Subarachnoid haemorrhage is a severe form of brain haemorrhage that occurs around the brain substance normally within the subarachnoid space. Subarachnoid space is a thin space between arachnoid membrane that covers the brain and the brain substance. In this space normally all the major blood vessels of the brain traverse to different locations. Any leak of blood from these vessels into this designated space is called SAH.

What is the cause?

Majority of the times it is caused by an abnormal local enlargement on these blood vessels which eventually rupture called “Aneurysm”. These are localized enlargements like berries on these blood vessels. They enlarge with time and burst with slightest strain causing massive bleeding. They can be singular or multiple or identical on both sides called mirror aneurysms.

How does it develop?

Most of them are from birth or occur in later part of life due to weakness or thinning if the vessel wall that increases in size and with time due to flow dynamics. Depending upon the size and the rate of enlargement they can rupture any time. Some remain as it is and are diagnosed by scans done for some other purpose called “Incidental or Unruptured Aneurysms”. These are of importance that these aneurysms grow with time and eventually rupture with time. So it is important to treat such incidental aneurysms before they really rupture. The outcomes are much better when we treat before they really burst.

How do they rupture?

They are like small time bombs in the head in a literal sense. As the blood is flowing through the vessel it enters the aneurysm causing turbulence within. This in turn will slowly enlarge the aneurysm like a balloon and also make the vessel wall thinner with time. Beyond a particular level of stretching the vessel wall gives way either due to blood pressure or by any physical strain, straining in the toilet for hard motion or during coitus making them rupture. Once aneurysm ruptures it can bleed considerably inside the brain. At times bleeding can be so severe causing an instant death. So a good number of subarachnoid haemorrhage patients do not reach the hospital.

The risk of re – rupture persists while on transport or even after reaching the hospital, till it is treated. Therefore they need to be treated as an emergency as early as possible. The primary goal is to prevent bleeding from the ruptured aneurysm. Soon after the rapture body tries to protect by forming a clot around the aneurysm. But this clot cannot prevent re-bleeding nor give total security. So it is mandatory to identify the aneurysm and seal it before it bleeds again. If unfortunately bleeds second time the life risk increases by many fold.

 How common is this?

This accounts for about 10% of Brain attacks in general. Commonly affects adults, slightly more common in women. It can rarely manifest in childhood.

 What are the symptoms?

Presentation of a ruptured aneurysm is classical. Sudden severe headache that has never been experienced before, with vomiting, neck pain and loss of consciousness. That’s why this headache is called “Thunderbolt Headache” or “thunder clap headache”.

How to diagnose?

With the typical history and clinical examination showing neck stiffness is classical to make a diagnosis. CT scan confirms the diagnosis by showing presence of blood in subarachnoid spaces around the brain. The amount of blood, at times helps in guessing the possible location of aneurysm. Cerebral angiography is definitive and gold standard in establishing diagnosis. Angiography gives information about size, shape, location, status of blood flow including presence of multiple aneurysms. It is necessary to study all the blood vessels of the brain in order to identify presence of multiple aneurysms CT Scan of the Brain will provide the quickest diagnosis for Subarachnoid bleeding. Presence of blood in the basal cisterns and around the brain is classical and diagnostic.

What can precipitate a rupture?

High blood pressure, any strenuous work can rupture an aneurysm. However, sudden rupture during sexual intercourse in men and during labour among women is well known.

What is the effect of pregnancy on aneurysm?

Aneurysms are known to enlarge during pregnancy. Mostly due to hemodynamic changes that happens in the 2nd trimester. Increased blood volume and associated high blood pressure is the cause. That’s why rupture is also common in the mid trimester or during delivery due to the physical strain associated. It is preferable to avoid normal labour in such situations.

What should be the IMMEDIATE action?

