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By:

Quaid Najmi

4 January 2025 at 3:26:24 pm

Cold wave triggers spike in cardiac arrests

Mumbai : As winter temperatures go for a spin across the country, hospitals are witnessing a significant surge of around 25-30 pc in cardiac emergencies, a top cardiologist said.   According to Interventional Cardiologist Dr. Hemant Khemani of Apex Group of Hospitals, cold air directly affects how the heart functions.   “Low temperatures make blood vessels tighten. When the arteries narrow, blood pressure shoots up and the heart has to work harder to push the blood through the stiffened...

Cold wave triggers spike in cardiac arrests

Mumbai : As winter temperatures go for a spin across the country, hospitals are witnessing a significant surge of around 25-30 pc in cardiac emergencies, a top cardiologist said.   According to Interventional Cardiologist Dr. Hemant Khemani of Apex Group of Hospitals, cold air directly affects how the heart functions.   “Low temperatures make blood vessels tighten. When the arteries narrow, blood pressure shoots up and the heart has to work harder to push the blood through the stiffened vessels,” said Dr. Khemani.   Elaborating on the direct effects of cold air on heart functioning, he said that low temperatures make blood vessels tighten, when arteries narrow, blood pressure shoots up and the heart must work harder to push blood through stiffened vessels.   Winter also thickens the blood, increasing the likelihood of clot formation and these combined effects create a dangerous ‘demand-supply mismatch’ for oxygen, especially in people with existing heart conditions.   This trend has caused concern among cardiologists as it adds to India’s already heavy cardiovascular diseases burden – with nearly one in four deaths linked to heart and blood vessel problems.   Dr. Khemani said that sudden temperature transitions - from warm rooms to chilly outdoors - can put additional strain on the heart and risks. “This abrupt shift loads the cardiovascular system quickly, raising the risk of a sudden (cardiac) event among vulnerable individuals.”   Lifestyle Patterns Added to these are the changes in lifestyle patterns during winter month that further amplify the danger. Most people reduce physical activities, eat richer foods, and often gain weight all of which combine to raise cholesterol levels, disrupt blood-sugar balance and push up blood pressure.   Complicating matters for the heart are the social gatherings during the cold season that tends to bring higher intake of smoking and alcohol, said Dr. Khemani.   Recommending basic preventive measures, Dr. Khemani said the chest, neck and hands must be kept warm to prevent heat loss, maintain a steady body temperature and reduce the chances of sudden blood pressure spikes, a low-salt diet, home-cooked meals, shot indoor walks post-eating, adequate hydration and at least seven hours of sleep.   He warns against ignoring warning signals such as chest discomfort, breathlessness, unexplained fatigue, or sudden sweating, pointing out that “early medical care can significantly limit heart damage and improve survival.”   The rise in winter heart risks is not unique to India and even global health agencies like World Health Federation and World Health Organisation report similar patterns.   The WHF estimates that more than 20 million people die of heart-related causes each year - equal to one life lost every 1.5 seconds, and the WHO has listed heart disease as the world’s leading cause of death for five consecutive years.   Seniors affected more by winter chills  Cold weather can hit the heart at any age, but the risk is noticeably higher for men aged above  45 and in women after 55, with the highest danger curve in people over 60, and elders with co-morbidities and history of heart diseases.   “People with existing cardiac problems face greater trouble in winter as the heart has to work harder. Even those without known heart disease can sometimes experience winter heart attacks, as chilly conditions may expose hidden blockages or trigger problems due to sudden exertion, heavy meals, smoking or dehydration,” Dr. Khemani told  ‘ The Perfect Voice’ .   However, contrary to perceptions, cold-weather heart issues have no connection to the COVID-19 vaccine, nor is there any scientific evidence linking the two, he assured.

Nepal’s Constitutional Amendments: A Debate on Reform and Stability

Updated: Oct 22, 2024

Nepal’s Constitutional

Nepal’s current political debate centres on the ruling coalition’s call for constitutional amendments. Led by the Nepali Congress and the Communist Party of Nepal-Unified Marxist Leninist (CPN-UML), the government argues that revisions to the constitution are necessary to address political and governance challenges. The amendments they propose include changes to the electoral system, tweaking the federal structure, and revisiting the nation’s secular status. They claim these reforms will lead to more inclusivity and stability in the long run.


On the other hand, the opposition, including several smaller parties, remains wary of such reforms. They argue that opening up the constitution to major changes could cause more harm than good, especially given Nepal’s complex political and ethnic landscape. There is a strong concern that amending the constitution without broad consensus could lead to political unrest and social division.


Key Amendment Issues

The debate over constitutional amendments revolves around three key issues:

Electoral System: There are calls to shift toward a more proportional representation system to ensure that smaller political parties and under-represented groups have a stronger voice in the political process. Currently, Nepal uses a mixed system, with some seats elected directly and others proportionally. The amendment would increase the number of proportionally elected representatives, giving smaller parties and marginalised groups more power. This change could bring more inclusivity, but critics also warn that it might further fragment an already divided political landscape.


Federalism: Nepal transitioned to a federal system in 2015, with the hope of decentralising power and promoting regional autonomy. However, challenges remain in balancing the power between the central government and the provinces. The proposed amendments aim to address these issues by altering the distribution of powers between the central and provincial governments to decentralise authority more effectively, empower regions, and address local governance issues. This would benefit provincial governments and historically under-represented regions, but it could also lead to conflicts over resource distribution and central control, especially in wealthier or politically dominant provinces. However, critics argue that such changes could destabilise the current system and weaken regional governance.


Secularism: Nepal has declared itself a secular state in its 2015 constitution, but this has been a topic of ongoing debate. Some groups, particularly those aligned with Hinduism, feel that secularism undermines the country’s religious heritage. While the current government has said that it’s not seeking to overturn secularism, there are discussions about refining the way secularism is addressed in the constitution to better reflect Nepal’s religious heritage, particularly its strong Hindu identity. While the state would remain secular, the changes might afford greater acknowledgement of Hindu traditions.


Challenges of Amending the Constitution

Amending a constitution is no small feat, especially in a country like Nepal, where political transitions have often been fragile. One of the main risks of making changes to the constitution is the possibility of increased political instability. The current constitution is only nine years old, and many fear that opening it up to amendments could lead to further fragmentation of the political landscape. Additionally, there are concerns about how these amendments could affect Nepal’s ethnic and regional balance. The federal structure, in particular, has been a sensitive issue since its implementation, and any changes to it could lead to discontent among certain provinces or ethnic groups.


Involvement of External Players: China’s Influence

Nepal’s geopolitical position between India and China means that any political or constitutional shift in the country attracts international attention. China, in particular, has been expanding its influence in Nepal over recent years, both economically and politically. Some analysts believe that the ruling parties’ push for constitutional reforms is also motivated by their desire to maintain a better relationship with China. As China continues to invest heavily in Nepal through its Belt and Road Initiative (BRI), there is concern that China’s involvement could subtly influence the direction of Nepal’s internal political decisions, including amendments to the constitution.


The debate over amending Nepal’s constitution highlights the delicate balance between reform and stability. While there are clear opportunities for addressing political challenges and improving governance, there is also the risk of destabilising the fragile peace that has been built over the past decade. Nepal’s leaders must tread carefully, ensuring that any changes are made with broad consensus and careful consideration of the nation’s complex political and ethnic fabric.


For India, watching these developments closely is essential, as Nepal’s stability and progress directly affect the region. Constitutional reform is a big change, and it must be handled with extreme caution to avoid unintended consequences.


(The author is an expert in foreign affairs. Views personal.)

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