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patient education news letter
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Police in China has closed 147,000 sites thatmanufactured or sold coun-terfeit food or drugs in thepast year, the governmentsays. According to newly re-leased figures from the Chi-nese Ministry of PublicSecurity police have shutdown 147,000 sites involvedin the fake food and drugtrade since August 2011.Over the same period the po-lice have reportedly resolved185,000 criminal cases linked to counterfeiting.Information from the public played a big role in theanti-counterfeiting cases. The Ministry says thepolice paid 12,000 informants $4,4 mill for helping
to identify and solve cases of fake food and drugs.Cases investigated by policeover the past year include theuse of reprocessed cooking oil.In this case police reportedlyshut down manufacturers of theillegal product - known as 'gutteroil' - and closed off supply chan-nels.Data on the success of anti-counterfeiting efforts comes asChina tries to show publicly thatit is taking control of the situation.
From October the State Food and Drug Adminis-tration (SFDA) will blacklist manufacturers of fakedrugs as part of the intensified anti-counterfeitingpush.
China Closes 147,000 fake
food and drug sites
Chief Editor : Dr. Aniruddha Malpani, M.D. Oct’ 2012
PTN
On September 13 the New YorkCity Health Department becamethe first in the USA to ban thesale of sugared beverages largerthan 16 oz. at restaurants, mo-bile food carts, sports arenasand movie theaters.It’s a bold experiment in the anti-obesity campaign, and while it’swidely supported by health pro-fessionals, it’s not popular withfood retailers or most city resi-dents.
Improving Patient & Family Health Literacy
1. Phosphoric Acid - Weakens bones and rots teeth
2. Excessive artificial sweeteners makes you crave more
3. Carmel Color - Made from the chemical caramel, is
purely cosmetic, it doesn't add flavour yet is tainted
with carcinogens.
4. Formaldehyde - Carciogen, it is
not added in soda but when you
digest aspartame, it will break
down into 2 amino acids and
menthanol formic acid -
formaldehyde (diet sodas)
5. High Fructose Corn Syrup is a
Concentrated Form of sugar fruc-
tose derived from corn. It in-
creases body fat, cholesterol and
triglycerides and it also makes you
hungry.
6. Potassium Benzoate preservative
that can be broken down to ben-
zene in your body. Keep your soda in the sun and ben-
zene = Carcinogen
7. Food Dyes = impaired brain function, hyperactive be-
havior, difficulty focussing, lack of impulse control.
Side effectS of Soda NY takes Lead
Smile More... Walk More...
Live life More...
Health News 1, 9,11,12 Disease Prevention 2 Editorial 3
Drug Information 4, 5, 6 Disease Information 7,8, 9
Coconut oil attacks the bacteria behind tooth decay andcould be used in dental care products, according to re-search.
Scientists found that coconut oil which had been treatedwith enzymes stopped the growth of Streptococcus bac-teria - a major cause of tooth decay.Tooth decay affects 60% to 90% of children in industri-alized countries.Speaking at the Society for General Microbiology's con-ference, the Irish researchers say that coconut oil alsoattacks the yeast which causes thrush.The research team from the Athlone Institute of Technol-ogy in Ireland tested the impact of coconut oil, vegetableoil and olive oil in their natural states and when treatedwith enzymes, in a process similar to digestion.The oils were then tested against Streptococcus bacteriawhich are common inhabitants of the mouth.Only the enzyme-modified coconut oil showed an abilityto inhibit the growth of most strains of the bacteria.
