Tuberculosis (TB) remains a significant public health challenge globally, and India bears the highest burden, accounting for a quarter of cases worldwide. Recognizing the diverse TB epidemiology across its states and the significant role of the private healthcare sector, India adopted a sub-national assessment approach. The National TB Programme has evolved significantly since the introduction of DOTS in 1997, embracing the Stop TB Strategy in 2006 and the End TB Strategy in 2015. A pivotal step was the integration of the TB program into the general health system under the National Health Mission (NHM), facilitating resource optimization and mainstreaming of human resources. The program was renamed the National TB Elimination Program (NTEP) in 2020, underscoring its ambitious goal.

Key Strategies and Innovations: India’s response has been characterized by prioritizing innovations across various domains.
• Diagnostics: Scaling up rapid molecular testing infrastructure with over 8,295 machines, establishing an annual capacity of over 14 million tests. Introduction of digital chest X-ray as a screening tool and exploration of AI-based tools for automated reading. Development and validation of indigenous tools like TrueNAT and Cy-TB.
• Treatment: Introduction of shorter drug regimens and focus on improving outcomes for drug-resistant TB, with treatment success rates reaching 87% for MDR-TB. Expansion of drug susceptibility testing (DST) to all TB patients.
• Digital Health: Development and implementation of Nikshay, a real-time integrated digital surveillance system for patient management and drug logistics. Utilization of digital adherence tools like 99-DOTS and Video DOT, and a multilingual national call centre, Nikshay Sampark, for patient counselling.
• Community Engagement: Decentralized initiatives like TB-Free villages/districts empowered local stakeholders and fostered healthy competition. Active Case Finding (ACF) campaigns are regularly organized to improve case detection and awareness. Engaging TB survivors as “TB champions” and mobilizing community support through initiatives like Nikshay Mitras.
• Socio-economic Support: Implementation of direct benefit transfer schemes to mitigate the socio-economic impact of TB, along with nutritional support initiatives through crowd-sourcing and enhanced financial assistance. Linking TB patients to social welfare schemes for vulnerable populations.
• Research and Development: Establishment of the Indian TB Research Consortium (ITRC) to foster research in diagnostics, drugs, vaccines, and implementation science. Collaboration with institutions like IIT Bombay for disease modelling. Progress in clinical trials for TB vaccine candidates and ongoing study for adult BCG vaccination.

Progress and Impact: India has witnessed a significant reduction in TB burden. TB incidence declined by 18% between 2015 and 2023, and TB-related deaths decreased by 24% during the same period, outpacing global averages. TB case notification rate increased from 1.5 million in 2014 to 2.6 million in 2024, and treatment success rates improved to 89% in 2023. Notably, almost 6 million additional TB patients from the private sector have been notified in the last decade with comparable treatment outcomes to the public sector. Several districts have achieved END TB targets based on sub-national certification.

Remaining Challenges: Despite considerable progress, challenges persist, including the sheer scale of interventions needed and the diverse socio-economic and epidemiological contexts across states. Addressing stigma, improving access to care in rural areas, and ensuring comprehensive implementation of TB Preventive Treatment (TPT) and vaccination programs remain critical. A significant proportion of symptomatic patients still do not seek care, and a considerable number of diagnosed patients are asymptomatic, contributing to missed cases.

Way Forward and Future Directions: The development of a new National Strategic Plan (NSP) aims to consolidate achievements and align with broader national health frameworks. Key priorities include:
• Enhanced Screening and Diagnostics: Deployment of highly sensitive screening tools like finger prick tests and cough AI tools, and further strengthening rapid molecular diagnostics.
• Expanded Prevention Efforts: Rapid scale-up of TB Preventive testing and treatment, and potential nationwide adult vaccination against TB based on ongoing study outcomes. Addressing social determinants like undernutrition and indoor air pollution.
• Strengthened Treatment and Support: Differentiated TB care, post-treatment follow-up, rehabilitation, and augmented DST for all drug-resistant TB patients. Continued research into newer drug regimens and molecules.
• Leveraging Technology: Enhancing digital surveillance tools with AI capabilities and telemedicine networks.
• Multi-sectoral Collaboration: Strengthening inter-ministerial and corporate engagement, and linking with social welfare schemes.
• Focus on Vulnerable Populations: Targeted interventions for high-risk groups identified through prevalence surveys.

