: Women over 65 can have increased cardiac risk because most of them tend to develop diabetes, hypertension or have high levels of bad cholesterol.

The Indian scenario: Indians develop heart disease about 10 years earlier than western populations—between 40–60 for men and 50–60 for women. High levels of lipoprotein, early onset of diabetes and hypertension, and dyslipidemia (elevated cholesterol) increase the risk.

Indian women’s unique risks: Hypertension often appears earlier and at lower body weight. Diets high in junk food and trans fats, sedentary jobs and stress raise risks.

Triple threat—diabetes, high blood pressure and thyroid disorders: High blood pressure stiffens blood vessels and reduces blood supply. Diabetes increases cholesterol deposition and vessel thickness, causing stiffening that can lead to early heart attacks. Thyroid disorders elevate blood pressure and add to cardiac risks.

Lifestyle changes are key: Your diet should contain large amount of fresh fruits and vegetables, and nuts and proteins. Reduce intake of carbohydrates. Exercise at least 30 minutes per day for five days a week, or 45 minutes four days a week. Implement these changes as early as possible.

Beyond the heart: A healthy heart is also crucial for a healthy brain. Deterioration of brain function increases risk of strokes. Women with poor cardiac health tend to have a higher incidence of miscarriages or premature deliveries. Other complications during pregnancy include heart failure, arrhythmias and pulmonary embolism (when a blood clot travelling through the bloodstream blocks an artery in the lung).

Heart disease and mental health: Women who have severe anxiety or depression are more prone to heart problems. Heightened levels of stress lead to increased heart rate. Depression can lead women to adopt unhealthy eating and sedentary habits. The risk of hypertension increases correspondingly.

Acute and chronic stress: Increasing levels of stress affect women’s health by increasing the incidence of hypertension and diabetes, which in turn compounds cardiac risks. Meditation, good music and books can help lower stress and reduce heart problems in the long run.

Questions women must ask doctors: Women should inquire about their risk of heart problems, especially those who have a family history of cholesterol, hypertension and diabetes. They must ask when they need to start getting evaluated based on their risk factors.

Links with autoimmune diseases: Autoimmune disorders like lupus and rheumatoid arthritis, besides bringing pain and stiffness, can cause vasculitis (inflammation in blood vessels). This can cause heart attacks and strokes.

The polycystic ovary syndrome connect: Because of impaired glucose tolerance and higher risk of diabetes, PCOS tends to increase cardiac risk. Optimal management of PCOS can prevent heart problems.

low-oxygen-parkinsons-treatment-hypoxia-research

Fri Feb 27 14:21:11 IST 2026

There is a saying that even amrut (nectar), when taken in excess, can become poison. The same is true of oxygen. At abnormally high levels, oxygen can damage tissues and organs. A new study in Nature Neuroscience reports that in Parkinson’s disease, cellular dysfunction leads to an accumulation of oxygen in the brain, which, in turn, drives neurodegeneration. Interestingly, the potential solution may lie in a low-oxygen environment—similar to the thin air at Mount Everest’s base camp.

Researchers from Harvard Medical School, Massachusetts General Hospital and the Broad Institute of MIT and Harvard found that exposing mice with a Parkinson’s-like condition to reduced oxygen levels helped restore their movement, reduced anxiety-like behaviours and halted further loss of neurons in the brain.

Parkinson’s disease affects more than 10 million people worldwide. It is marked by the progressive loss of neurons in the brain, leading to tremors and slowed movements. These neurons gradually accumulate toxic protein clumps called Lewy bodies, which are believed to disrupt mitochondrial function that powers the cell.

Anecdotal evidence show that people with Parkinson’s often report doing better at high altitudes. Similarly, long-term smokers—who typically have elevated carbon monoxide and lower oxygen levels in their tissues—appear to have a lower risk of developing Parkinson’s, though smoking carries significant risks for many other diseases.

However, researchers caution that the neurological recovery seen in mice has not yet been verified in humans. They also warn that unsupervised exposure to low-oxygen air can be dangerous and may even worsen Parkinson’s disease.

Still, the findings in mice open the door to an entirely new paradigm for treating Parkinson’s. Researchers in the team had previously observed that low oxygen could ease neurological symptoms in rare mitochondrial disorders such as Leigh syndrome and Friedreich’s ataxia.

In the latest study, researchers placed mice in a hypoxic environment after Parkinson’s symptoms had already appeared. As the mice showed a rebound in motor skills and a halt in neuron loss, scientists suggest that early intervention could potentially restore neural function in Parkinson’s patients.

To probe the underlying mechanism, the team analysed mouse brain cells. They found that mice with Parkinson’s symptoms had significantly higher oxygen levels in certain brain regions compared to the healthy mice and those exposed to low oxygen. This excess oxygen likely accumulates because dysfunctional mitochondria are unable to use it efficiently, leading to damaging levels.

Building on these findings, researchers are now developing experimental ‘hypoxia-in-a-pill’, designed to mimic the protective effects of low oxygen. They believe this approach may hold promise for other forms of neurodegeneration, too.

genrobotics-ai-robotics-solutions-bandicoot-g-gaiter-innovation

Tue Sep 02 13:58:16 IST 2025

It all began with a college project—an Iron Man–like suit, a wearable machine that could lift heavy loads and help soldiers in remote, harsh terrains. What four friends—Vimal Govind MK, Arun George, Nikhil NP, and Rashid K.—once built in youthful spirit has today grown into Genrobotics, a company developing breakthrough technologies that address challenges impacting not just people’s health, but also their livelihoods, dignity, and social inclusion.

“Our main idea has always been to use robotics and AI to address real problems in society,” says Vimal Govind, CEO and director of the Kerala-based firm that created pathbreaking robots. Developing a full-fledged exoskeleton and taking it to market required years and massive funding. So, the team repurposed a part of that project—the arm section—to create their first product, Bandicoot, a robot designed to clean manholes and sewers, replacing the hazardous work of sanitation workers.

The robot tackled not just the social stigma of manual scavenging but also its medical toll. “Manual scavenging is an inhumane practice that still claims a life every five days in India,” says Govind. “It is often tied to marginalized communities, where workers die young—often before 50—due to occupational diseases. When parents die early, their children are forced into the same work, trapping families in a vicious cycle. By introducing robotics, we’ve broken that cycle for many.”

Genrobotics then created its first product for disability rehabilitation, G-Gaiter, repurposing the technology originally developed for the leg section of the exoskeleton.

“At the core, the technology and vision were similar, and so was the impact—whether giving mobility back to a disabled person or freeing someone from a degrading, inhumane job, we were restoring dignity and independence,” says Govind.

G-Gaiter evolved into a world-class technology, giving Genrobotics a niche position in the physical medicine and rehabilitation segment. Govind notes that traditional gait training—heavily dependent on manual support—was largely inefficient, as walking involves the coordination of six limbs, which is nearly impossible for a therapist to control accurately with just their hands. The robot solved this challenge.

In both Bandicoot and G-Gaiter, government partnerships played a pivotal role. The Kerala Water Authority (KWA) was Bandicoot’s first client, while G-Gaiter has been deployed in both private and government hospitals.

Today, Genrobotics’ robots are employed across 22 Indian states and in four countries. In the gait trainer segment, Govind points out that G-Gaiter is four times cheaper than comparable foreign alternatives. “With new plants coming up in multiple locations, large-scale manufacturing will further reduce costs,” he says.

Genrobotics is now rapidly expanding its product portfolio. In sanitation and industrial robotics, products like the G-Spider robot are automating waste removal from canals. In healthcare, the focus remains on physical medicine and rehabilitation. “Within the next three months, we will launch an upper-body rehab device, complementing our existing robots to create a complete rehab ecosystem.

Additionally, our R&D team is working on humanoid and semi-humanoid robots, which we expect to launch in about a year. Our overarching vision remains improving mobility, delivering quality rehab, and creating advanced robotics solutions for society,” says Govind.

hangover-science-remedies-alcohol-aftereffects-solutions

Sat Aug 30 16:50:50 IST 2025

Interestingly, while hangovers are the most commonly reported negative effect of alcohol use, scientific study into the condition remains a niche interest.

Dr Sally Adams of The University of Birmingham is one of the few academicians involved in hangover research. “There is so much research on the effects of alcohol on the body, but nothing on the effects the following day,” she said, “This is an area that potentially has really serious consequences for physical and mental health. It costs the economy a fortune. It is an under-investigated topic, probably because we look at it in a trivial way.”

Anyone who has suffered a hangover knows that there is nothing trivial about them.

What are the symptoms of a hangover?

As hangovers are not a specific illness but are a combination of different reactions to the way your body reacts to excessive alcohol consumption, and as everyone reacts to alcohol in different ways, people experience hangovers in different ways. Genetics also play a role as genes determine how efficiently people metabolise ethanol, which is the form of alcohol found in beverages.

A survey published in the journal Alcohol and Alcoholism followed 1,410 Dutch students with hangover symptoms. It listed 47 symptoms, and the top 10 were:

* Fatigue

* Thirst

* Drowsiness

* Sleepiness

* Headache

* Dry mouth

* Nausea

* Weakness

* Reduced alertness

* Concentration problems

Also listed were: apathy, agitation, gastrointestinal problems, tremors, regret, guilt, depression, anxiety and vomiting. Symptoms will also depend on how much you have drunk and what you have drunk.

Cask-aged and matured beverages like whisky and cognac for example, contain complex compounds called congeners.

In his book Drink? The New Science of Alcohol and Your Health, David Nutt, professor of neuropsychopharmacology, wrote: “The longer whisky is stored, or aged, the more some of the alcohols will join together to form more complex alcohols called congeners.” It is thought that these may create worse hangovers.

Is there really a hangover cure? The bad news is, there is no definitive cure. But there is plenty you can do to treat the symptoms.

“If there was a miracle hangover cure, it would have to address all the symptoms,” said Adams, “and it would be very difficult for one thing to address the stomach irritation, the dehydration, the anxiety, the effect on the brain.”

In Las Vegas, Hangover Heaven is a hangover clinic which also sends medics to hotel rooms to deliver a regime of treatments that promises to get even the most debilitated revellers back on their feet within two hours. But the process is not simple. “Patients” are treated with a combination of drugs and therapies which include oxygen, Propranolol, a beta-blocker that slows heart rate, vitamin infused IV drips, Zofran, an anti-nausea medicine widely used in chemotherapy recovery and Toradol, a powerful painkiller.

But in the absence of prescription meds and IV drips, there are simple measures you can take to treat the main symptoms.

Hangover cures

Here are some at-home measures you can take:

1. Water (with added electrolytes)

This can be in the form of a sports drink. Dr Howard LeWine, from Harvard Medical Publishing, said: “Alcohol promotes urination because it inhibits the release of vasopressin, a hormone that decreases the volume of urine made by the kidneys. If your hangover includes diarrhoea, sweating, or vomiting, you may be even more dehydrated.”

“Although nausea can make it difficult to get anything down, even just a few sips of water might help your hangover,” he said.

2. Anti-inflammatories

Prof Nutt said, “Take ibuprofen when you go to bed and/or when you wake up, ideally with food as it can be harsh on the stomach lining.”

3. Stomach settler

Heartburn from an irritated stomach can be treated with an antacid, some of them also help to rehydrate. And some also contain aspirin and paracetamol for headaches and pain, and caffeine for drowsiness.

4. Positivity

Low mood and anxiety are overlooked symptoms but can also be profound, lasting long after physical symptoms abate. Adams recommends doing something that is gentle but enjoyable, like watching a comedy. “Psychologically, it helps to do something that is going to make you feel good. Whatever normally helps you if you feel low or anxious, engage in that,” she said.

5. Sleep

Alcohol has sedative properties which work for around four hours after which people commonly wake with a headache, feeling alert and unable to get back to sleep. “This is because your brain knows being intoxicated is potentially dangerous,” said Nutt. “As soon as you started drinking the night before your brain started to change.”

Although it can be hard, try to get a good night’s sleep after a drinking session.

6. Food

While it may be hard to keep food down initially, it is a good idea to try and eat something. One study investigated the effect of the amino acid L-cysteine on alcohol/acetaldehyde related after-effects. It concluded a dose of between 600mg and 1,200mg could help with symptoms of nausea, headache, stress, and anxiety.

L-cysteine is found in high protein food including eggs and cheese. Carbohydrates such as toast can help replenish depleted blood sugar levels.

7. B vitamins and zinc

A study published in The Journal of Clinical Medicine evaluated diets for 24 hours before and after excessive drinking occurred. Although it was a small cohort, with results based on the participants describing what they ate, rather than them being fed under supervision, the study did find that people whose food and beverage consumption contained greater amounts of zinc and B vitamins had less severe hangovers.

It might be worth a try, but don’t expect miracles.Some products market themselves as cures. It contains a range of compounds including “bacteria, L-Cysteine and vitamin B12” and claims to “contribute to the reduction of tiredness and fatigue and helps to support the immune system and contributes to normal energy levels”.

Dr Adams is cynical though, as some of them are a food supplement, not a medicine, and so can make claims without having to undergo rigorous peer reviewed testing.

Hangover myths

Myth 1: Just drink water. “One of the biggest myths is that water will solve everything, and that a hangover is only dehydration,” said Adams. “Water isn’t a miracle cure.”

Myth 2: Have a drink the morning after. Experts also dismiss drinking more alcohol to alleviate a hangover, a practice commonly known as “hair of the dog”. Prof Nutt said it “as the very worst thing you can do”.

“You are delaying your hangover by putting alcohol back into your brain,” he wrote.

