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Covid 19 Pandemic & Diabetes : 3 Recommendations to keep You Healthy and Safe

COVID 19 Pandemic & Diabetes : 3 Recommendations to keep you Healthy and Safe


                              We are facing the worst worldwide epidemic in recent memory. What is puzzling is that many infected people have no symptoms while a few others are seriously ill. This includes people suffering from Diabetes. The people having Diabetes are having a more severe form of infection. 

                               Here are the 2 scholarly articles that I have found out for you regarding COVID 19 infection and Diabetes. It is followed by 3 Recommendations for your safe journey through these turbulent times.

                         
                              The first article is from Dr. Sten Madsbad, Dept of Endocrinology, Hvidovre Hospital, University of Copenhagen, Denmark. https://bit.ly/3eDWQ0z

                               The Ongoing COVID 19 infection is a double challenge for people with diabetes. Diabetes is a risk factor for the severity of the disease. Diabetes increases the chance of getting any infection. People who have uncontrolled blood sugar levels are at high risk of developing infection and its more severe form. During the lockdown conditions, people have to control blood sugar in a situation with decreased or more variable availability of food.

                              COVID 19 (Coronavirus Disease ) is caused by coronavirus SARS- CoV-2 organism. It has quickly spread to more than 160 countries across the globe. The mode of transmission is primarily by respiratory droplets between people. It is characterized by a wide variety of symptoms including fever, cough and breathing difficulties.


                                     
















         The 2nd article is from Medical News Today published recently. https://bit.ly/3eCwE6d

                                         More than 425 million people worldwide have diabetes. There are two types of diabetes: Type 1 and Type 2. Gestational diabetes is another type that affects some women during pregnancy.
                                        Type 1 Diabetes is an autoimmune type and usually present from childhood. It results in no or very little insulin production. These patients need Insulin to be given externally.
                                          The majority of people have type 2 diabetes and are on oral medicines. Many have Obesity and hypertension as well. Some of them may need Insulin as well.
                                          According to the Center for disease control and prevention (CDC) people with diabetes who develop COVID 19 are at a higher risk of developing a serious illness like Pneumonia.

                               
                                 However, with good blood sugar control, people with diabetes can reduce the risk of getting severely sick from COVID-1                                                                                         Here are our 3 recommendations for COVID 19 and Diabetes.

  1. Control your Blood sugar properly. Check Your Blood Sugar and HbA1c levels. Maintain HbA1c levels around 6.5 to 7. Continue treatment as per your doctor's advice.
  2. Avoid Excessive Amounts of Carbohydrates and Sugar. You can increase protein intake. Similarly, Excessive salts and fried food items should be avoided. The intake of green leafy vegetables and salads should be increased.
  3. Continue Physical Exercises. During quarantine periods many people are unable to go outside for walks and outdoor exercises. Try to do some workouts at home to remain fit. You can do aerobics and yoga at home. Mindfulness can also help to reduce anxiety and stress during these turbulent times.





     Author: Dr. Nishikant Sharma  MD     FACP. Consultant Internal Medicine Specialist with Special Interest in the field of Diabetes.

       He is also a student at Northwestern University Coursera.

  He is an advocate of Quality Healthcare for all at affordable prices.

      He wants to empower people with scientific knowledge so that they can face diseases successfully with confidence and a positive attitude.

Click here to know more about How to boost your immunity during COVID 19 Pandemic: https://bit.ly/2yj0hsR





COVID 19 Pandemic : 3 Amazingly Simple ways to boost Your immunity and Protect Yourself from Infections.

COVID 19 Pandemic : 3 Amazingly Simple ways to boost Your immunity and Protect Yourself from Infections.

                                               COVID 19 infection has caused a devastating effect on the world. More than 19 lakhs of people have been infected. Many precious lives have been lost.
                                              We don't know how long this infection will persist. Can we develop the second infection? Answers to all these questions are not known. Why some people get infected but are asymptomatic while few others are seriously sick? Is there some immunity factor in those who survive the infection?


                                            Here are the two articles that I have found out for you regarding boosting your immunity from recent scientific publications.


                                            According to the article published by prestigious Harvard Medical School, you can boost your immunity by following certain universal methods. Your immune system does a remarkable job of defending you against disease-causing microorganisms But sometimes it fails.