Conclusion: India’s journey towards TB elimination showcases the transformative power of strong political will, strategic innovations, community engagement, and increased financial investment. While significant strides have been made, sustained and intensified efforts, focusing on addressing remaining challenges and leveraging emerging opportunities, are crucial to achieve the ambitious goal of a TB-free India by 2025. The lessons learned from India’s experience offer valuable insights for the global fight against this persistent epidemic.

Ending TB India’s Strategic
Reference: Lessons and updates from India’s National TB Elimination Program – bold decisions and innovative ways of fast-tracking progress towards ending TB, IJID Regions (2025), doi: https://doi.org/10.1016/j.ijregi.2025.100599

Dr. Shruti Patel
Senior Medical Advisor , Cadila Pharmaceuticals

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Chronic pain is typically defined as pain that lasts for more than three to six months, beyond the normal healing time of an injury or illness. It can occur anywhere in the body and may vary in intensity, from mild discomfort to severe, debilitating pain. Chronic pain can be continuous or intermittent, and it may be associated with a specific condition, such as arthritis, or occur without an identifiable cause.

Causes of Chronic Pain
• Injuries: Even after an injury has healed, pain can persist due to nerve damage or other factors. For example, a back injury may lead to chronic lower back pain.
• Medical Conditions: Conditions like arthritis, fibromyalgia, and multiple sclerosis are known to cause chronic pain. These conditions may involve ongoing inflammation, nerve damage, or other processes that contribute to persistent pain.
• Nerve Damage: Nerve pain, or neuropathy, can result from conditions such as diabetes, shingles, or traumatic injuries. This type of pain is often described as burning, tingling, or shooting.
• Psychological Factors: Chronic pain is closely linked with mental health conditions such as depression and anxiety. Emotional stress can exacerbate pain, creating a vicious cycle of pain and psychological distress.
• Unknown Causes: In some cases, chronic pain occurs without a clear cause. This type of pain, known as idiopathic pain, can be particularly challenging to treat.

Symptoms of Chronic Pain
• Persistent pain that lasts for months or longer
• Pain that ranges from mild to severe
• Aches, stiffness, or discomfort in the muscles, joints, or bones
• Sharp, shooting, or burning pain, often associated with nerve damage
• Fatigue, sleep disturbances, and reduced ability to perform daily activities
• Anxiety, depression, or other mood disturbances related to the ongoing pain

Effective Management Strategies for Chronic Pain
• Medications: Doctor prescribed pain relievers can be beneficial.
• Pain balm : Good Avurvedic pain balm like FireSens is helpful in relieving pain.
• Physical Therapy: Physical therapy can help improve mobility, strengthen muscles, and reduce pain.
• Psychological Support: Cognitive-behavioral therapy (CBT) and other psychological interventions can help patients cope with chronic pain by addressing the mental and emotional aspects of the condition. Stress management techniques, such as mindfulness and relaxation exercises, can also be beneficial.
• Alternative Therapies: Acupuncture, chiropractic care, and massage therapy are the alternative treatments that some people find helpful for managing chronic pain.
• Lifestyle Modifications: Regular physical activity, a healthy diet, adequate sleep, and avoiding smoking or excessive alcohol consumption can all contribute to better pain control.
• Interventional Procedures: For some patients, more invasive treatments, such as nerve blocks, spinal cord stimulation, or surgery, may be necessary to manage chronic pain.

Also read : Articles from Ajitkumarr

Ajitkumarr
Director, Aavishjia Private Limited
No. 28, 2nd Main Road, Muniswamy Layout,
Vidyaranyapura, Bengaluru 560097
Mail ID : marketing@aavishjia.com
https://www.aavishjia.com
Ph: 98451 83494

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Joint pain often prompts doctors to recommend a blood test for uric acid. Elevated levels of uric acid in the blood can lead to inflammation and pain in various joints, muscles, and surrounding areas. If uric acid levels are high, it is crucial to take steps to reduce them to prevent further complications.

Why Uric Acid Increases
Uric acid levels in the blood depend on two main factors: the production of purine and the excretion of uric acid through the kidneys and liver. About 75% of people with high uric acid have genetic factors that reduce their body’s ability to excrete uric acid efficiently. For the remaining 25%, high uric acid production is the primary issue.

