Are you feeling off-balanced or experiencing sudden feelings of dizziness or losing focus? These might be frightening sensations one can get. Though the sensation may last for only a few minutes, it can make people sick and limit their motion. Commonly known as vertigo, this condition is a symptom of an underlying health problem or multiple health problems.

“Vertigo” is one common type of dizziness. The sensation can last for a short time or it can stay for a few hours or days. Vertigo can make you feel like you are moving or like the room is moving around you, even when you are still. Vertigo can be caused by a number of different problems involving the inner ear or brain. One can experience the condition at any time. It can be while walking down the street or while sitting at the office that you may experience the false sense of your surroundings moving around or you moving around it.

Symptoms of vertigo

• Spinning (or the room is spinning around you)
• Tilting or swaying
• You tend to feel off-balanced

These symptoms can be at times frequent or irregular.  You may feel worse when you move your head, change position, cough, or sneeze. Depending on the triggers for vertigo, one may also show the following symptoms.

• Nausea or vomiting
• A headache or sensitivity to light and noise
• Double vision, trouble speaking or swallowing, or weakness
• Shortness of breath, sweating, or a racing heartbeat

What causes Vertigo:

Many conditions can lead to Vertigo. It is predominantly due to an imbalance in the inner ear or could be due to a problem associated with the central nervous system. Other common reasons for vertigo is benign paroxysmal positional vertigo which occurs due to the calcium build up in canals of the inner ear and vestibular neuritis which leads to ear infection and that causes inflammation around the nerves that help the body sense balance. Among the other conditions that can lead to vertigo are migraine, head injury, headache, ear surgery, brain stem disease, and stroke attack. Certain types of medications can also trigger vertigo. Sometimes, prolonged bed rest can also be one of the causes of vertigo.

When to seek help?

If you are having any symptoms of dizziness or vertigo along with other conditions like headache, fever, you should consult your doctor immediately. Seek help from the doctors when you have the following symptoms along with vertigo.

• New or severe headache
• Fever higher than 100.4ºF (38ºC)
• Double vision or having trouble seeing clearly
• Trouble in speaking or hearing
• Weakness in your arm or leg
• An inability to walk without assistance
• Passing out
• Numbness or tingling
• Chest pain
• Prolonged Vomiting

Risk factors of vertigo:

• An older adult (60 years or older)
• Have had a stroke in the past
• Have risk factors for stroke (eg, high blood pressure, diabetes, or smoking)

Vertigo is not a very dangerous condition, except that the sudden sensation of dizziness or imbalance can lead to discomfort. Few people may experience vertigo or dizziness at irregular intervals and they may not have any of the other symptoms. In such cases, it is advised to consult your doctor for further examination. Depending on the problem the person is facing, the doctor can recommend the following tests.

• Examination of the eyes – Your doctor might ask you to follow an object with your eyes or focus on something while moving your head from side to side.
• Examination of balance and gait – This test involves watching the way you walk. This is to see whether you lean or tilt to one side while walking and also to check your balance while your standstill.
• Hearing test – Your doctor or nurse will check your hearing in both ears.

Additional tests might include an imaging test, such as magnetic resonance imaging (MRI), to look at the structure of your brain.

Treatment:

Disease-specific treatment If the cause for your vertigo is identified, then the doctors will suggest medications, procedures, or lifestyle changes. In a few cases, treating the underlying condition relieves or resolves vertigo. This will also help in slowing disease progression and improving the overall prognosis.

Relieving vertigo and related symptoms — If the episodes of vertigo are severe or last for hours or days, then the doctor may recommend a medication to relieve severe vertigo and associated symptoms, like vomiting. Treatment with medication is not usually recommended if your vertigo lasts only seconds or minutes.

If you feel you are losing balance while standing and continuous dizziness, it is recommended to visit the Ear and Vertigo Clinic and the neuro-equilibrium vertigo assessment team. Visiting hospitals are safe as they are taking all the necessary precautions for patient’s safety.

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Once considered as a flu-like infection, COVID-19 has gradually shown us that this is nothing like Influenza and related flu-like illnesses. It has revealed its other myriad manifestations. Other than its well known respiratory manifestations, patients who are symptomatic with COVID-19 can show symptoms involving other organ systems. Presentation with neurological problems, muscle pain, low platelets, cardiac problems, etc is not uncommon. Ignoring early symptoms of COVID-19 and subsequent delayed diagnosis/treatment has often led to respiratory complications resulting in hospitalization in serious to critical condition. Patients with co-morbidities such as uncontrolled diabetes, morbid obesity, renal failure, and immunocompromised conditions such as organ transplants, blood-related malignancies pose a far higher risk as opposed to patients without these pre-existing health conditions.

