Overview

This is a disease that is transmitted from mosquitoes to humans and affects many people in the world. Found in densely populated countries and continents, like Africa, Asia and the tropics of the Americas, this has severe symptoms. This viral disease is caused by the Chikungunya virus of the Togaviridae. First identified in the United Republic of Tanzania in 1952 and subsequently in other countries like Africa and Asia. Since 2004 the outbreak of CHIKV virus has become more widespread and caused partly due to the viral adaptations allowing the virus to be spread more easily by Aedes albopictus mosquitoes. The transmission has been noted to persist in countries where there is a large population, but interestingly, the transmission has been interrupted on islands where a high proportion of the population is infected and then immune.

Symptoms

The onset of the disease is usually in 4-8 days and after a bite of an infected mosquitoes, it is characterized by an abrupt onset of fever and then joint pain. This joint pain is severed and lasts for a few days but may prolong for months maybe even years. Other signs are joint swelling, muscle pains, headache, nausea, fatigue and rash. These symptoms also overlap with those of dengue and Zika virus and can be misdiagnosed. Most people fully recover from the infection and experience only mild and sometimes the infection even goes unrecognized. However, there have been cases of eye, heart, and neurological complications. The elderly and newborns are more susceptible to the infection and if they have any underlying conditions then they are likely to become severely ill increasing the risk of death.

Diagnosis and treatment

The diagnosis and treatment of the virus may be done by blood sampling and other tests like reverse transcriptase–polymerase chain reaction (RT–PCR). Other tests detect the activity of the antibodies. These can be detected in the first week after illness onset and can be detected for about 2 months. Many clinical measures can be taken to address fever and joint pain. But there is no specific anti-viral drug treatment for the virus.

Preventing Chikungunya

As this disease is caused by the bite of a mosquito, you must reduce the opportunities to let the mosquito breed. Mosquitoes bite during the day and night, and for people who live in risk areas like southeast Asia, Africa and tropical regions of America, many outbreaks happen each year. The best way to prevent it is to protect yourself from the mosquito's bite. You also must get vaccinated before travelling to any of these regions. Use insect repellent, and wear long-sleeved shirts and pants. You can also treat your clothes and gear with permethrin. As we all know, they tend to breed in humid places and places where they have access to water, so try to close the rooms that are air-conditioned with screens and windows. Use nets and mosquito repellents if you are sleeping outside. There are many different types of mosquito repellents like paper, liquid etc, and they are quite effective. If your job needs, you to be stationary for long hours or frequently go outside you must take the necessary precautions.

When we talk about cancer prevention, the conversation usually turns to individual choices. Whether someone smokes, what they eat, how much they exercise, or how regularly they visit a doctor. These are important considerations, but they do not tell the whole story. A person's surroundings can influence their health in ways that are not always immediately apparent. The air they breathe every day, the conditions in which they work, the food they can afford and the healthcare available to them can all have a bearing on their risk of developing cancer.

In clinical practice, cancer rarely has one identifiable cause. It develops through a combination of factors, including age, genetics, infections, lifestyle and environmental exposure. Some of these can be modified. Others are tied to circumstances that people have little control over.

The air we breathe and the work we do

Air pollution is generally discussed in the context of respiratory and cardiovascular illness. Its association with cancer, particularly lung cancer, deserves equal attention. Fine particulate matter from vehicle exhaust, industrial emissions, construction dust and waste burning can remain in the air people breathe over long periods. Indoor air quality is another concern. In homes where wood, coal or other biomass fuels are used for cooking, poor ventilation can expose families to harmful smoke over many years.

The workplace presents a different set of risks. Construction workers, miners and employees in certain manufacturing industries may regularly come into contact with substances such as asbestos, silica dust and diesel exhaust. Prolonged exposure to these carcinogens is associated with specific cancers. The risk is not simply a matter of the nature of the job, but also the conditions under which it is performed. Protective equipment, adequate ventilation and routine workplace monitoring are therefore essential, not optional safety measures.

