The Kidneys- Our filter houses

Typical Human kidney is crescent shaped with 2 layers, the Renal Cortex and the Renal Medulla. The Vertebrates possess the kidneys on either side on the back portion. Kidneys are internal organs which are vital to ion and water balance and excretion.  The primary role of the kidneys is to flush out wastes from our body that allows optimal cellular function and to remove toxins that are generated by metabolism or ingested with a diet. The careful monitoring of the internal systems,  the adjusting of excretory patterns for perturbations from intake, endogenous production, external losses, or metabolic consumption is called homeostasis. The removal of toxins is called clearance.

Major functions of the kidney

1) Maintenance of body fluid composition

a)  Electrolyte homeostasis

b)  Water homeostasis

2) Excretion of metabolic end products and drugs

3) Regulation of blood pressure: renin production and sodium balance

4) Production of erythropoietin

5) Production of 1,25 dihydroxy-vitamin D

Additional responsibilities of the kidney include maintaining systemic hemodynamics and producing several important endocrine molecules. Homeostasis is the response to changes in intake, losses, and metabolic demands in order to maintain a relatively constant extra-cellular environment. The kidney balances intake and production against losses and consumption. y Blood Flows in the kidneys  generously  receiving 25% of the resting cardiac output. Kidneys also utilize large amounts of energy and oxygen.

Kidneys have 1% of body mass, each kidney having a high rate of blood circulation. Blood enters the kidney from renal artery, which branches into smaller vessels that give rise to the “glomerulus.” It passes total body blood volume every 4-5 minutes, filters 180 litres of blood per day and reabsorbs 178.5 litres of it. The kidney produces 1.5 litres of acidic (pH~6) urine per day. A 5% increase in filtration would generate 9 litres of urine per day although the regulation of kidney ensures that this does not happen. Once urine is formed, it passes into a cavity called the minor calyx, multiple minor calyces drain it into the major calyx which empties into ureters that drain the kidney. From there, the ureters empty into the urinary bladder where urine is stored.

The functional unit of the kidney is called nephron. Nephrons are composed of 2 elements:

◦ Glomerulus- A Twisted ball of capillaries which Delivers fluid to the tubule and Renal tubule which is Composed of a single layer of cells. There are 1 million nephrons in the kidney and they contain Water + urea, NaCL, KCL, phosphates, etc. Function of the nephron is to Filter everything out and take back what is worth keeping through reabsorption of water and salts and secretion of additional unwanted substances.

Each nephron filters blood to generate a “filtrate” composed of water and solutes (glomerular filtration), which then passes through a tubule that progressively modifies the filtrate, mainly by reabsorbing desirable solutes and water.

Being complex organs in structure and function, the kidneys have a deep interwoven relationship with the circulatory system.

Kidney disorders can occur silently 0ver time  developing into a chronic condition. Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over time .  It refers to damage to the kidneys and a decrease  in their ability to keep  the body healthy by only partially performing their functions. If kidney disease gets worse, wastes can build to high levels in the blood  resulting in a sick feeling. Complications such as high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage can develop.

Also, kidney disease increases the risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

Some important observations on CKD are:

·        Early detection can help prevent the progression of kidney disease to kidney failure.

·        Heart disease is the major cause of death for all people with CKD.

·        Glomerular filtration rate (GFR) is the best estimate of kidney function.

·        Hypertension causes CKD and CKD causes hypertension.

·        Persistent proteinuria (protein in the urine) means CKD is present.

·        High risk groups include those with diabetes, hypertension and family history of kidney failure.

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases.

Other conditions that may affect the kidneys are: Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney's filtering units. These disorders are the third most common type of kidney disease. Inherited diseases, such as polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue. Malformations  of organs in womb such as a narrowing that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys. Obstructions caused by problems such as kidney stones, tumours or an enlarged prostate gland in men and repeated urinary infections.

Most people may not have any severe symptoms until their kidney disease is advanced. However, some indications are such as feeling more tired and having less energy, have trouble concentrating, have a poor appetite, have trouble sleeping, experiencing muscle cramping at night, swollen feet and ankles, puffiness around your eyes, especially in the morning, have dry, itchy skin and needing to urinate more often, especially at night.

CKD can be detected by calculating the Glomerular Filtration Rate (GFR).  It is the best way to calculate kidney function.  It is calculated from blood creatinine, age, race, gender and other factors. GFR establishes stage of kidney disease and helps the nephrologists plan treatment.

GFR in people with increased risk of CKD due to other conditions such as diabetes, high blood pressure, family history, older age, ethnic group) is more than 90. Those with kidney damage with mild loss of kidney function it is 89-60. Mild to moderate loss of kidney function may give a GFR value of 59-44 and with moderate to severe function loss 44-30.

A severe loss of kidney function denotes GFR value of 29-15 and kidney failure below 15. A GFR below 60 for three months or more or a GFR above 60 with kidney damage (marked by high levels of albumin in your urine) indicates chronic kidney disease.

A simple urine test will also be done to check for blood or albumin (a type of protein) in the urine. When you have albumin in your urine it is called albuminuria.  Blood or protein in the urine can be an early sign of kidney disease.

Also an ultrasound or CT scan  can be performed to get a picture of the kidneys and urinary tract to establish size of kidneys , whether too large or too small, detection of  kidney stone or tumour and whether there are any problems in the structure of kidneys or urinary tract. Sometimes a kidney biopsy may be performed to check for a specific type of kidney disease, see how much kidney damage has occurred and help plan treatment. To do a biopsy, the doctor removes small pieces of kidney tissue and looks at them under a microscope.

Acute Kidney Injury (AKI) is another kidney condition of note which can lead to chronic kidney disease. It is a syndrome that results in a sudden decrease in kidney function or kidney damage within a few hours or few days. Dr. Javier A. Neyra has observed that AKI is common in patients who are in the hospital especially in the elderly and those in intensive care units (ICU). He says,” AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep a balance of fluid in your body. This can also affect other organs such as the brain, heart, and lungs. AKI is found through simple blood and urine tests. AKI can lead to chronic kidney disease (CKD), or even kidney failure needing dialysis (end-stage kidney disease). It may also lead to heart disease or death. Even mild AKI or a seemingly complete recovery from AKI may have some short- and long-lasting health problems.”

Major causes of AKI include Decreased blood flow to the kidneys. This can result from Hypotension (low blood pressure) or shock, Blood or fluid loss (e.g., bleeding, severe diarrhoea), Heart attack, heart failure, and other conditions leading to decreased heart function, Organ failure (e.g., heart, liver), Use of NSAIDs (e.g., ibuprofen, naproxen), Severe allergic (anaphylactic) reactions, Burns, Injury and Major surgery

AKI can also be caused by Direct damage to the kidneys due to conditions such as Acute glomerulonephritis (inflammation and damage to the kidney glomerular membrane) or Acute interstitial nephritis (allergic reaction that can be caused by several drugs) or Sepsis (total body response against infection which can cause poor organ function or poor blood flow) or an enlarged prostrate or kidney stones.