Many diseases and conditions can be spread through in-adequate hand hygiene as a result of not washing hands.Hands should always be washed:• Before, during, and after preparing food• Before eating food• Before and after caring for someone who is sick• Before and after treating a cut or wound• After using the toilet• After changing diapers or cleaning up a child whohas used the toilet• After blowing your nose, coughing, or sneezing• After touching an animal or animal waste• After handling pet food or pet treats• After touching garbageHand hygiene is critical to interrupt the spread of infec-tious diseases, such as the common cold, influenza, andgastrointestinal illnesses
Monsoon is welcome by all but itcomes with lots of diseases as theimmunity of the body is reduced. Thediseases associated with monsoonare malaria, dengue, Chikungunya,jaundice, gastrointestinal infectionslike typhoid and cholera, said PadmaShri & Dr. B.C. Roy NationalAwardee Dr. KK Aggarwal, Presi-dent, Heart Care Foundation of India.Apart from these, viral infections likecold and cough are also common.Patients with Chikungunya, typicallyhave joint pains, which will get relieved by flexing thelimbs. Dengue, if not adequately managed, can be fatalin 1–4% of cases. Chikungunya, though not fatal, cancause chronic debilitating joint pains lasting for years.Management of dengue involves fluid resuscitation andnot platelet resuscitation. If enough fluids are given, mor-tality can be reduced. The mortality period usually startswhen the fever subsides. Inappropriate misuse of antifever medicines can precipitate bleeding in dengue pa-tients. The water that gets collected due to rain becomes abreeding ground for mosquitoes. Contamination of drink-ing water is common. It is important to drink clean and
pure water to prevent diarrhea andgastrointestinal infections.Walking in dirty water during rainyseason leads to numerous fungalinfections, which affect toes andnails. Diabetic patients have to takecare of infections, which affect toes,and nails. Diabetic patients have totake a special care about their feet.Always keep the feet dry and clean.Avoid walking in dirty water. Keepthe shoes, socks and raincoats dryand clean.
Precautions have to be taken to prevent dampness andgrowth of fungus (mold) on and around the house wereasthmatic patients are living. Avoid fumigation in case ofasthmatic patients. Worms from underground comes to the surface and con-taminate the surface vegetables. In the presence of weakdigestive fire, this can cause gastric disturbances. It is be-cause of this reason that community lunches and mar-riage are prohibited in this season. One should eat light foods. Consuming barley, rice andwheat is good. Water should be boiled before use. Addingginger and green in daily diet is helpful. Eating warm foodis the rule.
COCONUT OIL COULD COMBAT TOOTH DECAY
MoNsooN rEDucEs tHE IMMuNIty of tHE boDy
Hand wasHing
PTN
Social injustice has
everything to do with ill-
nesses. Poverty is the
mother of all diseases
from common cold to
cancer. A child born to a
poor mother will have a
very small hippocampus
major, small pancreas,
small vessels etc making
that child get all killer dis-
eases in the 30s; in addi-
tion, the small
hippocampus unfits the
mind for any intellectual pursuits.
It is not prevention that should be our
motto but health promotion. Disease
is failed health promotion. Prevention
brings in screening in its wake which
promotes disease mongering. Every
human body is built to last as long as
it can, thanks to the immune system.
No one should try to be here for ever,
as s/he will certainly not succeed, doc-
tors and medicines notwithstanding.
The immune system needs boosting
on a regular basis to keep the person
disease free. Modern
medicine is not doing
that. Clean water, air and
food are of vital impor-
tance. One third of the
world population lives on
less than one meal a
day. Nutritional immune
deficiency syndrome
(NIDS) is the biggest
killer of children in poorer
countries, deadlier than
AIDS.
Poverty economics has
to be learnt not in Oxbridge but in the
slums of the poor countries. Then only
one gets the true picture. It is akin to
doing Dictator experiments of John
List in real life situations which
showed that mankind is not altruistic,
unlike the controlled experiments of
the 2002 Nobel winning work of Ver-
non Smith and Daniel Kahneman,
showing humankind to be hard wires
to be altruistic.
The medical profession, like all other
professions, has become homo eco-
nomicus. We, doctors, are not con-
cerned with poverty eradication lest
we should break our own rice bowl!
Doctors can never survive without pa-
tients while patients could survive
without doctors!
Hospitals and doctors have very little
to do with health of the populace.
More doctors and less health has
been the finding of the 14 industri-
alised countries’ study. (JAMA 2000;
284: 483-485) Civil engineers, politi-
cians, social workers, philanthropes,
and the altruistic social organizations
should be able to do something in
keeping the health of the public. Food,
shelter and water with a clean envi-
ronment, coupled with economic em-
powerment and ethical education
should do the trick to keep our im-
mune system at its peak. Will the pow-
ers that be wake up to this reality
please?
Professor BM Hegde,
Padmabhushan Awardee’2010
Health Literacy is a bridge from
illness to wellness. Leaps in
medical advances has left the
common man far behind. He
seems lost in the maze of com-
plex medical terms and sys-
tems.Why is he unable to
understand the names of dis-
eases and medical conditions
and associated issues which af-
flict him? These so-called ‘com-
plexities’ come in way of of his
receiving high quality medical
care or to simply look after his
general wellbeing. We cannot
assume that he is not inter-
ested in being healthy. The
answer is simple – there is a
severe shortage of the best
medicine called Health Liter-
acy. Studies have shown that
around 50% of the world’s
population is ‘health illiterate’.
