Novel Coronavirus (2019-nCoV); diagnosis, DO’s and DON’Ts, prevention


2019 Novel Coronavirus (2019-nCoV)-  WHO reported that a novel virus was identified by the Chinese authorities. It is a contagious virus, can transfer from human to human. WHO advisory

The virus is associated with an outbreak of pneumonia in Wuhan City, Hubei Province, China.

 

Clinical Features
Fever

Tightness of chest

Running nose

symptoms of lower respiratory illness

cough, difficulty breathing

Headache

Feeling unwell

Pneumonia

Kidney failure

Incubation period: 14 days

 

 

Mode of Transmission – Human coronaviruses most commonly spread from an infected person to others through

  • the air by coughing and sneezing
  • close personal contact, such as touching or shaking hands
  • touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands
  • rarely, faecal contamination

Prevention- How to reduce risk

How to protect yourself

There are currently no vaccines available to protect you against human coronavirus infection. You may be able to reduce your risk of infection by doing the following

  • wash your hands often with soap and water for at least 20 seconds
  • avoid touching your eyes, nose, or mouth with unwashed hands
  • avoid close contact with people who are sick

How to protect others

If you have cold-like symptoms, you can help protect others by doing the following

  • stay home while you are sick
  • avoid close contact with others
  • cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash and wash your hands
  • clean and disinfect objects and surfaces

 

Treatment

There are no specific treatments for illnesses caused by human coronaviruses. Most people with common human coronavirus illness will recover on their own. However, you can do some things to relieve your symptoms

  • take pain and fever medications (Caution: do not give Aspirin to children)
  • use a room humidifier or take a hot shower to help ease a sore throat and cough

If you are mildly sick, you should

  • drink plenty of liquids
  • stay home and rest

If you are concerned about your symptoms, you should see your healthcare provider.

 

DO’s and DON’Ts

DO’s:

  •   avoid close contact with others
  • cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash.
  • wash your hands and clean and disinfect objects and surfaces
  • take pain and fever medications (Caution: do not give Aspirin to children)
  • use a room humidifier or take a hot shower to help ease a sore throat and cough
  • drink plenty of liquids
  • stay home and rest- avoid crowded areas
  • consult a doctor

DON’Ts

-touching eyes, nose and mouth with unwashed hands

-Hugging, kissing, shaking hands while greeting

-spitting in public places

-taking medicines without consulting doctor

-excessive physical exercise

-disposal of used napkins or tissue papers in open areas

-touching surfaces usually used by public (railing, gates, etc)

-smoking in public places

-unnecessary testing.

 

For doctors and nurses

 CORONAVIRUS – DO’s in case of suspicion 

Obtain a detailed travel history for patients with fever and respiratory symptoms.

Is there a history of travel from Wuhan City, China on or after December 1, 2019?

Are there any Symptoms like runny nose, headache, cough, sore throat, fever and difficulty in breathing?

If yes to any or both questions above, then such patients to wear a surgical mask as soon as they are identified.

Healthcare professionals including doctors, nurses and others to conduct their evaluation in a private room with the door closed, ideally an airborne infection isolation room.

Personnel entering the room should use standard precautions, contact precautions, and airborne precautions and use eye protection (goggles or a face shield).

 

Recommendations for Reporting, Testing, and Specimen Collection

Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Patients Under Investigation (PUIs) for 2019 Novel Coronavirus (2019-nCoV)

Healthcare providers should immediately notify both infection control personnel and administration at their healthcare facility and their local or state health department in the event of a PUI for 2019-nCoV.

To increase the likelihood of detecting 2019-nCoV infection, collection of three specimen types, lower respiratory, upper respiratory and serum specimens for testing is recommended. Additional specimen types (e.g., stool, urine) may be collected and stored. Specimens should be collected as soon as possible once a PUI is identified regardless of time of symptom onset.

For biosafety reasons, it is not recommended to perform virus isolation in cell culture or initial characterization of viral agents recovered in cultures of specimens from a PUI for 2019-nCoV.

For further details on Guidelines for Collecting, Handling, and Testing and Laboratory Biosafety Guidelines refer – Information for Laboratories (https://www.cdc.gov/coronavirus/2019-nCoV/guidance-laboratories.html) This page includes interim guidance for laboratory professionals working with specimens from patients under investigation for human infections with 2019 novel coronavirus (2019-nCoV).

 

Infection Prevention and Control Recommendations for Patients Under Investigation

Airborne infection isolation

For additional infection control guidance you can visit CDC’s Infection Control webpage.

nurses and doctor at risk from mutated viruses

administrators prefer to refrain from  the risk to health workers

21 occupational risk to doctor and nurses

30 hours baby born to a Wuhan Coronavirus patient infected; possible vertical transmission


The child was born in Wuhan on Sunday and tested positive 30 hours later .