One can easily suspect this condition by the nature of the headache itself. They should be hospitalised immediately. Once the aneurysm ruptures, there is nothing to hold the bleeding except the nature’s protection by formation of blood clot around. This can give way at any time. That’s why most often they do bleed again within no time. Nearly 20% die instantly with first bleed. The second bleed doubles the death rate further. Hence the patient should be admitted to ICU, immediately, sedated to prevent strain, control blood pressure, provide pain relief, and treat other problems like seizures if present. Prevent a re-bleed by all means, and quickly investigate and treat.

What is the definitive treatment?

Sure way of preventing re-bleed is by eliminating the blood circulating through the aneurysm. This can be done by clipping or coiling based on the character of the aneurysm and the technical feasibility. Rest is mostly medical management.

What is clipping?

It is a definitive obliteration of aneurysm by placing a titanium clip around its neck, so that blood can’t enter into the sack further. This needs an open micro surgery. Neurosurgeon goes through the subarachnoid space and traces the location of the aneurysm and place the clip preserving the parent vessel. Advantage is we can wash out the blood in the subarachnoid spaces at the same time. These clips are permanent and stay inside for life time. Titanium clips do not interfere with future investigations like MRI.

Will they interfere with future imaging?

Presently these clips are made out of Titanium. They are inert biologically and do not react with the body. Only when we do a CT scan after surgery an artefact can be seen at the site of the clip. These clips are MRI compatible. One can undergo MRI safely after aneurysm surgery. However it is worthwhile informing the radiologist at the scan centre before the imaging starts.

What is coiling?

Coiling is an Endovascular treatment, where in a special coil is deployed into the aneurysmal sac or cavity to obliterate the aneurysm completely. This is done through angiography by using specialised catheters. Neurovascular lab and trained Endovascular specialist is mandatory. Advantage of this is no open surgery. This can be done for all aneurysms and in all age groups except in some special locations and types due to the technical difficulties.

What are the advantages of coiling?

 It is a minimally invasive procedure. This avoids open surgery. Aneurysms in the critical areas of the brain can be treated. Age is no bar. Coiling can be done as early as possible, even in persons whose conscious levels are altered or not normal.

 Can they be used for all Aneurysms?

Now a days most sophisticated catheters and coils are available. Majority of the aneurysms can be treated by coiling. There may be few technical reasons that one may defer this and prefer clipping. Nevertheless every aneurysm is different and the plan of treatment should be decided based on the individual merits. Often it is tailor made based on many factors. What are the Giant Aneurysms? As the name suggests they are big aneurysms more than 1 centimetre, sometimes can be huge in size. They are more common in women and in children. By virtue of their size they often behave like tumors causing progressive neurological problems or epilepsy. At times blood clots develop within the sac causing multiple strokes. Rarely they do rupture.

 How to treat Giant Aneurysms?

Bigger the size of the aneurysm more are the challenges in treatment. Ideally can be treated by Endovascular methods by using flow diverters. If not by open surgery. They are technically challenging and each one need to be dealt with a different strategy. Surgical treatment needs proper planning. The technique depends upon the complexity of the aneurysm.

What are flow diverters?

 They are special devices that can be placed inside the blood vessel through angiographic methods. This will divert the blood from entering into the Aneurysm sac so that gradually it will shrink. They are expensive devices. If the giant aneurysm is complex and in a critical location, a planned bye pass to divert the blood flow to the brain and later on surgical occlusion of main vessel itself have to be done to prevent a rupture. At times complex clipping methods are used to reconstruct the blood vessel.

Can multiple aneurysms be treated together?

Yes. More than one aneurysm can be treated in both methods depending upon the patient’s condition. First already ruptured one will be treated always. If accessible it can be done during the single surgery also.

Can aneurysm recur after surgery?

 If the aneurysm is treated totally they don’t re occur. But if the occlusion is partial then the residual part might enlarge with time. That should be watched over the years. But aneurysms can occur at a different location. By and large repeat angiogram will detect the presence of any other smaller aneurysms.

What are the incidental aneurysms?

 Now a days imaging of Brain has become very common due to the availability of diagnostic facilities. If aneurysm is found before its rupture while investigating for any other reason it is called incidental aneurysms. These require very close follow-up and treatment at an appropriate time. No aneurysm should be neglected are left alone. We now know the natural course of these aneurysms. With time all of them increase in size and rupture eventually. So they deserve a definitive treatment.

