HCFI wishes all readers a very Happy Independence Day!

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On this day, let us pledge to gain independence from doctor-patient discord and make way for better communication

New Delhi: 14 August 2018: As per a survey carried out among several doctors and patients by the Indian Medical Association and the Heart Care Foundation of India (HCFI), it was found that both the segments are unhappy and dissatisfied. The doctor-patient relationship is dying today and needs a CPR for revival. The need of the hour is to create awareness that this relationship is revivable just as it is possible to save a dying person with CPR.

There has been a paradigm change in the thinking of the public and a corresponding shift in the dynamics of doctor-patient relationship; from paternalism to patient-centric. Today, patients want to be equal partners in decisions about their treatment with the doctor acting as a guide and facilitate decision making. Patient autonomy is also now at the forefront of the principles of medical ethics.

Giving his views on this at a TedX session, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “I am a professional medical doctor, and this makes me accountable to a code of conduct. To practice medical science, I need to be different and for which reason, I am allowed to write doctor in front of my name. My job is to help and work in the interest of the patient. People look upon me as someone who will not harm but cure them. However, the case is different today. In a survey, the doctors said they are not happy with incidences of violence against them on the rise. Patients on the other hand felt that doctors do not communicate with them. This discord has seen an increase in the last few decades: due to lack of communication on the doctors’ part and lack of trust on the patients’ side.”

There are four kinds of patients: ignorant (not aware of any disease, 100% trust in doctors); informed patients (aware of diseases and their rights); empowered (more aware); and enlightened (question the doctor). Doctors are also of three kinds: those who do not wish to be questioned; those who give choices to patients; and those who spend time with them in assessing the condition and acting accordingly.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “Patients are more informed today, but doctors are still in the past. Miscommunication is therefore the number one cause of discord. As per the Bhagavad Gita, the primary reason for anger is the unfulfillment of aspirations and expectations. When a patient is not satisfied, he/she gets angry and abuses. As Krishna did for Arjuna, so should a doctor do for the patient. Listen to what the patient has to say about his illness, his concerns and then respond accordingly. Don’t be judgmental or critical if the patient slips up at times. Stay calm and patiently explain to him the necessity of compliance to treatment prescribed. This way the patient is reassured and will be more inclined to follow your instructions; he will come back to you instead of seeking a second opinion.”

Patients also have the responsibility of caring for doctors and following what they prescribe. Avoid preventable disorders and let doctors handle only medical emergencies. Help doctors ensure good health by following the health tips they give. This 15th August, it is time to aim for Independence from the doctor-patient disputes.

Some health sutras from HCFI

  • High blood pressure, blood sugar and blood cholesterol can remain silent for up to a decade.
  • A pulse rate of less than 60 or more than 100 is abnormal.
  • Weight loss of 10 kg can reduce upper blood pressure by 5-20 mmHg.
  • Restricting salt intake to less than 6gm per day can reduce upper blood pressure by 2-8 mmHg.
  • A 1% increase in cholesterol increases chances of heart attack by 2%.
  • A 1% increase in good HDL cholesterol decreases chances of heart attack by 3%.
  • Any chest pain, which lasts for less than 30 minutes duration is not a heart pain.
  • Keep air pollution (particulate matter PM 2.5 and PM 10 levels) below 80 µg per cubic meter
  • To revive a cardiac arrest victim, compress the center of the chest of the victim within 10 minutes of death (earlier the better) at least for the next 10 minutes (longer the better), with a speed of at least 10×10=100 per minute.

Irritable Bowel Syndrome (IBS) is the 2nd most common cause of work absenteeism in India & negatively impacts quality of life reveals survey by HCFI

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  • Medical Practitioners surveyed feel that peppermint oil is a safe and better treatment option that can help alleviate symptoms
  • Over 3000 patients and 300 medical practitioners participated in the survey

Delhi, April 19, 2018: A study conducted by the HCFI, a leading National Health NGO has revealed that about 5-10% of the population surveyed experiences symptoms of Irritable Bowel Syndrome (IBS) such as abdominal pain, diarrhoea, constipation or incomplete evacuation. Yet, a majority of them do not seek medical help.

The study aimed at analyzing IBS from the physician and patient’s point of view – awareness about the disease, its impact on day-to-day life and treatment options. It is interesting to note that even though 84.6% of the respondents felt that abdominal pain or other symptoms of IBS cannot be ignored, an overwhelming 58% of them use over-the-counter medications for relief and did not see a doctor. Given the impact of IBS on a person’s day-to-day life, it is important to raise awareness about IBS amongst both the medical fraternity and patients about IBS.

