SUNDAY, SEPTEMBER 27, 2020 (PAGE 4) PERSONALITY SOCIETY “Music has become more free over years” Cycle makes a comeback in Jammu Sitar maestro Pandit Ravi Shankar was the first have a career making music quite freely, you know getting S S Sodhi injury or illness, but can be built up to a demanding physical workout. among the very few to go beyond the boundaries of to explore and experiment with multiple styles and mak- Cycling, just as walking, is known to be one of the A fun way to get fit - the adventure and buzz you Hindustani classical music to work with different music ing music that comes from my heart, from my own healthiest activities that one can do whether youth or styles. authentic desires," the sitar virtuoso said. elderly. During pandemic, bicycles have emerged as one get from coasting down hills and being outdoors means His daughter, sitarist Anoushka Shankar, who has Besides performing as a solo sitarist, her composition- of the safest means of moving around. It is overwhelm- you are more likely to continue to cycle regularly, com- experimented with crossover music, said she is grateful al work has led to several cross-cultural collaborations ing to see people of Jammu hitting back on the streets pared to other physical activities that keep you indoors the music scene has become more liberal since and allows with artistes such as Sting, rapper M.I.A, pianist Herbie with revival of cycling culture in various parts of the city or require special times or places. her to explore various genres and forms. Hancock, Mexican guitar duo Rodrigo y Gabriela and vio- such as Gandhi Nagar , Shastri Nagar, Trikuta Nagar, Time-efficient - as a mode of transport, cycling "It was really rare for people to cross over, there were linist Joshua Bell. Sidhra,National Highways, etc. replaces sedentary (sitting) time spent driving motor very few examples of some legends who had managed to Apart from co-writing the music for the British TV vehicles or using trams, trains or buses with healthy have a career in classical music and explore other forms series "A Suitable Boy", Shankar also worked with Both young and old can be seen paddling around especially in early morning and late evening when there exercise. but it was definitely something that people of my genera- Buddhist spiritual leader the Dalai Lama on his first stu- A shift to cycling will help us to maintain the current tion found scary," Shankar told PTI in an email interview. dio album "Inner World". is less vehicular traffic creating an impressive sight for levels of cleaner air obtained during lockdown, improve The 39-year-old, who had her father Ravi Shankar as Before the coronavirus pandemic hit the world and people who give importance to their health and fitness her guru and often shared the stage with him, remembers sent everyone scurrying indoors, Shankar was planning a routine. general health of the population and therefore improve the time when being able to explore music freely and tour with her sister Norah Jones and other famous Such mode of commuting needs to be given more pri- their resistance to critical reactions to any kind of virus. experiment with different styles was looked down upon artistes to celebrate the birth centenary of Ravi Shankar. ority by public in the coming times, keeping in mind The public at large should look at these safe modes of and not be approved of by the masters. The months that followed not just gave her "some of various health "I feel in the last 20-25 years things have opened up so the most amazing times" with her children but also made benefits of her more independent in cycling, such as, creating her music. improving body "I tried to allow things posture and coor- to be as simple and flexi- dination, decreas- ble as possible. And just ing body fat lev- get one day at a time els, reducing & responding to the situa- regulating BMI tion as it was. I had a lot of and maintaining challenging times with oxygen levels. things like learning how to Shifting away record myself, but also I from motorised found that very reward- system of trans- ing...I felt really proud of port to a non- the independence that I emission mode of have gained in music as transport like well," the mother of two cycling, can coun- said. teract the effects The six-time Grammy of emissions and Award nominee last helps us maintain month launched her latest Social Distancing album "Love Letters", per- too at the same haps her most personal time. According album till date. to various studies, Excelsior/Rakesh "Love Letters" is also Cycling con- Shankar's first exclusively lyrics-oriented album. She tributes to healthier lives by helping to prevent a large number of severe diseases: diabetes, breast and colon transport as safer alternatives of commuting especially has, in another first, lent in a traffic-heavy and congested Jammu city as ours. At her voice to "Lovable" cancer, osteoporosis, Alzheimer, depression, etc. It can also improve our effectiveness against any possible the same time, new cycle friendly paths could be built to along with Afro-French ensure safety and security of the cyclists on the roads. Cuban musical duo Ibeyi. infections. To cover the risks, the cyclists should wear The album, with six proper gears, helmets, other safety covers , follow road As the air quality has improved tremendously in tracks including "Those rules and maintain social distancing with other fellow Jammu during the lockdown periods, we should