The lymphatic system comprises a network of vessels, nodes, and organs, including lymph nodes, tonsils, spleen, and thymus, said Dr Manjusha Agarwal, senior consultant, internal medicine, Gleneagles Hospital, Parel, Mumbai

Social media is full of interesting information on your health and well-being. However, it is best to take them with a pinch of salt. So, when we came across an Instagram reel suggesting that wearing an underwire bra, or a very tight sports bra, can make one prone to lymphatic congestion in the breast tissue, we wanted to understand more. According to drainage and detox specialist Dr Caitlin Czezowski, since lymphatic fluid is a waste product, such congestion means that toxic fluid is sitting in your breast tissue. “Toxins drive inflammation which breaks down tissue, and as a result will cause problems like dense breasts, swollen/tender breasts, cysts or fibroids,” said Dr Czezowski.

According to her, one should ensure that the fluid is draining instead of sitting stagnant by incorporating lymphatic drainage. “This will improve the health and wellbeing of your breasts. I believe that this tool can be preventative when we do this regularly, (and ideally from a young age),” said Dr Czezowski.

What are lymphatic tissue toxins?

Lymphatic tissue toxins refer to harmful substances that can accumulate in the lymphatic system, a crucial part of the immune system responsible for filtering and draining fluids from tissues throughout the body. “The lymphatic system plays a pivotal role in maintaining fluid balance, transporting white blood cells, and filtering out waste products and toxins. When toxins build up in the lymphatic tissue, it can impair the system’s ability to function optimally, potentially leading to various health issues,” said Dr Manjusha Agarwal, senior consultant, internal medicine, Gleneagles Hospital, Parel, Mumbai.

The lymphatic system comprises a network of vessels, nodes, and organs, including lymph nodes, tonsils, spleen, and thymus. According to Dr Agarwal, lymphatic vessels carry a colourless fluid called lymph, which contains immune cells and waste products. She added, “Lymph nodes act as filters, trapping and removing harmful substances before returning the purified lymph to the bloodstream.”

Dr Agarwal stressed that draining lymphatic tissue often facilitated through techniques like lymphatic drainage massage or specific exercises, is essential for several reasons:

Toxin removal

The lymphatic system acts as a drainage system for cellular waste, toxins, and excess fluid. Draining lymphatic tissue helps eliminate these accumulated toxins, preventing them from causing cellular damage or contributing to inflammation.

Immune system support

The lymphatic system is a key player in the body’s immune response. “Draining lymphatic tissue ensures the efficient movement of immune cells, enhancing the body’s ability to identify and combat infections, viruses, and other foreign invaders,” said Dr Agarwal.

Reduced swelling

When the lymphatic system becomes congested or sluggish, it can lead to fluid retention and swelling, known as lymphedema. Draining the lymphatic tissue helps alleviate swelling, promoting better circulation and reducing discomfort.

Improved circulation

Lymphatic drainage supports overall blood circulation by preventing the accumulation of fluid and toxins in the interstitial spaces between cells. Improved circulation facilitates nutrient delivery to cells and enhances oxygenation, said Dr Agarwal.

Enhanced detoxification

Effective lymphatic drainage contributes to the body’s natural detoxification processes. By removing waste and toxins, it supports the liver and other organs involved in detoxifying the body, said Dr Agarwal.

If you're dealing with chronic stress, anxiety, or other mental health issues, it's advisable to consult with a healthcare professional for a comprehensive assessment, said Dr Manjusha Agarwal, senior consultant, internal medicine, Gleneagles Hospital Parel Mumbai. 

Yoga and mindfulness practitioners advocate the need to focus on one’s breath as a technique to reduce stress and anxiety. While clinical studies are limited, there are different breathing patterns and techniques that are all over social media. While we have covered many of these in our fitness series, one such that deserves your attention is the 4-2-8-2 breathing method, a type of Pranayama, touted to lower the heart rate.

But before we dive into what the method is all about, here’s what to know about Pranayama and the heart rate.

According to neurologist Dr Sudhir Kumar, Apollo Hospitals, Hyderabad, Pranayama or yogic breathing results in multiple health-related benefits, including lowering of resting heart rate. “Studies have shown that practicing pranayama regularly causes lowering of systolic and diastolic blood pressure and heart rate. It also helps in reducing stress and has a calming effect on the mind,” said Dr Kumar.

Pranayama improves focus and concentration resulting in better cognitive functions. Benefits of pranayama are seen across age groups (younger as well as older people) and in both normal-weight as well as overweight people. Dr Kumar added that people suffering from lung diseases such as asthma and chronic obstructive pulmonary disease (COPD) notice an improvement in respiratory functions after practicing pranayama.

