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Dr. Abhishek Shankar, MD is an Assistant Professor in the Radiation Oncology Department at Lady Hardinge Medical College and Associated Hospitals, Delhi. He has worked in various capacities i.e. Resident, Research Fellow, and Faculty at All India Institute of Medical Sciences, Delhi from 2012-2019. He is an NCI Cancer Prevention Fellow and the recipient of numerous national and international awards. He is a member and chairman of several national and international committees.
In this recent interview with NewsGram, he has answered all the questions regarding cancer and cancer care at a time when many oncologists and cancer patients are worried about the emerging challenges to cancer care delivery in the wake of the ongoing COVID-19 pandemic!
Kashish: Despite a lot of awareness on cancer, many people are still not aware of its treatment and consequences. What do you want to say about this? How well India is prepared to fight cancer?
Dr. Abhishek: Well, I would like to say “awareness” is a very broad term. Hearing the word “cancer” doesn’t makes you aware of the disease. So, there are many components of cancer like signs and symptoms of cancer, risk factors for cancer, what you need to do if you are having a symptom related to some particular cancer, etc. So, people are aware but this awareness is limited to the metropolitan cities where they are more exposed to information on cancer provided by the print media or electronic media. People might have good knowledge about cancer, they might have a positive attitude but the practice is required to detect cancer at earlier stages. To put the provided information into action for cancer prevention is missing in every part of the country, whether it is a metropolitan city or the rural parts of the country. Just having “knowledge” about something does not prove to be useful unless and until it is applied into practice.
I feel that the awareness is scattered. Now cancer has reached most of the families in every society, so many people feel connected whenever it comes to the disease but that is not to be termed as awareness. It becomes very essential for me to differentiate “awareness” from “pseudo-awareness”. Probably people have more awareness of cancer by reading on the internet, so the outflow of the right information is very much important.
People have this belief that drinking tea in a plastic cup causes cancer, but at the same time, they are ignoring the fact that smoking causes cancer. They can smoke 14 cigarettes a day, but they will complain to a tea seller that they don’t want their tea to be served in a plastic cup because it causes cancer! So this is pseudo-awareness. People these days are getting more rumored information from WhatsApp and Facebook University which is very dangerous. We need to focus on the right information and cigarette smoking is the definite cause of cancer but drinking tea in a plastic cup is not actually a risk factor for cancer, it may have some effects but it is not proven.
The right focus for taking the right action for cancer prevention is very important, and you will only be able to focus rightly only if you know the right information and this is missing in our country. Cancer has become a public health problem. Almost 10 billion people are dying because of cancer globally. There’s a need for people to become aware of cancer because as soon as they encounter a cancer symptom, they can rush to a doctor and seek timely medical support.
Many people avoid doing marriage in a family where somebody is suffering from cancer, so, there’s a strong need for us to work on awareness so as to understand what is right, wrong or a myth. In a resourceful country like India, people should be made aware in order to minimize the mortality rate related to cancer.
Kashish: We are still amid these unprecedented times of COVID so what, especially, do you want to tell cancer patients/caregivers about COVID-19?
Dr. Abhishek: Well, in 2020 March, this was a very impatient question for an oncologist and nobody was knowing the answer, interestingly! It was the situation in which everybody was in dilemma regarding what to offer, what not to do etc. Initially, it was said that cancer patients are more at risk to get infected with the coronavirus, and if they got so, their chances of mortality from COVID will be more as compared to the other people.
Over the period of time, we have managed well. In the era of evidence-based medicine, we probably relied on personal testimony, viewpoints, personal experiences which never happened in the history of cancer treatment.
Over a period of time, everything has been streamlined. Cancer patients are guided to continue their treatment the way it was because apparently, we have to make a balance. In the initial period of time, we were having this dilemma that why do we have a need to expose them? but still, they are encouraged not to visit their cancer center unless not necessary. Now, every guideline says that you don’t have a need to halt your cancer treatment, you must continue it. We know now that this pandemic is more than one year old and we don’t know when will this end. So, now, we have adjusted because we realized that cancer patients get only one chance to get cured and hence we need to continue with the treatment as any gap in the treatment over the period of time will affect the final outcome for a cancer patient. We have changed our day-to-day working in the best interest of the patient.
