It is a no-brainer that aging causes your body organs to get old too. This results in a range of health problems in old age. According to the National Council on Aging, close to 92% of elderly have at least one chronic disease, and 77% have at least two.

Keeping aware about the common health problems your seniors might face helps plan for the prevention and stay prepared for any impending health emergency. Want to take care of your elderly in the best possible ways but not sure where to start? Check their 33 health parameters with a single health checkup. Book test now.  

Here are 6 most common health conditions in elderly and ways to manage them:

1. Heart disease:

The heart is one of the most vital body organs that pumps blood to various parts of the body. Aging can cause changes in the heart and blood vessels, increasing the chances of heart disease. This is a chronic condition that causes close to two-third of all deaths among the aged. The concern gets manifold since the symptoms of heart disease are not always apparent and are highly likely to get ignored. Ways to prevent and manage heart-related ailments in elderly include

  • Keeping check and restricting the intake of bad fats (trans fats and saturated fats).  
  • Motivating to cut down on alcohol (or remove it altogether) and quit smoking
  • Exercising at least 20-30 minutes every day
  • Limiting daily salt intake to reduce sodium consumption

2. Diabetes:

This is chiefly a lifestyle-related condition that results in an inability to process sugar by your body. High blood sugar can have serious long-term effects on the health and can also lead to kidney disease, heart diseases, etc. The risk of getting diabetes increases as one ages. In fact, adults aging 65 or older are at a greater risk of becoming diabetic.

Ways to prevent and manage diabetes in elderly include

  • Avoiding a sedentary lifestyle and keeping active in day-to-day routine
  • Reducing carb and unhealthy fats in the diet
  • Testing for blood sugar levels from time to time
  • Taking medicines (and not skipping any dose) as advised by your doctor

3. Dehydration:

This means that your body lacks enough levels of fluids. Absence of adequate body fluids can have an adverse impact on your health, particularly in old age, because it can be linked to other serious problems like urinary tract infections, electrolyte imbalance, etc.

Ways to prevent and manage dehydration in elderly:

  • Drinking at least 3 litres of water every day. People with heart failure need to be watchful of excess water intake.
  • Limiting the intake of fluid-depleting drinks like alcohol and caffeinated beverages
  • Taking more of fruits, herbal teas, etc.

4. Chronic constipation:

Not able to defecate properly and feeling full is a fairly common problem in elderly. This might not have any immediate serious implication, but when it becomes frequent and severe, it can lead to troublesome issues such as bloating, indigestion, nausea, and stomach pain. The major cause of constipation can be as simple as a lack of physical activity and fiber in diet.

Ways to prevent and manage constipation in elderly:

  • Including more fruits and green leafy vegetables in the diet to consume more roughage
  • Keeping well-hydrated
  • Exercising regularly to maintain healthy bowel movements
  • Seeking expert help if the lifestyle changes do not help

5. Conditions related to mental health:

Similar to physical health, mental health tends to deteriorate with age. This pretty well explains why around 15% of people aging 60 and above are affected with at least one mental health condition. Elderly people are likely to develop Alzheimer’s disease, depression, and anxiety.

Ways to cope with most of these mental health problems need a customized approach, however, following steps can help in a generalized manner:

  • Staying connected with neighbors, family, and friends. Virtual connect amid the pandemic is of utmost importance if you can’t be around your loved ones 
  • Adopting a pet
  • Picking up a new hobby like gardening, knitting, pottery, etc.
  • Journaling to keep a check on feelings and emotions

6. Bone and joint related disorders:

Conditions such asosteoarthritis, rheumatoid arthritis, and muscle aches are common in elderly. In fact, arthritis affects almost half of all people of age 65 and older. Bone and joint related disorders can have a massive impact on the quality of life as they affect your participation in daily activities.

Ways to manage symptoms related to bone, muscle and joint-related conditions in elderly include:

  • Participating in physical activities within your range of movements
  • Taking enough of calcium and vitamin D rich foods to never fall short of these nutrients
  • Ensuring to get enough sun
  • Including various anti-inflammatory foods in the daily diet such as nuts, seeds, fatty fishes like salmon, etc.
  • Getting tested for arthritis and related conditions as and when advised by your doctor
  • Having fall support in bathrooms to avoid any accidental fall

Along with following measures to prevent or manage health conditions in your elderly, make sure to shower your love and care in every possible way! That’s indispensable.

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It is easy to measure how much weight you have gained and how faster you can walk a mile. Calculating your heart health may not be that straightforward, but knowing just a few numbers can provide a pretty accurate picture of your current heart health. Tracking these numbers is important as it motivates you to maintain healthy numbers and improve the less healthy ones. The better aware you are of these numbers, the higher your control on your cardiac health will be.

Here are the 6 numbers you must know for a healthy heart

1. Blood Pressure:

The ideal blood pressure range is 120/80 mmHg or less. The upper number is systolic blood pressure, which measures the pressure your heart exerts on artery walls while beating. The lower number is diastolic blood pressure, which measures the force of your blood against the artery walls when your heart is at rest between heartbeats. Blood pressure often, but not always, rises as you age. If it’s too high, it strains the heart and arteries. Over time, high blood pressure or hypertension can cause the heart to enlarge or weaken. It is often called the silent killer, because it usually lacks obvious symptoms but it raises risks of heart attack, stroke, heart failure and kidney disease. It is recommended that you check your blood pressure at least once every two years after the age of 18, and once every year if you are at an increased risk of high BP or age 40 or older.

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2. Blood Glucose:

While blood glucose levels are an indicator of diabetes, they also help predict your heart health. That’s because people with diabetes are twice as likely to have risk of having a heart attack or stroke.