Medics were monitoring the baby closely, but said its condition was stable 

  • Doctors warned the virus might be passed from mothers to unborn babies
  • Another 17-day-old baby in Wuhan was also found to be infected by the virus
  • Coronavirus death toll continues to soar as at least 493 people have been killed 
  • A Chinese baby born to a Wuhan coronavirus patient has been diagnosed with the deadly disease 30 hours after being delivered.Doctors in China. The child was born in Wuhan on Sunday and tested positive 30 hours later .
    Medics were monitoring the baby closely, but said its condition was stable
    • Doctors warned the virus might be passed from mothers to unborn babies
    • Another 17-day-old baby in Wuhan was also found to be infected by the virus
    • Coronavirus death toll continues to soar as at least 493 people have been killed
    • A Chinese baby born to a Wuhan coronavirus patient has been diagnosed with the deadly disease 30 hours after being delivered.Doctors in China are now fearing that the infection could be passed from mothers to their babies in the womb.The news came after experts claimed that the virus might also be spread by faeces. The infected child, whose gender has not been revealed, was born in Wuhan on Sunday. Its mother had been confirmed to have the coronavirus before going into labour.
    • Medics gave the baby a test 30 hours later and the result turned out to be positive. The baby was then transferred to the Wuhan Children’s Hospital, which has been appointed by the government to treat all infected children.The three-day-old baby’s condition was stable and it was being closely monitored, the hospital announced through a post on its official social media account today.’This reminds us to pay attention to a potential new transmission route of the coronavirus – vertical transmission from mothers to babies,’ said Dr Zeng Lingkong, chief physician from the hospital’s Department of Neonatal Medicine.
    • he newborn is one of the two babies that have been found to carry the coronavirus by Wuhan Children’s Hospital. Another 17-day-old baby was found to be sickened after being born healthy on January 13. The hospital said its family hired a wet nurse to look after it on January 22, but the wet nurse was diagnosed with the disease shortly after.The baby’s mother was found to have the coronavirus on January 26 and the baby started to cough and develop a fever three days later. The child was diagnosed with the virus on January 31 after doctors gave it a series of medical checks.
    • Medics are yet to confirm if the baby had caught the virus from its mother or its wet nurse.On Saturday, doctors and nurses wearing hazmat suits and goggles delivered a 7lb 14oz boy in Wuhan Union Hospital.
    a
    are now fearing that the infection could be passed from mothers to their babies in the womb.The news came after experts claimed that the virus might also be spread by faeces.The infected child, whose gender has not been revealed, was born in Wuhan on Sunday. Its mother had been confirmed to have the coronavirus before going into labour.
  • Medics gave the baby a test 30 hours later and the result turned out to be positive. The baby was then transferred to the Wuhan Children’s Hospital, which has been appointed by the government to treat all infected children.The three-day-old baby’s condition was stable and it was being closely monitored, the hospital announced through a post on its official social media account today.’This reminds us to pay attention to a potential new transmission route of the coronavirus – vertical transmission from mothers to babies,’ said Dr Zeng Lingkong, chief physician from the hospital’s Department of Neonatal Medicine.
  • he newborn is one of the two babies that have been found to carry the coronavirus by Wuhan Children’s Hospital. Another 17-day-old baby was found to be sickened after being born healthy on January 13. The hospital said its family hired a wet nurse to look after it on January 22, but the wet nurse was diagnosed with the disease shortly after.The baby’s mother was found to have the coronavirus on January 26 and the baby started to cough and develop a fever three days later. The child was diagnosed with the virus on January 31 after doctors gave it a series of medical checks.
  • Medics are yet to confirm if the baby had caught the virus from its mother or its wet nurse.On Saturday, doctors and nurses wearing hazmat suits and goggles delivered a 7lb 14oz boy in Wuhan Union Hospital.
  • corona virus
  • risk to doctor and nurses from mutated virus

Stools, diarrhea may be hidden risk of Corona Virus Spread


While most of screening for Corona virus is  focused on respiratory samples from pneumonia cases to identify corona-virus patients,  there is possibility that doctors might have ignored a less apparent and hidden source of the spread: diarrhea.

The new corona-virus was detected in faeces inthe first case confirmed in the United States and that finding could point to a hidden risk in the spread of the virus.

“It’s not only excreted in your respiratory secretions, it’s also secreted in your stool,” Scott Lindquist, the state epidemiologist for infectious disease at Washington State’s Department of Health, said on a conference call on Friday, reported Bloomberg.

Fang Li, an associate professor of veterinary and biomedical sciences at the University of Minnesota, said that the SARS and Wuhan viruses attach to the same protein receptors, which are seen in the lungs and intestines.

John Nicholls, a clinical professor of pathology at the University of Hong Kong, told Bloomberg that fecal material “would be a very likely place where you might get the transmission.”

“If it’s using the same receptor as for SARS, I can’t see why it shouldn’t be replicating in the gut,” he said.

