Home Solutions
Home Solutions
Total Solutions for your home

HEALTH

Patient Problems / Complications and Appointment
Upcoming Event Registration
BUY / SELL

If you are a Doctor

Upload your own Health Article

What are you looking for?
Post a Job

Upload your OffersFees

Register as Doctor
Update your Profession Details

If you are a Doctor

Upload your own Health Tips

HOME SOLUTIONS

Home Solutions Suggested:

CANCER 

E-MAGAZINE


ECZEMA TREATMENT

E-MAGAZINE

STRESS MANAGEMENT

E-MAGAZINE

MENSTRUAL HYGIENE MANAGEMENT

E-MAGAZINE

ISCHAEMIC HEART DISEASE

 E-MAGAZINE


OBESITY CONTROL

E-MAGAZINE


DIABETES CARE 

E-MAGAZINE


BLOOD PRESSURE CONTROL

E-MAGAZINE

DENGUE PREVENTION & CONTROL 

E-MAGAZINE

DO'S & DON'TS OF SNAKE BITE
Acute encephalitis syndrome
STEPS TO OVERCOME MALNUTRITION
HEALTHY BALANCE DIET
BEST DOCTORS DETAILS
ABOUT WHO
OVER USE OF ANTI - BIOTICS
DO'S & DON'TS OF SNAKE BITE


DO'S AND DON'TS OF SNAKE BITE









Acute encephalitis syndrome

Acute encephalitis syndrome

popularly known as (CHAMKI FEVER)


Acute encephalitis syndrome (AES) is a serious public health problem in India. It is characterized as acute-onset of fever and a change in mental status (mental confusion, disorientation, delirium, or coma) and/or new-onset of seizures in a person of any age at any time of the year. The disease most commonly affects children and young adults and can lead to considerable morbidity and mortality.

Viruses are the main causative agents in AES cases, although other sources such as bacteria, fungus, parasites, spirochetes, chemicals, toxins and noninfectious agents have also been reported over the past few decades.

Japanese encephalitis virus (JEV) is the major cause of AES in India (ranging from 5%-35%).Herpes simplex virus, Influenza A virus, West Nile virus, Chandipura virus, mumps, measles, dengue, Parvovirus B4, enteroviruses, Epstein-Barr virus and scrub typhus, S.pneumoniae are the other causes of AES in sporadic and outbreak form in India. Nipah virus, Zika virus are also found as causative agents for AES. The etiology in a large number of AES cases still remains unidentified.

AES due to JEV was clinically diagnosed in India for the first time in 1955 in the southern State of Madras, now Tamil Nadu. During 2018, 10485 AES cases and 632 deaths were reported from 17 states to the National Vector Borne Diseases Control Programme (NVBDCP)*in India, with a case fatality rate around 6 per cent. AES cases were reported mainly from Assam, Bihar, Jharkhand, Karnataka, Manipur, Meghalaya, Tripura, Tamil Nadu, Uttar Pradesh.

SYMPTOMS

Acute Encephalitis Syndrome (AES) is a general description of the clinical presentation of a disease characterized by high fever altered consciousness mostly in children below 15 years of age.

Clinically, a case of AES is defined as a person of any age, at any time of year with the acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) AND/OR new onset of seizures (excluding simple febrile seizures). Other early clinical findings may include an increase in irritability, somnolence or abnormal behavior greater than that seen with usual febrile illness. 

CAUSES

Acute Encephalitis Syndrome (AES) has a very complex etiology. Causative agents of AES include a wide variety of viruses, bacteria, protozoa, fungi, and non- infectious agents. While Japanese encephalitis virus (JEV) is a leading cause of acute encephalitis syndrome in India (ranging from 5-35%), the etiology in a large number of cases however remains unidentified. In India during 2018, 15% of cases of AES were found positive for infection due to JEV.

Herpes simplex virus, Influenza A virus, West Nile virus, Chandipura virus, mumps, measles, dengue, Parvovirus B4, enteroviruses and scrub typhus, S.pneumoniae are the other causes of AES in sporadic and outbreak cases in India. In many cases, however, no etiological agent is determined. Tick-borne encephalitis virus – TBEV, Zika virus, Nipah virus are also found positive in AES cases.

Some are the zoonotic disease, that transmitted from animals to humans via mosquitoes (e.g. Japanese encephalitis virus, and West Nile virus) or ticks, (Tick-borne encephalitis virus), while for other flaviviruses humans are the natural hosts; these include dengue virus (DENV), and Zika virus (ZIKV).

Although AES cases other than JE continue to be reported throughout the year, there is an overall increase of total AES cases since the month of June, peak during July- August and decline in September- October.