There are a lot of precautions that the cancer patients/ caregivers must follow such as maintaining hand hygiene and respiratory hygiene. We keep on instructing our patients about the follow-up guidelines. They have to adhere to that. In many hospitals abroad, they have prepared COVID-dedicated cancer hospitals. Even if the cancer patient is COVID positive, there’s no need for him/her to avoid treatment.
Kashish: So does survival with cancer make a person more prone to getting infected with COVID-19?
Dr. Abhishek: See, cancer patients undergo immunotherapies and chemotherapies which makes the immune system weak. In general, cancer disease cause some level of immuno-suppression to the patient. So, it is always said that apart from affecting the respiratory organs, COVID also affects the major blood vessels of the body, and if the immune suppression is due to any cause, you become more prone to have the disease. Cancer patients are always on immuno-suppressive things and hence are always advised to take precautions, wear a mask even before COVID arrived so that the infection can be avoided. In these unprecedented times of COVID, we have always advised them to follow the same protocol because the chances of getting the severe form of infection and progressing to the critical form of the disease, ICU infection, and death from the disease are more common in cancer patients as compared to the normal people. so be it an undergoing patient, or a patient who is on maintenance, all must follow the necessary precautions to avoid getting infected.
Kashish: Many people are doubting to receive COVID Vaccination due to fear. Do you feel that the vaccine is safe for cancer patients or those undergoing maintenance therapy for cancer?
Dr. Abhishek: The vaccine is safe for everyone including cancer patients, but there are few guidelines which are given on some special suggestion that everybody needs to follow. Coming to the people who have already undergone transplantation for conditions such as hematological malignancies, they are advised to at least get three months’ time after the completion of their transplant to get vaccinated because they are already on immuno-suppression so it might not help them like normal people. People who are having hematological malignancy and receiving cytotoxic therapies (chemotherapy) are advised to check for the neutrophil (a type of white blood cell) count. Until and unless the neutrophil count is normal, the patient must delay vaccination because ultimately, his/her ability to fight the disease is not proper. If the neutrophil count is okay, one can get the vaccine.
People with solid malignancies such as breast cancer or lung cancer are advised to get the vaccine whenever it is available, and it will always go on the advice of the treating oncologist. So as I said, the people who are on chemotherapy are advised to give a gap of three months and in most cases, it is advisable to take the vaccine. People who are on Radiotherapy are advised to take the vaccine if their surgery has been done, so probably for them, there must be a gap of few weeks.
If you are taking steroids for any reason, it is advisable to discuss with the oncologist, as many of the companies producing vaccines have indicated that when a person is already on steroids, probably the corticosteroid may reduce the response to the COVID vaccine. So, you should always discuss with the oncologist.
If a cancer patient has had a history of a serious allergic reaction, then there comes a serious need to concern the oncologist otherwise it can really make them land into a problem. The cancer patients who have already undergone and recovered COVID infection can delay the vaccination to three or six months depending upon the antibody titer. There are no special guidelines for cancer patients if you are thinking about the vaccination.
Kashish: At last, would you like to share some tips/advice for cancer patients/survivors and their dear ones to remain emotionally stable and stronger amid these unprecedented times?
Dr. Abhishek: I think I am not the right person to give them advice because probably whatever learning I have had from them is incredible. Cancer patients teach you to be humane in your life, to be humble in your life, to always remain positive in your life. It is very difficult for us to explain to somebody that you have 6 months of your life left. Probably, I can’t even imagine the intensity of the optimism cancer patients have with which they live the leftover duration of their lives. So, cancer patients are a great source of learning for an oncologist and I will always want to say to them that please keep on teaching us like this because you are a great source of inspiration for us, and you always encourage us to do great works in our life. We feel very lucky to serve you and do a bit from our side for you.
(Dr. Abhishek Shankar can be reached through e-mail at firstname.lastname@example.org, or via his Twitter handle: @ShankarAbhishek)
– Interview and graphical content prepared by Kashish Rai (Twitter: @KaafyyFilmyy)
Amit Rai Jain, a Baghpat-based businessman, has found 16 coins made of silver and copper which have a bull and a horseman engraved on them.