Do they require treatment?

Yes. On a long term study we know that every aneurysm enlarges with time till to the point of rupture. We have observed the results are far better if we treat them before they rupture. It is like any other surgery and they can be totally normal. Otherwise every year the risk of bleeding increases, putting them to higher risk over the time. In addition once diagnosed it is a big psychological fear as well. It is like sitting with a time bomb inside the head.

What are infective aneurysms?

Due to the presence of infection in the blood from either septicaemia or infective endocarditis the blood vessel wall itself will get infected. As a result it becomes soft and weak and gradually enlarges becoming an aneurysm. They are also called Mycotic aneurysms. They are generally rare now due to the aggressive treatment of infections and availability of good antibiotics.

What are the rare presentations?

Aneurysms in special locations can present with odd symptoms that can be completely misleading.

1. Sudden onset vision loss in one eye due to ophthalmic artery aneurysm

2. Sudden closing of one eye due to PCOM aneurysm

3. Frozen eyeball due to intra cavernous aneurysm

4. Double vision due to carotid aneurysm at the skull base

5. Bleeding from the nose due to Giant aneurysm eroding the anterior skull base

6. Hoarseness of voice due to vertebral artery aneurysm

7. Facial paralysis due to vertebral aneurysm

8. Facial pain due to Basilar artery aneurysm

9. Intra cerebral clot due to Mycotic aneurysm

Also Read: Brain : The King and a King maker 

Dr. NK Venkataramana

Founder Chairman & Director Neurosciences

Brains Hospital, Bengaluru.

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Parkinson’s disease (PD) is the second most common degenerative disease that affects the brain, causing significant disability. The incidence of PD varies from 8.6 to 19 per 1 lakh population. Every year, 50,000 new people are diagnosed with the disease. Parkinson’s disease primarily affects the movements of the body, making the person slow in all the activities, and is associated with shaking of the body called tremors.

CAUSES

The exact cause of the Parkinson’s disease is not clearly understood. However, there are several propositions:

1. Environmental – Exposure and consumption of pesticides, environmental endotoxins and heavy metals have been incriminated.

2. Genetic – Several gene abnormalities which influence synuclein protein metabolism have been identified for contributing to an entity called Hereditary or Familial Parkinson’s Disease. The prominent genes are Parkin gene and Alphasynuclein gene.

3. Idiopathic – A majority belong to this category where the exact cause is not known. It is also known as primary PD.

4. Secondary PD – Tumours, vascular infarcts, drugs, and metabolic diseases can produce Parkinsonism. Based on this, the disease is classified as follows:

1. Primary or Idiopathic.
2. Secondary or Acquired.
3. Hereditary or Familial.
4. Parkinson Plus syndromes.

SYMPTOMS

The cardinal symptoms of Parkinson’s disease are: 1. Shaking of hand or leg (tremor) at rest. 2. Slowness of movement (Bradykinesia). 3. Stiffness of limbs and body (rigidity). 4. Stooping posture with imbalance (postural instability).

1.TREMOR: Most common symptom. It can be on one side or both sides, affecting the hand, leg or both. Shaking of the hand with pill-rolling movements of the thumb at rest is the classic symptom.

2. BRADYKINESIA: Parkinson’s disease dominantly affects the motor movements of the body. Hence there is slowness of movement along with difficulty in the whole course of movement process, planning, initiation and execution. This will make the person slow in all the activities. The face becomes expressionless.

3. RIGIDITY: Stiffness of muscle tone affecting the smoothness of all the movements and activities. It may be associated with joint pains, leg pains and back pain. In the advanced stages, it can be severe with total cessation of movement, making the person wheelchair bound and disabled.

4. POSTURAL INSTABILITY: As the disease progresses, they develop impaired balance with frequent falls, sustaining several injuries and fractures. The other recognized motor movements include a rapid shuffling gait with a forward belt posture called festination, speech and swallowing difficulties; the handwriting becomes very small and irregular.