Clinically AKI can be detected through a blood test for creatinine to find out how well the kidneys are working by estimating the glomerular filtration rate (eGFR) and also by A urine test to find protein in the urine (proteinuria) which may show kidney damage

other preventive measures include Staying well hydrated – drinking a lot of water and avoid long term use of drugs that are toxic to the kidneys such as NSAIDs (ibuprofen, naproxen) or herbal remedies or supplements.

Kidney failure is a term referred to a condition of 85-90% of impaired kidney function. People with this condition have to undergo Dialysis treatment which removes excess wastes and fluid from the blood. With sufficient treatment, overall health improves and patient will have more energy to cope with life. Inadequate dialysis may result in accumulation of excess wastes and fluids in the blood.

 In addition, studies have shown that receiving adequate dialysis treatment increases lifespan of the patient. Dialysis dose is established by a test called Kt/V.. Another test used is called urea reduction ration (URR). Three major types of treatment are available for patients with kidney failure. They are haemodialysis, peritoneal dialysis and kidney transplantation. Haemodialysis may be done at a dialysis center or at home, and treatments usually take place three times a week. Peritoneal Dialysis may be done at home, at work, at school or wherever a clean, private space is available for bag exchanges. The two types of peritoneal dialysis are automated peritoneal dialysis (APD), which requires the use of a machine, and continuous ambulatory peritoneal dialysis (CAPD), which is machine-free.

Kidney Transplants can come from living donors, who are usually family members, spouses or friends of the patient. Transplants can also come from people who died recently (non-living donors).

It is important to note that treatment does not cure kidney failure and that each type of treatment has its benefits and drawbacks. Each choice has to be carefully weighed.

Kidney failure interferes with the body's natural immunity, increasing chances of some infections such as hepatitis or AIDS through dialysis treatments. Those in line for dialysis are vaccinated before hand for such diseases which may be acquired through blood transfusion.

Almost all patients and their families have fears before starting treatment as to how long one can survive with the disease and it is normal and expected. In such a situation referral to the dialysis unit where treatment will take place by the doctor should be consulted who have already been through it.

Diet with less salt, avoiding high potassium and phosphorus foods and limited intake of fluids can be severely harsh on the patient. Small amounts of restricted foods can be had topped with spices and tangs suitable to one’s palate.

Frequent Mood changes are also common among kidney patients due to Uremia or the build up of waste products in the blood, making them irritable. The stress caused by chronic illness itself may lead to frustration and mood swings. The experience of having an older parent with chronic illness can be difficult. Treating them with dignity and respect while, at the same time, taking more responsibility for their care, requires a delicate balance of patience, sensitivity and frankness especially with the elder caretaker in the family.

Kidney risk groups must avoid alcohol, pain killers such as analgesics, Nonsteroidal anti-inflammatory drugs (NSAIDs) and over the counter medication.

World kidney day is observed on every second Thursday of March. On this occasion it was divulged by Dr. Sanjay K. Agarwal, Professor and Head of Nephrology, AIIMS Delhi that one in every 10 adults in India suffers from chronic kidney disease (CKD), and at any given point, nearly five lakh patients are in need of life-long dialysis or transplant. He further said that “only 6,000 patients received new kidney and another 30,000 could afford or get access to dialysis. For the remaining 4.5 lakh, there was no definitive treatment and their survival was difficult beyond a few weeks.”

Dr. Agarwal noted that “just two simple tests to check the level of protein in urine and a blood test for measuring serum creatinine once a year can help prevent the disease. If the tests are normal, they can be repeated after a year.”

Present in drinking water, it is believed that Sodium bicarbonate can reduce the progress of kidney damage. It results in higher O2 levels through increased alkalinity to the cells. New research by British scientists at the Royal London Hospital shows that sodium bicarbonate can dramatically slow the progress of chronic kidney disease.

The findings have been published in the Journal of the American Society of Nephrology. Dr. SK Hariachar, a nephrologist who oversees the Renal Hypertension Unit in Tampa Florida stated, upon seeing the research on bicarbonate and kidney disease, “I am glad to see confirmation of what we have known for so long.  I have been treating my patients with bicarbonate for many years in attempts to delay the need for dialysis, and now we finally have a legitimate study to back us up. Not only that, we have the added information that some people already on dialysis can reverse their condition with the use of sodium bicarbonate.”

Herbal supplements are a big no for kidney patients. People with high risk of kidney disease or those who are already kidney disease patients should not use herbal supplements. Use of herbal supplements is unsafe if you have kidney disease since some herbal products can cause harm to your kidneys and even make your kidney disease worse. Also, your kidneys cannot clear waste products that can build up in your body. Herbal supplements may contain Potassium or Phosphorous, minerals that can put pressure on the kidneys and worsen their condition. Some supplements made in lax conditions may contain heavy metals.

Mechanisms of action have been studied in clinical studies for some herbs. Their effects are mainly related to anti-inflammation, antioxidation, antifibrosis, regulation of immune system, anticoagulation, and improvement of metabolic disturbance. Active ingredients purified from herbs that have been studied in CKD include saikosaponin a and d (SSa and SSd) and triptolide. However, the active compounds in many decoctions or patent medications are still unknown, and clinical trials demonstrating their efficacy for treatment of CKD are limited.

Kidneys are sensitive organs. We need to evaluate and take informed decisions on medications being prescribed by doctors and ensure that no harmful drug is being given. For example doctors may say that PTH hormone level  is high and prescribe Calcium Channel Blocker, such as amlodipine which needs to be avoided and substituted by ACE inhibitor such as Quinapril, and Accupril. The Parathyroid glands control calcium levels in the body. Thyroid gland will release calcium into the blood stream from the bones to maintain calcium balance, after calcium is blocked to the heart by drugs such as amlodipine. More PTH will be released, side effects shall be controlled by another drug and so on until all accumulatively start having a derogatory impact on kidneys.

According to Brig AS Narula one lakh patients with end stage renal disease report at hospitals every year. In a community based study by Agarwal et al , from Delhi in Northern India the prevalence of earlier stages of CKD was reported to be 7852 per million population.

 Brig AS Narula further observes that India has a rising burden of chronic diseases such as hypertension and diabetes. The increase in number of CKD patients can be partially attributed to the epidemic of chronic diseases and the aging population. India has the largest number of diabetics in the world with a prevalence of 3.8% in rural and 11.8% in urban adults.

