Patients charter for tuberculosis.

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The patient’s charter outlines the right and responsibilities of people with tuberculosis. It empowers people with the disease and their communities through this knowledge. It is endorsed by the WHO.  Stop TB partnership, national governments and civil society organizations.

Patients have the right to

CARE

  • Free and equitable care for tuberculosis.
  • Quality care meeting and international standards.
  • Benefit form community care programs like DOTS

DIGNITY

  • Be treated with respect and dignity.
  • Social support of family, community and national programs.

INFORMATION

  • Information about available care services,
  • Be informed about condition and treatment
  • Know drug names, dosage and side effects.
  • Access to medical records in local language.
  • Have peer support and voluntary counselling.

CHOICE

  • A second medical opinion with access to records.
  • Refuse surgery if drug treatment is at all possible.
  • Refuse to participate in research studies.

CONFIEDNCE

  • Have privacy, culture, religious beliefs respected.
  • Keep your health condition confidential
  • Care in facilities that practise effective infection control.

JUSTICE

  • File a complaint about care and to have a response,
  • Appeal unjust decisions to a higher authority
  • Cote for accountable local, national patient representatives

ORGANIZATIONS

  • Join or organize peer support groups, clubs and NGO’s.
  • Participate in policy making in TB programs.

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SECURITY

  • Job security from diagnosis through to cure.
  • Food coupons or supplements if required.
  • Access to quality assured drugs and diagnostics.

PATIENTS RESPONISILITIES

Patients have the following responsibility.

SHARE INFORMATION

  • Inform healthcare staff all about. Your condition.
  • Tell staff about contacts with family, friends etc.
  • Inform family and friends and share your TB knowledge.

FOLLOW TREATMENT

  • Follow the prescribed plan of treatment.
  • Tell staff of any- difficulties with treatment.

CONTRIBUTE TO COMMUNITY HEALTH

  • Encourage others TB-Test if they show symptoms.
  • Be considerate of care-providers and other patients.
  • Assist family and neighbours to complete treatment.

SHOW SOLIDARITY

  • Show solidarity with all other patients.
  • Empower yourself and your community.
  • Join the fight against TB in your community.

This is part of the Axsheya and DOTS program of TB prevention, feel free to print, share and use this information.

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Know the RO water purifier price for your home.

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Water purification

Once up on a time there were no industries,  no deforestation and less pollutions, so water was clean like the air. The dead and decaying plants and animal carcass created antibody giving the rivers their mysterious healing power.

Now things are different, water is polluted, and we need to purify water. So how does water get cleaned? What are processes that allows purification. But before that let us look at the relevance of water.

Earth is made up of 82% of water was what we learnt at school, the USGS water science school says that it is 71% lets stay with that. This water manifests as different water bodies, oceans, seas, lakes, rivers and even within us.

In our everyday life we need water to sustain us, we either drink it or used it cook, we also use water to bathe and clean. Water is an essential part of our existence.

The 2014 WHO report claims that 842,000 deaths/year are courtesy waterborne disease. These deaths could have been prevented if adequate care had been taken. Clean, safe portable water is necessity. Indiscriminate urbanization like remote location is hugely challenged when it comes to sanitation. This also raises challenge to safe and hygienic drinking water. Water contains, ions, algae, nutrients, parasites sometimes minerals and lot more.livepure2

various methods are used for purification, these methods are established depending on the purpose of water consumption.

  • Boiling water of course is the most traditional way of doing things
  • Filtration. This is a physical process and eliminates water and gross particle suspensions.
  • Distillation or boiling water condensing it and collecting it is another popular method.
  • Sedimentation, uses basin or clarifier, it separates amorphous metal hydroxide from water, this is commonly called demineralization.  Studies however say that removing minerals from water could cause digestive and urinary problems.
  • Slow and rapid sand filtration, are biologic process where sand is used . water seeps through the layers of sands, slowly until it is safe for consumption.  In the rapid sand filter activated carbon is used which removes taste and odor from water.
  • Flocculation and coagulation is the term that is used  when chemical components are added to water to remove unwanted particles both organic and inorganic.
  • Chlorination is another popular methods, but this harmful both to germs and humans.
  • Iodinization is done using 2% tincture of Iodine, this kills, bacteria and viruses when added to water but is only moderately effective when it comes to Protozoa.
  • Calcium hypochlorate or Pool Shock is used. It is safe and effective as long as it is not mixed with other chemicals or algaecides. It is quite economic to. But it is essentially an alternate chlorine product.
  • Finally we have the ultra violet rays. For this method to be effect the water needs to be clear.