ques- Words", has notes of cyclists. tion ourselves whether we want to go back to the old tremendous loss and Cycling for health and fitness ways of taking motorised transportation for short com- much when I visit teenagers who Anoushka Sharma heartbreak, possibly brought into her work by per- It only takes two to four hours a week to achieve a mutes or use a cycle instead, especially for short dis- are beginning to play," the London- sonal health issues and her divorce from British general improvement to your health. Cycling is: tances? based musician said. Interview director Joe Wright last year after a marriage of Low impact - it causes less strain and injuries than World over cities such as Berlin, Milan, London, Over the years it has become nine years. most other forms of exercise. Rome and Paris have created pop-up bike lanes during normal for people to experiment. "These were difficult times, which pushed me into A good muscle workout - cycling uses all of the COVID pandemic either by painting the lane or just by "I haven't personally seen that kind of great disap- some very vulnerable places. I've written from a personal major muscle groups as you pedal. putting bollards along the length of the roads. Similar proval anymore." place before, but this time there was something particu- Easy - unlike some other sports, cycling does not measures can be taken by the government to transform Shankar, who went through periods of confusion and larly tender about the process. It was a creative challenge require high levels of physical skill. Most people know uncertainty over choosing her style initially, has exten- to be brave enough to allow the music to remain as raw as the roads and streets into safe zones for cyclists. These how to ride a bike and, once you learn, you don't forget. will be easier to use. Earlier, we used to take our cars to sively created "crossover music" with non-classical music it began," the musician added. Good for strength and stamina - cycling styles such as jazz, electronica, flamenco and blues. For "Those Words", Shankar worked with cellist and the local market. But now we can use this. increases stamina, strength and aerobic fitness. It is certainly an environment-friendly way of com- "I have definitely gone through phases of wondering if composer Ayanna Witter-Johnson, Indian singer Shilpa As intense as you want - cycling can be done at I belong or if I am giving that enough, doing enough. But, Rao and dancers Guro Nagelhus Schia and Vebjørn muting we could implement in our lovely city Jammu. very low intensity to begin with, if recovering from I guess, overall I feel very grateful that I have been able to Sundby. (The author is a social activist and an educational consultant)

HEALTHLINES VITAMIN D Deficiency: A Serious Concern COVID-19 and its impact on Heart Dr Arvind Kohli Emergent hospitalization and management in coronary care unit Dr.Gautam Sharma, Dr. Bodh Raj Sharma differs depending on the age and health conditions. However, a Diagnostic Consideration of Covid19 Cardiac patients concentration less than 20 nanograms per milliliter is generally World Heart Day is celebrated every year on 29th September. ECG : This basic investigation is very important for assess- The COVID-19 pandemic has once again made the considered inadequate and requires immediate treatment. It is aimed at creating Awareness amongst people regarding heart ment of myoCardial Injury acute coronary syndromes and researchers throughout the world to investigate the role of Treatment For Vitamin D Deficiency ailments and the range of associated health issues. The day is arrhythmias Vitamin D in increased immunity against Corona Virus. The find- If one is diagnosed with a vitamin D deficiency, the doctor will commemorated to promote different preventable steps and ing that deficiency of Vit-D is linked to increased susceptibility of likely prescribe vitamin D supplements. Tablets/ sachets/ liquids changes in lifestyle to avoid any cardiovascular diseases, like heart Biomarkers Cardiomyocyte injury, as quantified by cardiac an individual to corona virus infection had made doctors to of 60000 IU of Vit-D once weekly for 4-8 weeks is prescribed by attack, stroke,and heart failure So this years theme is asking the troponin (Trop T) concentrations, and haemodynamic stress, as hypothesise that vitamin D supplementation could be a promis- the medical practitioner depending on the Vit-D serum levels. If world to Use Heart to beat CVD (cardiovascular diseases) quantified by B-type natriuretic peptide (BNP) may occur in ing therapeutic agent for the prevention of COVID-19. one has a severe deficiency, then high-dose vitamin D tablets or At present we are living in unprecedented times. The COVID- COVID-19 infections and there elevation above a particular range General public is generally unaware of their Vit-D status. liquids may be prescribed by the doctor. One should also make 19 pandemic has taken the world by storm and has cast spotlight is important for assessment Many a time people come to know that they are deficient in Vit- sure to get vitamin D through sunlight and the food rich in this on the healthcare profession, as well national healthcare systems D-Dimers D-dimers are generated by cleavage of fibrin D only when they visit a doctor or an orthopedician with a com- vitamin. and we don't know what course the pandemic will take in the monomers by prothrombin and indicate the presence of thrombin plaint