                                             The germs invade successfully and make you sick. Is it possible to intervene in this process and boost your immune system? What if you improve your diet? Take certain vitamins or herbal preparations. Make other lifestyle changes in the hope of producing a near-perfect immune response. This article makes a case of a healthy diet, proper exercises, and good sleep.

                                   
Healthy Salad 

https://bit.ly/34Ao6bs
                                         In the second article from Cleveland Clinic, the author discusses the role of the 3 vitamins to improve your immunity.


                                        The old saying," An apple a day can keep the doctor away," may have truth behind it after all. Eating nourishing foods rich in certain vitamins can help your immune system fight off illness.


                                          In this article registered dietitian, Julia Zumpano discusses these vitamins. How these vitamins can keep you healthy. She discusses the role of Vitamin C, Vitamin B6 and vitamin E in this article. One should eat colorful fruits and vegetables to get adequate vitamins.
https://cle.clinic/3et7Gqb


                                     We are struggling to cope up with the pandemic of COVID 19. Here are 3 Amazingly Simple ways to boost your immunity. If you have good immunity then you can face any infection. Based on the articles I would recommend these 3 Simple ways to boost your immunity.


  • Improve Your Diet: Increase the intake of Vitamins and Antioxidants in your diet. This includes increasing intake of green leafy vegetables and colored fruits. Adequate amounts of Protein and micronutrients should be in the diet.

  • Avoid Infections:-Regularly wash your hands for 20 seconds with soap. Use Alcohol-based sanitizers. Use Face masks. Maintain Social Distancing.

  • Embrace Positive Lifestyle changes: Stop Smoking. Smoking destroys lung tissues. Regular Exercises and Good sleep also boosts your immunity. Maintaining healthy body weight is always helpful.


                           If you are worried about getting some infection then remember these 3 points.
These simple steps will keep you and your family healthy and protect from infections.
                           If you have more queries then we will be glad to answer your questions. You can leave your queries in the comment section. You can subscribe to our newsletter. Please press the subscribe button and leave your Email Address.





Dr. Nishikant Sharma MD FACP is a Consultant Physician. He is an Internal Medicine Specialist. He has his own Clinic Near Mumbai India. His area of practice includes Diabetes and Heart Diseases. He is a Fellow of the American College of Physicians. He has wide experience in treating Infectious diseases as well. He travels to the US  to attend many Conferences and Research Seminars. He is also a Medical writer and content creator He is currently a student at Northwestern University. Coursera. Follow him on Twitter @Nishant26718040 or Linkedin. You can visit his website: www.drnishikantmd.com
https://www.coursera.org/learn/nurture-market-strategies/home/welcomeLatest on Total number of Cases Update from John Hopkins University Coronavirus Resource Center
https://coronavirus.jhu.edu/map.html

How to Boost Your Happiness and Inner Strength through Contentment

                         How to Boost Your Happiness and Inner Strength Through Contentment?

                           What is Contentment? 

It is difficult to define the term.

                                                         Contentment is a happy state of mind. It is definitely not something euphoric. It is a peaceful state of mind. It is a state of peaceful satisfaction. Different people can give different definitions. This state is described in many religious texts including the Bible and Vedas.
                                                        We are in constant pursuit of happiness. Happiness seems to elude us. We think that when I will buy that BMW car I will be happy. I will be happy when I will have a bungalow or a big house or a yacht. I will not rest until I reach that goal. So in this constant search for elusive happiness, we are running. In the meantime, we are stressed out every day. This leads to what is popularly known as burnout.

                               Here a story that can explain what is Contentment.

