Monsoon fever can be deceptive and dangerous

Health Care, Heart Care Foundation of India, Medicine Comments Off

Any medication should be taken only in consultation with a specialist

New Delhi, 30 July 2018: The number of those with fever and other associated conditions increases during monsoons in India, indicate statistics. However, in this season, any episode of fever should not be taken lightly as there may be many diseases responsible, the commonest being viral, malaria, dengue, or Chikungunya. Awareness need to be created on identifying the warning signals and getting expert help at the earliest to avoid comorbidities.

With the monsoon, varsharitu starts in India. In Ayurveda, it is the time for aggravation of Vata or the movement functions in the body. While this is a time to rejoice, it is also imperative to take certain precautions, especially in children, failing which they can become susceptible to a host of diseases and infections.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “While one should not ignore persistent fever during monsoons, it is also important to not indulge in self-diagnosis. Fever can be an indication of various conditions and monsoon fever, in particular, can be deceptive. Viral fever is associated with cough, redness of the eyes or nasal discharge. Dengue is accompanied by fever with rash and pain in eye movement. Chikungunya is a triad of fever, rash, and joint pain. Typically, the joint pain increases on compression of the joint. Malarial fever comes with chills and rigors and will have a normal phase in between two episodes of fever. Fever in jaundice disappears after the onset of the condition. Lastly, typhoid fever is often continuous with a relatively low pulse rate and with toxic feeling.”

Many of the diseases in this season occur due to water stagnation and resultant breeding of mosquitoes. Contamination of drinking water is also common. It is important to drink clean and pure water to prevent diarrhea and gastrointestinal infections.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “There is no need to consume antibiotics unless there is a feeling of toxemia. Antibiotics in cases of sore throat are only required if associated with pain in the throat while swallowing food or red angry–looking tonsils. Except for paracetamol or nimesulide, other anti-fever medicines should not be used indiscriminately as they can reduce a person’s platelet count. Most diseases in this season are self-limiting and can take 4 to 7 days to resolve. The basic precaution involves proper hydration, especially on the days when fever is subsiding.”

Some tips from HCFI

  • Eat light food as the GI system of the body cannot digest heavy food.
  • Do not eat leafy vegetables without washing or boiling as they may be contaminated with eggs of round worms. Beware of eating snacks at some outside stall.
  • Beware of electrical deaths in this season as the coolers without earthing can leak electricity.
  • Do not walk barefooted as most worms can come out and cause the infection. Do not keep wet clothes and leather without proper drying them as they may attract fungus.
  • With each shower of rain, the BP may fluctuate so medications must be revisited.
  • Do not play in stagnant water as rat urine mixed with rain water may produce lactosyrosis (fever with jaundice)
  • Do not let water accumulate in the house or surrounding areas. Drink only boiled or safe water as there are more chances of diarrhea, jaundice, and typhoid in this season.

Malpractice fears are the chief reason that doctors overtreat

Health Care Comments Off
  • NEET-PG 2018 is being conducted on 7th January 2018 (Forenoon Session)

Number of Cities 147

Number of Centers 364

Number of Candidates 1,33,435

Security Features: Finger prints and digital photograph capture, CCTV surveillance, frisking with handheld metal detector, provision of jammers at all centers and seating of candidates and room allocation of invigilators

  • India reported more over 1.5 lakh cases of dengue in 2017 and 250 deaths; 60,000 cases of Chikungunya were reported across the country. The data from the National Vector Borne Disease Control Programme (NVBDCP) under the Union Health Ministry showed that maximum dengue deaths were reported from Tamil Nadu (63 deaths out of the total 23,035 cases). Tamil Nadu was followed by Maharashtra, where 41 people died from dengue out of the total 7,442 cases reported. As many as 37 deaths were reported from Kerala while the disease claimed the lives of 28 people in Uttar Pradesh.
  • Haryana Health Minister Anil Vij has indicated the private hospitals to make self-regulatory rules after the state government cancelled the licence of the blood bank and pharmacy of the Fortis hospital at Gurugram. “With the action against Fortis Hospital, corporate-type hospitals should get a message that they make self-regulatory rules. Only minting money should not be the aim of hospitals,” Vij told ANI on Sunday.
  • Chikungunya virus (CHIKV) infection leaves about one quarter of those infected with persistent arthritis, according to data from the Chikungunya Arthritis Mechanisms in the Americas (CAMA) study. The joint symptoms, however, do not appear to be associated with persistent infection, suggesting it is safe to treat patients with regimens used for other types of inflammatory arthritis. Chronic joint pain after CHIKV is present in 30% to 70%. The most commonly affected joints are wrists, ankles, and fingers, and initial joint pain lasts a median of 4 days. With a median follow-up of 20 months, 25.4% of participants report that they had persistent joint pain. Factors associated with persistent pain included initial symptoms of headache or joint pain, 4 or more days of initial symptom, 4 or more weeks of initial pain, missed work, missed normal activities, and college graduate status. At follow-up, most patients had only one swollen joint, but also had tenderness in three more joints, with a mean global pain score of 47. The authors write in an article published online December 20 in Arthritis & Rheumatology.