The AES cases in Muzaffarpur, Bihar and adjoining litchi producing districts have been observed mostly during April to June particularly in children who are undernourished with a history of visiting litchi orchards. In 2014, a relationship between consumption of litchi and AES was postulated by National Centre for Disease Control, Delhi (along with Centre for Disease Control US) in acute encephalitis in children, in Muzaffarpur*.

DIAGNOSIS

The National Vector Borne Disease Control Programme in India has set up country wide surveillance for AES through sentinel sites with a focus on detecting Japanese encephalitis (JEV). In the sentinel surveillance network, AES/JE is diagnosed by lgM Capture ELISA, and virus isolation is done in National Reference Laboratory.

Laboratory-Confirmed case is a suspected case with any one of the following markers:

  • Presence of lgM antibody in serum and/ or CSF to a specific virus including JE/Entero Virus or others
  • Four-fold difference in lgG antibody titre in paired sera
  • Virus isolation from brain tissue
  • Antigen detection by immunofluroscence
  • Nucleic acid detection by PCR

MANAGEMENT

Management of AES is essentially symptomatic. First line of management should be started at grass root level. To reduce severe morbidity and mortality it is important to identify early warning signs and refer patient to higher health facility.

Danger Signs-

  • Fever with any one of the following:

Lethargy/ Unconsciousness/ Convulsions

Pre referral care-

  • Sponging with tap water if fever is present
  • Nothing to be given orally
  • Management of airway and breathing- Clear Airways
  • Patient’s position –
    • Turn the patient on the side to reduce risk of aspiration.
    • Keep the neck slightly extended and stabilize by placing cheek on one hand.
    • Bend one leg to stabilize the body position.
  • Referral to nearest first referral health facility.

COMPLICATIONS

The disease affects the central nervous system and can cause severe complications, seizures and even death. The Case Fatality Rate (CFR) of this disease is very high and those who survive may suffer from various degrees of neurological sequeale. (An estimated 25% of the affected children die, and among those who survive, about 30- 40% suffers from physical & mental impairment).

PREVENTION

National Programme for Prevention and Control of Japanese Encephalitis(JE)/Acute Encephalitis Syndrome (NPPCJA):

Considering the complexity of AES problem and to reduce morbidity, mortality and disability in children due to JE/AES, Government of India has developed a multi-pronged strategy with convergence of the concerned Ministries

  • Ministry of Health and Family Welfare:

o  Strengthening and expanding JE vaccination.

o  Strengthening of public health activities

o  Better clinical management of JE/AES Cases.

o  Physical medicine and rehabilitation (PMR)

o  Establishing of district counselling centres

o  Monitoring, supervision and coordination

o  Research-cum-intervention project

  • Ministry of Drinking Water and Sanitation for provision of safe water supply
  • Women and Child development for providing high quality nutrition to the vulnerable children
  • Ministry of Social Justice and Empowerment for establishing District Disability Rehabilitation Centers for disability management and rehabilitation.
  • Ministry of Housing and Urban Poverty Alleviation (HUPA) for ensuring the supply of safe water in slums and towns
  • Ministry of Human Resource (Department of School Education) to provide special facilities to disabled children for their education.

The major objectives of NPPCJA:

(i) to strengthen and expand JE vaccination in affected districts- In JE endemic areas, JE mass vaccination campaign is done using a single dose of live attenuated vaccine (SA-14-14-2) in children between 1- 15 years of age followed by routine immunization of children. Two doses of JE vaccination are provided under Universal immunization, first at 9-12 months along with measles and second with DPT booster at 16-24 months in JE endemic areas. JE vaccination of adult population is also started in selected districts of few endemic states.

(ii) to strengthen surveillance, vector control, case management and timely referral of serious and complicated cases;

(iii) to increase access to safe drinking water and proper sanitation facilities to the target population in affected rural and urban areas;

(iv) to estimate disability burden due to JE/AES, and to provide for adequate facilities for physical, medical, neurological and social rehabilitation.

(v) to improve nutritional status of children at risk of JE/AES;

(vi) to carry out intensified IEC/BCC activities regarding JE/AES.

STEPS TO OVERCOME MALNUTRITION

STEPS TO OVERCOME MALNUTRITION

Action Plan for Overcoming the Curse of Malnutrition Critical actions are recommended based on this holistic approach and analysis (also see a Nutrition Security Framework in Attachment 2). These actions are divided into two categories: 

1) what needs to be done; and 

2) how to do it. 

