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By Dr.Amrita Basu(MBBS,MS) on
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By Dr.Amrita Basu(MBBS,MS) on 4
WritingAPageday
Dr.Amrita Basu(MBBS,MS)
I was hearing about the Blue zones everywhere. But I had no intention of watching the documentary,I wanted the source. That’s why I decided to read the book. The Blue Zones 9 Lessons for living Longer by Dan Buettner.The best part about the book is, it focuses on food habits and longevity secrets from both the East and the West. Boiled down, its about eating healthy, and less meat seems to be a big takeaway.
Estimated reading time: 3 minutes
When do you get up? When the sun rises.
When do you sleep? When the sun sets
Work for health or wealth.The secrets of timeless congeniality and socializationWhat grows in Nicoyan garden?Corn, beans,papaya orange.
Okinawa has ikigai .Costa Rican talk about and plan di vida-strong sense of purpose.
The book is written a very lucid language and takes us on a journey with the author as he delves into the lives of the centenarians in different countries. The language and culture barriers make things slow but our author is determined. He visits Okinawa, the Greek blue zone, American blue zone, and a few others while sharing tips on how to create your blue zone.
Charlie Munger was 99 when he died.I want to know what he ate and what he did daily too. He was a billionaire who managed one of the world’s biggest investment companies and lived an active life making money. None of the people our author interviewed had a modern-day life story like him.It was mostly in out-of-the-way places, people who didn’t have the trappings of modern life or a career as such. For most people, the connection to the people interviewed will be lacking,even though their simple eating and simple living will resonate. Few of us can manage to live in a mountain village rearing goats and eating the same food every day even with the best company. So there’s a need for examples from the world as we know it too.
In the blue zones, many seemed to hear and see less as they grow older and those functions are crucial for good quality of life and fighting dementia. I found no mention of the use of aids for seeing better or hearing aids to help those who didn’t hear so well. Both of which improve quality of life,overall functionality and brain functions.
The data presented is mostly hearsay and even the bibliography lacks hard data. That saying it’s interesting that the author received a budget for traveling and doing the work he did. Goes to show that longevity research has a lot of interest and everyone wants an option to do it right where they are.
Living longer and better is a wonderful goal to have.
Give this book a reading when you can do so with an open mind, otherwise, you might fall victim to a different sort of bias. A flag bearer of time-proven common sense advice that would benefit everyone when backed by more scientific data.
By Dr.Amrita Basu(MBBS,MS) on 12
Sleep Equity for Global Health. Do doctors need sleep?
Why don’t the Government and Medical Education systems the world over explain why diminished capacity because of poor sleep is not a problem for healthcare workers?
Why is there no Sleep Equity for healthcare workers? Why is it okay to ignore the elephant in the room in this case? Why do students and residents everywhere end up thinking it’s okay to sacrifice sleep for work or play? Why is there no real talk about sleep equity? On this world sleep day we discuss the very topic, that makes me hope things will be better.
In 2024, I wish there would be a worldwide rethink about the need for sleep hygiene to be at the center of good health. The 2024 World Sleep Day Theme ‘is “Sleep Equity for Global Health.”
Sleep is essential to health, but measurable differences in sleep health persist across populations across the world, creating additional burdens and reinforcing health inequities.
Hello isn’t this the perfect theme to write about? This is one reason I gave up a well-paying stable Government job in a Medical College.I was tired of being without sleep for 3 days a week.It got to be too much and I was on the way to becoming a basket case before each of those days. Sometimes it was 48 hours continuous on call and that didn’t work well with a toddler in tow.
But let me start at the beginning. As a medical student, I was used to long hours of study. But I always liked my 7 /8 hours night sleep. I slept well. Things changed when it was our internship when sleeping became fragmented and scattered and we were welcomed into the torture of sleepless nights with no day-off the next day. There is a day off theoretically, but you are supposed to finish all pending work and report to your superiors and by the time you go home, you are so high on adrenaline and stress hormones that falling asleep is next to impossible. But I took naps here and there, keeping it like a relay with a close group of friends. Plus, my boyfriend, now husband was very helpful and when I was ill or not able to manage a night, he exchanged with me. That was very kind of him. That debt of kindness is impossible to repay. But his health suffered too. So my guilt was there manning the fort.
But during the PG days, that benefit was absent because now we were in two different medical colleges and work was hard, but once we got married, things got better somewhat. Also, night duties in my UG and Pg involved being with a group of friends, seniors, and consultants only a phone call away. There was work and sleeplessness, but not too much stress. Duties could range from 90 hours to 120 hours a week depending on the year of residency. I managed.
