Handigodu Syndrome

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Handigodu Syndrome

Handigodu syndrome or Handigodu Joint disease is an inherited disorder mainly characterized by osteoarthropathy. It was mainly endemic to Malnad region in Karnataka state, India. It is scientifically known as spondylo epi (meta) physeal dysplasia. It affects spine, epiphyses and metaphyses of the long bones of the limbs. 

Prevalence of this disease is not relevant nowadays, as it confined to specific geographic parts of the villages, Karnataka, India.It is a progressive skeletal disorder, starting with severe hip and joint pain, forces the patient to crawl and then, cripples. Most of them are short statured because of spine involvement.

The causative factors are uncertainly defined. It may be due to consanguinity, low protein intake and environmental toxins.

Regarding management of the handigodu disease, patients are treated for pain and swelling with analgesics but no cure.

Coronary Artery Diseases

Coronary Artery Diseases

The epidemic of coronary artery diseases is widely prevalent among Indian population. Four people die of heart attack every minute in India and the age group is mainly between 30 and 50 years. This is not frighten you, but to provide a wake-up call.

Risk factors of coronary artery diseases

It might be due to genetic predisposition leading to premature coronary artery diseases and anatomical abnormalities such as dilated coronary arteries called ectasia with pro thrombotic (easy clot forming) tendency.

Other risk factors are diabetes mellitus, high blood pressure, high blood lipid levels, obesity, smoking, sedentary life style, smoking, alcoholism, consumption of fast foods and high level of stress.

Symptoms

• Unstable Angina- Central crushing chest pain or discomfort, which may spread to the arms, neck, jaw, stomach and back. Constant dull pain or heavy feeling on chest, not relieved by rest, Glyceryl Trinitrate tablets or sublingual spray.
• Stable Angina- Chest pain on physical activity but settles after a period of rest, Glyceryl Trinitrate tablets or sublingual spray.

Management

• Emergency management for unstable angina- It is life threatening, so that, seek medical help immediately. Call an ambulance, go to nearby specialist hospital.
• Emergency management for stable angina- Consult specialist soon. Medical management includes drugs e.g. cholesterol lowering medications, beta blockers, nitroglycerin and calcium antagonists etc.
• Surgical management- It includes coronary interventions such as angioplasty, coronary stent and coronary artery bypass grafting.

Prevention

The public should be educated about risk factors through awareness programs. Focus on ‘stop smoking and alcoholism’ and 'dietary approach' means avoid fatty foods and eat at regular intervals. The regular exercises and outdoor games are essential to keep every one healthy.

They should watch their BMI (for details see (http://understandhealthtips.blogspot.in/2014/10/body-mass-index.html)) and waist hip ratio (for details see(http://understandhealthtips.blogspot.in/2014/10/waist-hip-ratio.html)). Keep blood pressure, blood sugar and blood lipids under control. Do annual screening periodically (for details see(http://understandhealthtips.blogspot.in/2014/11/annual-health-check-up.html)).

World AIDS Day- 01/12/2014

World AIDS Day

World AIDS Day, observed on 01 December in every year, is one of the official public health campaigns, initiated by World Health Organization. All over the world including government organizations, educational institutions and non-governmental organizations observe the day, giving importance to raise the awareness against prevention and control of AIDS pandemic, which is caused by HIV virus.

The facts of HIV

Human Immunodeficiency Virus attacks the body's immune system and higher the chance of getting secondary infection. This virus is transmitted mainly through sexual contact without a condom and by sharing infected needles or equipment. This is the fact that 90% of people are getting infected through the unprotected sexual contact. No one could develop vaccine yet, thus, no cure for HIV.

The main aim of observing World AIDS Day is to create awareness regarding route of transmission, prevention and control measures including use of condoms and disposable syringes.

The theme of World AIDS Day 2014 is closing the gap between prevention and treatment. To achieve 'Zero HIV case' in 2030, we have to close the gap between the people who have access to HIV prevention and treatment and who haven't.

