Latest news with #RashmiMabiyanKaur
Time of India
10-05-2025
- Health
- Time of India
From Muhurat Births to Mental Health Crises: A Gynaecologist's Wake-Up Call for Mother's Day
New Delhi: Motherhood, once considered a natural phase of life, is today often marked by complexity, planning, and vulnerability. In India, nearly half of all pregnancies are now labelled high-risk—a stark reality that reflects not just changing biology, but also changing society. On this Mother's Day, Rashmi Mabiyan Kaur from ETHealthworld explores the changing landscape of motherhood with insights from Dr Arpana Haritwal, Principal Consultant - Obstetrics & Gynaecology at Max Smart Super Speciality Hospital. According to Dr. Haritwal, the most prominent driver of high-risk pregnancies is advanced maternal age. More women are choosing to have children later in life—often due to career aspirations, late marriages, or fertility delays. While empowering in some ways, this shift brings heightened risks: diabetes, hypertension, preterm delivery, and even increased chances of miscarriage. Modern lifestyles—characterised by poor diets, sedentary routines, rising obesity, and stress—are compounding these medical challenges. Another unsettling trend is the preference for caesarean sections based on convenience, social status, or even astrology. 'The 'too posh to push' mindset is real,' Dr. Haritwal says candidly. 'Fear of labour pain, hospital convenience, and beliefs in auspicious timing have increased non-medical C-section rates.' But the consequences can be serious—longer recovery, future pregnancy complications, and increased health risks for both mother and child. From surgical site infections to delayed bonding between newborns and mothers, the ripple effects of a C-section done without medical necessity can be long-lasting. 'It's critical for expecting parents to make informed decisions guided by medical need, not fear or superstition,' she urges. Postpartum Care: The Invisible Phase While pregnancy receives significant attention, postpartum care is often neglected. 'Mental health, adequate sleep, and physical rehabilitation are the most overlooked aspects,' says Dr. Haritwal. Today's new mothers are expected to "bounce back" swiftly, even as they grapple with exhaustion, hormonal shifts, and societal pressure. One pressing issue is postpartum depression, which often hides in plain sight. 'It's very common but rarely discussed. Crying spells, anxiety, mood swings, and withdrawal are red flags families should not ignore,' she explains. While mild symptoms may resolve within weeks, severe cases require medical intervention—and the first step is to normalise seeking help. Today's first-time mothers face a web of modern pressures that were largely absent a generation ago. She outlines some of the most striking challenges faced by today's first-time mothers: the overwhelming information overload from the internet, which often leads to confusion and anxiety; the pressure of social media, which creates unrealistic parenting standards; the struggle to balance work and motherhood amid limited maternity support; the weakening of traditional support systems due to nuclear families and urban isolation; and the growing economic burden of raising a child in an increasingly expensive world. These realities make the journey of motherhood feel more like a marathon than a celebration. The romanticised notion of motherhood is now tempered with hard decisions, fatigue, and resilience. Despite these hurdles, Dr. Haritwal emphasises that preparation and support can turn the tide. Women over 35, for instance, can lower their risks by starting preconceptional counselling, undergoing early screening, and taking prenatal supplements months before trying to conceive. She also urged that families must show up—not just during baby showers, but in the sleepless nights, the teary breakdowns, and the quiet moments of doubt. This Mother's Day, let's give them what they truly need—understanding, informed support, and the freedom to speak openly about the challenges of bringing life into the world. More than celebration, every mother deserves care—before, during, and long after birth.