Ten to 20 percent of SARS patients experienced diarrhea, according to the Centers for Disease Control and Prevention (CDC). Diarrhea was the source of a major outbreak of that coronavirus in a Hong Kong complex. The CDC said that coronaviruses most commonly spread through the air by coughing and sneezing or close personal contact. In rare cases, the viruses spread through fecal contamination.

risk to doctor and nurses from new and mutated germs

Corona virus

‘Reel Heroes vs Real Heroes’ Naseeruddin Shah’s Daughter Assaulted Vet clinic staff


‘Reel Heroes’ are seen proudly hitting the doctors and health staff in films and earn money and accolades for “acting” so well. But in the process, they give a message to society that they can hit and assault doctors and health staff with impunity, in case the patients feel unsatisfied. Being right or wrong does not matter. Projecting only negativism about medical profession by ‘REEL Heroes’ has resulted in demoralization, belittling and consequent increasing assaults on doctors.

Working on same principles, there was an incident, where health staff of vet clinic was assaulted by kin of “REEL Heroes”. An impression is being created to assault health staff, when-ever there is some dissatisfaction, specially by ‘Reel actors against Real actors’.

A non-cognisable offence has been registered against Naseeruddin Shah’s daughter Heeba Shah for allegedly assaulting two employees of a veterinary clinic reported mid-day. The complaint was registered on 17 January. The NC has been registered under sections 323 (voluntarily causing hurt), 504 (intentional insult) and 506 (criminal intimidation). The incident allegedly occured on 16 January and was captured in the clinic’s CCTV camera. The footage has been submitted to the Versova police, where the complaint has also been registered. The clinic is called The Feline Foundation. Heeba was helping out a friend, Supriya Sharma, by taking her two cats for sterilisation to the clinic.According to the report by mid-day, Heeba Shah entered the clinic in the afternoon at 2.50 pm on 16 January. She was asked to wait outside as surgery was on inside the clinic. After waiting for some time, Heeba allegedly got aggressive with her words and said, “Don’t you know who I am? How can you make me wait for so long outside without any assistance? How come no one helped me to get my cats’ cage out of the rickshaw on arrival?”As can be seen in the video, Heeba also physically assaulted the staff by pushing and slapping the person. She can also be seen yelling at the staff.

Reel heroes or Real heroes-Media projection

Self-proclaimed social activist ‘the Hero’ tring to espouse the cause of hapless patients, by projecting doctors as deceitful. In the process of self-projection as saviours of innocent patients, the ‘hero’ presents doctors as villains of the fleece tragedy as a generalization. Whole profession is painted with the same brush by ‘Reel Hero’, thereby creates a wave of huge mistrust among masses against ‘Real Heroes’ and true saviours.

Unfortunately masses trusted more on the person, who was dancing to entertain them rather than a doctor who was awake at night, trying to save lives. Sadly, in an era of media dominance, ‘Reel heroes’ get projected as ‘Real heroes’. The real become invisible behind the glittery mist. Masses fail to envisage the bigger real picture and are grossly mistaken by another projected story.

The old adage “All that glitters is not gold” is particularly relevant in current era of media domination, where media projection shapes the perception and may defy the reality. Media has dominated our lives and can sway the opinion formation of masses.

Media projections create a mirage of illusional glitter wherein there is blurring of real life from the reel life of heroes. The larger-than-life unreal persona of the celebrities on screen looks too charming and sometimes becomes undeniable and dominates mind of masses. The super-human characters played out in films and television appear to be too real. The problem arises when the imaginary characters of the reel life stories are emulated in real life. The naivety of masses to perceive the projected character as the real one goes beyond a reasonable thought process and imagination.

These roles played in films are not really act of inspiration in real life as the actual purpose accomplished in the end of a movie is entertainment of society and business for themselves. In present era, more people will choose to watch the criminal trial of a celebrity rather than the biography of a truly great human being.

At the best, a particular projected character (and not individual acting star) may be a role model. An actor or super star, is simply doing his work of “acting” in the end. This work of acting may bring an entertainment of few hours at the most.

One should not stray away from the wisdom to choose between what we consume merely for our entertainment or face in real life. One needs to differentiate between rationale truth behind the celebrity gimmicks in the media and exaggerated sensationalism. Sensation created merely for a commercial successful venture should not be allowed to overpower the judgments of real life.

But the problem starts, when these false perceptions created merely by a projected glimmer takes the shimmer away from the real worthy. The real professionals and people who are worthy of glory become invisible behind the glittery mist, a haze, the unreal and the unhelpful in real life.

A soldier contributes to our society much more in real terms. Even a junior doctor saves many lives in a day in emergencies as compared to work of a superstar in films. A teacher, nurse or scientist have contribution which is more fruitful to our generation. The reel actor merely imitates the real life lived and actual work done by real heroes like soldier, doctor or teacher. Someone who only acts and behaves like one, is respected and paid thousand times or more than ‘the real one’.