Your blood sugar level can fluctuate depending on the time of day, when you eat and what you eat. The most commonly used way to take a reading is a fasting blood glucose test. Fasting blood glucose levels less than 100 mg/dL is considered normal. Levels of 100 to 125 mg/dL indicate prediabetes. Anything above 125 mg/dL is considered diabetes. Your doctor may also order a hemoglobin A1c (HbA1c or glycosylated hemoglobin) test. The A1c test measures your blood sugar levels over the previous three months. No fasting is required for the test. Normal A1c reading is below 5.7 percent.

3. Blood Cholesterol:

Cholesterol is a waxy, fat-like substance that your body needs to perform natural functions like, digesting foods, producing hormones, and vitamins; but the clause is to get the right amounts only. The two main types of cholesterol produced by your liver are low density lipoprotein or LDL, the “bad” cholesterol, and high density lipoprotein or HDL, the “good” type. Measured together, along with 20 percent of your triglyceride level, they add up to your total cholesterol score. An ideal cholesterol score is less than 200 mg/dL; between 200 mg/dL and 239 mg/dL is borderline high. A reading of 240 mg/dL and above indicates high cholesterol. LDL cholesterol levels should not be more than 100 mg/dL. Focus on tamping down your LDL, it can clog up arteries including those that feed your heart and brain. The good cholesterol can help eliminate the bad cholesterol from your bloodstream, but only to a degree.

4. Body Mass Index:

BMI is a ratio of weight to height that tells you whether you’re overweight or obese. Your healthy target is 18.5 to 24.9. A BMI score between 25 and 29.9 is considered overweight; a score over 30 is considered obese, dangerous to your overall health. The higher your BMI, the greater your risk for a wide range of health problems, like heart disease, stroke, high blood pressure and type 2 diabetes.

5. Waist circumference:

Waist circumference is considered a better way to measure body fat than relying on BMI alone. People who have an apple-shaped body carry more weight around their abdomen and have a wider waist; and those having a pear-shaped body have narrower waist as they carry more fat around hips and thighs. It’s believed that apple-shaped people are at a higher risk for heart disease and diabetes, compared to those who have a pear-shaped body. A waist circumference of more than 35 inches in women, and 40 inches or more in men is considered elevated and indicative of increased heart disease risk.

6. Resting heart rate:

Your resting heart rate is simply how many times your heart beats per minute while your body is at rest. For most people, a resting heart rate between 60 and 100 bpm is considered normal, but certain factors like stress, hormones and medication can affect your rate. A lower resting pulse isn’t necessarily a concern because a lower rate is usually a sign of greater cardiovascular fitness. If your heart is in better shape, it doesn’t need to work as hard to maintain a steady beat. However, if your heart rate is abnormally low, i.e., under 40, or you frequently have unexplained rapid heart rates, and either one of these conditions makes you feel dizzy or weak, consult your doctor right away.

Concluding note

Your diet plays an important role in managing and improvising your heart health. Make sure to sit less and keep moving in between working hours. Taking medications when required in addition to lifestyle changes, can provide an extra boost to bring your numbers within the healthy range. Getting tested regularly and tracking your numbers will keep your heart healthier.

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Do you feel tired and lethargic even after being well rested? Are you one of those who constantly complain of fatigue and exhaustion from performing the bare minimum? You need to pay close attention to this, as it might be an underlying symptom of Chronic Fatigue Syndrome (CFS). It is a disorder that is characterized when a person feels too tired or exhausted, even after taking proper rest. It is sometimes also referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).

All of us feel tired, but when this tiredness starts taking a toll on your day to day activities, and lasts for more than 6 months, it is a clear sign of CFS. Other noticeable signs are when you often wake up tired in the morning, or wake up frequently at night without any apparent reason, have troubles doing multitasking, feel dizzy or just feel like lying or sitting again as soon as possible, finding difficulty in fulfilling responsibilities at home or at work.

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Chronic fatigue syndrome is likely to occur two to four times more in women than men, especially women in the age bracket of 40-50. Though most cases are mild, 1 in every 4 cases develop severe symptoms later in their cycle. Nobody is safe from CFS, even children and teens can suffer from CFS. If you have light symptoms, you can manage fairly well, in case you have moderate symptoms, you might have problems moving around or working actively. However if you have severe symptoms, it can affect your life adversely and can be as bad as any heart disease or rheumatoid arthritis. Though these can vanish in some cases, what is known as remission, however these can also return or relapse.

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What causes CFS?

Although researchers and doctors haven’t yet come to any conclusion as to what can be the cause behind suffering from CFS, some researchers claim that following factors might be held responsible:

  • Compromised/weak immune system
  • Excessive stress
  • Hormonal imbalances
  • Genetic predisposition

Recognizing the symptoms of CFS

Though the symptoms might vary from person to person, there are certain signs that can lead you to recognize chronic fatigue syndrome sooner and better. Many of the symptoms of CFS can also be attributed to several other medical conditions. One needs to be watchful of the following symptoms:

  • Feeling tired even after a good night’s sleep
  • Chronic insomnia
  • Extreme fatigue after physical activities (known as post-exertional malaise (PEM))
  • Heart palpitations- fast or irregular heartbeats
  • Difficulty in concentrating
  • Muscle pain
  • Blurred vision or seeing spots
  • Recurring headaches
  • Swollen lymph nodes in the neck and armpits
  • Joint pain without redness or swelling

How is CFS diagnosed?

Currently there isn’t any particular diagnostic test for CFS. In fact, as many as 84%-91% suffering from CFS are yet to receive a diagnosis.