Adams said: “You are just chasing the drugs.” She said that while reaching for more alcohol the next day may not indicate addiction, the transition from using alcohol to experience pleasure to using it to escape feelings is an unhealthy pattern of behaviour.

What causes hangover symptoms anyway?

Hangovers are a combination of conditions—both physical and psychological—caused by the excessive consumption of ethanol in alcohol. Different processes in the body contribute to different symptoms which vary in intensity depending on several factors, including the amount and type of alcohol consumed and the circumstances in which it is drunk.

A number of factors can contribute to hangover symptoms.

Dehydration. “Alcohol is a diuretic, so quite often there is dehydration and an electrolyte imbalance, particularly if you have been sick,” said Dr Adams.

Inflammation of the gastrointestinal tract. “[Around] 80 per cent of alcohol is absorbed by the stomach and small intestine, so the inflammation of those areas can also cause gastric symptoms.”

Acetaldehyde production. One of the ways alcohol is metabolised in the body is by an enzyme called alcohol dehydrogenase (ADH). This breaks down the ethanol and creates a compound called acetaldehyde during the process.“This is toxic for humans and is responsible for the sweating, heart-racing, vomiting and nausea you feel.”

Release of neurotransmitters. Excessive consumption creates an imbalance in neurochemicals. “The brain will try to put that right and get everything back to correct levels but sometimes that doesn’t happen, and we get a lot of neurotransmitters released that cause us to feel anxious and low the next day”. This psychological aspect of a hangover creates what has been termed “hangxiety” or “beer fear” and can affect judgement and reactions long after a breathalyser will deem it safe for you to drive.

Other factors that cause hangovers are inflammation and mitochondrial damage, particularly in the liver. Mitochondria are the energy-producing elements in every cell and are susceptible to damage from the free radicals produced by acetaldehyde.

FAQs

How long do hangovers last?

This can vary for people and depends on many factors. But generally, hangover symptoms can last 24 hours or longer.

Does drinking water help with a hangover?

Yes, drinking even small sips can help with a hangover. Be wary that drinking water alone won’t ‘cure’ it though. Try to have water with added electrolytes.

Can I be biologically more likely to have a hangover?

Genetics may play a role in how a person reacts to alcohol and experiences a hangover. This is because our genes can determine how efficiently we metabolise ethanol.

diabetes-management-india-holistic-care

Sat Aug 30 16:02:17 IST 2025

India is the diabetes capital of the world. World Health Organisation data says there are 7.7 crore adult diabetics (type 2) and nearly 2.5 crore prediabetics in the country. More worrying is that half the population is unaware of its diabetic status.

Diabetes is a complex metabolic disorder that needs a nuanced understanding of genetics, lifestyle and modern medical management.

Layman’s definition

Think of it as a problem with the body’s ‘sugar control system’. Usually, insulin—made in the pancreas—acts like a key, helping sugar from our food enter the body’s cells to be used for energy. In diabetes, either the pancreas isn’t making enough of that key, or the key doesn't fit well any more, so sugar stays in the blood.

The spectrum

Type 1 diabetes is an autoimmune condition where the body’s defence system attacks insulin-producing cells. The exact cause is not known but research suggests it’s a mix of genetic predisposition and certain environmental factors—viral infections being one possible trigger. This form typically appears suddenly in youngsters and requires lifelong insulin therapy.

Type 2 diabetes develops differently, with the body gradually becoming resistant to insulin’s effects or the pancreas struggling to keep up with demand. Being overweight, physically inactive, having a family history, and ageing, all increase the odds. It can start with no obvious symptoms.

Gestational diabetes occurs during pregnancy when hormonal changes reduce insulin effectiveness. Women with a history of gestational diabetes, those who are overweight or who have a strong family history face higher risks.

The Indian context

India’s diabetes epidemic is the result of a convergence of genetics, rapid urbanisation and changing lifestyles. Indians have a genetic predisposition to develop diabetes at lower body weights compared with western populations.

Regional variations

Urban south Indians show particularly high diabetes rates, partly because of genetics and dietary patterns. Certain ethnic groups, like Punjabis and Gujaratis, are also more vulnerable. While rural areas had lower rates, prevalence is rising rapidly as lifestyle changes penetrate these regions.

Our relationship with food

Food occupies a central place in Indian social life, which creates unique challenges for diabetes prevention and management. White rice, deep-fried snacks and sweets feature prominently in both daily and festive meals, and refusing food can be seen as rude in social settings. Many Indians also eat dinner late, which affects blood sugar control. There can be workarounds such as switching to brown rice or millet and reducing portion sizes.

The sugar misconception

Complete sugar avoidance isn’t necessary—moderation and overall dietary balance matter more. You might get diabetes even without eating a grain of sugar in your life. White sugar, brown sugar and jaggery all affect blood sugar similarly. While jaggery might contain trace minerals, the amounts are insignificant from a health perspective.

Artificial sweeteners

Most approved artificial sweeteners have undergone extensive testing and are generally safe in moderation. Research is ongoing about their effect on gut health and metabolism, so the key lies in using them as part of a broader strategy to reduce cravings rather than as a magic solution.

Recognise warning signs

Several classic signs warrant attention—unusual thirst, frequent urination (especially at night), unexplained weight loss and persistent fatigue. Some people notice their vision becoming blurry or wounds taking longer to heal.

Beyond obvious symptoms

More subtle changes can also hint at diabetes. Frequent skin infections, particularly in skin folds, can provide early clues. Some people develop dark, velvety patches on the neck or underarms—acanthosis nigricans—often linked to insulin resistance. Women might notice recurrent yeast infections, while men might have erectile dysfunction.

Modern diagnosis and screening

While fasting glucose, post-meal glucose, and HbA1c (which shows average blood glucose level over two to three months) tests remain the diagnostic backbone, screening approaches have become more proactive. For people at higher risk, doctors now recommend earlier and more frequent screening, sometimes starting in the 20s. Continuous glucose monitoring, once reserved for diabetics, is increasingly used to spot slight increases in blood sugar levels that routine tests might miss.

The ripple effect

Over the years, high sugar levels quietly damage the small blood vessels and nerves that keep organs healthy, explaining why no organ system remains unaffected.

The heart connection

Blood vessels can develop blockages earlier in diabetics, increasing the risk of heart attacks and strokes. Blood pressure and cholesterol monitoring are as crucial as glucose control in diabetes management.

Kidney complications

The microscopic filters that clear waste from the blood can thicken and scar, allowing protein to escape into the urine—an early sign that can progress to kidney failure if left untreated.

Eye problems

The fine vessels feeding the retina might start to leak or develop fragile new branches that break easily, threatening vision over time. Regular eye exams can detect these changes.

Nerve damage

Reduced blood flow and chemical changes from persistently high blood sugar levels interfere with nerve signalling, leading to tingling, burning or numbness, most commonly in the feet.

Emergency situations

Hypoglycaemia (low blood sugar) is one of the most immediate diabetes-related dangers. It can cause sweating, trembling, confusion or even brief loss of consciousness, requiring immediate correction with something sugary.

Diabetic ketoacidosis occurs more often in people with type 1 diabetes when the body has too little insulin and begins breaking down fat rapidly, producing harmful acids in the blood. This causes nausea, vomiting, rapid breathing and drowsiness, requiring immediate treatment.

Be vigilant

Family members should be able to recognise when something is off—for example, if the person suddenly seems quiet, confused or starts sweating. Many clinics now encourage caregivers to attend sessions to practise real-life emergency situations.

Gender and age

Men are often diagnosed earlier, sometimes during heart health check-ups, while women may have menstrual irregularities or recurrent infections as early warning signs. Women with diabetes face a relatively higher risk of heart disease. Blood sugar control influences fertility and pregnancy outcomes, with poorly controlled diabetes increasing chances of miscarriage or premature delivery.

Schools need to develop support systems

While some urban schools have begun implementing support measures—such as staff trained to help with glucose monitoring or emergency responses—this is far from standard practice. In many cases, parents still have to explain the child's needs to teachers and classmates. Wider awareness, clear school policies and basic health training for staff would make a significant difference.

Management targets

For most diabetics, home glucose monitoring involves checking fasting and post-meal levels several times weekly, while HbA1c testing occurs every three to six months in clinical settings. Generally, HbA1c below 7 per cent indicates good control for adults, though children, elderly patients and those with other medical conditions may have adjusted targets.

Beyond glucose monitoring, diabetes care includes annual eye examinations, kidney function tests, foot checks for nerve damage, blood pressure and cholesterol reviews, and dental visits.

Exercise is medicine

At least 150 minutes of moderate activity weekly—such as brisk walking, cycling or swimming—provides significant benefits, while strength training twice weekly offers additional advantages. Ask your doctor what exercise is best for you.

Common management mistakes

Skipping glucose checks allows gradual changes to go unnoticed until they become serious. Many people make medication adjustments based on single readings without consulting health care providers, while others eliminate all carbohydrates instead of practising portion control or lean on ‘diabetic-friendly’ packaged foods that still raise blood sugar levels.

Misconceptions

Dangerous misconceptions include believing that starting insulin means the situation is hopeless, or that herbal remedies alone can cure diabetes. While some traditional practices may support overall health, they cannot replace established medical treatment.

The technology revolution

Continuous glucose monitoring provides real-time information, helping reveal patterns that occasional finger-stick tests might miss. Automated insulin pumps can adjust delivery based on glucose readings, while smartphone apps help track food intake, exercise and medication adherence. These technologies are particularly valuable for young adults and those with variable schedules.

Looking ahead

Early detection through improved screening, better understanding of genetic and environmental risk factors, and advancing treatment options provide hope for millions. The key lies in moving beyond individual responsibility to create supportive environments—from schools that accommodate children with diabetes to workplaces that encourage healthy eating and physical activity. Health care systems must provide culturally sensitive education while families learn to balance tradition with health needs.

Research frontiers

Artificial pancreas systems combining continuous glucose monitoring with automated insulin delivery are transforming Type 1 management. Stem cell research aims to replace destroyed insulin-producing cells. Personalised medicine approaches recognise that diabetes isn’t identical in everyone. Gut microbiome research may reveal new prevention and treatment targets.

abortion-india-stigma-cost-mtp-challenges

Thu Jan 08 21:13:14 IST 2026

Richa Saxena walked the hospital corridor, whispers trailing behind her—not of care or concern, but of judgment.

She was at the health centre for an abortion. A doctor herself—a third-year resident in Maharashtra—she felt each gaze sear into her. She was unmarried. The news spread quickly among the nurses.

“I was six weeks pregnant,” she says. “I was mentally prepared, but not for the slut-shaming and the expense.”

The hostility and comments from nurses and taunts from bystanders about her ‘missing husband’ left her humiliated—even within her own profession.

Richa’s ordeal mirrors what countless women in India continue to endure.

Decades of progressive policies have enabled women to strive for equality. But when it comes to control over their own bodies, do they truly have the final say?

Though abortion is legal in India with certain conditions, the emotional toll, social stigma, legal hurdles and health risks make it a tumultuous experience.

Dr Veena J.S., assistant professor, department of forensic medicine and toxicology, PSG Institute of Medical Sciences and Research, Coimbatore, recalled cases from recent years. After talking to the women involved and the investigating officers, she realised that the issue with medical termination of pregnancy (MTP) in the country was deep rooted. “One common element I could see was that all of them pleaded with gynaecologists in a government hospital for abortion; among them, two were unmarried,” says Veena. “They went to the government doctors because they could not afford private clinics. They were well within three months of pregnancy, but all doctors denied abortion, saying that it was not legal to terminate after three months. And, they pointed out, there was no clause for terminating pregnancy in unmarried women.”

Many women look beyond government hospitals for reasons that include privacy and the wait period, with marital status, too, being a contributing factor. A study on abortion care-seeking practices in India, published by peer-reviewed journal Cureus, found that, among married women, about half of the respondents sought abortions in private facilities while over a quarter did so at home. Among unmarried women, around 90 per cent turned to private clinics or home abortions. Previous studies had reported how women hesitated to seek help from public facilities because of the requirement of repeated visits, longer waiting and confidentiality issues.

Dr Gayathri Sanjeev from Delhi had a positive personal experience of abortion at a private clinic. “I paid Rs1,000, including consultation and post-MTP care, like antiemetics (drugs that prevent vomiting) and painkillers,” she says. “The doctor never asked for my partner, nor tried to guilt me into continuing the pregnancy. I felt respected for my decision. A board in the clinic said: 'MTP/abortion is done here'.” But, she is aware that her case is an exception rather than the norm. “I get to hear from many patients from different parts of the country about the trauma they had to go through because they decided to abort the foetus,” she says.

Adding to the misery, the financial burden, including costs like post-abortion care and mental health support, puts a woman in a spot. The rates vary from place to place and can be exceptionally high if access and societal support are missing.

“I spent around Rs20,000 for the tablets and the complete procedure, including scans and consultation, left me with a bill of Rs30,000,” says Richa. “I was speechless as I know that the pills do not cost more than Rs500. Why the loot?”

The Cureus study also observed that women belonging to lower social and economic classes undergo abortions at home rather than at a health facility, and suggested that women with financial constraints avoid using abortion services from health care facilities because of direct or indirect costs.

While some medical experts feel that private hospitals take advantage of the urgency of the patient and charge exorbitant prices, a Mumbai-based doctor, speaking on condition of anonymity, justified the prices, saying that there was no ethical issue as long as the price was transparently discussed. What would be unacceptable, he says, would be charges that are not declared before the procedure. “When you look at MTP as a taboo, the prices are bound to rise,” he said. “Rather, if it is [seen as] just another procedure, the prices would come down.”