Time of India
30-04-2025
- Health
- Time of India
Disconnected Care and Digital Overexposure Fuel India's Autism and ADHD Surge: Dr Samir Dalwai
New Delhi: In this wide-ranging and urgent conversation with ETHealthworld's Rashmi Mabiyan Kaur, Dr. Samir Dalwai , Developmental Behavioural Paediatrician and Spokesperson for the Indian Academy of Paediatrics , raises a red flag on the escalating neurodevelopmental challenges facing children in urban India, including autism , ADHD , anxiety, and a growing spectrum of subclinical behavioural issues. Drawing on over two decades of clinical experience, Dr. Dalwai underscores the profound impact of excessive screen exposure, the critical shortfall in early diagnosis and intervention, and the disconnect between clinical care and school systems. He calls for a nationwide shift toward human-centric parenting, timely detection, and coordinated, outcome-driven support—before irreversible damage is done. You've worked with thousands of children over the past two decades. What trends have you observed in the incidence of autism, ADHD, and learning disorders among children in urban India? The trends indicate an alarmingly increasing number of children with not just autism, ADHD, and other diagnosable conditions, but also those that present as subclinical. This means their behaviour may not fit into a definitive diagnosis, but they exhibit multiple concerning indicators such as aggression, poor attention span, hyperactivity, impulsivity, poor sitting tolerance, anxiety, anger issues, poor self-esteem, self-harm, and poor emotional resilience, among others. Why is early diagnosis and intervention crucial in neurodevelopmental disorders—and where does India currently fall short? Early diagnosis and interventions are crucial to improving the child's quality of life. The brain is also very adaptable during early childhood, and early interventions can go a long way in maximising developmental potential. At the same time, equipping families with the support and resources they need can help them better understand and meet their child's needs. At present, India falls woefully short in terms of awareness, both within and external to the medical fraternity. The numbers of trained doctors and support staff are also lacking. How can we bridge the gap between clinical detection and support systems in schools and public health programs? The biggest challenge in the Indian ecosystem is that there are multiple stakeholders involved in the child's care who are not on the same page. For instance, while schools are focused on academic performance, therapy focuses on clinical improvements. The goals of Individualised Education Programmes (IEPs) and therapy are not aligned. This gap can be bridged by making the child's improvement the focus and mandating the monitoring of outcomes as per standardised guidelines or by an independent body. You've been vocal about the dangers of excessive screen time for children. What are the most serious cognitive and behavioural issues you're seeing as a result? Pervasive human interaction and nurturing care in the first few years of a child's life are essential for normal development. With screens and digital gadgets replacing these within a very short span of time, the development of children has been impacted in several ways, including delays in the development of crucial cognitive, social, and emotional skills. How do screen habits in early childhood impact brain development, emotional regulation, and attention span? Human interaction and nurturing care in the first few years of a child's life help the child's brain to develop innumerable networks. These networks are crucial for behavioural and communication skills, as well as emotional and cognitive development. Early childhood learning must comprise diverse engagements and exposure in familiar, nurturing environments, where adults help children to learn and cope with different social situations over a substantial period of time. When these interactions occur within a non-judgemental environment and with a non-intimidating approach, a child can develop social cognition. Screens replace this gradual pace of learning with intense, enrapturing, and provocative exposures that target 'fight or flight' responses. They encourage the child to seek instant gratification, develop binary thinking, and engage in impulsive actions. At the same time, increased screen time decreases the opportunities available to a child to learn and develop rational thought, tolerance, social diversity, and empathy. Children end up living in a false world, driven by instant gratification and violence, and triggered by the need to always be in their comfort zone. We are seeing increasing cases of anxiety, inattention, and the inability to communicate or get along with peers. The heightened reliance on screens means that the basic framework for normal human social existence is not being laid down. Many parents struggle with setting digital boundaries. What are the key principles of a healthy digital diet for children under 10? It is essential to focus on restricting or limiting screen time rather than aiming to eliminate it altogether, which may be a utopian and hence unattainable goal. The key principle of a healthy digital diet involves helping the child to learn the boundaries that govern their entire day—including mealtimes, playtime, study time, outdoor time, visiting/spending time with family and neighbours, etc. Setting up daily timetables that include all of these, sticking to them, and role-modelling time discipline as adults is important. Rewarding overall observance of schedules motivates the child to stick to the entire day's timetable (and unconsciously develop healthy boundaries) as a part of his/her lifestyle. Children learn that following boundaries is beneficial as it helps