What is the 4-2-8-2 breathing method all about?

The 4-2-8-2 breathing method, also known as box breathing or square breathing, is a simple and structured breathing technique that involves inhaling, holding the breath, exhaling, and then holding the breath again, each for a specific count. In the case of 4-2-8-2, it means inhaling for a count of 4, holding the breath for 2 counts, exhaling for 8 counts, and holding the breath again for 2 counts.

Is this breathing method effective?

This breathing method is often promoted for its potential benefits in promoting relaxation, reducing stress, and helping with anxiety. “The structured pattern of this technique may have a calming effect on the nervous system, and the focus required during each breath cycle can help divert attention from stressors,” said Dr Manjusha Agarwal, senior consultant, internal medicine, Gleneagles Hospitals Parel Mumbai.

Here’s a breakdown of the steps:

1. Inhale for 4 counts.
2. Hold the breath for 2 counts.
3. Exhale for 8 counts.
4. Hold your breath again for 2 counts.

According to Dr Agarwal, while there is anecdotal evidence and some support from studies suggesting that structured breathing techniques can help reduce stress and anxiety, it’s important to note that individual responses may vary. “Some potential benefits of this technique include increased mindfulness, improved focus, and a sense of relaxation,” said Dr Agarwal.

It’s crucial to approach breathing techniques as complementary practices rather than standalone solutions for mental health concerns. “If you’re dealing with chronic stress, anxiety, or other mental health issues, it’s advisable to consult with a healthcare professional for a comprehensive assessment and appropriate guidance,” said Dr Agarwal.

The diagnosis of Biliary cancers, also known as cholangiocarcinoma or bile duct cancers can be devastating. Intrahepatic bile duct cancer develops within the liver's bile ducts, while extrahepatic bile duct cancer originates outside the liver.

Gallbladder cancer is a malignancy that arises in the gallbladder wall, often discovered during investigations for gallstones or gallstone removal
surgery.

Risk factors for bile duct and gallbladder cancer encompass various elements that elevate the likelihood of developing these types of cancer.
These include age, with the majority of cases occurring in individuals aged 55 to 70. Medical conditions such as primary sclerosing cholangitis (PSC), chronic liver diseases, inflammatory bowel diseases, a history of bile duct cysts (choledochal), liver fluke infection, family history, exposure to smoking, and excessive alcohol consumption can all contribute to an increased risk of developing bile duct and gallbladder cancer.

The symptoms of bile duct cancer: Bile duct cancer often presents with subtle and nonspecific symptoms in its early stages, making diagnosis challenging. Patients may experience unexplained weight loss, abdominal pain or discomfort, fatigue, and jaundice. Changes in urine colour and stool may occur due to the obstruction of bile flow. As the cancer progresses, individuals may develop nausea, vomiting, itching of the skin (pruritus), and a general feeling of malaise.

Advanced bile duct cancer can manifest with more severe symptoms such as ascites (fluid buildup in the abdomen), enlarged liver or spleen, and anaemia due to blood loss.

Early warning signs of gallbladder cancer include jaundice, abdominal pain, bloating, and unexplained weight loss. These symptoms may not seem alarming at first but should prompt a visit to the doctor for further investigation. As gallbladder cancer progresses, additional warning signs may become apparent.

These can include nausea, vomiting, fever, and an overall feeling of weakness or malaise.
Bile duct and gallbladder cancer often present complex treatment challenges due to late-stage diagnosis and limited treatment options. Surgery is the primary method for localised, resectable tumours, but the aggressive nature of these cancers often leads to recurrence or metastasis.
Emerging approaches such as liver transplantation show promise in select patients, offering new hope for improved long-term outcomes.
Chemotherapy and targeted therapy are being explored to combat advanced bile duct and gallbladder cancers. Immunotherapy has also shown potential in some cases, harnessing the body's immune system to target cancer cells. Endoscopy is helpful in patients with bile duct cancer. Diagnosis may be done using endoscopic techniques like endoscopic ultrasound where the needles can be used for biopsies from the tumour, biliary stenting - plastic or metal that helps in resolution of jaundice, fever, infection. If the tumour blocks the stomach, the patient has recurrent vomiting and he can't digest food well, then also endoscopy helps by either starting through the tumour to relieve the blockage or by creating a bypass from the stomach.

(Article courtesy: Dr Meghraj Ingle Director and Senior Consultant Gastroenterology Gleneagles
Hospital Parel Mumbai)

Cold wave | There is a marginal increase in our metabolism in the winter months as the body works harder to stay warm. This can trigger cravings for rich foods or more food. However, eating indiscriminately and exercising less can lead to unwanted weight gain.