Dr Jayasree A.K., professor, community medicine at the Medical College in Kerala’s Kannur, believes cultural and religious sentiments are some of the reasons for the stigmatisation of MTP. The toxic social attitude needs to be eliminated, she says, while stressing the need for women to be able to make their choices without hesitation and have autonomy over their bodies. She also agrees that there needs to be some form of regulation in private hospitals to monitor MTP prices.

The horrendous experience of seeking MTP and the lack of accessibility often drive many to prefer dropping the foetus through unsafe methods. Religious teachings frowning upon the concept of abortion add to a lack of awareness.

While recurrent abortions may lead to infertility, the risk is higher if it is done under unsafe circumstances. Maternal mortality related to childbirth is much higher than the mortality associated with safe abortion.

What will happen if the state does not intervene to resolve the stigma related to abortion rights? “Mortality and morbidity related to lack of safe abortion will rise if measures are not taken to resolve the stigma,” says Veena of PSG, who works extensively for abortion rights. “The mental health of women will have a huge impact on future generations because, even now, child care is considered the sole duty of mothers. Another danger would be that the private sector will have more authority over women's autonomy.”

Australia-based gynaecologist Dr Joseph Johnson says that despite the liberalisation of MTP in India, religious and cultural influences, social stigma and access barriers remain significant hurdles. From a patient’s perspective, he says, India can take pride in having a progressive legal framework that compares favourably with countries like the UK and Australia, and, to a large extent, surpasses the policies of many US states. Nevertheless, access to safe and legal MTP remains uneven across the country, especially in situations when maintaining confidentiality is paramount.

“Many gynaecologists remain reluctant to offer MTP services, particularly for non-medical indications,” he says. “In cities like Kochi, only a handful of specialists offer comprehensive MTP care in reputable hospitals when the termination is sought for personal or socioeconomic reasons. This limited access has contributed to the rise of smaller clinics, which charge steep prices and operate in a largely financially unregulated manner. But one should still appreciate the fact that even in these small clinics, procedures are performed by qualified specialists.”

An earlier study on abortion care from Jharkhand, published in the Economic and Political Weekly, had observed that women who could not afford to pay for a qualified private physician sought care from unlicenced or government facilities.

“When affordability is denied, abortion service in the private sector becomes a money-minting option,” says Veena. “An abortion medicine kit, which can be self-administered and costs not more than 1,000, will change to a days-long hospital stay, minting money for the private sector. Women who cannot afford the service will be forced to approach quacks or take loans.”

While the abortion laws in India have evolved to recognise a woman’s right to choose, the ground reality is harsher. It is often a choice that comes at a steep price.

chinas-artificial-womb-robot-a-glimpse-into-future-of-human-birth

Fri Feb 27 14:21:45 IST 2026

Chinese researchers have announced that they are developing a humanoid robot with an artificial womb designed to replicate the entire process of human pregnancy—from conception to birth. Led by Dr Zhang Qifeng of Kaiwa Technology, the project was unveiled at the 2025 World Robot Conference in Beijing. The artificial womb, filled with synthetic amniotic fluid and connected to a nutrient delivery system, is intended to support foetal growth through a full-term gestation. A prototype is expected by 2026, with an estimated cost of about 1,00,000 yuan (around Rs12 lakh).

The idea builds on earlier work, like the 2017 “biobag” experiment in Philadelphia, where researchers kept premature lambs alive for up to four weeks in a fluid-filled bag that mimicked the womb. Not surprisingly, the project has triggered heated ethical debates—ranging from concerns over disrupted maternal bonding and psychological effects on children to questions about sourcing eggs and sperm. Supporters, however, see it as a breakthrough for infertility treatment and a way to reduce pregnancy-related health risks.

Artificial wombs are an idea that is at least a century old. In the 1920s, British-born Indian scientist J.B.S. Haldane, a pioneer in evolutionary biology, predicted that by 2074 most births could be ectogenic (development of an embryo outside the body), freeing women from pregnancy and reshaping society. Literature and fiction also embraced the concept. For instance, in Aldous Huxley’s 1932 dystopian novel Brave New World, artificial gestation plays a central role. Modern research for artificial wombs builds on this vision.

European philosopher and medical ethicist Anna Smajdor is someone who had studied extensively the potential of artificial wombs to alter human reproduction and its evolutionary implications. She argues that if childbirth no longer depended on the birth canal, the evolutionary pressure against larger foetal heads or brains would weaken, since complications like obstructed labour would no longer act as a filter. This could mean that human reproduction faces major shifts, allowing traits like larger heads or brains to persist.

Genes related to uterine function or pelvic adaptations are under selective pressure because they are critical for successful vaginal delivery. If artificial wombs make natural pregnancy rare, these genes could accumulate mutations over many generations, as their functionality becomes less critical for reproductive success. This is analogous to the evolutionary loss of function in vestigial structures like the human appendix.

Smajdor also looks at the social and ethical dimensions of ectogenesis, arguing that it could separate reproduction from women’s biology, which may challenge traditional gender norms and lessen the physical and social burdens of pregnancy. She sees this potential separation as a form of liberation for women. However, critics raise concerns about the commodification of reproduction and the weakening of the maternal-foetal bond because of artificial gestation. Nevertheless, thinkers like Smajdor believe that a full shift to artificial wombs is unlikely without global mandates. She believes that cultural and ethical barriers would remain, making a mix of natural and artificial reproduction a more realistic scenario for the coming decades.

dementia-proofing-your-brain-a-neurologists-lifestyle-guide

Sat Jul 26 18:32:36 IST 2025

Dr Dale Bredesen, a neurologist who has worked in many of California’s major universities, is known for boldly claiming that Alzheimer’s disease can be reversed, even in the case of severe degeneration after several years of living with the condition.

In 2014, Bredesen was touted as the first doctor to have successfully reversed memory loss in people diagnosed with the disease, after a small study he led at the University of California, Los Angeles. He has since written two books about the power of a dementia treatment regimen he has designed, called ReCODE.

He has now written a third, called The Ageless Brain. It is no less defiant of the current medical consensus. Research has shown that “there is no reason why anyone should get dementia in the first place,” Breseden claims, “and the idea that there is nothing that can be done for people who already have the disease is just outdated at this point”. With dementia cases set to triple worldwide by 2050, this is exactly the news that many of us are desperate to hear. But could such a thing really be true?

That our lifestyles go a long way in determining our dementia risk is solid scientific fact. “There is some evidence that certain diets, such as the MIND diet which is based on the traditional Mediterranean diet, can help to prevent dementia or slow cognitive decline,” says Barbara Sahakian, a professor of clinical neuropsychology at the University of Cambridge. “I am yet to see any method that can reverse Alzheimer’s symptoms, however.”

“There is currently no cure for any type of dementia,” agrees Dr Richard Oakley, an associate director of research and innovation at the Alzheimer’s Society, though “around 45 per cent of dementia cases could be prevented or delayed with lifestyle and societal-level changes”. Engaging in just 35 minutes of physical exercise per week, for example, has been associated with a 41 per cent lower risk of developing dementia compared with a completely sedentary lifestyle.

The earlier in life we adopt a regimen of clean eating and frequent exercise the better for the health of our brains. But there is much we can do in midlife, says Bredesen, who is far more optimistic than most of his colleagues in the field.

In fact, “your forties and fifties are really the sweet spot when it comes to dementia prevention,” says Bredesen. Though we are living for longer, “our brain spans aren’t yet matching our lifespans,” he explains, and our 40s and 50s are the right time to make sure that you stay sharp into your eighties and beyond.

“People find that they are pretty healthy throughout their 30s, but that things start to feel different when they hit 40, and then andropause and menopause comes in from around 50 and make everything different again,” says Bredesen. “This is when the first signs of cognitive decline might set in, like slower mental processing and worsened memory, and at this point, there really is a tremendous amount that you can do to reverse them and make sure you never get dementia.”

That said, it won’t be easy. “Reversing or preventing dementia is extremely difficult, because it involves wholesale change in the way a person is living their life, what they are eating, how they are exercising, socialising and sleeping,” explains Bredesen. The good news is that “getting even a few of these right is enough to massively reduce your risk of developing Alzheimer’s”.

Here is Bredesen’s prescription for a lifestyle that could successfully ward off dementia.

Make sure you eat the right diet (and it isn’t the one you think)

What we eat affects the health of our brains, and most of us know that now. But the best diet for your brain goes a step beyond the Mediterranean diet and the advice is to eat lots of vegetables and oily fish, according to Bredesen. His ReCODE protocol includes a ketogenic (high fat, low carbohydrate) diet, with a small amount of fasting, both “to reset the body’s sensitivity to insulin” and avoid insulin resistance in the future.

Insulin resistance is thought to affect up to 40 per cent of people aged over 40. Those who are overweight and inactive are most at risk, but this issue is typically identified through a blood test. Insulin resistance is problematic when it comes to dementia risk because it can lead to a build-up of amyloid and tau, two proteins that are thought to damage brain cells. Meanwhile, ketones, a type of chemical produced by the liver in the process of breaking down fat, may be helpful in delaying or preventing the onset of Alzheimer’s disease, according to some research. “The purpose of this diet is to restore insulin sensitivity and to restore your body’s ability to make ketones when needed,” explains Bredesen.

For this, the doctor prescribes a diet that is heavy in cruciferous vegetables like Brussels sprouts and cabbage, as well as fermented food such as sauerkraut, though produce sprayed with insecticides and herbicides is to be avoided (as these can contribute to toxic exposure, another risk factor for dementia). Low-mercury fish, pastured chicken and eggs are in, while grains, dairy products and simple carbs like white bread are out. Fibre and healthy omega-3 fats from sources such as avocados, nuts and seeds are given a starring role—both “help your gut microbiome, which we know now is crucial in protecting your brain,” says Bredesen.

It is also best for your brain, Bredesen believes, to fast for 12 hours overnight, and for at least three hours before bed—if you eat dinner at 7pm, you should have breakfast at 7am the next day, no earlier and no later. A small amount of fasting before bed and in the morning helps to regulate your glucose levels, a key factor in insulin sensitivity. He, however, doesn’t advise people who want to ward off dementia to try intermittent fasting or fast for much longer than 12 hours at a time, as “you don’t want to starve your body of the energy it needs”.

Exercise a lot, in different ways

When it comes to dementia, any amount of movement is far superior to none at all, as shown by a recent study from the Johns Hopkins Bloomberg School of Public Health, which found that just five minutes of “moderate to vigorous” exercise a day can cut dementia risk by over 40 per cent (if stuck to every day of the week for four years). The reason for this seems to be that exercise increases blood flow, stimulating the growth of new brain cells and reducing inflammation, the chronic sort of which is linked to increased risk of cognitive decline.

But most of us struggle to find the time to exercise, and it only becomes less appealing as you age. So how can you get the most bang for your buck? Bredesen advises people to aim for at least 30 to 40 minutes of exercise a day, five times a week, and to include three to four strength training sessions for no more than 20 minutes at a time and regular cardio.

“The two kinds of exercise are very complementary in what they do for the brain,” says Bredesen. “Running is especially great because it improves your coordination. Any kind of aerobic exercise improves blood flow and promotes better sleep, while strength training improves insulin sensitivity. Anyone who is physically able to do so should be trying to build or at least maintain muscle and strength.”

Those in midlife should consider incorporating some high-intensity interval training (HIIT), adds Bredesen. The practice combines the most useful aspects of aerobic and strength training, he explains in his book, and the combination of short bursts of exercise and short breaks “does seem to do something special in the brain”, though HIIT shouldn’t be treated as a full replacement for longer aerobic or strength training sessions.

Bredesen also recommends exercise with oxygen therapy to anyone with vascular problems, a predictor for dementia, as this can improve the oxygenation of a person’s bloodstream and lower blood pressure. “But that can be pretty expensive, and it is still important that people just get out if this is outside of their budget.”

At the end of the day, “you just want to aim to get your heart rate up at least five times a week, every week,” says Bredesen. “A very gentle walk won’t cut it, but going slightly uphill or more quickly than is comfortable is enough.” The best kind of exercise is the one that you will stick to. “Figure out what works well for you, and then add to that if you can. I like to play pickle ball or some tennis with my wife,” he says.

Get enough sleep (but not too much)

Most people in midlife could do with getting a bit more sleep, women especially. Perimenopausal women get less sleep than both postmenopausal and pre-menopausal women, according to some research, with more than half getting less than seven hours of sleep per night—deemed the minimum for good brain health.

The sweet spot for sleep is in fact seven hours, “with at least an hour of deep sleep and an hour and a half of REM (rapid eye movement) sleep,” advises Bredesen. But too much sleep is bad for the brain; regularly sleeping for nine hours or more “is associated with risk for dementia”.

All this is because sleep helps to “cleanse and restore” the brain, ridding it of unhelpful influences and preparing it for the next day. REM sleep, when dreaming occurs, seems especially important. Research suggests that for every percentage decrease in the REM sleep we get, dementia risk rises by 9 per cent. Deep sleep, meanwhile, seems to be the crucial period in which the brain rids itself of waste products.

To know whether you are actually getting enough sleep each night, and enough deep sleep and REM sleep at that, it isn’t enough to simply count the hours between your bedtime and your morning alarm. Though we might not remember it, the average person wakes between two and five times in the night, cutting the time actually spent sleeping.

“It is well worth investing in a fitness tracker that has a sleep function,” says Bredesen.