Causes
Here are the primary causes of high uric acid:
1. Genetic Factors: Inherited Traits: Genetic predisposition can lead to reduced efficiency in the kidneys’ ability to excrete uric acid. This is seen in approximately 75% of people with hyperuricemia.
2. Dietary Factors
• High-Purine Foods: Consuming foods rich in purines can increase uric acid production. These include:
• Red meats (beef, lamb, pork)
• Organ meats (liver, kidney)
• Certain fish (anchovies, sardines, mackerel)
• Shellfish (shrimp, crab, lobster)
• Alcoholic beverages, especially beer and spirits
• Sugary Foods and Drinks: High-fructose corn syrup and sugary drinks can elevate uric acid levels.
3. Medical Conditions
• Kidney Disease: Impaired kidney function can lead to decreased excretion of uric acid.
• Metabolic Syndrome: Conditions such as obesity, hypertension, and insulin resistance are associated with higher uric acid levels.
• Hypothyroidism: Underactive thyroid function can reduce the body’s ability to process and excrete uric acid.
• Psoriasis: This inflammatory skin condition increases cell turnover, leading to elevated uric acid production.
• Certain Cancers and Treatments: Rapid cell turnover or destruction during chemotherapy can release large amounts of purines into the blood.
4. Medications
• Diuretics: Commonly used to treat hypertension, diuretics can increase uric acid levels by reducing its excretion.
• Aspirin: Low doses of aspirin can reduce uric acid excretion.
• Immunosuppressant: Drugs like cyclosporine, used in organ transplant recipients, can increase uric acid levels.
5. Lifestyle Factors
• Obesity: Excess body weight increases uric acid production and reduces its excretion.
• Dehydration: Insufficient fluid intake can concentrate uric acid in the blood, making it harder for the kidneys to excrete it.
• High Blood Pressure: Hypertension is often associated with reduced kidney function, affecting uric acid excretion.
6. Age and Gender
• Age: Uric acid levels tend to increase with age.
• Gender: Men are more likely to have higher uric acid levels compared to premenopausal women. However, postmenopausal women have increased risk due to hormonal changes affecting uric acid metabolism.
7. Alcohol Consumption
• Beer and Spirits: These are particularly high in purines and can significantly increase uric acid levels.
8. Rapid Weight Loss
• Crash Diets and Fasting: These can lead to increased breakdown of body tissues, releasing purines into the bloodstream and raising uric acid levels.

Symptoms of Gouty Arthritis
Gouty arthritis, a common result of high uric acid, often presents with sudden, severe pain. Approximately three-quarters of sufferers first experience pain in the big toe, while others may feel it in the small joints of the knees, hands, or feet. Symptoms include pain, swelling, heat, and redness, often appearing without warning. Recurrent episodes can lead to joint damage and deformity, making timely treatment essential.

Steps to Reduce Uric Acid
Herbal Remedies:
• Amritaballi (Guduchi or Giloy): This herb acts as a panacea for joint problems. Drinking a decoction of Amritaballi can reduce the severity of gout and prevent recurrences when taken a couple of days a week.
• Ginger: Adding ginger to the Amritaballi decoction enhances its anti-inflammatory properties. Regular consumption of this combination can provide significant relief.
Panchakarma Treatments:
• Virechana and Basti treatments in Ayurveda are effective for acute and chronic uric acid issues.

Dietary Adjustments:
• Avoid foods high in purines, such as all types of alcoholic drinks, meat, cauliflower, mushrooms, and peanuts, for at least three months.
• Eggs, almonds, figs, and cashews can be consumed as they do not contain purines.
• Most fruits, vegetables, and whole grains are safe and beneficial.
• Contrary to some beliefs, milk and milk products do not contain purines and can be included in the diet.

Hareetaki (Terminalia chebula) Powder:
• Mixing half a spoon of Hareetaki powder with hot water before bedtime can be effective in managing uric acid levels.
Ayurvedic Medicine:
• Special Ayurvedic infusions designed to lower uric acid can help alleviate symptoms and prevent flare-ups.

Managing high uric acid requires a combination of herbal remedies, dietary changes, and traditional treatments. By following these steps, individuals can reduce inflammation, alleviate pain, and prevent joint damage associated with gouty arthritis. Regular monitoring and lifestyle adjustments are key to maintaining healthy uric acid levels and improving overall joint health.

