Science, experience, and learnings pertaining to COVID-19 test is evolving at a global level. From what we have already learnt at our COVID Lab at Metropolis, we present to you this useful information which may help you understand the nuances of the test.

Is it possible for a person to test positive without having symptoms at all?

Yes, it is possible. Globally, it has been observed that few patients remain asymptomatic and yet test positive.

A positive result means that these individuals are silent carriers of the infection. A recent ICMR study said that 80% cases tested positive in India are asymptomatic.

If your result comes positive, as per protocol your result is notified to the ICMR and the state health authorities. It is important not to panic because of a positive result and follow the guidelines as advised by the authorities.

How reliable is a POSITIVE test result?

Positive results are considerably reliable based on following criteria:

  1. The RT PCR Test involves two parts; a screening test as well as confirmatory test before the patient is declared “POSITIVE”. This acts as a double check on the final result that is given to you.
  2. During testing, multiple genes are detected for a patient to be labelled “POSITIVE”.

What is a false-negative result and why does it happen?

Currently, the RT PCR is the best test available to test for COVID 19. At times, there is a possibility of having a false-negative result. A false negative result means a patient’s test result is negative even though the patient has the virus in the body.

A false negative result may happen when a patient undergoes testing very early in the infection, that is within one to two days of infection. A repeat test after 2-3 days may become positive.

A false negative result may be reported if the sample is not collected properly. A nasopharyngeal swab is collected from deep inside the nose and an oropharyngeal swab is collected from deep inside the throat. Improper collection leads to not having enough virus in the sample for it to be detected during testing.

Another reason for a false-negative result is when the sample is not stored or transported properly. The RT PCR test involves detection of the Viral RNA. If sample is not transported or stored properly, the RNA in the virus tends to get inactivated or damaged and is undetectable.

The samples need to be transported in a special viral transport medium and at Metropolis, we ensure that sample integrity is maintained by following proper protocols during sample collection, storage, and transport.

Is it possible that a patient is tested POSITIVE at one lab and subsequently tested NEGATIVE in another lab?

This is very much possible and below is the explanation for the same

If testing is done few days apart with fresh samples taken at each lab: When you test for COVID 19 at one lab on a particular day and when you undertake the test at another lab after a few days, chances of a different result is very high because virus in the body gets reduced day by day. Patients who have good immunity clear the virus faster and may test negative within the 4th or 5th day. Studies show that virus can get cleared as early as 4.3 days of infection.2 This is also the reason why some people have no symptoms and still test positive.

If same sample is tested at two labs: If the same sample is tested at two different labs, the results in an ideal scenario should match. However, if the results do not match, there could be multiple reasons. Different labs use different kits, and this has a direct consequence on the test result. At Metropolis, we use kits, subject to availability, that were found to be 100% concordant in true negative and true positives, in study done by ICMR. Also, if the sample is not transported properly from one lab to another, the virus may get inactivated leading to a difference in the result.

If new sample is taken on same day: Suppose you have a negative result from one lab and if a fresh sample is taken and tested at another lab on the same day, the results should match. If the results do not match; the reason could be the use of different kits and if the sample collection is not done correctly as explained above.

Is it possible that a patient is tested NEGATIVE at one lab and then tested POSITIVE at another lab?

  1. If a patient gets tested too early (< 2 days of infection), there is chance of the first test being false negative. On repeat testing after a few days, the patient may be reported positive.
  2. Improperly collected sample as explained above may result in false – negative and a repeat test may be positive.
  3. The RT PCR test involves detection of viral RNA. The RNA particle is extremely labile which means that it disintegrates and gets inactivated if sample is not stored or transported correctly. This may lead to a difference in results.
  4. If different type of sample is used for test. RT PCR test can be performed on different types of samples: nasopharyngeal sample, oropharyngeal sample, saliva, or sputum. All these samples have different sensitivity levels. So, if a nasopharyngeal sample was tested negative the first time, if the same person gives a sputum sample in the second test, there will be a difference in test result. In India, testing is not allowed on sputum sample at present.

How does one know that he/she is free from virus?

If you test negative twice 24 hours apart, as per current guidelines, you may be discharged from patient care. However, there are exceptions cited in literature and patient may still shed virus in stool for 4 to 5 weeks after infection. 6 That is why it is important to continue following the safety precautions and guidelines.

