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Indian Express
02-08-2025
- Health
- Indian Express
Hepatitis A surges with monsoon: What tests to do, what vaccines to take and how to keep the virus at bay
When a 30-year-old woman walked into Dr Rommel Tickoo's clinic, one look at her yellowish eyes told him that she had a liver problem. Sure enough, when the internal medicine expert at Max Healthcare, Delhi, checked her liver enzymes, they were through the roof. Her enzyme levels stood at around 3,000 IU/L — the normal ranges are between 7 and 55 IU/L. She tested positive for hepatitis A, a viral infection usually transmitted through contaminated food and water. With several gastrointestinal infections and vector-borne diseases being common during the monsoon, getting the correct diagnosis may be a challenge. 'The typical symptoms, such as yellowing of skin and eyes that people associate with hepatitis, are not the first ones to appear. The yellowing happens at later stages of the disease, where there are high levels of accumulated bilirubin (a yellow pigment produced when the red blood cells break down, usually cleared out by the liver). A person should ideally go to a doctor before this happens,' says Dr Tickoo. Why a test matters The overlapping symptoms, which can be caused by other gastrointestinal infections, are the reason that doctors go in for tests to be sure. As Dr Suranjit Chatterjee, senior consultant of internal medicine at Indraprastha Apollo Hospital, Delhi, says, 'During this season, you would either see food and water-borne infections, vector-borne infections and some respiratory infections. Usually, patients coming in with symptoms such as loose motions, vomiting, loss of appetite have gastrointestinal diseases such as hepatitis A, E, gastroenteritis or typhoid. High fever, headache and body ache would usually be the symptoms in patients with vector-borne diseases such as dengue, malaria or chikungunya.' Dr Tickoo usually gets such patients tested for complete blood count, liver enzyme and C-reactive protein, the last indicative of the inflammation in the body. Then he prescribes tests for dengue, malaria, typhoid, and in some cases, especially concerning the women and elderly, he gets a urine culture to check for urinary tract infection. When to see a doctor People who get fever, nausea, vomiting or diarrhoea should go to a doctor if the symptoms seem to be worsening or do not seem to be improving after a couple of days. Dr Chatterjee advises that anyone who is immunocompromised — for example, if they are living with conditions such as heart diseases, liver disease, kidney disease, diabetes, cancers, HIV, or have undergone an organ transplantation — should go to their doctor sooner. 'One should also go to a doctor immediately if their symptoms are unmanageable, say if they are vomiting or getting loose motions more than 20 times a day,' he says. Do not pop pills at will Importantly, people with these symptoms should only take medicines such as paracetamol and those to prevent vomiting when at home. 'Other medicines such as Combiflam should be avoided. Pain medications such as diclofenac or mefenamic acid should also be avoided, especially when diseases like dengue are likely. These medicines are known to increase the risk of bleeding in patients with dengue. Antibiotics are a strict no-no. They are of no use in cases of viral infections such as hepatitis, can lead to growing antimicrobial resistance and, importantly, may also affect the results of certain tests we need to confirm our diagnosis,' says Dr Tickoo. While most people with hepatitis A get better within four to 16 weeks, some go on to develop serious complications such as liver failure and coma. 'It is, however, impossible to tell who will get the complications. So it is essential that everyone who has the hepatitis A infection takes rest and helps the body recover,' says Dr Ashwini Setya, senior consultant of gastroenterology at Medanta, Gurugram. What to eat during recovery While at home, patients should ensure that they drink plenty of fluids and eat healthy meals as per their appetite. 'It is a myth that people need to eat bland, boiled food. They should only eat as much as they feel like. Usually, people's appetite reduces significantly when they have a hepatitis infection. Force-feeding can lead to more nausea,' says Dr Setya. It is better to boil water and follow hand hygiene, according to Ritika Samaddar, regional head, dietetics and nutrition, Max Healthcare. 'During the recovery phase, liver cells are regenerating. So they need protein in the form of eggs, milk and paneer. They need good fat, so normal refined, olive and nut oils work, but in moderation. A teaspoon of ghee can be had too to whet the appetite. Carbs are equally important for regenerating liver cells. Have small, frequent meals,' she says. However, she warns that the diet discipline must be adhered to strictly for at least six months. 