What We Know About Post-COVID ‘Long-haulers’

It has been more than a year since the COVID-19 pandemic spread like wildfire around the world. According to the World Health Organization (WHO), since December 2019, when the first case of COVID-19 was identified in Wuhan, China, more than 119 million people have been infected and more than 2.6 million people succumbed to the virus. 

After more than a year, we have come to know a lot about this virus, but we are still learning something new every day. In most cases, adults who are infected with COVID-19 experience mild symptoms that last for about 10 days, while in some cases, people can have more severe symptoms that last for up to 20 days.

However, in some very rare cases, patients experience lingering symptoms that last for one, two, or even three months. This group includes those who have experienced both mild and severe cases. Initially, these lingering symptoms were ignored as a real medical issue. As health experts step in to try to manage this group of patients and learn more, many are now referring to this group as coronavirus “long-haulers” or “long-COVID.” 

This concept is not unique; after many illnesses, including the common cold, influenza, and Epstein-Barr, post-viral symptoms can occur.

The most common symptom which persists is fatigue. However, body aches, shortness of breath, difficulty concentrating, inability to exercise, headaches, and difficulty sleeping are all symptoms of this condition. It is difficult to predict who will become a long hauler. According to an article in Science, people who were mildly affected by COVID-19 can still have lingering symptoms whereas severely ill people can be back to their normal health in two months. 

One of the symptoms described by these people is “brain fog,” one of the most confusing symptoms for long-haulers. Patients have reported saying they are unusually forgetful, confused, or can’t concentrate even when watching TV. This affects a wide range of COVID-19 patients, including those hospitalized and placed in intensive care, and those with mild symptoms that did not require hospitalization, adding to the confusion around this condition. Continued symptoms are more likely to occur in people over the age of 50, people with multiple chronic illnesses, and those who became very ill with COVID-19.

Two groups of people affected by the virus can be categorized as long-haulers:

  • Those who experience some permanent damage to their lungs, heart, kidneys, or brain that may affect their ability to function
  • Those who continue to experience debilitating symptoms despite no detectable damage to these organs

While the precise cause of these conditions cannot be determined, an early analysis by the United Kingdom’s National Institute for Health Research suggests that ongoing long-term COVID symptoms may be due to four syndromes:

At present, health officials are learning more about this condition to determine the best approach to help these COVID-19 long haulers. These patients need proper attention to help them, along with a holistic approach to treat their symptoms. With proper research, we hopefully will be able to provide better care to patients in the future and find a remedy for this condition. 

World Health Day 2021 – For A Fairer, Healthier World

More than 50 years ago, on this date, April 7, the World Health Organization (WHO) was founded to help all people attain the highest levels of health. Each year on this day, we mark the founding of the WHO and draw attention to a specific health topic of particular global importance.

The theme for World Health Day 2021 is “building a fairer, healthier world”, an especially vital topic given the COVID-19 pandemic. 

The theme for this year has two facets: ‘healthier’ – the right of every human being to be able to enjoy good health; and ‘fairer’ – equal opportunity without distinction of race, religion, color, gender, age, ethnicity, political belief, economic or social condition.

COVID-19 has made it more difficult to create a healthy and fairer society, as the pandemic has gravely affected many countries, but has most severely impacted countries and communities that were already vulnerable. These communities have limited access to reliable healthcare facilities and are more likely to suffer negative effects as a result of steps taken to control the pandemic. 

As we brave this pandemic, the theme for this year seems rightfully chosen. The gap in access to healthcare during this pandemic has widened by quite a lot – especially between the rich and the poor, but also across gender lines. In many cases, individuals with COVID-19 or other diseases are not being able to access healthcare, and have been deprived of basic treatment or health services. 

No one should be put in a situation where they have to choose between receiving health services or feeding their family members. This is a very difficult choice to make and many will have to make it if one of the family members becomes ill. Often the poorest members of our communities with little income to spare are the hardest hit as many individuals do not get proper healthcare, which puts them at a higher risk for health problems, or they are plunged further into poverty as a result of paying for healthcare services.