We have been fortunate to have faced the pandemic after several other countries earlier in the year. The experience of medical professionals from these countries has shed light on some complications of the viral infection that ultimately lead to fatality. One of the most worry-some and life-threatening complications with COVID 19 is the formation of blood clots in multiple arterial systems. These blood clots or what is called ‘thrombosis’ occur in the arteries and prohibits/slow down blood flow. This can lead to stroke, heart attacks, and such. Hence one of the most important aspects of the treatment of COVID-19 in a significant number of patients includes medications that prevent or treat these blood clots.

30-year-old Mahesh (name changed on request) presented to the Emergency room in Columbia Asia Hospital, Whitefield with severe abdominal pain, a few days after being discharged from another hospital in the vicinity with COVID-19. He was subsequently admitted to Columbia Asia hospital for treatment of “infarct” in the right kidney due to thrombosis or blood clots in the right renal artery. This was a complication of his recent COVID-19 infection.

Dr. Naveen Chandra, Consultant, Interventional Cardiologist, Dr.NarendraReddy, Consultant, Vascular surgeon Intensivist team lead by Dr.Ramkumar from Columbia Asia Hospital, Whitefield evaluated the patient for the unusual complication and started the treatment accordingly. Furthermore, an angiogram was performed and doctors confirmed the presence of blood clots or thrombosis in the right kidney. This led to ischemia or reduced blood supply to the kidney, leading to an infarct. Immediately, thrombus extraction was performed. He was managed with blood thinners(anti-coagulants) and COVID-19 related medications accordingly. The patient was successfully discharged within a week of admission.

Elaborating on the case Dr. Naveen Chandra, Consultant, Interventional Cardiologist, Columbia Asia Hospital Whitefield said “It has been shown very conclusively now that COVID-19 infection not only causes respiratory problems but also can induce blood clots in arteries leading to life-threatening complications and morbidity as well. We see an increase in the incidence of heart attacks, strokes, clots in pulmonary vessels duringCOVID-19 infection. Early recognition and timely treatment are crucial in improving outcomes for the disease”.

Dr.IndiraKedlaya, Consultant, Internal Medicine/Geriatrics, Columbia Asia Hospital Whitefield added “Initiation of anticoagulation(blood thinners) for few weeks are just as important as treating the infection itself in a large number of COVID patients. They are treated with injectable blood thinners in the early course of the disease and continued upon discharge either with injectable blood thinners or oral blood thinners for a few weeks. But in Mahesh’s case, he developed clots despite being on these medications. Hence a high index of suspicion is required to identify and successfully treat such complications.”

Mahesh has now recovered and has been discharged from the hospital on oral blood thinners. He has followed up in the outpatient department and continues his recovery process.

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Breastfeeding is one of the important factors for a newborn and the mother. Especially when it is a premature baby, introducing the baby to the mother’s breastmilk takes a lot of effort. Breastfeeding can act as a shield to protect premature babies from most of the health issues they develop in the initial stages. If the baby is premature and accepts the mother’s milk, it helps in reducing problems like gut gangrene and infection thus aiding in quick recovery and early discharge.

Babies are considered to be pre-term if they are born before the 37th week of pregnancy. If the babies are delivered before 33 weeks, they are not strong enough to be breastfed thus keeping them away from the required nutrition. Until about 32 weeks, babies cannot coordinate sucking, swallowing, and breathing during breastfeeding or bottle-feeding. The reflex of sucking and swallowing is established only after 34 weeks. Hence, mothers need to extract breast milk to feed the baby.

Preterm can be divided into 3 different categories.

1. Extreme preterm – babies born in less than 28 weeks
2. Very preterm – babies born between 28-32 weeks
3. Moderate to late preterm – babies born between 32 to 37 weeks

It is important to understand that the feeding procedure could be different for the different gestation periods. Although breastfeeding a premature baby is not always easy, following these tips can help you get your preemie breastfeeding experience off to a good start.

Pump it and save it:

Premature babies can’t always nurse effectively. The mothers have to pump the milk which will then be fed to the babies through the feeding tube.

Child delivery can be an overwhelming experience. However, trying to pump the breast milk within a few hours of delivery is important for a better breastfeeding outcome. Also, it is crucial to pump the milk often as the baby needs frequent feeding. Preemie moms may have to pump milk about 8 times a day.

Read about breastfeeding:

Although breastfeeding is a natural process, it may not come naturally for all. Therefore, it is crucial to read about breastfeeding and also consulting the lactation consultant. They will help the preemie mom to breastfeed effectively. The first drops of milk which are secreted is called the colostrum which is rich in antibodies and is important to feed to the baby.