References:

  • Yang et al. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections
  • Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases.
  • Kelvin et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study.
  • Carl et al. SARS COV 2 viral load and severity of COVID-19
  • ICMR revised testing strategy for Covid19 in India, 20 March 2020.
  • Yongjian et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples
  • MCGM, Revised guidelines for COVID-19 testing
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Heart, the little organ sitting in our chest, works continuously throughout our life. It keeps on pumping and circulating blood in our body.

While our heart works tirelessly to keep us going, we do our bit by damaging it in every possible way -many a times subconsciously.

On World Heart Day which falls on 29th September, let us come together and make conscious efforts to know this very important organ and vow to take care of it.

What is heart and what are its functions?

The heart is a muscular organ that pumps blood and circulates it throughout our body, making up the circulatory system. The blood carries oxygen and nutrients to the body tissues which is the basic requirement of survival.

What are the different ailments of heart?

Heart failure is the deadliest among all the heart problems but to reach to that point the heart goes through a number of phases. It starts from Angina or chest pain due to blockage in the blood vessel supplying blood to the heart muscle. If remained untreated it may eventually lead to Myocardial Infarction or Heart Attack in common terms which happens because of death of cardiac muscle cells. Other ailments in this cycle are LVH (Left Ventricular Hypertrophy), IHD (Ischemic Heart Disease) and CHD (Congestive Heart Disease). Other ailments like Valve diseases and Cardiomyopathy are also common in the Indian Population.

The most common of them all which leads to high rates of mortality and hospitalization, is Heart Attack. Let us understand what the possible indicators of the onset of heart attack could be.

Signs and Symptoms of heart attack:

Many people, who have a heart attack, pose with some warning signs while some remain totally asymptomatic. The early warning signs of a heart attack include:

  • Breathlessness
  • Cold Sweat
  • Palpitation
  • Pain in upper body parts

Severe signs and symptoms include

  • High to very high chest pain
  • Severe pain in upper body parts, mainly shoulders and upper arms
  • Nausea and Dizziness
  • Heavy Breathing

What are the risk factors of a heart attack?

A heart attack can occur to anyone but there are some risk factors that enhance the susceptibility to an attack. They are categorized into Uncontrollable and Controllable risk factors.

Uncontrollable risk factors:

  • Age- In Today’s fast-moving world people as young as 35 years of age are also vulnerable, however the prevalence is more common in age group of 60+.
  • Sex- Men are more susceptible as compared to women. However, post menopause, women become more susceptible.
  • Race- People of African descent are more susceptible.
  • Family History- People who have a family history of heart ailments are at a greater risk.

Controllable risk factors:

  • Smoking
  • Alcohol consumption
  • Obesity
  • High cholesterol
  • Unhealthy diet
  • Lack of exercise
  • High Sugar Levels
  • Stress

How can you prevent a heart attack?

There are many risk factors that are not in your control but of course, there are risk factors which we can control.  Following are some basic tips that keep away the chances of a heart attack.

Adopting a healthy lifestyle should be the first step in dealing with the possible chances of a heart attack. Quitting the awful habit of smoking should be on top priority. Other things that can be done to improve the health of the heart are:

  • Maintaining a heart-healthy diet

There are many heart-healthy foods that cut off the chances of a heart attack. The best foods for heart health include:

  • Fishes with high omega-3 content like salmon, mackerel, trout, herring, and tuna
  • Nuts like almonds and walnuts
  • Dark beans like black beans or kidney beans
  • Berries like blueberries, cranberries, raspberries, and strawberries
  • Red, orange, and yellow vegetables like carrots, red peppers, sweet potatoes, etc.
  • Fruits like papaya, oranges, etc.
  • Dark chocolate
  • Flax seeds
  • Tofu
  • Regular workout

Working out regularly is a must. Indulge in any physical activity like running, swimming, yoga, or a sport.

  • Quit alcohol and smoking

Alcohol consumption and smoking do irreparable damage to the heart. Quit them as soon as possible.

  • Regular Check-ups

Regular heart check-up is really necessary. Keep a tab on your lipid, sugar and weight levels. Consult your doctor at regular intervals.