Access to healthcare should be a fundamental right for every individual. All people and communities deserve access to quality healthcare without suffering financial hardship. Work also needs to be done to raise awareness about personal health, as well as affordable and acceptable healthcare options, and pricing and quality. 

People from all backgrounds deserve the full spectrum of healthcare services needed throughout life, from health promotion to prevention, treatment, rehabilitation, and palliative care. This should be based on a strong primary healthcare system and care should be provided within the family. This means the key to better care should be at home as much as possible. 

At Praava, we leverage technology to make healthcare more accessible to patients all over Bangladesh. We are also doing the best we can to keep costs down for our patients to serve the wider community. We regularly benchmark our prices against similar high-quality healthcare institutes to make sure our prices remain affordable. It’s our motto to maintain high quality at an affordable price.

On this World Health Day, we all need to work together to build a fairer and healthier world and to finish the work that started more than 50 years ago. As the pandemic has shown, the need for proper healthcare is a basic human right and one that we should all fight for.

Answers To Your Concerns About The COVID-19 Vaccine

There has never been a time where the general public has gotten to know so much about vaccines. It has been hard to keep up with all the information about the COVID-19 vaccine and it has become challenging to know what’s true and what’s not.

Here are a few things to help you access the right information about the AstraZeneca COVID-19 vaccine:

How do I know if I am allergic to the COVID-19 vaccine?

If you have had a severe allergic reaction to any of the components of the vaccine then you should not have the AstraZeneca vaccine. 

Components of Oxford-AstraZeneca Vaccine are:

One dose (0.5 ml) contains:

COVID-19 Vaccine (ChAdOx1-S* recombinant) 5 × 1010 viral particles

* Recombinant, replication-deficient chimpanzee adenovirus vector encoding the SARS-CoV-2 Spike glycoprotein. Produced in genetically modified human embryonic kidney (HEK) 293 cells. This product contains genetically modified organisms (GMOs).

The other excipients are L-histidine, L-histidine hydrochloride monohydrate, magnesium chloride hexahydrate, polysorbate 80, ethanol, sucrose, sodium chloride, disodium edetate dihydrate, and water for injections.

If you have ever had a severe allergic reaction to another vaccine or injectable medication then consult with your doctor first. 

If you have an allergy to food, oral medications, or other triggers like dust, latex, etc, you can still get vaccinated. 

Anyone with a history of having had a severe allergic reaction should stay under observation for 30mins after taking the vaccine.

I have a chronic condition, is it safe to get the vaccine?

Those who have chronic medical conditions like diabetes or chronic kidney disease are more likely to suffer from severe COVID-19 and its complications, which makes it more important that you get vaccinated soon. Currently, there is no globally definitive treatment for this disease and vaccination is the only way to be able to curb this pandemic. Therefore, it is important that those with chronic conditions do get the vaccine. If you are unsure about your particular condition, then you can check this approved list by the UK National Health Service as well as discussing with your doctor. 

Do you have a weakened system due to cancer, HIV, or take immunosuppressive medications?

Specific data on those with a weakened immune system is not available yet however as these patients are at increased risk of severe COVID-19, they should not be excluded from getting the COVID-19 vaccine – rather, they should be prioritized. Patients should have a discussion with their doctor and be warned that they may have a reduced immune response to the vaccine and so these patients should be counseled to still wear a mask, physical distancing, and frequent handwashing even after getting the vaccine.

Why do I have to keep on social distancing and wearing masks after getting the vaccine?

The AstraZeneca COVID-19 vaccines help to decrease the severity of the disease. However, research is ongoing on whether the vaccines can prevent you from getting infected or transmitting the virus. Therefore, even after vaccination, you can still be a carrier of the virus and not display symptoms. Keeping this in mind, vaccinated persons can still transmit the virus to those who have not been vaccinated like children and pregnant women. 

If I have had COVID-19, do I still need to take the COVID-19 vaccine?

Yes. If you have previously had COVID-19, your body will have produced antibodies but these may only be present for 3 months. Therefore to prevent the chance of re-infection, it is recommended to get the COVID-19 vaccine. 

If I am sick on the day I am due to get my COVID-19 vaccination, can I still get it?

