Maintaining hand hygiene is a way of harm reduction

Health Care, Heart Care Foundation of India, Medicine No Comments

Infections such as soil-transmitted helminth and dysentery can be avoided in children with hand washing

New Delhi, 21st February 2019: Statistics from the WHO indicate that last year, about 1.5 billion people globally were at risk of contracting soil-transmitted helminth (STH) infections — or roundworms. About 270 million pre-school children and 600 million children of school-age live in areas where these parasites are intensively transmitted. India accounts for a quarter of the world’s STH-infected children; 64% of them are younger than 14 years.

Open defecation, contaminated soil and water, uncooked food, and not following basic hygiene are the main reasons for transmission (worm larvae and eggs). If undiagnosed, the worms persist in the body and lay thousands of eggs every day. These cause a decline in iron, protein and vitamin A levels, leading to anemia, a lower appetite, malnutrition, and diarrhea.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Adult worms live in the lumen of small intestine. The female worm produces fertilized eggs much faster in the stool. These eggs prefer warm, shady, moist conditions where they can survive for five years. They hatch in the small intestine within days of consumption of contaminated food or water and release larvae every minute in the next 10 days. Most worms are asymptomatic. During migration in the lung, a patient may have asthma-like attack. A high burden of worms in the intestine can cause nutritional deficiency and heavy infection can also cause nutritional obstruction. Eggs do not appear in the stool for at least 40 days after infection.”

The Ministry of Health and Family Welfare launched the National Deworming Programme in 2015. This is one of the largest fixed-day, mass drug administration public health programmes in the world, and aims to reach out to over 230 million children by 2020. Deworming tablets (Albendazole) are administered under this initiative which has garnered many accolades globally, especially from public health advocates of neglected tropical diseases.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Maintaining good hygiene and sanitation through hand washing and other techniques is a way of harm reduction in children and adults alike. Proper hand washing can prevent several fatal diseases as well. Some other points to be considered to prevent STH include provision of clean drinking water, safe fecal sludge management, and safe disposal of waste and recycling.”

Some tips from HCFI

Respiratory hygiene This is important to prevent cross infection, specifically, from flu and related respiratory illness. One should keep a minimum distance of 3 feet, from a person who is coughing, sneezing or singing.

Hand hygiene This is the fundamental principle for any disease prevention and the catch phrase is “before and after”, that is, one should wash hands before and after eating food, touching any infected material, seeing a patient or after normal evacuation of stool in the morning.

Food hygiene This means maintaining hygiene at home while cutting, serving and eating food. While cutting a vegetable, the surface or the cutting board should be clean and hygienic including the knife, hands, water, utensils etc. If that hygiene is not possible, follow the formula of ‘boil it, heat it, peel it, cook it or forget it’.

Water hygiene This involves drinking safe water, safe drinking glass, proper washing of glass, not washing multiple glasses in the same utensil and picking up glasses properly.

Sexual hygiene This involves washing local areas before and after sexual contact.

Nail hygiene This is very important especially for food handlers, because they are responsible for water and food disease. It is important that they be given typhoid vaccines and de-worming tablets every three months.

Substance abuse releases up to 10 times more dopamine

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The number of addiction cases have increased drastically in India

New Delhi, 20th February 2019: As per a recent survey conducted by the National Drug Dependence Treatment Centre (NDDTC) of the All India Institute of Medical Sciences (AIIMS), states including Uttar Pradesh, Andhra Pradesh, Punjab, Chhattisgarh, and Arunachal Pradesh have emerged as front runners in alcohol abuse and health complications due to the same. About 5.7 crore people in India suffer from alcohol-related problems and need treatment. Of the 16 crore who consume alcohol, the prevalence is 17 times higher among men.

Over 4 lakh children and 1.8 million adults need help for inhalant abuse and dependence, said the survey. The current use of Heroin is 1.14%, followed by pharmaceutical opioids (current use 0.96%), and opium (current use 0.52%). This was more prevalent in Uttar Pradesh, Punjab and Haryana.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Unlike activities like food, drinking, reading, music, which produce the optimum levels of dopamine, addictive substances or behaviors can release up to 10 times more dopamine. This leads to the “high” that is associated with use of drugs. Recurring activation of the “reward system” due to repeated use of addictive drugs leads to addiction. Drugs that modify dopamine affect motivation, motor functioning, sense of pleasure and important events experienced by a person. On the other hand, drugs that affect serotonin affect the ways how a person learns, remembers, sleeps and feels emotions.”

