
Docs: Pulmonary rehabilitation can help patients with lung diseases
chronic obstructive pulmonary disease
(
COPD
), ILD,
asthma
, lung disease and
lung cancer
often struggle with breathing difficulties.
In such situations,
pulmonary rehabilitation
is a treatment that helps improve the quality of life of these patients, said senior chest physician Dr Gaurav Agrawal, speaking at a CME programme at Allahabad Medical Association (AMA) Convention Centre on Sunday.
During his lecture titled Pulmonary Rehabilitation-- Beyond Medication, Agrawal said, "This treatment focuses on exercise,
respiratory techniques
, diet and mental health. The aim of this process is to increase the breathing capacity of patients and improve energy levels."
Dr Agrawal emphasised that "It can be lifesaving, especially for those who have to be hospitalised frequently due to respiratory problems."
The programme concentrated on enhancing patients' physical capabilities. Experts explained, "Exercise programmes focus on improving patients' physical and mental capacity. Respiratory techniques also improve the breathing capacity of patients, which allows the use of oxygen more effectively."
The comprehensive programme addresses mental health concerns, stress management and proper nutrition. Benefits include enhanced breathing, increased physical endurance, improved mental wellbeing, better ability to perform daily activities, and strengthened muscles for managing lung conditions.
Notable participants included Dr JV Rai, Dr Ashish Tandon, Dr Ashutosh Gupta, Dr Sujit Singh, Dr Anoop Chauhan and Dr Atul Dubey.

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Indian Express
12 hours ago
- Indian Express
‘I had the American dream, but I dropped it': 4 family members share the unseen toll of cancer caregiving in India
Sakshi Agrawal had just finished school – her life was only beginning– when tragedy struck: her father was diagnosed with oral cancer. At 18, she made a decision that would define the next two years – she paused her education to care for him. 'I stayed home to manage his treatment and care. It wasn't just about missing college—it was about putting my entire life on hold,' recallsed Agrawal, now 31. Her brother eventually quit his job and returned home during their father's final months, sacrificing career opportunities in a field with limited prospects locally. Agrawal's story isn't unique. Across India, millions quietly shoulder the exhausting responsibility of caring for loved ones with cancer, often becoming invisible casualties of a disease that demands everything from everyone it touches. In India, where family obligation runs deep, caregiving is rarely seen as a choice; it's an expectation. But the emotional and physical toll this takes on families remains largely unspoken, hidden behind cultural notions of duty and sacrifice. 'I associate one word with caregiving: exhaustion. Bone-crushing exhaustion,' said Saumya Sharma, 31, who cared for her father from 2018 until he passed in 2021, and is now supporting her mother through breast cancer treatment. 'The other one is probably resentment. Resentment with the sick, maybe sometimes, but mostly it is resentment with the situation. No matter what you do as a caregiver, it is never enough. It is as if you stop existing and now only the sick person exists,' she told A 2022 study cited by mental health expert Anjali Pillai, psychologist and programmes lead at SafeStories, Pune, found that two in five caregivers of cancer patients screened positive for depression. Yet, she says, this is just the tip of a crisis hiding in plain sight. For Pavithra Sekar, 28, caring for her mother with stage 3 breast cancer means living in a constant state of vigilance. 'Your brain always has the guard switch on. My mom won't sleep easily, and often she won't say what's bothering her, and we end up in the ER. There are no peaceful nights.' The financial burden is crushing. 'Cancer is a chronic disease, so not all bills are covered by insurance. Surgery and radiation are covered, but chemotherapy and regular medication are not. Medicine alone costs us Rs 20,000 a month,' she said. To manage expenses, Sekar lives on the city's outskirts, enduring a six-hour daily commute to work. The personal toll is just as devastating. 'I've been turned down by men and their families because they fear I'll also get cancer and they won't be able to support us,' she said, adding, 'No one really understands the intensity of cancer.' Sharma's sacrifice was perhaps the most dramatic. After earning admission to an Ivy League MBA programme and working in Boston, she returned to India in 2021 when her father's health declined. 'My company was applying for my H1B, but I dropped the American dream. I don't regret it. I was restless in the US knowing my family was suffering.' Healthcare professionals are witnessing this crisis firsthand. Dr Srinath, senior oncologist and founder at Asha Hospitals, observed that 'caregivers often carry the emotional weight of the diagnosis as heavily as the patient, but with far fewer outlets to express it.' The impact on patient care is direct and measurable. 'When a caregiver's physical or emotional reserves are depleted, it affects their ability to provide consistent and compassionate care. I have seen instances where caregiver exhaustion compromises the accuracy of medication administration or leads to missed follow-ups,' Dr Srinath said. Padma Shri Dr Rajendra A Badwe, chief executive of Tata Cancer Care Foundation and former Director of Tata Memorial Centre, has seen the full spectrum of caregiver experiences: 'Caregivers of cancer patients commonly face a range of challenges. Physically, they often experience fatigue and exhaustion from the demands of caregiving. Emotionally and psychologically, anxiety and depression are common, along with an inability to care for their own needs.' Yet he's also witnessed remarkable resilience. 'Some of them show remarkable courage to face the situation and garner strength to arrange everything so that no stone is unturned in treatment of their loved ones,' he told What makes the caregiver crisis particularly acute in India is the cultural context. For Ayushi Mathur, 37, who has been caring for her mother with metastatic breast cancer since 2018, the challenge is compounded by cultural expectations. 'Sacrifices and hard work are seen as your duty. You're just expected to do it.' Neha Cadabam, senior psychologist at Cadabams Hospitals, said this mindset leaves little space for caregivers to acknowledge their pain. 'Many internalise their distress, fearing it would be seen as selfish or inappropriate,' she said. The trauma can linger long after the crisis ends. 