The prevalence of hypertension has been 12-17% among rural adults. It is estimated that 25-40% of these patients are likely to develop CKD, with a significant percentage requiring renal replacement therapy. The health care system in our country is not designed to provide the required level of care for CKD at the primary or secondary level.

In developing countries various health care programs have been devoted to communicable diseases, nutritional deficiencies and population control and recently to acquired immunodeficiency syndrome. For non communicable diseases such as diabetes, hypertension and CKD the focus has been on developing advanced treatment facilities at the tertiary level.

The staggering costs incurred in developing these centres of excellence needs to be recognized thus making it imperative to shift the approach from provision of renal replacement therapy to early detection and prevention of CKD. This approach may additionally reduce the morbidity and mortality of underlying conditions such as diabetes and hypertension, which is related directly to the presence of albuminuria or degree of renal function impairment.

#kidneys #chronic kidney disease #kidney prevention and cure #kidney treatment and options

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Stress – Watch out for it as it hunts for you !

Stress – Watch outfor it as it hunts for you !

Stress is that unhealthy feeling inside, the uncomfortable factor refusing to budge and going unnoticed by self. It is often accompanied by a sense of impending disaster at times, expecting relentlessly for the worst to occur or fearful of what the future holds, nervousness, tense or a perpetual worried demeanour, jittery feeling….Anxiety !

Stress is the strain and hardships the Syrian civilians are going through, felt equally by those trying to accommodate or refuse entry to them.

As the modern age and day bring us technology and a glut of knowledge, they charge us for it too with serious mind and body conditions such as Stress. As time passes by Stress is acquiring more and more significance and attention. It is a problem of each one of us as we negotiate through the rigmaroles of everyday life, glued to our cell phones.

In a country like India the sheer number of people in every sphere of life including a hospital bed can in itself be over stressing, individual reasons causing stress notwithstanding. Trying for school admissions, bill payment lines, any government institution interface, traffic policeman, traffic itself , Boss at workplace, pollution, corruption, rising cost of living, shopping lists, noisy markets and roads, hostile city environs and smart phones are all habitat related causes of stress.

In the words of rock star David Bowie, “ a brain like a ware house it had no room to spare, I had crammed in so many things in store, everything in there, and all the fat skinny people, and all the tall short people, and all the somebody people, and all the nobody people, I never thought I need… so many people.

Stress has been defined by many. Dr. Hans Seyle, an authority on stress defines it as “ the rate of wear and tear caused by life.” Stress has both positive and negative shades. The medical dictionary defines stress as an organism's total response to environmental demands or pressures. Miller-Keane Encyclopaedia and Dictionary of medicine defines stress as “ reactions of the body to forces of a deleterious  nature, infections, and various abnormal states that tend to disturb its normal physiologic equilibrium (homeostasis).”

Farlex Partner Medical Dictionary defines it as “forcibly exerted influence; pressure.”

A state of physiological or psychological strain caused by adverse stimuli, physical, mental, or emotional, internal or external, that disturb the functioning of an organism and which the organism naturally desires to avoid.

In mechanics stress is defined as the force per unit area applied to a body or object, measured in pascals (pa) or newtons (N.m^-2). 

Stress is defined as the Psychological and/or physiological response of an organism to any demand made upon it by agents threatening its physical or emotional well being. Stressor is any factor or reason or instigator that causes a stress response. 

Stress types are many, such as physical, caused in the body, could be due to a sudden change in body condition. Chronic stress could be due to an illness or changes in the body due to time.

Emergency Stress caused by external agents, such as an accident or foreseeing one involves the adrenal gland, which releases the hormone epinephrine into the blood. This pumps up the heart rate and blood pressure, pumping all sugar supplies into the blood and dilating all blood vessels in the muscles to receive the energy such as the dilating of the pupils of the eye upon witnessing or hearing something horrific. The hormone supply remains steady and continuous in case of prolonged injury or disease thereby creating possibilities of an adrenal exhaustion, a fatal condition.

Lack of appetite before an exam, goose pimples while watching a thriller or the thought of danger are all forms of psychological stress.

Stress in practical terms , one that we all can co relate to is work related stress. Irrationally demanding superior, peers, target pressure, inefficient time management, poor team handling, inability to perform multi tasking, inability to meet organisational expectations, negligent growth or increments, insecure future, threat of losing the job are all pertinent to this category. As one grows older and travels up the corporate ladder, stress increases further with every increase in designation and responsibility.

Options to tackle this kind of stress are to go for a job change or downgrade to a lesser pressure position within the same organisation. Hectic work ethic often results in lack of time for family and friends and loved ones. This is a major reason for stress too.

Indecision at appropriate moments, inaction and feeling of helplessness are major causes of stresses as well. Ignorance is not bliss in the case of stress. It in itself shall cause unknown stress.

Domestic Stressors include negative self esteem, loss of confidence and not addressing pressing issues, marital discord, ineffective parenting or lack of parenting skills; and lack of family support concept and inadequate resources and funds.

In some cases, anxiety is produced by physical responses to stress, or by certain disease patterns and medications.

Anxiety can be safely defined as a bye product of stress and distinctly different from it. To understand both we must understand anxiety as well.

Anxiety is being anxious, in the context without reason, due to fear, figments of imagination working overtime.

According to the Farlex medical dictionary anxiety is a multi system response to a percieved threat or danger. It reflects a combination of biochemical changes in the body, depending upon the patient’s personal history, memory and social situation in terms of intensity and frequency of anxiety attacks.

Anxiety is related to fear. It  is often unfocussed, vague and hard to pin down to a specific cause. In this form it is called free floating anxiety. It is a multidimensional response to stimuli in the person’s environment, or a response to internal stimulus.

Anxiety can be a symptom of certain medical conditions as well such as the dysfunction of the endocrine system, hypo thyroidism, respiratory distress syndrome, mitral valve porphyria and angina pain ( angina pectoris, when pain occurs in chest or left arm due to blocked arteries and inadequate supply of blood to the heart).

Certain medications also cause anxiety as a side effect, such as drugs meant to treat asthmatic or thyroid conditions, psychotropic drugs, local anaesthetics and anti inflammatory drugs such as flurbiprofen and ibuprofen. Caffeine consumed in good quantities can cause anxiety. Withdrawal from certain prescription drugs, primarily beta blockers and corticosteroids, can cause anxiety. Withdrawal from drugs ofabuse, including LSD, cocaine, alcohol, and opiates, can also cause anxiety.

Sigmond Freud believed that all phobias and internal conflicts give rise to anxiety.