The first set of recommendations (what needs to be done) are based on evidence of which interventions have been the most effective in India and other countries. There is also a need for some consensus about “how” to ensure these interventions are implemented. This leads to the second set of recommendations, which may be the most critical. These “how” recommendations are based on an analysis of the current situation and opportunities as well as on expertise and programming experience. 

Recommendations: What Needs to be Done to Achieve Nutrition Security A significant body of Indian and global evidence indicates that the following are the most critical and effective actions to improve nutrition security in India: 

1. Focus on proven, essential nutrition interventions, the timely initiation of breastfeeding within one hour of birth, exclusive breastfeeding during the fi rst six months of life, the timely introduction of age-appropriate complementary foods at six months (adequate in terms of quality, quantity and frequency), hygienic child feeding practices, improved nutrition for women (especially adolescent girls, pregnant women and lactating mothers), focusing on iron and folic acid supplements and deworming, and timely, high quality therapeutic feeding and care for all children with severe acute malnutrition (with leadership from the Ministry of Women and Child Development). 

2. Focus on proven, essential primary health care interventions: full immunisation, bi-annual vitamin A supplementation with deworming for infants and young children, appropriate and active feeding of children during and after illness, including oral rehydration with zinc supplementation during diarrhoea and timely, high quality therapeutic feeding and care for all children with severe 19 A Leadership Agenda for Action acute malnutrition (with leadership from the Ministry of Health and Family Welfare). 

3. Promote personal hygiene, environmental sanitation, safe drinking water and food safety (with leadership from Ministry of Rural Development).

4. Integrate household food and nutrition security considerations into the design of cropping and farming systems (with leadership from Ministry of Agriculture). 

5. Expand and improve nutrition education and awareness as well as involvement and accountability for improved nutrition at the community level (with leadership from the Ministry of Women and Child Development and the Ministry of Panchayati Raj [local self government] and including others, such as the Ministry of Information and Broadcasting and the Department of Education). 

How to Do It: 

Based on the Indian context and signifi cant programming experience, the Coalition recommends the following methods to improve nutrition security. 

1. Expand efforts to engage and empower vulnerable communities, particularly women in these communities, to overcome malnutrition (e.g., through Gram Sabhas, self help groups). 

2. Ensure that nutrition related programmes focus on key nutrition outcomes and are reaching the priority target groups of children under two years of age, and women (especially adolescent girls, pregnant women and lactating mothers), in order to break the intergenerational cycle of malnutrition and to achieve the desired results. 

3. Strengthen the focus on improving nutrition through a leadership and coordination mechanism with clear authority and responsibility, working from local to national levels (e.g., possibly through a mechanism like a Ministry of Nutrition). 

Discussion of Recommendations What to Do... 

1. Focus on proven, essential nutrition interventions (with leadership from MWCD programmes). A review of evidence and experience indicates that the country should focus on the most effective interventions: Overcoming the Curse of Malnutrition in India 20 • Timely initiation of breastfeeding within one hour of birth • Exclusive breastfeeding during the fi rst six months of life • Timely introduction of complementary foods at six months • Age-appropriate complementary feeding (adequate in terms of quality, quantity and frequency) • Hygienic infant and child feeding practices, safe drinking water and basic sanitation • Timely, high quality therapeutic feeding and care for all children with severe acute malnutrition (SAM), including ready to use therapeutic foods, through a community- based approach combined with a facility based approach for children with medical complications of SAM • Improved nutrition for women, including iron and folic acid supplements and deworming for adolescent girls, pregnant women and lactating mothers 

2. Focus on proven, essential primary health care interventions (with leadership from the MHFW programmes). A review of evidence and experience indicates that the country should focus on the most effective interventions: • Full immunisation and bi-annual vitamin A supplementation with deworming for infants and young children • Appropriate and active feeding of children during and after illness, including oral rehydration with zinc supplementation during diarrhoea • Improved nutrition for women, including iron and folic acid supplements and deworming for adolescent girls, pregnant women and lactating mothers • Timely, high quality therapeutic feeding and care for all children with severe acute malnutrition, including ready to use therapeutic foods • Address micronutrient malnutrition in a holistic manner through a food cum fortifi cation of appropriate foods strategy; promote and improve consumption of iodised salt 

3. Promote personal hygiene, environmental sanitation, safe drinking water and food safety (with leadership from the Ministry of Rural Development programmes). The proven priorities in this area should be: • Promote use of safe drinking water 21 A Leadership Agenda for Action • Encourage personal hygiene and environmental sanitation, especially use of toilets and hand washing with soap • Ensure safe food handling practices during storage, cooking and eating. 