Being unwell is not a contra-indication to getting a COVID-19 vaccine, and it will not prevent the vaccine from working or increase the chance of side effects. However, it is best to wait until your symptoms have improved before you get vaccinated. If you are on antibiotics, you can still get the vaccination. 

How effective is the Astrazeneca vaccine against some of the new variants? 

According to CDC, we are still learning how effective the vaccines are against new variants of the virus that causes COVID-19. Early data show the vaccines may work against some variants but could be less effective against others. We are learning more each day about the characteristics of new variants.

Importance of getting vaccinated
  • It’s everyone’s responsibility to do their part and get vaccinated to help to contain the virus
  • COVID-19 vaccines are perhaps the best hope for ending the pandemic 

Experts estimate that herd immunity would require around 80-90% of the population to have COVID-19 immunity, either through prior infection or vaccination. That’s why experts are encouraging the public to get the COVID-19 vaccine. Herd immunity means that enough people in a community are protected from getting a disease because they’ve already had the disease or because they’ve been vaccinated. Herd immunity makes it hard for the disease to spread from person to person. It even protects those who cannot be vaccinated, like newborns or people who are allergic to the vaccine.

World Autism Awareness Day 2021

World Autism Awareness Day is observed every year on April 2 to draw attention to the struggles that people with autism face regularly. Autism, also known as autism spectrum disorder (ASD), is a lifelong developmental disability that affects a person’s social skills, communication, behavior, and relationships. It typically starts from early childhood and affects every individual differently. Although there is no single cause for autism, early diagnosis allows a child to obtain the care and treatment they need. 

Signs and Symptoms:

Typically symptoms of autism are observed before a child turns 3. Some people even show signs from birth.

Common symptoms of autism are:

  • Lack of eye contact
  • Limited range of interest 
  • Overly strong interest in certain topics
  • Repetitive actions such as saying the same words again and again or rocking back and forth
  • High sensitivity to sounds, touches, smells, or sights that other people consider normal
  • Ignoring other people
  • Not looking at things when another person points at them
  • Not wanting to be held or cuddled
  • Having difficulty understanding or using words, gestures, expressions, or tone
  • Using a sing-song, flat, or robotic tone 
  • Having difficulty adjusting to changes in routine
  • Seizures are also a risk for children with autism, although they may not start until adolescence

Diagnosis

Since there is no medical examination for ASD, such as a blood test, diagnosing this condition can be difficult. To make a diagnosis, doctors examine the child’s behavior and growth.

ASD can be diagnosed as early as 18 months of age. By the age of two, an experienced professional’s diagnosis can be considered very accurate. Many children, however, do not obtain a definitive diagnosis until they are much older. 

Autism in Bangladesh:

A study from 2018 examined autism in a rural community in Bangladesh and found that the prevalence of autism was 0.75/1,000 in children aged between 18–36 months. The highest prevalence rate was found for children with cerebral palsy, which was 5.6/1,000 children, and next was children with delayed development, which was 2.6/1,000. 

In another 2016 study of all age groups by the Ministry of Social Welfare of Bangladesh, autism was found to represent 19% of total neurological disabilities recorded.

Treatment:

Currently, no treatment or cure exists for autism. Early detection and intervention, however, have been shown to improve a child’s growth. 

Early detection is essential as it enables families to take immediate action to improve their child’s health and quality of life.

Early intervention programs and therapy for children up to 3 years old help them learn important skills like speaking, walking, and interacting with others.

If you think your child has ASD, or if there is an issue with the way he or she plays, reads, talks, or behaves, talk with your child’s doctor or a specialist about your concerns.

A child with autism is often referred to by the term “special child.” Yes, they are special, and they need special support and care to foster their special skills or abilities. With the right nurturing, encouragement, education, and commitment, their talents can be nurtured and they can live a life of identity, respect, and honor.

Colorectal Cancer – Preventable, Treatable, and Beatable

Colorectal Cancer Awareness Month

In March of each year, Colorectal Cancer Awareness Month is observed globally to increase awareness about colorectal cancer. Building awareness plays an important role in early detection and reducing mortality rates. 