Thrombophlebitis

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Thrombophlebitis or phlebitis is the inflammation of vein. It may occur due to thrombus (blood clot). These blood clots are formed because of injury or prolonged immobility. Here, I am going to write about the phlebitis related to improper insertion of IV cannula, its mechanism, treatment and preventive measures.

Inflammation of superficial veins is might be due to injury, for example, when one does not insert the IV cannula properly or attempts to insert the IV cannula 2-3 times, it may irritate the vein wall.  It causes profuse bleeding. Immediately after endothelial cell  injury, platelets are activated.This response initiates leukocyte rolling and forms blood clots, which stick into the wall of the vein. The formation of blood clots in the dermis layer called as thrombosis. It leads to inflammatory reaction. The combination of inflammation and thrombosis leads to thrombophlebitis. Signs are swelling, redness, warm and pain in touch.

About the resolution of inflammation,  a number of pro-inflammatory factors including IL-1Beta and Tumor Necrosis Factor and monocytes influx into the thrombus. It is denatured by the circulating enzymes and absorbed into the blood circulation. This phenomena is called as thrombolysis.The thrombophlebitis will be resolved within 2-7 days.

Treatment

• Elevate the affected area
• Apply warm moist pack for 15-20 minutes
• Apply Glycerin Magnesium Sulfate paste for relieving inflammation and pain
• Analgesics and anti inflammatory medications can be prescribed

Preventive measures

• Must change the IV cannula after 72 hours(3 days)
• While inserting IV line, if swelling appears, withdraw it immediately and compress the area with cotton for 5 minutes.
• After infusion of medication, flush the IV cannula with normal saline or Hep Flush (Heparin lock Flush Injection).
• Inspect the area for any signs of infection such as swelling, redness, warm and pain in touch. If there are any signs of infection, remove the IV cannula and opt another site for insertion.

Ebola Virus Disease

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Ebola Virus Disease

Since the past two decades, the world has been experiencing the outbreaks of viral diseases such as Severe Acute Respiratory Syndrome, Bird flu and Swine flu. Now, we are experiencing the outbreak of Ebola virus.

The Ebola virus disease or Ebola, is a disease caused by Ebola virus in humans and other primates. It was firstly identified in 1976 in two different outbreaks- one in Sudan and the other in Zaire.The main factors contributing for an outbreak is, human activities like changes in land use, urbanization, high density population in cities, climate change and under utilization of health care systems.

The incubation period is 2-20 days.The Ebola infection shows a sudden onset of the disease resulting fever, chills and malaise. Later it progresses to vomiting, diarrhea and hemorrhagic conditions at its peak.Finally, it results in uncontrolled bleeding, shock, convulsions and severe metabolic disorders. The death of the victim usually occurs within about two weeks.

The African Fruit Bat is considered to be the natural host for the Ebola viruses as well as the major sources of human infection.It can be spread through direct contact with body fluids of an infected person which includes blood, urine, saliva, semen and indirect contact with environment contaminated with fluids. It does not spread through air.

Currently no drug or vaccine can cure this disease. So, it is very important to focus on reduce the risk of wildlife to human transmission and human to human transmission. The outbreak containment measures are safe burial of infected people,quarantine measures for 21 days, maintain clean environment and practice hygienic measures.

Sure, this outbreak will subside one day, though only after consuming many lives.  At the same time, when it reappears, the world will be ready with high tech weapons to fight it...hopefully...

World Diabetes Day- 14 November

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World Diabetes Day- 14 November 2014

It is a primary global awareness campaign for diabetes mellitus and is held on 14 November of each year. It was introduced by the International Diabetes Federation and the World Health Organization in 1991. The day marks the birthday of Frederick Banting who discovered insulin in 1922.