Also read : Dr Venkataramana Hegde articles

Dr Venkataramana Hegde

Veda Wellness Center
Nisarga Mane, Sirsi
Uttarakannada District
Ph:9448729434

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Gestational diabetes in mother increases the risk of pre-diabetes and obesity in kids. In case you suffer from gestational diabetes during the course of your pregnancy, do not panic. The condition is quite common and can be managed easily, without causing any harm to the baby

What is Gestational diabetes mellitus (GDM)?

Gestational diabetes mellitus (GDM) is the development of high blood sugar that develops during pregnancy and usually disappears after birth of the child. Although gestational diabetes may occur at any time during the pregnancy, it is more common in the second half of pregnancy.

Gestational diabetes increases the chances of post-partum depression, stillbirth, caesarean section, pre-eclampsia as well as the child’s health and development post birth. The woman herself also has a greater chance of developing GDM in subsequent pregnancies and overt diabetes later in life. There is emerging evidence for the use of moderate exercise, probiotics and vitamin D in the prevention of GDM.

How  gestational diabetes affects child?

Studies have established that 10 to 14 year old children born by women who suffered from untreated gestational diabetes are at higher risks of developing pre-diabetes as well as obesity, compared to children whose mothers did not suffer from the high blood sugar.

“Our study shows that independent of a mother’s weight or genetic predisposition to diabetes, a mother’s blood sugar level during pregnancy independently adds to the risk of both obesity and glucose intolerance in her child,” says lead researcher Boyd Metzger, professor emeritus of medicine at Northwestern university Feinberg school of Medicine.

Another study conducted at The Northwestern university Feinberg school of Medicine also concluded that irrespective of the mother’s genetic disposition to diabetes or weight, the blood sugar level of the mother during pregnancy can independently have an impact on the obesity and glucose tolerance that the baby develops after birth.

The mother’s blood sugar levels and the efficiency of metabolism affect the child’s metabolism and glucose tolerance. In order to lower the risk of developing gestational diabetes and to lower the ill effects on the child, effective management of gestational diabetes is necessary. Gestational diabetes can be managed effectively by adopting a healthy diet and eating pattern, continuous monitoring of blood sugar levels and by undertaking regular physical activity.

Insulin injections may also be required by some women in order to keep the condition of gestational diabetes in control for the rest of their pregnancy. Once the baby is born, however, the need for insulin injections ceases. Gestational diabetes usually disappears after the birth of the baby.

The following are some tips to manage gestational diabetes:

• Exercise more: Medical professionals advise and recommend exercises that might be good for both pregnant and baby. Try to fit in about 15 minutes of physical activity in daily routine and increase this duration to about 30 minutes gradually over a period of time.
• Test and monitor blood sugar levels: Test your blood sugar levels regularly, in order to ensure that the added exercises and the dietary changes have actual effect on blood sugar levels.
• Work on diet: To control blood sugar levels, gynaecologist may suggest to consult a registered dietitian so as to help diet plan and make sure to stick to it. Diet plan has to ensure that gestational diabetes is under control, while baby receives enough nutrients and calories that it required for proper growth and development. The diet should contain high fiber and low glycemic index foods.
• Take regular medication: In case blood sugar levels remain high despite making the above mentioned changes in lifestyle, medical professional may prescribe some medications to keep blood sugar in check and ensure the protection of baby. In case these medications do not work as well, insulin injections may be recommended as the next logical step for the management of gestational diabetes.

Dr. Radha S. Rao
Bengaluru 

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Imagine you have a minor cut and the bleeding does not stop. This can happen to those people with Hemophilia. It is an inherited bleeding disorder where the body lacks the ability to make blood clots, a process needed to stop bleeding. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery. Small cuts usually aren’t much of a problem. In severe conditions, bleeding that happens inside the body especially knees, ankles, elbows and brain can damage your organs and tissues and can be life-threatening.

There are several different types of hemophilia. Hemophilia A (Classic Hemophilia) caused by a lack or decrease of clotting factor VIII and Hemophilia B (Christmas Disease) caused by a lack or decrease of clotting factor IX are the two most common types. Hemophilia A is the most common X-linked genetic disease with a worldwide incidence of approximately 1 case per 5000 males, with approximately one-third of affected individuals not having a family history of the disorder. Hemophilia B occurs in approximately 1 in 25,000 male births. It is less prevalent than hemophilia A.

The condition is not curable currently, but it can be treated to minimize symptoms and prevent future health complications. Genetic counselling is the main tool for the prevention and control of genetic disorders, targeted at families with an affected birth or with a family history of the disorder.

