Apollo Health Blog
Obesity is abnormal accumulation of body fat, usually 20% or more over an individual’s ideal body weight. It is defined as Body Mass Index (BMI) equal or more than 30. BMI is calculated as the ratio of body weight in kg to square of height in meters. There are other ways of measuring obesity like fat thickness, waist circumference.
The incidence of obesity is increasing day to day. “In every region of the world, obesity doubled between 1980 and 2008,” As per WHO’s The World health statistics 2012 report, Today one in six adults that is, half a billion people (12% of the world’s population) are considered obese.” Though India is a developing country with malnourishment, now a days India is gaining weight. Obesity has reached epidemic proportions in India in the 21st century, with morbid obesity affecting 5% of the country’s population. It is more prevalent in urban population & females.
Studies show that in India, nearly 15 to 20% of children are overweight and 30% are in the risk of falling in this category. It is these statistics that ring major alarm bells. In India, many studies have shown that the prevalence of overweight among adolescents varies between 10% and 30%. Another important concern is that as high as 60 to 70% may continue to be overweight or obese in adulthood.
Causes of obesity:
- Hormonal disturbances
- Diet habits: Excess eating of high calorie food, Irregular eating habits
- Life style: sedentary habits
Effects of obesity & relation with Diabetes:
Obesity has its deleterious effects on all systems such as Respiratory disease, Stroke, Cardiovascular problems, Gall stone disease, Gout, Osteoarthritis, Hormonal abnormalities, Diabetes & Cancer. Diabetes and obesity are mutually related. India is diabetes capital of the world. 40.9 million people are diabetic in India, this is expected to rise to 69.9 million by 2025.
Glucose maintenance in the body is a complex process. Whenever food enters the system glucose needs to be absorbed into cells by insulin. Secretion of insulin is helped by incretins which are the substances produced by hind gut that stimulate the Beta cells to produce insulin. Secretion of insulin inhibited by anti incretins secreted by fore gut. Poor sugar control is the major contribute for the development of Diabetes which is due to excessive calorie intake, poor secretion of insulin, insulin resistance. All these are strongly associated with obesity.
- Metabolic syndrome
- Type II Diabetes
- Obstructive sleep apnea
- Venous & Lymphatic stasis
- Chronic respiratory hypoventilation
- Hypertrophic cardiomyopathy
Complications of Obesity:
- Psychological -
- Eating disorders
- Poor self esteem
- Social isolation & stigmatism
- Greater the BMI – Early the premature death
- Increased incidence of co-morbidities & cancers
Management of Obesity:
Obesity management is a multidisciplinary approach with several modalities like conservative, medical, non surgical, minimally invasive & major surgical approaches.
Conservative approach is the base line primary modality achieved through changing dietary habits, life style. This will certainly help in early phases of obesity but requires a lot of dedication, commitment.
Medical management mainly targets on inducing early satiety.
Non surgical methods are Gastric balloon which will be placed endoscopically. It is useful when BMI is 25-30.
Surgical approach is well known as Bariatric or Weight reduction surgery. Most people are not successful losing weight with diets. As someone becomes overweight, the risk of developing other serious diseases dramatically increases. Surgery has proven to be the most effective method to treat severe obesity. Surgery is of choice when both conservative & medical management fails.
Dr RAJNESH C REDDY
MBBS; MS,FICS Bariatric surgeon Fellow In Laparoscopic surgeon
Senior consultant Laparoscopic & Bariatric surgeon
Apollo Health City, Hyderabad
Chronic Obstructive Pulmonary Disease (COPD) is characterized by obstruction of the airflow into and out of the lungs leading to shortness of breath, cough and sputum production. It is a progressive disease which often leads to continued decrease in lung function over time. COPD is also known as Chronic Obstructive Airway Disease (COAD).
When you breathe in, each air sac fills up with air like a small balloon as they are elastic in nature. Similarly when you breathe out, the air sacs deflate as the air goes out. The air sacs if stretched out are almost the size of a tennis court.
In a person suffering from COPD, less air flows in and out of the airways because of any of the following reasons:
The airways and air sacs lose its elasticity.
The walls between the air sacs are destroyed.
The walls of the airways become thick and inflamed.
The airways make abnormally more mucus thus clogging them.
Obstruction of air flow may result from either of the two types of COPD:
Emphysema: It is a condition characterized by damaged air sacs (alveoli).
Chronic Bronchitis: it is characterized by inflammation of the air way track.
