Spinothalamic tract

(By Sauledeg (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons)

Why our left brain does control the right part of the body and our right brain controls the left part of the body?

The human brain separates into two cerebral hemispheres such as right and left, connected by corpus callosum. The human brain passes and receives information from different parts of the body through Mid-brain, Pons, Medulla and Spinal Cord. Regarding spinal cord, outer part consists of white matter and inner part is grey matter. A collection of nerve fibers that connects human body to brain is called tract. There are two types of tracts; corticospinal tract and spinothalamic tract. The tract begins from human brain and passes through the spinal cord to the body parts  is called as corticospinal tract. The tract begins from body parts and passes through the spinal cord to human brain is called spinothalamic tract. The spinothalamic tract divides into three order neurons called Neuron 1, Neuron 2 and Neuron 3.

When one feels touch or pain or temperature on right leg, the sensation passes to the right side of the spinal cord through dorsal nerve root ganglion (Nerve 1) and enters into the right side of the dorsal gray column of the spinal cord (Nerve 2). Then, it crosses to the left side of the gray column of the spinal cord, passes through the upper part of the white matter of left side of the spinal cord, comes out from the same side of the spinal cord, moves upwards through the medulla, pons, mid-brain (Nerve 3) and finally reaches in the left part of human brain (cerebral cortex). This tract is called as spinothalamic tract.

The left part of the human brain receives the sensation from the right leg through spinothalamic tract and as part of reply to the sensation; left sided brain sends the impulses to left part of spinal cord through the mid-brain, pons, medulla and crosses to right part of spinal cord. Finally, it comes out from the spinal cord and  reaches to right sided body parts, this tract is being called as corticospinal tract. An example of result of an impulse is withdrawal of leg from pain or temperature. Thus, the right side of the brain controls the left side of the body and the left side of the brain controls the right side of the body through the spinothalamic tract and corticospinal tract.

Pulse Polio Program 2015

(By Shobhit Gosain [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons)

Pulse polio Program 2015

In India, the fight against polio was started by launching Expanded Program in Immunization (EPI) in 1978. This program was able to cover 40% of all infants. In 1985, Universal Immunization Program (UIP) was launched to cover all districts, despite of having around 28,000 reported cases in India. Meanwhile, World Health Organization has initiated Polio Eradication program in all countries in 1988.In 1995, India has launched Pulse Polio Program, with an aim to eradicate poliomyelitis by vaccinating all under five children at 100% with two doses in a year in addition to routine immunization schedule. Here, the 'pulse' means 'post resuscitation and initial utility in life saving efforts'.

To eradicate the polio, Govt. of India focuses on three strategies such as

• Routine immunization of infants with three doses of polio vaccine
• Supplementary Immunization activities (SIAs) including National Immunization Days (NIDs) to cover the entire country, Sub National Immunization Days (SNIDs) to cover some parts of the country and Mop-up activities to cover 100%.
• Surveillance and investigation of cases of Acute Flaccid Paralysis (AFP)

The main aim of NIDs to immunize the children at booths on the first day and follow up on missed children on the following two days. When a child comes for polio vaccine, health care provider enters the name and address and administers two drops of oral polio vaccine (0.1ml). It is considered as a single dose of vaccine and subsequently, child has to receive the second dose of vaccine in second round. Then, the health care provider marks the left little finger with black ink. 

On the following two days, the health care providers have to conduct house to house survey to immunize the missed cases on the spot and marks the house as "P" with white chalk in front of the house . If the house is locked or not receptive, they mark the house as "X" in front with an indication of revisit the house on coming days. This is for the implementation of mopping up strategy.

Vaccine Vial Monitor also plays a vital role in the program. It suggests the quality of vaccine by indicating the color changes of inner square to outer circle. If the inner square is in white color, the vaccine can be used. Otherwise, it has to be discarded.

The time to add the name of polio in the list of eradicated disease is near by. The Govt. of India has announced the dates of NIDs, first round on 18-01-2015 and second round on 22-02-2015. Let us intertwine our hands to push the name of polio to the pages of  small pox from the present to the past.

Cardiopulmonary Resuscitation (CPR)

(Image by Rama (Own work) [CC BY-SA 2.0 fr (http://creativecommons.org/licenses/by-sa/2.0/fr/deed.en)], via Wikimedia Commons)

Cardiopulmonary Resuscitation (CPR)

It is an emergency procedure in cardiac arrest to maintain the blood flow to the brain and vital organs by compressing chest manually in an unconscious patient with no pulse and no breathing or abnormal breathing such as agonal gasping.

During CPR in an emergency, one has to focus on critical concepts such as

• push hard and fast
• allow maximum chest recoil during compression
• compression a rate of at least 100/min 
• should not interrupt compression often or for long

Follow these steps to perform chest compression:

• Ensure the scene is safe
• Rescuers should wear gloves 
• Keep the patient in supine position and on a flat and firm surface
• Remove the clothes from the chest of the patient
• Keep the heel of the one hand on the middle and center of the chest and place the other hand on the top of it with fingers intertwined ( draw an imaginary line between the nipples)
• Push hard and fast and count it loudly

Depth of the compression is

• For adults- 2 inch/ 5 cm
• For children-2 inch/ 5 cm
• For infants- 1.5 inch/ 4 cm

Facts to be considered:

• If the rescuer's hands and wrists are arthritic, keep one hand on the chest and grasp the wrist of the hand with the other hand to support it for deep chest compression. This technique may be useful to push hard and fast.