In CFS, people actually don’t look sick, hence the doctor cannot judge what condition they are suffering from.

  • Your doctor might ask certain questions to rule out the possibility of other conditions to draw a conclusion. Doctors might want to know your medical history, they might order some tests such as vitamin D deficiency to rule out other potential causes of your fatigue.
  • You doctors would want to make sure that you at least have the core symptoms previously mentioned, their duration and severity of your unexplained fatigue.
  • They will also need to know the names of all the prescription and over-the-counter medicine you take, in case one of them is causing your symptoms. These may include any supplements, even so-called “natural” or “herbal” remedies that can have potential side effects, and they cause problems if used with other medications you’re taking.
  • Tests like CBC blood tests or urine tests to rule out other conditions, such as anaemia can also be suggested.
  • An underactive thyroid gland needs to be ruled out too.

What is the possible treatment for CFS?

Your medical examiner might suggest some over the counter medicines to tackle sleep disorders. Some doctors also suggest stimulants after weighing the pros and cons of this as it might not be the wisest option for people with CFS, as they can get irritated or agitated real quick. Medicines like ibuprofen or aspirin might help with the joint or the muscle pain that comes with CFS. For tackling orthostatic intolerance, other prescription drugs can be prescribed.

Though there is a lot of research still going on in understanding and finding a cure for CFS, certain lifestyle changes can be beneficial in reducing the discomfort to a great extent. Managing CFS can be challenging for some; they can take help from doctors, therapists, or some support group to tackle the post symptoms of CFS as well as their transition phase to come out more relaxed and happy. Working closely with your doctor is the best option as there is no one-size-fits-all treatment for CFS.

Making some positive changes in your day to day lifestyle can bring in great relief when dealing with CFS. Start with creating a regular sleep routine, if you are in the habit of sleeping in the afternoon, you might want to skip that and instead sleep on time at night. Avoid drinking alcohol and excessive caffeine, to ease insomnia problems. Make every effort to keep stress at bay, that’s really important! Yoga, tai chi, acupuncture, and massages from time to time can also help with relieving some pain that comes with severe CFS. Always consult a doctor before beginning either exercising or going for medication therapy.

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Vitamin A: A vital nutrient

There is no denying that vitamins are important nutrients for day-to-day body functions and optimum growth. Vitamins can be of two types: Fat-soluble and water-soluble. Vitamin A is a fat-soluble nutrient that exists naturally in the foods you eat and plays a vital role in your body. It can also be taken through supplements.

The vitamin A found in food items is of two forms:
1. Preformed vitamin A (retinol and retinyl esters) that occurs exclusively in animal products, like dairy and fish

2. Provitamin A carotenoids that are abundant in plant foods such as fruits, vegetables and oils.

Your body needs to convert these forms of vitamin A to retinal and retinoic acid. These are the active forms of the vitamin that can be further utilized by organs and organ systems.

Food items rich in Vitamin A

Before we take a look at what food items can enrich your body with vitamin A, it is important to note that out of the two forms found in the food, animal-based preformed vitamin A is more readily absorbed and utilized by your body than plant-based pro-vitamin A carotenoids. For this reason, people who follow plant-based diets (vegans) should be cautious about getting enough vitamin A-rich foods.

Animal-based sources of vitamin A:

  • Egg yolks
  • Butter
  • Cod liver oil
  • Chicken liver
  • Salmon

Plant-based sources of vitamin A:

  • Sweet potatoes
  • Pumpkin
  • Carrots
  • Spinach
  • Kale
  • Cabbage
  • Red peppers

Health benefits of Vitamin A:

Vitamin A is vital for a healthy you- it supports cell growth, immune system, fertility and eyesight. In fact, the role of vitamin A in vision and eye health is the most well-known of all.

For a better vision: The active form of vitamin A, retinal A, combines with a protein called opsin to form rhodopsin. This molecule is essential for your color vision and low-light vision. Furthermore, a scientific study has shown that higher blood levels of certain forms of vitamin A (beta-carotene, alpha-carotene and beta-cryptoxanthin) may decrease the risk of age-related mascular degeneration by up to 25%.

Boosts your immune system: Vitamin A is involved in the formation of B- and T-cells that are key players in regulating immunity and guarding against diseases. Studies have demonstrated that vitamin A deficiency can cause increased levels of pro-inflammatory molecules, which play against your immune system.

Fertility and fetal development: Both male and female reproductive systems need vitamin A for optimal functioning as it plays a role in sperm and egg development. This vital vitamin supports fetal development too.

Other functions: Vitamin A helps maintain surface tissues such as your skin, intestines, lungs, bladder, etc.

Vitamin A deficiency:

A lack of sufficient vitamin A levels in the body can hamper several bodily functions and pose a risk of multiple health complications, including:

  • Night blindness
  • Infections, particularly in the throat and chest
  • Hyperkeratosis (dry, bumpy skin) and acne
  • Fertility issues in men and women
  • Delayed growth in children

According to the WHO, deficiency of vitamin A is the leading cause of preventable blindness in children globally. In addition to this, vitamin A deficiency adversely affects pregnant women and fetus by raising the risk of anemia and slowing growth and development, respectively.

Check your vitamin A levels with a simple blood test:

The vitamin A blood test measures the level of vitamin A in your blood. Another name of vitamin A test is retinol test. It is a simple blood test that people can get done with not much discomfort. The needle usually feels like a prick.

Interpreting vitamin A test results

Your test results will tell if you have too much or too little vitamin A in your blood.

Normal values range from 15 to 60 mcg/dL or 0.52 to 2.09 micromol/L. The normal levels can vary slightly among different laboratories since they may use different measurement units or test different samples.

