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The newly emerged Covid-19 virus has changed our lives in many ways. The lockdowns imposed by many countries have closed all but essentials services to prevent community transmission of the virus, with more stringent steps threatened as case numbers and mortality data grow by the minute.
Healthcare, an essential service at any time but never more so than in a crisis such as this, has been severely affected as the primary focus is shifted to the management of the crisis and other health emergencies rather than routine care.
Many elective surgeries are being deferred or delayed and patients are being advised to avoid non-essential hospital visits and switch to tele-consultation for arising problems.
For many cancer patients this situation is a living nightmare as they face not only the threat of Covid-19, the pressure of lockdown restrictions but also intense uncertainty regarding the future of their cancer treatment and its associated outcome.
Cancer patients are facing a stark choice regarding continuing treatment or delaying it to mitigate the Covid-19 risk. Many cancer patients in India travel huge distances to receive treatment but right now they cannot access treatment even if they wish to proceed as airlines and rail services are not operating.
Understandably, patients want concrete answers about when they can start cancer treatment, what the implications are if there is a gap in their treatment on their chances of recovery and the risks for their safety if they do attend the hospital.
There is no one-size-fits-all answer to these questions.
The psychological impact on patients and their families is starting to reveal itself.
The son of a recently diagnosed patients wrote to us: “My father has been diagnosed with kidney cancer with lung metastasis 21 days ago. His immunohistochemistry sample could not be processed in this lockdown and he was advised to stay at home considering his age of 83 years. I am worried about his cancer but at the same time this infection too.”
Another patient’s family wrote: “Is it safe to visit hospital for PET-CT as I have heard that cancer patients are more prone to catch infection?” His mother has colorectal cancer and is post-surgery and post four cycles of chemotherapy. She was scheduled for PET-CT for evaluation but was frightened to approach to the hospital in the lockdown.
In ordinary times, cancer patients face uncertainty and have to fight on many fronts to deal with the economic, social, family and personal challenges that a cancer diagnosis brings. During active treatment cancer patients require frequent hospital visits, pre-operative & post-operative stays, chemotherapy sessions, laboratory tests and radiological imaging, daily appointments for radiotherapy sessions (often over weeks). Extended hospital visits mean that cancer patients, many of whom are immunocompromised as a result of the side-effects of treatment, are more likely to be exposed to infection.
Data emerging from many countries affected by the pandemic suggests that the majority of the Covid-19 patients who require hospitalisation are suffering from heart disease, respiratory disease, diabetes, hypertension or cancer.
Here we have tried to address many of the concerns of cancer to minimise the fear and uncertainly related to cancer treatment and its outcome amidst this Covid-19 crisis.
Which cancer patients are at high risk for coronavirus infection?
Cancer patients who are older (more than 70) and having one or more associated co-morbidities, i.e., cardiovascular diseases, hypertension, diabetes, and lung diseases are at high risk for coronavirus infection.
What are the symptoms of coronavirus disease in cancer patients?
Coronavirus diseases are associated with symptoms which include fever, a new persistent dry cough, difficulty in breathing, fatigue, sore throat. New evidence suggests some patients are experiencing the loss of smell and taste. Presentation of the disease is not different in cancer patients but chances of progression to severe or critical diseases are more common with cancer patients.
What are the chances of getting coronavirus infection if cancer patients come to hospital for their treatment?
Chances of getting coronavirus infection does increase with frequent hospital visits. It has been reported between 10 – 30% in reports from different hospitals in China where Covid-19 patients were getting treatment.
Should I visit the hospital?
In this present scenario, the best advice is to minimise the hospital visits for cancer patients and that tele-consultation can be a good alternative to avoid direct contact between patients and cancer care provider for the vast majority of routine appointments.
I am currently having cancer treatment. Should I continue my treatment or stop it as I have to go to hospital frequently for my treatment.
No cancer patients should halt, postpone or cancel their treatment as stated in guidelines from various cancer institutions/societies/hospitals. Patients who are in hospital must adopt the contact and droplet precautions, which means wearing a mask, covering outdoor clothes and extra sanitation steps. Hospital staff should be following the same guidelines. Discuss how to minimise visits with your healthcare provider or if any procedures can be done at home.
My cancer doctor has advised to me delay the surgery/chemotherapy/radiotherapy. Should I follow my doctor’s advice or get surgery/chemotherapy/radiotherapy done at another hospital?
There is a time limit on how long someone can delay cancer treatment without it impacting their recovery. Patients need to have a discussion with their cancer care provider about their unique circumstances. One size does not fit all. In some cases, patients may be reasonably advised to switch to other treatment modalities. If there is an issue related to transportation and stay, patients are encouraged to start the treatment at the nearest cancer centre where appropriate treatment is available rather than travel.