What causes this disorder and who are at the risk?

Hemophilia occurs when a clotting factor is missing or levels of the clotting factor are low. The majority of hemophilia cases are congenital which means that a person is born with the condition. One can also develop acquired hemophilia with no personal or family history of hemophilia. However, acquired hemophilia is a rare autoimmune disorder.

The biggest risk factor for developing this disorder is having family members who also have the disorder. Haemophilia predominantly affects the males.

Signs and Symptoms to watch out for

Depending on the level of clotting factors, signs and symptoms of hemophilia vary. In mild conditions, the bleeding is moderate and might bleed only after surgery or trauma. However, in severe cases, one can bleed easily for seemingly no reason. Some of the common signs and symptoms include:

1. Bleeding into the joints

2. Bleeding into the skin (which is bruising) or muscle and soft tissue causing a build-up of blood in the area (called a hematoma)

3. Bleeding of the mouth and gums, and bleeding that is hard to stop after losing a tooth

4. Bleeding unusually after vaccinations

5. Bleeding in the head of an infant after a difficult delivery.

6. Blood in the urine or stool

7. Nosebleeds without a known cause

8. Delayed bleeding after an injury

Although very rare, sometimes a simple bump on the head can cause bleeding into the brain for some people who have severe hemophilia. It is a state of emergency and immediate medical help must be taken.  Severe headache, vomiting repeatedly, seizures, feeling lethargy or seeing double vision or sudden excessively sleepiness are some of the signs.

Diagnosis:

It is usually diagnosed through a blood test. It helps identify the type of hemophilia and its severity. Reviewing the symptoms, personal medical history and clinical evaluation are recommended.  Since the disorder affects males in general, many people with a family history of hemophilia get their baby boys tested soon after birth.

Treatment:

Treatment focuses on replacing the missing protein and preventing complications. It involves giving or replacing the clotting factors that are too low or missing. This is done by infusing (administering through a vein) commercially prepared concentrated FVIII or FIX product.

In more severe cases, one may need to go to physical therapy for rehabilitation if hemophilia has damaged your joints. And, if you have pain associated with the condition, your doctor may prescribe or recommend pain medications to help alleviate the pain.

Also Read: World Hemophilia Day: Lets pledge to raise awareness 

Dr. Stallin Ramprakash

Consultant – Paediatric Haematology, Oncology & BMT

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 Viral hepatitis A, B, C, D & E are the ones that infect the human liver cells, A&E being transmitted feco-orally and B, C and D are transmitted parenterally (via blood). On World Hepatitis Day 2022, WHO has highlighted the need for bringing Hepatitis care closer to the primary health facilities and communities so that people have better access to treatment and care, no matter what type of hepatitis they may have.

The world is currently facing a new outbreak of unexplained acute Hepatitis infections affecting children. This outbreak brings our attention to thousands of acute viral hepatitis infections that occur among children, adolescents and adults every year. Most acute Hepatitis infections cause mild disease and even go undetected. Global efforts prioritize the elimination of the Hepatitis infections B, C and D infections. Unlike acute viral hepatitis, these 3 infections cause chronic hepatitis that lasts for several decades and culminate in over 1 million deaths per year from cirrhosis and liver cancer. These 3 types of chronic hepatitis infections are responsible for over 95% of hepatitis deaths.

The viral hepatitis infection is a cause of serious concern and the WHO aims to reduce the burden of new hepatitis B and C by 90% in the coming years. In its effort to do so the world health organization had laid down the path to reduce hepatitis deaths from liver cirrhosis and cancer by 65%, ensure that at least 90% of the people infected with hepatitis B and C are diagnosed well in time and 80% of the patients who require treatment receive appropriate treatment. We as individuals should be aware about these treatable viral infections so that timely diagnosis and treatment can help save lives.

Dr. Apurva Pande
Consultant – Hepatologist, Bengaluru

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What is stroke?

A stroke (cerebrovascular accident – CVA), Pakshaghata in Ayurveda occurs when there is a disruption of blood flow to the brain. This can happen for various reasons, but main categories:

• Ischemic Stroke: Common type of stroke, accounting for about 87% of all strokes. It occurs when a blood vessel in the brain is blocked by a clot (thrombus) or a clot that travels from another part of the body (embolus). The lack of blood flow deprives the brain of oxygen and nutrients, leading to damage.
• Hemorrhagic Stroke: Occurs when a blood vessel in the brain ruptures or leaks, causing bleeding into or around the brain. It is rare stroke, but often more severe.