“If persistent CHIKV infection is responsible for ongoing arthritis, immunocompromising disease modifying agents may be improper and potentially dangerous treatments. Alternatively, if CHIKV does not persist in the joint, then evaluation of immunomodulating arthritis agents could be useful,” they write. CHIKV causes arthritis through induction of potential host autoimmunity suggesting a role for immunomodulating medications in the treatment of CHIKV arthritis or that low-level viral persistence exists in synovial tissue only that is undetectable in synovial fluid.”

  • Malpractice fears are the chief reason that doctors overtreat. As per a research published in journal PLos One, physicians across a wide range of specialties and practice settings reported that, in their estimation, 20.6% of all medical care was unnecessary, including 22% of prescription medications, 24.9% of tests, and 11.1% of procedures. An overwhelming 84.7% of the 2106 survey respondents identified malpractice fears as the chief reason that doctors overtreat. Fear of litigation was followed in descending order by: Patient pressure/requests (59%); difficulty accessing prior medical records (38.2%); borderline indications of disease (37.7%); inadequate time to spend with patients (37.4%); lack of adequate information/patient history (36.7%) and pressure from the institution or management (20.8%). Significantly, only 9.2% of respondents identified “financial security of physicians” as the reason for overtreatment. 70.8% said that physicians are more prone to provide unnecessary procedures “when they profit from them.”

Only 2-3% of patients harmed by negligence pursue litigation, of whom about half receive compensation. But about 55% of physicians are being sued. But no matter what the outcome of the suit, the preparation, time spent, anxiety, and harm to ones reputation weigh heavily on physicians minds.

  • Nurses fill shoes of striking doctors at Beawar hospital (TNN). Jaipur: With the doctors on strike, nurses have stepped in their shoes at a hospital in Beawar district. The 300-bed Amrit Kaur District Hospital saw at least 1,500 outpatients every day, which has drastically come down 500 after the strike began on December 16. Principal medical officer Dr MK Jain said, “We have issued orders empowering nurses to see the patients. At least 30 doctors are on strike and only three of us are on duty currently.” He added that once the nurses prescribe the medicine, one of the three doctors verify it and sign the prescription card.
  • CDC urges shingles vaccination for patients 60+. If you’ve ever had chickenpox, there’s a good chance you’ll develop shingles — −a viral infection that causes a painful rash and blisters. The CDC estimates 1 in 3 people will get shingles in their lifetime, and risk increases significantly after age 50. The CDC currently recommends the vaccine Zostavax. It cuts the risk of developing shingles by half and is given in one dose as an injection. This recommendation is likely to change as a result of a recently approved vaccine that reduces the risk of shingles by as much as 90 percent. The new vaccine, called Shingrix, isn’t available to the public yet, but is expected to be this year.
  • Dr D Nageshwar Reddy was honored with the prestigious Dr MG Garg All Time Achievement Award by the Indian Medical Association (IMA). Dr Reddy who is currently the chairman of Asian Institute of Gastroenterology, Hyderabad and President of World Endoscopy Organization was shortlisted for this award in recognition of his distinguished contribution to medical services in India and globally. Speaking about the achievement Dr Reddy said, “It is heartwarming to be recognized for all that youve done. This is just the beginning, theres still a long way to go when it comes to medical advances”. Dr Reddys main area of research interest has been in G.I. Endoscopy particularly in Therapeutic Pancreatio Biliary Endoscopy and Innovations in Transgastric Endoscopic Surgery.
  • You cannot buy happiness. Current research is confirming what many of us have heard from our elders and spiritual leaders: satisfaction comes with being engaged, doing good and focusing on the present.
  • Continuously moving while sitting at a desk may boost metabolic rate more than sitting or standing at a desk. Using a desk fitted with a movable footrest raises metabolic rate more than sitting or standing at a desk as per a report published in the journal Work. Using a desk fitted with the moving device raised metabolic rate 7% more than standing and 17% more than just sitting. Movement while sitting had no impact on the cognitive function of participants.

Dr KK Aggarwal

Padma Shri Awardee Vice President CMAAO Group Editor-in-chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

IMA Policy on Antibiotics

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At the Antimicrobial Resistance Conference held in New Delhi yesterday to discuss the IMA Antibiotic Policy the following decisions were taken. Doctors should write the antibiotic in a box to differentiate it from other drugs in the prescription. The role of antibiotics should be discussed in an informed consent. When prescribing antibiotics clear instructions should be given to the patient about no refill of antibiotic prescription without signature of the doctor. No antibiotic cover or prophylactic antibiotic should be given without a high degree of clinical suspicion. No antibiotics should be prescribed in following conditions o Small bowel diarrhea o Fever with cough and cold o Dengue o Chikungunya o Malaria o Fever with rash Early initiation of antibiotics is the rule in suspected sepsis bacterial pneumonia meningitis and confirmed TB. Food Safety and Standards Authority of India FSSAI should make it mandatory for food companies to label all poultry and agriculture products as Antibiotic free . IMA will be writing to the Health Ministry to formulate clear guidelines about safer disposal of left over antibiotics.

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