Skin to skin contact:

Irrespective of the birth weight, skin to skin contact of the mother and baby helps in ensuring warmth and aids in the initiation of breastfeeding.

Feeding on the breast:

Once the premature baby is more than 34 weeks of gestational age, while holding the baby, they may try to move towards the breast. As they grow stronger, these babies can be breastfed directly. In this stage breastfeeding and tube, feeding can be combined.

Breastmilk is vital to the baby. Every drop of milk that the baby gets is like medicine – strengthening and building their immune system and providing the nutrition they need to grow.

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Cancer remains among the most dreaded diseases of our times as it brings drastic change in the lives of the patients dealing with it and those around them. Cancer is almost like a battle that the patient fights but it’s a battle that engulfs all those around the patient as well. Diagnosis of cancer brings along a crisis for the patient as well as the primary caregiver of the patient. Along with the right treatment and the medicines, cancer requires the patient’s will power and determination. In this, a significant role is played by those around the patient who not only need to be a strong support system for the patients but strengthen their own self.

Becoming a caregiver for a cancer patient usually comes suddenly and under extreme circumstances when the person is least prepared, has uneven guidance and usually does not have the sufficient healthcare support to begin with. With the increased awareness towards cancer, the delivery of care towards the cancer patients has also seen a shift. The advancement of treatment has extended the survival rates and that in turn has enhanced the role of caregivers. It has been observed that adequate support from caregivers benefits the patient.

In providing care to a cancer patient, a caregiver needs to be prepared mentally, physically, psychologically on a day-to-day basis. From daily activities like visiting the doctor, making meals to providing emotional support, patient’s caregiver needs to cover a vast expanse of responsibilities. Appropriate involvement of caregivers is necessary for optimal treatment of cancer patients. Being a cancer caregiver consists of fulfillment of multifaceted role and several tasks. The demanding role also needs a lot of patience.

The role of a caregiver majorly involves taking charge of providing physical support, emotional support, clinic visit support, meal-prep support, and mental strength. Some of the ways in which caregiver helps the cancer patients include:

Family frame: Proper support from a caregiver enables the patient fight through the battle but not alone and hence ease the struggle to some extent. Cancer takes a toll on the family but a good caregiver can help to avoid anyconflict between the family, the clinical team and also help in dealing with the changing condition of the family.

Emotional and mental well-being: Dealing with cancer is an emotional and mental test as the person needs to constantly uplift themselves and keep up with the deteriorating changes in one’s body as well as the surroundings. Having someone with you in such a taxing time boosts the spirit and help in overcoming the cancer struggle.

Financial support: A caregiver also needs to be prepared for financial changes, not only provide the patient with monetary aid for the treatment but also be ready for some deductions at times in the income as the patient might have to quit their professional life.

Apart from taking care of the cancer patients, the caregivers themselves experience physical and psychological concerns and become vulnerable towards depression due to the stress involved. Providing care and support to a cancer patient is a challenging task. The caregiver must maintain his/her own psychological as well as physical health. Some of the tips that a caregiver can keep in their mind are:

• Take care of yourself. It can be hard to maintain your health and balance for a long time as the stress builds up. The stress can have both physical and psychological effects
• Cancer treatment’s journey is a long one and requires patience to deal with one’s own thoughts as well as with that of patient’s.
• It’s alright to ask for help if you have any confusion or are feeling too stressed as a caregiver. Take an honest look at what you can and cannot do.
• Make time for yourself and recharge your mind, body, and spirit to be a better caregiver.
• Educate yourself about the illness and the medical treatment.

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Pune: Columbia Asia Hospital Whitefield celebrated World Kidney Day by felicitating the donors and transplant patients as token of gratitude. India being called the diabetes capital of the world, awareness of organ donation is very important, as diabetes also plays a major role in kidney failure.

The event was graced by Dr. Chaitanya Pathania General Manager, Dr. Namita Sinha Verma (Chief of Medical Services), Dr. Manoharan B ( HOD – Dept. of Nephrology), Dr. Pallavi Patri (Sen. Consultant – Nephrology) & Dr. Hari Prasad ( Consultant – Nephrology).

Event was inaugurated by lighting the lamp of Hope by the post-transplant Recipients & Donors along with Dr. Chaitanya, later followed by a keynote by Dr. Manoharan B & Dr. Pallavi Patri & a presentation given by Dr. Hari Prasad on How to Prevent Kidney Disease.

There were around 50 participants gathered in the event from which 10 were post-transplant recipients & donors & 15 were the dialysis patients. The transplant patients shared experiences about their pre & post treatment & answered the queries raised by the gathering.

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