NON-MOTOR SYMPTOMS:

Involvement of various parts of the brain can lead to a variety of non-motor symptoms which are equally disabling. Cortical involvement causes Dementia, Cognitive Impairment and at times Frank Psychosis. Basal ganglia damage leads to apathy, restlessness and impulse control disorders. Brainstem involvement leads to depression, anxiety and sleep disorders. Peripheral nervous system problems can cause Orthostatic Hypotension, constipation, pain and sensory disturbances. They can also have hallucinations, constipation, drooling of saliva, speech and swallowing difficulties.

Also read: Dementia – lifestyle changes can lower the risk 

DIAGNOSIS

Parkinson’s disease is usually diagnosed by clinical history and examination. There is no specific lab test to establish the diagnosis. However, CT Scan , MRI Scan, SPECT (Single photon emission spectrography) and PET (Positron Emission Tomography) will help in identifying the underlying diseases and also to some extent identify Parkinson Plus Syndromes.

PD PLUS SYNDROMES: These are a variety of progressive degenerative disorders that affect the brain and mimic the main Parkinson’s disease. However, it is important to differentiate since the treatment and the outcomes are completely different. These disorders, unlike PD, progress very rapidly, making the individual disabled in a very short time.

TREATMENTS

All the current available treatments are focused on relieving the symptoms, delay disease progression, preserve and improve functional capacity. The options available are:

1. MEDICAL THERAPY: Levodopa (supplementation of Dopamine) is the mainstay of the medical treatment. This drug is taken orally in multiple doses and relieves all the major symptoms of PD. As the disease progresses, the patients develop drug tolerance, leading to incremental increase in the dosage, often resulting in side effects. When the side effects appear or efficiency of the drug comes down, surgical treatment needs to be considered. This drug acts by directly replacing the dopamine levels in the brain.

The other drugs are to enhance the dopamine production and also to produce symptomatic relief, and also used in combination. They include dopamine agonists, Mao Inhibitors, Anti-cholinergic drugs and Amantidine. All the other non-motor symptoms will be treated symptomatically as and when required. APOMORPHINE is the drug that is recently introduced in Indian market. This is the only drug in injectable form. It can be used whenever a person cannot take oral medications or before surgery.

2. SURGICAL THERAPY: Since Dopamine replacement has its own clinical uncertainties and side effects beyond a particular stage of the disease, surgical treatment is considered to improve the quality of life. Surgical therapy includes:

a. Stereotactic lesioning

b. Deep Brain Stimulation (DBS)

c. Stereotactic Radiosurgery (SRS)

3. MOLECULAR THERAPY: This includes:

a. Cell therapy

b. Gene therapy

c. Monoclonal antibodies

d. Immunotherapy

REHABILITATION

Last but not the least, all these patients require constant rehabilitation to improve their life skills. Several of such treatments will be tailor-made to suit the individual requirements. They include physical therapy, speech therapy, gait therapy, dexterity therapy and cognitive therapy. Despite many years of research and understanding, treatment for Parkinson’s disease remains challenging. All the available therapies today are not curative. So the enigma continues along with the search for newer options. The caregivers also need to understand the problems and the dynamics of the illness. The challenges for the future are early detection, establishing a screening test, predicting the disease, progression and outcome and to create a research model for the future.

Dr. NK Venkataramana

Founder Chairman & Director Neurosciences

Brains Hospital, Bengaluru

The post Parkinson’s Disease (PD) – Causes, Symptoms, Diagnosis, Treatments appeared first on Health Vision.

Bangalore, October 29th: In a bid to mark the World Stroke Day, Brains Hospital, Richmond Road, on Thursday inaugurated a comprehensive “Stroke Unit”. At the moment the health care burden due to stroke is huge. Every year 2 million people are getting affected.

Stroke is the leading cause of disability in the world as on today.  With the increasing life span as well as risk factors like Diabetes and Hypertension the burden is only increasing further year after year. At the same time all the advanced research and understanding is not getting translated to the benefit of society. Also it is to be noted that primarily stroke is preventable.