Cigarette smoking: it is one of the major causes of COPD.
Environment: Heavy exposure to environmental pollution and poor ventilation at home may cause COPD. Use of wood and other fuel to burn for cooking is often a cause especially among women.
Occupational exposure: Certain occupations like coal mining, welding, etc may gradually lead to development of COPD.
Genetics: Genetic makeup of an individual may also play a role in developing COPD.
Symptoms include the following:
Shortness of breath
Bluish discoloration of skin
Pulmonary function test
Dr. Sai Praveen Haranath, MBBS, MPH, FCCP,
Consultant Intensivist & Pulmonologist,
Apollo Health City, Hyderabad,
Chair-Disaster Response Network Steering Committee,
Member-Occupational & Environmental Diseases Network Steering committee
3 Winter Skin Care Resolutions –
1. Excessive dryness of the skin is what mainly causes skin allergies during winter, and hence preventive measures revolve around controlling that.
2. Use skin moisturizing creams regularly. These skin creams may be applied liberally over the affected area immediately after a bath and work best when applied when the skin is still a little moist.
3. Don’t use harsh soaps that dry up your skin. Select ones with a neutral pH.
If your doctor prescribes you medications for your particular condition, do take them regularly without fail.
Sugary Drinks- can they give you diabetes?
Glucose, Fructose and Sucrose are commonly known as “Simple Sugars”. They provide the sweet taste in our food, and our tongue cannot differentiate one from the other. Our body coverts complex carbohydrates, for example starch, to glucose, a monosaccharide. As the amount of glucose rises in the blood, pancreatic beta cells release Insulin. In the presence of Insulin, cells use this glucose to provide energy . Fructose, also a single molecule, is present naturally in fruits, and is also. added to sweeten beverages. Fruits contain fibre, which slows the absorption of fructose. However, fruit juices are a concentrated form of fructose and juicing reduces the fibre content. Also the Pancreas does not release insulin in response to fructose, as it requires a different mechanism to break it down. Fructose itself does not provide satiety to our hunger, and has been proved to promote obesity, fatty liver and insulin resistance. Sucrose is the common table sugar, and is obtained from sugar cane and sugar beets. It consists of both Glucose and Fructose.
All three provide calories in equal amount for every gram consumed. Excess of energy consumed in any form is stored as fat, and might eventually lead to obesity. Evidence from population based studies suggests that modest to excessive consumption of sweetened beverages have a higher risk of causing diabetes than food of the same calorie count. In the EPIC-Norfolk study; consumption of soft drinks, sweetened milk beverages was associated with higher risk of diabetes. Replacing them with unsweetened drinks was suggested as a replacement for Diabetes prevention. Another Meta analysis was published in British Medical Journal in 2015. The conclusion was “Habitual consumption of sugar sweetened beverages was associated with a greater incidence of diabetes. Consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes” So are sweet drinks healthy? The answer to this question depends on how it’s consumed and what foods it replaces.
As a nation which has large number of potential diabetics, reducing the consumption of total calories, especially sweetened drinks (natural or artificially) and increasing physical activity would play an important role in prevention of Diabetes.
Dr.Rabinder Nath Mehrotra
MBBS; MD (Internal Medicine); DM (Endocrinology); DNB,
Endocrinologist, Apollo Health City, Hyderabad
Pneumonia, an infection of the lungs, needlessly affects millions of people worldwide each year. Pneumonia infections can often be prevented and can usually be treated.
Globally, pneumonia kills nearly 2 million children younger than 5 years of age each year. This is greater than the number of deaths from any infectious disease, such as HIV infection, malaria or tuberculosis. In India approximately 4 to 5 lakh of children die of pneumonia. Thus we are holding 25% of global burden among children.
Pneumonia is one of the leading cause of death in adults. Pneumonia is a major health & public issue in both developing countries like India & developed part of the globe, like USA. For example, each year in the United States, about 1 million people are hospitalized with pneumonia, and about 50,000 people die from the disease. There’s no gross data available in India to say exact epidemiology in Adults.
Chest x-ray of an adult patient with pneumonia.
What Is Pneumonia?
Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. The lungs are filled with thousands of tubes, called bronchi, which end in smaller sacs called alveoli. Each one has a fine mesh of capillaries. This is where oxygen is added to the blood and carbon dioxide removed. If a person has pneumonia, the alveoli in one or both lungs fill with pus and fluids (exudate), which hinders the gas exchange. Pneumonia can strike suddenly or gradually. With appropriate treatment, one can expect to get better in around one week to 10 days.