In reality, people need more than mere entertainment, reel role models and actors in their real lives. Unfortunately, reel projection for purpose of entertainment is more easier to enact and has become more profitable than actual performance in real life.

Human-to-human transmission of China Corona virus # symptoms # doctor, nurses


Symptoms: including fever, coughs, breathing difficulties and pneumonia.

Coronaviruses are transmitted between animals and people, and the outbreak in Wuhan has been linked to a now-closed seafood market where live animals were reportedly sold. Preventive measures were also being taken to protect doctors and health care workers.

Patients carrying specially unknown germs are handled by doctor and nurses, who have no clue, what they are dealing with. Time gap in such patients coming to the hospital and the exact diagnosis of finding a dreaded disease, may be quite dangerous to doctors and nurses.To add to the problem, In large number of patients, exact viruses cannot be diagnosed or even suspected. In many cases of ARDS, the causative organism cannot be isolated or identified. It is important for doctors and nurses to take universal precautions at every level. There can be many more viruses or germs which are yet to be discovered or mutated ones that are unknown.

H1N1, Zika, Ebola, SARS are few examples, just to imagine that they existed and handled by health workers as unknown germs, till they were discovered.

China’s National Health Commission has confirmed human-to-human transmissionof a mysterious Sars-like virus that has spread across the country and fueled anxiety about the prospect of a major outbreak as millions begin travelling for lunar new year celebrations.

Zhong Nanshan, a respiratory expert and head of the health commission team investigating the outbreak, confirmed that two cases of infection in China’s Guangdong province had been caused by human-to-human transmission and medical staff had been infected, China’s official Xinhua news agency said on Monday.

Authorities earlier reported 139 new cases of the new strain of coronavirus over the weekend, bringing the total number of infected patients to 217 since the virus was first detected last month in the central city of Wuhan.

Cases were confirmed in Beijing, Shanghai, and Guangdong province in the south, heightening fears ahead of the lunar new year holiday, when more than 400 million people are expected to travel domestically and internationally.

State broadcaster CCTV said on Monday evening there were seven suspected cases in other parts of the country, including Shandong in the east, and the south-western provinces of Sichuan, Guangxi and Yunnan. Five people who travelled from Wuhan were also being treated for fevers in Zhejiang province.

“People’s lives and health should be given top priority and the spread of the outbreak should be resolutely curbed,” said China’s president, Xi Jinping, weighing in on the matter for the first time.

The strain has caused alarm because of its connection to severe acute respiratory syndrome (Sars), which killed nearly 650 people across mainland China and Hong Kong in 2002-03. Three people have so far died in the current outbreak, which has spread to Thailand, Japan and South Korea.

The World Health Organization has said an animal source was “the most likely primary source” of the outbreak, with “some limited human-to-human transmission occurring between close contacts”. Researchers worry the number of infections has been severely underestimated.

21 occupational risk to health workers

Doctor & nurses at risk from unknown or mutated germs@ Mystery virus in China


 

First pneumonia death from mystery virus in China, world on high alert

          The  viruses, bacteria are germs  had been discovered only in last one century and many more are still not known. Patients carrying specially unknown germs are  handled by doctor and nurses, who have no clue, what they are dealing with.   Time gap in such  patients coming to the  hospital  and  the exact diagnosis of finding a dreaded disease, may be  quite dangerous to doctors and nurses. To add to the problem, In  large number of patients, exact viruses cannot be diagnosed or even suspected. In many cases of ARDS, the causative organism cannot be  isolated or identified.  It is important for  doctors and nurses  to take universal precautions from the beginning. There can be many more viruses or germs which are yet to be discovered or mutated ones that  are unknown.

21 occupational risk to doctor and nurses

H1N1, Zika,  Ebola,  SARS  are few examples,  just to imagine that they existed and handled by health workers as unknown germs, till they were discovered.

The death of a 61-year-old man  due to pneumonia from a mystery virus in the central Chinese city of Wuhan on Saturday has put the world on high alert against another new life-threatening illness. Seven of the 43 others diagnosed with the disease are in a critical condition, but no new cases have been reported since January 3.

To protect the world still smarting from the lightning spread of devastating viral diseases such as H1N1, Zika and Ebola, the World Health Organisation (WHO) issued this year’s first  international travel and trade alert on  on January 10 that advised all international travellers to report symptoms of fever with breathlessness and difficulty breathing, especially if they have travelled from China.

On January 9, China announced that the cluster of pneumonia cases reported in December in Wuhan in the Hubei Province of China was caused by a new coronavirus.

Only six viruses from the coronavirus family infect humans, which would make the new one the seventh to cause human disease. The coronavirus viruses cause diseases ranging from the common cold to very severe and life-threatening illness from Middle-East Respiratory Syndrome that caused 851 deaths since it was identified in 2012, and the Severe Acute Respiratory Syndrome (SARS), which killed 774 of the 8,098 people infected in an outbreak that started in China in 2002.