Secondly, the disability following a stroke is again preventable. Thirdly, stroke isn’t a onetime event in life. It can strike again and again making the matters worse. The recovery rate continues to be poor in our country due to lack of awareness and timely action. Time is very crucial factor that determines the ultimate outcome, extent of recovery as well as time taken to it.

“In the light of above mentioned problems BRAINS Hospital has launched the first of its kind Stroke Unit that provides 360 degree care for this condition. The dedicated Stroke team at BRAINS is committed to fight this burning problem addressing all relevant factors influencing the management currently. We have established technology, process, protocol, systems, training, call centre, awareness, advocacy, continuity of care in acute, chronic and long term including rehabilitation, follow up and monitoring. The single most aim is to prevent a stroke in high risk people, if not get them back to the society as normal as possible” Said Dr NK Venkataramana, Founder Chairman & Chief Neurosurgeon, Brains Hospital, Bangalore.

The unit is operational 24/7. In case of any emergency one could contact: The emergency helpline: 9483240925.

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As the age increases one is more susceptible to having a stroke and also a strong family history increases the risk. Many factors such as obesity, diabetes, high blood pressure, smoking, physical inactivity increases the incidence of stroke. But there are ways one can prevent stroke attack or in medical terms cerebero vascular accident.

Many factors such as obesity, uncontrolled diabetes, high blood pressure, smoking, physical inactivity increases the chance of stroke. Simple change in habits, eating healthy, regular walking or any fitness routine can go a long way in keeping one healthy to prevent stroke.

Stroke – Risk factors:

1. Maintaining blood pressure is important for your vascular health to prevent the incidence of a stroke attack. If an individual is hypertensive or having high blood pressure the stroke risk is higher, hence regular monitoring of B. P and taking medications regularly as prescribed by the doctor for blood pressure is important. Stopping medications if the blood pressure is under control without consulting a medical professional or self-medicating is dangerous and will have serious consequences.

2. “Lose Weight”- This is repeated for prevention of many diseases but more so for stroke incident as obesity and especially abdominal obesity or visceral fat increases stroke risk. Strive for weight loss gradually and do not follow any FAD diets. A Balanced calorie deficit diet with physical activity will have an effective healthy weight loss than YO YO dieting. Consult qualified health professionals for customized diet recommendation and fitness routine which suits your work schedule and daily lifestyle.

3. Keep your Blood sugar under control by taking the right food loaded with complex carbohydrates, fiber in the form of vegetables and fruits of low glycemic index and balancing it with exercise like walking. Take your medicines or insulin regularly as prescribed by your doctor and regular monitoring of blood sugars will also help you to keep a track of your fluctuations in sugars. High blood sugar damages the blood vessels and diabetics are at an increased risk.

4. Quit smoking and take the help of a counselor to break the habit and find alternatives to break the craving. Act fast and do not delay as you know each day this dangerous habit is slowly spoiling your lungs and making you more susceptible in this pandemic situation.

5. Physical inactivity and stress are also a risk and simple exercises and fitness routine like stretches and brisk walking in the morning sunlight will do wonders to your overall health. Yoga and meditation are the best proven stress busters as deep breathing will enhance your respiratory health and help you relax. Maintaining a Food and exercise dairy will also motivate and keep you aware of your daily healthy habits.

6. Act FAST and do not delay to get into a healthy lifestyle to not only prevent stroke but also many other diseases to live a healthy and active life.

Ways to prevent stroke:

1. Recommended salt intake for an adult is only 5gms/day or one teaspoon by WHO. We all exceed this amount so do not add salt on the table- for e.g. do not add or sprinkle salt on your curd rice, salads,juice or buttermilk, chaas, fruits.

2. Increase fiber intake by including 1-2 servings of vegetables with your lunch and dinner in any form such as dry curries, low fat vegetable gravies, salads, raita or a traditional vegetable dish which you are familiar with in your region.