Train your brain with big and small challenges

Fitness is a matter for your brain as well as your body, says Bredesen, and to protect yourself from dementia, you must challenge it over the course of your life. Research now shows that “cognitive reserve” isn’t enough. Instead you must constantly present your brain with new tasks and challenges.

That doesn’t always have to mean putting your brain through a structured boot camp. Bredesen recommends that people in midlife “take on a small cognitive challenge each day, a medium cognitive challenge each month, and a big cognitive challenge each year”. It needn’t be complicated, “but some degree of intentional brain training has been shown time and time again to help prevent dementia”. The point is that each challenge encourages you to go about your life slightly differently, making your brain work harder and remain “plastic”, in a more flexible state of growth.

Examples of a small challenge include trying a new kind of puzzle (making the switch to sudoku if you are a regular crossword-er), visiting a new coffee shop or simply “setting up your desk in a new part of the house if you are someone who works from home,” says Bredesen.

A medium challenge, meanwhile, might entail cooking recipes from a cuisine you haven’t yet tried your hand at, or listening to a new kind of music. “But the key is that the nature of the challenge has to change each month,” says Bredesen.

A hard challenge, your year-long project, should involve “true mastery” of a subject, says Bredesen. Learn a language, become a chess expert or finally learn how to do algebra, “so long as it has nothing to do with your day job, as you won’t find the benefits of a more plastic brain here”.

lissun-mental-health-india-tech-empathy-distribution-healthcare

Sat Jul 26 18:25:25 IST 2025

Technologists Krishna Veer Singh and Tarun Gupta share striking parallels: both worked in the US, held roles at internet giants, and met while working at Uber, where they bonded over shared values. But it was their personal struggles with mental health—and the lack of accessible solutions—that inspired them to build LISSUN in 2021, a tech-driven mental health platform for India.

“These gaps exist at multiple levels—awareness, acceptance, access and affordability,” says Singh. “From the start, our goal was to reach large, underserved populations using technology.”

But the duo knew that building a mental health app wouldn’t guarantee use. “That’s why we focused on distribution from day one. First-time entrepreneurs build products; second-time ones build distribution. We consider ourselves 1.5-timers—we’ve learned from both ends,” Singh adds.

Instead of offering therapy as a standalone service, the Gurugram-based LISSUN integrates it into real-life care journeys. They began with high-stress domains like infertility and maternity. “We embedded our services in IVF clinics, maternity hospitals, cancer care and dialysis centres—places where patients already face intense emotional strain,” says Singh.

Next, they entered the student wellness space, particularly among those preparing for competitive exams like JEE and NEET. LISSUN partnered with coaching centres in Kota, Indore, Vashi, Shakarpur and other tier-2 or tier-3 towns, becoming one of the largest mental health support providers in this segment.

Their third focus was children with special needs, such as those with ADHD, autism and developmental delays. LISSUN began launching dedicated physical centres to support this group.

Operating in a hybrid model—both digitally and physically—LISSUN’s in-house therapists offer psychotherapy, physiotherapy, clinical psychology, assessments and pharmacological support. Meanwhile, their AI-based tools enhance care delivery—analysing session data, tracking outcomes and suggesting interventions. Predictive models are also in development to flag at-risk users early.

Despite rising need, stigma around mental health persists. Singh says this makes their embedded approach essential. “A diabetic patient is fine taking pills but hesitates to see a psychologist. By integrating mental health into their regular care path, we sidestep stigma rather than confront it head-on,” he says.

Singh believes the younger generation offers hope. “Even 10- to 12-year-olds are open to discussing mental health,” he says. “In small towns, too, we see this shift. As today’s teens become financially independent adults, help-seeking behaviour will become the norm.”

Interestingly, women still seek support more than men—not because they need more help, but because they’re more open. “Men tend to suppress and deny the need,” says Singh.

Another insight: the metro vs. non-metro divide is narrowing. “The awareness gap is closing fast,” he says.

However, regulation remains a challenge. “Mental health is still evolving as a policy priority. There’s a lack of standardisation in therapy practices, qualifications and digital care delivery. We need frameworks that support innovation while protecting users,” says Singh.

LISSUN’s journey shows how empathy, tech and distribution can come together to fill deep systemic gaps in mental health care—making it accessible, contextual and stigma-free.

india-healthcare-rare-diseases-government-action-rare-diseases

Sat Jul 26 18:20:15 IST 2025

For a person living with a rare disease, what should be the ultimate eligibility criteria for timely access to approved and available treatments? Should it be their ability to pay? Their nationality? A biased estimate of potential improvement? Or, perhaps an assumption about their future contribution to the nation?

At the age of one, I was diagnosed with spinal muscular atrophy (SMA), a rare progressive neurodegenerative disorder. At the time, there was no definitive treatment available—only supportive care and symptom management. In 2017, when I was 18, I developed pneumonia, which led to respiratory failure. Since then, I have relied on a tracheotomy tube to breathe, along with regular nebulisation, BiPAP therapy and supportive medication.

In the weeks following my tracheotomy, my pulmonologist tried to keep me hopeful, saying I would recover soon. But the infections kept recurring. I still remember him telling my parents in disappointment, “The girl is taking so much effort... but the problem is that every time she takes a step forward, she stumbles three steps back.” What else can happen when you live with a disorder that keeps progressing?

The first treatments for SMA—nusinersen and onasemnogene abeparvovec—were approved by the US FDA in 2016 and 2019, respectively. Nusinersen is a lifelong treatment administered at regular intervals and costs about Rs92 lakh per injection. Onasemnogene abeparvovec is a one-time intravenous gene therapy for children under two and costs approximately Rs16 crore.

In 2020, the FDA approved risdiplam, the first oral drug for SMA. It is also a lifelong treatment taken daily. Currently, risdiplam is the only SMA drug marketed in India. One bottle is priced at Rs6.2 lakh. Even at the discounted rate offered to the Indian government, the cost for a patient weighing more than 20kg is at least Rs60 lakh per year. The Central government’s National Policy for Rare Diseases provides a maximum of Rs50 lakh in financial assistance—insufficient for continued treatment.

While none of these medicines can cure SMA, they are highly effective in slowing its progression and preventing life-threatening complications, leading them being regarded as life-saving drugs. Access to these drugs can significantly improve patients’ health and quality of life. Continued access, particularly to treatments like nusinersen and risdiplam, is vital.

Rare disease patients in India have long struggled to access these exorbitantly priced life-saving drugs. Since early 2021, courts have been hearing petitions demanding affordable treatment for all. A landmark judgment came on October 4, 2024, when the Delhi High Court ruled on a batch of petitions (titled Master Arnesh Shaw v Union of India) filed by patients with rare diseases like SMA, Duchenne muscular dystrophy, and Gaucher’s disease. The ruling included detailed directions to the National Rare Diseases Committee, the Union government and pharmaceutical companies.

It was disheartening, however, when the Supreme Court later stayed this judgment.

Proper support for rare disease patients must begin with awareness and include a well-coordinated system for diagnosis, treatment administration, rehabilitation and creating accessible environments. India still lacks a complete registry of rare disease patients. Though 12 centres of excellence have been approved for treatment, many patients—especially children and those with severe health issues—cannot easily travel long distances to register or attend follow-ups. More hospitals need to be added to the network.

Ensuring treatment for all rare disease patients will require active negotiation with pharmaceutical companies and better budget allocation and use. The Rs50 lakh financial assistance cap must be removed to ensure uninterrupted access to lifelong therapies. The government must also invest in developing indigenous drugs and strengthening the generic drug industry.

Patent monopolies play a major role in keeping prices unaffordably high. Life-saving drugs should not be treated as profit-generating commodities. If negotiations fail to bring prices down, the government should not hesitate to invoke the public interest safeguards under the Indian Patents Act.

As Martin Luther King Jr said in 1966, “Of all the forms of inequality, injustice in health is the most shocking and inhumane.” The government must act swiftly and effectively—not by prioritising certain patients or delaying decisions, but by ensuring fair access to treatment for all those living with rare diseases.

The writer is a 26-year-old artist, writer and blogger living with SMA type 2. Bedridden since 2017, she is actively raising awareness about the lived realities of people with disabilities.

how-brain-directs-blood-mosso-fmri-connection

Fri Feb 27 14:23:54 IST 2026

In the late 1800s, Italian physiologist Angelo Mosso made a curious observation while studying a patient with a skull defect that left part of the brain exposed. He noticed that when the patient became angry, the exposed area visibly swelled with blood. This led Mosso to explore the idea that changes in cerebral blood flow could reflect mental activity.

He had already observed that in newborns, the fontanelles—the soft spots where the skull has not yet fully fused—pulsate with the heartbeat, and noted similar pulsations in adults attending his clinic. Mosso devised a graphic recorder to document these pulsations and demonstrate that blood pressure changes in the brain caused by mental exertion occur independently of pressure changes elsewhere in the body.

Mosso’s groundbreaking observations would, nearly a century later, lay the foundation for the development of functional magnetic resonance imaging (fMRI), a brain scan that measures blood flow to different regions as a proxy for neural activity during various tasks.

Notably, the brain is one of the body’s most energy-hungry organs. Though it makes up just 2 per cent of body weight, it consumes nearly 20 per cent of the body’s energy. To meet this demand efficiently, the brain must direct blood flow to the regions that need it most. This targeted delivery of blood in real time is an evolutionary adaptation. It has been observed that this mechanism is impaired in cases of neurodegeneration.

Interestingly, the precise mechanism behind this dynamic distribution of blood remained a mystery for a long time. Now, researchers at Harvard Medical School have uncovered key details of how the brain directs blood to active areas as they work. Their findings are published in Cell.

The researchers conducted a series of experiments in mice, revealing a cellular signalling highway that supports this mechanism, involving a couple of key genes. They found that the brain rapidly signals the need for more blood in specific areas via endothelial cells, which line blood vessels in the brain. These endothelial cells then communicate quickly through “gap junctions”—tiny channels connecting neighbouring cells.

Using this wide-reaching and coordinated signalling system, which runs through the inner linings of blood vessels, the brain instructs the vessels when to dilate or contract, depending on need. The researchers note that since the brain’s vascular network is similar across mammals, the same system likely operates in humans. The Harvard team suggests that if these findings hold true in humans, they could significantly improve the interpretation of fMRI scans, potentially offering new insights into the relationship between blood flow and neural activity.

understanding-neurodivergence-explained

Sat Jul 26 17:39:29 IST 2025

DR AJIT SINGH BAGHELA

Consultant, paediatric neurology, Artemis Hospitals. His extensive experience in diagnosing and managing neurodevelopmental conditions focuses on early intervention strategies and family-centred care, besides battling stigma. A nature lover, he enjoys swimming and trekking.

Neurodivergence encompasses natural variations in human cognition, including autism, attention-deficit/hyperactivity disorder (ADHD), dyslexia and other neurological differences. Fifteen to twenty per cent of the global population is considered neurodivergent. According to the World Health Organization, one in 100 children worldwide is diagnosed with autism spectrum disorder (ASD). Recent studies indicate that about one in 100 children in India under age 10 may has autism, and nearly one in eight have at least one neurodevelopmental condition.

Understanding neurodivergence

It refers to the natural differences in how people’s brains work and process information. Think of the brain as a complex computer system—while most computers run on similar operating systems, neurodivergent brains operate on different, equally valid systems. These differences affect how individuals think, learn and communicate with the world.

Spectrum of conditions

The most common neurodivergent conditions include ASD, ADHD, dyslexia and other learning differences. Autism affects social communication and behaviour, often accompanied by repetitive patterns and intense interests. ADHD causes difficulties with attention, impulse control and hyperactivity. Dyslexia primarily impacts reading and language processing abilities. These conditions frequently overlap—someone with autism may also have ADHD, or a person with ADHD might struggle with dyslexia. Comprehensive evaluation by trained professionals is crucial for identifying all conditions. Anxiety and depression are common among neurodivergent individuals. Other co-occurring conditions include obsessive-compulsive disorder, bipolar disorder and epilepsy.

Dual perspective

Neurodivergence exists in a unique space—it is both a natural variation in human brain function and, when necessary, a medical condition requiring support. This dual understanding is crucial. On one hand, neurodivergence represents the natural diversity of human cognition, much like how people have different heights, eye colours or physical abilities. It is not something that needs to be ‘fixed’ or ‘cured’. On the other hand, many neurodivergent individuals face genuine challenges in daily life that benefit from medical support, therapeutic interventions and environmental accommodations. This balanced perspective helps reduce stigma while ensuring people get help.

The Indian context

In India, ASD, ADHD and learning differences like dyslexia are the most frequently encountered neurodivergent conditions. The number of diagnosed cases has increased significantly over recent years, due to growing awareness among parents, teachers and health care professionals. Urban areas show higher diagnosis rates, partly due to better access to specialists and diagnostic facilities.

Challenges

Many families, particularly in rural areas, still attribute neurodivergent behaviours to supernatural causes or poor parenting. Social stigma remains strong, often preventing families from seeking help. The lack of trained specialists outside major cities creates significant barriers to diagnosis and treatment. Additionally, many learning disorders go undetected in schools that lack proper screening programmes.

Age-related manifestations

Neurodivergent conditions present differently across age groups, making early recognition crucial. In young children with ADHD, hyperactivity and difficulty concentrating are prominent, while adults may struggle more with organisation and restlessness. Autism in early childhood often manifests as difficulties with social interaction and communication, but teenagers and adults may face challenges interpreting social cues and maintaining relationships. Dyslexia typically becomes apparent when children struggle with reading and writing, though adults may continue to find reading tasks particularly challenging. Understanding these developmental changes is essential for providing appropriate support at each life stage. What works for a child may not be effective for an adult, and interventions must evolve with the individual’s changing needs.