The Bottom Line

Maintaining a proper heart health is the only thing that could keep us going. On this World Heart Day, come together and pledge that we will know our hearts and will always take care of it.

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Dr Anita Suryanarayan, Vice President (South India & Sri Lanka), Metropolis Healthcare

The modern woman plays many roles, and her health is of paramount importance in helping her get through the day. Every woman’s health is dependent on and affected by a variety of factors. It is important that every woman after a certain age, goes for regular physical check-ups to be forewarned of any ailment. Diseases like diabetes, high/low blood sugar, calcium deficiency, thyroid malfunction and such can be detected with simple tests, undertaken periodically.

Here are 10 important health tests that every woman should make note of:

Body Mass Index Check

Body Mass Index (BMI) is a measure of body fat based on the individual’s height and weight. There are multiple apps and online BMI Calculators that can calculate your BMI by dividing your weight in kilograms by your height squared in metres, on entering your height, weight, gender and age. The BMI Calculator then analyses the intensity (high, medium or low) of the individual’s BMI and compares the data with others in the same height and age bracket.

Anaemia Check

A person is considered anemic if they have a low count of RBCs in the body. Low haemoglobin (HGB) level in the red blood cells leads to low absorption of oxygen in the blood, physical weakness or dizziness.

Vitamin Deficiency Check

It is common to find Indian women who have a deficiency in Vitamin D and B12. A deficiency in Vitamin B12 for women who are planning for a pregnancy or are pregnant could result in a problematic pregnancy. Vitamin D is extremely critical to maintain healthy bones and calcium absorption, as calcium depletion sets in with age.

Blood pressure screening

Check your blood pressure every two years starting at the age of 18. Ideal blood pressure for women is less than 120/80 mmHg (millimetres of mercury). In case of persistent high-blood pressure, do a stress test as well.

Blood glucose tests

Women should get a blood glucose test every three years starting at the age of 45 to test for diabetes or pre-diabetes. However, if you have a family history of diabetes, then begin early and start getting your blood sugar checked in your 30s itself.

Cholesterol check

Women should have their cholesterol checked, at least periodically post 25, to decrease the risk of heart diseases. If the results are normal, the AHA recommends testing once in three years.

Pap smears and pelvic exams

Recommended to begin at 21 or even earlier if women are sexually active, this is an important test to reduce risk of cervical cancer, which is the second leading cause of death in women.

Mammograms and breast exams

A manual exam where a doctor tests for lumps and abnormalities is recommended from the age of 20 up until 40. It is recommended to do a mammogram every one or two years beginning at age of 40, as recommended by the American Cancer Society.

Bone density screening

Women should start getting screened for osteoporosis with a bone density test at age 65. However, those who have been detected with calcium deficiencies or have a personal or family history of fractures should get a DEXA scan earlier.

Colon cancer screening

It is ideal to begin a colon cancer screening at age 50 and is typically performed once in five or ten years depending on the technique used. An Abdominal Ultrasound would be apt. For this exam, a technician moves the transducer (A small microphone-like instrument that gives off sound waves and picks up the echoes as they bounce off organs) along the skin over your abdomen. This test can be used to look for tumors in your liver, gallbladder, pancreas, or elsewhere in your abdomen. A non-invasive virtual colonoscopy is another option. Those with a greater risk of colon cancer may need earlier or more frequent cancer screening tests.

To lead a healthy inside and happy outside life it is important to ensure you keep your body in check and go for regular tests. It’s time you made your health a priority!

Metropolis Healthcare brings to you the most advanced labs with scientific state-of-the-art facilities backed by the experience of over 2000+ technicians, 500+ pathologists and over 100+ MD pathologists to give you the accurate results of your blood test. We have a track record of doing 30mn+ tests every year with the most accurate results, because we re-check, re-check and re-check to give you the best.

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Monsoon is the season that conveys satisfaction to our life as it makes nature cool after the hot and searing sun is done with its dominance over the late summers. Yet, even the cool downpour of the monsoon, brings with it negative health impacts from which you need to secure yourself. Truly, there are a lot of health issues that are brought about by monsoons and we ought to be very careful to protect ourselves from it. In the event that you have children and elderly individuals at home, they will be truly powerless on natures influence and might develop symptoms of certain infectious diseases.