A lower than normal range means you can be deficient in vitamin A and may need to increase your vitamin A intake or take supplements. This may cause mild symptoms like:

  • Dry or inflamed eyes
  • Night blindness
  • Recurring infections
  • Skin rashes
  • Dry skin

A higher than normal value means you have an excess vitamin A in your blood. Too much of vitamin A can also pose health risks and cause symptoms like:

  • Hair loss
  • Loss of appetite
  • Bone and muscle pain
  • Double vision
  • Liver and spleen enlargement
  • Nausea
  • Diarrhea

Don’t get too much of it
Vitamin A is fat-soluble and stored in your body. Thus, it can reach unhealthy levels over time if an excess of it is consumed. Make sure to stick to sufficient levels, get tested from time to time, and steer clear of high dose supplements.

The Takeaway
It is important to keep an eye on your vitamin A levels. Falling short of this vital vitamin can cause multiple health problems ranging from night blindness to chest infections. You can check your vitamin A levels with a simple blood test. Always consult a doctor to know what your test results suggest and how you should move ahead.  

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CRP test: The Basics

CRP stands forC-reactive protein, which is a protein molecule made by the liver. Usually in a healthy person, the CRP levels in the blood are low. However, if there is an inflammatory condition in the body, CRP levels rise. A CRP test measures the levels of CRP in the blood. This can help detect inflammation due to acute health conditions or monitor the disease severity in chronic conditions, including:

  • Bacterial infections, such as sepsis
  • Fungal infections
  • Inflammatory bowel disease
  • Autoimmune conditions like lupus or rheumatoid arthritis

The CRP test has found an important role in COVID monitoring. Got COVID-19 and caring at home? Do get your health parameters checked with our extensive COVID monitoring profile.

At times, high CRP levels may be a sign of a serious infection or other condition.

What type of symptoms may warrant a CRP test?

Your doctor may advise you to get a CRP test if you have symptoms of an underlying inflammation or bacterial infection. Symptoms may include:

  • Fever
  • Chills
  • Rapid breathing or heart rate
  • Nausea and vomiting

Role of CRP test in COVID-19

Based on worldwide data and recommendations from experts, CRP test has become a requisite for people with COVID-19 admitted in hospitals. What is most significant is that elevated levels of CRP may help in early detection of cases that can progress into severe COVID-19.

Though coronavirus is a respiratory virus that replicates in the nose, throat, and lungs, moderate or severe disease can cause hyperinflammation in the body. This dysregulated immune response can be lethal. Hence, keeping a track of inflammatory markers like CRP becomes crucial.
Normally, CRP level in blood is less than 5 mg/L. According to a study that looked at the clinical characteristics of people with COVID-19, a significantly elevated CRP levels (average 20 to 50 mg/L) were seen in COVID‐19 cases. People who had severe COVID-19 had a far elevated CRP level as compared to the people with mild disease. CRP elevations were observed in up to 86% in severe COVID‐19 cases. Another study reported that while those who had severe symptoms had on average CRP levels of 39.4 mg/L, those with mild symptoms had an average CRP levels of 18.8 mg/L. Other evidence has also shown that CRP is increased at the initial stages in the moderate or severe group than those in the mild group. The authors also observed that the chances of developing severe symptoms is increased by 5% for every one‐unit rise in CRP levels in people with COVID‐19.

High CRP levels in COVID-19 cases can indicate the need for hospitalization and advanced treatment modalities. In a study, people who died from COVID‐19 had about 10 fold higher levels of CRP than those who recovered.

CRP Test can pinpoint which COVID cases should get steroids. People with low CRP levels or (no elevation in CRP levels) can be highly likely to recover with just symptomatic treatment, as seen in clinical scenarios.

How long does CRP levels take to normalize?

Usual levels of CRP in blood is less than 5 mg/L. Within 4-6 hours of the inflammatory stimulus, secretion of CRP starts rising, which doubles every 8 hours and peaks within 36 – 72 hours, and returns to normal around 3 days after the stimulus settles down. Hence, your doctor may advise you to repeat CRP after 3 days in COVID-19 if the levels in the previous CRP test were higher, to see if the infection is progressive or dwindling. 

What do the test results mean?

A high level of CRP means you have some type of inflammation in your body. However, a CRP test does not detect or explain the cause or location of the inflammation. Your doctor may order more tests to figure out what’s causing the inflammation. Please note that CRP levels rise in any inflammatory process, and not just COVID-19. Also, some other factors can raise your CRP levels too, such as cigarette smoking, obesity, and lack of physical activity.

Are CRP and hs-CRP tests the same?

A CRP test is many times confused with a high-sensitivity-(hs) CRP test. However, they are not exactly the same.

Both these tests measure CRP levels, but are used to diagnose different conditions. An hs-CRP test measures much lower CRP concentrations and is used to assess risk of heart disease.

Stay informed and take informed decisions about your health tests.

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The second wave of COVID-19 has evoked a sense of fear and devastation in many minds. The pandemic-related lockdowns, health issues of self and loved ones, financial crisis, and inability to meet near and dear ones- all have contributed towards a stressful environment. Fear and uncertainty are dominating our minds.

Social distancing never meant emotional distancing

The COVID-19 pandemic has had a major impact on our lives. Many of us are facing challenges that can be stressful and overwhelming. There is no denying that social distancing is necessary to reduce the spread of COVID-19, but some people have to go through the feeling of loneliness. Human interaction is important and lack of it has become one of the most important causes of pandemic-related stress. Remember, social distancing means physical distancing and not emotional distancing! Stay connected to your friends and family via virtual modes.