Who Is At Risk for Pneumonia?
Certain people are more likely to become ill with pneumonia:
- Adults 65 years of age or older
- Children younger than 5 years of age
- People who have underlying medical conditions (like asthma, diabetes, Heart disease HIV, Chronic Kidney Disease, COPD, Cancer, Alcohol habit & Smoking)
Causes and Types of Pneumonia:
Pneumonia can be caused by viruses, bacteria, and fungi. The common causes of viral pneumonia are influenza and respiratory syncytial virus (RSV), and a common cause of bacterial pneumonia is Streptococcus pneumoniae (pneumococcus).
When someone develops pneumonia in the community (not in a hospital), it’s called community-acquired pneumonia(CAP). Pneumonia developed during or following a stay in a healthcare facility (like hospitals, long-term care facilities, and dialysis centers) is called healthcare-associated pneumonia (HCAP), which includes hospital-acquired pneumonia(HAP) and ventilator-associated pneumonia(VAP).
The symptoms of pneumonia depend on the age of the person, the cause and severity of the infection, and any existing problems with immunity. Some of the symptoms may include:
- Breathing difficulties
- General malaise
- Loss of appetite
- Abdominal pain
- Chest pain
- Blue coloration of the skin around the mouth (cyanosis), caused by lack of oxygen.
A range of causes
Pneumonia can be triggered by a cold or bout of flu, which allows the germs to gain access to the alveoli. In approximately half of all cases, no cause is ever found. Bacteria, Viruses, Mycoplasma, Tuberculosis & Rarely Fungi
If you or your child or the person you are caring for seems to be recovering well from a cold or flu, but then gets worse, pneumonia may be the cause. See your doctor immediately, since pneumonia can be life threatening in high risk groups.
Pneumonia is diagnosed using a variety of tests, including:
- General examination
- Chest x-rays.
- Sputum tests
- Naso-pharyngeal swab (eg- H1N1 RT PCR to diagnose viral pneumonias like Swine flu)
- Blood tests (like cultures, CBP ESR, Blood Urea, S. Creatinine, ABG are first line of blood investigations)
- Bronchoscopy (rarely Pneumonias demand advanced investigations like Bronchoscopy, particularly to rule out underlying Lung cancer, Foreign body in airway, Tuberculosis & fungal organisms)
In the days before antibiotics as many as 1 in 5 people with pneumonia could die from pneumonia and recovery was sometimes very prolonged. Antibiotics are thus a mainstay of treatment. For the most cases antibiotics are treatment of choice. In mild cases, which can be treated @ home, can be treated with oral tablets:
- Hospital admission – for babies, young children or anyone who is very unwell. Those who are pretty sick (as decided by pulmonologist or a GP) have to be admitted into ICU. Once fever is completely controlled for more than 24hrs without a paracetmol, pulmonologist can start think of to initiate a discharge.
- Plenty of fluids – taken orally or intravenously
- Medications – to relieve pain and reduce fever
- Rest – sitting up is better than lying down.
Treatment of Complications:
- Empyema / Para-pneumonic effusion: Empyema is presence of pus in the covering layers of lung & requires some surgical intervention.
- Lung Abscess: Presence of pus filled cavity in lung tissue. Antibiotics are usual stay of management & might require surgical management.
- Hemoptysis: Hemoptysis is coughing out of blood. It’s a life threatening complication, usually suggests a severe underlying damage to the lung and usually necessitates an ICU admission.
- Pneumothorax: Collection of air in the pleural space. It’s a rare complication & usually requires surgical management.
- Septic Shock with MODS (Multi organ Dysfunction Syndrome) : Toxins released from bacteria at times lead to drop in blood pressure & compromise in function of various organs like Kidney (Renal Failure) & Liver (Liver dysfunction). This if not addressed at right moment with an aggressive approach in an ICU, there’s every chance that we might lose patients in close to 40% of times.
Since the introduction of streptococcal pneumonia vaccine in the year 2000, there is a considerable reduction in severity of disease in population. It has resulted in 35% reduction in admission rates & severe form of streptococcal infections like Bacteremia (blood stream infection) & Meningitis (infection to covering layers of brain).
One of the most common types of bacterial pneumonia is pneumococcal pneumonia, caused by infection with Streptococcus pneumoniae. There are vaccines against this strain that reduce the risk of infection.