Your metabolic rate is the highest when you wake up and slows down as the day draws to a close. But does the nip in the air spell a speedier metabolism? Especially as we tend to feel hungry and like to munch on something almost all the time during winter? Are there things to keep in mind, even as much of north India is going through a severe cold wave?

Why do we crave calorie-rich foods in winter?

“The changing seasons have a great impact on the processes of the body, including digestion and metabolism. As the temperature drops, we begin to naturally crave heartier, calorie-dense foods to provide warmth and energy. This can lead to an increase in overall calorie consumption and potentially contribute to weight gain if not managed carefully,” says Dr Manjusha Agarwal, senior consultant, internal medicine, Gleneagles Hospital, Parel, Mumbai.

“In the summer months, higher temperatures can lead to decreased appetite as our bodies expend less energy staying cool. This can result in a decrease in overall calorie intake and potentially impact metabolism. The availability of fresh fruits and vegetables during the summer months can have a positive effect on digestion due to their high fibre content,” she says.

India's youth faces a heart attack epidemic. Learn how processed foods, stress, and bad habits fuel this crisis & tips to fight back with diet, exercise & lifestyle changes.

The rise of heart problems in India is a cause for concern as it reflects the changing lifestyle and dietary habits of its people. With the increasing consumption of processed and fast foods, coupled with sedentary lifestyles, there has been a surge in cardiovascular diseases across the country. 

According to Dr Sameer V Pagad, Senior Consultant Interventional Cardiologist, Gleneagles Hospital Parel, types of heart problems in youngsters: Hypertension or high blood pressure is seen due to factors such as poor diet, lack of exercise, and stress are contributing to this trend. In addition, a concerning number of young people are being diagnosed with atrial fibrillation, a condition that can lead to stroke and other serious complications if left untreated. A sedentary lifestyle and excessive alcohol consumption are major contributors to the rise of atrial fibrillation among the youth.  Furthermore, cardiomyopathy, a group of diseases that affect the heart muscle, is also becoming more common in young individuals. Genetic predisposition, substance abuse, and viral infections have also been identified as key factors in the prevalence of cardiomyopathy cases among youngsters. 

The growing menace of heart problems in young populations emphasises the need for early detection and proactive management strategies to ensure better health outcomes for this demographic. While advances in medical technology have improved treatment options, it is crucial to address the root causes and promote healthier living through education and lifestyle interventions. The need for holistic approaches focusing on diet, exercise, stress management, and regular health screenings is imperative to combat this growing epidemic effectively. It's time for individuals to take charge of their heart health proactively rather than reactively seeking medical help after developing serious issues.

Adhere to these heart-friendly tips:

1. One great way to keep your heart healthy is to engage in regular physical activity. While many people focus on intense workouts, even moderate exercise like brisk walking or yoga can have a significant impact on heart health.
2. Finding ways to reduce stress in your daily life can also be beneficial for your heart. Whether it's through meditation, deep breathing exercises, or engaging in hobbies you enjoy, managing stress levels has been shown to lower the risk of heart disease.
3. Another important aspect of heart health is maintaining a balanced diet. While it's common knowledge that fruits and vegetables are good for the heart, incorporating omega-3 fatty acids from sources like salmon and flax seeds can also provide immense benefits.
4. Staying well-hydrated is crucial for a healthy heart as proper hydration helps maintain blood volume and prevent dehydration-related strain on the cardiovascular system.
5. The impact of smoking and substance abuse on the hearts of youngsters cannot be overstated. Not only does smoking significantly increase the risk of heart disease, but it can also lead to conditions like atherosclerosis, which is the build-up of fatty deposits in the arteries. Substance abuse can have detrimental effects on cardiovascular health, as many drugs can cause elevated heart rate, irregular heart rhythms, and increased blood pressure. It is essential to quit smoking and stay away from illicit drug abuse to keep the heart healthy.

Air pollution has risen to become one of the biggest environmental health risks across the globe. According to a report by the World Health Organization (WHO), outdoor air pollution is estimated to have caused 4.2 million premature deaths worldwide in 2019. An innovative invention to measure individual exposure to air pollution comes in the form of personal silicone wristband monitors. These can absorb harmful compounds called polycyclic aromatic hydrocarbons (PAHs) in the air and provide insights into individuals’ exposure to harmful air pollutants.

PAHs are a group of organic air pollutant compounds resulting from the burning of coal, oil, gas, wood, garbage, and tobacco. They are widespread environmental pollutants associated with conditions like allergic asthma, chronic obstructive pulmonary disease (COPD), lung cancer and even cardiovascular issues.