Prevention of Stroke or Paralysis:

• Manage Blood Pressure: Blood pressure is a significant risk factor for stroke. High BP puts excessive force on the walls of the blood vessels throughout the body, including in the brain. Over time, this damages blood vessel. High BP leads to Atherosclerosis (is the build-up of fatty deposits /plaques inside the blood vessels). These plaques can narrow the blood vessels, reducing blood flow. High BP also damage the delicate blood vessels in the brain. This damage can result in the formation of blood clots or emboli, leading to an ischemic stroke. High BP weaken the blood vessel walls, making them more susceptible to rupture. This can result in a hemorrhagic stroke. High BP often coexists with other risk factors for stroke, such as diabetes, high cholesterol, and smoking. So regularly check your blood pressure and work with your doctor to keep it within a healthy range through lifestyle changes or medication if necessary. Furthermore, it is of utmost importance not to discontinue blood pressure medication or alter the dosage without consulting a medical professional. Research has shown that individuals who cease their blood pressure treatment are at risk of experiencing strokes. Therefore, self-medication should be avoided.
• Life style modification: Good sleep is must for proper function of human body. Minimum 6 – 8 hours of sleep daily is required as it helps to rejuvenate the damaged cells.
• Engage in Regular Physical Activity: Sedentary life style is also a major risk factor. Exercise can help maintain a healthy weight, lower blood pressure, and improve overall cardiovascular health. Aim for at least 150 minutes of moderate-intensity exercise per week.
• Maintain a Healthy Diet: maintaining a balance between quality and quantity of food is important. A diet rich in carbohydrate, fibre, proteins, vitamins and minerals should be consumed. So including fruits, vegetables, whole grains, and lean proteins can help reduce the risk of stroke. Limit your intake of saturated fats, sodium, and processed foods.
• Detoxification: Proper urination and defecation are essential to remove impurities from the blood. This help to regulate blood pressure.
• Manage Stress: Chronic stress and emotions can contribute to stroke risk. Find healthy ways to manage stress, such as through relaxation techniques, meditation, or counselling.
• Control Diabetes: Individuals with diabetes have an increased risk of stroke. Managing blood sugar levels and maintaining a healthy diet is crucial in preventing stroke.
• Avoid Smoking and Alcohol: Smoking and excessive alcohol consumption increase the risk of stroke. Quit smoking and limit alcohol intake to reduce your risk.

Treatment – Stroke Management in Ayurveda

Ayurveda states that the origin of diseases, including stroke and high blood pressure, is rooted in Vegarodha, and thus, the key to averting illnesses is:

“रोगा: सर्वेपि जायन्ते वेगोदीरण धारण।“

To maintain good health, it is imperative to heed the natural urges of life: hunger, thirst, sleep, rest, urination, defecation, hiccups, crying, and laughter. These essential bodily functions should proceed unhindered, as obstructing them can lead to adverse consequences.

Conversely, it is advisable to refrain from surrendering to artificial urges, such as eating when not hungry, drinking without thirst, or indulging in these activities for mere entertainment or to please others. Such practices can exert undue stress on the body, potentially affecting the heart and brain.

Treatments

A range of Ayurvedic treatments designed to promote healing includes.

• Dhara: medicated oil is steadily poured on the affected body part of the patient.
• Nasya: focuse on strengthening muscles, nerves, and circulation above the shoulder area.
• Udvartana (Udwarthanam): Dry herbal powders or herbal paste prepared with medicated oils is used in massage
• Basti (Medicated Enema): Done in various forms, such as Matra Basti, Anuvasana Basti, and Nirooha Basti. Done for nourishing, strengthening, and stabilizing overall bodily functions.

Ayurveda offers remedies that enhance blood circulation, clear obstructions in the circulatory system, and safeguard neurological health. Herbs like Brahmi and Vacha are known for their neuro-protective properties. Ayurveda employs a systematic detoxification process to optimize digestive function and eliminate Ama, which refers to incomplete digestion and blockages in the body, including the brain.