Colorectal cancer is a preventable, treatable, and beatable disease, and it is one of the few cancers that can be effectively managed through screening. We should take prevention seriously which is always a cheaper and better option, and ultimately, can help save lives.

What is colorectal cancer? 

Cancer that originates from the colon and rectum is referred to as colorectal cancer. As per the World Health Organization (WHO) cancer mortality statistics, colorectal cancer is the third most common cause of cancer in the world in both men and women. It is estimated that about 4.3% of people will be diagnosed with colon or rectum cancer at some point in their lives. In Bangladesh, colorectal cancer is the third most common cause of all cancer deaths in the country. The main risk factor for colorectal cancer is increasing age. Around 90% of colorectal cancers are diagnosed after the age of 50

Colorectal cancer is not a contagious disease. Factors that increase a person’s risk of colorectal cancer include increasing age, high fat intake, a family history of colorectal cancer and abnormal tissue growth also known as polyps, the presence of polyps in the large intestine, inflammatory bowel diseases, and primarily chronic ulcerative colitis.

Symptoms of colorectal cancer 

Colorectal cancer might not cause any symptoms until it becomes late-stage, but when it does, it may cause one or more of these symptoms:

  • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
  • Rectal bleeding with bright red blood
  • Blood in the stool, which might make the stool look dark brown or black
  • Cramping or abdominal pain
  • Weakness and fatigue
  • Unintended weight loss

Many of these symptoms can also be caused by conditions other than colorectal cancer, such as an infection, hemorrhoids, or irritable bowel syndrome. Still, if you have any of these symptoms, it’s important to see your family doctor right away so the cause can be found and treated.

Preventing colorectal cancer 

The most effective prevention is early detection and removal of precancerous cells and tissues before they turn cancerous. Even in cases where cancer has already developed, early detection still significantly improves the chances of recovery, as cancer can be surgically removed before spreading to other organs. 

Other preventive measures include:

  • Regular physical activity
  • Hormone replacement therapy lowers the risk in postmenopausal women
  • Diets with reduced fat intake and increased fiber
  • People with a family history may take advantage of genetic counseling, followed possibly by genetic testing
Screening to help early detection of colorectal cancer 

Screening for colorectal cancer can greatly reduce the risk of death associated with the disease. The US Preventive Services Task Force (USPSTF) recommends strongly that screening should begin at age 50 for average-risk adults. 

People at high risk might need to start screening before age 45. This includes people with:

  • Strong family history of colorectal cancer 
  • Personal or family history of certain types of polyps
  • Personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • Family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP)
  • Personal history of radiation to the abdomen or pelvic area to treat a prior cancer

Praava’s molecular cancer diagnostics lab performs numerous tests for colorectal cancer – including screening through blood tests and therapeutics. Praava’s tests include:

Screening:
  • Septin 9 methylation test – The procedure for screening is through a blood test
Therapeutics:
  • KRAS mutation test – The test is done through the blood sample
  • NRAS mutation test – The test can be done with both blood and a tissue sample
  • BRAF Mutation test – The test can be done with both blood and a tissue sample

If you are at high risk for colorectal cancer, talk to your healthcare provider to learn more and take measures accordingly.

World Oral Health Day 2021 – Be Proud of Your Mouth

In March of every year, the FDI World Dental Federation celebrates World Oral Health Day to raise awareness about the importance of oral health. The theme, “Be Proud of your Mouth,” is an essential message that should be a part of our daily lives.

How to take care of your mouth

To keep our mouths clean and healthy we must brush our teeth, rinse with water, and floss regularly. It is also important to avoid alcohol, tobacco, and all types of tobacco-related habits, such as chewing betel leaves, which cause oral cancer – one of the most common cancers in Bangladesh. 

Tips for a healthy mouth

Starting from childhood, a person should maintain proper teeth brushing. For babies, their gums should be cleaned every night before going to bed with a soft clean wet cloth. Both children and adults should brush their teeth once after breakfast and once before going to bed. 