Here are 7 Tips to boost your mental health

1. Take breaks from sensational news stories:

It is good to be informed, but if we know that those things are putting us under stress, then we can stop it for some time. Keep yourself away from overtly negative news, especially if you have COVID-19 or have been caring for a loved one at home. Do not check upon daily numbers as it can fuel anxiety. Remember every medium counts from the T.V to the newspaper. Be careful about the balance of watching important news and the news that could cause you to feel depressed and disrupt your mental health.

2. Connect with others:

While social distancing measures are in place, try to connect with your friends and family through social media, by phone or mail etc. It is said that by opening up about your problems, you are getting an extra hand to solve them and you can be relieved to a great extent. Avoid feeling or making others feel negative, which increases your anxiety. Stay in touch with each other. Share your problems with your family and friends. And keep asking them too.

3. Make routine calls to your friend:

It helps to manage your anxiety, and will help to adapt to the present situation. The first thing you have to do in this is to separate your working hours and non-working hours. Do not mix them at all. Try to balance professional and personal lives.

4. Proactively manage your sleep:

Good sleep can prevent many health problems. Being sleepless can increase stress levels. Vice versa, when we are under stress, it directly affects our sleep.

Now the question is, how do we sleep well? If you want to have a good sleep, then you have to take care of a few things.

  • Protect yourself from blue light like mobiles and tablets, at least 1 hour before bedtime.
  • Maintain a proper routine around your sleep and wake times
  • Read books that relieve you of stress
  • Do not see anything that stresses you before you go to sleep.
  • Exercise every day.

5. Start “something” that makes you happy:

Include a few habits in your routine that help you to make yourself happy. Learn singing, dance, paint, play indoor games, read books or write stories- feed your hobbies in your free time. Make time and do not always blame your busy schedule. Try to do something creative in your non-work hours that engages your mind, makes you happy, and helps you to reduce your stress.

6. Exercise as a depression medicine:

Clinical studies suggest that regular exercise produces chemicals such as dopamine and serotonin, which are as effective as antidepressants or psychotherapy for treating mild depressions. Most people will not have access to the gym, so it is necessary to create a daily exercise routine at home. Doctors recommend exercising between 30-40 minutes for 5 days a week. So, make a small start with a 10-minute walk, then add a few minutes daily. Practice meditation on a routine basis.

7. Eat food that helps you overcome stress:

This means eat everything healthy! A well-nourished body is better at dealing with stress. Increase your intake of whole grains, vegetables i.e., especially green vegetables, seeds, olive oil, cruciferous vegetables such as broccoli, cauliflower, cabbage, kale, and Brussels sprouts.


Feel free to talk about mental health. Never feel hesitant when talking about mental health, that is utterly wrong. People should be encouraged to talk about their feelings. It is not necessary that you talk to the family. You can also talk to someone who understands you and gives you the right advice. Take help from various support helplines. Do not give up! We are in this together and will come out stronger and tougher!

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D-dimer: The basics

D-dimer, a fibrin degradation product is a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. This protein is termed as D-dimer because it contains two D fragments of the fibrin protein joined by a cross-link.

Blood clotting is a crucial process that prevents excessive blood loss in case of an injury. Your body physiologically dissolves the clot once your injury has healed. However, in case of a blood clotting disorder, clots can form even when you do not have an injury, or they do not dissolve after healing of an injury. These conditions can be very serious and life-threatening and a D-dimer test can assess if you are suffering from one of these conditions. The D-dimer test has become highly important in COVID-19 pandemic as its elevated levels have been associated with disease severity and mortality trends. If you have been diagnosed or recovering from COVID and worried about how COVID impacted your health parameters, a D-dimer test can give valuable insights into it.  

How is D-dimer produced?

When you get a cut, your body undergoes a sequence of steps to make your blood clump up. It is considered as a normal part of healing, as without a clot, you would keep bleeding and have much more blood loss. However, once the bleeding stops, you do not need the clot any longer as your blood flow gets hampered because of clotting. Thus, your body takes a series of steps in a different direction and breaks the clot down.

At the completion of all processes, D-dimer is the leftover product floating around in your blood and is detectable for up to eight hours after formation until the time the kidney clears it out. Thus, a dimer, a single fibrinogen molecule, is considered as one of the important proteins produced by the liver involved in the process of coagulation. In normal conditions, the levels of D-dimer are low whereas high levels of D-dimer in your blood indicates presence of a major clot.

Several studies suggest that levels of D-dimer may rise sharply in the case of COVID-19 and is associated with the severity of the disease. 

What is the D-dimer test used for?

The test is also known as fragment D-dimer test or fibrin degradation fragment test.

D-dimer test is commonly used to assess a blood clotting disorder including:

  • Deep vein thrombosis (DVT) : a blood clot situated deep inside a vein. Although these clots normally affect the lower legs, they can also occur in other parts of the body.
  • Pulmonary embolism (PE) : defined as a blockage in an artery in the lungs. The most common cause of PE is loosening and travelling of a blood clot from another part of the body to the lungs.
  • Disseminated intravascular coagulation (DIC) : a condition characterized with the formation of several blood clots that further results in organ damage and other serious complications. The most common causes of DIC are traumatic injuries, infections or cancer.
  • Stroke : the blockage in the blood supply to the brain due to a clot in the arterial system of the brain vasculature.

How is the D-dimer test performed?

There is no special instruction for you to follow before undergoing this test. Your health care professional will take a blood sample from a vein in your arm, using a small needle. After the insertion of a needle, a small amount of blood will be collected into a vial. You will feel a little pinch or sting when the needle goes in or out of the skin.