Each year, it focuses on a theme related to diabetes mellitus. Themes in the past were diabetes and human rights, diabetes and lifestyle and the cost of diabetes. Recent themes include 

• 2007-2008: Diabetes in children and adolescents
• 2009-2013: Diabetes education and prevention
• 2014-2016: Healthy living and diabetes

The World Diabetes Day Logo

The circle symbolizes life and health. The color 'blue' represents sky that unites all nations. The blue circle signifies the unity of the diabetes community world wide in response to the diabetic pandemic.

Activities

Activities include health camp, free screening, public information meeting, poster presentation, workshop, newspaper article, walk, run, cycle race, quiz program, debate session, diabetic diet exhibition, public health education program, puppet show, radio and television programs.

To conclude,

World Diabetes Day 2014

Maternal Near Miss(MNO)

Maternal Near Miss/ Obstetric Near Miss

A ' near miss' is an unplanned event that didnot result in injury or damage, but had the potential. This is a fortunate break in the events prevented an injury or death. This term actually represents safety.

A maternal near miss case is defined as 'women who nearly die but survived from complications that occurred during pregnancy, child birth or with in 42 days of termination of pregnancy. In practical terms, those who survived from life threatening situations during those minutes.

The concept has been coined by WHO, to focus on the health system failures in relation to obstetric care.

The CBH criteria( Cairns Base Hospital, Far North Queensland) for potential cases of ONM are

• any admission to ICU
• APH/PPH requiring operative interventions
• severe pre-eclampsia
• pulmonary embolism
• ruptured ectopic pregnancy
• shock

The proposed WHO Near Miss Criteria

Near Miss Criteria(WHO)

The near miss audits in hospitals based on WHO criteria, will help to analyse the ill women, identify the deficiencies in the care and able to do comparisons between or within the countries. This will, ultimately, help to reduce the maternal morbidity and mortality worldwide.

MUDD Mapping (My Understanding through Dialogue and Debate)

It is an acronym for My Understanding through Dialogue and Debate. It is an innovative, interactive teaching learning activity where the main participant is the learner and the central activity is dialogue.

Goal

To bring learners together so that they can engage in purposeful dialogue to achieve sustained understanding of a subject matter.

It reflects the five principles of adult learning by knowledge. 

These principles are self concept, experience, readiness to learn, orientation of learning and motivation to learn. Every word in the acronym MUDD is intentionally assigned by Kay Barrington.

‘M’ implies that the learner will take ownership for learning. It also reflects the learner’s acquisition of knowledge.

‘U’ refers to understanding of the subject by the learner.

‘D’ invites the individuals to share their ideas, views, positions and propositions. It is the expression of understanding about a concept.

‘D’ involves a higher level of thinking including critical thinking exercises. It is used when a learner has sufficient knowledge to enter a debate with another learner on a same concept with a different point of view.

MUDD mapping is very effective method learning by the learners and it can foster the partnership of teaching and learning.

World Mental Health Day-10 Oct 2014

The World Mental Health Day 2014 torches light on  schizophrenia. It provide an opportunity to focus as a nation on an issue that affects all.

Schizophrenia is a mental disorder characterized by abnormal social behavior and failure to recognize realities in life.

They may

• living in their own world
• see or hear things which are not real
• believe in irrational ideas
• acts strangely as they respond to delusions and hallucinations.

Management

The primary treatment consists of anti psychotic medications such as Olanzapine, Risperidone and Clozapine, often in combination with psychological and social support.

Living with a person with schizophrenia

• When they refuse treatment

People with schizophrenia may refuse treatment. In such cases, family and friends may need to take action to keep their loved one safe.

• When they become violent

They are not usually violent. If they become violent, seek professional help right away.

• When they are addicted to substance abuse

Addiction is common among patients with schizophrenia. Try to introduce alternative strategies e.g. nicotine replacement methods to quit smoking, with professional help.