Despite the efforts of the municipalities to ensure that water supplied to houses are safe, the water is not safe to portable and consumed.  Being aware of this most of us boil or filter the water. Boiling does eliminate lot of germs but it has its limitations. Water needs to boiled for at least 20mnts to kill the microorganism. It could get recontaminated when it cools down.  It consumes time and alteration of taste occurs with the escaping oxygen.

UV Light is a safe way to purify water, it can destroy the micro-organisms. This process is the ultraviolet germicidal irradiation and it uses 250-270 nanometer wavelength of ultraviolet light rays. Unlike the chlorinated water, it does effect the taste or smell of water.

UV light process is a physical one and not a chemical one. it renders the microbe ineffective by destroying the genetic material inside the cell. Though it is possible render water totally sterile, it is not practical when it comes to household applications, which is the claim is the water is 99.99% microbe free.

With UVLight the advantage is major disease causing bacteria like E.coli, typhoid, dysentery etc. get nullified without changing the taste or smell of water.

There are a few limitations however like

  • UV purification is effective when the light is strong and exposure to the water is adequate.
  • The water should be  clear of suspended and dissolved particles so that its intensity is not reduces.
  • Unfiltered water could shield microbes from UV-rays.

The RO and UV purification system offered by Livpure makes it the best option as  passes the water through 6 filters, including the RO filter filtering the water so that it is almost crystal clear, this is now allows the intensity to be optimal, water is clear there is nothing to shield the microbe from the UV rays, so the  water becomes microbe free. Finally essential minerals are incorporated into the water to ensure that the water is healthy.

livepureLivpure has products of various efficacy and economy… you could choose the right one for you here.. RO water filter prices..if you are confused how to choose you could invite the Livpure expert to check the quality of the water in your zone and choose the right one.

 

 

Tuberculosis Awareness

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Tuberculosis is is a highly infectious disease caused by a bacterium called mycobacterium tuberculosis TB is a disease with devastating social and economic costs. Morbidity and mortality due to TB is higher than due to any other infectious disease.

This gets spread through the air when a person suffering from TB sneezes or coughs, the TB germs get into the air in the form of tiny droplets these tiny droplets when inhaled by a healthy person can cause disease. A single TB patient can infect about 10 -15 people in a year.

The reality of TB in India is

  • 40% of Indian population is infected with TB
  • Every year 18 lakh people in India develop TB of which nearly 8 lakhs are infectious.
  • 4 lakh people die in India due to tuberculosis every year.
  • TB causes enormous social and economic disruption as it affects the most productive age group that is 15-55yrs.
  • The burden of TB is enhanced by the stigma attached to it.
  • TB
  • Kills more women in India than any other disease

Symptoms of TB

  • Cough for 2 weeks or more
  • Evening rise of body temperature
  • Weight loss
  • Loss of appetite
  • Chest pain
  • Blood streaked sputum.
  • Quite a few times TB effects organs other than the lungs. TB is diagnosed through sputum examination, and if necessary chest X-ray. If the TB is else where then the procedures are different.

DOTS is a strategy adopted in revised national tuberculosis control program under DOTS the patients swallows the drugs in the presence of a health worker or DOT provider. This ensures regular and complete drug administration. Further, in this strategy the total number of doses and total duration of treatment is reduced with more effective standardized drug regimens. This has proved effective in all countries adopting dots.

DOTS is administered in two phases.

Intensive phase – this is of two or three months duration. During this phase a health worker or a trained person watches as the patient swallows the drugs in his presence three times a week.

Continuation phase – this is of four to five months, during the continuation phase, the patient is issued medicine for a week in multiblisher combipack of which the first doses swallowed by the patient in the presence of the health worker or trained person. it has been proven by clinical trials that thriece a week alternate day treatment is as effective as daily treatment.

Citizens  responsibility in TB management

  • You can volunteer as a DOT provider for TB patients in the neighbourhood.
  • Advice anyone coughing more than two week to get sputum tested.
  • Motivate TB patients to complete the treatment.

This article is part of the TB awareness drive, please feel free to download or share.

Patient Education.

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The petition below came to me from  www.change.org of course most of the petitions are idiotic, to me this was blasphemy. Here is a young unmarried girl whose periods were late.