What do the results normally mean?

Different labs may do the test differently, so the normal values of the test may differ. Your doctor can help you understand more clearly what your results mean.
● If the level of D-dimer is within normal limits, it means you probably don’t have a clotting disorder.
● If your levels of D-dimer are higher than normal value, you may have a clotting disorder such as PE, DVT, etc.
However, it cannot assess where the clot is located or what type of clotting disorder you have.

What does an elevated D-dimer in COVID-19 patients mean?

COVID-19 primarily causes lower respiratory tract infection presenting as cough, fever, dyspnea, and lethargy. However, few cases of the infection can progress into its severe forms like multi-organ failure, DIC, etc. Therefore, it is crucial to discriminate appropriately among infected patients, who are at higher risk of severe infection to treat them early for better prognosis. Raising D-dimer values can help identify people who can be at higher risk of COVID-19 complications.

Although the D-dimer test can rule out venous thromboembolism (VTE) in COVID-19 patients, an increased level of D-dimer does not necessarily mean that a patient has VTE. Due to low specificity of D-dimer test, it can be found in several other conditions, such as malignancy, trauma, liver disease, heart disease, sepsis, CPR or recent surgery. Therefore, take help of your doctor to decide your condition in the clinical context. Do not self-medicate or self-diagnose.

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When and how often should D-dimer be measured?

There is no strict guideline as to how frequently D-dimer levels should be tested for management and/or monitoring of COVID-19 patients. Follow your doctor’s advice regarding health tests.

What is the outcome of increased D-dimer in a patient with COVID-19?

Various data suggests that D-dimer greater than 1 μg/ml is strongly associated with in-hospital death of COVID-19 patients.1
Similar findings are evident from other research that showed elevated D-dimer at admission and significantly, increasing D-dimer levels (3- to 4-fold over lab reference range) over time are related to poor outcomes such as increased clots, organ failure, etc.

In a nutshell

A higher level of D dimer in the body is indicative of presence of clot in the body which is regarded as a dangerous sign in patients with COVID-19. D-dimer in combination with other markers can also assist during the treatment of these patients, as the higher their D-dimer is, higher is the number of clots in the lung and the higher the chances of respiratory failure. Thus, D-Dimer test can be used to indirectly measure the severity of COVID-19 disease and assess its complications at an early stage.

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Hi there, how confident are you of your health numbers?

According to most surveys done across the globe, men are less likely to visit doctors as compared to women. In fact, they prefer clinic visits only when they are seriously ill or nagged by a loved one. In a study done in the US, nearly 60 percent of men don’t regularly see a doctor. In another survey conducted overseas, nearly half of the 500 men surveyed said their health is something they don’t talk about. Indian men are no different!

To all the men reading this, make sure to prioritize your health as you do for your family. And for all their loved ones, feel free to nag men in your life to get regular health checkups done and consult a doctor for any discomfort bothering them.

Not sure which health checkups are important to check men’s health, we got you covered.

1. Cholesterol Levels:

According to the American Heart Association, all adults over the age of 35 should get their cholesterol checked every 5 years. You might need to begin screening as early as 20 years of age if you have certain risk factors such as diabetes, smoking, a body mass index (BMI) over 30, family history of stroke, or first-degree relatives who have had deranged cholesterol levels.

You can get your cholesterol levels measured with a simple blood test . It typically looks for three parameters- good cholesterol, bad cholesterol, and triglycerides.

Here is what good and bad cholesterol actually mean.

High levels of bad cholesterol and triglycerides are linked with heart disease, diabetes, and stroke. In general, a total cholesterol level of 125-200 mg/dL is considered normal.

2. Blood Pressure Readings

Blood pressure (BP) is the pressure exerted by your blood on the walls of blood vessels. A high BP puts you at risk of various health conditions like heart disease, kidney disease, and stroke. It is very easy to check your BP numbers at home with the help of a BP monitor. The readings give two numbers: the first is the pressure in your arteries when your heart beats and second is the pressure between beats. The BP values are 120/80 mm Hg or less, it is within the normal range. If your BP is higher, consult your doctor and he/she might want to check it more frequently. A single high reading does not mean your BP is high. Usually, the diagnosis of high BP needs two readings taken 4 hours apart of higher than 120/80 mmHg.

3. Diabetes

Do you know men are at a high risk of getting diabetes as compared to women? The risk of getting diabetes increases as you age. As per guidelines, if you are over age 44, you should be screened every 3 years.

Other risk factors for developing high blood sugar levels include:

  • Having a family history of diabetes
  • Having a BMI over 25. It means that you are overweight. If you are overweight, your doctor can ask to start diabetes screening at a younger age.
  • Having a BP number above 130/80 mmHg
  • Ensure to test your blood sugar level for diabetes regularly. Book an HbA1c test here.

4. Eye Examination

Your eyes are precious! But how often do you really get bothered to consult an eye specialist? Get your eyes examined every 2 to 4 years if your age is between 40 and 54, and every 1 to 3 years for ages 55 to 64. Having an eye examination becomes all the more important every year if you have diabetes.

A quick tip for all those who are glued to their laptops or cellphones 24×7: Make sure to blink your eyes every 20-30 seconds. This lubricates eyes naturally and prevents eye pain and discomfort.  

5. Prostate Cancer

It is one of the top ten leading cancers in India. Men over 65 are more likely to develop this. Furthermore, having a family history of prostate cancer increases your risk of getting this condition. It is a slow-growing cancer, but some types are more aggressive. Screening tests may help in early diagnosis and finding the right support well within time. Health tests for prostate cancer include a digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test. Ask your doctor about your risks and how often you should get PSA testing.