them do everything they like – but within reason. A common mistake that parents make is to only focus on disciplining the child with regard to his/her digital time, without placing this in the context of the child's daily routine. What are some early warning signs of digital addiction in children that parents often miss? Every child is attracted to gadgets, especially digital gadgets. As a common rule of thumb, digital gadgets should only be introduced to them after three years of age. A child can be considered addicted when (s)he cannot limit or restrict their use of screens. The earliest sign in a child is the inability to adhere to the schedule that has been established for him/her. Choosing screen time over human engagement, which can involve meeting relatives and friends, and physical playtime or outdoor time with digital time is another serious red flag. Disordered sleep is another significant indicator. Refusal to give up the device and getting into conflict with caregivers over the use of the device is a clear sign of impending addiction. Do you believe India is ready for a national policy that limits or regulates social media access for minors? It is imperative since the challenges to voluntarily regulating the use of social media are enormous. Most children today are already fairly addicted, as are their parents. Most importantly, the lack of social engagements and the gradual change in lifestyles with a growing focus on individual and solitary pursuits make such monitoring very difficult. Many businesses have a vested interest in the use of digital media by consumers. They will, thus, resist any change to the status quo. In many ways, I believe that it is already too late since many parents sincerely believe that introducing their children to digital platforms is for their own good and that becoming familiar with AI is best for their future. What reforms would you prioritize to address adolescent mental health issues, including rising cases of self-harm, depression, and aggression? All reform must be focused on reestablishing the role of human engagement in an adolescent's life. During adolescence, children deprioritise parents and stop viewing them as role models. Instead, they become more concerned with their peers. Developing an environment that drives the child towards sports, music, games, and other forms of recreation that necessitate human engagement must be considered. The only antidote for screen time is human time. Secondly, increased self-awareness and easy access to quality counselling and help for adolescents is a must.
Time of India
28-04-2025
- Health
- Time of India
India's Malaria Elimination Strategy: Digital Health, AAMs and Genetic Innovation
New Delhi: India is at a critical juncture in its mission to eliminate malaria , with tribal and hard-to-reach regions posing the final and toughest challenge. In an insightful conversation, Dr. Sita Rama Budaraja, Advisor, Health, Tata Trusts , discusses with Rashmi Mabiyan Kaur, Principal Correspondent at ETHealthworld, how strengthening primary healthcare through Ayushman Arogya Mandirs , preparing for the malaria vaccine rollout, leveraging digital innovations, and embracing cutting-edge genetic research are shaping India's roadmap to a malaria-free future. He underscores that addressing healthcare gaps in marginalized communities, while building trust and resilience into systems, is key to achieving malaria elimination by 2030. Where does India stand in its fight against malaria today? The concept of the 'last mile' is particularly pertinent to India's malaria elimination efforts. Despite significant progress, most malaria-related illnesses and deaths still occur in remote, tribal, and forested areas. These regions continue to have limited access to timely and quality healthcare, making this final stretch in the fight against malaria both the most difficult and the most important. However, efforts such as strengthening the primary healthcare system through Ayushman Arogya Mandirs (AAM) are improving healthcare delivery. These centers are helping improve healthcare services at the local level by bringing essential diagnosis, treatment, and prevention closer to communities that need them most. How do you see the integration of malaria services into existing primary healthcare systems evolving, especially under the Ayushman Bharat Health and Wellness Centres framework? Ayushman Bharat Health and Wellness Centres, now renamed Ayushman Arogya Mandirs (AAMs), have been set up to deliver 12 essential primary healthcare services, including the prevention and control of communicable diseases. In this setup, integrating initiatives that emphasize locally endemic diseases such as malaria is very important, particularly in areas where the disease is widespread. In such regions, early detection, timely treatment, and preventive measures will be key priorities. Strengthening the role of frontline health workers, ensuring a steady supply of diagnostic tools and antimalarial medicines, along with increasing community awareness, are all important steps in making malaria care more accessible through AAMs. Tata Trusts has been involved in strengthening health systems. How central is primary healthcare in the roadmap to malaria elimination, especially in tribal or hard-to-reach areas? An effective primary health system is crucial for ensuring community well-being and achieving equitable health outcomes. A strong foundation in primary care can deliver long-term benefits across the population. Tata Trusts' healthcare portfolio has consistently focused on strengthening primary healthcare and health systems, both in urban centers and in hinterlands across the country, while actively supporting government efforts to build resilient and responsive healthcare infrastructure. In Madhya Pradesh, Tata Trusts is