'Hepatitis A is a self-limiting infection. But sometimes there can be a relapse if you do not take care. Besides, you could be at risk of other strains of the hepatitis virus. A diet discipline is a must,' says Samaddar. She even suggests a strict preventive regime: 'Please drink only filtered and boiled water, even cook with it. Wash all your fruits and vegetables thoroughly. Do not eat raw or undercooked foods. Avoid street food, cut fruits and even ice drinks from the roadside or restaurants.' Take the preventive shot There are five hepatitis viruses that cause liver disease in humans. Hepatitis A and E are transmitted through contaminated food and water and usually do not lead to lasting liver damage. Hepatitis B, C and D, on the other hand, are usually transmitted by blood and can lead to chronic infections. At present, vaccines are available against hepatitis A and B. This may also reduce the risk of hepatitis D, which can only occur in people who have hepatitis B infection. While there is no vaccine for hepatitis C, there is an effective antiviral treatment. 'When it comes to water-borne hepatitis, any person who has had hepatitis A is immune for life, but hepatitis E can happen multiple times,' says Dr Setya. Hepatitis E infection in a pregnant woman can lead to abortion of a foetus and increase the risk of maternal mortality, he adds. So, who should take the hepatitis A vaccine? Doctors recommend it for children, students living in hostels, people who eat out often or those who are immunocompromised. Others may also take it to reduce the risk of an infection, but it is not necessary for everyone. (With inputs by Rinku Ghosh) Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government's management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country's space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University's Dart Centre. Dutt has a Bachelor's Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More
Time of India
24-06-2025
- Health
- Time of India
After uptick, Covid cases & deaths decline
New Delhi: After nearly a month of surge, Covid-19 cases and deaths due to the virus are on the decline. The number of active cases, which had crossed 7,000 on June 11, has declined to 4,425, govt data shows. One fatality was recorded in the last 24 hours in Nagpur. "Covid-19 is now endemic. It is not a serious threat. That's why many people aren't getting themselves tested even when symptoms surface," said a senior doctor. The virus is causing mild fever with most patients recovering at home in 2 to 3 days. "Only those with co-morbidities such as cancer, kidney disease and heart disease need to take extra care," the doctor added. Dr Rommel Tickoo, director of internal medicine at Max Saket, said: "We don't advise Covid tests for everyone with fever, cough and cold. But due to the panic and anxiety caused by a surge in cases in the last few weeks, some patients have come to us with positive Covid tests. Treatment involves symptomatic management and rest. In case of Covid or Covid-like symptoms, we also advise keeping away from others to check the spread of infection," he said. Dr Arjun Khanna, who heads pulmonology department at Amrita hospital, Faridabad, said that one new feature of the current wave is that Covid-19 has become clinically less distinct from other viral respiratory infections.
Time of India
23-06-2025
- Health
- Time of India
Covid-19 wave ebbs; cases, fatalities on the decline; doctors now advise rest, not tests
NEW DELHI: After nearly a month of surge, Covid-19 cases and deaths due to the virus are on the decline. The number of active cases, which had crossed 7,000 on June 11, has declined to 4,425, govt data shows. Tired of too many ads? go ad free now One fatality was recorded in the last 24 hours. "Covid-19 is now endemic. It is not a serious threat. That's why many people aren't getting themselves tested even when symptoms surface," said a senior doctor. The virus is causing mild fever with most patients recovering at home in 2 to 3 days. "Only those with co-morbidities such as cancer, kidney disease and heart disease need to take extra care," the doctor added. tnn Dr Rommel Tickoo, director of internal medicine at Max Saket, said: "We don't advise Covid tests for everyone with fever, cough and cold. But due to the panic and anxiety caused by a surge in cases, some patients have come to us with positive Covid tests. Treatment involves symptomatic management and rest. In case of Covid or Covid-like symptoms, we also advise keeping away from others to check the spread of infection," he said. Dr Arjun Khanna, who heads pulmonology department at Amrita hospital, Faridabad, said that one new feature of the current wave is that Covid-19 has become clinically less distinct from other viral respiratory infections.