He found the coins from a mound, known locally as the 'Katha mound' in Khekhra, close to the Delhi-Saharanpur highway, on Sunday.
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Jain told reporters that some of the coins are from the late 12th century AD, which is the era of Rajput king Prithviraj Chauhan.
"I keep frequenting the area, which is rich in archaeological finds. This time, it revealed something considered fascinating in Indian numismatics. The coins which I found belong to a series of Rajput rulers who remained dominant in the region comprising Rajasthan, Haryana, and the western Gangetic plains from the eighth century to 12th century AD," he said.
Jain, is a member of the Culture and History Association, an organisation comprising historians from western Uttar Pradesh.
K.K. Sharma, head of the department of history, Multanimal Modi College, Modinagar, confirmed the antiquity of the coins.
Picture of some ancient coinsUnsplash
"This is an interesting find as the area remained with the Rajput kings for a couple of centuries. Horse and bull inscriptions on coins were quite common in those days. Horses used to be the primary vehicle of soldiers during battles and their depiction on coins is not a surprise. In fact, close to two dozen rulers between the seventh and 17th centuries used horses in some form or the other on their coins," he said.
Baghpat is well-known for the discovery of interesting historical artifacts, the most sensational being three chariots unearthed during the Archaeological Survey of India excavation held in Sinauli in June 2018, which marked the 'first-ever' physical evidence of Bronze Age chariots in India.
In 2006, Sinauli had revealed Harappan-era burial grounds where several discoveries were made such as that of painted grey ware pottery, skeletons, bronze swords, and copper vessels.
Keywords : ancient, coins, silver, copper, archaeological, kings, discovery, historical, artifacts, Uttar Pradesh, India, Rajput.
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With an aim to examine the wide-ranging narratives and the very definitions of the art of sculpture, Palette Art Gallery's forthcoming exhibition, 18 Dimensions - is a show dedicated to sculptures underlining the important works by 18 contemporary artists, who have made a significant impact on the Indian and Global art landscape.
Bringing a seductive edge to the visual arts, an element of pleasure to one's life and working environment, the exhibit is an effort to showcase a broad scope of contemporary sculpture from the abstract and the minimal to the popular, making socio-political commentary that is deeply contemplative and thought-provoking.
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The show reflects on a large number of materials and methods from casting to the modes of assemblage as well as minimalism, conceptualism making visible the process of making in most of the works.
Also Read : What Remains, art exhibition at Kala Ghoda
Featuring over 18 artists, the intention is to present a range and variety of sculptural expressions and encourage viewer participation and physical engagement with artworks once again, as the city opens up to mobility from the studios of Arunkumar HG, Ashiesh Shah, Gigi Scaria, G. R. Iranna, L. N. Tallur, Narayan Biswas, Mrinalini Mukherjee, Manjunath Kamath, Pooja Iranna, Himmat Shah, Jagannath Panda, Rajesh Ram, Riyas Komu, Sangam Vankhade, Sumedh R, Subodh Gupta, Sudarshan Shetty, Valay Shende, Vibha Galhotra and Vipul Kumar, the exhibition studies their involvement with the influences probing the limits and possibilities inherent in a sculpture's inescapable three-dimensional physicality.
One of the highlights of the show includes a selection of the rare hemp works by artist Mrinalini Mukherjee. Known for her distinctly contemporary style and use of dyed and woven hemp fibre, she worked with an unconventional material in the world of sculpting. Her four-decade-long career was an exemplar of a practice dedicated to formulating a language that was a mix of abstraction and figuration.
Keywords : art gallery, sculpture, exhibition, Palette Art Gallery, Bikaner House, New Delhi, contemporary, abstract, materials, conceptualism.
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By Dr Anil Batra
The winter comes with its own set of hassles. New moms have to be careful because they have to take care of themselves and their babies. It becomes imperative to protect babies from the harsh season.