                                                    A long long time ago there was a hard-working Stonecutter. He used to cut stones at the base of a big mountain. He used to live in a nearby village. He was a great believer in God. He had all good qualities like honesty and truthfulness. God always loves his devout children. One day when he was working he saw a King going from the nearby village. The king was wearing a beautiful thick golden robe and shining ornaments. He prayed to God. Oh God, I am your devout servant. I have to work so hard. Please make me the King for a few days. God loves his faithful children. God said ok I will make you a King.
                                                  He was very happy. It was summer and he was walking on the road. On a sunny afternoon, he started sweating. He looked up and said oh This Sun seems to be more powerful than a King. Why not become a Sun. He prayed to God. God oh great God Please turn me into Sun. God said ok. Your wish is granted. He became the Sun.
                                                 He was very happy for a few days. One day clouds came and no one could see the Sun. Oh, these clouds seem to be more powerful than I am. They can stop my rays from reaching the earth. I should become Clouds then. He prayed to God. God said ok I will grant you one more wish. He turned him into clouds
.
                                                 He was then floating in the air happily over the sea and land. Suddenly he was struck on the head. He could not move ahead. He opened his eyes and then saw a big mountain in front of him. He said this mountain seems to be stronger than I am. I should become a mountain then. He prayed to God. Oh, mighty God, you can do anything. Turn me into a big mountain. God said ok. God turned him into a big mountain.
A Mountain
                                                 When he became a mountain he was very happy. He thought now I am big and strong. In the afternoon he felt pain around his legs. Someone was cutting stones from the base of the mountain. He looked down and saw a Stonecutter cutting stones. Oh, he said this Stonecutter is stronger than a mountain. He can cut through a mountain! I should become a Stonecutter again.
                                               He fell on the feet of God and said Oh God please grant me one last wish. God said ok you were not happy when you were Stonecutter and now you want to become a stonecutter again? He said Yes. I was a fool running around. I have realized my mistake. I am happy in the way I was. Please make me a stonecutter. God said I grant you your last wish. He became a stonecutter again. He was finally very happy and contented.

                                                 This story tells us about contentment. We always like what others have. But we don't realize their problems. We spend our lives in a state of discontentment and unhappiness.
                                                  It is no wrong to dream big. It's also not wrong to work hard. But its important to remain healthy and happy also. It is equally important that one should not develop gastric ulcers, high blood pressure, addictions while chasing the dreams. If you are happy today then you can certainly be happy tomorrow. You should be able to enjoy your work. When you enjoy your work you tend to get better results. Your productivity goes up. Your energy level goes up. Don't let your work become an endless rat race. This will increase your blood pressure and stress levels. This leads to burnouts and sleepless nights.

                                                This leads us to the second quality of contentment. Its called Gratitude. When we are contented we feel grateful to all the people who work hard for us like Soldiers fighting for us on the borders or nurses caring for patients in the hospital. We should be thankful to all the people who work tirelessly for the community. Only a contented person can do that. A discontented person can only find faults in others. He will be unhappy eternally.


Learn more about how to Reduce Stress:-
https://www.mindfulnessdrnishikantmd.com/2019/04/do-you-have-stress-do-you-want-to.htmlDifferent Forms of Mindfulness:-
https://www.mindfulnessdrnishikantmd.com/2020/01/different-forms-of-mindfulness-many.html

What is ARDS (Acute Respiratory Distress Syndrome)? How Coronavirus COVID 19 causes ARDS?

What is ARDS(Acute Respiratory Distress Syndrome) 

How Coronavirus COVID 19 causes ARDS?


                                Acute Respiratory Distress Syndrome is a condition characterized by acute respiratory failure due to congestion or edema in the lungs. It occurs after acute lung injury which causes increased permeability of the alveolar-capillary membrane also known as the basement membrane. Accumulation of fluid prevents oxygen from reaching the body through the alveolar membrane in the lungs. It shows up in X-Ray Chest as opacities in Lung fields. In China it has been found that CT Chest is capable of detecting early pneumonia in this COVID 19 infection.
                               Those who are suffering from ARDS end up having damage to the walls of the air sacs in their lungs. The air sacs which are also known as alveoli help oxygen pass through into our red blood cells. ARDS can lead to diffuse alveolar damage. This prevents oxygen from entering our bloodstream and body.
                                 In normal healthy lungs, oxygen within these air sacs (alveolus) travels through to small blood vessels (capillaries). These tiny vessels, in turn, deliver the oxygen to your red blood cells. Red Blood cells carry oxygen to the brain, digestive systems and every other part of the body. For example, if the blood supply to the brain decreases you can feel very giddy. This is the sign that the brain is getting less blood supply.
                                                            Acute lung injury occurs as a result of the unregulated hyper response of systemic inflammatory response to infection or injury. Direct injury can occur in conditions like
  • Aspiration
  • Toxic Inhalation
  • Near Drowning
  • Chest injury/Contusion
  • Diffuse Infection    
  • Infections Like Coronavirus COVID 19       
                              Indirect Lung Injuries can occur after Severe Sepsis. It can also occur after Severe non thoracic trauma.