supporting the state government in bolstering 500 selected Ayushman Arogya Mandirs (AAMs) to effectively deliver the 12 essential components of primary healthcare, as envisioned under the National Health Mission. The objective is to develop these AAMs into model centers of comprehensive primary care. In Odisha, the state with the highest incidence of malaria cases, the Trusts supported the state government in ensuring early detection and treatment of malaria in selected tribal pockets. This focused intervention has led to a significant reduction in the disease burden across the project areas. What challenges persist in early diagnosis and treatment of malaria at the primary care level, and how can these be addressed through better workforce or technology support? Key challenges in early diagnosis and treatment of malaria at the primary care level include delayed detection, limited human resources, and inadequate medical infrastructure, particularly in remote areas. Access to emergency healthcare for severe malaria cases, such as cerebral malaria, renal complications, and anemia in pregnant women, remains a significant barrier. To address these, strengthening Ayushman Arogya Mandirs (AAMs), enhancing diagnostic capacity, and improving emergency transport systems are critical. Targeted efforts involving key stakeholders and public-private partnerships (PPPs) can further aid surveillance, continuous reporting, and deployment of trained personnel in remote areas. India is closely watching the rollout of the RTS,S/AS01 malaria vaccine in Africa. How do you see the malaria vaccine fitting into India's broader malaria elimination strategy, especially in high-burden states like Odisha, Chhattisgarh, and Jharkhand? The RTS,S/AS01 malaria vaccine targets Plasmodium falciparum (P. falciparum), the parasite that causes the most severe and often fatal cases of malaria. In India, P. falciparum is the most common strain found in tribal and forested regions, especially in high-burden states like Odisha, Chhattisgarh, and Jharkhand, areas that still face major challenges due to limited access to healthcare. Given these conditions, the vaccine could be a valuable addition to India's malaria control efforts. It has the potential to be effective in these high-risk regions if included in the national immunisation programme. How can digital health tools be leveraged to monitor vaccine coverage, track outcomes, and flag gaps in real-time? Digital health tools offer significant potential to enhance malaria control efforts. By integrating real-time data systems, we can track vaccine coverage, monitor treatment outcomes, and identify geographic or demographic gaps quickly. Portable microscopes to test for suspected cases of malaria and mobile-based platforms can support frontline workers in capturing and uploading data at the point of care, while dashboards can enable timely decision-making at district and state levels. Tata Trusts has piloted three distinct digital health models, each demonstrating promising outcomes. In Andhra Pradesh , a hub-and-spoke telemedicine model was implemented to improve rural healthcare access, reaching villages around Vijayawada. In Uttar Pradesh, the Trusts partnered with NGOs such as Ramakrishna Mission Hospital in Vrindavan and Varanasi to support grassroots digital health initiatives. In Telangana, a joint venture with the state government was successfully scaled and evolved into a sustainable program. The experiences from these projects can be leveraged by the government in strengthening the supply chain tracking systems, improving accountability, resource allocation, and program responsiveness—ultimately contributing to more efficient and equitable malaria surveillance and intervention delivery. Looking ahead, what kind of policy and operational groundwork should India lay now to be malaria vaccine-ready in the coming years? In the coming years, India's malaria vaccine strategy should focus on areas where Plasmodium falciparum is most common, mainly remote and tribal regions that carry a large share of the malaria burden. To prepare for vaccine rollout, it is important to start building the necessary policies and systems now. This includes identifying high-risk districts through strong disease tracking, planning for the vaccine within the existing immunisation system, and ensuring that cold storage facilities are available even in the most remote locations. What innovations—whether digital, diagnostic, or programmatic—are you most optimistic about in helping India eliminate malaria by 2030? Programmatic innovations are crucial to eliminating malaria by 2030. Strengthening disease surveillance with advanced technologies will provide more accurate estimates of the malaria burden, support informed decision-making, and enhance risk prediction. Developing new methods of vector control and personal protection will complement current strategies, improving their effectiveness and sustainability. Through genome mapping of mosquitoes, Tata Institute for Genetics and Society ( TIGS ) has identified over 3,000 previously uncharacterized genes linked to insecticide resistance and parasite transmission. Leveraging this data, TIGS is developing gene-drive technologies aimed at rendering mosquitoes incapable of transmitting the Plasmodium parasite, thereby reducing malaria incidence without harming ecosystems. This innovative approach exemplifies how precision science can be harnessed to address public health challenges in an environmentally conscious manner. Additionally, improving logistics and ensuring the quality of malaria treatments and diagnostics will ensure their consistent availability. Timely detection and diagnosis in both high and low-endemic regions, supported by rapid diagnostic tests and mobile platforms, will be key to preventing further spread.