The immune system of newborn babies is developing, which makes them susceptible to respiratory infections. But, you can take preventive measures to keep your child warm and safe. Newborn babies need extra care until their immune system becomes stronger to protect their bodies from the harmful effects of viruses and bacteria that usually become more active in the winter season. A drop in the temperature can aggravate different processes in the body, therefore, moms need to take extra care of newborn babies during winters.
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New moms can follow the given tips to take care of their little ones and protect them from the harmful effects of harsh winds blowing outside.
Keep the temperature warm in the baby's room
Use a portable heater in the baby's room to keep the temperature warm. The air becomes dry due to the excessive use of a heater. Therefore, keeping a humidifier to balance the moisture levels.
Also Read : A newborn baby clothing guide
The baby's skin is very sensitive and the harsh, dry, and cold air can make the skin dry. Therefore, apply a good moisturizer to keep it soft and smooth. Choose a moisturizer made of milk cream and butter, especially for children. This will keep the skin of your baby soft.
Massage is important to keep your baby's skin soft and healthy. Massage helps to improve the blood circulation in the body that helps in boosting strength. Use a natural oil to massage the body of your child. Make sure the room is warm where you massage the baby.
Avoid using heavy blankets
You can comfort your baby by laying a light blanket to keep your baby warm. Avoid using a heavy blanket to cover your baby during winters because your baby would not be able to move his arms and legs while sleeping. In this process, your baby may pull it up on its face and this can cause respiratory distress. Thus, use a light blanket and keep the room temperature optimum.
Choose comfortable dressing for your baby. Unsplash
Dress your baby comfortably
Choose comfortable dressing for your baby. Avoid wrapping your baby in thick sweaters, gloves, and socks. This will restrict its movement and he/she will become irritable. Choose clothes depending on the room temperature. The clothes should cover his/her baby but should not restrict movement. You can use light gloves and socks to cover your hands and feet to keep your baby warm at night.
Breastfeeding is the most important activity that can keep your baby healthy. Breast milk consists of required nutrients and antibodies that will enhance the immune system of your baby and will protect him/her against diseases. During breastfeeding your baby will feel warm and cosy that will also give him comfort.
Maintain proper hygiene
Mothers should be careful when handling newborn babies in winters. You will be the first point of contact for your baby. Therefore, make sure you keep yourself clean and healthy. Wash your hands before handling your baby. Germs can easily enter your baby's body through your dirty hands. Therefore, make sure you wash your hands or sanitize them before attending to your baby. Also, ask visitors to wash their hands.
Take care outdoors
If you want to take your child outdoors make sure it is not freezing temperature. Take your child out for fresh air only if the temperature is not too cold and remember to cover your baby properly before taking them out. Taking your baby out will help to give fresh air and will improve their health.
Common issues that may arise in newborn babies during winters
Winter brings flu and other viruses that can easily spread and affect anyone. Common issues that may arise in newborn babies during winters include the following:
Apply a good moisturizer to keep the baby's skin soft and smooth. Unsplash
Parents can take care of their newborn babies from various diseases that may affect them in the winters in the following ways:
If your baby suffers during the winter season, you should consult a pediatrician.
You can give a homemade solution if your baby suffers from a cold. Check with the doctor and you can only give a saline solution or nasal drops.
Keep your baby well hydrated. Keep breastfeeding your baby and also give water if necessary.
Cuddle your baby lovingly and give him warmth along with other precautions.
In the first winter, you can take preventive measures to take care of your little ones and keep them safe. Maintain proper hygiene and keep your house warm. Avoid visitors if your child is not feeling well.
How often to give a bath to your baby in winter?
It is not necessary to give a bath to your baby every day. You can bathe your baby after 2-3 days in winter. You can sponge bathe your newborn every other day in winter.
Check the temperature of the room before giving a bath to your baby. The room temperature should be warm and comfortable for your baby.
Check the temperature of the water. Make sure the water is not too hot or cold. The temperature of the water should be right for the body of your baby. Check the temperature by touching the water with your elbow or wrist.
Use mild soap and shampoo to bathe your baby in winter. Also, apply oil and moisturizer to the skin to keep it soft and prevent skin allergies.
Keywords : winter care, babies, immunity, mothers, temperature, breastfeeding, hygiene, influenza, winter, disease, paediatrician, soft.
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