So, Here are some Expert Tips by renowned Doctors to help you Enjoy the Monsoon:

Ensure that you have a clean surrounding

Drink a lot of water and other liquids to flush out toxic materials from your body

Almonds, yogurt and curd keep up the required hydration levels in the body

Drink green tea and other fluids that detoxify you and keep your system clean

Say no to street food. At least till the monsoons are over

Image Source:

Maintain a strategic distance from the utilization of foods that are prone to infections

Eat apple, mango, pear, and pomegranates

Stay away from direct contact from contaminated patients

Use hand sanitizer routinely

Make proper use of mosquito repellent and keep yourself covered

Following these rules helps you to stay sheltered and solid amid monsoons. Continuously fling on nourishing food sustenance’s and be hygienic by taking essential preliminary measures like cleaning your home, washing your hands properly, and so on. If you fall sick or have a prolonged fever make sure you consult your doctor and get a blood test done because you might be suffering from an infectious disease.

Metropolis brings to you the most advanced labs with scientific state-of-the-art facilities backed by the experience of over 2000+ Technicians, 500+ Pathologists and over 100 MD Pathologists to give you the accurate results of your blood test. Whether it’s Dengue or Malaria or any other test, we have a track record of providing you with the most accurate results, because we re-check, re-check and re-check to give you the best.

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Almost, everybody likes and waits for the rainy season after going through the scorching summers. While rains is the time to enjoy hot tea and snacks, but monsoons are additionally the time when infectious diseases are on the ascent. Because of the warm, wet and muggy atmosphere, diseases get to be regular amid the monsoons.

There are some regular monsoon infections that you should know of and that’s why we at Metropolis have decided to do this post, to help you survive the monsoon infections like a boss.

So, Here is a list some prevailing monsoon diseases and ways to prevent them:
Typhoid:

This nasty water-borne infection is brought about by the consumption of contaminated water and dirty sanitation. The regular effect of typhoid is high fever, tormenting pain in the abdomen area and cerebral pain. Additionally, a sore throat can likewise indicate that you might be suffering from typhoid.

How to Prevent This Disease?

  • Drink boiled water
  • Avoid Street Food
  • Wash Your Hands often
  • Avoid cold food

Jaundice:

Jaundice can be a really painful experience. It is a kind of sickness that is caused by excessive bilirubin in the blood and causes your skin to become yellow. The worst part of it is that, the sickness harms your liver beyond imagination.

How to Prevent Jaundice?

  • Keep a check on your lifestyle
  • Drink clean water
  • Get hepatitis vaccinations
  • Avoid excessive alcohol
  • Eat healthy food

Malaria:

Malaria is a disease that is caused by the reproduction of female anopheles mosquito in spots containing stagnant water. This is the most common disease during the monsoons. The normal manifestations of this disease incorporate high fever, tormenting pains in the body, body chills, sweating and vomiting.

How to Prevent Malaria?

  • Use mosquito repellent
  • Wear long sleeves
  • Use a mosquito net during the night

Dengue:

This disease is normally caused by Aedes mosquitos and they have a track record of frequently wreaking havoc upon your well-being. They usually attack during the early mornings and bring destruction upon your life. The most common symptoms of Dengue are extremely high fevers, rashes and severe pain throughout the body.

How to prevent Dengue?

  • Wear protective clothing
  • Make sure there is no stagnant water near your home or inside your home
  • Use as much as mosquito repellents possible
  • Screen your windows

Leptospirosis:

Leptospirosis is otherwise called Weil’s disorder. It is brought about by contact with muddy water or garbage. The basic manifestations of leptospirosis are cerebral pain, inflammations, tormenting muscle cramps and high fever.

How to prevent Leptospirosis?

  • Cover yourself completely when you step out of your home
  • Don’t neglect cuts and bruises
  • Cover your feet

In case you get fever, it is always better to consult your doctor and get yourself diagnosed to find out what tests are to be done for the season. However, while a large number of today’s medical tests generate exact results, false negative or positives do happen and are a common phenomenon.

A false negative is a test outcome that indicates that a person does not have an ailment or condition when the individual really has it. Correspondingly, a false-positive test result demonstrates that a person has a particular ailment or condition when the individual really does not have it. Hence it is important to choose an accredited laboratory which will give you accurate diagnosis so you don’t lose time in beginning the right course of treatment.