This means that one out of 2
persons is unable to obtain,
process, understand and to
use that information to make
good decisions about his
health and medical care.
Editor’s
Desk
Dr. Aniruddha Malpani, M.D.
Founder Director,
Health Education Library for
People (HELP)
SubSCRIbE TODAYfor 12 Issues Just Rs. 100 Soft Copy by email
Rs. 150 for Hard Copy including postage
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A difference is only A differenceif it mAkes A difference.
“Literacy is a bridge from misery tohope.- ― Kofi Annan
PTN
Instructions or counseling for the patient prescribed withTablet Ofloxacin. OfloxacinType of medicine: Fluoroquinolone antibioticUse: Used to treat certain infections that are caused bybacteria. It works by killing the bacteria which cause theinfection. Infections includes chest/lungs, urinary-tractand skin infections.before taking ofloxacinBefore taking ofloxacin make sure your doctor knows:• If you are pregnant, trying for a baby or breast-feed-
ing.• If you have ever experienced tendon (a tissue that
connects muscle to bone) problems after taking anyother quinolone antibiotic such as ciprofloxacin, lev-ofloxacin, moxifloxacin, nalidixic acid or norfloxacin.
• If you have a history of kidney or liver disease.• If you have a history of diabetes or heart diseases• If you have a history of epilepsy/seizure.• If you have ever had mental health problems.• If you have myasthenia gravis (a muscle weakening
disease).• If you know you have glucose 6-phosphate dehydro-
genase (G6PD) deficiency.• If you are taking other medicines, including those
available to buy without a prescription, herbal andcomplementary medicines.
• If you have ever had an allergic reaction to this or anyother medicine.
How to take ofloxacin• Take ofloxacin exactly as prescribed by your doctor.
It is usually taken once or twice a day depending onthe infection being treated.
• If you have been told to take ofloxacin twice a day,space your doses out evenly throughout the day.
• You may take this medicine with or without food. • Keep taking this antibiotic until the course is finished
unless you are told to stop. This is important in orderto prevent the infection from coming back.
• Do not take indigestion remedies (antacids) or med-icines containing iron or zinc, in the 2 hours before orafter you take ofloxacin. This is because they inter-fere with the way ofloxacin is absorbed by your bodyand stop it from working fully.
• Drink extra fluids so you will pass more urine whileyou are using this medicine. This will keep your kid-neys working well and help prevent kidney problems.
• If you forget to take a dose, take it as soon as you re-member and then continue as before. Do not taketwo doses together to make up for a forgotten dose.
Getting the most from your treatment• Do not take non-steroidal anti-inflammatory
painkillers (NSAIDs) such as ibuprofen while you arebeing treated with ofloxacin.
• Ofloxacin may cause your skin to become more sen-sitive to sunlight than normal. Protect your skin par-ticularly if you are exposed to strong sunlight for longperiods during the day.
• Ofloxacin may impair your ability to concentrate.Make sure your reactions are normal before driving,operating machinery or doing other jobs which couldbe dangerous if you were not sufficiently alert.
• If you have diabetes, you may need to check yourblood glucose levels more regularly as ofloxacin mayaffect the levels of sugar in your blood.
• If you still feel unwell after completing your course ofthis antibiotic, make another appointment to see yourdoctor.
• Some people develop thrush (redness and itching inthe mouth or vagina) after taking a course of antibi-otics. If you think you have thrush, speak with yourdoctor.
Possible Side Effects While using Ofloxacin:Along with their useful effects, most medicines can
cause unwanted side-effects although not everyoneexperiences them. These usually improve as yourbody adjusts to the new medicine, but speak withyour doctor if any of the following side-effects con-tinue or become troublesome.
Important Note: If you develop any of the following raresymptoms, contact your doctor for advice straight away:• Swelling of your tongue, mouth or face or any prob-
lems with your breathing.• A severe rash.• Pain or inflammation in your joints (particularly in your
hips, knees or ankles).If you experience any other symptoms which you thinkmay be due to this medicine, speak with your doctor andseek advice.How to store ofloxacin• Keep all medicines out of the reach and sight of chil-
dren.• Store in a cool, dry place, away from direct heat and
light.
