Fireworks are used worldwide to express festivity and cheer especially in India during Diwali. But if the fireworks are not handled under supervision or guidance it could lead to injury to skin and eyes. These eye injuries can cause serious and irreparable damage to vision. Every year during Diwali, hospitals notice several fold increases in firework injuries. Lack of awareness on safety for lighting crackers and not using protective eye gear are responsible for the majority of these injuries. Most susceptible to injuries during Diwali are members of the pediatric age group who are not under the supervision of responsible adults.

Fireworks responsible for a large number of ocular injuries:

Firework injuries are responsible for a large number of ocular injuries. Generally, patients complain of a foreign body sensation, ocular pain, reduced vision, redness, tearing and photosensitivity or photophobia. The most common injuries include hyphema, eyelid injuries, traumatic iridodialysis, retinal detachment and corneal abrasion,” said

Fireworks can also cause lid and ocular surface chemical and thermal burns. This in turn can lead to corneal opacity and blindness. Sometimes it causes globe perforation and intra ocular foreign bodies in the eye due to projectile injuries. This can lead to irreversible loss of vision.

Use protective eye gear while bursting crackers:

Therefore, this Diwali, it is imperative that one uses protective eye gear while bursting crackers and while children should actually not be allowed to burst crackers at all, if they have to, they must do so under strict parental supervision.

Ideally fireworks should be set off outdoors in a clear area, away from houses, dry leaves or grass or other flammable materials. One should always keep a bucket of water nearby for emergencies and for pouring over fireworks that fail to ignite or explode. Never light fireworks in a container, especially a glass or metal container and never try to relight or handle malfunctioning fireworks. Just soak them in water and dispose safely. Even spectators can be at risk so it is advised that safety instructions be followed and fireworks be viewed from at least 500 feet away.

Further, projectile fireworks, like rockets and bombs, which are responsible for the majority of injuries, should be strictly avoided. Even the seemingly harmless sparkler fireworks can be dangerous, as they burn at more 1093 degrees celsius, therefore sparkler mishaps have also been known to create serious eye injuries and even death.

The DO’s and DONT’s in case of eye injuries :

1. Don’t use any eye drops without doctor’s advice.

2. Don’t rub your eyes

3. Don’t rinse your eyes

4. Don’t apply pressure

5. Don’t remove any objects that are stuck in the eye.

Dr Venkatesh Babu

Consultant, Ophthalmologist

Dr. Agarwal’s Eye Hospital Bengaluru

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November 6, 2020: COVID-19 doesn’t seem to spare anyone, and especially to those having comorbid conditions such as diabetes. In India, 73% of the COVID-19 deaths are linked with comorbidities including diabetes, hypertension, cardiovascular and respiratory diseases, reveals the data of the Ministry of Health and Family Welfare, GoI. Undoubtedly, Diabetes has been observed among the most common comorbidities in COVID-19 patients.

In the diabetes awareness month, to know the role of diabetes in aggravating diabetes onslaught, the truth behind COVID induced diabetes and other diabetes-related issues were discussed at length in ‘India COVIDiabetes E-Summit’ organised  by the ‘Healthcare Advocacy Group’ — HEAL Foundation in association with ICCIDD on 5^th Nov’ 2020.

‘India COVIDiabetes e-Summit’ was the 10^th Episode of the HEAL-Thy Samvaad series, wherein public healthcare experts, Diabetologists, Endocrinologists and heads of medical research bodies participated vigorously; deliberated on different topics of the e-Summit and supported to celebrate ‘Blue Diwali’ with a purpose to inculcate awareness around diabetes amongst the masses and its prevention as ‘Blue-colour’ depicts the sky that vaults all national borders: A way of saying diabetes affects us all. Coincidently, first time in 20 years World Diabetes Day (WDD) and the festival Diwali are falling on 14^th November 2020.