Metropolis Healthcare brings to you the most advanced labs with scientific state-of-the-art facilities backed by the experience of over 2000+ Technicians, 500+ Pathologists and over 100+ MD Pathologists to give you the accurate results of your blood test. Whether it’s Dengue or Malaria or any other test, we have a track record of doing 30mn+ tests every year with the most accurate results, because we re-check, re-check and re-check to give you the best.

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Ovarian Cancer – Do You Know How To Fight it?

Being a woman is tough. Among other challenges, being a woman also biologically increases the risk of certain disease and health problems. Ovarian cancer is one such example.

Some common cancers affecting women
While certain cancers have been proven to have gender preferences (for example Gall Bladder Cancer), women have to deal with a complete set of gynecological cancers unique to their biology reproductive functions. These include cancers of the uterus, cervix, and ovaries. Though less commonly known, Ovarian cancer (referring to any cancerous growth that occurs in the ovary) is the 5th most common cause of cancer deaths in women globally. It also has the highest rate of death among all gynecological cancer, with the 5-year survival rate being as low as 46%.

Majority of ovarian cancers arise from the epithelium (outer lining) of the ovary. In extreme cases, the cancer may spread to other organs in the pelvic region, like the fallopian tube, uterus, bladder, colon, or rectum.


Known causes of ovarian cancer
Although, the precise causes are not known, there some known and observed risk factors for ovarian cancer.

  • Family History: Women with close relatives who have had ovarian cancer, or breast cancer, have a higher risk
  • Genetics: Women with mutation in genes BRCA1 and BRCA2 have 50% chances of developing the disease
  • Age: Mostly beyond 65 years of age
  • High number of ovulations and late menopause
  • Infertility or fertility treatments
  • Women who have been diagnosed with breast cancer
  • HRT (Hormone replacement therapy)slightly increases a women’s risk of developing ovarian cancer
  • Obesity and being overweight
  • Suffering from endometriosis

Symptoms of ovarian cancer
Signs and symptoms of ovarian cancer are frequently absent or very subtle in the early stages. As such, most women are diagnosed with cancer only at a later stage.

Early symptoms include:

  • Pain in the pelvis
  • Back pain
  • Pain during sexual intercourse
  • Pain on the lower side of the body

As the cancer progresses, following symptoms may manifest:

  • Feeling constantly bloated
  • A swollen tummy
  • Discomfort in your tummy or pelvic area
  • Feeling full quickly when eating, or loss of appetite
  • Needing to pee more often or more urgently than normal
  • Breathlessness

How to diagnose ovarian cancer?
The first step of diagnosis is to get a blood test done to measure the level of a protein called CA125, followed by an ultrasound scan. If the test results suggest the possibility of ovarian cancer, the patient should then consult with gynecological oncologist for further tests and diagnosis.

What are the treatment options for ovarian cancer?
Treatment options for ovarian cancer depend on the stage and extent of the cancer. The medical oncologist may recommend a single type or a combination of various treatments. Some of the most effective treatment modes for ovarian cancer are as follows:

Surgery – The surgical removal of the tumor is the most common approach.  In extreme cases, the surgery includes removal of the ovaries, fallopian tubes, uterus, nearby lymph nodes, and omentum. This is called a total hysterectomy.

Chemotherapy – In this treatment option, patients typically receive a combination of carboplatin (Paraplatin) and paclitaxel (Taxol) intravenously.

Hormone Therapy – Hormone therapy may be added to the treatment plan in order to cut off estrogen supply to the cancer cells and slowing their growth.

Oncologists may sometimes use radiation therapy if there are small traces of cancer in the reproductive system, but not as a standalone treatment.

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We are what we eat!

Our health is a combination of a number of external and internal factors. Genetics and environment work in synergy to make us who we are. One of the most popular factors, and perhaps the most significant one, is food. In the age of instant over sharing and ensuring aesthetic over quality, we often see but don’t really understand what is on our plate.

Most people are aware of common food allergies and how to deal with them, regardless of whether they suffer from it or not. Food intolerance on the other hand isn’t a widely popular or understood concept, as it should it. One may think that dish was under cooked, or a spice overpowered the whole dish, or the food contained ‘something that didn’t sit well with me’ and attribute to it as a cause of a physical reaction of discomfort after eating certain foods. Seldom do people realize that they may be intolerant.