Side-effects - these affect less than 1 in 100 peo-
ple who take this medicine
Feeling or being sick, indigestion, abdominal pain
Diarrhoea
Headache
Dizziness
Difficulty in sleeping, eye irritation, cough and skin
itchiness
What can I do if I experience this
Eat little and often. Stick to simple or bland foods
Drink plenty of water to replace lost fluids. If the diar-
rhoea is severe or continues to be a problem, speak
with your doctor
Try to manage with a suitable painkiller. If the
headache continues, speak with your doctor
If affected, do not drive or operate machinery
If any of these become troublesome, speak with your
doctor
Drug Information Ofloxacin
Reference:1. www.thomsonhc.com, Micromedex (R) 2.0, 2002-
2012, Thomson Reuters (Healthcare) Inc.2. http://www.cimsasia.com/3. Product Information: FLOXIN(R) oral tablets,
ofloxacin oral tablets. Ortho-McNeil, Raritan, NJ,2011.
Attended by: Samson P.G., Drug Information Pharma-cist, DIRC, KSPCDisclaimer: Information provided by the center is authen-tic and should be used judiciously by the healthcare pro-fessionals only. The center will not accept anyresponsibility of liability arising on using the provided in-formation and it rests entirely on the user.
Karnataka State Pharmacy Council Drug Information & Research Centre514/E, I Main, II Stage, Vijayanagar Club Road, Bangalore – 560 104 PH: 23383142; 23404000,9900032640 Fax: 23202345
E-mail: [email protected]; Web: www. karnatakadruginfo.com
f you've ever been treated for severe painfrom surgery, an injury, or an illness, youknow just how vital pain relief medicationscan be.Pain relief treatments come in manyforms and potencies, are available byprescription or over-the-counter (OTC),and treat all sorts of physical pain—in-cluding that brought on by chronic condi-tions, sudden trauma, and cancer.Pain relief medicines (also known as"analgesics" and "painkillers") are regu-lated by the Food and Drug Administra-tion (FDA). Some analgesics, includingopioid analgesics, act on the body's pe-ripheral and central nervous systems toblock or decrease sensitivity to pain. Oth-ers act by inhibiting the formation of cer-tain chemicals in the body.Among the factors health care profes-sionals consider in recommending or pre-scribing them are the cause and severityof the pain.TYPES OF PAIN RELIEVERSOTC MedicationsThese relieve the minor aches and painsassociated with conditions such asheadaches, fever, colds, flu, arthritis,toothaches, and menstrual cramps.There are basically two types of OTC pain relievers:acetaminophen and non-steroidal anti-inflammatorydrugs (NSAIDs).Acetaminophen is an active ingredient found in morethan 600 OTC and prescription medicines, includingpain relievers, cough suppressants, and cold medica-tions.NSAIDs are common medications used to relieve feverand minor aches and pains. They include aspirin,naproxen, and ibuprofen, as well as many medicinestaken for colds, sinus pressure, and allergies. They actby inhibiting an enzyme that helps make a specificchemical.Prescription MedicationsTypical prescription pain relief medicines include opioidsand non-opioid medications.Derived from opium, opioid drugs are very powerfulproducts. They act by attaching to a specific "receptor"in the brain, spinal cord, and gastrointestinal tract. Opi-oids can change the way a person experiences pain.Types of prescription opioid medications include• morphine, which is often used before and after sur-
gical procedures to alleviate severe pain• oxycodone, which is also often prescribed for mod-
erate to severe pain• codeine, which comes in combination with acetamin-
ophen or other non-opioid pain relief medications andis often prescribed for mild to moderate pain
• hydrocodone, which comes in combination with acet-aminophen or other non-opioid pain relief medica-tions and is prescribed for moderate to moderatelysevere pain
FDA has recently notified makers of certain opioid drugsthat these products will need to have a Risk Evaluationand Mitigation Strategy (REMS) to ensure that the ben-efits continue to outweigh the risks.Affected opioid drugs, which include brand name andgeneric products, are formulated with the active ingre-dients fentanyl, hydromorphone, methadone, morphine,oxycodone, and oxymorphone.FDA has authority to require a REMS under the Foodand Drug Administration Amendments Act of 2007.Types of non-opioid prescription medications includeibuprofen and diclofenac, which treat mild to moderatepain. uSE AS DIRECTEDPain medications are safe and effective when used asdirected. However, misuse of these products can be ex-tremely harmful and even deadly.
