Hypothermia is a major cause of mortality during winter in India

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Avoid hypothermia in this winter by taking certain necessary precautions

New Delhi, 20th January 2019: According to a recent report, about 44 people died in Delhi between 1 January and 6 January, includng a two-year-old child due to the cold weather conditions. Several of these deaths may probably be due to a condition called hypothermia.

Hypothermia is generally defined as having a core body temperature of 95 degrees Fahrenheit or lower and can occur when the outside environment gets too cold or the body’s heat production decreases.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “People can die of hypothermia in the winter season. Imagine a situation when you come across people lying in an area with no clothes early in the morning. One of them is shivering and the other one is not. The one who is shivering indicates that his body is trying to compensate with the low body core temperature. The other one, who is not shivering, may be dead, dying or normal. Recall your naturopathy teaching Sar Thanda, Pet Naram and Paon Garam. If the sole of the feet and the feet are cold and the person is not shivering, this is a medical emergency. On the contrary, if the person is not shivering and the feet are warm, it is not medical emergency. Therefore, hypothermia with no shivering and hyperthermia with no sweating are bad signs.”

An individual may suffer from hypothermia if he or she has been exposed to cool temperatures and shows one or more of the following signs: slowed or slurred speech; sleepiness or confusion; shivering or stiffness in the arms and legs; poor control over body movements; slow reactions, or a weak pulse.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “In hypothermic deaths, a person can be revived even after hours of cardiac arrest. Only once the body temperature is brought back to normal CPR will be effective. That would mean that consciousness gets frozen and does not leave the body when the temperature is below 35°C. This forms the basis for induced hypothermia after death to revive the brain.”

Some tips from HCFI

Here are a few tips to help older people avoid hypothermia.

  • Make sure your home is warm enough. Set the thermostat to at least 68 to 70 degrees.
  • Even mildly cool homes with temperatures from 60 to 65 degrees can lead to hypothermia in older people.

To stay warm at home, wear long underwear under your clothes, along with socks and slippers. Wear several layers of warm loose clothing to help trap warm air between the layers. In India, wear a monkey cap.

  • Use a blanket to keep your legs and shoulders warm and wear a hat or cap indoors.
  • When going outside in the cold, it is important to wear a hat, scarf, and gloves or mittens to prevent loss of body heat through your head and hands. A hat is particularly important because a large portion of body heat can be lost through the head.
  • Check if any prescription or over-the-counter medications you consume can increase your risk for hypothermia.
  • Remember hypothermia with no shivering is a bad sign

Medical Tourism in India continues to show steady growth

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Affordability, availability, and advanced technologies are some reasons for this growth

New Delhi, 25 July 2018: As per recent statistics, India currently contributes to about 18% of the global medical tourism market. Its medical value travel (MVT) was pegged at $3 billion in 2015 and is estimated to grow at a CAGR of 15%, according to a report by FICCI and IMS Health, a health industry information firm. It has been estimated that by 2020, India’s medical tourism industry could be worth $9 billion, and account for 20% of the global market share.

Medical tourism is the process of traveling outside the country of residence for receiving medical care. This originally referred to the travel of patients from less-developed countries to developed nations in pursuit of the treatments not available in their homeland. Another major reason for the rise in medical tourism in India is the availability of alternative treatment options such as Ayurveda and Naturopathy.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “India is the preferred destination for cardiology, orthopedics, transplants, and ophthalmology. The country also enjoys high credibility in wellness, preventive, and alternative medicine.Affordability, high quality healthcare, availability of specialist treatment and advanced technologies are just a few reasons that have made India a much sought-after destination. Furthermore, the diversity of its flora and fauna, its natural beauty including a rich and vibrant cultural heritage has already put India on the tourist map. Many facilities in India have become a destination for learning and healing together. One can opt for a complete body detox using Yoga techniques and learn them too.”

Bangladesh and Afghanistan continue to be the top countries from where the maximum number foreign tourist arrivals (for medical purpose) is seen. In 2017, about 2.21 lakh tourists from Bangladesh are estimated to have come to India for medical reasons.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said,“Understanding the need for holisticwellness, the Government of India has constituted a Medical and Wellness Tourism Board as adedicated institution to guide the promotion and positioning of India as a competent andcredible medical and wellness tourism destination.The Board hasrepresentatives from government departments, tourism and hospitality sectors,the Indian Medical Association and experts in various disciplines including Wellness and Yoga,apart from other stakeholders. Another significant development to be mentioned here is theformation of an integrated Ministry of Ayush, with a special Department of Yoga.”

IMA is a member of National Medical and Wellness Tourism Board. The following recommendations are likely to be implemented.