“Though currently there is no evidence of human-to-human transmission, we need to remain vigilant. WHO has shared with all Member States technical guidelines on surveillance, testing as well as infection prevention and control practices for suspected cases. WHO is in close contact with national authorities in the region and will extend all possible support to ensure core capacities are geared up for addressing potential cases that may come to countries,” said Dr Poonam Khetrapal Singh, WHO regional director, South East Asia Region.

Unknown threat

Some countries in the region, including Indonesia, Myanmar and Thailand, have started screening passengers travelling from China for pneumonia symptoms at airports. The health ministry reviewed the situation with WHO experts on Wednesday and plans to start providing travellers with risk-reduction information at airports and other ports of entry, travel agencies and conveyance operators.

“We are waiting and watching as entry screening at ports of entry like airports, seaports, train stations and border check-posts are not cost-effective. It is resource-intensive but offer little benefit,” said a health ministry official, who did not want to be named.

Though no pneumonia have been reported outside Wuhan, which has a population of 11 million, WHO said there is need for caution as the city is a major domestic and international transport hub with heavy population movement. Travel in the region is expected to significantly increase during the Chinese New Year in the last week of January, which increases the potential of infected travellers carrying to other parts of China and the world.

New viruses are formed when mutate to jump species and cause infection in humans. SARS jumped from the civet cat into humans, MERS from dromedary camel, H1N1 from pigs, and Ebola from bats, just to name a few.

The Wuhan City cases have been linked to the South China Seafood Wholesale Market, where some of the patients worked as dealers or vendors. The Huanan Seafood Wholesale Market deals with fish and other seafood, including sea mammals, along with chicken, bats, rabbits and snakes.

Signs of trouble; The clinical signs of the new lung infection are mainly fever, with a few persons reporting difficulty in breathing. Clinical signs include chest x-rays showing bilateral lung infiltrates (markings) associated with pneumonia and tuberculosis.

With no infection among health care workers treating the patients, preliminary information suggests there is no significant human-to-human transmission, but till the mode of transmission is clearly established, it’s best to take precautions to stay safe.

The WHO advises people travelling in or from affected areas (currently Wuhan) to avoid close contact with people with acute respiratory infections; wash hands frequently, especially after direct contact with ill people or their environment; and avoid close contact with live or dead animals. In case of respiratory symptoms before, during or after travel, travellers must seek medical attention and share their travel history with the doctor.

“The WHO advises against travel or trade restrictions on China based on the information currently available on this event,” said Dr Singh.

 

 

An Urban Jungle: where animals hunt Humans


Danger of stray dogs is increasing every day around us. As the strays population in increasing, now they are grouped and see vulnerable humans as easy prey. Packs of dogs have become dangerous and difficult to control. Protected by Dog lovers and animal right laws, the danger to normal people of being hunted even around their homes is real. Human right of being in a safe environment is being ignored. Is it not hypocritical that you care for a violent stray who is a threat to the society? Problem is not about loving and feeding dogs, but simultaneous apathy towards safety of humans. Such dog lovers most of the time, totally ignore the fact that these dogs are a threat to children and older people. An immediate sense of hatred towards such dog lovers is a consequence and a natural thought.

Just one of uncountable examples. An 80-year-old woman was attacked by stray dogs while she was going to a temple in Ludhiana city on Tuesday. She was admitted to DMC Hospital for treatment. Residents claimed that a group of 15-20 stray dogs has created terror in the area. The pack of dogs often attacks people including children. The said despite their repeated complaints to the authorities they have not got any kind of relief from this problem.

It is not uncommon dogs chasing children and older people. In a recent incident and a common one , the loud barking sounds were intermixed with cries of a child, who was running and screaming for his life. Two stray dogs were near him, trying to hunt him as a prey. As they got nearer to him, I somehow managed to get some stick from a plant and managed to save the child and shoo away the dogs. The nine year old child just clung to me, almost pale, dizzy and his eyes closed with fear. His football was in his lap, which he was trying to use as shield. A shield which society, government, courts and so called “dog-lovers” failed to provide. This child must be the life for his parents and could have been in a great trouble that day because of apathy of few “Animal Lovers”. For whom animal love is like a hobby to be projected for hollow public applause. I looked around, a gentleman was comfortably sitting with his small dog and reading newspaper. He did not even bother to look at what was happening. He was the person, who used to feed these stray dogs and claimed himself to be a “Dog lover”. He was totally unperturbed by the fact that a child was about to lose his life because of these wolf like dogs roaming freely. Similar apathy has been displayed by government and courts with a result that thousand suffer from dog bite every day.

Apart from the injury part, Rabies is a disease spread by dog bite, which is not treatable. Getting anti-Rabies serum becomes another Herculean task.

Courts have also upheld animal rights. That is right but they did not formulate policies to ensure safety of humans from these violent strays.