Proper brushing techniques include:

  • Up and down motion
  • 45-degree angle rotatory movement
  • Using a medium-short bristled brush

In between brushing time:

  • Rinse your mouth with water or mouthwash after each meal
  • Use dental floss

One should also intake vitamins and proper protein-rich food to build up strong teeth structure and body immunity, and avoid eating too many sugary foods such as candy, soft drinks, and fast food, which can cause cavities and other problems.

Visits to the dentist

Children and adults should visit the dentist every six months to avoid dental problems and oral diseases, which are common in Bangladesh. Every dental visit can make you more protected against long-term problems.

During the pandemic

During the pandemic, it is recommended for older people and people with chronic diseases to make fewer in-person visits to the dentist, and only go if it is necessary or if you are advised by a doctor. If anyone in your household is suffering from a cold, cough, or fever, please consult with your dentist remotely through video consultations first. 

If you visit a dentist in person, please keep the following in mind:

  • Make sure that the dentist is wearing a proper mask, face shield, hand gloves, etc.
  • Make sure the dental chamber is disinfected between patients
  • Check if cleanliness and disinfection guidelines are being maintained 

Things to keep in mind for at-home dental care:

  • Use separate basins for teeth brushing if possible
  • Use covered toothbrushes or keep each toothbrush separately
  • Try to do warm saline rinsing (one glass of warm water mix with a pinch of salt) after each meal

At Praava, you can take advantage of video consultations to provide you with virtual dental care. To learn more, call 10648.

This month, in the spirit of Oral Health Day, let’s do all we can to keep our mouths clean and healthy, and remember – be proud of your mouth!

Different Types of Masks and Should We Be Double Masking?

If 2020 were to be summarized in pictures, I am sure the picture of a mask would be in the top 5. Masks and the various questions surrounding them have been in the news from the very beginning of the pandemic, and even after a year now, we still have some of the same queries:

  • What type of mask should we be wearing? 
  • How should we wear them? 
  • Should we be double masking? 

First of all, do we need to wear masks? The answer to that is a resounding yes. Quickly into the pandemic, all researchers agreed that COVID-19 (SARS-CoV2) is an airborne virus and so wearing a mask protects those around you as well as yourself. There have been many medications and therapies tested to see what can combat this virus, but masks and social distancing have been repeatedly proven to reduce transmission of COVID-19 (SARS-CoV2). 

Different Types of Masks:

Let’s start with the various masks available in the market and how effective they are in regards to protecting you from COVID-19 (SARS-CoV2). 

N95 Masks

These are the most effective out of all the masks available. These have an electrostatic filter that catches particles. When fitted and worn properly, they can trap 95% of particles as small as 0.3 microns. Centers for Disease Control and Prevention (CDC) recommends that this mask be worn by healthcare workers who do high-risk aerosol-generating procedures like intubation. 

Surgical Masks

Surgical masks are made of three-layered non-woven fabric. The top colored layer is medical grade polypropylene in a web-like structure. They have small bendable wires that allow them to fit around the nose but overall are loose-fitting masks. These masks prevent large-particle droplets, splashes, or splatters containing germs from entering the nose and mouth. They are not as effective as the N95 masks but offer more protection than cloth masks. These are recommended for healthcare workers, COVID-19 patients, and those who look after them. 

Cloth Masks

Cloth masks are worn by the general public. The effectiveness of these masks depends on how they have been made. A single layer mask is only 26% effective but adding multiple layers can increase effectiveness to 50%. A study published last September has shown that out of cotton, polyester, and silk, silk was shown to be a breathable fabric and can repel large droplets. When choosing a cloth mask, make sure it has multiple layers with a tight weave. If fibers in the mask can be seen when held up to the light, then it is not likely to be effective. 

Effectiveness of Double Masking

Currently, there are no studies to prove whether double masking – wearing a cloth and a surgical mask – is more effective. However, given the increasing number of coronavirus variants and transmissibility, prevention of the virus is imperative. Therefore, it makes sense that double masking can provide a better fit on the face as well as preventing virus particles from entering or exiting the nose or mouth. 

Movember – Why November is Men’s Health Awareness Month – & Why It’s Important!