Influenza is a common preceding viral infection. Being vaccinated against influenza can help prevent that infection and the pneumonia which may complicate it.
Other vaccines like, Haemophilus influenza, Measles, Pertussis, Zoster & Mumps also useful for prevention.
Protect Your Health with These Healthy Living Practices
Try to avoid close contact with sick people. Good hygiene practices includes washing hands regularly with soap & water, cleaning frequently touched surfaces, and coughing or sneezing into a tissue or into your elbow or sleeve. You can also reduce your risk of getting pneumonia by limiting exposure to cigarette smoke and treating and preventing conditions like diabetes.
Things to remember
- Pneumonia is an infection of the air sacs of the lungs, caused by bacteria or viruses.
- Anyone of any age can be affected, but children under the age of four years and the elderly are very susceptible.
- Certain people can be immunized against one of the most common types of bacterial pneumonia- People shall get timely vaccinated.
- Hit Hard & Hit fast rule works here (Immediate & Appropriate empirical antibiotic has to be started) without wasting time by waiting for culture reports.
- Central government has not taken measures to include vaccinations to prevent pneumonia as a part of National Immunization Schedule.
Dr VIJAY KUMAR CHENNAMCHETTY
INTERVENTIONAL PULMONOLOGIST & SLEEP DISORDER SPECIALIST
APOLLO HEALTH CITY, HYDERABAD
Brain stroke is the occurrence of neurological deficits due to cerebrovascular cause (problem related to blood vessels of the brain). There are two types of stroke one of which is called Ischaemic stroke which occurs because of partial or total blockage of blood vessel by a blood clot resulting in decreased or total cessation of blood supply to a part of the brain. Brain cells(neurons) die as a result of this and with each minute of lack of blood supply about 1.7million cells die . The other type of stroke is called haemorrhagic stroke in which blood vessel ruptures leading to leaking of blood into the brain tissue. Ishaemic stroke are by far more common than haemorrhagic stroke (75%versus25%).
The common risk factors for stroke include high blood pressure, diabetes mellitus, increased blood cholesterol, cigarrette smoking, excessive alcohol intake and heart disease. The other risk factors include old age,male sex,sedentary lifestyle and mental stress. Though stroke mostly occurs in older individuals there is a increasing trend of its occurrence in younger people mainly to stress,change in dietary habits and hectic lifestyle.Some of these also have a family history of stroke at young age.
Stroke commonly manifests in the form of sudden onset of weakness of one half of the body,inability to speak or comprehend properly, slurring of speech, double vision or dimness of one half of vision, unsteadiness while walking. It can also manifest as severe headache and decrease in level of consciousness. Diagnosis is done by a brain scan most commonly CT scan and in some situations MRI may be necessary.
The most important thing to do when some body has a stroke is to rush to the hospital as early as possible since the only approved therapy for ischaemic stroke is intravenous administration of clost bursting drug rtPA(recombinant tissue plasminogen activator) in the first 4.5hrs after the onset of symptoms. Even in this period patients who receive earliar have better outcome than who receive latter. Beyond first few hours we can only give medication to prevent a second stroke by using blood thinners such as aspirin and clopidogrel. In some situation anticoagulants like warfarin may be necessary. The best thing to do is to prevent stokes from happening by adopting a healthy lifestyle including diet rich in fiber and low in cholesterol, regular exercise and medcation as required for risk factors like hypertension and diabetes mellitus.
Dr.Chenna Rajesh Reddy
Apollo Health City Hyderabad
World Food Day-A Zero Hunger Challenge
“In a world of plenty, no one, not a single person should go hungry”-Ban Ki Moon, UN Secretary-General
Even though, during the past decade, India has witnessed accelerated economic growth and emerged as a global player, it is still home to one-third of the world’s poor with 37 percent of India’s population falling below the poverty line and 18% of the population being undernourished. Along with the international concern for the rise of obesity and diabetes, there is also a focus on poverty and the undernourished.
World food day, a UN initiative is an action against hunger, observed every year in all countries around the world. On October 16th, people declare their commitment to eradicating hunger. Hungry people have learning difficulties, are less productive at work, are sick more often and live shorter lives. The figures are shocking. In a world of plenty, 805 million people, one in nine worldwide, live with chronic hunger. Around 60% of the hungry in the world are women and 4 in 10 children in poor countries are malnourished damaging their bodies and brains and almost 5 million children under the age of 5 die of malnutrition-related causes every year.