In between I was lucky to find a low-pressure consultancy during which I became a mommy.
But then things got worse with my posting in a district medical college where the horror of horrors, you don’t know it till it faces you , there was no restroom for doctors, but only for students and nurses. So I had to either sit in the ward or keep visiting from the rental I was staying at. Other than the problem of drunk ambulance drivers, drunk people on the streets, and drunk patients in an emergency, the horrifically barking groups of stray dogs kept my emergency duties sleepless in more ways than one.
The worst part was that the stress was so bad that it started giving me nightmares two days before the duty was scheduled. There was no backup, no team, no support system. Only inappropriate behavior, lawlessness disregard for the truth, turning a blind eye to the problem and just blaming the messenger. Some of my senior colleagues were helpful and it was because of them that my night duty loads were less gradually and theirs and my husband’s support helped me do a job that I loved but couldn’t live with anymore. Not with sanity at least.The time was coming for a change and winter was not far behind.It was Septemeber of 2018 when my husband and I resigned.
After working for around seven years, I gained back my sanity and resigned from a permanent government job for which I had always dreamt, planned, and worked. I still have PTSD when I remember those nights.
I have been a private practitioner since 2018, and I choose my work with care. I can be a good doctor and do my best only when I am also a healthy, well-rested doctor. It is important to never compromise certain things in life. One of those is sleep (both quality and quantity) and the second one is inner peace.
You cannot have the second one without a good night’s rest.
The best method to sleep better is to sleep on time and wake up on time according to the circadian rhythm. Late nights, excessive social media scrolling, too much screen time, heavy meals, late at night, and too much excitement before bedtime can all cause disturbed sleep. For doctors though,it will need regulations be implemented by straight-thinking, non sleep deprived people.
Hope you sleep well at night , because nothing’s worth losing your sleepover.
References:
1.Sleep Deprivation
Joseph A. Hanson 1, Martin R. Huecker 2
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
2023 Jun 12.
https://pubmed.ncbi.nlm.nih.gov/31613456/#:~:text=Excerpt,apnea%2C%20depression%2C%20and%20anxiety.
2.The Dangers of Sleep-deprived Physicians https://www.amnhealthcare.com/blog/physician/locums/the-dangers-of-sleep-deprived-physicians/
3.Sleep deprivation and physician performance: Why should I care? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200708
Writing this for UBC and Blogchatter blog hop
By Dr.Amrita Basu(MBBS,MS) on 0
Writing and researching my next book on nature and play for daily wellbeing
I am an ENT surgeon by profession, previously working at a Medical college. I believe the Internet is God’s way of providing health and wealth information for all. The important thing is to find the right information.
In 2017 I wrote about the home we were planning to move in one day and why I was researching paint colours.I wanted lead-free paint and when finally in 2023 the work was finished, Nerolac was still the best option. Incidentally, interior paints in India were supposed to have a maximum of 90ppm lead since 2016 but that brings a self-certification the problem is still persistent. Plus industrial lead-free paint was not a necessity and the continuous leaching of lead in soil, air water continues at multiple levels. Its also very difficult to find which paint is lead-free!
Kansai Nerolac is a Japanese company which is much before its time. It has no added lead in its paint according to the information available publicly. When you invest in lead-free paint today, you ensure protection for the people who live in it, and the people who breathe in it, and one day if you want to repaint, less pollution while scraping off the paint. In the long run, it’s a win-win for you and nature. The smell which accompanies the fresh paint is when you inhale the maximum amount of lead. When paint flakes of , that’s a problem too.
There’s a distinctly lower IQ, leading to an overall loss of lifetime earnings plus the cost of potential healthcare impact has a significant impact on the economy of a country.So a short-term profit of selling low-cost paint has a very high price in terms of human resources and actual economic turnover. Interestingly Nerolac is on par with all paint brands of repute in India when it comes to cost. You don’t have to shell out excess of your budget.
Other than paint the other sources of lead exposure are air, water, soil , food, and taking one step at a time will help us go lead-free surely and steadily.
The economic cost of childhood lead exposure in India is a whopping 236 billion dollars.(source)The study was done by Toxics Link and International Pollutants Elimination Network (IPEN), a network of over 600 non-governmental organisations.The problem is that in 2016 Indian Government had made 90ppm the max limit of lead, self certification was advised. While I believe in supporting local and Made in India, the lack of monitoring for small companies producing paint was not something I wanted to trust my home with.
The cheaper paints containing lead appear like a win for homeowners who don’t know about the dangers of lead and sometimes it’s the interior decorators who make the decision .Do you know the biggest problem? The lead in water reaches you through the fruits, vegetables, and all products you consume. It’s called the food cycle and until we phase out lead at all levels, everyone gets slowly poisoned.