Symptoms of anxiety are headaches, dizziness, nausea, diarrhoea, tingling sensation in the feet or hands, sweating, numbness, blankness of the mind, tight breathing, clutching sensation in the shoulder blades and chest, trembling hands etc. Cognitive symptoms of anxiety include recurrent or obsessive thoughts, feelings of doom, morbid or fear-inducing thoughtsor ideas, and confusion, or inability to concentrate.

The diagnosis of anxiety is complex because of the variety of its causes and the highly personalized and individualized nature of its symptom formation. There are no medical tests that can be used to diagnose anxiety by itself. However sometimes medical practitioners use the Hamilton Anxiety scale and the Anxiety disorders interview schedule and or check blood sugar and thyroid levels.

Medications include anxiolytics or tranquilizers. These are either benzodiazepines or barbiturates which are now not in common use since they have to do with the slowing of the nervous impulses. Benzodiazepines relax the skeletal system and soothen the limbic one. Drugs under this category include chlordiazepoxide and diazepam. Such druga may be addictive in nature. Since anxiety often co exists with depression, doctors often use anti depressants for treatment such as escitalopram oxalate with imipramine with a combination of ormonoamine oxidase inhibitors.

Beta blockers which block the body’s reaction to stress harmones glucocorticoids and catecholamines are also used for treatment of anxiety such as propranolol, atenolol etc.

We can safely conclude that anxiety is a bye product of stress. This suggests that stress is a condition which needs to be identified and treated since it is deeply linked with disease. Recently results of many ongoing or concluded studies trying to establish a connection has revealed that certain diseases such as atherosclerosis, coronary artery disease, respiratory disorders, body pains, hyper tension or blood pressure, bowel diseases such as infections and diarrhea,asthma, allergies, colitis, migraine headaches, and peptic ulcers are caused by stress. Although there is no conclusive data to support the link, however in studies stress subjects had enhanced symptoms of aforementioned diseases relatively to normal ones, suggesting that stress catalyses the onset of disease and aids in disease development in humans.

High levels of stress cause constant release of stress hormones, such as adrenaline, cortisol, and dehydroepiandrosterone, which stresses the endocrine glands and may result in hormonal imbalances and adrenal dysfunction. This can translate into anxiety disorders, insomnia or sleeplessness, depression, skin allergies, rashes and weakened immune system.

Stress is linked to high blood pressure, abnormal heartbeat (arrhythmia), blood clotting, and hardening of the arteries (atherosclerosis). Eminent researchers such as Hsu et al. investigated whether insomnia is linked with higher risks for heart attacks and strokes. Researchers compared the frequency of cardiovascular events in 22,040 adults diagnosed with insomnia and 22,040 without it. During a10-year follow-up, the insomnia group had a significantly higher incidence of myocardial infarction and stroke. These findings are consistent with the growing evidence that poor sleep quality is a risk factor for adverse cardiovascular outcomes.

Depression is an independent predictor of adverse outcomes in patients with heart failure (HF), Analyzing data from 457 patients, Hwang et al. found that worsening somatic depressive symptoms, but not cognitive-affective symptoms, were independently associated with increased mortality of Heart Failure patients. The results although clearly point out to a connection between stress, depression and heart function.

Recent research suggests that self-esteem may be associated with improved parasympathetic nervous system functioning. In a large sample of healthy adults who wore ambulatory monitoring devices and completed electronic diaries, Edmondson et al. as reported by Forbes found that momentary increases in anxiety were associated with acute increases in ambulatory systolic blood pressure and that high self-esteem buffered this association between momentary anxiety and blood pressure. Thus, high self-esteem may confer cardiovascular benefit by reducing the acute cardiotoxic effects of anxiety.

Muscle tension due to stress can cause back and shoulder blade pains and cause bowel related gastroesophageal reflux disease to worsen. It can also result into painful menstrual periods, erectile dysfunction and low fertility.

       A person suffering from stress can feel helpless and irritable ( cranky), frustrated, ill tempered,       having constant negative thoughts, tense all the time with a feeling of impending doom, tiredness or fatigue,sleeping disorder or over sleeping and Lack of energy or focus.

Treating Stress – Many ways and techniques of treating stress have been propounded. Meditation and practicing Mindfulness in particular have proved to be effective in reducing stress and depression, improving attention and cognitive performance, and even increasing grey matter density in the brain. Exercises, workouts and doing things which build up confidence and health may also help.

We shall mainly focus on the main three, meditation, mindfulness practice and relaxation.

Meditation involves focusing the mind on an object or word combined with a passive attitude and a comfortable physical position. It involves concentrating on an intrinsic visual or thought and dwelling upon it for as long as possible to relax the mind and free it of clutter. Meditation is aprogressive process and involves many stages in it’s cycle, slowly exhibiting capability to de clutter the mind, increased capacity to concentrate and control thoughts and automatically brings feelings of more control and thus has an overall distressing effect on the mind.

Rationale-Meditation is believed to produce a state of relaxation that is incompatible with feelings of anxiety to induce a “trance state” that elicits positive mood and/or to provide a period of “rest”.

Meditation has been propounded by sages and ascetics in the Indian mythology and used as a tool for spiritual upliftment and used as a practice by those pursuing intellectual or spiritual goals.

Mindfulness on the other hand  is a mental practice used to focus attention on the present moment, rather than on the usual “chatter” that’s going on in our heads. It also helps a person learn to not get caught up in his or her thoughts, but instead simply to acknowledge them and let them go.

Jon Kabat-Zinn, the founder of mindfulness-based stress reduction (MBSR) at UMass, has described mindfulness as paying attention, on purpose, to the present moment, curiously and non-judgmentally.

. “More and more people report using meditation practices for stress reduction, but we know very little about how much you need to do for stress reduction and health benefits,” said lead author J. David Creswell. While conducting research studies on two groups to evaluate effects of mindfulness on stress they observed-“When you initially learn mindfulness mediation practices, you have to cognitively work at it — especially during a stressful task,” said Creswell. “And, these active cognitive efforts may result in the task feeling less stressful, but they may also have physiological costs with higher cortisol production. However mindfulness practice has a positive controlling effect on stress.”

In the words of Alice.G.Walton, a contributor to Forbes, on mindfulness- “In principle, the answer is beautifully simple – thoughts don’t have to be believed. You can just acknowledge the ridiculous or negative thoughts that pop into your head, chuckle at them, and then release them. This is the essence of mindfulness.”

That’s the fundamental first step: Realizing the uselessness of most of our thoughts and how much negativity and sorrow they bring. “We often can’t see how painful the everyday chatter is. That chatter actually takes a lot of effort. But when we try to suppress it, it usually backfires, and makes things worse. The key to changing the cycle is that we HAVE to become disenchanted with it, and realize how painful it is.” Once we do this, getting out of it is, for the most part, easier.