A Guide to SAfe uSe of PAin Medicine
PTN
Consumers who take pain relief medications must fol-low their health care professional's instructions carefully.If a measuring tool is provided with your medicine, useit as directed.Do not change the dose of your pain relief medicationwithout talking to your doctor first.Also, pain medications should never be shared withanyone else. Only your health care professional can de-cide if a prescription pain medication is safe for some-one.Here are other key points to remember.With acetaminophen (Paracetamol) :• Taking a higher dose than recommended will not
provide more relief and can be dangerous.• Too much can lead to liver damage and death. Risk
for liver damage may be increased in people whodrink three or more alcoholic beverages a day whileusing acetaminophen-containing medicines.
• Be cautious when giving acetaminophen to children.Infant drop medications can be significantly strongerthan regular children's medications. Read and followthe directions on the label every time you use a med-icine. Be sure that your infant is getting the infants'pain formula and your older child is getting the chil-dren's pain formula.
With NSAIDs:• Too much can cause stomach bleeding. This risk in-
creases in people who are over 60 years of age, aretaking prescription blood thinners, are takingsteroids, have a history of stomach bleeding or ul-cers, and/or have other bleeding problems.
• Use of NSAIDs can also cause kidney damage. Thisrisk may increase in people who are over 60 yearsof age, are taking a diuretic (a drug that increasesthe excretion of urine), have high blood pressure,heart disease, or pre-existing kidney disease.
With opioids:• Use of opioids can lead to drowsiness. Do not drive
or use any machinery that may injure you, es-pecially when you first start the medication.
• The dose of an opioid painmedication that issafe for youcould be highenough tocause an over-dose and death insomeone else, es-pecially children.
KNOW THE ACTIVE IN-GREDIENTSA specific area of con-cern with OTC painmedicines is whenproducts sold fordifferent uses havethe same active in-gredient. A coldand cough remedymay have thesame active ingredi-ent as a headacheremedy or a prescrip-tion pain reliever.To minimize the risks ofan accidental overdose,consumers should avoid tak-ing multiple medications withthe same active ingredient at the
same time.All OTC medicines must have all of their active ingredi-ents listed on the package. For prescription drugs, theactive ingredients are listed on the container label.Talk with your pharmacist or another health care profes-sional if you have questions about using OTC medi-cines, and especially before using them in combinationwith dietary supplements or other OTC or prescriptionmedicines.MISuSE AND AbuSEMisuse and abuse of pain medications can be extremelydangerous. This is especially so in regard to opioids.These medications should be stored in a place wherethey cannot be stolen.According to the National Institutes of Health, studieshave shown that properly managed medical use of opi-oid analgesic compounds (taken exactly as prescribed)is safe, can manage pain effectively, and rarely causesaddiction.But the abuse of opioids is a significant public safetyconcern. Abusers ingest these drugs orally, and alsocrush the pills in order to snort or inject them.Commonly abused opioid pain medicines include pre-scription drugs such as codeine, and the brand-nameproducts Oxycontin (oxycodone), Vicodin (hydrocodone
with acetaminophen),and Demerol
(meperidine).Addiction isjust one seri-
ous danger ofopioid abuse. Anumber of over-dose deathshave resultedfrom snorting
and injecting opi-oids, particularly
the drug OxyCon-tin, which was designed tobe a slow-release formula-tion.
uSE OPIOIDS SAFELY: 3KEY STEPS
1. Keep your doctor informed.Inform your health care profes-
sional about any past history ofsubstance abuse. All patients
treated with opioids for pain requirecareful monitoring by their health care
professional for signs of abuse and addic-tion, and to determine when these analgesics
are no longer needed.2. Follow directions carefully. Opioids are associ-ated with significant side effects, including drowsi-ness, constipation, and depressed breathingdepending on the amount taken. Taking too much
could cause severe respiratory depression ordeath. Do not crush or break pills. This can alter
the rate at which the medication is absorbedand lead to overdose and death.3. Reduce the risk of drug interac-tions. Don't mix opioids with alcohol, anti-histamines, barbiturates, orbenzodiazepines. All of these sub-stances slow breathing and their com-bined effects could lead tolife-threatening respiratory depres-sion. P
TN
Causes, incidence,
and risk factors
Atopic dermatitis is
due to a hypersensitivity reac-
tion (similar to an allergy) in
the skin, which leads to long-
term swelling and redness (in-
flammation) of the skin.
People with atopic dermititis
may lack certain proteins in
the skin, which leads to
greater sensitivity.
Atopic dermatitis is most com-
mon in infants. It may start as
early as age 2 to 6 months.