Government has not made out any policy to safeguard public from such attacks nor have courts come up with any solid guidelines, which can save public, children, women and older people from such bites.

Animal lovers while pretending of “dog love” have formed NGOs and have donations and accumulate money. But have failed to create shelters for stray dogs. Neither have any steps been taken to save people from dog bites. So consequently, people especially vulnerable are children and older people who are mauled and eaten alive by stray dogs. What responsibility and accountability these animal lovers and NGO bear towards such incidents? Why people who collect money in name of animals do not take care and form shelters for these strays? every single death from such preventable cause raise a question on this issue.

Apathy of these so called dog lovers towards humans is appalling.

Besides dog bite and injuries, animal and dog poop is an health hazard. Following are the diseases which occur in community because of animal poop.

Problem of animal poop with dust : It is all around us. It is actually even a bigger health problem than open defecation by humans. Humans defecate in country side and in open fields. But stray animals and dogs are everywhere. Even owner of pet dogs make them defecate outside their own houses and on the roads and wherever their dogs chooses. This poop dried and mixed with dust, acts a source of infection to the community.

Life threatening infections : dog’s and animal faeces is a big health hazard. It is even worse than a dog bite since it spreads infection in entire community. A dog’s digestive system can handle just about anything that it eats and this makes its poop very toxic. Animal faeces contain pathogens, which are known to cause severe diseases, infections and organ failure. These heavy loads of bacteria increase the risk of infections in the community. But pregnant women, children and people with suppressed immune systems may are more prone to these infections. Many diseases may be spread by millions of these dogs and other animals like pigs, cattle as their faeces contain parasites, bacteria and viruses. These include life threatening bacterial infections by E. coli, MRSA, Leptospira, Salmonellosis, Campylobacteriosis, brucellosis, Rickettsia and parasitic infections like Giardiasis, Whipworm, Hookworm, Roundworms, Tapeworms, Cryptosporidiosis, Echinococcosis, Leishmaniasis etc. Viral infections like rabies, influenza and other viruses may also spread through these animals.

Environmental health Hazard: Storm water runoff due to extensive rainfall can wash off all these droppings into drains, many of which are connected to river systems and water sources in our country. This can lead to a widespread source of waterborne illnesses. Dry poop on the roads is mixed with dust particles and in the air. So everyone is living in a highly infectious environment. This may be an important cause of high rates of community acquired infections among our population.

SUGGESTION: the Government, NGOs and people who claim to be “animal lovers” should create shelters to save strays “as well as people”. It should be mandatory that all the dog and animal (stray or pet) droppings are properly collected and disposed off. This single step can do wonders as it will reduce infections, people’s suffering, save lives and eventually reduce use of antibiotics. A rationale mind will definitely appreciate the danger due to strays, and can initiate proper steps rather criticizing above said facts in the name of animal rights. An animal has no sense of responsibility, so rights should be limited accordingly.

dog poop: obstacle to Swatch Bharat

Myths and facts about ICU ventilator: small boat in sea storm


 

 Some one who is drowning, a small boat can  save his life, till sea storm settles or the victim reaches a safe land. The boat will not settle the sea storm, but enough to save a person from catastrophe. In reality, ventilator is the invention, which should be worshiped. But contrarily, due to wrong projections and misguided perceptions, it has been hated despite saving lives.

     Although doctors and ventilators are in a similar situation, projected in a wrong way,  hated in spite of doing good work and saving lives. They are hated and despised, despite the only ones of help in life and death situations. Following are few myths and fact about ventilator.

  1. Myth : Once on ventilator, patients do not survive: common myth is that  once the patient is placed on ventilator, he will not survive.  Human body,  when  gets severely  diseased or  under stress, heart and lungs need to be supported for saving the life, till ailment    So, when the battle for saving live is ongoing, almost all the patients will have to be placed on the ventilator. It is a last ditch attempt made to save the patient’s life. However when the patients do not survive people feel that it’s the ventilator which has caused death, rather than a rational thought about severe disease as a cause.

             In reality, it is the severity of disease and possibility of death, when ventilator is required. It is necessary to support life.

  1. Myth : Ventilator is a modality for mere prolongation of life: every disease has a spectrum. Every disease can progress  from a reversible  to irreversible state. As an effort is ongoing while waiting to reverse the process, the patient will need  ventilator to sustain life. Unless the disease reaches a stage of  irreversibility,  ventilator is indispensible  for an  absolute need to maintain life. Since in serious condition, it is an uncertain prognosis.  In retrospect, combined with application of an average wisdom, the time of uncertainty and institution of ventilator   can be  interpreted  as a mistake.  As the whole exercise is labeled as futile and expensive by relatives.   it’s a grey area and the  negative thoughts are fuelled because of retrospective wisdom in hindsight.  The real prognosis can not be predicted in real time.

In reality, Ventilator is a machine which just  supports respiration and not  responsible for  heart beating. Therefore it   buys time for healing and treatment of primary disease.