What ends up on the plate is not always a choice

Diet is another area where personal circumstances matter. What a person eats is influenced by affordability, availability, working hours and household responsibilities. A consistently poor dietary pattern, particularly one high in processed meat and low in fibre, is associated with an increased risk of certain cancers. Excess body weight is also linked to several cancers, including colorectal, endometrial and postmenopausal breast cancer.

This does not mean that eating a particular food will cause cancer, or that avoiding one ingredient will prevent it. The concern is with patterns that develop over time, alongside other risk factors. Advising people to eat better is only useful when that advice considers what they can realistically afford and access.

Why some communities face greater challenges

The same health advice does not translate into the same opportunities for everyone. People living in congested neighbourhoods may have limited control over their exposure to pollution. Workers in informal or unregulated sectors may not have access to adequate protective equipment or occupational health services.

These circumstances can also determine how quickly someone receives a diagnosis. A persistent cough, unexplained weight loss, a breast lump or unusual bleeding may initially be dismissed. For someone who has to travel long distances, lose a day's wages or pay out of pocket for investigations, seeking medical attention is not always straightforward. By the time they reach a specialist, the disease may have progressed.

Early detection, therefore, is not just about recognising symptoms. It also depends on whether people can access a doctor, undergo the necessary investigations and complete their follow-up care.

Prevention has to go beyond individual choices

There are established ways to reduce cancer risk. Avoiding tobacco, limiting alcohol, maintaining a healthy weight and staying physically active all matter. HPV and hepatitis B vaccination can help prevent cancers associated with these infections. Screening for breast, cervical and oral cancers should be undertaken as recommended, based on age and individual risk. A persistent or unusual symptom should always be evaluated rather than left unattended.

But prevention cannot stop at the doctor's consultation room. Cleaner air, safer workplaces, better housing and affordable diagnostic services need to be part of the larger conversation.

A person's risk of cancer is shaped by more than the choices they make. It is also influenced by the conditions in which they live, work and seek care. Recognising this is important because prevention becomes meaningful only when people have a fair opportunity to act on it.

(Dr Rajesh Shinde - Director – GI (HPB–Colorectal) & Thoracic Surgical Oncology, Apollo Cancer Centre, Western Region, Apollo Hospitals)

Winter brings a significant rise in respiratory problems, particularly among people living with asthma. Increased air pollution, falling temperatures and exposure to dust and other airborne irritants can trigger inflammation in the airways, leading to symptoms such as coughing, wheezing, chest tightness and breathlessness.

While these factors can make asthma more difficult to manage, many patients also make treatment-related mistakes that can worsen their symptoms and increase the risk of an asthma attack.

One of the most common mistakes is discontinuing inhalers when symptoms improve. Asthma is a chronic inflammatory condition, and the absence of symptoms does not necessarily mean that the underlying inflammation has resolved. Controller inhalers, particularly those containing inhaled corticosteroids, help reduce airway inflammation and prevent flare-ups.

Stopping these medications without medical advice can leave patients vulnerable to sudden exacerbations, especially during periods of high pollution.

Another concern is the excessive reliance on rescue inhalers. These inhalers provide quick relief by relaxing the muscles around the airways, but they do not necessarily address the underlying inflammation. Frequent use may indicate that asthma is not adequately controlled and that the patient's treatment plan needs to be reviewed by a doctor. Patients should not increase their medication dosage or frequency without appropriate medical guidance.

Incorrect inhaler technique is another frequently overlooked problem. Patients may use their inhalers too quickly, fail to coordinate inhalation with medication release or neglect to hold their breath briefly after inhaling. These mistakes can prevent the medicine from reaching the lungs effectively. Regularly reviewing inhaler technique with a healthcare professional and using a spacer, where recommended, can significantly improve drug delivery.

Many patients also underestimate the importance of continuing their prescribed treatment during symptom-free periods. Some turn to steam inhalation, home remedies or over-the-counter cough medications instead of following their asthma management plan. Although certain supportive measures may provide comfort, they cannot replace prescribed asthma medication. Hot steam can also cause burns and should not be used as a treatment for asthma.