The official celebration of World Food Day is at the Expo Milano 2015, attended by UN Secretary-General Ban Ki-moon and the director-general of the Food and Agriculture Organisation (FAO) of the United Nations, José Graziano da Silva. They along with Italy’s president, Sergio Mattarella, and the country’s ministers for agriculture and foreign affairs, Maurizio Martina and Paolo Gentiloni, will unveil the topic for 2015 – “Social protection and Agriculture: Breaking The Cycle Of Rural Poverty” which aims to ensure direct access to food or the means to buy food.
Of the total Indian population 67.6% is rural and 57.2% of land under agriculture. And agricultural development has a huge contribution to the social protection and economic growth of India. Most of this rural India, shows poverty; an inability to buy nutritious food, hence being undernourished and underdeveloped. In order to fight hunger and eliminate poverty we must work to create a transformation in our rural communities with investment, providing decent jobs, decent conditions and decent opportunities so that our nation can have a balanced growth and the rural areas can fulfill their potential.
“Men, women and children need nutritious food every day to have any chance of a free and prosperous future. Healthy bodies and minds are fundamental to both individual and economic growth, and that growth must be inclusive for us to make hunger history,” said World Food Programme executive director Ertharin Cousin.
Ending hunger is everyone’s responsibility. All of us have a role to play, even through the commitment to change simple day to day actions and decisions-The Zero Hunger Challenge, Milan Expo 2015.
What we can do as individuals:
- Prevent food wastage, and immediately source the left-over food to orphanages or the needy.
- Sponsor a meal for the needy or a group in a rural area.
- Donate or Volunteer for CRY (Child Rights and You) to prevent child labor, sponsor education and food in order to bring about a qualified future rural population.
- Invest in agricultural land and support the farmer which might also reap you benefits.
- Include 4 different, color fruits and vegetables per day in your meals.
- Exercise for a minimum of 30 minutes per day or maintain 10,000 steps per day on your pedometer.
- Stay active and love yourself enough to lead a healthy life.
Ms Syeda Amena Omer,
Clinical Dietitian ,
World Hospice and Palliative Care Day is celebrated the second Saturday of October every year and falls on 10th October, this year (2015).
Palliative Care in India is in a relatively early stage of development and consequently faces many problems. India is ranked 67th in an 80 country study of ‘Quality of Death Index’ by a Singaporean Philanthropic organization. This shows that as a country we are woefully inadequate in providing meaningful palliative care to the needy. This is to do with end-of-life care facilities, the state’s formal palliative care policy in place, the funding available, the medical problems, the social and spiritual issues, the time to spare, and the people ‘s training for taking care of the people needing palliative care.
The progress on providing end-of-life care in countries like India, China,Mexico, Brazil and Uganda is slow. Availability of specialized palliative care workers is very important and it is here that countries like UK score particularly well. Therefore efforts made in this direction would be fruitful in the short and longterm.
Opioid availability is seriously limited in India and this, along with non-availability of some inexpensive drugs is a big medical problem in India. Adding to the suffering patient’s burden is the resultant prescription of expensive drugs. Using opoids is not addictive – a commonly held myth – addiction is rare when used safely under hospice physician’s guidance.
A system based on out-patient care is effective and it empowers families to care for patients at home. This way we can dispel the myth that ‘Hospice’ is a place. Whenever possible inpatient facility and home visits should be available for those who need them.
Private insurers should cover Hospice Care. This to a large extent would dispel the myth that only people with money have access to hospice care. Hospice care should be part of mainstream health provision by the state so that everyone has access to hospice palliative care. Hospice care is for all ages from infancy to adulthood with any number of medical conditions and the myth that it is just for the elderly should be dispelled through public education . Another myth that hospice care is to be provided at the end of one’s life should be dispelled. This is by providing specialized care by trained personnel so that the individual feels that he/she is living as fully as possible until the end on his/her terms.
All physicians especially oncologists should spread the above message and strive to improve palliative and hospice care in India by educating and including the community in these efforts.
Dr SVSS Prasad,
Senior Consultant Medical Oncologist,
World Heart Day is an annual event which takes place on 29 September every year. Each year’s celebrations have a different theme, reflecting key issues and topics relating to heart health. This year theme is creating heart-healthy environments. World Heart Day was founded in 2000 to inform people around the globe that heart disease and stroke are the world’s leading causes of death, claiming 17.3 million lives each year.
Together with World Heart Federation members, World Heart Day spreads the news that at least 80% of premature deaths from cardiovascular disease (CVD) could be avoided if four main risk factors – tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol – are controlled.