4. Integrate household food and nutrition security concerns into the design of cropping and farming systems (with leadership from Ministry of Agriculture). • Promote agricultural and horticultural programmes and policies to increase the supply and consumption of safe, nutritious foods and to promote food based remedies for nutritional maladies, with emphasis on addressing micronutrient defi ciencies • Mainstream nutrition considerations into the National Horticulture and Food Security schemes such as Rashritya Krishi Vikas Yojana • Expand availability of low cost nutritious foods in rural areas though the Universal Public Distribution System, public-private partnerships, women’s self help groups and other mechanisms (including high quality complementary foods for children ages 6-24 months) • Review and revise existing programmes, such as the Mid Day Meal Scheme to improve the quality of foods provided and the nutrition education elements of the programmes • 

The National Commission of Farmers has produced important recommendations in this area, such as: 

(1) defending the gains of the Green Revolution in intensive agriculture areas; 

(2) developing contingency plans for different weather possibilities; 

(3) states with unutilised yield reserve should be encouraged to improve production and productivity; 

(4) more crop and income per drop of water continuing to work for completing the unfi nished agenda of Land Reform; and 

(5) ensuring a remunerative price for farm commodities 

5. Expand and improve nutrition education, awareness and involvement at community level (with leadership from the Ministry of Panchayati Raj and MWCD, together with assistance from others, such as the Ministry of Information and Broadcasting programmes). • Increase PRI leadership in nutrition security: - Improve sensitisation and training of PRI members on priority nutrition issues Overcoming the Curse of Malnutrition in India 22 - Promote the formation and active functioning of Village Health and Sanitation Committees, with oversight from Gram Sabhas, in order to focus on nutrition and engage and empower vulnerable families - Expand PRI role in monitoring the functioning and outcomes of nutrition programmes at community level - Increase awareness of entitlements among poor households, especially women, for example, by the distribution of entitlement cards listing the various health, nutrition and development programmes available • Promote the use of information technology platforms and innovations (e.g., Gyan Chaupal, e-governance, National Knowledge Mission) for nutrition education and monitoring efforts; Encourage the Grameen Gyan Abhiyan Movement (village knowledge movement) and Gyan Chaupal (village knowledge centres) to focus on nutrition; Establish Village Nutrition Literacy Centres • Issue clear Government guidelines on the priority interventions and target groups for improving nutrition, to encourage all programmes to focus on these evidence based, priority interventions • Improve the nutrition education and counselling skills of all frontline service providers (e.g., Aganwadi workers, Auxiliary Nurse Midwives, Accredited Social Health Activists); expand nutrition education for public health and medical professionals; promote the development of a public health nutritionist cadre • Expand nutrition education programmes in schools • Expand Government programmes to empower and educate women’s self help groups and other community-based organisations about nutrition issues and key actions they can take (e.g., community production of high quality foods, dietary diversifi cation, grain banks) • Expand NGO, community-based organisations, civil society, citizen’s charters and private sector involvement in nutrition, including public-private partnerships and corporate philanthropy, with appropriate regulations designed to protect the public’s health (e.g., corporate support for nutrition education programmes) 

HEALTHY BALANCE DIET


HEALTHY BALANCE DIET



5 keys to a healthy diet (BY WHO)

Breastfeed babies and young children
breastfeeding icon

  • From birth to 6 months of age, feed babies exclusively with breast milk (i.e. give them no other food or drink), and feed them "on demand" (i.e. often as they want, day and night)
  • At 6 months of age, introduce a variety of safe and nutritious foods to complement breastfeeding, and continue to breastfeed until babies are 2 years of age or beyond.
  • Do not add salt or sugars to foods for babies and young children
Why?

On its own, breast milk provides all the nutrients and fluids that babies need for their first 6 months of healthy growth and development. Exclusively breastfed babies have better resistance against common childhood illnesses such as diarrhoea, respiratory infections and ear infections. In later life, those who were breastfed as infants are less likely to become overweight or obese, or to suffer from noncommunicable diseases, such as diabetes, heart disease and stroke.

Eat a variety of foods

variety of foods icon


  • Eat a combination of different foods, including staple foods (e.g. cereals such as wheat, barley, rye, maize or rice, or starchy tubers or roots such as potato, yam, taro or cassava), legumes (e.g. lentils, beans), vegetables, fruit and foods from animals sources (e.g. meat, fish, eggs and milk)
Why?

Eating a variety of whole (i.e. unprocessed) and fresh foods every day helps children and adults to obtain the right amounts of essential nutrients. It also helps them to avoid a diet that is high in sugars, fats and salt, which can lead to unhealthy weight gain (i.e. overweight and obesity) and noncommunicable diseases. Eating a healthy, balanced diet is especially important for young children's and development; it also helps older people to have healthier and more active lives.

