Aao School Chalen: A national project undertaken by IMA

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School health is very important as schools are not just centers that impart formal education, they also influence overall development of a child. To enjoy good health during adulthood, healthy lifestyle including hygiene habits must be inculcated during childhood. These habits learned during childhood last through to adulthood and all their lives. Moreover, children are naturally inquisitive and keen learners. So, they are both beneficiaries of any health-related activity and agents of change in their family.

To this end, the Indian Medical Association (IMA) has adopted “Aao School Chalen Project” initiated by Delhi Medical Association in the recent past as a National Project. The 5th of every month has been designated for any activity related to this project.

Visit your old school if you can or any nearby school during the school assembly and interact with students and teachers to sensitize them on issues of public health importance. Speak to the principal of the school beforehand about this. It need not be long-drawn talk, but should be a short talk of 10-15 min duration. Get a certificate (proforma) signed by the Principal. Send the proforma to IMA HQs along with the photographs taken with students during assembly for records.

We have identified few topics for the coming months and there will be common points for discussion for uniformity.

The first topic for 5th August is “vector-borne diseases”. The 10 uniform messages for first lecture are as follows:

1. Mosquito-borne diseases are preventable and manageable if detected early.
2. Do not allow water to stagnate in or around the houses, particularly in plastic containers.
3. Wear full sleeves clothes during monsoon season.
4. All patients suffering from dengue, malaria, chikungunya, Japanese encephalitis should use bed nets while sleeping.
5. Treatment of malaria should be started early; it can be for 3 days or 14 days depending on the type of malaria.
6. All patients with dengue do not require platelet transfusion.
7. IMA Slogans: “Katwaieyga to nahi” (I hope you will not get me bitten by a mosquito) or “My premises are mosquito-free, you are invited at my premises”.
8. Look for mosquitoes: inside or outside the house; both small and big containers, during day or night; in the room or on the roof; floor or up on the walls; larvae or the mosquito.
9. Let all schools be declared by the principal as being mosquito-free.
10. Let every child speak a slogan: “From now onwards my house will be mosquito free”.

The schedule of the talks is as under:

• 5th September: Lifestyle
• 5th October: Menstruation myths
• 5th November: Health and Hygiene
• 5th December: Substance Abuse

States and Local Branches of IMA are requested to circulate this information to all the members.

Since, this is a national health project, IMA requests all its members to participate to make it a success.

Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

Rotavirus, one of the leading causes of diarrheal infections in India

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• Accounts for about 40% of all diarrhea cases
• Rotavac introduced to combat the spread of this infection among infants and young children
New Delhi, 21 June 2017: Statistics indicate that one of the leading causes of moderate-to-severe diarrhea in India is Rotavirus and accounts for about 40% of all diarrhea cases requiring treatment. More children across India die due to diarrhea than AIDS, malaria, and measles combined. It has also been estimated that India alone contributes to 22% of all global diarrheal deaths in children below 5 years. Among those more vulnerable include malnourished children and those with poor access to medical care.

Between 80,000 to 1,00,000 children die in India annually due to Rotavirus diarrhea and another 9 lakh are admitted to the hospital with severe diarrhea. A highly contagious disease, Rotavirus is spread when a child comes in contact with infected water, food, or hands. This is known as the fecal-oral route. This virus can survive for long periods of time on hands and various surfaces. This condition also increases the risk of dehydration in very young children.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Rotavirus attacks the villus tip cells of the small intestine, obstructing digestion and absorption. Once the villi become blunted, the malabsorption of carbohydrates leads to diarrhea. In young infants and children, this infection can further cause severe diarrhea, dehydration, electrolyte imbalance, and metabolic acidosis. The virus is shed in high concentration in the stool of the infected children. They can easily catch an infection by touching something that is contaminated and then putting their hands in the mouth. The risk of infection is more in hospitals and day care settings.”

Last year, the health ministry launched India’s first, indigenous rotavirus vaccine called Rotavac. Developed indigenously under a public-private partnership between the Ministry of Science Technology and the Health Ministry, this vaccine is expected to significantly reduce hospitalization and other conditions associated with diarrhea due to Rotavirus infection.

Adding further, Dr Aggarwal, said, “Making this vaccine free of cost is indeed a great move by the government. It is immensely important for the health and well-being of children in the country. Apart from vaccination, it is important to create awareness on maintaining adequate hygiene and sanitation and also ensure access to clean drinking water to avoid any such infections from spreading.”