Time of India
23-04-2025
- Health
- Time of India
From Pixels to Precision: AI's Emerging Role in Personalized Cancer Treatment
New Delhi: Artificial intelligence (AI) is steadily emerging as a vital co-pilot in the fight against cancer, offering new possibilities in diagnosis, treatment planning, and clinical efficiency. In an exclusive interaction with journalist Rashmi Mabiyan Kaur, Dr. Nikhil S Ghadyalpatil , Director of Medical Oncology at Apollo Cancer Centre , Hyderabad, shared how AI is being seamlessly integrated into their clinical workflow—not to replace doctors, but to enhance their decision-making capabilities and streamline the delivery of personalized cancer care . As per Dr Ghadyalpatil, the AI system acts as a digital assistant that scans new patient data, flags urgent findings, and suggests evidence-based treatments. It's currently being integrated across imaging, pathology, and electronic medical records (EMRs), with a particular focus on rare cancers and complex genomic profiles. 'The real value of AI lies in shrinking the time between data generation and clinical decision-making,' he noted. 'Often, treatment options go beyond textbook guidelines, and AI helps ensure no actionable mutation or imaging clue is missed.' AI applications are already showing promise. In radiology, genomics, and pathology, the team is exploring ways to use AI to correlate MRI scans with genomic data or pathology slides to determine genetic mutations more rapidly and affordably. AI is also being tested to reduce human error in oncology pharmacology prescriptions—errors that, while rare, can have serious consequences. Building this AI ecosystem has not been without hurdles. Standardizing data across disparate formats—particularly handwritten clinical notes and non-standard pathology images—has been time-consuming. Another challenge? Earning clinician trust. 'AI success is less about algorithms and more about clinician trust,' Dr. Ghadyalpatil explained. 'If the tools are transparent and support clinical judgment, they will be embraced.' The hospital's strategy emphasizes smart scaling: start narrow, validate rigorously, and adapt to local needs. 'Don't blindly adopt Western models,' he cautioned. 'India is different. AI tools must be trained and validated on Indian data to offer meaningful insights.' Their current focus areas include AI-driven radiomics in early-stage lung cancer, predictive models combining PET/CT scans with biomarkers in breast and lung cancer, and structured dashboards that summarize clinical notes to detect early warning signs of complications like neutropenia or sepsis. He also stressed the importance of addressing systemic challenges: data interoperability, clinician training, lack of local validation, and limited infrastructure in smaller cities. 'Less than 20% of Indian cancer centers have structured digital archives,' he noted. 'That has to change.' Looking forward, Dr. Ghadyalpatil sees immense potential for AI in early cancer detection and rural screening—through tools like smartphone cytology and low-cost thermal imaging. 'If we build the right digital infrastructure, train our teams, and choose our pilots wisely,' he said, 'AI can become a silent, steady partner in delivering truly personalized cancer care—across all corners of India.' He envisions India developing its own treatment insights through privacy-preserving AI trained on data from hundreds of hospitals.