Hidden signs

Many neurodivergent individuals learn to mask or hide their differences, making recognition challenging. A person with autism might mimic social behaviours without fully understanding them, appearing socially competent while struggling inside. Someone with ADHD might seem engaged externally while battling focus issues internally. Others experience sensory sensitivities or anxiety that aren’t immediately apparent. These masked presentations can lead to delayed diagnosis and inadequate support. Girls and women are particularly prone to masking, often resulting in under-diagnosis.

Role of genetics and family history

Genetics play a significant role in neurodivergence, with conditions like autism, ADHD and dyslexia frequently running in families. If one family member has a neurodivergent condition, the likelihood of others being neurodivergent increases. However, genetics is only part of the story—environmental factors and developmental influences also shape how these conditions manifest. Family history assessment helps health care providers evaluate risk and implement early support.

Environmental influences

During pregnancy and early childhood, environmental factors can influence neurodivergent development. Exposure to harmful substances like lead or alcohol during pregnancy, maternal infections, poor nutrition or high stress levels can increase risks. Birth complications, premature birth or low birth weight may also contribute to neurodevelopmental differences. While these factors are important, neurodivergence typically results from complex interactions between genetics and environment. Understanding these influences helps promote healthier pregnancies and supports early intervention strategies.

Early warning signs

Parents and teachers should watch for several key indicators that may suggest neurodivergence. These include delayed speech or motor skills, difficulty with eye contact, challenges focusing or staying still and struggles in social situations. Other signs include repetitive behaviour, heightened sensitivity to sounds or textures, and difficulties with reading, writing or following directions. These signs can vary significantly between children and often appear in early childhood.

Timing of diagnosis

Some neurodivergent conditions can be reliably identified as early as 18 to 24 months, particularly ASD. Others like ADHD or dyslexia may not become apparent until preschool or early school years (ages 4-7), when attention, reading and learning challenges become more evident.

Diagnostic process

This typically begins with developmental screenings by paediatricians or specialists, who assess behaviour, communication and learning abilities. If concerns arise, comprehensive evaluations follow, including detailed interviews, standardised questionnaires and direct observation. A team of professionals may be involved, including developmental paediatricians, child psychiatrists, clinical psychologists, neurologists, speech-language pathologists and occupational therapists.

Diagnostic tools and their limitations

Current diagnostic tools, such as the Autism Diagnostic Observation Schedule and Vanderbilt ADHD Rating Scales, are generally reliable when used by trained professionals. However, they have limitations. Many rely on observation and caregiver reports, which can be subjective. Cultural differences, masking behaviours and co-occurring conditions can complicate diagnosis. Some tools may not fully capture how neurodivergence presents in girls or adults. This is why comprehensive, multi-step evaluations are essential for accurate diagnosis.

Gender differences in diagnosis

Boys are diagnosed with certain neurodivergent conditions more frequently than girls, partly because their symptoms are often more obvious or disruptive. Girls may show subtler signs like inattentiveness or daydreaming rather than hyperactivity, or they may be better at masking their difficulties through social mimicry. Traditional diagnostic tools, largely based on male presentations, may miss these subtler manifestations in females.

Hormonal and developmental factors

Hormones like testosterone and oestrogen influence brain development during prenatal and early childhood periods. Exposure to different hormone levels in the womb may affect social behaviour and cognitive patterns, potentially influencing the likelihood of developing conditions like autism or ADHD. Some researchers suggest that girls may require stronger genetic or environmental triggers to manifest these conditions, possibly due to protective effects of oestrogen.

Educational accommodations

India’s education system is slowly adapting to accommodate neurodivergent students. The Rights of Persons with Disabilities Act of 2016 mandates inclusive education, allowing children with disabilities to attend mainstream schools with appropriate support. Project Inclusion has trained over 3.6 lakh teachers to better understand and support neurodivergent students. Challenges remain, including rigid curricula, limited resources and insufficient teacher training. Progress continues toward creating more flexible learning environments and providing specialised support for diverse learning needs.

Treatment approaches

Effective treatment for neurodivergence typically involves individualised approaches combining behavioural therapies, educational support and sometimes medication. Applied Behaviour Analysis can help individuals with autism develop social and communication skills. ADHD may be managed with medication and behavioural strategies. Dyslexia responds well to specialised reading programmes and educational accommodations. Early intervention and personalised treatment plans are crucial for optimal outcomes. The goal is not to eliminate neurodivergent traits but to help individuals develop coping strategies and maximise their potential.

Family and community support

They can better support neurodivergent individuals by learning about and accepting different ways of thinking and behaving. Education about neurodiversity reduces stigma and increases empathy. Creating inclusive environments at home and in public spaces helps neurodivergent people feel valued and understood. Flexibility, patience and open communication are essential. Joining support groups and community programmes provides valuable resources and shared experiences.

Long-term outcomes and support systems

Neurodivergent individuals may face challenges in education, employment and relationships due to differences in communication, sensory processing and social interaction. However, with appropriate support systems, many can achieve successful outcomes. Beneficial support systems include inclusive education programmes, workplace accommodations, mentorship programmes and community awareness initiatives.

what-happens-to-your-body-when-you-fall-in-love

Sat Jul 05 15:43:47 IST 2025

It is the topic that has occupied the minds of poets and philosophers since time immemorial: love. With Shakespeare famously writing: “The course of true love never did run smooth.” Love can drive us to distraction, but what is actually going on in our brains and bodies?

Dr Helen Fisher, biological anthropologist and author of Anatomy of Love, says, “When you fall in love, there are a lot of bodily responses. The neurotransmitter norepinephrine, which plays a key role in arousal and alertness, causes increased heart rate, increased blood pressure, and dilation of pupils.” Norepinephrine and adrenaline can cause sweaty palms and butterflies in the stomach, she says.

Fisher says the first thing we need to be clear about is what drives the feeling of romantic love. This, she says, is foremost: dopamine—a neurotransmitter and hormone that acts in the brain to give feelings of pleasure, satisfaction and motivation.

In 2005, she and her colleagues from the New York-based Albert Einstein College of Medicine, were the first to put people in love into brain scanners and study the brain circuitry of romantic love.

“We found increased activity in a little factory near the base of the brain that makes dopamine and sends it to many regions in the brain, giving you the focus and energy, motivation and craving for a particular person, and the belief that this person is totally special,” says Fisher, “You can talk until dawn, you have euphoria when you’re with them and despair when you’re not.”

In contrast to this, she says the feelings of lust and attachment, although similar, are different systems in the brain.

“Lust is driven largely by testosterone and initially evolved to create the desire to start the mating process. Dopamine enabled our forebears to focus on just one person. Together, lust and romantic love evolved to pass on our DNA. Then deep attachment, driven largely by oxytocin, evolved to enable us to stick together long enough to ensure the survival of our young,” she says.

Long-term love and positive illusions

In 2011, Fisher and her team also looked at long-term love, studying 10 women and seven men who were married an average of 21 years and said they were still in love with their partner.

“We put them in the brain scanner and the brain regions for lust, romantic love and attraction all became activated when they looked at a photo of their long-term partner. We were able to prove that you can remain in love long-term.”

She also studied happiness, finding that those who scored very high on the partnership happiness scale also showed more activity in three other brain regions: those associated with empathy, with controlling your own stress and emotions, and with the ability to overlook the negative points of your partner.

“We are built to remember the negative, known as negativity bias,” says Fisher. “But when you are in love, activity in this brain region reduces, known as positive illusions. You overlook the negative and think of the positive things about your sweetheart.”

But Fisher’s view that dopamine is the driver of love, and that love, lust and attachment are led by three different brain systems is hotly contested.

Dr Adam Bode, a romantic love researcher at the Australian National University in Canberra, believes that love is much more complicated—and that far from dopamine, it is actually the neurotransmitter opioids that actually drive love.

He says, “My colleagues and I believe love is much more complex and that love, lust and attachment are highly interlinked. We also believe that opioids are very important in the feeling of being in love, more so than dopamine.”

Lust vs. love

Dr Anna Machin, an evolutionary anthropologist and author of Why We Love: The Definitive Guide to Our Most Fundamental Need, also agrees that love is a very complicated science. She has spent 20 years looking at love from a biological and evolutionary perspective, mostly at the University of Oxford.

Is love at first sight a real thing? She says, “Love is where you develop a psychological attachment for someone. It’s a very complicated phenomenon, led by opioids. It definitely does not occur when you first set eyes on someone, that’s different chemicals at work, chiefly dopamine, oxytocin and serotonin. So, I am sorry to break it to people, but there is no such thing as love at first sight. It is lust at first sight.”

She explains that while lust is “an unconscious drive related to reproduction” love involves both unconscious and conscious cognition.

The unconscious area—essentially the limbic part of the brain—is ancient and drives lust, passion and nurture, the drives we share with other mammals.

“Attraction is a completely unconscious drive, a quick, sensory process that will reward you to cross the room and say hello to someone you fancy,” she says.

In contrast, love also engages the conscious brain, or neocortex, which gives us empathy, trust, abstract ideas about our relationship and the ability to love in the absence of the other person.

“This is what separates humans from other animals in terms of love, in that our love uses both those areas of the brain,” she says.

In her research, she has looked at the physiological effects of love and lust on the body.

She says, “The adrenalin causes all the bodily effects we know of—the racing heart, the butterflies. But in long-term love, the butterflies and racing heart are replaced by bio-behavioural synchrony. This is when every mechanism in your body comes into synchrony with your partner when you interact with them.”

She explains that if two people who are in love spend five minutes together, their neurochemical levels will become the same, as will their blood pressure, body temperature and heart rates.

“We see this with children and parents as well, which is why a baby is laid on a parent’s chest, to get its bodily mechanisms to match the parents,” she adds.

A whole body experience

Machin reiterates that the one thing we really need to know about love, is that it is not just in the brain or heart.

“The neurochemicals released in love are also released when we physically hurt ourselves, it’s a natural painkiller. But it’s also released in the physical interactions, when we touch, hug or laugh with people,” she says.

Love and its neurochemicals processes apply consistently in all ages, she says. “You can fall in love as profoundly when you are 21 as when you’re 55. And it really is a whole-body experience, not just in your brain,” she says.

ai-predictive-healthcare-revolutionising-post-discharge-care

Sat Jul 05 15:39:12 IST 2025

In 2016, Suman Katragadda—one of the founding members of the health care analytics practice at PwC US—came to Hyderabad to meet senior government officials about public health schemes. He was scheduled to return the same day, but a delay forced him to miss his flight. Instead, he decided to drive to his home town, four hours away by road.

“That night, however, I developed severe pain in my lower abdomen and back,” he recalls. “I was admitted to hospital and diagnosed with a kidney stone. They performed a blasting procedure and I was hospitalised for two days.”

After discharge, he began experiencing intense headaches and vomiting. “The pain worsened when I sat or walked but eased when I lay down,” he says. Reaching the doctor for a follow-up proved difficult. “The hospital kept saying he was in surgery, with patients or off duty,” says Katragadda. “It took nearly two days to speak to him.”

When he did, the doctor suggested it was likely a minor spinal fluid leak from the epidural and advised him to “drink plenty of water and lie down”.

Katragadda was stunned. “If it was that simple, why didn’t anyone tell me at discharge—or at least when I called the hospital? I could’ve avoided so much pain and anxiety,” he says.

“That experience,” he says, “exposed a critical gap in India’s health care system: the lack of continuity after discharge. If I faced this after a routine procedure, what must patients with serious conditions like heart failure or pneumonia go through? Their post-discharge journey must be even harder.”

Katragadda soon realised that post-discharge care gaps are not unique to India—they are a global issue. While consulting for a leading US medical institution, he reviewed two discharge summaries for men with congestive heart failure—one was 44, the other 65. “What struck me was that both summaries were identical and extremely basic,” he says. “They simply advised: if you have fever, chest pain, or shortness of breath, call 911 or return to the ER.”

Curious, he turned to the American College of Cardiology's guidelines and found that 26 potential symptoms can emerge after discharge. “My first question was: why weren’t all 26 mentioned?” he recalls. The answer? Patients wouldn’t remember them anyway. “But shouldn’t they at least be documented?” asks Katragadda.

He then learned that 50 per cent to 60 per cent of patients lose their discharge summaries before even reaching home, and most cannot recall specific instructions within a couple of days. This glaring gap in continuity of care became the seed for Katragadda’s idea to create Heaps.ai, a predictive model-based solution for medical care management.

The application analyses a user’s comorbidities, medications, living conditions and compliance history to forecast deviations in recovery. “We realised if we could predict when and how a patient might stray from the care path, we could intervene early,” says Katragadda. “That insight shaped how we designed the system.”

Initially focused on cardiology, the platform soon expanded. “Now, we cover 16 to 18 specialities and have care pathways for 36 chronic conditions,” he says.

Today, the platform does not just monitor vitals—it provides a comprehensive care management plan that includes scheduled doctor visits, lab tests, medication tracking, adherence nudges and targeted patient education. For instance, a patient with diabetes and high cholesterol receives an integrated roadmap, rather than siloed instructions from different specialists. The system synchronises appointments and required tests and begins nudging behavioural changes days before each medical touchpoint.