Food Allergy and Food Intolerance: The Difference
Many think that food allergy and food intolerance are same, but actually they are not. Food Allergy is caused due to an immune reaction towards a specific food protein (allergen). Food intolerance is actually a digestive system response to certain foods. Food Allergy is an acute immediate reaction, whereas food intolerance is a chronicle reaction. For example, lactose intolerance is a condition where one’s body cannot successfully digest milk. It does not make a person allergic to all milk byproducts.

Trends in India 
Metropolis Healthcare is one of the first labs to conduct a detailed research study using the Protein Microarray Biochip Test for Food intolerance. Using the microarray biochip, 220 food items are embedded on the chip and fluorescence Elisa is used for reporting. The data collected by Metropolis was analyzed age-wise and food item wise and the Percent positivity were calculated. Cut off levels were set, so that based on the values generated from the test researchers can then identify whether the food tolerance for the patient was normal, borderline or elevated. Only patients who had elevated results were retested after a specified amount time recommended by the doctors. The final results of the test found that most women, men, and children are intolerant to cow milk and wheat.

Testing and Management
The reason it is most essential to know what food or ingredient one is intolerant to is that long-term consumption of non-tolerated food causes gut inflammation and accounts for development of various chronic diseases. This in turn may lead to several other health problem and serious chronic conditions. Elimination of diets based on food intolerance testing is recommended in irritable bowel syndrome, atopic dermatitis, and more such conditions.

Most doctors believe that the protein miccroarray food intolerance test is a better tool for identifying Food Intolerance in the most non-invasive, adjuvant, objective and quantitative manner. The information provided by this test gives better insight for diet planning in terms of avoidance or usage of alternate sources for certain foods. Patients can further seek better guidance and interpretation of the reports from gastroenterologist and dieticians to correct their eating habits.

Those who are taking the test need to keep some points in mind. The patients need to include everything they normally eat in their diet for at least two weeks before testing. This test is not recommended for children under 2 years and pregnant women.

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1

Over 70% of the population deficient in Vitamin D 
Do you experience regular body aches and feel tired all the time, for no plausible reason? There’s a good chance your body may be lacking a sizeable amount of Vitamin D. Detailed research and data analysis of over 103563 samples during the last 5 years in Chennai, between the age group of 0 to 80, has revealed the alarming extent of the Vitamin D crisis. A majority of the people tested (60%) displayed symptoms of insufficient Vitamin D presence. About 20% of the population was declared as being deficient while a rare 1% suffered from hyper-vitaminosis. Only 16% of the total population had sufficient levels of Vitamin D, but shockingly, this range featured the least number of children aged 10 to 20.

Why do we need Vitamin D?
Popularly known as the ‘Sunshine Vitamin’, Vitamin D is produced by the body in response to the skin being exposed to sunlight. It rarely occurs in nature otherwise, though few foods have been credited to being good sources of the vitamin. As a fat-soluble type of vitamin, it is stored in the body tissue and helps us utilize the calcium from our diet. Vitamin D deficiency or insufficiency can lead to bone mineralization, which may in turn result into bone softening diseases.  Rickets, for example, is common in children with severe deficiency and conditions like osteomalacia and osteoporosis in adults.

Why are we deficient in Vitamin D?
It is easy to wonder how such a large population lacks a nutrient available abundantly and freely in nature. The recent spike in the trend of Vitamin D deficiency, not just in India but globally, may be attributed lack of physical activity and closed-door work life. A large chunk of the population is working desk-jobs limiting their movement and consequent exposure to the sun. Kids these days have started staying in with digital game rather than sweat morning to evening kicking a football around. Increased consumption of adulterated and processed foods has also weakened our bodies, which had resulted into insufficient synthesis of Vitamin D.

One of the major challenges in identifying and overcoming this health concern is that a majority of the population is not even aware that they may be deficient. People are quick to ignore symptoms such as fatigue and ache or attribute it to stress. Recent studies in India indicate that despite exposure to sunlight for 30 minutes, the body cannot reach adequate levels of vitamin D. One theory also suggests that this could be due to our ethnicity and dark complexions, in addition to excessive use of sun blocking products.