During winter, patients should monitor local air quality, reduce prolonged outdoor exposure when pollution levels are high, avoid tobacco smoke and other respiratory irritants, and keep their prescribed medication accessible. Wearing a well-fitting mask outdoors may help reduce exposure to particulate pollution, although it does not eliminate the risk.

Most importantly, people with asthma should have an individualised asthma action plan and attend regular follow-ups. Worsening breathlessness, difficulty speaking in full sentences or symptoms that do not respond to the prescribed reliever require urgent medical attention. With correct inhaler use, consistent treatment and timely medical review, most patients can manage their asthma more effectively even during highly polluted winter months.

(By Dr. Arunachalam M, Sr. Consultant and HOD-Pulmonology, Yatharth Super Speciality Hospital, Noida)

Changes in stride like a slower walking pace, fewer steps or a change in the way your arms move may be considered as signs of ageing. However, an emerging study suggests that minor differences in walking patterns could be subtle, early indicators of Parkinson’s disease. According to the study, these signs can can emerge years before Parkinson's diagnosis.

Published in the Journal of Neural Transmission, the study analysed movement data from more than 73,000 participants in the UK Biobank. Researchers found that certain changes in walking behaviour could indicate a future Parkinson’s diagnosis, surfacing up to 6.8 years beforehand.

The findings indicate that Parkinson’s disease may begin developing long before its more familiar symptoms like tremors and stiffness, become noticeable.

Findings From The Study

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Researchers examined data from 73,413 people who wore wearables that track movement for seven days. Their health records were then followed for up to 10 years. Of the participants without Parkinson’s at the time of the movement assessment, 314 were diagnosed with the disease during follow-up.

Using a digital analysis tool called Watch Walk, researchers examined 17 characteristics related to gait. They identified five walking characteristics that were consistently linked with a subsequent Parkinson’s diagnosis:

• Fewer steps each day: Participants who later developed Parkinson’s recorded lower daily step counts than those who did not.
• Slower walking speed: People who were diagnosed later tended to walk more slowly, including at their maximum walking speed.
• Shorter walking periods: They also spent a lesser amount of their time walking in longer, continuous stretches.
• Changes in step regularity: Their steps showed less consistent rhythm, indicating alterations in the regularity of their walking pattern.
• Reduced natural arm swing: They spent more time walking with their arms in a static position instead of swinging naturally.

Effects Of Parkinson’s Disease On Walking

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Parkinson’s disease is a progressive neurological disorder that affects movement. It occurs due to the loss of nerve cells that produce dopamine in a brain region called the substantia nigra. Dopamine helps regulate movement, coordination and other functions.

As dopamine levels decline, the brain's ability to coordinate movement is affected. This can lead to bradykinesia, or slowness of movement, rigidity of muscle, tremors and balance issues.

These changes can also affect gait. A person may take smaller steps, walk more slowly, experience difficulty moving or reduced swinging arms.

The study's findings suggest that some of these motor changes may be detectable in everyday movement well before the condition is formally diagnosed.

Changes in walking speed, balance, step length or arm movement can occur for several reasons, including ageing, joint problems, injuries, medication effects and other neurological conditions.

Parkinson’s disease is, however, diagnosed through a clinical assessment, which considers a person's symptoms, medical history and neurological examination. Other symptoms that may warrant medical evaluation include:

• A tremor especially when the affected hand or limb is at rest.
• Slowness in everyday movements like dressing or getting up from a chair.
• Muscle stiffness or rigidity.
• Problems with balance.
• Smaller handwriting or changes in speech volume.

Early Detection Of Parkinson’s Disease

Although there is currently no established treatment that stops or reverses the underlying progression of Parkinson’s disease, an earlier diagnosis can help people manage symptoms, access rehabilitation and support sooner.

Exercise, physiotherapy and medical care can help maintain mobility, balance and quality of life. Early assessment can also help doctors distinguish Parkinson’s from other conditions that may cause similar movement difficulties.