A study published in Nature Journal aimed at identifying personal characteristics and behaviors associated with a person’s PAH exposure was conducted by environmental epidemiologists at Columbia University Mailman School of Public Health in collaboration with an interdisciplinary team of researchers at Oregon State University, Pacific Northwest National Labs and Mt. Sinai School of Medicine. It focuses on identifying the sources of exposure to PAHs, which was hitherto not looked into extensively. The study states that comprehensive identification and characterization of a person’s exposure to air pollution is a critical step toward identifying individuals at risk of high exposure levels and developing targeted interventions based on the sources of exposure.

“This study represents a significant advancement in our understanding of personal PAH exposure”, says Julie Herbstman, director of the Columbia Center for Children’s Environmental Health and senior author of the study. “By uncovering the variables that play a crucial role in exposure levels, we are better equipped to develop interventions aimed at reducing health risks,” says Herbstman in a press release.

Study conducted on pregnant individuals

“Exposure to air pollution during pregnancy can cause adverse birth outcomes like fetal growth retardation, low birth weight and preterm births, making pregnant women a vulnerable population,” says Dr Soumya Das, consultant pulmonologist, Manipal Hospital Salt Lake, Kolkata. Prenatal exposure to air pollution can make a child more prone to developing allergic rhinitis, asthma, and other airway disorders. 

The study, which was conducted on 177 people in their third trimester of pregnancy, who were based in New York, highlights that exposure to PAHs can be damaging during this phase. During the study, silicone wristband monitors were deployed to gauge people’s PAH exposure. The participants shared details about their demographics, employment and lifestyle such as smoking, choice of cooking fuel and traffic exposure in a questionnaire, following which they wore the personal wristband monitors for 48 hours. A second questionnaire completed after the monitoring period involved questions about their potential exposure sources while wearing the wristbands.

How do wristbands monitor air pollution?

According to an article published by National Institute of Environmental Health Sciences, silicone mimics the process of absorption of chemicals into our body. Hence, organic chemicals from the surroundings — air, water, and even one’s skin — get absorbed into it. These can be extracted and analyzed in the lab to determine which chemicals a person was exposed to, and in what quantity.

Individual factors affect air pollution exposure

“Several variables, such as their socioeconomic status, mode of commute, area of residence and even occupation, can influence a person’s exposure to air pollution,” shares Dr Harish Chafle, senior consultant intensivist, chest physician, bronchoscopist and sleep disorder specialist, Gleneagles Hospital, Mumbai.

In the New York-based study, researchers examined 61 PAH compounds and compared them to 75 questionnaire variables. The study found country of birth, income, maternal age, transportation type, time spent outdoors and seasons as the variables most frequently predictive of PAH exposure. It also underscores the utility of silicone wristbands to monitor air pollution and the associated health outcomes. Sarah McLarnan, MPH, a PhD candidate at Columbia Mailman and the study’s first author, was quoted saying that researchers were able to combine insights from the questionnaire and data from the wristband deployment to ‘refine measurements of exposure sources in terms of time and space, enabling more accurate source characterization’.

“The study is a step in the right direction to measure individual exposure to PAH and carry out necessary interventions to prevent the adverse effects of air pollution on personal health,” says Dr Chafle. He adds that conducting the study on pregnant women can help potentially control the health risks that air pollution poses to the health of the mother and the fetus.

Dr Das shares that while the study can help improve awareness about the different variables contributing to a person’s air pollution exposure, more actionable measures are required to reduce ambient air pollution.

Takeaways

The New York study aimed to identify different variables associated with an individual’s exposure to air pollution by deploying personal silicon wristband monitors on pregnant women. The study found income, country of birth, time spent outdoors, maternal age, transportation type, and season as the variables most frequently predictive of PAH exposure. The right insights can help identify high-risk individuals and develop targeted interventions.

Premature heart attacks, a growing concern, are becoming more prevalent among younger individuals. While traditionally thought of as an issue affecting older people, research indicates that the number of cases in people under 50 is on the rise. Lifestyle choices play a significant role in premature heart attacks. However, genetic predisposition and underlying health conditions cannot be overlooked.

Lifestyle choices play a significant role in premature heart attacks. However, genetic predisposition and underlying health conditions cannot be overlooked.

Stress and mental health have also emerged as critical contributors to early-onset heart disease.

It becomes increasingly important for individuals to prioritize regular check-ups and adopt healthy habits from a young age to mitigate the risks associated with this alarming trend.