Eat plenty of vegetables and fruit

veggies and fruits icon




  • Eat a wide variety of vegetables and fruit
  • For snacks, choose raw vegetables and fresh fruit, rather than foods that are high in sugars, fats or salt
  • Avoid overcooking vegetables and fruit as this can lead to the loss of important vitamins
  • When using canned or dried vegetables and fruit, choose varieties without added salt and sugars
Why?

Vegetables and fruit are important sources of vitamins, minerals, dietary fibre, plant protein and antioxidants. People whose diets are rich in vegetables and fruit have a significantly lower risk of obesity, heart disease, stroke, diabetes and certain types of cancer.

Eat moderate amounts of fats and oils

fats and oil icon




  • Use unsaturated vegetable oils (e.g. olive, soy, sunflower or corn oil) rather than animals fats or oils high in saturated fats (e.g. butter, ghee, lard, coconut and palm oil)
  • Choose white meat (e.g. poultry) and fish, which are generally low in fats, in preference to red meat
  • Eat only limited amounts of processed meats because these are high in fat and salt
  • Where possible, opt for low-fat or reduced'fat versions of milk and dairy products
  • Avoid processed, baked and fried foods that contain industrially produced trans-fat
Why?

Fats and oils are concentrated sources of energy, and eating too much fat, particularly the wrong kinds of fat, can be harmful to health. For example, people who eat too much saturated fat and trans-fat are at higher risk of heart disease and stroke. Trans-fat may occur naturally in certain meat and milk products, but the industrially produced trans-fat (e.g. partially hydrogenated oils) present in various processed foods is the main source.


Eat less salt and sugars


salt and sugars icon


  • When cooking and preparing foods, limit the amount of salt and high-sodium condiments (e.g. soy sauce and fish sauce)
  • Avoid foods (e.g. snacks), that are high in salt and sugars
  • Limit intake of soft drinks or soda and other drinks that are high in sugars (e.g. fruit juices, cordials and syrups, flavoured milks and yogurt drinks)
  • Choose fresh fruits instead of sweet snacks such as cookies, cakes and chocolate
Why?


People whose diets are high in sodium (including salt) have a greater risk of high blood pressure, which can increase their risk of heart disease and stroke. Similarly, those whose diets are high in sugars have a greater risk of becoming overweight or obese, and an increased risk of tooth decay. People who reduce the amount of sugars in their diet may also reduce their risk of noncommunicable diseases such as heart disease and stroke.



BEST DOCTORS DETAILS
25 Bihar doctors get Times Healthcare Achievers award

PATNA: Doctors are considered next to God on the earth applying their knowledge to help their patient recover. To acknowledge the efforts of healthcare pioneers in Bihar, Times Group once again took up an initiative to felicitate them with Times Bihar Healthcare Achievers 2015 awards.

Altogether 25 doctors from different fields were honoured at the function organized at Hotel Chanakya on Sunday evening. Whereas Dr Dilip Sen and Dr B K Chaudhary were honoured with lifetime achievement award, Dr Prakash K Mishra was felicitated for his contribution to community healthcare.

In the field of anaesthesia, Dr Ajit Gupta bagged the award while Dr Ajay Kumar Sinha was awarded in cardiology. Others who were felicitated are: Dr Man Mohan (cardiothoracic surgery), Dr Alok Kumar (dentistry), Dr Ajay Kumar (endocrinology), Dr Brijlal (ENT), Dr Bimal Kumar (gastroenterology), Dr Manoj Kumar (general and laparoscopic surgery), Dr Ramji Singh (general physician), Dr Ravindra Kumar Das (internal medicine), Dr Om Kumar (nephrology), Dr Mukund Prasad (neurosurgery), Dr Rahul Kumar (neurology), Dr Anita Singh (obstetrics and gynaecology), Dr Rajiv Sharan (oncology), Dr Bibhuti Prasan Sinha (ophthalmology), Dr Amulya Singh (orthopaedics), Dr Bindey Kumar (paediatric surgery), Dr Anil Kumar Jaiswal (paediatrics), Dr Prabhat Ranjan (pathology), D Prem Kumar (radiology) and Dr M N Singh (respiratory medicine).

The achievers were selected by an eminent jury comprising, among others, Justice (retired) S K Singh, Nalanda University VC Gopa Sabharwal, founder member-secretary of Asian Development Research Institute Shaibal Gupta and IGIMS director Dr N R Biswas.
ABOUT WHO
OVER USE OF ANTI - BIOTICS

    

WHO REPORT

HEALTH SEARCHES (A-Z)

Reviews System WIDGET PACK