• When they attempt suicide

It is hard to predict which people with schizophrenia are prone to commit suicide.Watch them carefully. If they give any cues, get the professional help right away.

With medication, therapy and strong social support, they are able to control symptoms as well as gain independence in activities of daily living.

If you shower love, support and help the person with schizophrenia for getting proper treatment, I am sure, you can make a difference.

Best Scientific Paper Award 2014

I have presented a scientific paper about " health behavior and level of stress among adolescent boys" in a National Conference, conducted by ICCR, Omayal Achi College of Nursing and SCARF, Chennai, India. I got "Best Paper Award" for my presentation.

Rokitansky syndrome

I am very glad to say that a woman's dream come true. In October 2014, it was reported that a 36 years old Swedish woman, who was diagnosed with Rokitansky Syndrome and was undergone womb transplant, gave birth to a healthy baby.

Mayer-Rokitansky-Küster-Hauser Syndrome

Mayer-Rokitansky-Küster-Hauser Syndrome is a disorder that affects female reproductive system. It is a congenital malformation, characterized by a failure of development of mullerian duct, resulting in underdevelopment of uterus and vaginal hypoplasia.

It may be associated with other malformations such as renal agenesis, ectopia of kidneys and cardiac anomalies.

Signs and Symptoms

• Primary Amenorrhea

• Infertility

• Difficulty with sexual intercourse

• History of recurrent urinary tract infection

Management

Goal: To provide the patient with an unscarred vagina

• Perineal dilation

• Vaginal reconstruction by Mclndoe technique with skin graft

• William's vaginoplasty with vulval flap

• Intestinal neovagina uses an isolated segment of bowel

• Uterus transplantation

In conclusion, the risk for transmission of the disease can not be predicted, as the genetics of the MRKH Syndrome is very little known currently.

World Geriatric Day- 1st October 2014

World Geriatric Day

'Let us join together to active and healthy aging for Elderly Persons'

 

Elderly care is the fulfillment of demands and needs by them. It encompasses wide range of services such as assisted living, home care, adult day care and hospice. The most important part of elderly care is to love them and keep them active.
There are different ways to keep them active:

• do different forms of physical activity every day
• more aerobic exercises
• pursue hobbies
• take part in social activities
• have balanced diet
• shift to vegetarian food including more fruits and vegetables
• have good sleep
• pay attention to foot care
• use assistive devices if needed
• regular medical check ups
• take medicines according to physician's prescription

Taking care of them is a part of our tradition and culture......yes....let us care for our elders....

World heart day-2014

World Heart Day

World heart day -2014

                     ‘Creating heart healthy environment’
World heart day, which dates back to 2000, is an annual global awareness day, its objective to create awareness among people around the globe that the heart diseases and stroke are the world’s leading causes of death, claiming 17.3 million lives each year.

The theme of world heart day focuses on an environment in which we live, work and play should not increase our risk of cardio vascular diseases. The environment factors such as air pollution, water pollution, availability of healthy foods and mental environment at place of work play a vital role in contributing cardio vascular diseases.

Talking about pollution, smoking including passive smoking create accelerated rate of diabetes, hypertension and atherosclerosis. Staying in crowded places where hygiene of air and water is poor, the risk of infectious diseases is very high and this can lead to rheumatic heart diseases.

About availability of healthy foods, one should focuse on low carbohydrate, low fat and high protein rich foods including fresh fruits and vegetables. It is very essential to stress on low salt intake, as World Health Organization targets a 30% reduction in salt intake worldwide by 2025.

But, environment is not restricted to just the physical environment, it also covers mental environment including place of work, the pressure to perform, long working hours and skipping meals etc.

Marriage related acts in India

Marriages can be registered under various acts including the Hindu Marriage Act, 1955, Special Marriage Act, 1954 and Indian Christian Marriage Act, 1982.

The Hindu Marriage Act, 1955
Under the act, bride groom and bride of any caste under the Hindu religion are eligible to get married. The bridegroom must complete 21 years and bride must be over 18 years.