She was upset because her doctor warned her about pregnancy and sexually transmitted diseases, well that is what every physician would do considering that Chlamydia is the largest killer in India. with i-pills being advertised girls have become lax about protected sex.

The issue might seem gender biased but the implications of Chlamydia is definitely more for a woman likewise the trauma of an abortion is experienced by the uterus and the not male reproductory system.

Of course the only thing the girl could complain is if her problem is not addressed. And it is normal to check the sexual history of a person when they turn up with delayed periods, it is also normal to ask for menstrual history.

Also a doctor only gives medical advice looking after or care taking is the onus of the patient, unless the patient is a inpatient.

If this girl had been married then the history taking would gone in another direction.

My doctor gave me moral advice instead of looking after my health!

I am a young unmarried woman and I visited a gynaecologist because my period was late.

She immediately started questioning me. She asked me whether I was married, whether I was having sex with my boyfriend and whether my parents knew.

She told me that if I had sex, I would get pregnant or catch a sexually transmitted disease. She did not give me the medical advice that I needed.

I felt uncomfortable and unsafe around her.

Unfortunately, there are many doctors like her, who treat single women with suspicion or refuse to treat them at all.

sharmila, no one should be denied health services. That is why I have joined hands with other single women to fight for our health rights and dignity.  

We have drafted 10 commandments that gynaecologists should follow in order to treat single women with respect and in a professional manner. 

Sign this petition and ask gynaecologists to follow these guidelines.

It is the duty of doctors to take care of their patients, irrespective of personal bias. Many doctors follow this duty, but the ones who do not, put their patients’ lives at risk.

sharmila, doctors should treat medical issues, not give moral lectures. With your support we can break the stigma about single women and sexual health.

Thank you for your support,

Pooja on behalf of Haiyya

(Name Changed)

 

World Vitiligo Day

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Smooth  white  patches on various parts of the body caused by lack of natural pigment is known as vitiligo, and June 25th of 2011  the world vitiligo day was created to create awareness of this condition. Since then they have broadened their activities to handling bullying, social neglect, tremendous psychological trauma and disability.

Vitiligo is defined as a skin disorder characterized by smooth, white patches on various parts of the body, caused by the loss of the natural pigments.

There could be other symptoms, like

  • Premature greying of the scalp, eyelashes, eyebrows,.
  • Whitening or loss of colour of the mucous membrane inside the mouth.
  • Loss of colour or colour change in the retina (eye)

Vitiligo can affect any part of the body, but de-pigmentation usually develops first on the areas of the skin like feet, arms, face and lips. The de-pigmentation could be

  • Focal or limited to one or few areas of your body.
  • Segmental Loss of skin colour usually on only one side of the body
  • Generalized that is wide spread.

There is no definite age when it manifests, though in most cases 20-30 is the age when the patches begin either on the face above the eyes, or on the necks. Sometimes, armits, elbows, genitalia, hands or knees may be the first effected area. There is no gender or racial predilection seen.

When a person suffers from vitiligo there is no melanin in the skin, melanin is produced by the melancocytes and is responsible for the skin colour. The normal pigmented skin cells get replaced by flat cells, creating white patches with irregular borders.

Most vitiligo suffers are otherwise healthy and have normal skin texture and sensation. However people with autoimmune disorders like hypo  or hyper thyroidism, Addison’s disease, Vitamin B12 deficiency seems to have greater incidence of vitiligo. Poor oral hygiene has be linked with incidence of Vitiligo.

The course of the disease is quite difficult to predicit from spontaneous regression; it can go to progressive spread. Vitiligo cannot be cured, it can only be managed. But it is not contagious and not painfully.

The goal of the treatment would be restore the skin pigmentation. Since treating any skin disease is long drawn process and impact of therapy may not be visible for several months. The various treatments available are.

  • Topical steroids are quite effective in re-pigmentation however it takes almost about 3months before effects are seen. The steroid has to be applied three times daily on the skin. There could be adverse effects like thinning of the skin or streaks of colour on the skin.
  • Topical immune-modulators are also prescribed. People with small areas of pigment loss on the face and neck see results with this.
  • PUVA which is a combination of Psoralen which renders a person more sensitive to light and UVA rays are used to darken the light areas of skin. Psoralen could be either topical or oral. Since Psoralen renders the skin sensitive to light, the person also becomes more sensitive to sunlight so it is necessary to use sunscreens.
  • De-pigmentation of the normal skin to match the white patches is done if other treatment procedures fail. This is considered only if more than half the body is affected by vitiligo. The medication used is called Monobenzone which is so potent that contact with other people should be avoided for at least two hours or they might land up getting bleached.