3. Seasonal Fruits to be included two- three times a day. Can be had with your breakfast or a mid-morning or evening healthy snack or after dinner.

4. Exercise- Incorporate a simple brisk walk for 30-40 minutes or in two 20 minute sessions which suits your daily schedule.

5. Yoga and meditation, listening to music of your choice, laughing or interacting with a friend, playing board games and spending time with family are great stress busters

Sreemathy Venkatraman
Clinical Nutritionist
BRAINS Hospital

The post Stroke – Risk factors and ways to prevent it appeared first on Health Vision.

Bengaluru: The entire world is facing the challenge of Covid-19 disrupting health, social and economic status of a country. The number of people affected is alarmingly increasing posing a threat to life. Among the health workers, the mortality has been significantly high due to the constant exposure to the high viral load.  Since we do not have an effective anti-viral drug against the COVID 19, there is a need to depend on other safety measures to combat this menace.

In the light of the current situation, Germkill India have innovated a completely bio organic product “Citrobioshield” which has been time tested for anti microbial activity to be very effective against Covid 19. This was today announced in collaboration with BRAINS Hospital where this product has undergone detailed preclinical testing for the last three months and has been proven very effective.

Citrobioshield is 100% natural and organic

This fact has been tested extensively as per the international norms using the standard assessment measures stringently by the certified labs. The data is quite robust and supportive of the fact that citrobioshield has an effective viricidal activity especially against Covid 19. Therefore, this innovative product can be used at all healthcare as well as high risk areas where community is  at risk to reduce the  viral load in the environment. This is a very unique product and highly effective in preventing and combating the Covid 19 illness by a simple process.

Citrobioshield is 100% natural and organic broad spectrum, multipurpose antimicrobial with effective activity against SARS-CoV2 virus. This is Made-in-India antimicrobial, stable upto 108 degree centigrade and fulfills all the criteria for an ideal disinfectant while being safe for the environment, humans and animals. It is essentially an extract of citrus fruits containing sinensis and citrus reticulate (Bio flavonoids).  It is formulated and manufactured in Bangalore by Germkill India.

Citrobioshield is made by using only certified organic bio – degradable ingredients and manufactured according to the regulatory requirements of Govt of India. Citrobioshield is a Made-In-India product that has been extensively evaluated using international standards of testing (ASTM and EN standards) both in India and abroad.

Citrobioshield has a rapid onset and long lasting bactericidal, fungicidal and viricidal activity. The 10% Citrobioshield solution was completely viricidal for SARS-CoV2 with a contact time of just 10 minutes. It has been tested and found effective against many microorganisms of clinical significance (such as Methicillin resistant Staphylococcus aureus, Pseudomonas, Candida albicans, E Coli ,SARS-CoV2, HIV) in both laboratory and clinical settings.

Clinically tested  and completely safe:

This product has undergone detailed preclinical testing and has been shown to be non-toxic in animals by both oral and inhalation routes. Citrobioshield inhalation has been clinically tested in COVID19 patients and found to be completely safe. It is odorless, non-carcinogenic, non-mutagenic, non-irritant and not allergic. Citrobioshield is usually administered as fog using special equipment. The liquid will get evaporated as fog along with few droplets.   Citrobioshield fogging can therefore be easily adopted for regular disinfection at various places including hospitals, community gathering areas and closed spaces such as schools, offices etc,.

Since it is a biological product, non corrosive and non inflammable, it does not cause any damage to the epithelium nor  to the  sophisticated machines.  Hence, no displacement of equipment or people is required while fogging.  Together with broad spectrum antimicrobial activity, Citrobioshield can safely be used for disinfection and can be readily used at hospitals, wards, ICUs and operation theaters to disinfect surfaces, beds, instruments and ventilator tubings. Frequent fogging can be performed between the two procedures without delaying the routine work.