  1. Myth : Ventilator will cause death:

one can understand this simple logic on the basis that patients are placed on dialysis when kidneys fail. Patients are placed in cast when bones are fractured for a fixed predefined period of time. Similarly patient is placed on ventilator when lungs fail. Ventilator is used till the time  lungs recover and become fully functional.

                        In reality; Risk is because of disease, which needs ventilator and not vice versa. Ventilator is a friendly machine which helps people who have failed lungs.

  1. Myth : Doctors and hospitals keep dead patients on ventilator for financial gains

Fact:  placing patient on ventilator is a very critical decision, taken in best interest of patient to buy time, to so as to treat the disease.  A patient needing on ventilator is actually so sick, that not  instituting ventilator will risk the patient’s life. Knowing all these facts, doctors take a decision to keep the patients on ventilator.

         As once the patient is on ventilator,  it is a stress for the doctor to take the patient off the ventilator. As such ventilator is a SANCTUM SANCTORUM life saving machine,  to be used only in life and death situations.

 

  1. Myth : Its miracle if the patient placed on ventilator survives.

Given the fact that placing the patient on ventilator on scientific facts. There are clear indications  for putting the patient on ventilator.   A much larger patients put on ventilator are actually saved and go home.

Fact:  Everyday thousands of patients are placed on ventilator and sent home to lead a normal life: Any patient who is given general anesthesia is placed on ventilator in the operation theater and then taken off the ventilator at the end of the surgery. In these cases patients are placed on ventilator so as patient can be put to deep sleep (called anesthesia) during which surgery on desired part can be carried out. Soon after the surgery patient are taken off the ventilator and soon thereafter discharged for home after few days of healing.

 

  1. Myth :Doctors place patients on ventilator at their own will:

Fact:   there are scientific parameters which decide when the patient should be placed on the ventilator and when the patient should be taken off the ventilator. So the decision to place the patient is scientific and based on objective parameters.

  Contrary to this popular myth, it is a compulsion for the doctor to put patient on ventilator to prevent death in serious situations.  Doctors are usually thinking several steps ahead of lay person about medical science.

  1. Myth :All patients placed on ventilator are unconscious:

 

Fact: this is not necessary. Usually patients are sedated  for their comfort.  they can be made to walk, write and even perform small tasks when on ventilator, depending upon their lung condition.

  Patients are also put on ventilator in case of airway failure when unable to protect their airway for various reasons. Another reason why patients are placed on ventilator is inability of the patients to protect his or her airway. Conscious and alert patients can swallow normally formed mouth secretions.  When patients consciousness level is dulled the ability of the patient to protect his airway is lost or compromised. This causes secretions from mouth to enter into the lungs trough the airway i.e. trachea causing infections in the lungs. The only way to prevent this and protect the patient’s lungs is to place a tube in his airway and then place them on the ventilator.

 

  1. Myth: Patients can be kept alive by placing on the ventilator:

General masses  have a feeling that patient can be kept alive by keeping them on the ventilator. Even  a dead person can be kept alive by placing on the ventilator, which is not true.

In reality:  It is machine used only for breathing and not heart and brain.

  1. Myth : Ventilating the dead patients:

    this is a common allegation on medical profession.  This is no truth in this projected and perceived hearsay.

       Facts: Assumptions are based on thoughts of lay persons. Patients on ventilator, may look like dead, because of the disease, sedation and paralyzed by drugs. But their heart and brain are working, so they can not be declared dead.

    If there is some incident, it  needs to be proved by medical personnel. In reality, it can  be a very rare and remote  exception. These untrue projection are creating lots of mistrust about life saving machine.

The problem is about correct projection and  majority of people without  knowledge of medical science  do not  even  know the large  number of lives  been saved by the ventilators.

In nutshell: serious conditions  and life threatening situations need higher technical interventions, to save a life. If correct projections are made, ventilators are life saving machines.

About ventilator

History of ventilator

South Asians at higher health risks: Low lean mass


The research further establishes that this low lean mass has been a constant in South Asians for almost 11,000 years.

South Asians, even those who move to other countries, are at a higher risk of diabetes than people of most other ethnicity, and according to a study published last week in Nature Scientific Reports, the reason for this is their relatively low lean mass

The research further establishes that this low lean mass has been a constant in South Asians for almost 11,000 years.

Higher lean mass is associated with superior performance in some, but not all, sports.

Mesolithic hunter-gatherer ancestors of South Asians were much taller, but low lean mass has characterised South Asians for at least 11,000 years, putting them at higher risk of type-2 diabetes and other non-communicable diseases (NCDs) such as heart disease, according to the study which analysed 197 archaeological and recent South Asian adult skeletons.

Height decreased by 8.5cm in men and 7.7cm in women when South Asians transitioned from hunting and gathering to farming around 9,000 years ago, but their lean mass (organ and muscle mass) has remained unchanged over the past 11,000 years, the study said.