Non invasive management of vitiligo include make-up, skin products should ideally include UVA and UVB for protection from sunburns.

Surgery may be considered in very severe cases, skin from healthy area is taken and grafted the procedure is not only laborious it is also expensive and could cause tissue scaring. Most people with Vitiligo need lot of emotional support to deal with the chronic skin condition.

Studies are being carried out to stimulate melanocytes with a drug called afamelanotide, prostaglandin 2 is another component that is being tested and it is found useful when the vitiligo is localized.  Oral Tofacitinib which is used in the treatment of rheumatoid arthritis has shown the potential to reverse colour loss.

Studies in alternative medicine has shown that Gingko Biloba could return skin colour, minor studies with alpha-lipoic acid, Folic acid, Vitamin C, Vitamin B12, and phototherapy could restore skin colour.

Hypnotherapy has proved helpful in many cases.

Vitiligo is non- infectious, whitening of the skin either locally or the entire body, it cannot be cured, but can be managed with medications and UVA therapy. In many cases hypnotherapy is known to help.  Options like Gingko Biloba has also proved useful and more studies are conducted on it.

World Clubfoot Day 2017

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A club foot is a deformed foot, which twisted such that the sole cannot be placed on the ground. The medical terminology for this is Talipes Equinovarus and is a congenital deformity, which causes one or both feet to turn upwards. The cause for this is not known, however current research does indicate genetic factors.

Clubfoot has the tendons on the inside shortened, the bones are of unusual shape and the the Achilles tendon is tightened. If it is left untreated it would appear as if the person is walking on their ankles. The arch is more pronounced and calf muscles tend to be underdeveloped.

Usually the defect is diagnosed at by visual examination at birth, sometimes it can be diagnosed before birth. Most children exhibit only clubfoot while sometimes it is accompanied by other problems like Spina Bifida.

The risk factors, genetic history plays an important role, and the gender distribution is greater in male as compared to female.

The cause is as of now is unknown, and the intra-uterine placement of the foetus does not play a role. One possible cause is a disruption in the neuromuscular pathway. Some environmental pointers have been suspected like mother being a diabetic or a smoker. There has also been a link between early amniocentesis and clubfoot.

Elements of treatment include

  • Manipulation and casting. The baby’s foot is gently stretched and manipulated into a corrected position and held in a place with long-leg caste i.e. toes to thigh.
  • Achilles tentomy.

The clubfoot is not going to get better on its own, treatment is a must. Near normal foot is required such that the child can play and wear normal footwear.

The affected foot is about size or a size and half smaller than the normal foot. The calf muscle of the affected foot will also stay smaller.  The child has a tendency to feel sore at the legs, or feel tired quicker than his/her peers.

Clubfoot despite being congenital, of unknown origin seen predominantly in male, may or may not be associated with other disabilities is manageable the child can go on to live a normal life once the defect is addressed.

http://globalclubfoot.com/world-clubfoot-day/

https://www.miraclefeet.org/get-involved/world-clubfoot-day-2017/

Life with MS —

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#LifeWithMs

world Multiple Sclerosis day is 31st May.

Multiple sclerosis is a disease of the central nervous system, the white matter that surround the nerve fiber hardens, and term

Multiple sclerosis is a disease of the central (cerebrospinal) nervous system. In this disorder, the white matter surrounding nerve fibers becomes hardened. The term multiple sclerosis (MS) literally means “many scars.” The hardened areas of nerve tissue are called plaques. The symptoms, severity, and course of multiple sclerosis are highly variable, depending partly on the sites of the plaques and the extent of the deterioration of the white matter. The deterioration of white matter in the nervous system slows nerve impulses leading to nervous system incoordination.

 

Multiple sclerosis,(MS) is an immune disorder, where the immune system  of the body is directed against the central nervous system, (CNS) though the precise antigen that are sensitized to attack are not known,  it refered to as immune mediated rather than auto-immune.

The fact sheet of MS is as follows – common in the age spectrum of 20 -50yrs, more in women than in men, though people of all ethnic origins are known to have it , the dominant ethnic community seems of European descend. The susceptibility  appears to be passed genetically.  The incidence rates higher further away from the equator, this leads to the belief that exposure to sunlight could impact the MS risk.