of pain in bones especially of legs and arms or backache. In Sources Of Vitamin D future but we do know that taking care of our hearts right now is formation or reflect an unspecific acute phase response from infec- Vit-D deficiency, the calcium concentration in the serum decreas- Food: Very few foods in nature contain vitamin D. The flesh of more important than ever. People with heart disease and its risk tion or inflammation. D Dimers also may indicate the presence of es and it may leach out from the bones into the blood to maintain fatty fish (such as salmon, tuna, and mackerel) and fish liver oils factors are more vulnerable to severe forms of COVID-19, and up disseminated intravascular coagulation associated with shock the calcium balance as it is required for the vital functions of the are among the best sources. Small amounts of vitamin D are to 1 in 5 patients hospitalised by COVID-19 have evidence of heart Markers of haemostasis including activated partial thrombo- human body. The balance of serum ionized calcium blood con- found in cheese and egg yolks. Vitamin D in these foods is prima- muscle injury. plastin time, prothrombin time, centrations results from a complex interaction between parathy- rily in the form of vitamin D3 and its metabolite 25(OH)D3 . So we stress for this years fibrin degradation products and roid hormone, vitamin D, and calcitonin. Vitamin D is vital for Some mushrooms provide vitamin D2 in variable amounts. additional and most important D-Dimers should be monitored our body as it regulates calcium homeostasis and maintains bone Sun exposure: Most people meet at least some of their vitamin aim is to UseYour Heart to fight routinely. In particular, eleva- integrity. It not only plays a vital role in skeletal growth but also D needs through exposure to sunlight. Ultraviolet (UV) B radia- COVID-19 because COVID-19 tions of D-Dimers have been has other critical biological actions in neurodevelopment and tion with a wavelength of 290-320 nanometers penetrates uncov- can wreck your heart, Even if associated with poor outcome function. ered skin and converts cutaneous 7-dehydrocholesterol to pre- one hasn't had any symptoms Non-Invasive Imaging vitamin D3, which in turn becomes vitamin D3. Despite the beyond its scientific backing, the Echocardiography can be per- importance of the sun for vitamin D synthesis, it is prudent to notion that a COVID-19 patient formed bedside to screen for limit exposure of skin to sunlight and UV radiation. UV radiation might wind up with long-term CardioVascular complications is a carcinogen responsible for skin cancer and metastatic lung scarring or breathing issues and guide treatment. , FoCUS( melanoma. has the ring of truth but over the Focussed Cardiac Ultrasound Dietary supplements past few weeks, the evidence has Study) and critical care In supplements and fortified foods, vitamin D is available in strengthened that cardiac dam- echocardiography are probably two forms, D2 (ergocalciferol) and D3 (cholecalciferol) that differ age can happen even among the preferred modalities to chemically only in their side-chain structure. Vitamin D2 is man- people who had coronavirus image patients with COVID-19. ufactured by the UV irradiation of ergosterol in yeast, and vita- infection but never displayed Limited evidence exists for the min D3 is manufactured by the irradiation of 7-dehydrocholes- cardiac symptoms use of lung ultrasound to differ- terol from lanolin and the chemical conversion of cholesterol. Patients with CardioVascular entiate ARDS (single and/or Benefits Of Vitamin D risk factors including male sex, confluent vertical artefacts, Aid in Weight Management: There is a connection between advanced age, diabetes, hypertension and obesity as well as small white lung regions) from Heart failure obesity and vitamin D deficiency, with some studies even show- patients with established CV and cerebrovascular disease have Cardiac CT should be performed when there is a potential ing that getting enough of this key vitamin could also aid in been identified as particularly vulnerable populations with impact on clinical management, including evaluation of sympto- weight loss. increased morbidity and mortality when suffering from COVID-19. matic suspected CAD, acute symptomatic heart valve dysfunction, Boosts Brain Health Heart Ailments left ventricular assist device (LVAD) dysfunction, Pulmonary It is unfortunate that Vitamin D deficiency affect millions Vitamin D is important for the brain health and its function- Though it often resolves without incident, myocarditis Embolism which warrants an, urgent structural intervention. around the world and can come with serious consequences which ing. Vitamin D receptors are widespread in brain tissue, and vita- (Inflammation of heart musculature) can lead to severe complica- Cardiac CT is preferred to TEE to rule out the presence of intrac- may be due to the less exposure to sunlight and vegetarian diet min-D's biologically active form (1,25(OH)(2)D3) has shown tions such as abnormal heart rhythms, chronic heart failure and ardiac thrombus. In patients with acute chest pain and suspected containing less Vitamin D as compared to the the non-vegetarian neuroprotective effects. The Vitamin D deficiency is associated even sudden death. Myocarditis appears to result from the direct obstructive CAD, CCTAngiography is the preferred non-invasive diet. Lack of awareness regarding this deficiency enhances