Inorganic lead and lead compounds are probably carcinogenic to humans (Group 2 A) according to IARC. Other than painting, other sources of lead were gasoline. The Indian government phased it out in 2000.
Children being of growing age are the most vulnerable population and they get exposed from multiple sources. A study done in Pakistan showed workers taking home clothes dusty with lead-contaminated dust and thus exposing their children and family to lead.
Many famous lipstick brands still contain lead and the lack of regulations and awareness is scary. Children especially shouldn’t be exposed to makeup if the ingredients are not known, as it’s very difficult to determine which has lead and which doesn’t.More on that in a later post.
The strongest epidemiological evidence is for lung and stomach cancers. They are consistently but weakly associated with occupations and industries that involve lead exposure. (source)
Having calcium, and iron supplements reduces the absorption of lead and a high-fat diet could increase the absorption of lead.
Dr.Amrita Basu(MBBS,MS)
Boskabady M, Marefati N, Farkhondeh T, Shakeri F, Farshbaf A, Boskabady MH. The effect of environmental lead exposure on human health and the contribution of inflammatory mechanisms, a review. Environ Int. 2018;120:404–420. doi: 10.1016/j.envint.2018.08.013.https://pubmed.ncbi.nlm.nih.gov/30125858
El-Naggar NE-A, Hamouda RA, Mousa IE, Abdel-Hamid MS, Rabei NH. Biosorption optimization, characterization, immobilization and application of Gelidium amansii biomass for complete Pb2+ removal from aqueous solutions. Sci Rep. 2018;8(1):13456. doi: 10.1038/s41598-018-31660-7.https://pubmed.ncbi.nlm.nih.gov/30194341
Exposure to lead increases the risk of meningioma and brain cancer: A meta-analysis
Yu Meng 1, Caoli Tang 2, Jun Yu 3, Shiyao Meng 4, Wanying Zhang 5 https://pubmed.ncbi.nlm.nih.gov/32146339/
Potential Health Risks of Lead Exposure from Early Life through Later Life: Implications for Public Health Education.Adejoke Christianah Olufemi et al. Int J Environ Res Public Health. 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9741093/
Working group on the evaluation of carcinogenic risks to humans: inorganic and organic lead compounds. IARC monographs on the evaluation of carcinogenic risks to humans. Lyon (FR): International Agency for Research on Cancer; 2006.
Khan D.A., Qayyum S., Saleem S., Ansari W.M., Khan F.A. Lead exposure and its adverse health effects among occupational worker’s children. Toxicol. Ind. Health. 2010;26:497–504. doi: 10.1177/0748233710373085. [PubMed] https://pubmed.ncbi.nlm.nih.gov/20538706/
publications.iarc.fr/_publications/media/download/3795/3bd750c699c77431d0db7b28b0123fa12c901a38.pdf(opens in a new tab).
Healthwealthbridge Disclaimer health information provided on this blog is for general awareness and doesn’t in any way replace a doctor’s professional medical advice. Kindly consult your doctor in case of any decision regarding your health, and diet.
By Dr.Amrita Basu(MBBS,MS) on 0
Project green : Did you realize you are currently living one of your dreams?
These are pictures of plants we planted in 2021. When the COVID scene made playing outside difficult, we (our friends and us) invested in small plots of land to plant trees together and play.Playing outdoors is a much needed activity that helps prevent the gloom and doom of growing up.As adults we forget to play ,go outside and just enjoy nature.That’s the reason we see so many cases of lifestyle diseases turning into epidemics.We took a chance with this and life changed forever.
I realized I was living one of my dreams
We started with a small spot behind our family home in the village ,which was turned into a kitchen garden.We also planted fruit trees like banana,jamun,guava,mango,litchi,Jamrul,sabeda, papaya for getting fresh seasonal fruits from the garden.
My husband grew up in a small village in West Bengal.The family home when we decided to renovate in 2020 was in a ramshackle condition.As it happened there was someone living there on a rent basis but the upkeep was poor.
That’s when my husband and his elder brother decided to get the home repaired and renovated .I had only 2 conditions, budget and we should be able to spend time here on weekends or on weekdays as the schedule allowed.So a big no to renting it out.
The work happened and I have written and shared about it previously and the rest as they say is history.
Its not easy to create a calm spot in these busy times.But our village home helps us do just that.