'Many caregivers experience flashbacks, anxiety, or a sense of purposelessness once their role ends,' Cadabam said. A caregiver's state of mind can shape the patient's outlook. 'When caregivers are calm and present, patients feel more secure. If they are distressed, patients can internalise that stress,' said Dr Srinath. Dr Badwe recalled one patient whose husband said, 'When so many good things happened to us, we never asked, 'Why me?'—so why ask now? We will face this together.' Despite the critical role caregivers play, India's healthcare system offers them minimal support. 'At present, India's healthcare system is still deeply focused on the patient, with very little formal support for the caregiver,' noted Dr Srinath. Mathur's experience, too, reflected this gap: 'Unfortunately, this is something that we haven't witnessed yet. While there have been silent acknowledgements of the emotional needs of a caregiver, however, there hasn't been any direct conversation or space given to discuss the emotional needs of caregivers.' Left to their own devices, caregivers develop whatever coping mechanisms they can. Sharma, dealing with the complex emotions of caring for someone with whom she had a 'difficult relationship,' sought therapy while in the US. 'I had a difficult relationship with my father, and when I was in the US, I took therapy to process how I was feeling about his deteriorating condition,' she said. 'To cope, I do meditation whenever I can. I also write and try my best to go to the gym. I also consume marijuana gummies from time to time when I feel a lot of stress,' Sharma said. Agrawal's struggle continues years later. 'That uncertainty, never knowing how he'd be the next day, or what news we'd get, weighed on me constantly. It was emotionally exhausting. I didn't know how to process what I was feeling at the time, and honestly, even today, I struggle. I find it hard to open up or feel emotionally comfortable around people,' she said. Caregivers often only process their trauma years later. Sharma fell into depression three years after her father's death. 'During the illness, you live in survival mode,' she said. Pillai said this is common: 'Even after recovery or loss, many live as though the next crisis is just around the corner.' Experts call for systemic reform. Dr Badwe recommended patient navigation services, distress assessment tools, and AI-enabled coping apps for caregivers. Pillai said, 'Hospitals must integrate routine mental health check-ins and provide on-site counsellors.' As India grapples with rising cancer rates—with over 1.4 million new cases diagnosed annually—the army of invisible caregivers continues to grow. These family members are sacrificing their careers, health, and happiness to fill the gaps in a healthcare system that hasn't yet learned to see them.


Hindustan Times
a day ago
- Hindustan Times
Can doctors from some countries work in the US without residency? Here's what we know
For decades, international medical graduates (IMGs) had one clear path to practicing in the United States: completing a US residency. That remains the rule in most of the country. But with a looming physician shortage, a growing number of states are opening new doors for foreign-trained doctors. According to the Federation of State Medical Boards (FSMB), at least 18 states have now created licensing programs that allow certain IMGs to begin practicing without first completing a full US residency. At least 18 US states have now created licensing programs that allow certain international medical graduates to start practicing without first completing a full US residency.(Representative image/Unsplash) States including Florida, Virginia, Wisconsin, Idaho, Minnesota, and Texas issue provisional licenses to doctors who already hold an active license abroad, pass the US medical exams, and work under supervision for a set period (FSMB). Also read: 'Both will have to make concessions': Marco Rubio on Ukraine-Russia peace deal How state programs are changing the rules The details vary state by state. Tennessee, for example, lets internationally trained doctors with significant prior experience practice under supervision for two years before applying for a full license. The Cato Institute notes that Florida, Virginia, and Idaho have similar pathways, designed to get qualified physicians treating patients sooner while still ensuring oversight. Other states, including Colorado and Iowa, offer re-entry or restricted licenses to IMGs. These programs allow foreign-trained physicians to practice, but often come with limits on scope. As the resource site USMLE Sarthi points out, eligibility criteria differ widely. Some states are more flexible, while others impose strict requirements before granting any independent practice rights. Also read: 'Absolutely disgusting': ICE arrest of TikToker Tatiana Martinez sparks anger on social media National standards still apply Despite state-level reforms, national rules have not gone away. The American Medical Association (AMA) stresses that all IMGs must still obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG), which verifies that foreign degrees meet US standards (AMA). Nearly all states also require passing scores on all three steps of the United States Medical Licensing Examination (USMLE) before granting a full license. The push for change comes amid mounting concerns about access to care. The Wall Street Journal has reported that the US could be short more than 40,000 primary care physicians by 2030, a gap that has many states rethinking traditional barriers (WSJ). At the same time, research published in the BMJ and highlighted by Time Magazine found that patients treated by foreign-trained doctors in the US had slightly lower mortality rates than those treated by US-trained physicians, underscoring the value IMGs can bring to the system. FAQs Can foreign doctors practice in the US without residency? In most states, residency is still required, but around 18 states now allow provisional licensing for qualified IMGs. Which states allow doctors to work without residency? States including Florida, Virginia, Wisconsin, Tennessee, Idaho, and Texas have created alternative pathways. Do IMGs still need to pass exams? Yes, ECFMG certification and USMLE exams remain mandatory nationwide. Why are states changing rules for IMGs? The reforms aim to address America's growing physician shortage, projected to exceed 40,000 doctors by 2030. Are foreign-trained doctors as qualified as US-trained ones? Studies, including one published in the BMJ, suggest that patients of foreign-trained doctors in the US had slightly better outcomes.