Speaking about the need to raise awareness Dr KK Aggarwal – President HCFI said, “A simple mantra that everyone must remember is that if there is no pain, it can’t be IBS. Raising awareness about the disease incidence is key. ”

Dr. G S Lamba, Chief of Gastroenterology and Hepatology, Sri Balaji Action Medical institute, Delhi, opined, “Drinking lots of water and increasing your fiber intake may help regulate IBS symptoms, especially if relaxation methods and other ways to constipation is a problem. Fiber is found in bran, bread, cereal, beans, fruits, and vegetables. Apart from this, regular exercise is also beneficial and so are stress reduction methods or counselling. It is important to not use over-the-counter medications without consulting a specialist. Peppermint oil as an antispasmodic has been found beneficial in managing IBS symptoms.”

Speaking about this, Dr. Uday C Ghoshal, Professor, Gastro Dept, Sanjay Gandhi Post Graduation Institute of Medical Sciences, Lucknow said, “There is a lack of awareness about IBS in India and the fact that it is one of the leading causes of work absenteeism. Some symptoms of this condition include constipation, diarrhoea or both.Associated psychological disturbances & multiple somatic symptoms are also associated with in a proportion of patients.”

The most common symptom of IBS is abdominal pain with changes in bowel habits (diarrhoea and/or constipation). Abdominal pain is typically crampy and varies in intensity. Some people notice that emotional stress and eating worsen the pain and that having a bowel movement relieves the pain. Women may notice an association between pain episodes and their menstrual cycle.

The results of the survey conducted amongst the medical practitioners on the treatment methodologies for IBS revealed that almost 55.9% of the doctors use a symptom-directed, multidrug approach in the treatment of IBS; 54.5% doctors prescribe antispasmodics; and another 30.8% prescribe antibiotics, antispasmodics.

About 80% of the doctors surveyed believe that an ideal antispasmodic for the treatment of IBS should offer relief from symptoms of abdominal pain/discomfort, bloating/flatulence and complete evacuation and also possess minimum side effects. Peppermint oil has emerged as a good option since almost half of the participating doctors feel that it is effective in relieving abdominal pain, gas, bloating and fecal urgency through its selective effect on the smooth muscles of the intestine.

There is an unmet need in the treatment of IBS, as, despite the wide variety and effective treatments available, most patients do not get appropriate treatment. More widespread knowledge and proper use of available therapies (such as diet restriction and peppermint oil) will enable both the physicians as well as patients in achieving a better quality of life and relief from symptoms.

Some interesting insights from the patient survey include the following.

  • 84.6% said that pain in abdomen and altered bowel habits cannot be ignored
  • 58.3% people self-treat symptoms with over-the-counter drugs
  • 33.3% feel that the condition is not serious enough to contact a doctor
  • 8.3% would seek no treatment at all
  • 46% say IBS hampers their daily life
  • 50% of them said they would take multiple drugs including antibiotics, antispasmodics etc., each time they have an attack
  • 41.6% opted for diet change or probiotics for each attack

Lack of awareness impedes the treatment of celiac disease in India

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Genetic susceptibility is a major factor in the development of this condition

New Delhi, 09th April 2018: According to statistics, celiac disease affects almost 0.7% of the world’s population. In India, about six to eight million Indians are estimated to have this disease, and its prevalence in the North Indian community is 1 in 100.There is a lack of awareness about this condition and the need of the hour is to educate people.

Celiac disease is a serious autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. Genetics has a major role in the prevalence of this condition and therefore, children are equally susceptible to it.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “People suffering from celiac disease cannot digest a protein called gluten which is found in barley and wheat flour. Gluten triggers immune system in patients to damage small intestine villi. As a result, patients cannot absorb nutrients from food and remain malnourished which could lead to anemia weight loss and fatigue. Celiac disease patients suffer from fat malabsorption. A gluten free diet is also recommended for patients with wheat allergy dermatitis herpetiformis multiple sclerosis autoimmune disorders autism spectrum disorders ADHD and some behavioral problems. Gluten containing cereals are wheat barley rye oats and triticale. Gluten is also present as a food additive in the form of a flavoring stabilizing or thickening agent. In these conditions one should switch over to gluten free foods.”

Gluten allergy, unlike traditional allergies, cannot be pinned down as its onset is gradual with symptoms that may resemble other conditions: headaches, stomach cramps, bloating, anxiety, depression, and so on. Gluten can gradually erode the villi in the small intestine and prohibit the body from absorbing nutrients from food.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “A person with celiac disease must stay away from items like wheat, rye, semolina, durum, malt and barley. It is a good idea to check labels at the back of packed products to check for traces of gluten. Some items that may contain gluten include canned soups, condiments, salad dressings, candies, and pasta. However, all this does not mean one cannot have variety in meals. It is possible to use alternatives such as rice, sorghum, quinoa, amaranth, bajra, ragi and buckwheat.”

Some HCFI tips.

Switching to a gluten-free diet is a big change and can take some time for a person to get used to. There are many naturally gluten-free foods which are also healthy and delicious. Some of these include the following.

  • Beans, seeds and nuts in their natural, unprocessed form
  • Fresh eggs
  • Fresh meats, fish and poultry (not breaded, batter-coated or marinated)
  • Fruits and vegetables
  • Most dairy products

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