Nanavati Max superspeciality Hospital

Hello,

I am Hemalata Arora. I am a consultant and internal medicine and I am also a board certified internal medicine physician from the United States. Today I would like to speak to you about the common influenza virus sometimes it is confusing and sometimes it can be dangerous, so let us understand what is the flu all about? The flu can spread from person to person via contact or droplet when they touch each other or sometimes when we they are coughing on others, infected person is coughing on other people, it can spread from person to person.

Now what is the flu caused by? It is caused by the influenza virus which comes in 3 to 4 type A, B, C and D. Most commonly the flu caused by type A and sometimes type B. Most of the large virus pandemics that we have heard of the flu, swine flu pandemic, asian flu pandemic are usually caused by type A virus.

Then how do we distinguish between a common cold and flu? Most of the flu symptoms are high fever, chills, body aches, very severe body aches, weakness and fatigue along with throat pain, sore throat with cough which is usually not productive, the nose is slightly stuffy but not usually very running, eyes can be a bit congested but usually not very watery. Most of the symptoms are usually because of the fever, very bad body ache and very severe fatigue. In the common cold however these symptoms are much more muted then running of the nose and watering of the eyes, sneezing, all of that is much more and the body ache, fatigue as much as much less, fever usually occurs but lesser in degree, so this is the difference between common cold and flu.

Now when should we see the doctor when we think we may have the flu, now there are certain high risk groups such as small children i.e. under the age of 5 and specially under the age of 2, anybody who is over the age of 65 i.e. elderly people, pregnant women and anybody who has any chronic medical condition like lung disease, heart failure, kidney or liver disease, diabetes any of these people if they contract which they think might be the flu should see a doctor.

What are the emergency signs in which other adults also should see a doctor? If you have these symptoms and also have been experiencing chest pain, breathlessness, severe recurrent vomiting or if the flu symptoms somehow get better for a couple of days then seem to get worse, which may suggest the bacterial pneumonia, there's another reasons call the emergency warning signs for which you must immediately seek medical care.

What other ways to treat flu infection? The ways to treat flu infection is primarily, a lot of rest, fluids at least 3 to 4 litre per adult per day and some paracetamol to be able to reduce the fever and any symptomatic medication to reduce the throat pain, it will be best to avoid any non-steroidal anti-inflammatory drugs like brufen and other medications, so that the body is not negatively affected, a lot of rest and fluids can be a way to treat this infection.

What are the complications if you don't treat this infections or if you have emergency warning signs and don't pay heed to them? Complications can be pneumonia, sinus infections, ear infections and sometimes when it gets pretty bad especially in the elderly and debilitated you can have acute respiratory distress syndrome which can be respiratory failure.

Now what are the ways of treating medically? There are some antivirals which are available for treating the flu virus, now these antivirals are usually used again in these high risk groups mostly, also within the first 48 hours only antivirals are effective, after 48 hours of the symptoms onset there's no point in taking these antivirals unless there is any complication that has arisen. This should always be under the prescription of a doctor.

What are the various preventing flu? The best way of preventing the flu is to avoid contact, the best ways to clean your hand all the time, wash your hands, thorough hand washing for at least 20 seconds with soap and water so that any contact that you may have had in the day before you touch your face or eat your food should be removed and cover your cough, a lot of times people are coughing in your midst and you are not able to control that, the best way is for all people who have any kind of cough is to be able to cover the cough, even you must cover it with the tissue in front of your face like this or if tissue or napkin is not available you must use the crook of your elbow that is also another very effective way of covering the cough.

Another thing is to stay at home, all sick people must avoid public contact and stay at home for the entire duration of the illness so as to prevent spreading germs, There are also other medical ways to prevent advent of flu such a thing is called chemoprophylaxis, if you or your closed one has suffered the flu and there are people in that person's contact who may have debilitating conditions, chronic illnesses and would suffer badly from the they can take antivirals preemptively this is called chemoprophylaxis, again needs to be done with the prescription of a doctor.

What are the vaccines that can be used to prevent the flu virus? There are certain flu vaccines usually these vaccines are made every year by the pharmaceutical companies under the direction of WHO, so usually the vaccines last, immunity lasts about 8 to 12 months and must be taken every year, it is highly recommended again for the high risk groups, small children, elderly, pregnant women and people with debilitating conditions like liver and Kidney disease, respiratory conditions like asthma, heart failure and other immunocompromised conditions.