Since changes in lean mass are unlikely over the next four to five generations, making lifestyle interventions are crucial to containing NCDs, which account for 60% of all deaths in India.

The study suggests that while height is determined by nutritional factors, physique (bone breadth and lean mass) reflects ecological pressures. “The decrease in height probably took place very quickly (over hundreds of years rather than thousands). After the initial drop in height with the adoption of farming, it then continued to decrease very slowly between about 5,000 years ago and today,” lead author Dr Emma Pomeroy, lecturer in the Evolution of Health, Diet and Disease, Department of Archaeology, University of Cambridge, said in an email interview. “The ancient origins of low lean mass in South Asians would be most consistent with long-term adaptations to ecological pressures, rather than more recent dietary change or the impact of 19th-20th century famines exacerbated by British colonial policy,” said the study. Ecological pressures include adaptation to a predominantly hot, equatorial climate, which may have led to selection for lower body mass (which generates less heat and increases heat loss through a greater surface area to volume ratio) to reduce thermal load. “Low lean mass is present at birth in South Asian babies compared with European babies; even after South Asian families migrate to other parts of the world, such as the UK, after several generations in this new environment, their children still have low lean mass compared with children of European ancestry. This strongly suggests a major heritable component to South Asian low lean mass, but the contributions of genetic, epigenetic and environmental conditions are still unclear,” said Dr Pomeroy, referring to a study on type-2 diabetes in migrant South Asians published in The Lancet in 2015. People of South Asian ancestry are at a higher risk of diabetes even after risks like unhealthy diet, sedentary lifestyles and obesity are factored in. For example, South Asians in London have a two to three times greater type 2 diabetes compared with those of European ancestry, with onset typically five years earlier and at a lower body mass index (by 5 kg/m2). “The implications of the study are that low lean mass is a very ancient characteristic, so it is unlikely to change much in the coming generations. This means that other interventions, especially the promotion of healthy lifestyles, are particularly critical to manage the growing health and economic burden of chronic diseases,” said Dr Pomeroy.

Building muscle mass and high fitness levels have the potential for averting diabetes, and even heart disease.

 

 

Breathing OZONE # rising Pollution


 

Rise in ozone levels is considered as one of the triggers for respiratory ailments. Irritation can occur in the respiratory system giving rise to coughs and an uncomfortable sensation in the chest. It may reduce lung function and make breathing difficult. There are no data available in the country to establish a direct correlation between mortality and high levels of ozone.

Oxidizing substances, such as oxides of nitrogen and oxidants from automobile exhaust, react with Sunlight to produce ozone.

Ozone — a pollutant that cause respiratory ailments, damage crops and forests — has been the highest in Delhi among the NCR cities of Gurugram, Faridabad, Noida and Ghaziabad for the last three years.

highest Ozone pollution in Delhi among NCR cities in last 3 years .

Compared to Delhi, Noida experienced 49 days on which ozone was high, Gurugram recorded 48 days, Faridabad encountered 11 such days, and Ghaziabad encountered eight days of high ozone, in the last three years

Data submitted in the Lok Sabha on Friday by environment minister  revealed that “between 2016 and 2018, Delhi encountered at least 95 days, on which Ozone was found to be as one the ‘prominent pollutants’ in the city’s air”.

“Usually, it is the level of particulate matter (PM10 and PM2.5) that remains high in Delhi,” an official of the Central Pollution Control Board (CPCB) said.

Compared to Delhi, Noida experienced 49 days on which ozone was high, Gurugram recorded 48 days, Faridabad encountered 11 such days, and Ghaziabad encountered eight days of high ozone, in the last three years. Even though ozone in the upper reaches of the atmosphere is good for humans as it absorbs the sun’s harmful ultraviolet rays, when it is generated on the ground level, from vehicular and industrial fumes, ozone undergoes a chemical reaction in the presence of sunlight and turns harmful.

“This year, till May 31, Delhi has already encountered 23 days of high ozone. Faridabad has recorded the highest number of days this year so far, at 55. Gurugram and Ghaziabad recorded six and three

such days, respectively, while Noida didn’t record any such day so far,” the CPCB official said.

Safar, a pollution forecasting agency under the earth sciences ministry, had been issuing warnings of ozone pollution over the past two weeks. The Centre for Science and Environment, a Delhi-based NGO, released a report last week, which also showed that between April 1 and June 5, ozone levels were high on at least 16% days this year, compared to 5% days in 2018.

The highest concentration in 2019 went up to 122 mpcm, which was 1.22 times higher than the eight-hour average standard.

“This is a serious trend as ozone can have an adverse effect on those suffering from asthma and respiratory conditions. If this trend continues or worsens, the graded response action plan will also have to be enforced to address the precursor gases that form ozone — NOx, hydrocarbons etc — and crack down on vehicles and industry,” Anumita Roychowdhury, executive director (research and advocacy), CSE, said

 

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