In the words of Judson Brewer, MD, PhD, “It’s kind of like beating your head against tree vs. eating chocolate,” says Brewer. “You realize, ‘wow, there’s something better than banging my head against the tree; guess I’ll eat more chocolate.’” When we have something to compare our normal thought process to (like chocolate, or, in reality, a better mental state), we realize how painful our norm has been. It’s just a matter of seeing that difference (the head-banging vs.the  chocolate or self-obsession vs. mindfulness), and we naturally become disenchanted. We can’t force it, it just happens.

“Mindfulness essentially means moment-to-moment awareness. Although it originated in the Buddhist tradition, you don’t have to be Buddhist to reap its benefits,” says Drew Hansen, a Forbes contributor. Mindfulness includes a broad spectrum of informal activities in addition to meditation.

Here are a few simple techniques that can be incorporated every day, even at work:

Spend at least 5 minutes each day doing nothing

Getting in touch with one’s senses by noticing the temperature of one’s skin and background sounds around.

Paying attention to walking by slowing the pace and feeling the ground against one’s feet.

Another approach is the “There is a way - Alternative De-stressing Approach”-(TADA). In this when ever stress symptoms appear one is required to step aside into observance mode and observe oneself or others, pay attention to how one is reacting and behaving and feeling. This is nothing but observing what one is doing, saying, thinking, and feeling. However not passing judgement but accepting behaviour is an important aspect of this technique, since acceptance is not agreement. If you find yourself being out of control then you accept the fact that you are out of control without judgement
Stating that you are accepting the event is necessary at first. However, as you use the TADA technique you will find it to be more spontaneous. The last aspect of the TADA technique is the trust factor. The element of trust implies that the stressful events that are happening and recurring in your life are there for a perfect reason-and that reason is good.

This approach helps de-stress and has gathered a lot of steam and popularity in handling stress techniques world over.

Clarity leads serenity. If you’re stressed with work, get clear about exactly what tasks must be done and pen them down to prioritise. They will actually turn out to be much lesser than when thought and perceived in the mind to be a handful. Avoid Learned Helplessness – failing to respond or act to improve our circumstances.

Feeling of control and tidiness also improves stress levels. We always must have our home, office and car for example in proper order and shape. As the esteemed behavioural psychologist Martin Seligman has shown, there’s a strong correlation between feelings of control and well being.

Focus on helping other people. This brings about a feeling of satisfaction and adds meaning and variance to the mind helping in de stressing.

Taking wholesome and multipronged action to improve habitat or surroundings or while addressing a problem situation also works wonders. It results in some things working out wonderfully and encourages one to keep moving on, tasting more success, confidence and satisfaction all of which are stress busters.

Relaxation techniques are also useful for reducing stress. People use progressive relaxation which involves doing exercises which relax a particular set of muscle or muscle clusters.

All said and done stress needs to be recognised mostly by self evaluation and treated as good as any other body condition. After all life is just to be lived once. Who knows how long there is to live but he who desires quality of life more than quantum of life shall better reap the joys of life.

At the end of it all stress handling or stress management is more of an art and requires conscious, sustained and guided effort. We all will agree that in life all that will matter in the end is what prepared us better for the end and made the end as stress free as possible, where the end is nothing but to be seen as a new beginning.

Disclaimer: The opinions and suggestions given in the write up are our own and should not be interpreted as a prescription for any drug or diagnosis of disease, for which readers should visit specialist medical practitioner only. There is no intent to duplicate any content from anywhere, quotes or specific knowledge is taken for education and non commercial objectives.

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#StressStrain #Anxiety #StressTreatmentControl

Shimbhala 500 ml A potent herbal Extract for the Heart-Testimonials

Shimbhala is a simple formulation made of extracts of Ginger,Garlic,Lemon, Apple Cider Vinegar with Honey. It helps in treatment of Arthrosclerosis in which arteries harden and inner walls accumulate plaque which blocks the arteries and restricts blood flow, thereby increasing the chances of a heart attack or myocardial infarction.

Shimbhala helps prevent cardiac incidence and reduces the risk of a heart problems by keeping cholesterol in check and promoting smooth blood flow. Shimbhala further tones up the circulatory system.

Testimonial-1

 Atul Kumria

Age-50, Location New Delhi, General Manager with a recruitment Firm. Previously in Telecom Sales

I am an active 50 year old with a cardiac history of suffering a heart attack in February, 2007, at the age of 44 years. I was a smoker with a family history of cardiac disease. My father and mother have both dies of congestive heart failure. My father had a series of Myocardial Infarctions apart from suffering from Angina Pectoris, Pulmonary congestive disorder and what doctors called cardiac asthma. My Grand father died of cardiac failure too.

After my attack, lucky that I survived, I simultaneously underwent angioplasty in the same artery and got one medicated stent at Metro Heart Hospital, Lajpat Nagar, New Delhi in which one of my main arteries was stented. My doctor told me that the other artery was also blocked 90% and actually it also required stenting. Lack of finances forced us to leave that option.

I was put on to Shimbhala as an alternate medicine by my cardiologist/interventionist himself and my artery which in the first angiography had shown 90% blockage had opened up with 45% blockage after two years of constant intake of Shimbhala, 15 ml daily.

Prescriptive drugs are meant to keep cardiac condition regulated and in check but are not known for opening up blocked arteries or reversing a cardiac condition. Originally I was prescribed medicines that I am supposed to consume lifelong, which includes cholesterol lowering Statin 10mg, betablocker 80mg, anti hypertension drugs combination of three salts total 20 mg daily and aspirin.

After using Shimbhala for 2 years continuously and subsequently intermittently, my prescriptive drug quantities have decreased substantially. Statin 10 mg has come down from 10 mg to nil. Statin drug prolonged usage definitely causes muscle atropy, which is pain and weakening of the entire muscular system, fatigue and weakness in the limbs. Liver function also worsens faster with Statins as the drug acts on the fat in the liver itself.

BetaBlocker dosage, Telmisartan IP reduced to 80mg from 100mg 0f proponolol earlier. Clopidogrel and Aspirin dosage has gone down from 150 mg to 75 mg.

I do not have to eat Statin anymore as my cholesterol, triglyceride counts are always well within limits. Stopping Statin gave a boost of energy in itself and I feel much more relaxed in the mind and body with my overall condition. Thanks to Shimbhala.

My quality of life has improved tremendously and I do not suffer from any chest pains which used to keep re-occurring time and again. After the attack I had started feeling very insecure as I would experience short term pains in the left area of the chest, both front and back and I would always carry a nitroglycrin spray (imported from  Germany) and sorbitrate tablets in my pocket for emergency use.

I do not feel breathless anymore and I go for long walks whenever I get the opportunity from my work schedule. I feel more energetic than before and am certainly more confident as I underwent a severe post attack trauma and had totally lost the zeal and confidence to be working remain outdoors.