The best way to deal with the flu is to prevent it. Prevention is by keeping yourself clean, covering your cough and avoiding contact with people if anyone has the illness. I hope this was a useful information on the flu virus and its prevention, stay healthy.

Thank You.
 

Hello,

I am Dr. Hemalata Arora. I am an MD physician and infectious disease specialist. Today, I would like to speak to you about diabetes and give a little insight about how diabetes happens and how we can manage it without too many medications and insulin and such things. Diabetes, as we have heard, is a lifestyle disease. What does lifestyle disease mean? Lifestyle disease means it is the result of some of the choices that we have made in terms of diet, in terms of exercise or not doing exercise, in terms of stress and our working hours, alcohol consumption, etc. These are our lifestyle choices and as a result of these choices, we get some diseases. Diabetes is the major one of those. You also may have heard that diabetes can be of type 1 and type 2 kinds. Now, type 1 is genetic in origin and affects very few people and is usually treated only with insulin. We shall not talk about that one today because that is not the major public concern.

The public health concern of major importance is diabetes type 2. To understand diabetes type 2 we must understand the word insulin resistance. What does that mean? when we consume sugar of any amount immediately the pancreas releases insulin and causes the sugar to be removed from the blood into the cells of the muscle where it is used for energy. Now a little amount of sugar at infrequent intervals and insulin is able to handle it very well. If the sugar is being consumed more regularly when I say sugar it also means other carbohydrates, especially the simple ones because the sugar comes immediately into the blood like when we have fruit juices or sweets or any maida products or such things. When the sugar comes immediately into the blood, the insulin spikes immediately and the sugar is pushed into the cells. When the sugar is pushed too much into the cell, then the cell start becoming little resistant. What does this mean? this means more insulin is required to push the same amount of sugar into the same cell, the cell is resistant. Now, where does resistance develop from?

There is some inherent changes that happen in the cell and it also happens because of fat. Now there is the link between obesity and diabetes. When we keep on consuming more foods, our sugar content as well as fat content, we start depositing more fat. When the fat is deposited the fat doesn't just sit there and do nothing. It actually releases some inflammatory chemicals which then go and affect these muscle and liver cells which are supposed to take in the glucose. what do they do? they change ever so slightly the structure of the insulin receptor, making the insulin that is floating around in the blood difficult for it to bind with these receptors and cause the glucose to be getting into the cell. Thus, developing insulin resistance. So what happens then is more and more insulin required, secreted by the pancreas to do the same function. After some point, after maybe 10 to 15 years or 5 to 10 years of insulin resistance then diabetes can set in. This is really how diabetes sets in, it can be called a slow food poisoning in one way or the other, especially refined carbohydrates poisoning.

What is the solution, how can we reverse this, is this even possible to reverse? yes, very much possible to reverse, what we must do is to reduce the constant stimulus to insulin for a reasonable amount of time so that the body is able to reset this whole process again and maybe become more insulin sensitive. Can we use medications to treat diabetes? Yes everyone is using medicines to treat diabetes but what the medicines do? what medicines do, is to stimulate the pancreas to secrete a little bit more insulin so that some more help is given. Still they also stimulate the kidneys to excrete sugar so that literally the sugar that is coming in, is secreted or they help the stomach or the intestine don't observe the carbohydrates that we are putting in and instead we pass them out in the stool. So this is the role of the medicines but the main thing that should be changed, which is the only way to actually help reverse the disease, is to change what we eat.

Reduce the number of refined carbohydrates and sugar that we eat and certain kinds of oils that we eat and then we have a good chance of reversing this diabetes. This has to be something which is pervasive and done almost continuously for the rest of the person’s life to be able to make this change. Along with this exercise and other lifestyle changes as in stress mitigation are extremely helpful. This is what I would like to speak about. Is diabetes reversible? yes it is and the way I have told you is basically with diet. What dietary changes specifically small and big can be done, it is mostly revolving around sugars and simple sugars, refined carbohydrates and such foods. Whole grains are better, vegetables are excellent and some kinds of non-vegetarian food is also very good. The rest of the food that we eat everything packaged and such should be avoided as much as possible. I hope this was helpful.

Thank you!