Heaps.ai does not charge patients. Its revenue comes from insurance companies, hospitals, governments and corporates. “For insurers, we help reduce readmission rates,” Katragadda explains. “For corporates, we manage employee health. And for governments, it is about population health management. Think about it: if a company pays Rs100 in premium and the insurer pays out Rs120 in claims, next year’s premium won’t stay at Rs100. It’ll go up. That’s where we step in to manage risk.”

Katragadda says that for governments, Heaps.ai manages populations covered under schemes like Ayushman Bharat and state employee health programmes. “The focus is on reducing chronic and repeat hospitalisation, shortening hospital stays and improving health outcomes,” he says.

The company credits its predictive model with multiple life-saving interventions—while also helping hospitals retain patients. Katragadda recalls one such instance involving a police constable who was admitted with chest pain and breathing difficulty. After treatment and a four-day hospital stay, he was discharged and appeared stable. But on the 21st day, the system flagged a high risk of recovery deviation.

A care coach called, guided by AI-generated prompts. “One of the first questions was: ‘Can you check if one leg looks more swollen than the other?’” says Katragadda. The patient initially said he felt fine but admitted to mild swelling on his left foot. At the nurse’s request, he sent a photo—revealing fluid retention. He was rushed to the hospital and underwent surgery the same day. “That intervention likely prevented a cardiac arrest—or a far more complicated emergency,” Katragadda notes. “And it ensured the hospital didn’t lose the patient to another facility.”

Katragadda, who holds a PhD in statistics, explains that traditional care coordination typically requires 10 to 12 staff for 1,000 patients. “With our system, one person can manage up to 2,500 patients,” he says. “It is a major leap in efficiency and scalability.”

Heaps.ai’s solution is trained on over 5 million data points from multiple countries and functions as an adaptive learning platform. It already serves clients in six countries.

Katragadda adds that a significant number of deaths and repeat hospitalisations occur because patients fail to return to the hospital despite being advised to. “That’s where AI can truly make a difference,” he says.

diet-and-depression-a-surprising-link

Sat Jul 05 15:33:38 IST 2025

A diet plan that suits one’s lifestyle, body type and background is good for physical health. Notably, diet affects depression risk, too. Until now, healthy diets were thought to reduce depressive symptoms, while unhealthy diets were linked to worsening them. However, a new study in BMJ Nutrition, Prevention and Health suggests that dietary patterns extend beyond a simple ‘healthy’ versus ‘unhealthy’ distinction. The study finds that stressful adherence to diets, especially low-calorie diets, may be associated with depressive symptoms.

The Mediterranean diet—rich in heart-healthy fats and centred on fruits, vegetables, whole grains, legumes and herbs—is widely regarded as one of the healthiest eating patterns. Previous research has linked it to reduced depressive symptoms. The new study points out that little is known about the more varied and often restrictive diets people follow in real-world settings and how they affect mental health.

In reality, people often experiment with various diets in pursuit of better health. Common approaches include calorie restriction, nutrient-specific diets (like low-fat or low-sugar) and established plans designed for conditions such as diabetes or hypertension. However, researchers point out that the impact of these diets on depression remains underexplored and often inconclusive.

To address this gap, a team analysed data from 14,329 women and 14,196 men in the US between 2007 and 2018, comparing their dietary habits with responses to the PHQ-9 questionnaire, which measures depressive symptoms. Participants were grouped into four dietary categories: calorie-restricted, nutrient-restricted (low fat, sugar, carbs or sodium), condition-specific diets (like DASH or diabetic) and no specific diet. Findings showed that most people did not follow any structured diet. Only 8 per cent reported calorie restriction, 3 per cent followed nutrient-restricted diets and about 2 per cent adhered to an established medical diet. Roughly 8 per cent of all respondents showed signs of depression.

The study found no significant link between nutrient-restricted or condition-specific diets (like diabetic diets) and depressive symptoms. However, individuals on calorie-restricted diets, particularly men and those who were overweight but not obese, had higher PHQ-9 scores, indicating more severe depression.

Overweight individuals on nutrient-restricted diets also showed higher depressive symptoms. Men in this group had elevated somatic scores (related to physical distress and anxiety) and higher cognitive-affective scores (reflecting negative thoughts and emotions) compared to women not on any diet.

The study suggests that dieting may worsen depression if calorie cuts come at the cost of essential nutrients. Inadequate calorie intake and poor nutrient diversity can trigger deficiencies and physiological stress, potentially deepening depressive symptoms.

The study also found that men were more prone to worsening depression on restrictive diets. Researchers suggest this may be due to men's higher nutritional needs—deficiencies in mood-regulating nutrients like omega-3s and B vitamins could intensify depressive symptoms.

For those on low-calorie diets for weight loss, behavioural therapy would be beneficial, according to researchers. The study also notes the key takeaway is to ensure that one’s diet is nutritionally balanced and not overly restrictive. And weight loss, the researchers stress, is not just a physical process but an emotional and psychological journey as well.

keep-your-brain-young-10-habits

Sat Jul 05 14:58:08 IST 2025

We used to think that the only thing that could happen when you get older is that things go downhill. Thankfully, we have moved past that phase. We now recognise, for example, that dementia is an abnormal trajectory of ageing. While some change in our cognition is expected, it does not need to interfere with our daily lives.

In 2008, Prof Emily Rogalski at Northwestern University in Illinois, US, coined the term SuperAger, defining them as someone over the age of 80 that has memory performance at least as good as people in their 50s and 60s.

At the time she hadn’t found any SuperAgers. “We knew we were setting the bar really high,” says Rogalski, now professor of neurology at the University of Chicago. One thing her team realised early on is that the outer cortex of a SuperAger’s brain looks more like that of a 50- or 60-year-old.

“What usually happens with ageing is that the outer layer shrinks a bit. And that is associated with changes in our memory and thinking abilities. In SuperAgers, we don’t see that biological thinning,” explains Rogalski.

Scientists haven’t yet unlocked the secret recipe for keeping your brain young, but they have identified ways in which SuperAgers differ from the rest of the ageing population. And lifestyle is key.

In recent years, the term has become a little bit muddier. In common parlance it has been applied to those with physical health that is well preserved as their cognition. Prof Jugdeep Dhesi, a consultant geriatrician and president of the British Geriatrics Society, says: “It’s very difficult to disentangle cognition and physical health. There’s an overlap.”

We know that genetics are responsible for about 20 per cent of how we age. The rest is down to us. “We can make positive changes at any time,” says Dhesi.

So what habits do experts on ageing think we should learn from SuperAgers?

1. SuperAgers weather the bad times

The SuperAgers Rogalski meets have not always had the easiest of lives, but they have been able to let things go and persevere through challenges. “We have had holocaust survivors, individuals who have lost their entire families and they were the only ones to survive, people who have lost kids at a young age or been in poverty; really terrible life experiences where it would have been easy to say, ‘Man, this is too much’, but they chose a different path,” she says.

Attitude towards adversity is something that Dr Dawn Harper, health and wellbeing ambassador at retirement villages operator Rangeford Villages, kept encountering when she wrote her book Live Well to 101. “I have met many people who have held on to anger, which I believe has contributed to both mental and physical ill health,” she says.

Letting go can be a real challenge for some. Her advice is to buy a notebook and write down something that made you smile today. “It could be something as simple as the first snowdrop coming to life. It will help you see life through a positive lens.”

2. SuperAgers do not let ageism hold them back

Images of frail, older people sitting in wheelchairs looking sad do us all a disservice. That is a scientific fact.

Prof Becca Levy, of Yale School of Public Health in the US, has spent her academic career researching the impact of negative and positive beliefs about age. She has found that individuals who have a positive attitude to ageing tend to have better physical, cognitive and mental health. One study showed that among those who have an injury in later life, if they have positive age beliefs they will recover much faster.

In another study of the population of the town of Oxford, Ohio, everybody was asked about their age beliefs. Levy matched those findings to longevity information and found those individuals who had more positive age beliefs had on average a 7.5-year survival advantage over those who had adopted a more negative view of ageing. “We know what children as young as age three have taken in the age beliefs of their culture,” says Levy.

In her book Breaking the Age Code, Prof Levy came up with a method for combating negative perceptions of ageing called the ABC Method.

“A” stands for awareness. “Be more perceptive in noticing the ways you’re being given messages about ageing. Both negative and positive,” Levy says.

“B” stands for “Blame ageism, not ageing”. When something goes wrong, Levy says we should not immediately blame ageing itself. “Is there something else contributing to it going wrong? Could it be ageism contributing to a health problem?”

“C” is for challenge. Find ways to challenge negative age beliefs that one encounters. “This can happen on an individual level and also by creating a social movement towards age positivity.”

A source of inspiration to Levy has been Japan, where she spent time earlier in her career. “At the time they had the longest life span in the world—it’s still one of the longest—and I was interested in what the culture contributed to that longer life span,” she says. “One of the things I noticed was how positively the older members of the culture were treated. They were celebrated and featured in pop culture in a way that showed admiration. Comic books had older characters with rich social lives.”

3. SuperAgers converse

The SuperAgers that Rogalski researches all report higher levels of social connection than their peers.

While we know that loneliness is a killer (social isolation puts people at a 50 per cent increased risk of developing dementia) there is more to spending time with others than it making us feel good.

Talking is good for our brain. “It’s hard to have a conversation,” says Rogalski. “It’s good for your brain to have to think how to respond to a question.”

So it is not just the community, social and emotional side of socialising that benefits us: “It’s also keeping your brain thinking about whatever your topics are.”

4. SuperAgers volunteer

Strongly linked to this idea of socialising is the evidence that many SuperAgers have a strong sense of service.

“Many of them volunteer, and find ways for intergenerational connection,” says Rogalski.

As well as helping them to be adaptable cognitively, there are the social benefits associated with spending time with others. “In the community where I live,” says Dhesi, “there are lots of older people who volunteer. And we know that volunteering brings loads of mental health and social benefits.”

5. SuperAgers DO get ill

The word Super might make you think that you have to be invincible to qualify as a SuperAger. Not true.

Rogalski looked at medication use, as types of medications compared with controls are one way to measure health. “We see that with SuperAgers, medication use is similar compared to a group of cognitively average 80-year-olds. It’s not that they [have got away] scot-free [in not] needing medications.”

However, SuperAgers are more likely to follow a healthy lifestyle, which gives them good chances of recovery. Not least their attitude.

6. SuperAgers are creative

A common negative age belief is that we only associate creativity with youth. However there is no evidence that older people are not as creative as younger people.

“There is actually a lot of evidence of people really flourishing in later life in terms of creativity,” says Levy. “People like Matisse and Michelangelo.”

Dhesi agrees: “My mother-in-law is really into arts and crafts. She makes all her own birthday cards for her family.”

The benefits of creativity are that you are using your hands, brain and giving yourself purpose.

7. SuperAgers learn new skills

A willingness to try to learn new things is another key difference that Rogalski has identified between SuperAgers and their peers.

“We do know from other studies the importance of keeping your brain elastic. We think of it like a muscle,” she says. “It turns out our brain is really responsive to learning new things, especially things that are challenging.”

Dhesi recently received a call from her mother, saying she had met someone who knew how to make a particular Indian dish that she has never learnt how to make: “So she’s invited this younger woman over to her house to teach her how to make it.”

It is an added benefit that the woman is younger. “We know there are loads of benefits of intergenerational relationships,” says Dhesi. “That shared wisdom between generations is important. Spending time with someone who is younger than you might be able to give you different perspectives.”

8. SuperAgers keep moving

It is unsurprising that SuperAgers tend to keep active physically, as well as mentally.

Physical activity results in increased oxygen intake, which helps your body perform optimally. However, we know that most people over 75 are not physically active, which means they are not moving for longer than 30 minutes a week. “That’s a tiny level of activity,” says Dhesi.

She is constantly encouraging patients to get moving. “We can see changes in muscle from sedentary behaviour within 24 hours, so if we can delay that change, or prevent it, then that is really important,” she says.

Neither her parents nor her in-laws have a cleaner. “They all do their own dusting and hoovering. They just pace it better now,” she says.

Dhesi’s tips include making sure that you are moving from sitting to standing 20 times every couple of hours. “That will help build up those leg muscles.” She adds: “Things like step counts really do help. It makes you competitive with yourself and your friends.”

9. SuperAgers eat their veg

Multiple studies have shown that the diets of SuperAgers tend to be high in fruits, vegetables, whole grains and fish, and low in red meat, butter and sweets. These diets may help slow cognitive decline and reduce the risk of dementia.

“Try changing your thinking about ‘meat and two veg’. At home we think of the vegetables as the main affair and the protein as a side dish. I am convinced of the benefits of a plant-based diet,” says Harper.

At the very least try to avoid beige-coloured foods and opt for colour on your plate. “Even if that is a kiwi, an orange, some greens with your meat and fish in the evening,” says Dhesi.

10. SuperAgers indulge, in moderation

Living a long and healthy life doesn’t mean it has to be a boring one. Although if you are socialising as much as a SuperAger does, it could hardly fail to be fun.

That certainly does not mean you cannot have a drink while you are doing it. Studies have shown that people who drink moderately were 23 per cent less likely to develop Alzheimer’s disease or signs of memory problems than those who do not drink alcohol.

The key, though, is moderation. “[SuperAgers] have not all been born into the groups you would expect to live longer,” says Dhesi. “They come from difficult backgrounds, but they’ve all made important life choices about not smoking, drinking in moderation, cooking and eating well and being physically active.”

the-real-impact-of-pollution-on-health

Sat May 24 16:05:25 IST 2025

The rising intensity of air pollution is wreaking havoc on our health. On November 18, 2024, New Delhi recorded the highest air quality index (AQI) that has been recorded in India—a staggering 1,081. With this, the city infamously earned the distinction of being the most polluted in the world that day. What is particularly disturbing in that New Delhi isn’t just any other city—it, along with parts of the National Capital Region (NCR), is home to 33 million people.