I enjoy the time I spend amongst green plants and trees.They don’t want anything from us and are always there to give us oxygen,shade,fruits and soothe our eyes.Thats the kind of friend I want for life.My plan forever is to earn enough to support myself my family and nature.Because I found out ,they best way to stay healthy is becoming a part of nature.
By Dr.Amrita Basu(MBBS,MS) on 0
Why is colon cancer rising in young? There is mounting evidence linking an unhealthy diet, one high in processed meat and fat, and low in fruits and vegetables to early-onset colorectal cancer. Other scientists have turned their focus to bacteria that live in the gut, also called the gut microbiome adults. Colon cancer risk is vastly lowered by following a healthy diet and daily exercise, avoiding processed food, and screening for those with genetic risks of colon cancer. Significantly, a healthy diet and exercise help prevent most non-communicable diseases.
Excluding skin cancer, colon cancer is the 3rd most common cancer in USA.In the western world its 8 times more common than in India.
The commonest cancers in the Western world are:Lung, colon and rectum, and prostate in men and breast in women.
In India: the leading cancers in men –oropharynx, stomach and esophagus.Uterine cervix, breast, and oropharynx in women.[2]
CRC is Rising in those below 50. It is now the sixth most common cancer in India.
The incidence of CRC in India is approximately 4.7/100,000 among males and 3.2/100,000 amongst females.[Source]
Relatively higher Incidence of Colon cancer less than 40 years of age, is found in Kolkata than in other cities, according to Pal.[source]
Altered gut bacteria die from ultra-processed food and antibiotic use, obesity, and even lack of exercise.
Obesity, insulin resistance, drugs, and alter the gut microbiome and increase colon cancer risk.
Known risk factors include hereditary syndromes, ulcerative colitis, and Crohn’s disease.
The reason behind lower CRC in India is our diet low in fats, and rich in fruits and vegetables and spices like curcumin.
When I was studying MBBS, I didn’t know anyone personally who had colon cancer,in fact, the C word was not a regular except in the cancer wards. But over the years I have known people (personally not patients) affected by breast cancer, thyroid cancer, colon cancer, and in one case three different cancers in one person over 3 years.
One of the people with Colon cancer was a male with a family history of colon cancer and another solid organ tumor, a history of smoking, and obesity. Diagnosed in his mid-fifties. In his case, the first symptom was abdominal discomfort, with no obvious obstructive symptom, but clinically pallor was present but no significant weight loss. The other person with colon cancer had no family history, and no symptoms except sudden spells of weakness. The latter had liver metastases and the colon cancer was inoperable. But good chemotherapy is giving her a fighting chance. In both cases, the indomitable spirit of the people affected made me realize how important our mindset is.
The first case was followed up six monthly to yearly. However, the screening was CEA and CT scan of which the CT scan for the abdomen was never done by the patient after the first year. Somehow a repeat colonoscopy was done only one time at one year post surgery. There was a recurrence involving the proximal jejunum after 4 years and this time it was T4N2M0
That’s why I am writing about colon cancer. To build awareness about a highly preventable cancer.
When to get started?
How frequent?
With what tool?
Based on current guidelines, it is important to know your family history when it comes to screening for certain types of cancer. Ideally, screening should begin about ten years before the diagnosis of the cancer in the last known family member who had it. If you are above the age of 45, it may be necessary to undergo routine screening.
Types of polyps include: There are different types of growths in our colon, such as adenomatous, hyperplastic, inflammatory, or hamartomatous. Not all adenomas, which are a type of growth, turn into cancer. Adenomatous polyps, which are a specific type of growth larger than 10 mm, have the highest risk of becoming cancerous. Because of the discomfort, cost, and unknown reasons, many people in the Western world don’t get a colonoscopy, let alone India. Plus the cost has to be kept in mind for all such invasive procedures.
In the case of the male patient, I mentioned he didn’t have significantly elevated CEA and even on recurrence, the CEA was within normal limits. Monitoring of CEA at intervals of 3 to 6 months is the single most effective method of detecting early relapses. The benefit of monitoring, however, decreases after 2 years[source].
Your doctor will know the best method for follow-up screening. Awareness is crucial. Since the symptoms are often similar to other common conditions like hemorrhoids (piles), fissures, irritable bowel disease, and inflammatory bowel disease the delay in diagnosis is inevitable. Public interest and educational awareness for this highly preventable cancer may help save many lives through timely screening and modifying risk factors.