This year, World Heart Day’s theme is creating heart-healthy environments. The places in which we live, work and play should not increase our risk of cardiovascular disease (CVD). But individuals frequently cannot make heart-healthy choices due to environmental factors, such as the availability of healthy food or smoke-free zones. World Heart Day 2015: Heart Choices Not Hard Choices. By ensuring that everyone has the chance to make healthy heart choices wherever they live, work and play. World Heart Day encourages us all to reduce our cardiovascular risk, and promotes a heart-healthy planet for those around us.
Availability of healthy food: The healthiest foods are among the richest sources of many of the essential nutrients needed for optimal health. By eating the healthy food, you’ll get all the essential nutrients that you need for excellent health, including vitamins, minerals, phytonutrients, essential fatty acids, fiber and more for the least number of calories. The healthy foods are common “everyday” foods. These include the fruits, vegetables, whole grains, nuts and seeds, lean meats, fish, olive oil, herbs and spices that are familiar to most people. The food that the majority people can easily find at their local market. We suggest foods that are not only familiar and available, but also affordable, especially if you purchase them locally and in season. This is also the time when they are the freshest and of the best quality.
Smoke-free zones: The term smoke free environment is sometimes used indiscriminately to discuss both 100 percent smoke free areas as well as segregated and ventilated areas. A truly smoke free environment in a business is one in which no smoking is allowed within any company building or vehicle. Depending on the company, smoking may be permitted in certain outdoor areas designated for that purpose. For smoking areas within the building, a special and separate ventilation system must be installed in order to prevent smoke from leaking into other areas of the structure. The implications of a smoke free environment in small businesses such as restaurants, bars, and shops also extend to customers. The company should also publicize any assistance in quitting smoking, such as a cessation program or monetary rewards. It may be more successful to implement a smoke free policy in stages. For example, smoking might first be restricted to a designated area, then eliminated from company property entirely. However, the success of gradual implementation can vary from workplace to workplace.
Dr.V.Surya Prakasa Rao
‘SUICIDE THE HIDDEN PANDEMIC’
According to the National Crime Record Bureau India, Suicide clock 2013, (ncrb.nic.in/adsi2013/ADSI-2013.pdf) by 248 suicides by MALES per day, 121 suicides by Female per day out of which 62 were HOUSEWIVES, 89 suicides per day due to FAMILY PROBLEMS. The WORLD HEALTH ORGANIZATION (WHO) reports as INDIA registering the highest estimated number of suicides in the world in year 2012, amongst the youngsters in the 15-29 years age range. In the world health rankings India stands at number 12 for Suicide. Suicide death rate per 100000 is 21.21, and the list goes on…. One may ask what’s new or important about this data. Well sooner or later this hidden pandemic may surface very near to you!!
So get a head start on this topic. If you are an adult, have a checklist for yourself and your near-dear ones. It is very important to even talk about Suicide with kids as young as 9-10 years old, in a non-threatening manner, so they are able to understand and discriminate about ‘HAPPY-SAD to VERY-VERY-VERY SAD’.
A basic checklist
- See & notice if someone is having too much prolonged sadness,
- Persisting hopelessness,
- If this sadness suddenly changes to being/appearing very CALM/HAAPY
- Is an individual self-absorbed in talking about death, futility of life and general pleasures,
- Giving about personal possessions,
- More interested in reading/acquiring information on obituaries, methods of dying,
- Neglecting personal care, health issues or other important commitments,
- Has a history of alcohol, narcotic drug/s abuse/usage,
- Is diagnosed or has a life threatening disease,
- Has a history of DELIBRATE SELF-HARM, PREVIOUS ATTEMPTS TO SUICIDE,
- History of Physical or SEXUAL abuse,
- Family history of mental disorder.
- Is indicating a loss in rational thinking,
- Wants to be alone MOST of the time, tries to avoid- previously enjoyable activities,
- Trying to finish work/put things in order, saying sudden goodbyes.
If these symptoms ring a bell in your ears/mind, seek help of a mental health professional- a PSYCHOLOGIST, a PSYCHIATRIST, even your family doctor. It is better to be alert than to be sorry later. The family members carry the stigma, pain and guilt of a suicide through the life.
We need to develop healthy physical and mental health, better problem solving skills, positive interpersonal relationships, Empathy towards fellow beings and overall HOPE in LIFE.
APOLLO HEALTH CITY