The crisis is nothing short of a curse for the residents of the Indo-Gangetic plains—a region that houses nearly half of India’s population. According to a 2019 study by the Energy Policy Institute at the University of Chicago, individuals living here are expected to lose up to seven years of life expectancy as compared to those in less polluted regions. The major culprits here are vehicular emissions, industrial and construction activities, and the widespread use of biomass for heating and cooking—all of which release fine particulate matter and toxic gases into the atmosphere.

It’s not just the air pollution—water, soil and occupational pollution are also causing irreversible harm—not only threatening present and future generations but also weakening the potential of human resources to contribute meaningfully to nation-building.

How does pollution cause such damage?

Pollution induces DNA mutations, causes epigenetic changes that alter gene expression, and triggers chronic inflammation—all of which promote cancer development and progression.

The numbers are mind-boggling. According to The Lancet, pollution was responsible for approximately nine million premature deaths in 2019. Of these, 6.7 million were due to air pollution, while water pollution led to 1.4 million deaths. Likewise, toxic occupational hazards, excluding workplace fatalities due to safety hazards, accounted for 8.7 lakh deaths. Here, it is important to reinforce that the total effects of pollution on health would undoubtedly be larger if more comprehensive health data could be generated, especially if all pathways for chemicals in the environment were identified and analysed.

The Lancet Planetary Health Study found that long-term exposure to air pollution results in 1.5 million excess deaths annually in India. PM2.5—fine particles smaller than 2.5 micrometers—penetrate deep into the lungs and bloodstream, posing several health risks. The study, which analysed data across every 1x1x1km in India from 2009 to 2019, provides the most comprehensive view yet of the deadly impact of the polluted air.

While a strong connection between pollution and cancer is well-documented and established, here are some other diseases that are attached to this scourge—asthma, chronic obstructive pulmonary disease. Water pollution causes cholera, typhoid, hepatitis A, and dysentery. Soil contamination contributes to kidney and liver damage, neurological and gastrointestinal disorders, and weakened immune systems.

The crisis is intensifying and it is spreading. If corrective and concrete measures are not put in place, it is only a matter of time before other parts of the country (besides the Indo-Gangetic plains) become equally impacted. It has been seen that over the years a concerted effort against tobacco products has led to a decline in their consumption. Governments across the world, and specially in India, need to be complimented for their aggressive measures against such products; these have yielded positive results and the industry is in a downward spiral.

The impact of air pollution on the health of the people is much more severe than ever before. It requires robust and collective efforts on a war-footing. That is, if we sincerely want to protect the health of our people, and reduce the overall health care costs which are rising at a steep rate of 14 per cent annually.

Dr Rawal is medical director and chief of genitourinary oncology services at Rajiv Gandhi Cancer Institute & Research Centre, Delhi.

car-t-cell-therapy-for-cancer-treatment-advantages

Sat May 24 15:39:13 IST 2025

Interview/ Dr Sattva S. Neelapu, professor, department oflymphoma-myeloma, division of cancer medicine, The University of Texas MD Anderson Cancer Center

Dr Sattva S. Neelapu is a leading global expert in advanced cancer treatment methods like CAR T-cell therapy, which is transforming cancer care. He spoke to THE WEEK on the sidelines of Cura Immunis, a national conclave on CAR-T cell therapy held at the Medical Trust Hospital in Kochi. Excerpts:

Q/ Could you explain the science behind the CAR T-cell therapy?

A/ CAR T-cell therapy is a form of genetically engineered T-cell therapy. The goal is to harness the power of the immune system to treat cancer.

We begin by harvesting T cells, which are a type of immune cell in the body. Then, using a virus as a vehicle, we introduce an artificial receptor into these T cells. This artificial receptor functions like a heat-seeking device—it is designed to recognise a specific molecule found on the surface of cancer cells.

Once the modified T cell encounters a cancer cell carrying that target molecule, the receptor activates the T cell. This triggers the T cell to attack and kill the tumour cell.

In that sense, it is often referred to as a “living drug”. After we infuse these modified cells back into the patient, they can multiply into billions and travel throughout the body to hunt down and destroy cancer cells.

Q/ What advantages does this therapy offer compared with traditional treatments like chemotherapy or radiation? With chemotherapy, for instance, it is more or less like 'carpet-bombing'. How is CAR T-cell therapy different?

A/ Right. So, this therapy was initially approved for use in patients who had already failed standard treatments, including chemotherapy and radiation—especially in cases like lymphomas and leukaemia. It is considered a completely different modality—this is immunotherapy.

One of the key advantages is that it does not cause the standard side effects typically associated with chemotherapy and radiation. And because it is a living therapy, these CAR T-cells can remain in the body for months or even years. In fact, there is data showing that these cells can persist for over 10 years.

Q/ So it is like a one-time treatment?

A/ Exactly. In many cases, it is a “one-and-done” treatment. And because these engineered T cells remain active in the body, they act like an internal surveillance system, continually monitoring for cancer recurrence. That is one reason why the remission rates are higher with this therapy, and in some cases, it even offers the potential for a cure—especially when all other treatments have failed.

Q/ You mentioned that CAR T-cell therapy does not cause the side effects associated with traditional treatments, but what are the side effects of this modality?

A/ There are some short-term side effects, typically seen within the first two weeks after the infusion. This is because of the activation of the immune system. The most common is a flu-like illness during the first week—patients may develop fever, body aches, chills and sometimes even low blood pressure or difficulty breathing. This cluster of symptoms is known as cytokine release syndrome (CRS). It occurs because the activated T cells produce cytokines. CRS can affect anywhere from 50 per cent to 90 per cent of patients. It is generally manageable. We usually treat it with standard medications like paracetamol to control fever and anti-inflammatory drugs, if needed.

The second common side effect is neurological toxicity. Some patients may experience temporary confusion or difficulty speaking. This usually happens during the second week and is typically short-lived—lasting two to four days—and completely reversible.

However, after about three months, some patients may have a slightly increased risk of infections, such as sinus infections or bronchitis. This is because the immune system takes some time to fully recover. To manage that, we often prescribe prophylactic antiviral and antibiotic medications, and in some cases, intravenous immunoglobulin infusions.

Q/ What kind of cancers are currently being treated with CAR T-cell therapy? Is it effective for all types of cancers?

A/ Currently, in India, CAR T-cell therapy is primarily approved for B cell lymphomas and B cell leukaemias—specifically, B-cell non-Hodgkin lymphoma and B-cell acute lymphoblastic leukaemia. These cancers can occur in both adults and children.

There are also ongoing clinical trials to treat another form of cancer called multiple myeloma, which affects the bone marrow. In the US and some other countries, CAR T-cell products have already been approved for multiple myeloma. While it is not yet approved in India, trials are underway, and we expect it could receive approval here within the next year.

Q/ Do you see CAR T-cell therapy becoming standard treatment for more common cancers in the future?

A/ Yes, there are active efforts to develop CAR T-cell therapy for other solid tumours such as breast, lung, and kidney cancers. Clinical trials are ongoing, and while the results so far have been more challenging compared with blood cancers, progress is definitely being made. So yes, it is possible that over the next decade, CAR T-cell therapy could become a standard option for a broader range of cancers.

Q/ What are the unique challenges and opportunities in implementing CAR T-cell therapy in a country like India? Is it capital-intensive?

A/ Absolutely. One of the biggest challenges is cost. Unlike traditional drugs, which are off-the-shelf products, CAR T-cell therapy is made individually for each patient using their own immune cells. That means every dose requires a separate manufacturing process, which includes genetic engineering—so, it is quite expensive.

The second challenge is time. Manufacturing the therapy for each patient typically takes three to four weeks. While many patients can be stabilised using other treatments during this period, not all can afford to wait.

The third challenge is infrastructure. CAR T-cell therapy cannot be administered just anywhere—it requires specialised transplant centres and highly trained physicians. The staff need to be equipped to anticipate and manage potential side effects like CRS and neurological toxicity. So at this stage, it is mostly available in advanced stem cell or bone marrow transplant centres.

Q/ So, in a way, this therapy reflects a broader shift in health care—moving away from the “one-size-fits-all” model to a more customised, patient-specific approach.

A/ Absolutely. CAR T-cell therapy is a form of personalised medicine. It is tailored to each individual because it is made from their own immune cells.

Personalised therapies can take many forms. Some target specific genetic mutations or molecular abnormalities in a patient's tumour. While CAR T cells do not target gene mutations directly, they do recognise and attack molecules specifically expressed on the patient’s cancer cells. So in that sense, it is still very much personalised.

The overall idea is that the more tailored the treatment is to an individual patient, the more effective and long-lasting the response is likely to be. That is the direction in which cancer treatment—and medicine in general—is heading.

Q/ How does CAR T-cell therapy improve the quality of life for patients compared with conventional treatments? Also, how soon can a person typically return to a normal, active life?

A/ That’s a great question—and definitely one of the major advantages of CAR T-cell therapy. As I mentioned earlier, it is typically a “one-and-done” treatment. The most intense side effects usually occur within the first two weeks, during which the patient is admitted to the hospital. Most patients recover to their baseline health within about a month after receiving the therapy.

Now, compare that to traditional treatments—chemotherapy regimens can last six months, and for some leukaemias, even one to two years. With CAR T-cell therapy, it is a single infusion, and the recovery timeline is much shorter.

In fact, studies in lymphoma patients have shown that recovery after CAR T-cell therapy is significantly faster compared with standard stem cell transplants, which involve high-dose chemotherapy and can take up to six additional months for patients to return to baseline. So yes, CAR T-cell therapy offers a much quicker and smoother path back to normal life and work.

hypertension-is-a-long-term-condition-that-can-be-managed-with-continuous-attention

Sat May 24 15:29:07 IST 2025

Understanding hypertension

Also known as high blood pressure, it is a condition where the force of blood pushing against the walls of your arteries is consistently too high. Imagine your heart as a pump and your arteries as pipes. If the pressure inside those pipes becomes too strong over time, it can damage the walls and strain your heart.

Measuring blood pressure

There are two numbers: systolic (when the heart beats) and diastolic (when the heart rests between beats). For example, if your reading is 120/80mmHg, 120 is the systolic and 80 is the diastolic pressure. A normal blood pressure reading is less than 120/80mmHg. When blood pressure remains high for a long time, it increases the risk of problems like heart attack, stroke, kidney disease and vision loss. The danger with hypertension is that it often shows no symptoms, which is why it is commonly called a ‘silent killer’.

Understanding the ranges

At stage one, systolic is between 130 and 139, and diastolic between 80 and 89. Stage two is when systolic is 140 or higher, while diastolic is 90 or higher. It is a hypertensive crisis when systolic is over 180 and diastolic is over 120.

How Indians differ from Caucasians

Indians tend to develop heart disease at a younger age and at lower body weights compared with western populations. We also have a higher prevalence of salt sensitivity, central obesity, insulin resistance and early onset of diabetes. All of these make us more vulnerable even at borderline blood pressure readings. Many Indian doctors prefer to intervene earlier, sometimes even during the ‘elevated’ phase, especially if the person has additional risk factors like family history, diabetes or obesity. This is because studies have shown that cardiovascular events in Indians often occur without warning and at lower blood pressure thresholds.

Do not ignore even slightly elevated readings

Blood pressure above 130/80mmHg should raise concern, especially with other risk factors. Early diagnosis and proactive intervention are critical.

Types

Primary (essential) hypertension: This is the most common and develops gradually. It is usually linked to a combination of genetic and lifestyle factors. Secondary hypertension: Caused by an underlying condition such as kidney disease, thyroid disorders, adrenal gland problems or certain medications (like birth control pills, steroids or overuse of painkillers).

The first type has no identifiable cause. Secondary hypertension often appears suddenly and may be more severe. Diagnosing and treating the root cause of secondary hypertension can sometimes lead to a complete resolution.

Age is a risk factor

Especially for men. Those over 65 or maybe even before that can have it. Hence, frequent check-ups are advised. Women may develop high blood pressure after 65.

Heredity

If your parents or close relatives have high blood pressure, you may have a higher chance of developing it. Inherited traits combined with unhealthy lifestyle habits can trigger it sooner. In India, where family medical histories are often poorly documented, it is even more important to proactively monitor blood pressure.

A weighty issue

Indian diets are often high in salt because of pickles, papads and packaged foods, which increases risk. Fat tissue, especially around the abdomen, produces substances that promote inflammation, insulin resistance and hormonal changes, all of which can elevate blood pressure.

Losing even 5 to 10 per cent of body weight can significantly improve blood pressure control. In some cases, patients who lose significant weight are able to reduce or even stop their blood pressure medications under medical guidance.

Hypertension in children

Though less common, it can occur because of underlying health problems like kidney disease or heart defects. But with increasing obesity and sedentary habits, even healthy children are now showing higher blood pressure levels. Early diagnosis is important.

Sleep is crucial

This is the time the body regulates several processes, including blood pressure. People with sleep apnoea—a condition where breathing repeatedly stops and starts during sleep—experience drops in oxygen levels and repeated awakenings. These disturbances activate the body’s stress response, keeping blood pressure elevated even during the night. Over time, this can lead to chronic hypertension. Poor sleep quality, even without apnoea, also increases stress hormone levels, disrupts natural blood pressure rhythms, and might lead to daytime fatigue and weight gain, further worsening blood pressure. Maintaining good sleep hygiene, such as avoiding screens before bed and sticking to a routine, can have a significant positive effect.