phys- with a higher risk of developing conditions like schizophrenia, infection of the virus attacking the heart, or possibly as a conse- ical and mental disorders. However, a proper Vitamin D rich diet imaging modality since it is accurate, fast and minimizes the expo- depression, anxiety, seasonal affective disorder and insomnia. quence of the inflammation triggered by the body's overly aggres- sure of patients. and supplements alongwith the 5 to 15 minutes sunshine thrice a sive immune response. and it is not age-specific: This is an incred- Prevent Cancer Formation Cardiac Magnetic Resonance CMR is preferred investigation week may resolve the defficiency. The Vitamin D is also known as ibly tricky diagnosis. Some studies have found that vitamin D deficiency may be for diagnosis of acute myocarditis.especially in patients having the sunshine vitamin and being produced by the body in response Patients with myocarditis often experience symptoms like linked to a higher risk of certain types of cancers. According to a typical symptoms like elevated troponins, ventricular dysfunction to skin exposure to the sunlight. shortness of breath, chest pain, fever and fatigue-while some have review in Frontiers in Endocrinology, vitamin D is believed to and/or severe arrhythmias that cannot be explained by other diag- Symptoms Of Vitamin D Deficiency affect tumor cell growth, cell differentiation and even destruction no symptoms at all. According to some reports, as many as 7 per- Low vitamin D levels may have various side effects and some cent of deaths from COVID-19 may result from myocarditis. nostics and imaging methods. of cancer cell. Take home advice Patients with cardiovascular (CV) risk fac- of the most common symptoms of a deficiency include weakness Strengthens Bones The Ventricular arrhythmia that sometimes accompanies it is tors and established cardiovascular disease (CVD) represent a in the legs, arms and hands, chronic fatigue, back pain, neck pain, One of the most well known benefits of vitamin D is its pow- also worrisome, and it has been found to be fairly common vulnerable population when suffering from COVID-19. They have depression, disturb sleep, anxiety, weak or broken bones, numb- erful effect on bone density. Getting regular sun exposure and among COVID-19 patients high potential of having cardiac injury and increased risk of mor- ness in legs and arms, weakened immune system, inflammation consuming a variety of vitamin D foods in your diet is one of the Heart Failure is another very important presentation of heart and swelling best ways to keep our bones healthy and strong. ailments and can be compounded by ARDS,covid lung bidity and mortality and hence prompt and early diagnosis of Causes Of Vitamin D Deficiency Improves Immune Function injuries,and myocardites these heart ailments is extremely important for management Vitamin D deficiency can occur for a number of reasons which Vitamin D aids in cell replication and helps to protect against Patients who developed coronavirus infection and there are well set protocols for usage of various drugs like anti- includes low consumption of the recommended levels of the vita- the development of autoimmune conditions and infections. recovered,subsequently it was found that about 10 weeks after coagulants anti arrhythmic drugs and heart failure directed min over time, limited exposure to sunlight, dark skin individu- Thus, Vitamin D being the sunshine Vitamin is essential for their initial symptoms, 37 percent of them were diagnosed with medical therapy, like beta blockers, ACEInhibitors, ARBs. als, kidney diseases, inability of the digestive tract to absorb vita- our sound health particularly, bones, brain and teeth. One must myocarditis or myopericarditis-and fewer than half of those had Further where ever required the coronary intervention for acute min D, obesity, diet without or less amount of Vitamin D. take care of it through periodical tests and proper treatment. showed symptoms at the time of their scans done during the ill- coronary syndrome and devices like Extracorporeal Membrane Tests For Vitamin D Deficiency Sunshine and rich Vitamin D diet and supplements are the solu- ness Any such cardiac sequelae lingering weeks to months after Oxygenerator (ECMO) support for ARDS and failing heart should The most accurate way to measure how much vitamin D is tion for its deficiency. Consult the doctor for the proper diagno- the fact is clearly concerning, be established through a blood test. A level of 20 nanograms/milliliter to 50 sis and treatment through supplement and medicines incase the Acute Coronary Syndromes COVID-19 patients might abrupt- Its very important to follow the theme "Use your heart to fight ng/ml is considered adequate for healthy people. A level less than deficiency is severe. If we become conscious at the early stage we ly develop acute cardiac complications (such as ACS or pulmonary COVID-19 but still be careful. Just don't get the virus in the 12 ng/ml indicates vitamin D deficiency. Although, there is no shall save ourselves from its dire side effects and consequences. embolism [PE]Patients present with acute chest pain shortness beginning. As of today, it's still the best defense we've got." consensus on vitamin D levels required for optimal health and (The authors are working with the University of Jammu) of breath features of shock called cardiogenic shock and need (The author is Consultant CTV Surgeon SSH GMC Jammu)