The manifestation is through various symptoms and that depends on the area of central nervous system that is affected. There could be visual disturbance, blurring of vision, double vision, optic neuritis, involuntary rapid eye movement, and sometimes, loss of total eye sight. Since the neuromuscular system is challenged there could loss in balance, tremor, difficulty in walking, giddiness, clumsiness, weakness and fatgue. Altered muscle tone can produce spasms or muscle stiffness. A person with MS may experience tingling a burning feeling in the area of body facial and/or muscle pain. Speech could be disturbed, like there could be slurring, or slowing of rhythm. There could be increased sensitivity to heat, short term memory may be challenged, concentration and judgement or reason could be altered depression is another common symptom.

The MS-Society  says that people with MS on an average have 7 years less than the longitivity of the general population, the cause of death im most cases is same as what happens to most MS free population, that would include  cardio-pulmonary disorder or cancer. What is effected however is the quality of life., though people do not become severely disabled, they do experience symptoms that cause pain, discomfort and inconvenience.

It is difficult to predict the progress of MS in peole, the severity of disease varies  about 20%  with MS exhibit no symptoms or exhibit mild symptoms. About 45% exhibit moderate issues.   The course becomes unpredictable as the signs of onset are very benign and more disabling or devastating, from medical perspective it is regarded as incurable.

The patterns can put into 4 types.

  1. Relapsing- remitting MS seen in about 25% of the MS sufferers, the relapses are unpredictable, the relapse occurs with either new symptoms manifesting or aggravation of existing symptoms. The remission or recovery can occur either in days or months, and it might be partial or total recovery. This is a pattern seen in younger people.
  2. Benign MS is seen about 20% of the cases where a person has one or two attacks with complete recovery, this does not worsen with time, the disability is not permanent, and is associated with less severe symptoms at onset.
  3. Secondary progressive MS seen in about 40% of cases and is the commonest, it onset may be the relapse-remission  pattern  as the disease progresses the disability increases.
  4. Primary progressive MS seen in15% of the cases is characterized by slow onset and progressively worsens. There is accumulation of deficits and disability.

The symptoms of MS are usually first noted between the ages of 30 and 50. Women develop the disease almost twice as often as men.

 

The risk factors that could indicate a greater chance of developing a severe form are

  1. Age – over 40yrs on the intial onset of symptoms.
  2. If the symptoms affect more than one area of the body.
  3. The intial symptoms affects the mental, urinary or motor controls.

As cure is not identified we go with managing, and prognosis can be predicted.

  • The frequency of symptom attack.
  • The duration between the attacks.
  • The percentage of recovery from each attack.
  • The involvement of sensory impulses like tingling, vision loss or numbness.

The treatment of MS is more symptomatic and  aimed at reducing the underlying inflammation caused by immune system attack on the nervous system.  The aim of therapy is more rehabilitative and focused to improving quality by improving coordination, and developing coping strategies. There is a need to change attitudes, lifestyles and the patient will have to avoid heat. Maintainance of genral health is important and also proper diet, rest and exercise and priorities to conserve energy.

I found Edgcar Cayce’s take very interesting, to him MS was resultant of chemical imbalance due to failure of the glandular system producing the substances that NS requires for self maintainance. His focus was glands associated with the liver, Edgar Cayce noted that nervous system does not function in isolation from rest of the body. the cycle of nutrition supply and removal ofwaste product had to be constant, any lapse in this would result in the detoriation of nervous system. Though he was not able to pinpoint the precise detoriation.

Though Edgar Cayce’s MS  reading are oriented towards physical pathology, he also emphasizes on mental and spiritual patterns, many begin with this karmic condition and that mental and spiritual attitudes of the afflicted person would be addressed if there was to be healing.

Glands are believed to be spiritual centers of the body, the key centers of the body/soul connection, presumably soul patterns from past lives can play out in this manner.

Emotional make up of MS patients exhibits a certain amount of mental hardness, stubbornness and inflexibility.

Edgar Cayce suggest the intial step as change in person’s attitude, an understanding of why the symptoms manifested. This understanding can help the individual heal. He then recommended massages, wet battery vibrations where gold chloride was the primary solution used. He also recommended dietary changes where friend and highly processed food was avoided and diet was balanced with vegetables and fruits. Sea food was considered beneficial, primary meats were acceptable.

Please note this article is just for information. And not for self diagnosis or therapy.