I thank my cardiologist for introducing me to Shimbhala and giving me an opportunity to live with a certain level of quality, enjoying every moment that I live. After my attack I thought I could not live a normal life anymore but Shimbhala improved my overall condition quite dramatically and I have been lucky enough to go along with my highly skilled and motivated trekker wife. We have done numerous mountain climbing trips and expeditions in the Uttarakhand Himalayas, post the attack, including the latest we did, the high altitude Chandrashila Peak winter expedition, (kedarnath valley height 16000 ft), the Roop Kund Trek in Uttarakhand, apart from many nature trails and mountain driving marathon, as one of my other passions is driving like crazy in the hills and for long distances such as Binsar, Munsiyari, Khirsu,Chopta and many other exotic locations in Uttarakhand.

I have met many Ayurvedic doctors some of whom say that garlic extract may reduce plaque in arteries but garlic in itself is tamsik food and may become the cause of onset of other diseases. If we assume this theory to be true, I am quite clear that to experience other diseases, we need to survive heart disease first !

Thank you Shimbhala once again and keep it up.

Atul.kumria@gmail.com

+91 9310802618

Testimonial-2

Ajay Seth

Age-49, Location New Delhi, Vice President with an automotive component export house.

I am a busy family man, mostly from home to office and back with a routine of 2 to 3 international trips in a year. I have been suffering from sporadic chest pains and high cholesterol. My cardiologist diagonosed it as Angina Pectoris and prescribed al lot of drugs to me.

Walking for 15 minutes would give me a constricted feeling in the chest and sometimes tingles in my left arm. My office work began to suffer as I was not able to cope with my work demands and my own strong work ethic. I remember feeling extremely let down in life and I used to feel quite down. I started looking around for alternatives and someone advised me to start having Shimbhala.

Initially Shimbhala 15 ml dosage daily resulted in loose stools for me however after a week or so it started getting better and normalised after a fortnight. I noticed I was more energetic and able to go for daily brisk walks which earlier I was not able to do. I come back from work and go for a 45 minute brisk walk. My prescription drug for lowering cholesterol has also reduced to 5 mg from earlier 10mg.

 I am back at intensive touring internationally and very recently have been promoted to VP-Sales within my organisation. Doctors have declared my condition as Stable Angina as I no longer have the pains here and there and neither do I have any more pain or numbness in my left arm. I eat very plain food and avoid all kinds of fried foods or fat rich foods. I do not eat red meat and neither indulge in any smoking or alcohol consumption. I have also been able to benefit tremendously from meditation and a lot of my group mates in the meditation group are also benefitting from the amazing results of Shimbhala.

I thank Shimbhala for easing my situation and all those friends and loved ones who stood by me in my troubled times.

Ajayseth65@yahoo.com

(m) +91 9810029801

Testimonial-3

Ritesh Sabharwal

Age-47, Location New Delhi, General Manager-Sales with a lubricating Oil division of an MNC.

I am a heavy weight individual having been on the heavier side ever since college days. I love to eat all kinds of tasty foods especially Panjabi preparations and am a moderate drinker and smoker. I was diagnosed with diabetes at an early age and have ever since been on ant diabetic drugs and diet regimen. I had developed a high blood pressure condition also and was unaware of it for more than a year. Chest pain and severe dizziness drove me to a check up and I was diagnosed with Unstable Angina Pectoris.

Prescriptive drugs helped stabilise my condition. I am still using 20 mg of telmisartan and rosuvastatin 10mg. I have diabetes controlling drug dose of 20 mg daily. and one of my close friends advised me to use Shimbhala 500 ml as it contained artery healing ingredients. I have now been having it regularly for more than one year and have no intentions of stopping it. I have got used to it and the day I skip it I feel there is something left to do which I am missing on.

I have no more constrictive feeling in my chest or laboured breathing. In fact I had frequent bouts of pain and numbness in my joints which has also disappeared. I have started going for morning walks and the improvement in my condition has helped me to even regulate my eating (calorie intake monitoring). I am walking for almost 90 minutes daily and intend to shed 20-30 kgs. Thinking upon the benefits of having Shimbhala, the uppermost in my mind is the wholesome energy and lively feeling I have and to be able to stick to my hectic touring schedule.

Ritesh.sabharwal66@gmail.com

+919988848343

Testimonial-4

Atul Vohra

Age-38, Location Chandigarh, manager with a Private Firm in Sales and Marketing

My problem since last four years has been high LDL cholesterol. I eat outside all the time forcefully due to the nature of my job. I have been a moderate smoker and love to socialise. When I was diagnosed with a cholesterol problem the doctor advised me to bring about changes in my lifestyle and start getting used to the idea of sticking to a simple way of life without any chronic bad habits.

Although I reduced my smoking and liquor intake I started feeling quite unsettled and was not able to come to terms with the idea of having developed a bad health condition at such an early stage of life.

My chemist advised me to use Shimbhala as according to him he had started it with many patients all reporting good result and improvement in their respective conditions. Although I will admit I was irregular initially with the daily dosage (also because I never liked the taste or smell) I slowly got used to it and then gradually it became a habit.

I have now used Shimbhala for six months and stopped it only after 5 consistent normal readings of triglycerides and LDL cholesterol. I am much better now and I feel the same intrinsically as well. I have told about Shimbhala to all my friends and colleagues and many of them have started using it, some for their parents who have a heart condition or those who have joint aches.

Thank you for giving me this platform to share my experience and I hope it will reach many.

Atulvohra.chd@gmail.com

(m) +918054979697

Testimonial-5

Mohan Lal

Age-57, Location Chandigarh, Jr. Engineer with PWD, Chandigarh U.T.

I am well settled in Chandigarh and about to retire in 2016. I have been a bidi smoker ever since childhood and have had no illness all my life until recently when I was diagonosed with heart disease. I was advised by pass surgery as I had multiple blockages in my arteries. At the time of diagnosis I was unable to walk more than 10 to 15 steps as it would increase my breath rate and heart rate. I had to curtail a lot of my activities and cut down on my evening social life as well. However I decided not to go in for surgery as I neither had the finances nor could I gather enough courage to do so.

Ever since I have used Shimbhala for almost one and a half years now. I am not completely out of danger but I have been able to improve upon my condition quite a bit. I go for long slow walks now in the morning on the Sukhna Lake and I do not feel breathless anymore. My cholesterol and blood Pressure are both stable and within limits and I follow a very simple diet plan now. I drive around on a two wheeler as I have always done and I don’t feel scared as initially when I developed the heart problem I had stopped driving as it would scare me.

I plan to continue having Shimbhala and hope that I would scrape through without going in for surgery as I am very scared of them and especially open heart surgery which anyway does not enjoy a very high success rate.