What precautions should cancer patients take amidst the coronavirus crisis?
Cancer patients are advised to practice social distancing, maintaining at least a two-metre distance from anyone who does not share their home. Regular handwashing with soap or alcohol-based hand rub is a necessity. If a member of your household develops Covid-19 symptoms such as cold, cough or fever they should self-isolate as much as is reasonably practical. Patients are advised to avoid crowded places and stay in well-ventilated rooms. Patients are advised not to shake hands and organise longer prescriptions for regular medicines well in advance of running out.
I have been receiving information on WhatsApp, Facebook and other sources about coronavirus prevention and treatment. How can I confirm what is real and what is fake?
A lot of incorrect information has been circulating leading to fear and uncertainty. There are trustworthy information sources available, being updated regularly as new evidence emerges and is evaluated by experts such as the World Health Organization (WHO) and the Indian Council of Medical Research (ICMR). Patients and their caregivers should use these and not rely on social media.
Also Read: Snapchat Brings ‘Lensathon’ to India
In conclusion, cancer patients and caregivers are facing difficult decisions to understand and weigh up the risk and benefits of continuing treatment in its current form in this crisis.
Although current guidelines support the continuation of treatment where possible, patients must talk to their individual cancer care provider to explore if their treatment should be reasonably modified in the ways outlined above to reduce their individual risks of exposure to Covid-19.
(Dr. Abhishek Shankar is Assistant Professor in Radiation Oncology at Lady Hardinge Medical College & SSK Hospital, Delhi. Dr. Deepak Saini is Project Officer at Cancer Control and Prevention Division of Indian Society of Clinical Oncology, Delhi. Views expressed are personal.)
By Olivia Sarkar
Comforting Christmas cocktails help you enjoy the celebrations and get into the festive spirit. The Leela Palaces, Hotels, and Resorts offer distinctive cocktails ranging from Hot Toddies to Decadent Egg Nogs. Sit back and enjoy one martini at a time to make the festive season a little brighter.
Dirty Chai Eggnog:
30 ml Bourbon
30 ml Baileys
90 ml Hot milk tea
Sweet cream foam to top up
Cinnamon powder and star anise.
1. In a heavy bottomed med sauce pot, prepare tea with milk. Strain and let it cool.
2. In a cocktail shaker add egg white, Bourbon, Baileys with whole spices. Shake well.
3. Pour the tea in the glass followed by ingredients from cocktail shaker.
4. Garnish with nutmeg and cinnamon powder, whole star anise
Eggnog is a Christmas favourite that is accustomed to toasts for good health and prosperity.| Pikist
Inspired by the Christmas Spirits and holiday flavours is a wonderful concoction of warm whisky, sweet vanilla, and thick butter.
45 ml Butter fat washed Whiskey
20 ml Ginger bread syrup
15 ml Spiced Apple liquor
2 dashes of Bitters
1/2 teaspoon Vanilla extract
1. Pour all ingredients into a cocktail shaker
2. Shake well
3. Pour into an old-fashioned glass
4. Garnish with Gingerbread cookie
Inspired by the Christmas Spirits and holiday flavors is a wonderful concoction of warm whisky, sweet vanilla, and thick butter. | Flickr
(Keywords: Santa's Apple, Egg Nogs, December, Cocktail, Cocktail, Christmas, holiday, celebrations)
Probiotics may significantly improve the symptoms of pregnancy-related nausea, vomiting and constipation, finds a new study.
The study, published in the journal Nutrients, showed that nausea hours (the number of hours participants felt nauseous) were reduced by 16 per cent, and the number of times they vomited was reduced by 33 per cent.
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Probiotic intake also significantly improved symptoms related to the quality of life, such as fatigue, poor appetite and difficulty maintaining normal social activities, as scored by questionnaires.
"The cause of nausea and vomiting during pregnancy is unknown to this date. Various theories have been proposed, but none of them is conclusive," said lead author Albert T. Liu from the University of California, Davis.
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"Nausea, vomiting and constipation during pregnancy can significantly diminish the quality of patients' lives. Once nausea and vomiting during pregnancy progress, they can become difficult to control, and sometimes the patient even needs to be hospitalized," Liu added.
For the study, the team involved a small yet significant number of participants who took a probiotic capsule twice a day for six days and then took two days off. They then repeated the cycle.