                               ARDS due to Coronavirus COVID19 has overwhelmed healthcare systems worldwide. Coronavirus can affect lungs directly by causing pneumonia and damage(necrosis) to lung tissues. It can lead to ARDS.


What Causes Acute Lung Injury (ALI)?:-

                                                                        All the above-mentioned causes lead to complex cellular and biochemical responses. Neutrophils lymphocytes (Type of White blood cells)  macrophages are released. They lead to increased production of cytokines. This leads to the production of inflammatory mediators like proteases, kinins, activators of complement cascades, intravascular coagulation, and fibrinolysis.

Pathology

                                                                   Pathological changes in ARDS involve over 3 distinct phases. Initial phase is exudative phase.Overall lungs are edematous and heavy. There are regions of Hemorrhages and Consolidation(Pneumonia). The initial phase is characterized by the formation of hyaline membranes composed of fibrin and other proteins in alveolar spaces and airspace.Proliferative phase causes increase in the disease process. Coagulation abnormalities(Increases Bleeding tendencies) can also occur in ARDS. Thromboembolism can occur. Fibrosis of the lungs can occur lead to long term breathlessness after recovery.


Clinical Features

                         At the time of initial injury and for several hours thereafter, the patient may be free of respiratory symptoms or signs. The first sign is an increase in respiratory rate which may go unnoticed initially. However, a seasoned doctor will be alerted by this definitely. This is shortly followed by breathlessness. High-grade Fever is another presentation, especially in COVID19 Infections. Redness of eyes may be there.
Pulse Oximeter showing Oxygen Levels
                         Simple measurement of SpO2 levels by Pulse Oximeters can show Oxygen saturation along with Pulse rate. Usually, Pulse rate increases and SpO2 levels fall. This needs to be confirmed by arterial blood gas level measurement. This facility is available in most hospitals. Initially, the chest is silent but then rales can be heard all over the chest. Extensive crepitations appear. Gradually heart rate increases further and respiratory rate also increases. In the beginning,
                       Nasal Oxygenation helps. Nasal oxygen can be given by soft nasal prongs or by a facial mask. Nebulization helps in bronchodilation. Nebulization can be done with bronchodilators to reverse constriction of airways. Inhalers can be of help in mild cases.

               Mechanical Ventilation

                             In the presence of ARDS, adequate oxygenation is usually not maintained with these less invasive measures. Non-invasive ventilators (NIV)can be tried. Endotracheal intubation is needed and volume -cycled ventilators should be initiated. The rationale behind mechanical ventilation is to increase mean lung volume. This opens up previously closed airways and improves oxygenation.
                           Most modern mechanical ventilators function by providing warmed and humidified air to the airway opening. It has a specific volume, pressure and time patterns. PEEP (Positive End Expiratory Pressure) can be added.PEEP mode increases mean alveolar pressure at the end of expiration. It thereby opens up closed alveoli and improves oxygen levels in the body.

How does the Corona Virus Affect Lungs?

                      Coronavirus spreads through droplet infection generated when a person infected sneezes or coughs. It then enters the other persons body through the nose. It can spread by saliva and discharge from the nose. It is also excreted in feces. Scientists are still not able to unravel the details of the spread of the virus. Some believe it can spread by talking also. The research is ongoing.
                       Other risk factor is age of the person. Older people(Above 60 Years) are more at risk of developing complications like ARDS. People suffering from Diabetes or on Immunosuppressive therapies like Steroids are also at greater risk. Patients suffering from HIV Infections are also at higher risk of developing complications like ARDS.
X Ray Chest Shows Lung Opacities
                     Coronavirus after entering the lungs causes consolidation and pneumonia. It can cause damage to the  alveoli. This leads to leakage of fluids in the lungs. This makes it difficult for oxygen to enter the bloodstream. Patients need ventilatory support for 10-14 days. The sooner they come out of ventilators the better is the outcome. Lying patients in the prone positions for 4 hours and changing positions does help. Chest physiotherapy also helps. Few patients may need reintubation after some days.


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