Citrobioshield retains robust viricidal activity, especially against SARS-CoV2 on surfaces including tiles and stainless steel. Citrobioshield is non toxic and not harmful for cleanroom environments and therefore suitable for BSL2 and 3 facilities that require stringent sterility measures. Citrobioshield is all in one solution, tested on viruses containing both lipid and non lipids , bacteria , fungi and resistant  spores. Hence, it is an ideal  agent that can be adopted in all healthcare locations, for its efficacy and ease of application.

“Citrobioshield is a fresh ray of hope in the fight against the COVID 19. I am extremely happy that this product has good antiviral activity that can protect the personnel as well as environment. It is a matter of pride that this is a  make in India product from Bangalore,” says, Dr. R Nagaraja Naidu the inventor and Founder of Germkill India.

Dr. R. Nagaraja further added, “The entire testing process has been conducted and validated as per the ICMR guidelines. Hence, we recommend that this should be adopted as a routine sterilization process as well as a preventive measure for the Covid 19 at all healthcare destinations. We sincerely request the Govt. of India and the respective state governments direct the authorities for such implementation.”

“Citrobioshield is an excellent and elegant product, simple to use, safe and effective.  It is our moral responsibility to protect the healthcare workers who are the frontliners in the battle of COVID 19. We are using this at our hospital extensively to protect the staff and also for sterilizing the  medical equipment and  ICUs” said Dr N K Venkataramana, Founder Chairman & Chief Neurosurgeon, BRAINS Hospitals.

The post Germkill India launches Citrobioshield ffective against COVID 19 appeared first on Health Vision.

Mother’s Nutrition has a lifelong impact on the child’s mental and physical heath. Maternal Malnutrition and Child Under nutrition results in stunting in less than 5 years age children and also Low Birth Weight (LBW). This has long term consequences like poor cognitive skills and susceptibility to infections.

India has a unique challenge which is the double burden of malnutrition. The CNNS (Comprehensive National Nutrition Survey) highlights overweight and obesity is common in Indian children also. A staggering 54% of Indians are anaemic. Hidden Hunger or micronutrient deficiencies are common in both the urban and rural population. Malnutrition in several forms is found in early adolescence and they also fail to meet the requirements of Physical activity. With more screen time and increase in consumption of junk foods there is increase in many micro nutrient deficiencies in both genders.

According to CNNS survey (2016-18) Top 3 Deficiencies in Boys & Girls

India being diverse in culture and food habits and varied socio economic strata it is difficult to tackle the problem of maternal malnutrition and under nutrition. Adhering to local traditional foods, RUTF (ready to use therapeutic foods) and sourcing local crops and produce is one simple and effective way to address local concerns in villages and districts. Communication in local language by the Health and ASHA workers on the importance of Nutrition will slowly bring about a change in the society. Socio Economic environment also contribute to malnutrition such as Gender Bias in the society (girl Child is neglected in some culture) education, sanitation & hygiene and of course poverty.

Key points to emphasize to tackle Malnutrition:

• Adequate Nutrition with Iron and Folic Acid Supplementation for women of Reproductive age and Expectant mothers
• Only Breast Feeding for the initial 6 months
• Infant and Young child feeding Practices to be counseled and its implementation monitored
• Introduction of Right Complementary Foods at 6 months along with Breast feeding
• Prevention of Anemia with Iron and Vitamin C rich foods
• Sanitation & Hygiene
• Prevention of Diarrhea
• Distribution of Fortified foods through ICDS (Integrated Child Development Services) and PDS (Public Distribution System)
• Sourcing locally and encouraging local farming to be self-sustained
• Emphasizing on Dietary Diversity
• Monitoring SAM ( Severe Acute Malnutrition) children in Anganwadis
• Education to school kids on importance of Nutrition

With Covid-19 ravaging most parts of World including India the burden of Protein Energy Malnutrition is also predicted to become worse. Effective Communication in Local languages on the right local foods to consume and ensuring Food Security to all will go a long way in reducing Malnutrition.

Sreemathy Venkatraman
Clinical Nutritionist & Dietician
Brains Hospital
Bangalore

The post Poshan Maa First 1000 days -India’s challenge is malnutrition. appeared first on Health Vision.