Thank you Shimbhala and AnushvedaWellness for continuing even home deliveries on call.

(m) +919915744741

Shimbhala is being used by thousands of users and many testimonials have been generated.

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For enquiry please call +919310802618 / +919988848343 or write on contactus@anushveda.com

Air Pollution - A Silent killer running Amok !

Air Pollution is the single largest risk to our health, threatening to assume draconic proportions and raining death all around! New studies reveal that air pollution causes cardiovascular diseases including angina, ischemic heart disease and strokes apart from causing respiratory disorders and obstructive pulmonary diseases. Both indoor and outdoor air pollution are responsible for these health issues.

The new study links beyond doubt cancer to air pollution as well.

Air pollution is the introduction of particulates, biological molecules, or other harmful materials into Earth's atmosphere. Air pollutants can be classified mainly into primary pollutants which have a direct impact on the atmosphere such as carbon emissions or sulphur dioxide emissions from industrial smoke. Secondary pollutants are caused by the chemical reactions of the primary pollutants, for example to smog we see in our cities.

Outdoor air pollution is increasing as a result of the inefficient combustion of fuels for transport, power generation and other factors such as home heating and cooking. Combustion processes produce a complex mixture of pollutants that comprises of diesel soot particles and the lethal killer, Lead.

Urban outdoor air pollution is estimated to cause 1.3 million deaths worldwide per year.
Some main sources of pollution are burning of fossil fuel (Petroleum, wood, dung, oil stoves etc) which emits pollutants such as carbon monoxide and nitrogen oxides. Carbon emission is linked with the process of incomplete burning of fossil fuel.
Other contributors are agricultural activities, industrial activities, mining operations and all emissions coming from domestic and indoor sources.
Pollution in cities is measured in terms of Suspended Particulate Matter in the air commonly known as SPM.

The pollution is further depleting the Ozone layer which is necessary for the ecosystem of the earth, which due to the gaseous imbalance lets in more sun light and heat, warming up temperatures world wide and what we term as Global Warming. Over the last 100 years, large amounts of carbon dioxide and other greenhouse gases are being released into the atmosphere. The majority of greenhouse gases come from burning fossil fuels to produce energy, although deforestation, industrial processes, and some agricultural practices also emit gases into the atmosphere. These Greenhouse gases act like a cover around our planet, trapping energy in the atmosphere and causing it to warm. This phenomenon is called the greenhouse effect and is natural and necessary to support life on Earth. However, the cumulative and excessive percentage of these gases in the atmosphere can change the Earth's climate and result in dangerous effects to human health and welfare including the ecosystem.

Premature melting of ice regions, increased sea water levels, loss of submarine life and changes in world climate in both intensity and frequency are the outcomes which are clearly visible.

Pollution is trapping us in our own backyard of technology and science, the hallmarks of the modern human race. We built it to facilitate us, satiate our ever increasing appetites for everything and truly demonstrating consumerism in all aspects of life. However a whole gamut of fallouts, consequences was never thought of, planners and the think tanks never had the foresight to build an appropriate structure of checks and balances. Some developed nations have just run away with the “the first one, the preferred one” advantage and have developed at the cost of polluting the whole atmosphere, having realised the perils of pollution and outsourcing manufacturing or processes which are polluting, twisting the global economies with their money power and clout. Now the developing ones although have woken up but still do not seem to be too concerned or atleast convey the impression of being hand tied. Most actions taken are out of compulsion and international pressure and the approach remains far too slow, lacking will.

On 25.03.2014 WHO declared that 7 million died in 2012 of air pollution caused problems. Approximately 15 deaths of every 100 were from air pollution related causes. This places the air pollution factor as the biggest environmental risk to health.

The report released by WHO has estimates which have been scientifically and logically driven and extrapolated on data received from satellites, findings of all ground level based institutions and region wise, country wise emission values and predictor analysis of pollution drifts mapped with existing natural air currents. The researchers have technology at their command which gives them better insights of regions, demographically and even rural and urban splits.

In 2012, regional analysis revealed low and middle-income countries in the WHO South-East Asia and Western Pacific Regions having the largest air pollution-related burden , with a total of 3.3 million deaths linked to indoor air pollution and 2.6 million deaths related to outdoor air pollution.

The findings of the WHO report show that outdoor pollution related total death count broken up reads as – 40% ischemic heart disease and 40% stroke vis a vis indoor pollution 34% stroke and 26% ischemic heart disease. Respiratory/pulmonary disorders in both remain between 10% to 11%. 

We can safely say that Air Pollution is a major reason of cardiac events and causes Heart disease. 

The Particulate Matter is responsible for thickening of the walls of the carotid artery, thereby increasing the chances of a myocardial infarction or stroke. The walls get thickened due to the deposit of particulate matter which is extremely tiny such as the PM1 (particulate matter one) which has the capability to pierce the blood stream and attach itself to free radicals in the blood and form plaque on the artery walls causing it to harden and thicken.

Visit AnushvedaWellness for more information on Heart Disease and Natural Treatment

The American Heart Association mentions modern cardio vascular studies that suggest the possible links between acute and/or chronic exposure to Particulate Matter and cardiovascular events. It may be related to increases in heart rate and blood pressure, fibrinogen, and blood coagulation factors; arterial vasoconstriction; inflammatory mediators (eg, C-reactive protein [CRP]); endothelial injury/dysfunction; and reduction in heart rate variability (HRV). Resultants may include myocardial ischemia (significant ST-segment depression during exercise testing, angina pectoris, or both), malignant ventricular arrhythmias, increased plaque accumulation and vulnerability, and increased possibility for acute thrombosis triggering acute coronary syndromes and cardiac events.

According to Dr Maria Neira, Director, WHO’s Department for Public Health, “ The risks from air pollution are now far greater than previously thought or understood, particularly for heart disease and strokes.”

 According to Dr Carlos Dora, WHO Coordinator for Public Health, “Excessive air pollution is often a by-product of unsustainable policies in sectors such as transport, energy, waste management and industry. In most cases, healthier strategies will also be more economical in the long term due to health-care cost savings as well as climate gains.”  

The Chinese context - A total of 16 of the world's top 20 most polluted cities are in china. No. 1 on the World Bank list is Linfen City in Shanxi Province, China which is known for it’s coal industry. Lead poisoning was described in a 2001 paper as one of the most common paediatric health problems in China. 30% children are reported to have excessive lead levels in their blood. A Green Peace campaigner Mr. Zhang Kai for East Asia reported improvement over last year in certain cities of China such as Beijing. However he said “this is the only silver lining in a situation where 90% of cities still record levels of pollution that far exceed China’s own air quality standards.” China is also trending towards frequent Industrial explosions, killing many on the spur of the incident and releasing pollutants in the atmosphere in abundance.