The Final word

If there is a single learning from the pandemic times you need to internalize- let it be keeping your health above everything else! It is high time that you understand the significance of regular health tests. Having your vital health parameters within normal range can not only help you prolong your life expectancy but also amplify the joy of living.

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If you have just recovered from COVID-19, it will be unwise to let your guard down as an ever-increasing number of patients are continuing to experience symptoms after their initial recovery from the disease. COVID-19, caused by SARS-CoV-2, is relatively a new disease, with fresh data being collected on a dynamic basis about the course of the disease, especially in terms of patients being declared “cured”.

Evidence demonstrates that most individuals after COVID infection do gain sufficient antibodies which can prevent their chances of reinfection. However, it is still inconclusive as to how long this immunity lasts. Various cases have been reported where patients have been re-infected. Hence, post-COVID care becomes more important, especially to those who belong to a high-risk category or are not able to take enough preventive measures to additionally protect their immune system. Guidelines recommending adequate preventive measures such as wearing a face mask, washing hands regularly and practicing social distancing should be strictly followed by such patients who have even recovered from the infection.

When is a COVID-19 patient considered “cured” and can resume his normal life?

According to CDC, adults with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset. Most adults with more severe to critical illness or severe immunocompromised likely remain infectious no longer than 20 days after symptom onset.

A patient can resume his routine activities while maintaining COVID-appropriate behaviour on the basis of the extent of damage of lungs and other tissues. The recovery period is likely to be longer for patients who suffered from more severe forms of the disease and those with pre-existing illnesses.

What are the complications experienced by a post-COVID patient?

Recovered patients after acute COVID-19 illness may continue to experience various signs and symptoms including fatigue, body ache, cough, sore throat, difficulty in breathing, etc. Some of the complications seen in patients include deleterious effects on lungs, kidneys, heart, and manifestation of black fungal infection, known as mucormycosis.

Therefore, a holistic approach is essential for follow up care and well-being of post-COVID recovering patients.

Post-COVID Follow Up Care

Nutritious diet
  • Eating a balanced nutritious diet, rich in immune boosting vitamins and minerals including fruits, vegetables, eggs and safe poultry is of utmost importance to speed up recovery
  • Some patients experience unexplained weight loss or weight gain, hence, weight adequate calories must be provided according to the patient’s nutritional status
  • Intake of protein is recommended to be 1.2-1.3 g/kg per day along with the increase in the supplementation of branched-chain amino acids to 50%, in order to prevent muscle loss and enhance the strength of respiratory muscles.
Keep yourself hydrated
  • Drink plenty of fluids.
  • Recommendations suggest that drinking warm water can be helpful for patients with scratchy throat or dry cough as it improves circulation and reduces nasal congestion
  • Addition of anti-inflammatory agents like honey or herbs like “mulethi” in kadhas and other concoctions can additionally aid in immunity.
Rest, exercise and meditation
  • Your body is still weak and susceptible to infections and complications after COVID-19 infection
  • Taking proper rest and sleep can help your body recover faster
  • Do not overstrain yourself
  • COVID patients are advised to practice breathing exercises to improve respiratory distress and relieve congestion
  • Performing the active cycle of breathing techniques (ACBT) with the help of physiotherapist can help you in clearing sputum from your chest
  • Doctors also recommend patients to not stay in bed all day, and try to sit in a chair for meals and perform activities such as short walks to improve physical strength and function
  • Therapeutic mediums, like yoga and meditation including yoga-asanas, such as pranayama, can improve recovery and help in dealing with stress associated with COVID -19 infection.
  • Advice for patients with respiratory symptoms like pneumonia is to rest for a week or 10 days before resuming exercising while patients suffering from chronic cardiac issues should take a break of 2-3 weeks before restarting their pre-illness exercise regimen.
Avoid indulging in deleterious habits

Avoid smoking and drinking alcohol, as they both are considered as risk factors for COVID infection and are deleterious to the healing efforts of the body.

  • Avoid smoking and drinking alcohol, as they both are considered as risk factors for COVID infection and are deleterious to the healing efforts of the body.
Medications and tests
  • Take regular medications for comorbidities as prescribed by your doctor
  • Patients who had a severe infection or breathing issues are asked to self-monitor their temperature, SPO2 levels, blood pressure and blood sugar at home for the first few weeks after being declared COVID free

  • Various tests suggested for patients recovered from COVID -19 infection are:
  • IgG antibody tests: The IgG antibody tests evaluate antibodies in your blood to ascertain how immune-protected you are.
  • Complete blood count (CBC): CBC tests are performed to assess different types of cells in your blood (RBCs, WBCs, platelets). This test can help your doctor estimate how you have responded to the COVID infection. In addition, the test also acts as a guide about the additional measures that are required for your body post-recovery.

  • Glucose, cholesterol tests: COVID -19 infection is known to cause changes in glucose and blood pressure levels of the patient. It is important to undergo these tests and keep track of blood glucose and cholesterol levels, if you have pre-existing conditions such as type-1 or type-2 diabetes, abnormal cholesterol or are susceptible to cardiac complications.

  • Vitamin D test: Vitamin D is an essential nutrient that helps in your immune function, therefore, its supplementation is vital for faster recovery from COVID infection

  • Chest scans: Majority of patients cured from COVID-19 complain about issues related to lungs. High resolution computed tomography (HRCT) scans are advised to diagnose the severity of disease and the residual level of lung involvement caused due to COVID infection.

  • Cardiac screening: Studies have revealed that COVID-19 infection causes widespread inflammation in the body, which further results in injury of heart muscles, leading to complications such as myocarditis, one of the most common problems reported in COVID patients.