Time of India
2 days ago
- Time of India
Fresh viral spurt across city as rain, sun play hide and seek
Kolkata: The temperature rise after a prolonged wet period revived a cough and cold outbreak that struck in July. With the mercury crawling up to 34.2°C last Tuesday and dropping to 29.9°C on Thursday, the mercury was on a see-saw ride. This unleashed the seasonal viruses yet again, at a time when viral and bacterial infections kept most hospitals fully occupied. "Over the past few weeks, there's been a noticeable uptick in influenza activity across Kolkata, particularly since the beginning of the monsoon season in July, when respiratory viruses often flare up. More febrile illnesses are reporting at our OPD now," said Jayanta Datta, senior internal medicine consultant, Charnock Hospital. "This is indeed worrying since we have seen a sudden footfall rise in our OPD and this would invariably increase admissions. Since we are running at near full capacity, it would again be a challenge to find beds for critical patients," said a hospital head. You Can Also Check: Kolkata AQI | Weather in Kolkata | Bank Holidays in Kolkata | Public Holidays in Kolkata | Gold Rates Today in Kolkata | Silver Rates Today in Kolkata The rise in temperature followed a prolonged rainy spell during which the maximum temperature dropped to 29°C last Friday. It has been crawling up since Monday, triggering yet another cough and cold epidemic in the city, with hundreds suffering from upper respiratory tract infections and an obstinate cough. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Best SIP Plans for NRIs in Germany – Get ₹2L Monthly Pension | Invest ₹18K PB Learn More Undo BP Poddar Hospital OPD has been receiving 15–20 patients daily, including school students and senior citizens. Respiratory illnesses are especially severe among the elderly, particularly those with COPD or a history of hospitalisation during Covid, in some cases requiring CCU or ward admission, said Abhijit Aich Bhaumik, consultant physician. "This has contributed to the existing bed crisis. The dominant viruses are Influenza A (H1N1, H3N2) and Influenza B, followed by rhinovirus, adenovirus, and streptococcus pneumoniae. Abrupt weather changes, combined with frequent transitions between air-conditioned spaces and outdoor heat, are increasing the severity and duration of illnesses," added Aich Bhaumik. The heat and humidity tend to elevate pollution levels, triggering allergic reactions in many individuals, said Fortis Hospital internal medicine consultant Joydeep Ghosh. "People often take multiple showers, consume cold drinks, or switch rapidly between outdoor heat and indoor air-conditioning. Such abrupt temperature changes challenge the body's ability to regulate its internal temperature, sometimes impairing immunity and leading to respiratory discomfort. The transition from hot, dusty streets to chilled indoor environments, especially when repeated frequently, can stress the body's defences," added Ghosh. Most patients had a mild fever followed by a persistent cough that refused to go. There was a spurt in Influenza A (H1N2), para-influenza, rhinovirus, and enterovirus, say doctors and microbiologists. Peerless Hospital detected 20-30 cases of Influenza A and B, rhinovirus, respiratory syncytial virus (RSV), typhoid, and scrub typhus in the last week. "This is the season for seasonal influenza or Influenza A and many have got tested with symptoms. We have also detected several dengue cases in viral panel tests in the last week. This could last several weeks, going by the temperature fluctuations and the consistent rain," said Peerless Hospital chief microbiologist Bhaskar Narayan Chaudhury. Seasonal viruses pushed OPD footfalls by 15-20% in the last ten days at Woodlands Hospital. "The elderly with existing comorbidities, and those with weakened immunity are being particularly affected. Patients typically present with moderate to high-grade fever, dry or minimally productive cough, headache, body ache, general malaise, and at times, loose watery stools," said Soutik Panda, critical care head, Woodlands Multispeciality Hospital. Stay updated with the latest local news from your city on Times of India (TOI). Check upcoming bank holidays , public holidays , and current gold rates and silver prices in your area. Get the latest lifestyle updates on Times of India, along with Happy Krishna Janmashtami Wishes ,, messages , and quotes !