Throughout the world, women live longer than men, and this gap varies tremendously in less developed countries. According to the CIA World Factbook, in Bangladesh, the average life expectancy for women is 76.5 years and 72 years for men – a four and a half year gap. When it comes to their health, many men have the mindset of “if it isn’t broke, don’t fix it!” – so unless there are clear indications of them falling sick or being unwell, they will think there is nothing wrong. A majority of men are just not aware of what they can do to improve their health and live healthier and happier lives. 

An internationally recognized campaign Movember was established by the International Movember Foundation and is observed annually during the month of November. It is the leading global organization committed to changing the face of men’s health. Every November, men around the world grow a mustache and women step up to support them, to raise awareness and funds for men’s health-specifically problems, such as prostate cancer, testicular cancer, mental health, and suicide prevention. 

Men around the world and in Bangladesh suffer from a number of health conditions that often lead to fatality:

Stroke (Hemorrhagic and Ischemic): This is the number one cause of death in men in Bangladesh. Controlling blood pressure, diabetes mellitus, cholesterol level, cessation of smoking, regular physical activity, can help to reduce the risk of stroke.

Heart Disease: This is also one of the leading causes of death in men in Bangladesh. Controlling blood pressure and cholesterol, eating foods low in sodium and trans fat, exercising often, and not smoking, can all significantly lower the chances of heart disease.

Diabetes Mellitus: Diabetes is one of the most common diseases in men. To reduce the risk of type-2 diabetes – check your risk of diabetes, manage your weight, exercise regularly, eat a balanced, healthy diet, limit takeaway and processed-foods, quit smoking, and control your blood pressure.

Mental Health: While mental health has always been a big taboo and mostly ignored in Bangladesh, particularly among men, about 16.8% of men in Bangladesh report poor mental health. This leads to most not seeking help, often even in dire conditions. If you think you are experiencing symptoms of anxiety or depression, it is important to talk to a professional counselor or psychotherapist.

In Bangladesh, 12.9% of men are at risk of developing cancer and 10% are at risk of dying before the age of 75 years. Some common cancers seen in men are:

Lung Cancer: 11.1% of men in Bangladesh suffer from lung cancer. Lung-cancer is one of the most common cancers in men and diseases like chronic obstructive pulmonary disorder (COPD) is fatal to men. The main symptoms of lung cancer include:

  • a cough that doesn’t go away after 2 or 3 weeks
  • a long-standing cough that gets worse
  • chest infections that keep coming back
  • coughing up blood
  • an ache or pain when breathing or coughing
  • persistent breathlessness
  • persistent tiredness or lack of energy
  • loss of appetite or unexplained weight loss

Keep your lungs breathing better – toss tobacco, avoid secondhand smoke, and watch out for irritants like air pollution, chemical fumes, and dust.

Prostate Cancer: This is the second most common cancer in men in Bangladesh. About 13.5% of men have prostate cancer with a 6.7% mortality rateSymptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis. When this happens, you may notice things like:

  • an increased need to pee
  • straining while you pee
  • a feeling that your bladder has not fully emptied

The best way to prevent it is by getting screened. Talk to your doctors to see if you should get a prostate-specific antigen (PSA) screening. 

Testicular Cancer: Although this is not very common, testicular cancer is seen increasing in young men. Typical symptoms are a painless swelling or lump in 1 of the testicles, or any change in shape or texture of the testicles. Testicular cancer can also cause other symptoms, including:

  • an increase in the firmness of a testicle
  • a difference in appearance between 1 testicle and the other
  • a dull ache or sharp pain in your testicles or scrotum, which may come and go
  • a feeling of heaviness in your scrotum

The best way to prevent testicular cancer is to learn how to do self-examination and knowing risk factors such as family history, race, and ethnicity.

For men starting at the age of 20 and beyond, the best things you can do to promote a long, healthy life are:

  • Get an annual physical exam by your primary care provider, including blood pressure, and height/weight checks
  • Annually screen for testicular cancer that includes monthly self-exams
  • Have cholesterol tested every six months
  • Screen for diabetes, thyroid disease, liver problems, and anemia
  • Depending on risk factors, screen for skin cancer, sexually transmitted diseases, and HIV infection, and alcohol and drug misuse
  • At 30, screen for coronary heart disease, especially with a strong family history of the disease and/or risk factors
  • At 40, screen for thyroid disease, liver problems, anemia, and prostate cancer
  • At 50, screen for cholesterol every six months; annually screen for Type II diabetes; lipid disorders; and skin, colon, and lung cancer. 
  • At 60, screen for depression, osteoporosis, dementia, Alzheimer’s disease, and abdominal aortic aneurysm. 
  • At 70, depending on previous findings, some screenings may be done every six months.