During the keynote address of ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad on ‘Best learnings of Diabetes Management in COVID-19 Times and ‘COVID induced diabetes: A reality or a myth’ Dr Shashank R Joshi, Padma Shree Awardee, Chair, International Diabetes Federation, South East Asia, Dean, Indian College of Physicians, Endocrinologist, Joshi Clinic, Lilavati Hospital, Apollo Sugar Clinic & Bhatia Hospital while answering a question put by Dr Swadeep Srivastava, Founder, HEAL Foundation and co-moderator of the E-Summit on the Indian Sugar Mills Association (ISMA’s) campaign of encouraging Indians to eat more sugar endorsed by the govt., said, “I condemn this initiative as this is not something we are proud of. Every 6 second, we are losing people with diabetes on the planet. We are in ‘Diabetes Awareness Month’, it is important to recognise that sugar kills. And sugar is a form of tobacco. I think trying to promote excess consumption of sugar is detrimental to health. And, such type of initiative if it is done by the govt., probably, I think, it hasn’t had the oversight of the health department, and I am certain that health department and experts will take it into cognisance and they will make their course correction. Probably, this has been done without their knowledge. It may have done by the sugar bodies to increase sugar consumption.”

“We have two things — we have severe malnutrition in India and that might need a little bit of sugar, normal healthy people need a little bit of sugar with exercise. Unfortunately, we are sedentary Indians and we keep eating, we love sweets. But caloric access is not recommended. All Non-communicable diseases can be increased by diabetes. Remember why diabetes is a big disruption in COVID because sugar is a cultural medium to grow any virus. As far as COVID-induced diabetes is concerned, so many patients who neither had diabetes nor any family history before they were contracted with COVID-19, but after 3-4 months, they are diabetic. Yes, there is COVID-induced diabetes as a distinct entity,” added Dr Joshi.

Answering the Indian Sugar Mills Association (ISMA’s) campaign of encouraging Indians to eat more sugar endorsed by the govt., while addressing the ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad, Dr Navin Verma, Assistant Director, Centre for Non-Communicable Diseases, NCDC, New Delhi, said, “Malnutrition maybe a component which needs to be addressed but not by promoting sugar in general. And definitely, if health ministry or other ministries have different opinions regarding this, they should sort it out. He further added that government has already issued guidelines in August to screen every diabetic patient. As lifestyle activities are the sheet anchor of all non-communicable diseases and diabetes is also a non-communicable disease, we need to correct our lifestyle to stay healthy.”

Elaborating on the COVID’s role in aggravating diabetes onslaught, Dr AK Jhingan, Chairman, Delhi Diabetes Research Centre, said, “Diabetics are very prone to COVID-19 infection. The normal morbidity in COVID is 2.3% while in diabetics, it is 7.3% — three times more. I have seen during the COVID scourge that elderly people, as well as 60% of males with diabetes, are the most vulnerable lots. As far as the sugar intake is concerned, the American Heart Association recommends for the male to take 36 gm and to women 24-25 gm added sugar daily.”

Addressing the ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad, Ms Shilpa Joshi, RD, Director, Mumbai Diet and Health Centre, Vice President, Indian Dietetic Association, Hon’ble Secretary-All India Association of Advancing Research in Obesity, said, “One of the greatest problems in Indian diet is the high content of carbohydrate. We need to reduce it. Usually, people take 60-65% carbohydrate in their diet while it shouldn’t be more than 50%. Ensure that the fat intake should be from natural sources only. Micronutrients like Zink, Vitamin B-12 must be provided to the COVID-19 patients to prevent infection. We need to hydrate with water and not with Cola. Increase the intake of fruits and vegetables and decrease the carbohydrate contents from the diet.”

While moderating ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad, Dr J Kumar, Group Medical Director, Paras Group of Hospitals, said, “Diabetes is a normal indisposition but during COVID times, people with comorbid conditions such as diabetes has turned vulnerable. Not to speak of COVID, if you are not keeping yourself healthy, any infection can attack you. So, the take-home message is — everyone needs to be careful and diabetics should be extra careful during COVID times to stay healthy and safe.”

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