In nutshell, an average COVID-19 patient usually takes 3 weeks to fully recover; however, new studies have focussed our attention towards those individuals who may have experienced severe effects on their kidney, lungs and heart, even long after they recovered. Therefore, it is not only crucial to adhere to guidelines of wearing masks, hand hygiene and practicing social distancing, these patients are also encouraged to consistently follow abovementioned practices to keep themselves healthy.

Taking care of a COVID-positive loved one at home? Check the health of the vital organs with COVID monitoring package

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COVID-19 Vaccine effectiveness

It’s been a little over a month since the second wave of COVID left many among us gasping for oxygen and running from pillar to post to save our loved ones. While the daily COVID cases in India have seen a decline in the past few days, our fight against the deadly virus is far from over. So, it is important for all of us to follow the COVID precautions including hand hygiene, social distancing, and masking up. And, we have another weapon against the pandemic- COVID-19 vaccine! Now more than ever, vaccination has become the ray of hope to bring us back the normal lives beyond pandemic.

COVID-19 vaccine in India

Starting May 1, everyone above an age of 18 years is eligible to get a COVID shot. As on May 15 2021, 18 crore vaccine doses have been administered in india. Currently, India has approved three COVID-19 vaccines- Covishield, Covaxin, and Sputnik V. All these three vaccines have proven efficacy against coronavirus (scientific name: SARS-CoV2).

How do vaccines work?

Vaccines contain weakened or inactive parts of a pathogen. When introduced in the body, these attenuated/ inactive pathogen remains act as a trigger and get your immune system to produce protective antibodies and T lymphocytes. Your body now recognizes the pathogen, and will be ready to fight back in a high momentum if it has to encounter the virus in future.

In a nutshell, vaccines provide immunity against infections without being naturally infected.  

Speaking of coronavirus specifically, it has two different types of proteins – spike protein (S Protein) and nucleo-capsid protein (N Protein). The S protein is located on the surface of the virus and the N protein is found inside the virus. The coronavirus gains entry into human cells through its Spike Protein and that is why most vaccines against coronaviruses are designed to target the spike protein. Depending on this target, the vaccines produce different types of antibodies in the body. Though Covishield’s technique employs the Spike protein only, and Covaxin has used the whole inactivated virus, both will produce anti-S antibodies (also called anti-SARS-CoV2 spike protein).

Got vaccinated and want to check if you have developed antibodies? Visit here for details.

Is this the same antibody test which tells us about past COVID infection?

So, the first and foremost thing that you must know is despite being a COVID antibody test, it is different from the antibody test that is taken to look for past COVID infection.

How is the anti-SARS-CoV2 Spike protein test different from the usual antibody test?

The COVID antibody test that is used to confirm past infection with Coronavirus is a Qualitative Test, which means it gives you an idea whether antibodies are present or absent. However, Metropolis has recently launched a quantitative antibody test called COVIPROTECT that gives you an exact measurement of the antibody titres available in your body. The antibodies against Spike Protein can be produced either post vaccination or post natural infection of COVID 19. The spike protein antibodies are generally developed after 2 weeks of second dose of vaccination or 4 weeks of exposure to infection.

The use of previously developed COVID antibody tests is limited in knowing the exposure status than to the actual antibody titre. With the advent of COVIPROTECT, it is likely that the qualitative test would become obsolete soon. As of now, Metropolis offers two types of COVID antibody testing:

  1. SARS CoV2 Antibody Quantitative (COVIPROTECT) (MRP: INR 1200 + Home visit charges)
  2. SARS CoV2 Antibody Qualitative (MRP: INR 450 + Home visit charges)

COVIPROTECT Test: Quantitative SARS CoV2 Antibody Test Against Spike Protein

While you plan to be a bit relaxed about certain routine activities after getting your full dose of COVID vaccine, it makes a lot of sense to know whether your body has developed the necessary antibody to fight the coronavirus post vaccination.

This is where the Quantitative antibody test against Spike Protein comes into play. It is better known as COVIPROTECT by Metropolis. This test uses Blood as the sample like a routine blood test.

When should I get my antibody level tested post vaccination?

It is recommended to go for this test after 2 weeks of your second dose of COVID vaccine to get accurate results.

Can antibody tests assess if your COVID-19 vaccine shot was effective?

The Centers for Disease Control and Prevention (CDC) discourages antibody testing for determining immunity after getting the vaccine. It is very likely for a vaccinated person to get a negative result from an antibody test, even if the vaccine was effective and protective. The major cause is different antibody tests kits used in labs detect antibodies to different parts of the virus. While some kits detect antibodies to the Spike protein of the virus, a few others detect antibodies to the Nucleocapsid protein. The point to note is that irrespective of which COVID vaccine you received, it would have produced antibodies to Spike protein (Covaxin due to being whole virus inactivated virus vaccine, produces antibodies to N protein too. But that does not imply that Covaxin would outshine Covishield in protection).

COVIPROTECT test kit identifies antibodies produced against Spike protein of the virus.and hence irrespective of which vaccine you received, it will catch the antibodies post vaccine.  

Vaccines are your best bet

Please note that even after testing negative on an antibody test, fully vaccinated people should not be worried about immunity gained post vaccine. It might happen if your antibodies level are at levels below the test’s threshold for detection. Also, in the months after vaccination, antibody levels may decrease below the detectable level.

Always get your test results interpreted through a healthcare provider for better understanding. For all lab test-related needs, visit Metropolis.

Make sure you get vaccinated. Motivate others to get the vaccine too. Let’s do our bit in helping India win over the pandemic!

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