In some cases, patients may encounter challenges related to the blood-brain barrier, rendering conventional medicines less effective for brain-related issues. However, Ayurveda offers potent solutions. Tatkshana Ayurveda has developed a specialized medication known as Grutha (ghee) that facilitates the transport of medicine to brain cells. Remarkably, Grutha pana, in conjunction with systematic detoxification, has shown significant efficacy in the recovery of patients, even in cases of Facial Palsy.

When it comes to stroke or paralysis, Tatkshana Ayurveda’s approach involves thorough nadi pariksha (pulse diagnosis) and extensive discussions with patients to understand their medical history. Based on this, personalized treatment plans are devised. Tatkshana Ayurveda provides both in-patient and out-patient facilities, ensuring comprehensive care for individuals seeking Ayurvedic treatment.

Dr. Ashakiran and Dr Manasa Bhat
Tatkshana Ayurveda
2nd cross, Marappanapalya, B/w Sandal soap factory and Goverdhan Bus-stop
Yeshwanthpur, Bengaluru – 560022
Ph: 77605 75333 / 87220 34900

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Why India’s Concern: Kerala has identified the cases of Nipah virus and the unnatural death of a person from Nipah virus on August 30 has made a focal point of concern regarding Nipah virus due to its history of recurrent outbreaks in India. The virus’s transmission from fruit bats to humans has sparked profound unease within the public health domain. The potential for rapid transmission and its alarmingly high mortality rate makes it a paramount issue in the country.

Causes and Symptoms: Nipah virus primarily infiltrates human populations through direct contact with infected animals or the consumption of contaminated food and beverages. The initial symptoms typically involve fever, headaches, and dizziness. However, in its severe form, the Nipah virus can progress to encephalitis, a condition marked by the inflammation of the brain. This advanced stage can manifest as seizures and coma, adding to the complexity of the disease.

Fatality: It can indeed be fatal, and it does not spare those it infects. Its high mortality rate underscores the gravity of the situation. It’s essential to understand that the outcome of the infection can vary from one individual to another, with some managing to recover under careful medical supervision while others succumb to its deadly grip.

Treatment Dilemma: Regrettably, as of now, there exists no targeted antiviral treatment for the Nipah virus. The primary approach to managing the disease involves supportive care. This encompasses a vigilant effort to alleviate the symptoms and provide intensive medical attention. Researchers are actively engaged in exploring experimental treatments and vaccines, offering a glimmer of hope for the future.

Precautions: In order to safeguard transmission of virus following actions must be taken:
• Animal Avoidance: Steer clear of contact with animals afflicted by the virus, particularly pigs and bats.
• Food Safety: Abstain from the consumption of raw date palm sap, as it stands as a recognized source of infection in specific regions.
• Hygiene Vigilance: Elevate hygiene practices, including frequent handwashing with soap and water.
• Protective Gear: When tending to infected individuals, employ proper personal protective equipment to staunch the possibility of person-to-person transmission.

Dr. Rohit Kr Varshney
Professor – Emergency Medicine
TMU Hospital, Moradabad

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People of all age groups develop symptoms of Restless Legs Syndrome (RLS). RLS is a neurological condition that causes an irresistible urge to move the legs. It is a chronic condition, that can last for years or be lifelong. The symptoms may begin in childhood or adulthood, however, older adults tend to suffer severely. It is one of the common disorders affecting more than 10 million cases per year in India. According to research, the prevalence of RLS in a South Indian urban population is 2.1%.

How does it interfere with quality of life (sleep and fatigue)?
People usually experience pulling, tingling and pain feelings while sitting or lying down which get worst at night. Sometimes, the symptoms become unbearable and in severe cases, it can affect the arms or other parts of the body in addition to the legs. The unpleasant feelings and the resulting need to move the legs often make it difficult for a person with RLS to fall asleep or stay asleep. Over time, it can affect the quality and amount of sleep which can lead to the development of mood swings, depression, or other health problems hindering the quality of life as well.

RLS is a partially heritable disorder more prevalent in women than in men. The presence of low iron content despite a normal hemoglobin, having high estrogen levels in women can influence dopamine and glutamate transmission, making them more vulnerable to this condition. Women are also more prone to have migraine, depression, and anxiety. These conditions can contribute to the development of RLS in women.