  • Government to facilitate e-Medical Visa.
  • Normally e-Visa given for 60 days but e-Medical Visa will be for 6 months.
  • e-Visa will have a permission for double entry, but e-Medical Visa will permit Triple entry.
  • e-Visa will be extendable to e-Medical Visa.
  • e-Medical Visa will be available at five major Indian Ports i.e. Mumbai, Cochin, Goa, Chennai and Mangalore.
  • e-Medical Visa will be available for 161 countries.
  • Presently, medical attendants are given Visa, but the Committee has recommended that medical attendants should also be given e-Medical Visa.
  • The Committee also recommended that all hospitals should have a common Greet and Meet Counter and it should be at major Airports / Ports.
  • Free SIM card at entry will be given to e-Medical Visa patient.
  • Committee have recommended a Translation App at Airports/ Ports.
  • All Medical Tourism Hospitals will have to be NABH or JCI Accredited. We are pushing for IMA accreditation also.
  • The Committee also recommended that fee for e-Visa and e-Medical Visa should be the same.

WHO confirms three Zika cases in India

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The first three cases of Zika virus infection were confirmed on Friday from Ahmedabad, Gujarat by the World Health Organization (WHO).

In its report dated May 26, 2017, the WHO said, “On 15 May 2017, the Ministry of Health and Family Welfare-Government of India (MoHFW) reported three laboratory-confirmed cases of Zika virus disease in Bapunagar area, Ahmedabad District, Gujarat, State, India. The routine laboratory surveillance detected a laboratory-confirmed case of Zika virus disease through RT-PCR test at B.J. Medical College, Ahmedabad, Gujarat. The etiology of this case has been further confirmed through a positive RT-PCR test and sequencing at the national reference laboratory, National Institute of Virology (NIV), Pune on 4 January 2017 (case 2, below). Two additional cases (case 1 and case 3), have then been identified through the Acute Febrile Illness (AFI) and the Antenatal clinic (ANC) surveillance.”

(Source: WHO, May 26, 2017)

Zika virus disease was declared as a Public Health Emergency of International Concern (PHEIC) by the WHO in February last year. And, in November 2016, the WHO declared an end to its global health emergency over the spread of the Zika virus.

Guidelines on the Zika virus disease were issued by the Ministry of Health and Family Welfare last year. NCDC, Delhi and National Institute of Virology (NIV), Pune were designated as the apex laboratories to support the outbreak investigation and for confirmation of laboratory diagnosis.

According to the WHO report, an Inter-Ministerial Task Force has been set up under the Chairmanship of Secretary (Health and Family Welfare) together with Secretary (Bio-Technology), and Secretary (Department of Health Research). The Joint Monitoring Group, a technical group tasked to monitor emerging and re-emerging diseases is regularly reviewing the global situation on Zika virus disease.

In addition to National Institute of Virology, Pune, and NCDC in Delhi, 25 laboratories have also been strengthened by Indian Council of Medical Research for laboratory diagnosis. In addition, 3 entomological laboratories are conducting Zika virus testing on mosquito samples.

The Indian Council of Medical Research (ICMR) has tested 34 233 human samples and 12 647 mosquito samples for the presence of Zika virus. Among those, close to 500 mosquitoes samples were collected from Bapunagar area, Ahmedabad District, in Gujarat, and were found negative for Zika.

However, this report has highlighted India’s vulnerability to vector-borne diseases due to its huge population, climate and people traveling into the country in large numbers. These cases provide evidence on the circulation of the virus in India suggesting low level transmission of Zika virus and chances of more cases occurring.

Dengue and Chikungunya are already endemic in the country. All these three diseases – Dengue, Chikungunya and Zika – are viral infections and share a common vector, the Aedes mosquitoes.

Dengue or Chikungunya-like symptoms with red eyes, fever with a rash or joint pain should not be ignored. Such cases could be Zika. Eliciting a travel history in such patients is very important.

There is no specific treatment. Patients should be advised to take paracetamol to relieve fever and pain, plenty of rest and plenty of liquids. Aspirin, products containing aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen should be avoided.

In view of the detection of Zika in India, the need of the hour is enhanced surveillance: community-based and at international airports and ports to track cases of acute febrile illness. While awareness needs to be created about the disease, the public needs to be reassured that there is no cause for undue concern.

There is no vaccine for Zika virus infection. Protection against mosquito bites is very important to prevent Zika infection. People traveling to high risk areas, especially pregnant women, should take protections from mosquito bites.

• Stay inside when the Aedes are most active. They bite during the daytime, in the very early morning, and in the few hours before sunset.
• Buildings with screens and air conditioning are safest.
• Wear shoes, long-sleeved shirts, and long pants when you go outside.
• Ensure that rooms are fitted with screens to prevent mosquitoes from entering.
• Wear bug spray or cream that contains DEET or a chemical called picaridin.

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