Addiction may worsen an underlying mental disorder or trigger a mental disorder such as attention-deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anxiety, depression etc. Such persons are more at risk of addictions.

Adding further, Dr Rajiv Garg, Sr Consultant Physician, said, “Reducing or stopping the consumption of alcohol is harm reduction. It can be the gateway to preventing other health complications later in life. Similarly, those who indulge in substance abuse should be counselled and provided with adequate help to be able to quit the habit.”

Some recommendations

  • Put it in writing why you want to reduce or stop: Write what you want to achieve for example will feel healthier; will sleep better, will improve my relationships.
  • Write confessions: learn and practice various confession exercises. This will help you take care of inner guilt which may be the precipitating factors.
  • Set a drinking limit: Those who are cutting back should set a limit as per your health. Most healthy people should limit to less than 40 ml in one hour, 80 ml in one day and less than 240 ml in a week. Women should take less than half of this amount.
  • Keep a diary of your drinking. For initial 3-4 weeks, keep track of every drink. Note the situations you are most likely to drink. Give each situation rating out of ten. Try avoiding those situations for the next few weeks.
  • Don’t keep alcohol within your reach. Remove alcohol from your living place. This can help limit drinking.
  • Eat your drink. Drinking slowly can help. Sip and do not gulp. Sip soda, water, or juice after each drink. This is called Mindfulness drinking. Be aware of your drinking will cut it down. Never drink on an empty stomach.
  • Keep a weekly spiritual fast. This will allow alcohol-free days. Decide not to drink a day or two each week.
  • Observe spiritual retreats: Observing spiritual retreats (Navratri by Hindus, Ramazan by Muslims, and Easter by Christians) with no drinking can help. Or try abstaining for a week or a month to see your commitment to not drinking.
  • Last but not the least, be persistent in your efforts to quit.

HCFI wishes all students best of luck for the upcoming examinations

Health Care, Heart Care Foundation of India, Medicine No Comments

It is imperative to avoid undue stress by not setting unrealistic expectations and following a healthy routine

New Delhi, 19th Feb 2019: As per statistics, during examinations, the prescriptions for anti-depressant drugs (or the so-called happy drugs) witness an increase. This is especially among teenagers in the age group of 16 to 19 years, in full-time education. The figure crosses 20% in schools in the West. The fear of failure and that of letting down parents are two of the most common factors leading to suicide and depression in this age group.

With boards and other exams around the corner, both students and parents are under immense stress. The expectation to excel in various subjects is a deterrent in preparation and puts undue pressure on students. Over time, increased exam-related anxiety can harm the body and lead to health issues. Unrealistic expectations can cause restlessness, irritability, sadness, anxiety, and even forgetfulness.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “At the outset, let me wish all those taking the board examinations all the best. Although exams play a part in determining your future career choices, they are not the only gateway to do so. Success in life does not depend on your performance in an exam but on how you cope with the challenges and come out of them. It is natural to feel nervous, but you should be able to talk about it with someone you feel comfortable. Speak to your parents, friends or teachers and get their advice. If you feel overwhelmed by studying for a long duration, it is a good idea to take a small break. This will help you feel refreshed and approach subjects better.”

Avoid any last-minute revisions. Also, once an examination is over, remember to not discuss the question paper at length. Worrying about what has already been done may hamper preparation for the next subject.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “The brain is not a machine and needs to unwind and refuel to function better. To do so, you must get adequate sleep and rest during the exams. Sleep deprivation can bring in several health repercussions, especially when coupled with stress. The brain needs time to assimilate the information you have gathered during the day, and it is important to give it that much time.”

Some other tips from HCFI.

  • Avoid junk food as it can slow you down, apart from making it difficult for you to concentrate.
  • Eat plenty of green vegetables, fresh fruits, and whole grains.
  • Snack on dry fruits and nuts.
  • Keep yourself hydrated by drinking plenty of water.
  • Avoid caffeine as it can leave you feeling dehydrated.
  • You could try drinking coconut water, lassi or green tea instead.
  • Meditate and try some relaxing Yoga to avoid stress.
  • Doing some deep breathing exercises can induce relaxation.
  • De-clutter your study space. An organized table can motivate you to study better.
  • Make connections between concepts and use mnemonics to remember things

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