For all men, regardless of your age, the following is recommended:

  • Laughter increases endorphins, thereby increasing longevity. Get a sense of humor and engage with others with whom you can laugh.
  • Don’t become a workaholic; it increases stress and can lead to health concerns such as hypertension and weight gain. Get a hobby that helps you decrease stress, exercise in the manner you prefer, and seek help with diet to maintain a desirable weight.
  • Avoid illicit drug use and high alcohol consumption
  • If sexually active, get tested regularly for sexually transmitted infections. You might think you are safe if you engage in sexual activity with only one person, but that person might be having sexual relations with others, a concept called serial monogamy.

Everyone needs immunizations to stay healthy, no matter their age. Even if you were vaccinated as a child, you may need updates because immunity can fade with time. Vaccine recommendations are based on a range of factors, including age, overall health, and medical history. You can get your vaccine shots you want at Praava or talk to your family doctor via video consultation about the recommended vaccinations.

Let’s raise more awareness this November about men’s health and encourage the men in our lives to lead a healthy and fulfilling life.  

Breast Cancer and the Importance of Early Detection

Breast Cancer Awareness Month, observed in countries across the world every October, helps to increase attention and support for awareness, early detection, and treatment for the disease. The theme for this year is – Importance of Early Detection.

Breast cancer is by far the most common cancer in women worldwide, both in developed and developing countries and according to International Agency for Research on Cancer (IARC) by the World Health Organization (WHO), breast cancer is the third most common cancer in Bangladesh with 12,764 cases as of 2018. We all know that women often neglect their health. Even women from the upper-class and upper-middle-class of the society, who don’t lack education or knowledge on the awareness of health issues, still tend to neglect taking care of their own health. They prioritize their family members and their needs or their busy work lives, over their health. Breast cancer doesn’t only affect women – it also affects men. According to Cancer Country Profile 2020 by WHO, 8.5% of the entire population of Bangladesh suffer from breast cancer at a 6.5% mortality rate.

Early diagnosis can help fight breast cancer effectively – in fact, if breast cancer is detected at the Stage 1 level, survival rates are only 95-99%; and the five-year survival rate for stage 2 breast cancer is 93% for women who have completed treatment. By contrast, women with stage 3 cancer have a five-year survival rate of 72%.

The most important risk factor for breast cancer is family history. There is a genetic predisposition for this cancer. If you have a family member who has been diagnosed with breast cancer, you should take special precautions to monitor for symptoms and, for women over 40, have regular mammograms.

There could be several symptoms of breast cancer like:

  • Lump in the breast or underarm
  • Swelling of part of the breast or any change in the size or the shape of the breast
  • Irritation or dimpling of breast skin
  • Redness or flaky skin in the nipple area or the breast
  • Pulling in of the nipple
  • Nipple discharge other than breast milk, including blood
  • Pain in the nipple area or any area of the breast

Although it is rare, men can also get breast cancer. The most common symptoms of breast cancer in men are:

  • A lump or swelling in the breast
  • Redness or flaky skin in the breast
  • Irritation or dimpling of breast skin
  • Nipple discharge
  • Pulling in of the nipple or pain in the nipple area

Symptoms can also occur with other conditions that are not aligned with cancer. The most common cause of a lump in the breast for women is fibroadenoma or called simply a breast mouse. It is a benign tumor and rarely progresses to malignancy. Men can also get fibroadenomas but this is very rare.