Time of India
17-06-2025
- Health
- Time of India
Covid-19: With 11 deaths, current wave toll in country past 100-mark
Representative image NEW DELHI: The country's death toll due to Covid-19 has crossed the 100-mark, reaching 108 after as many as 11 deaths were reported on Monday - the highest in a day in the current wave. Kerala reported seven deaths, while a death each occurred in Delhi, Maharashtra, Chhattisgarh and Madhya Pradesh. The seven victims from Kerala, which has been worst affected by the surge in Covid cases over the past few weeks, were all above 60 and had comorbidities such as cancer, pancreatitis, kidney disease and pneumonia. The victim from Delhi was a 67-year-old man with a history of lung cancer. Senior officials in the health ministry reiterated that most of those who have died due to Covid had co-morbidities, like cancer, kidney disease and heart disease. Kerala has the maximum number of active cases (1,920), followed by Gujarat (1,433), Delhi (649) and Maharashtra (540). Uttar Pradesh, Rajasthan and Haryana have also reported a few Covid-19 cases over the past week. It is suspected that the current surge in cases is being caused by emergence of new sub-variants of the coronavirus that can breach immunity developed through past infection and vaccination. However, experts say these aren't causing severe symptoms. Dr Rommel Tickoo, director of internal medicine at Max Saket, said there is no cause for panic as most patients with the infection have mild symptoms, as surface with the common flu. "We don't advise a Covid test for everyone with fever, cough and cold, though some patients have come to us with positive Covid tests. Treatment involves symptomatic management and rest. In case of Covid or Covid-like symptoms, we advise keeping away from others," he said. Official sources have maintained that most cases are being managed under home care. However, directives have been issued to all states to check facility-level preparedness and ensure availability of oxygen, isolation beds, ventilators, and essential medicines as a precautionary measure.
Indian Express
09-06-2025
- Health
- Indian Express
Why calcium and iron supplements should not be taken together
Are you one of those who has been advised to take calcium and iron supplements to make up for deficiencies but not found them to be effective enough? 'That's because many do not know how to take them, the way they should be gapped and the right time to take them,' says Dr Rommel Tickoo, Director, Internal Medicine, Max Healthcare. According to him, calcium and iron supplements should never be taken together because they compete for absorption in the digestive system, potentially reducing the effectiveness of both. 'Both calcium and iron use the same pathways in the intestines for absorption and vice versa. Taken together they could effectively cancel each other out. That's why when you pop both pills together after a meal, you don't see the intended effect,' he says. How should one take iron and calcium supplements during the day? One must take them several hours apart. So one can be taken in the morning while another can be taken in the evening. There is no hard and fast rule but considering both pregnant women and menopausal women need calcium, it is best taken in the morning. That's because the higher activity phase of the human body and the sunlight during the day can enhance your body's ability to absorb Vitamin D better and metabolise this mineral. Also avoid taking calcium at evening or night as the absorption is slower and can cause calcium stagnation. For those needing a quick boost of iron, taking it after they wake up works best because the body's iron levels are typically at their lowest. Should they be taken with meals or after them? One must realise that both iron and calcium are absorbed best when the stomach is empty as food can deter absorption. So make sure that you take them either 30 minutes before or at least two hours after a meal. Should one avoid taking dairy foods, which contain calcium, before taking an iron supplement and iron-rich foods before taking calcium pills? There is no study that proves dietary calcium and iron collide with supplements. Some foods contain oxalates and phytates, both of which can bind to calcium and iron, limiting their absorption. That's why we insist on having supplements before or well after a meal. Who needs these supplements? Iron plays a role in the production of red blood cells and enzymes, enhancing the immune systems. So those diagnosed with iron deficiency anemia or those at risk of developing it, such as pregnant women, infants, children and people with certain medical conditions need it. Calcium supplements are generally recommended for those who cannot get enough calcium through their diet, including those following vegan diets, those with lactose intolerance, those with certain digestive diseases, and pregnant, breastfeeding and menopausal women. In children, calcium and iron are critical for the nourishment and development of the skeleton and teeth.