Whatever the underlying cause may be there is a clear need for supplementing the diet and fortify it with Vitamin D. Certain foods with high Vitamin D content are fish, beef liver, egg yolks. Vegetarians can consume almond milk, soymilk, orange juice, cereals and mushrooms.

Testing and management
The modern, urban lifestyle doesn’t actively allow us to consume the right foods or give us time to get the daily dose of sunshine required by the body to create Vitamin D. Hence, it is important to get tested for vitamin deficiencies or insufficiencies and seek medical help to correct the condition.

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10 Important Health Tests for every Woman

Body mass index: This one is easy. There are numerous apps and online BMI Calculators that can calculate this for you. All you need to key in is your height and weight. A BMI on the higher side indicates obesity, which can assess the risk of serious health conditions like diabetes and heart disease.

Anaemia: Studies done by Metropolis suggest that 1 in 2 Indian Women are anemic. A largely vegetarian meal coupled with lack of awareness has led to the increasing trend in Anaemia. It is important to know you root cause of anaemia to efficiently treat it. Unusual exhaustion and dizziness indicate anemia. Read more about anaemia here.

Vitamin Deficiency: Indian women are deficient in Vitamin D and B12. To lead a healthy life, it is important for you to check the status of your vitamins and take corrective action. A deficiency in Vitamin B12 for women who are planning for a pregnancy or are pregnant could result in serious consequences. Vitamin D is extremely critical to bone health and calcium absorption. We recommend all women to get their vitamin levels checked.

Blood pressure screening: This is an extremely important and an easy screening to perform. It is generally believed that BP screening needs to begin post 40s but this is a test that needs to be done every two years starting at age 18. This health screening involves wrapping a cuff around the arm and pumping it up tightly. Ideal blood pressure for women is less than 120/80 mmHg (millimeters of mercury).

Blood glucose tests: Women should get a blood glucose test every three years starting at age 45 to test for diabetes or pre-diabetes. Before age 45, you may need to have your blood glucose levels tested if you have symptoms of diabetes or several risk factors. Your blood sample can be taken and tested at your doctor’s office or a lab. The range of normal test results can vary, but generally a test result of 100 mg/dL or higher indicates pre-diabetes or diabetes.

Cholesterol check. Women should have their cholesterol checked at least periodically post 25. If the results are normal, the AHA recommends testing once in three years. This screening is important for decreasing your risk of heart disease and is a very simple blood test. The ideal level is below 200 mg/dL (milligrams per deciliter) for total cholesterol.

Pap smears and pelvic exams: Recommended to begin at 21 or even earlier if you are sexually active, this is an important test to reduce risk of cervical cancer.  Cervical cancer is the second leading cause of death in women due to cancer and this can be entirely avoided by regular screening. . Barring any problems, women age 30 and older only need a Pap smear every three years if they have had three normal tests in a row.

Mammograms and breast exams: All prevention tests start early and so is Breast Cancer. A manual exam where a doctor tests for lumps and abnormalities is recommended starting around age 20 up to until 40. A mammogram is a screening test for breast cancer and involves applying moderate compression to the breasts so that X-ray images can be captured. Mammograms are done every one or two years beginning at age 40 as recommended by the American Cancer Society

Bone density screen: Women should start getting screened for osteoporosis with a bone density test at age 65. Women with risk factors for osteoporosis, such as having a slender frame or a fractured bone, should be screened earlier. For this test, you lie on the table while a scanning machine takes X-ray images of certain bones in your body. Healthy bones show a T-score (the measurement used to describe your bone density) of -1 or higher. The frequency of this health screening varies from woman to woman based on bone density and risk factors.

Colon cancer screening:  It is ideal to begin screening at age 50 and is typically performed once in five or ten years depending on the technique used. There are multiple screening tests for Colon Cancer, one of the traditional kind is called sigmoidoscopy, a procedure in which a lighted tube along with a camera are inserted through the anus to look at the lower part of the colon. While on the other hand, a colonoscopy involves a longer tube to examine the entire colon. With normal results, a flexible sigmoidoscopy needs to be repeated every 5 to 10 years and a colonoscopy only every 10 years. The non-invasive virtual colonoscopy is another option. People with a greater risk of colon cancer may need earlier or more frequent cancer screening tests.