The symptoms

Premature heart attacks can often go unnoticed due to the absence of typical symptoms in younger individuals. Warning signs may include chest discomfort, shortness of breath, and extreme fatigue. However, lesser-known symptoms such as jaw pain, upper back pain, and nausea could also indicate an impending heart attack. Individuals must pay attention to these subtler signals and seek immediate medical attention if they occur.

Furthermore, lifestyle factors such as stress, poor diet, and lack of physical activity can significantly increase the risk of premature heart attacks. Awareness is key in recognizing the symptoms of premature heart attacks.

Complications of a premature heart attack can have devastating consequences on an individual's long-term health. One common complication is the development of heart failure, where the heart is no longer able to pump blood effectively.

This can lead to symptoms such as shortness of breath, fatigue, and swelling in the legs and feet. Another serious complication is arrhythmias, which are abnormal heart rhythms that can be life-threatening if not managed properly.

Arrhythmias can cause dizziness, fainting, and in severe cases, sudden cardiac arrest. A premature heart attack can damage the heart muscle, leading to reduced overall function and an increased risk of future cardiovascular events.

Individuals who experience a premature heart attack may also face emotional and psychological challenges such as anxiety, depression, and post-traumatic stress disorder. It is essential to seek timely intervention to save your heart.

The diagnosis and treatment

Early diagnosis of a heart attack is crucial for saving lives and preventing long-term complications. However, diagnosing a heart attack in its early stages can be challenging, as symptoms may be subtle or dismissed as indigestion or anxiety.

Experts are constantly exploring new technologies and tests to improve the accuracy of early detection, such as high-sensitivity troponin tests which can detect even small amounts of cardiac markers in the blood. Prompt treatment is essential once a premature heart attack has been diagnosed. This typically involves interventions such as angioplasty to open up blocked arteries or medications to stabilize the heart rhythm. It is essential to stick to the guidelines given by the doctor and don't miss any consultation and follow-up.

The prevention

Preventing premature heart attacks is a crucial aspect of maintaining our overall health and well-being. One key strategy involves prioritizing regular physical activity and doing moderate exercise for five days a week to reduce the risk of heart disease. Incorporating a variety of aerobic activities such as walking, swimming, cycling not only strengthens the heart muscles but also helps to manage weight and control blood pressure.

Adopting a balanced diet rich in fruits, vegetables, whole grains, and lean protein sources is essential for preventing premature heart attacks. Eating foods high in antioxidants and omega-3 fatty acids can help reduce inflammation and protect against cardiovascular disease. Prioritize stress management techniques such as meditation or yoga, as chronic stress can contribute to the development of heart problems.

Authored by: Dr Sameer V Pagad, Senior
Consultant Interventional Cardiologist,
Gleneagles Hospital, Parel

Experts have been observing constant complains that beside getting rid of the cold, the cough is still a major issue. Conditions like post-nasal drip, bronchitis, asthma, secondary infections can be the reasons.

New Delhi: Although you have finally recovered from that unpleasant cold, the persistent cough it left behind refuses to go away. Experts have been observing constant complains that beside getting rid of the cold, the cough is still a major issue. Dr Manjusha Agarwal, Senior Consultant Internal Medicine Gleneagles Hospital Parel, Mumbai, explained that there can be various reasons for the same.
The expert said, "While the below listed are common reasons for prolonged coughing after a cold, it's important to note that each individual's experience may vary. Consulting with an expert can help determine any underlying conditions or provide specific treatment recommendations for relief from this persistent symptom."

Reasons why cough is still persistent?
* Post-nasal drip: "One possible reason why a cough can persist for weeks after a cold is due to post-nasal drip caused by inflammation in the sinuses. Even after the initial cold symptoms have cleared, mucus might continue to drip down the throat, irritating the airways and leading to a persistent cough. This can be common if there is an underlying sinus infection," she added.
* Bronchitis: If the cold virus has spread to the lower respiratory tract and caused inflammation in the bronchial tubes, this can result in a chronic cough that lasts longer than other cold symptoms.
Bronchitis typically requires rest and hydration for recovery, but sometimes it may necessitate medical intervention.

* Secondary infection, such as post-viral pneumonia, can occur when your immune system is preoccupied with fighting off a viral infection like a cold. Dr Agarwal said, "In such cases, the immune system may overlook a bacterial infection that can develop and require a different course of treatment. If you experience a cycle of getting sick, recovering, and then deteriorating again, it could indicate the presence of another infection."
* Asthma can cause coughing, and some individuals may experience an asthmatic response when they catch a cold. This response leads to the constriction of their small airways and results in wheezing. If you notice wheezing along with a cough during a cold, it may be indicative of something more than just a typical cough associated with the common cold.