The team found that probiotics were also found to reduce constipation significantly.Unsplash
The probiotics were available over-the-counter and mainly contained Lactobacillus., a type of good bacteria. Each capsule contained approximately 10 billion live cultures at the time of manufacture.
Participants kept 17 daily observations of their symptoms during the duration of the study, for a total of 535 observations for the researchers to statistically assess.
The team found that probiotics were also found to reduce constipation significantly.
Another finding was that vitamin E levels increased after taking probiotics. Higher levels of vitamin E were associated with low vomiting scores. (IANS/SP)
(Keywords : probiotics, pregnancy, nausea, vomiting, nutrients, symptoms, fatigue, appetite, constipation, vitamin.)
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By Olivia Sarkar
If the year 2020 appeared bleak for the world, the year 2021 served as a frightening reminder that it wasn't so much about the year as it was about the times we've come to live in. Every domain and industry has experienced seismic shifts, both for the better and for the bad. However, just a few fields have seen such a huge paradigm shift as online dating throughout the course of 2021.
It becomes critical to document and analyse the important observations in the year 2021's dating trends in order to determine where online dating stands and where it is headed. This is where a poll conducted by one of India's popular dating apps, QuackQuack, comes in handy. "The pandemic has undoubtedly thrown a few curveballs towards folks wanting to date," remarked Mr. Ravi Mittal, Founder and CEO of QuackQuack, in response to the survey report. Males and females, in my opinion, are fast coming to terms with a new universe of online dating every day, adopting more self-paced and healthier forms of dating, a growing process that will soon become the standard."
The key takeaways from the survey can be best summarized as below:
- Vaccination is a must: An overwhelming 8 out of 10 persons in the survey's sample size expressed support for mandatory vaccination as a prerequisite to a date. A considerable 65 per cent and 75 per cent of people in the 18-20 and 21-30 age categories, respectively, agreed on the same thing. The need of a double jab was consistently emphasized across the country's top cities and tier 2 cities, with 75 per cent and 70 per cent of the sample size in each believing that the first step toward a safe date would have to be complete immunization of the other.
An overwhelming 8 out of 10 persons in the survey's sample size expressed support for mandatory vaccination as a prerequisite to a date. | Photo by CDC on Unsplash
- Dating with a purpose: The poll revealed that, because of the Covid procedures in place, people have had little motivation to walk outside, leading them to think on the nature of the dates they've discovered on the dating app rather than searching for matches in a desperate manner. The survey found that 47 per cent of women and 35 per cent of men agreed with this behavioral change, and that the act of reflection and introspection allowed them to have healthier relationships than before.
The difference in deliberate dating trends between people who live in cities and those who live in rural or semi-urban settings was quite similar. While roughly 37 per cent of urban teenagers believed their dating experience had taken an intentional turn, 39 per cent of rural or semi-urban teenagers felt the same way.
The difference in deliberate dating trends between people who live in cities and those who live in rural or semi-urban settings was quite similar. | Photo by René Ranisch on Unsplash
- Location is pivotal: According to the survey, a whopping 58 per cent and 56 per cent of people between the ages of 18 and 20 and 21 and 30 preferred hooking up with someone from a different place to broaden their search for a potential spouse. This trend proved to be more prevalent among women, as 58 per cent of them were comfortable dating partners from foreign countries, compared to only 50 per cent of men. Further study into a demographic analysis of the sampled data found that 46 per cent of those living in major metro cities preferred dating outside of their home location, while 57 per cent of those living in smaller cities and towns favored the same.
According to the survey, a whopping 58 per cent and 56 per cent of people between the ages of 18 and 20 and 21 and 30 preferred hooking up with someone from a different place to broaden their search for a potential spouse. | Pixabay
- Video calling versus meeting in person: Due to the ongoing Covid problem across the country, a large majority of 56 per cent of 18 to 20-year-olds preferred having their first date on a virtual medium and were risk-averse, according to the survey. On the other hand, 43 per cent of persons aged 30 and up, who adhere to a more traditional approach, decided to meet in person while taking all essential safety steps.
43 per cent of persons aged 30 and up, who adhere to a more traditional approach, decided to meet in person while taking all essential safety steps. | Photo by Matt W Newman on Unsplash
According to the survey, a vast majority of 56 per cent of 18 to 20-year-olds preferred having their first date on a virtual medium and were risk-averse due to the ongoing Covid crisis across the country. In contrast, 43 per cent of people aged 30 and up who prefer a more traditional approach preferred to meet in person while following all necessary safety precautions according to the survey. (IANS/ MBI)
(Keywords: meeting, Video calling, Location, Vaccination, dating trends, 2021, Online Dating)