A Chinese watchdog group, released names of top polluted cities in China which includes Yangquan,Datong, Shizuishan in Ningxia Hui, Sanmenxia in Henan Province, Jinchang in Gansu Province, Shijiazhuang in Hebei Province, Xianyang in Shaanxi Province, Zhuzhou in Hunan Province and Luoyang in Henan Province

Beijing stood 28^th on ranking within China. Recently in the news for being one of the top most polluted cities in the world Beijing is atleast showing some signs of recovery and is slightly better off than New Delhi atleast. In Beijing, PM 10 levels decreased about 40 per cent from 2000 to 2013; in Delhi this has increased about 47 per cent from 2000 to 2011.

 The US context – The clean Air act has shown significant reduction across the board for major six pollutants. carbon monoxide pollution in the US reduced by went down by 51% for the period 2000 to 2010. For the same period Ground Level Ozone dropped 11%. Lead levels in air dropped by 89% from 1980 to 2010, Nitrogen dioxide by 52% and sulphur dioxide by 83%. The Clean Air Act Amendments of 1970 and 1977 authorized the regulatory Environmental Protection Agency more teeth to enforce stricter emission norms all across and results have been encouraging. The US is also engaged in finding long term solutions to the problem of emissions, researching ways and means to replace the internal combustion engine.

The European Union Context – For the period 1990 to 2013 reductions in emissions of almost all air pollutants has been reported. The largest fall was in sulphur oxides by 86.7 %, non-methane volatile organic compounds (NMVOCs) 60 %. Nitrous oxides (NOx) 53.5 %with ammonia  emissions falling by  27 % .

London- Nearly 9500 people have died in a single year in 2010, due to air pollution effects in London because of high levels of PM 2.5  and Nitrogen dioxide, a bye product of emission from diesel engines. In January 2015 NO2 levels in Oxford Street had exceeded the legal limit for the whole of 2015 in the space of just four days – while the limit was also breached in Putney High Street a day later.

However some of the counter measures taken by the UK Authorities include stricter Emission Zone standards, the delivery of more than 1,300 hybrid buses and capping of taxi age. The Mayor’s office in London also released plan for Ultra Low Emission Zone in London from 2020.

The Indian context – New Delhi-The Times Of India recently quoted a recent research study revealing that in Delhi the most lethal ultrafine particulate matter or PM1 had high levels even in lowest pollution pre monsoon season and that too in the perceived cleaner and posh parts of the city. PM1 is the smallest of all particles. It is 2.5 times smaller than PM 2.5, which is 30 times smaller than a human hair width. The PM1 particles are so small and weightless that now for vehicles with Euro 5 fuel standard, the emission is being measured are in number of pollution particles as against the weight of particles.

PM1 levels are 35% to 50% higher than PM 2.5 levels in Delhi which is alarming since PM 2.5  levels are as it is skyrocketing in Delhi. Delhi is has earned the dubious distinction of being the world’s most polluted city, singled out of 1600 cities mapped worldwide.

PM1 can easily penetrate deep within the lungs and blood stream. PM1 causes cardio vascular disease. T K Joshi, director of Centre for Occupational and Environmental Health (COEH) says "Since they get diffused with the blood, new research strongly suggests they can travel to the brain and cause strokes."

The National Green Tribunal has recently intervened in the face of inaction by the Delhi Government and issued a slew of directions to governments in NCR, most of which, although are yet to be implemented. It is heartening to see the NGT reviewing banning of old vehicles, diesel vehicles etc and even going to the extent of asking the manufacturers of cluster buses being used in Delhi for public transport as to why their models make so much noise.

Overall recommendations made by various institutions are gathering dust and the Delhi Government is still mulling over what to do and itching to pin it on the central Government for having done nothing either by releasing statements such as “it should not be the responsibilities of the state governments only to counter pollution. Centre needs to pitch in too.”Blame game is on and it is as murky as the Delhi smog.

Other parts of India fare no better. In India, more than half of the monitored cities have above-average or critical levels of particulate matter pollution below 10 micrometers. Future trending by any available technique is spelling impending disaster.

Steps taken by Government of India to curb air pollution include implementation of the Bharat stage-IV emission norms in 13 large cities including NCR for new 4-wheelers from 2010. Mass emission standards (Bharat Stage III) as a country wide notification defined for two, three wheelers and diesel driven agricultural tractors from April 1, 2010 throughout the country alongwith strict norms for in use vehicles in 2004. Usage of CNG vehicles for mass transport in cities such as Delhi. The Government also introduced alternate public transport systems such as the Delhi Metro and similarly trying to replicate in some other cities such as Jaipur, lucknow etc. Standards  have been developed for Oxides of Nitrogen (NOx), Sulphur Dioxide (SO2) and load based standards for particulate matter (PM) including revision of PM emission standard for the cement industry.

However In India the Agencies monitoring the environment and implementing standards and norms to follow and creating awareness are slow in response and seem to be debating possibilities more than imposing a few and implementing them on a war footing. Decisions have to go through red tape and recommendations being implemented on the ground with alacrity are not happening. The problem seems to be set for compounding further by all the ambitious economic growth projects the current government is embarking upon without developing any meaningful pollution control protocol.

The framework of controlling measures falls far short of the scale and speed at which pollution is increasing, both in terms of oversight as well as in recognition of the gravity of the issue. Actions proposed or taken till now do not justify the intent.

The metro city public however has started viewing Environment pollution in India more seriously. In a survey conducted and statistics released by PEW research centre on how Indians feel about sensitive and critical issues, 74% of the respondents displayed extreme concern on air pollution in 2015 as against 52% in 2014. 73% were very concerned on global warming too.

The shift in attitude towards pollution problem also stems from the fact that Delhi residents and public have been in International and domestic platforms both with a spew of articles and readings on Delhi’s air quality woes. Nicholas Dawes, an editor at The Hindustan Times, said the media coverage was just one reason for the attitude shift. “I think the people of Delhi are increasingly unwilling to tolerate tough circumstances,” he said.  Dr. Joshua S. Apte, an assistant professor of environmental engineering at the University of Texas at Austin, studying Delhi’s air pollution since 2007, said recognition was a start. “The thing that gives me greatest hope is the huge increase in awareness that I’ve seen in Delhi just in the past year.”

However, by and large the problem of Pollution at ground level still lies in the annals of “read about it, feel about it  and let someone else act on it.”

As Pink Floyd puts it “Your lips move but I can’t hear what you saying. Oh I have become comfortably numb.”
#AirPollution #fitness #wellness #healthyheart

Purchase Shimbhala 500 ml online and fight Heart Disease with natural herb extracts