Pregnant women more likely to get RLS
Pregnant women are at the risk. This may be contributed to the low serum iron and ferritin level, and high estrogen level during pregnancy. Studies have found that the prevalence of RLS among pregnant women ranged from 10 to 34%. It is RLS usually associated with a number of pregnancy complications such as preeclampsia and increased incidence of Cesarean sections. RLS is also more commonly in people with chronic kidney disease (CKD), especially those on haemodialysis. Anaemia, iron deficiency or high calcium levels in the blood are some of the factors that can cause RLS or worsen the symptoms.

Treatment:
RLS is a lifelong condition. The condition can be managed effectively with proper treatment. Self-care steps, lifestyle changes or medication may help. Movement, such as kicking, stretching, rubbing, or pacing, make the discomfort go away, at least temporarily. In severe conditions, medicines are prescribed. Basis your condition and severity, the doctor will be able to diagnose and provide a proper treatment plan.

A simple change in lifestyle works for those with mild symptoms.
• Getting moderate, regular exercise may relieve symptoms of RLS.
• One can also use soak the legs in warm water and give massages.
• Establish good sleep hygiene;
• have a regular sleep time and sleep in a cool, quiet, comfortable sleeping environment
• avoid caffeine.

Dr. Anuradha H K
Consultant Neurology, Bengaluru

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Imagine you have a minor cut and the bleeding does not stop. This can happen to those people with Hemophilia. It is an inherited bleeding disorder where the body lacks the ability to make blood clots, a process needed to stop bleeding. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery. Small cuts usually aren’t much of a problem. In severe conditions, bleeding that happens inside the body especially knees, ankles, elbows and brain can damage your organs and tissues and can be life-threatening.

 There are several different types of hemophilia. Hemophilia A (Classic Hemophilia) caused by a lack or decrease of clotting factor VIII and Hemophilia B (Christmas Disease) caused by a lack or decrease of clotting factor IX are the two most common types. Hemophilia A is the most common X-linked genetic disease with a worldwide incidence of approximately 1 case per 5000 males, with approximately one-third of affected individuals not having a family history of the disorder. Hemophilia B occurs in approximately 1 in 25,000 male births. It is less prevalent than hemophilia A.

The condition is not curable currently, but it can be treated to minimize symptoms and prevent future health complications. Genetic counselling is the main tool for the prevention and control of genetic disorders, targeted at families with an affected birth or with a family history of the disorder.

 What causes Hemophilia and who are at the risk?

It occurs when a clotting factor is missing or levels of the clotting factor are low. The majority of hemophilia cases are congenital which means that a person is born with the condition. One can also develop acquired hemophilia with no personal or family history of hemophilia. However, acquired is a rare autoimmune disorder. The biggest risk factor for developing it is having family members who also have the disorder. It predominantly affects the males.

 Signs and Symptoms

Depending on the level of clotting factors, signs and symptoms  vary. In mild conditions, the bleeding is moderate and might bleed only after surgery or trauma. However, in severe cases, one can bleed easily for seemingly no reason.

Some of the common signs and symptoms:

• Bleeding into the joints
• Bleeding into the skin (which is bruising) or muscle and soft tissue causing a build-up of blood in the area (called a hematoma)
• Bleeding of the mouth and gums, and bleeding that is hard to stop after losing a tooth
• Bleeding unusually after vaccinations
• Bleeding in the head of an infant after a difficult delivery.
• Blood in the urine or stool
• Nosebleeds without a known cause
• Delayed bleeding after an injury

Although very rare, sometimes a simple bump on the head can cause bleeding into the brain for some people who have severe hemophilia. It is a state of emergency and immediate medical help must be taken.  Severe headache, vomiting repeatedly, seizures, feeling lethargy or seeing double vision or sudden excessively sleepiness are some of the signs.

 Diagnosis:

Usually diagnosed through a blood test. It helps identify the type of hemophilia and its severity. Reviewing the symptoms, personal medical history and clinical evaluation are recommended.  Since the disorder affects males in general, many people with a family history of hemophilia get their baby boys tested soon after birth.

 Treatment:

Treatment focuses on replacing the missing protein and preventing complications. It involves giving or replacing the clotting factors that are too low or missing. This is done by infusing (administering through a vein) commercially prepared concentrated FVIII or FIX product. In more severe cases, one may need to go to physical therapy for rehabilitation if hemophilia has damaged your joints. And, if you have pain associated with the condition, your doctor may prescribe or recommend pain medications to help alleviate the pain.

Dr. Stallin Ramprakash
Consultant – Paediatric Haematology, Oncology & BMT, Bengaluru

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