Symptoms-signs-Diagnosis-Imaging-Colonoscopy-Biopsy-Ruling out metastases-Treatment Plan
Surgery
Chemotherapy
Immunotherapy
Downstaging preoperative therapy(radiotherapy and systemic therapy
Therapy for metastatic disease
Palliative therapy
Targeted therapy
In my experience both as a relative/friend of patients and as a doctor Tata Medical Centre in Kolkata Rajarhat and Mumbai both offer excellent comprehensive quality care at affordable rates.The best part is they try to give a overview of the treatment plan so that patient and their relatives are not caught by surprise.
A tertiary care center in southern India has a large database of colon cancer showing rectum as the most common site[source]
Most present in advance cases and that makes treatment difficult. Early diagnosis through screening makes this a highly treatable cancer with a good prognosis on timely management.
Unfortunately, though, screening has made prevention and mortality lower in the older population. Less than 50% population in UDSA shows a rising trend.63% increase in incidence from 1988 to 2015.
familial adenomatous polyposis, MUTYH-associated polyposis, juvenile polyposis, Cowden syndrome, Li–Fraumeni syndrome, and Peutz–Jeghers syndrome.
Relation of these with colorectal cancer requires multicentre trials with large populations to see genetic links in the Indian population.
Prevention of Colon Cancer like all other cancers involves healthy habits, including fresh food covering the nutritional groups to maintaining good health, exercise, avoiding alcohol, tobacco, and sleep. Together with screening of at risk population, we can fight this together.
Healthwealthbridge Disclaimer health information provided on this blog is for general awareness and doesn’t in any way replace a doctor’s professional medical advice. Kindly consult your doctor in case of any decision regarding your health, and diet.
1. The impact of hereditary colorectal cancer on the Indian population
Maharaj, R; Shukla, PJ; Sakpal, SV; Naraynsingh, V1; Dan, D1; Hariharan, S1
Indian Journal of Cancer 51(4):p 538-541, October–December 2014. | DOI: 10.4103/0019-509X.175307
https://journals.lww.com/indianjcancer/Fulltext/2014/51040/The_impact_of_hereditary_colorectal_cancer_on_the.53.aspx
2. Maharaj, R., Shukla, P. J., Sakpal, S. V., Naraynsingh, V., Dan, D., & Hariharan, S. (2014). The impact of hereditary colorectal cancer on the Indian population. Indian Journal of Cancer, 51(4), 538-541.
3. https://medicine.yale.edu/news-article/with-colorectal-cancer-rates-rising-among-younger-adults-a-yale-cancer-center-expert-explains-there-may-be-more-factors-behind-this-worrisome-trend/
4. https://m.timesofindia.com/life-style/health-fitness/health-news/colon-cancer-is-rising-among-young-adults-know-the-warning-signs-and-risk-factors/photostory/98738149.cms
5 Curcumin for chemoprevention of colon cancer
Jeremy James Johnson 1, Hasan Mukhtar
https://pubmed.ncbi.nlm.nih.gov/17448598/
6 Rising colorectal cancer in young adults
A warning for all! Let us adopt a healthy lifestyle and colorectal cancer screening
Patel, Amol; Hande, Vivek
7 Pal M. Proportionate increase in incidence of colorectal cancer at an age below 40 years: An observation J Cancer Res Ther. 2006;2:97–9
http://www.ncbi.nlm.nih.gov/pubmed/17998686
8 Venkataraman S, Mohan V, Ramakrishna BS, Peter S, Chacko A, Chandy G, et al Risk of colorectal cancer in ulcerative colitis in India J Gastroenterol Hepatol. 2005;20:705–9
https://pubmed.ncbi.nlm.nih.gov/15853982/
9 Colorectal cancer
Evelien Dekker 1, Pieter J Tanis 2, Jasper L A Vleugels 3, Pashtoon M Kasi 4, Michael B Wallace 5
https://pubmed.ncbi.nlm.nih.gov/31631858/
10 Colorectal Cancer
Mark Lawler, … Patrick G. Johnston, in Abeloff’s Clinical Oncology (Sixth Edition), 2020
https://www.sciencedirect.com/book/9780323476744/abeloffs-clinical-oncology
Roshan Radhakrishnan says "An extremely talented doctor and author of multiple books, Dr. Amrita does a great job managing multiple roles with ease." Anaesthesiologist (Human painkiller) ¦¦ Winner #TOIWriteIndia - S01 & 02 ¦¦ Finding #HeroesOfKindness across the world
Vishakha Talreja says "Amrita has immense knowledge of health-related content. Her writing style is reader-friendly and I have seen her blog posts go viral for the sheer fact that they are informative and helpful.
As a doctor too her knowledge is noteworthy and she always gives the right consultation that is in beat interests of those consulting her. She is also hands-on on the issues faced by her own community. Having worked with her I can definitely vouch for her professionalism and punctuality."
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