The power of small lifestyle changes

Regular physical activity (even 30 minutes of brisk walking daily), mindful eating, stress-relief practices (like meditation or yoga), adequate sleeping and quitting tobacco can significantly reduce blood pressure. Reduced salt intake means less sodium, hence less fluid retention that can raise blood pressure. However, any decision to reduce or stop medication must be made under doctor’s assistance. Some patients with more advanced hypertension might still need medication, but even in these cases, lifestyle changes enhance the effectiveness of treatment.

The DASH diet

The Dietary Approaches to Stop Hypertension diet is a proven eating plan designed to lower blood pressure. It emphasises fruits, vegetables, whole grains, low-fat dairy, lean protein, nuts and seeds. It also limits foods high in salt, sugar and saturated fat. This diet increases your intake of nutrients like potassium, calcium and magnesium, which are minerals that help control blood pressure. This diet can lower blood pressure within a few weeks, especially when combined with regular exercise.

The buzz about alcohol

When you drink alcohol, your heart starts beating faster, and your blood vessels become narrower. This causes your blood pressure to go up. If this happens occasionally, your body may recover, but if you drink regularly, especially in large amounts, it can lead to sustained high blood pressure, also known as hypertension. Alcohol also affects your nervous system and causes the release of hormones like adrenaline, which make the heart work harder and increase blood pressure even more. Over time, this added pressure can strain your heart, arteries, kidneys and brain, increasing the risk of heart attack, stroke and kidney problems.

Drinking alcohol also adds extra calories, which can lead to weight gain. It can interfere with blood pressure medications, making them less effective. People who already have high blood pressure are usually advised to limit alcohol or avoid it entirely.

Low blood pressure

While it is not always harmful, if it drops too low, it can reduce the flow of blood to the brain and other organs, causing symptoms like dizziness, fainting, blurred vision, fatigue and nausea. Drinking more fluids, eating small frequent meals, avoiding sudden position changes and wearing compression stockings may help. In some cases, medication is required.

Symptoms

In rare cases when symptoms do occur, they may include persistent morning headaches, dizziness, blurred vision, shortness of breath, chest discomfort, nosebleeds, fatigue or confusion—especially when it reaches crisis levels. Such situations demand urgent medical attention.

The illusion of normal

As symptoms are unreliable indicators, regular blood pressure monitoring remains the most effective way to detect and manage hypertension. Most people with high blood pressure will have no noticeable symptoms even if their readings are dangerously high. This asymptomatic nature makes hypertension particularly hazardous because damage to the heart, kidneys, brain and blood vessels can occur quietly over time.

When to start monitoring

Ideally around 18, and earlier if there are risk factors such as obesity, diabetes or family history. For healthy adults, blood pressure should be measured at least once every two years. After 40, or if you are at high risk because of lifestyle or genetic factors, annual monitoring is advisable. People already diagnosed or with related conditions like diabetes or kidney disease should monitor it more frequently, as per their doctor’s advice. Regular monitoring at home can also be helpful to track trends and avoid ‘white-coat hypertension’, where blood pressure rises only in clinical settings.

Diagnosis

Is by use of a blood pressure monitor (sphygmomanometer or digital BP machine). If readings are consistently above 140/90mmHg on different days, a doctor may diagnose it as hypertension. In certain cases, doctors may recommend ambulatory blood pressure monitoring, where a device records your blood pressure over 24 hours during normal daily activities.

At-home monitoring

It helps track how well your treatment is working and detects any sudden changes. For most patients, checking it once in the morning and once in the evening for the first week gives a clear picture. After that, once or twice a week may be sufficient unless your doctor advises more frequent readings. It is important to take the readings at the same time each day, sitting quietly for five minutes beforehand, and using a validated, properly fitting arm-cuff device.

A question of reliability

Home blood pressure monitors are generally reliable if used correctly. Devices with an upper arm cuff are preferred over wrist or finger monitors. Calibration and checking the device against your doctor’s readings from time to time ensures accuracy.

The harms of excess sodium

WHO recommends limiting salt intake to less than 5g per day, about one tea spoon. Reading food labels and choosing ‘low sodium’ or ‘no added salt’ products can help. Cooking at home with minimal salt and avoiding restaurant food is an effective strategy.

Do we need salt in our food?

In many cases, the natural sodium found in fruits, vegetables, grains and dairy products is sufficient to meet our body’s needs. Sodium is essential for fluid balance, nerve function and muscle activity, but only in small amounts.

Is rock salt healthier?

While rock salt may have trace minerals like magnesium and potassium, the difference in health impact is minimal.

Common medications

Doctors have a range of medications to treat high blood pressure, often chosen based on age, other health conditions, and how high the blood pressure is. Common classes include ACE inhibitors (which relax blood vessels), ARBs (which block hormones that raise blood pressure), diuretics (water pills that help the body remove excess sodium and fluid), beta-blockers (which reduce heart rate and output), and calcium channel blockers (which prevent blood vessels from tightening). Medications are often lifelong, but their doses may be adjusted over time based on response and side effects.

Potential side effects

Common issues include frequent urination (from diuretics), dry cough (often from ACE inhibitors), dizziness or light-headedness, fatigue, leg swelling or cold extremities. In rare cases, medications may affect potassium levels, kidney function or cause allergic reactions. The key is to not stop medication suddenly, as this can cause a dangerous spike in blood pressure. If side effects occur, your doctor can switch you to another drug or adjust the dosage.

The slow damage to the heart

Over time, high blood pressure makes the heart work harder than it should. This continuous strain causes the heart muscles, particularly in the left ventricle, to thicken. This is known as left ventricular hypertrophy. While this might initially help the heart pump more forcefully, it eventually reduces efficiency and leads to heart failure. High blood pressure also damages the arteries supplying the heart, accelerating the build-up of plaque (atherosclerosis), which increases the risk of heart attacks, angina and arrhythmias.

Hypertension and kidneys

The kidneys filter waste and excess fluid from the blood, and they need healthy blood vessels to function properly. High blood pressure damages these tiny blood vessels. Over time, this leads to chronic kidney disease. As kidney function declines, fluid and waste accumulate, which in turn can further raise blood pressure, creating a vicious cycle. Many people with uncontrolled hypertension end up needing dialysis or kidney transplants.

The link to the brain

The brain is highly sensitive to changes in blood pressure because it relies on a steady, uninterrupted flow of oxygen-rich blood. When blood pressure is consistently high, it damages arteries in the brain. A blocked artery causes an ischaemic stroke, while a ruptured vessel leads to a haemorrhagic stroke, both of which can be life-threatening. High blood pressure is also linked to vascular dementia, where poor circulation gradually damages the brain’s ability to think, remember or reason.

The role of stress

When you’re stressed, your body releases hormones like adrenaline and cortisol, which prepare you for a ‘fight-or-flight’ response. These hormones temporarily increase your heart rate and narrow your blood vessels, resulting in a spike in blood pressure. If stress is constant, these temporary spikes can turn into a long-term issue.

The eyes have it, too

Hypertension can harm the tiny, delicate blood vessels in the retina, leading to a condition called hypertensive retinopathy. This damage might cause symptoms like blurred vision, reduced clarity or, in severe cases, sudden vision loss because of bleeding or fluid leakage in the eye. Long-term high blood pressure can also lead to optic nerve damage and other complications. As these eye changes can occur silently, regular eye exams are essential.

Possible damage to arteries

Arteries become stiffer and narrower, a process called atherosclerosis, which reduces blood flow to critical organs and heightens the risk of heart attack or stroke. Peripheral artery disease occurs when arteries outside the heart, especially in the legs, become narrowed or blocked due to a build-up of plaque. High blood pressure contributes to this process by damaging the inner lining of arteries, making them more susceptible to plaque build-up. This reduces blood flow to the limbs, causing pain, cramps and weakness, particularly during walking or exercise. In severe cases, it can lead to ulcers, infections or even amputation. Managing hypertension is a critical step in preventing or slowing the progression of PAD, alongside controlling cholesterol, blood sugar and quitting tobacco.

A connection to sexual dysfunction

High blood pressure can lead to reduced blood flow to various parts of the body, including the reproductive organs. In men, this often causes erectile dysfunction, as the blood vessels in the penis may not dilate properly to maintain an erection. In women, hypertension may reduce sexual desire and arousal because of decreased blood flow or medication side effects.

Pregnancy induced hypertension

Although blood pressure often returns to normal post-partum, women who experience high blood pressure during pregnancy have a risk of developing chronic hypertension, heart disease and stroke later in life. It is important for these women to have regular follow-ups, maintain a heart-healthy lifestyle and monitor their blood pressure even after pregnancy ends.

Management during pregnancy

This has to be careful as it affects both the mother and the baby. Only certain medications are considered safe during pregnancy. Some severe cases necessitate early delivery. Regular postnatal check-ups help identify if treatment is still needed.

Hypertensive crisis

There are two types: hypertensive urgency and hypertensive emergency. In the first, the blood pressure is very high but without any signs of organ damage. It still needs prompt medical attention, but not necessarily emergency hospitalisation. In contrast, a hypertensive emergency includes symptoms such as chest pain, severe headache, vision changes, confusion, difficulty breathing or signs of stroke. This is life-threatening and requires immediate hospital care. Always monitor for symptoms and don’t wait to see if they subside.

The possibility of a reversal

With sustained lifestyle improvements such as weight loss, exercise, dietary changes and stress reduction, many people can achieve normal blood pressure levels. However, for most patients, the goal is to manage and control hypertension effectively rather than cure it.

Yoga and alternative therapies

These and other practices like meditation and deep-breathing exercises have been shown to help lower blood pressure. While not a substitute for medication, these therapies can be powerful complementary strategies.

Challenges in adhering to treatment

These include forgetfulness, side effects from medications, a lack of symptoms, cost of medicines and a poor understanding of the long-term consequences. Cultural beliefs and lack of family support can also play a role. Regular follow-ups, patient education, simple medication schedules and digital reminders can help improve adherence.

Management for the elderly

Requires a balanced approach to prevent complications like dizziness, falls or kidney dysfunction. Blood pressure targets may be adjusted based on overall health and other existing conditions. Doctors often start with lower doses of medication and increase gradually. It is also essential to monitor kidney function and watch for side effects. Lifestyle changes and proper hydration are equally important.

Misconceptions

The major one is that high blood pressure always causes symptoms. Another is the belief that once it is controlled, medication can be stopped. Many also assume that only older people get hypertension or that it’s solely caused by stress.

Quick advice

Don’t panic. Understand that it is a long-term condition and needs continuous attention. Start by making small but steady changes. Knowledge, consistency and a positive mindset can go a long way in ensuring a healthy life.

the-relationship-of-the-catholic-church-with-science-was-complex-and-at-times-adversarial

Sat May 24 15:19:10 IST 2025

On February 26, while admitted to the Gemelli Hospital in Rome, Pope Francis penned a message—not to the faithful, but to leaders in the fields of science and medical research who were to gather at the Vatican. The message spoke about the poly-crisis the world faces, from war to epidemics, and was addressed to the participants of the General Assembly of the Pontifical Academy for Life, held in Rome from March 3 to 5, on the theme: 'The End of the World? Crises, Responsibilities, Hopes'. “To avoid remaining immobile, anchored in our certainties, habits and fears, is to listen carefully to the contribution of areas of scientific knowledge,” wrote the Pope.

While the Catholic Church was a patron of learning, its relationship with science was complex and at times adversarial, especially when scientific ideas challenged the Church's doctrine. However, popes in the 20th century took steps to change that perception and foster a constructive dialogue. Pope Francis took this engagement to the next level by actively promoting scientific research, particularly in advanced medical fields and bioethics.

Francis reformed the Pontifical Academy for Life (PAV) by expanding its research horizons beyond traditional bioethical concerns (such as abortion and euthanasia) to a more global and integrative perspective and issues from geriatric care to data privacy. In March, in his message for the inaugural Vatican Longevity Summit, he reaffirmed a consistent theme in his bioethical vision: the call for renewed care for older adults and the promotion of a culture that views ageing not as decline, but as blessing.

He pushed PAV and other scientific bodies to be “cultural laboratories” for interdisciplinary dialogue on contemporary scientific and bioethical challenges. On many occasions Francis called for a balance between protecting health data privacy and fostering data sharing for the common good. He also called for equitable access to healthcare innovations and asserted the principle of justice as an integral part of bioethics. Notably, he also advocated strongly for a comprehensive global bioethics framework that takes into consideration environmental and social concerns.

Under Francis, the Vatican hosted many international conferences on regenerative medicine and stem cell research, focusing on adult stem cell therapies. These events brought together scientists, physicians, patients and policymakers. He also called for cutting-edge stem cell treatments to be made available to all, including the poor and those in developing countries, highlighting the importance of solidarity, generosity and the sharing of scientific knowledge. Notably, Francis did this even while maintaining the Catholic Church’s traditional opposition towards research and therapies that involve harm to human embryos and embryonic stem cells.

Francis appointed leading scientists to the Pontifical Academy of Sciences to encourage interdisciplinary research. Remarkably, just a month before his death, he named five new members to the academy: a planetary scientist involved in multiple NASA missions, a professor of genetics at Harvard Medical School, a Chinese biologist specialising in embryonic research, a molecular geneticist and an environmental scientist.