Here are some tips to prevent Rotavirus infection from spreading.
• Maintain proper hygiene around the house. Clean all surfaces and the floor thoroughly.
• Wash your hands after you change the infant’s diaper or use the washroom.
• Practice food safety at home.
• Drink clean water and keep all containers closed.

25 points that all doctors should know about malaria

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  1. Malaria is endemic throughout India except in areas located 5000 ft above sea level.
  2. It is largely prevalent in 16 states of India including the 7 North-Eastern states. These are Odisha, Jharkhand, Chhattisgarh, Madhya Pradesh, Assam, Tripura, Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, Andhra Pradesh, Gujarat, Maharashtra, West Bengal and Karnataka.
  3. Intensity of transmission varies from area to area. The areas, which have conducive geo-ecological and climatic conditions, inaccessible terrains, poor infrastructure, lack of health seeking behavior, poor availability of health services and high vector load have high disease burden and high mortality rates.
  4. Districts with predominant tribal population are the most affected due to poor availability of health services and lack of health seeking behavior.
  5. Main plasmodium species causing malaria in India are P. vivax and P. falciparum; each is responsible for 50% of the cases in the country.
  6. The incidence of malaria has been brought down from 2 million cases annually during the last decade to around 1 million cases annually during the beginning of current decade and it has been contained at that level for the last 3 years. Similarly, annual deaths due to malaria have also declined during this period.
  7. 152 districts have been identified as high endemic.
  8. During the year 2014, there was an increase in total cases and deaths due to malaria as compared to the year 2013. A total of 11 States/ UTs reported case rise in 2014 as compared to the previous year. The major states, which reported increase in malaria cases include Odisha, Madhya Pradesh, Chhattisgarh, Maharashtra, Andhra Pradesh, Tripura, Meghalaya and Mizoram.
  9. Some of the main reasons identified for this upsurge are increased surveillance since the introduction of Bivalent Rapid Diagnostic Test (RDT) in 2013 and focal outbreaks such as in the states of Tripura, Madhya Pradesh, Maharashtra, and Meghalaya.
  10. National Vector Borne Disease Control Programme is taking intensive malaria control measures with the ultimate goal of bringing down malaria incidence to the level that it is no more a public health problem.
  11. To achieve effective control of malaria, the program aims at early case detection through active, passive and sentinel surveillance along with prompt and complete treatment of all the detected cases.
  12. As per National Drug Policy for Treatment of Malaria- 2013, all fever cases suspected of malaria are to be investigated by microscopy or Rapid Diagnostic Test (RDT) for malaria.
  13. Although microscopy is the Gold standard test for malaria, bivalent RDTs are being recommended and used to detect malaria in remote, inaccessible areas, during malaria epidemic, for travelers and military forces.
  14. NVBDCP recommends only antigen-based bivalent RDTs (Pf and Pv) for diagnosis of malaria.
  15. As per the National Drug Policy (2013), P. vivax cases are to be treated with chloroquine for 3 days and primaquine for 14 days.
  16. As per the National Drug Policy (2013), P. falciparum cases are to be treated with Artemisinin Combination Therapy (ACT) i.e. Artesunate 3 days + Sulphadoxine-Pyrimethamine 1 day and single dose Primaquine on day 2.
  17. However, in North Eastern states, all Pf cases are to be treated with ACT-AL (Artemether-Lumefantrine combination) + Primaquine on day 2.
  18. All severe cases should be treated with injection Artesunate followed by complete oral ACT course i.e. of 3 days.
  19. The referral services are being strengthened for the management of severe cases. The referral mechanism under NHM is being used for referring cases.
  20. Special measures are being taken for epidemic preparedness and rapid response, through co-ordination with IDSP.
  21. To reduce the risk of transmission, Integrated Vector Management is being done through Indoor Residual Spraying (IRS) in selected high risk areas with API >2 (~80 million pop/annually), use of Long Lasting Insecticidal Nets (LLINs) and use of larvivorous fish and source reduction.
  22. Other important supporting interventions of the program include Behaviour Change Communication/ Information, Education & Communication (BCC/IEC), capacity building and inter-sectoral collaboration and NGO or Public Private Partnerships.
  23. In urban areas, more than 60% of the population seeks health services from private sector and other public undertaking and organized sectors. Their involvement in the programme is of paramount importance.
  24. To ensure timely action, actual disease burden, reporting from all the sectors needs to be captured and monitored.
  25. Any confirmed malaria case not responding to treatment within 72hours may be suspected for resistance. Such cases should be given alternative antimalarial and should be reported to the program for detailed investigation.

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