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Do you feel fatigued and energy draining out of you all the time. Does your child have difficulty concentrating? Or does she feel dizzy? Do you have leg cramps? Can’t fall asleep even if you are tired?

These are not symptoms of exhaustion or a long day at work/school but indicate a probable cause of Anaemia! Did you know that Anaemia is the most common condition that affects Indian women? Research done by Metropolis Healthcare indicates that 1 in 2 women in India are anaemic and that puts a large number of us under risk.

Also you would be surprised to know that there are over 400 different types of Anaemia. So adding a lot of spinach to your daily food may not help at all. While the most common reason for Anaemia is Iron Deficinecy, there are many other types of Anaemia and it is important to find out the exact cause.

Symptoms of anemia will vary depending on the type and cause, but include:

  • Fatigue and loss of energy
  • Unusually rapid heartbeat, particularly with exercise
  • Shortness of breath and headache, particularly with exercise
  • Difficulty concentrating
  • Dizziness
  • Pale skin
  • Leg cramps
  • Insomnia

Now let’s look at different types of Anaemia and Symptoms pertaining to each one of them

Type of AnaemiaSymptomsManagement
Anaemia caused by iron deficiency: Craving for paper, ice, or dirt/mud/chalk (a condition called pica) Soreness of the mouth with cracks at the corners A smooth or sore tongueWith iron deficiency anaemia your doctor may recommend iron supplements that contain the ferrous form of iron, which your body can absorb easily. Always consult with your doctor before taking iron supplements. Excess iron intake can be harmful.
Anaemia caused by vitamin B12 deficiency: A tingling, “pins and needles” sensation in the hands or feet.  Loss of sense of touch. An unsteady, wobbly gait and difficulty walking For vitamin B12 and folate deficiency anaemia, the treatment depends on the cause of the deficiency. If your body stores are depleted of vitamin B12, your doctor is most likely to prescribe vitamin B12 injections
Anaemia caused by chronic lead poisoning: Blue-black line on the gums referred to as a lead lineAbdominal pain, Constipation,  Vomiting, Seizures in severe cases, especially in childrenLead poisoning is treated by discontinuing exposure to lead and administering a medicine that binds and draws lead out of the body.
Anaemia caused by red blood cell destructionJaundice (yellow skin and eyes)Brown or red urine, Leg ulcersFailure to thrive in infancySymptoms of gallstones, Seizures, Abdominal painThe treatment of haemolytic anaemia may be tailored to the underlying cause. It is important to consider altering or stopping any medication or agent that is causing the condition.
Sickle cell anaemia: Fatigue, Susceptibility to infectionDelayed growth and development in children, Episodes of severe pain, especially in the joints, abdomen and limbsDoctors usually begin treatment that includes stimulation of a different type of hemoglobin which reduces the severity of the conditions

So lets look at some of most common tests used to screen for anaemia and diagnose the root cause:

Complete Blood Count

Often, the first test used to diagnose anemia is a complete blood count (CBC). The CBC measures many parts of your blood.The test checks your hemoglobin and hematocrit levels. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of haemoglobin indicates anaemia.

The CBC also gives information on mean corpuscular volum abbreviated as MCV. MCV is a measure of the average size of your red blood cells and a clue as to the cause of your anemia. In iron-deficiency anemia, for example, red blood cells usually are smaller than normal.

Other Tests and Procedures

If the CBC results show that you have anemia, you may need other tests, such as:

Hemoglobin electrophoresis: This test looks at the different types of hemoglobin in your blood. The test can help diagnose the type of anemia you have.

A reticulocyte count: This test measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate.

Tests for the level of iron in your blood and body: These tests include serum iron and serum ferritin tests. Transferrin level and total iron-binding capacity tests also measure iron levels.

To find out the exact cause of Anaemia, your doctor may recommend tests for conditions such as as kidney failure, lead poisoning (in children), and vitamin deficiencies (lack of vitamins, such as B12 and folic acid). In case a case of internal bleeding is suspected, then a stool test for blood is performed may be along with an endoscopy.

In rare cases, bone marrow tests are also performed to check if bone marrow is making healthy and enough blood cells.

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