To date, there is not sufficient knowledge on the causes of breast cancer, therefore, screening and early detection of the disease remains vital for breast cancer control. Simple measures such as self-breast examination is a well-accepted method where people examine their breast to detect any early lesion. There are other methods of screening for breast cancer such as an ultrasound of breasts and mammograms, which play an important role in the diagnosis of the condition. If a patient has a family history of breast cancer or their own history of benign tumors, then screening tests should be done annually. Otherwise, it is recommended for women over 40 years of age to get mammograms done every 3 years. Although ultrasound is not a routine screening test for breast cancer,  it is done in developing countries like Bangladesh.

Molecular cancer diagnostics tests can also play a vital role in cancer treatment. Those diagnosed with breast cancer at any stage should get a HER2 test done that can determine which targeted therapy or treatment protocol is best suited for a patient for early recovery. Treatment by surgery (removal of the lump) followed by chemotherapy or radiotherapy may be enough for a complete cure along with lifelong follow-up counseling which plays a crucial role. In advanced cases, the whole breast may have to be removed. A patient may also have hormone therapy after surgery, chemotherapy, and radiation are finished which can help prevent a return of the disease.

Creating continuous awareness and sharing knowledge about the cause, screening, investigation methods, and treatment for breast cancer can prevent the condition, although some cases may still progress to malignancy.

There are many success stories of women who have faced the ordeal with courage and determination and have been a source of inspiration for recovering breast cancer women. This year, let’s raise more awareness for early detection and help to curb breast cancer in our communities and in the world.

Mental Health for All: Greater Investment – Greater Access

The World Mental Health Day was first observed 28 years back on October 10, 1992, as an annual activity of the World Federation for Mental Health (WFMH) that was primarily aimed at supporting campaigning for mental health, educating, and raising awareness. Since 1996, World Mental Health Day has been observed with themes that focus on specific aspects of mental health. 

In 2020, as the world faces the COVID-19 pandemic, billions of people all over the world have been confronted by the unprecedented mental health consequences and the World Federation for Mental Health (WFMH) has taken this opportunity to promote the campaign on 10 October 2020 with the theme Mental Health for all: Greater Investment – Greater Access. 

Dr. Daniels, President of WFMH says, “Now more than ever greater investment in mental health is needed to ensure that everyone, everywhere has access to mental health care. The under investment in mental health has left large treatment gaps globally.” She added that mental health is an investment and not an expense and should be prioritized to avert a further catastrophe.

Mental health is important at every stage of life, from childhood and adolescence through adulthood. It refers to the healthy expression of emotions and healthy functioning which are the keys to emotional well-being, psychological well-being, and social well-being. The expected outcome of this is to realize one’s own potential, how one can cope with the normal stresses of life, working productively, and maintaining healthy relationships. But mental health has always been a big taboo and mostly ignored in Bangladesh. This leads to most not seeking help, often even in dire conditions.    

National Institute of Mental Health with the technical guide of the World Health Organization (WHO), conducted a survey named “National Mental Health Survey, Bangladesh 2018-19” which revealed that nearly 17% of adults in Bangladesh are suffering from mental health issues, where 16.8% are men and 17% are women, and among them, 92.3% do not seek medical attention.

Research on the impact of the COVID-19 pandemic on the mental health of the adult population in Bangladesh says that the prevalence of anxiety symptoms and depressive symptoms was 33.7% and 57.9%, respectively, and 59.7% reported mild to extremely severe levels of stress.

After being confronted by COVID-19 we have come to realize that there is no way to ignore the investment in mental health. Ensuring greater investment in mental health is a requirement, not a cost especially during these extraordinary times. So, to avert a further catastrophe, awareness and treatment of mental health must be prioritized.   

“We are already seeing the consequences of the COVID-19 pandemic on people’s mental well-being, and this is just the beginning. Unless we make serious commitments to scale up investment in mental health right now, the health, social and economic consequences will be far-reaching,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO).

Mental health is a continuous chain of processes. A parent with a healthy mental health condition can bring up their children with a healthy mental condition, family, and society with healthy mental health can contribute to creating empathetic, respectful, and resilient people. Creating awareness with effective information, promoting help-seeking behavior by addressing stigma plays a vital role to use the access of all facilities by government and non-government organizations.

Let’s join the movement collectively to make a commitment, and ensure our role for a nation with healthy mental health.