The Special Marriage Act, 1954
Special marriages will be registered after submission of an application to the registering office and they will put up a notice in his office. If there is no objection received within 30 days, the marriage can be registered.

The Indian Christian Marriage Act, 1982
Christian marriages can be registered under this act and the priests in the churches who are appointed by the government act as registers under the Indian Christian Marriage Act, 1982.

For registration

• Proof of marriage such as wedding invitations should be submitted
• Residence proof includes voter’s identification card, driving license and passport should be submitted
• Age proof includes birth certificate, school certificate or passport should be submitted Passport size photo of bride and bridegroom should be submitted.

To be noted: 
There is no time limit for registering the marriages under the Hindu Marriage Act. But it may vary in state wise, for example, under the Tamil Nadu Registration of Marriage Act, 2009; marriages should be registered within 90 days. If it exceeds 90 days, fine will be charged. Registration will not be done after a period of 150 days of marriage.

DIABETES MELLITUS

DIABETES MELLITUS- Types, Symptoms, Management
It is a disorder that involves the hormone producing part of the pancreas, leading to a partial or complete deficiency of insulin.

Types

• Type 1 diabetes mellitus

It is much less common in India (<5% of the total number of diabetic patients) and is associated with a near total lack of insulin. It is usually common among those who below the age of 30 years.

• Type 2 diabetes mellitus

It usually comes on after the age of 30 years and is associated with urbanization, modern life style and obesity where the body’s own insulin doesn’t function properly.

Symptoms of Diabetes Mellitus

Management of diabetes mellitus
This involves a crucial triad of DED (Diet, Exercises and Drugs).

Diet involves high protein, low fat and low carbohydrate foods such as plant based proteins, fish, chicken, milk products and soy products.

People with diabetes mellitus are encouraged to do exercises daily for better blood sugar control and to reduce the risk of cardiovascular diseases. It is recommended that an aerobic exercises can be planned for 30 minutes daily and the intensity and duration of exercise can be planned individually under physician’s guidance.

The recommended drugs are Biguanides, Sulphonylureas, Metaglinides, Alphaglycosidase Inhibitors, Thiazolidinediones (avoid in liver diseases) and Insulin therapy. The diabetic patients who are on drugs should be cautious about the side effects such as hypoglycemia and weight gain. They should always carry some sweet foods to counter hypoglycemic attack.

The Medical Termination of pregnancy - India

Unsafe abortions are taking a huge toll on lives of women, as these victims opt for backroom procedures. Here, I am posting about MTP Act in India to inculcate awareness among the public about "how can abortion legally be done?".

It extends to all states in India except Jammu and Kashmir. It lays down,

• The conditions under which a pregnancy can be terminated.
• The persons who can perform such terminations.
• The place where such termination can be performed.

·       The conditions under which a pregnancy can be terminated:

There are five conditions that have been identified in the Act, where the pregnancy might endanger mother’s life or cause injury to mother’s physical or mental health, where there is a risk of child being born with serious handicaps, where the pregnancy is the result of rape, where actual or reasonably foreseeable environments could lead to risk of injury to the health of the mother and an unwanted pregnancy resulting from a failure of any contraceptive devices.

·       The persons who can perform abortion:

If the length of pregnancy doesn't exceed 12 weeks, a Registered Medical Practitioner having experience in gynecology and obstetrics can perform abortion but, if pregnancy exceeds 12 weeks and is not more than 20 weeks, the opinion of two Registered Medical Practitioners is necessary to terminate the pregnancy.

·       Where abortion can be done:

Termination of pregnancy can be made at a hospital maintained by government or a place approved for the purpose of this Act by government. It should be done in hospitals in strict confidence. 

The written consent of the guardian is necessary before performing abortion in women under 18 years of age, and in case of lunatics even if there are older than 18 years.