Many people outgrow it by
early adulthood.
People with atopic dermatitis
often have asthma or sea-
sonal allergies. There is often
a family history of allergic con-
ditions such as asthma, hay
fever, or eczema. People with
atopic dermatitis often test
positive to allergy skin tests.
However, atopic dermatitis is
not caused by allergies. The condition tends to get worse
when the person is exposed to certain triggers.
The following can make atopic dermatitis symptoms
worse:
• Allergies to pollen, mold, dust mites, or animals
• Cold and dry air in the winter
• Colds or the flu
• Contact with irritants and chemicals
• Contact with rough materials, such as wool
• Dry skin
• Emotions and stress
• Exposure to too much water, such as taking too many
baths or showers and swimming too often
• Feeling too hot or too cold, as well as sudden temper-
ature changes
• Fragrances or dyes added to skin lotions or soaps
Symptoms
Typical skin changes may include:
• Blisters with oozing and crusting
• Dry skin all over the body or areas of bumpy skin on the
back of the arms and front of the thighs
• Ear discharge or bleeding
• Raw areas of the skin from scratching
• Skin coloring changes -- more or less color than the nor-
mal skin tone (See: Skin abnormally dark or light)
• Skin redness or inflammation around the blisters
• Thickened or leather-like areas, called lichenification,
which can occur after long-term irritation and scratch-
ing
Both the type of rash and where the rash appears can de-
pend on the age of the patient:
• In children younger than age 2, skin lesions begin on
the face, scalp, hands, and feet. They are often crust-
ing, bubbling, or oozing rashes that itch.
• In older children and adults, the rash is more commonly
seen on the inside of the knees and elbows, as well as
the neck, hands, and feet.
• During a severe outbreak, rashes may occur anywhere
on the body.
Itching, which is sometimes intense, almost always occurs.
Itching may start even before the rash appears. Atopic der-
matitis is often called the "itch that rashes" because the
itching starts, and then
the skin rash appears
from the scratching.
Signs and tests
A physical exam will be done.
A skin biopsy can be done to
confirm the diagnosis or rule
out other causes of dry, itchy
skin.
Diagnosis is based on the:
• Appearance of the
skin
• Personal and family
history
Allergy skin testing may be
helpful for people with:
• Hard-to-treat atopic
dermatitis
• Other allergy symp-
toms
• Skin rashes that form
only on certain areas of the
body after exposure to a spe-
cific chemical
SKIN CARE AT HOME
Taking care of your skin at
home may reduce the need for medications.
Avoid scratching the rash or skin:
• Relieve the itch by using a moisturizer, topical steroid
cream, or other prescribed cream and taking antihista-
mines to reduce severe itching.
• Keep your child's fingernails cut short. Consider light
gloves if nighttime scratching is a problem.
Keep the skin moist (called lubricating or moisturizing the
skin). Use ointments (such as petroleum jelly), creams, or
lotions 2 - 3 times a day. Moisturizers should be free of al-
cohol, scents, dyes, fragrances, or other chemicals. A hu-
midifier in the home will also help.
Avoid anything that makes your symptoms worse. This
may include:
• Foods such as eggs in a very young child (always dis-
cuss with your doctor first)
• Irritants such as wool and lanolin
• Strong soaps or detergents, as well as chemicals and
solvents
• Sudden changes in body temperature and stress, which
may cause sweating and worsen the condition
• Triggers that cause allergy symptoms
When washing or bathing:
• Keep water contact as brief as possible and use gentle
body washes and cleansers instead of regular soaps.
Short, cooler baths are better then long, hot baths.
• Do not scrub or dry the skin too hard or for too long.
• After bathing, it is important to apply lubricating creams,
lotions, or ointment on the skin while it is damp. This will
help trap moisture in the skin.
Complications
• Infections of the skin caused by bacteria, fungi, or
viruses
• Permanent scars
Prevention
Studies have shown that children who are breast-fed until
age 4 months are less likely to get atopic dermatitis.
If the child is not breast-fed, using a formula that contains
processed cow milk protein (called partially hydrolyzed for-
mula) may decrease the chances of developing atopic der-
matitis.
ATOPIC DERMATITIS
PTN
Diabetes can harm your eyes. It can damage the smallblood vessels in your retina, the back part of your eye.This is called diabetic retinopathy. Diabetes also in-creases your risk of having glaucoma, cataracts, andother eye problems.You may not know there is any damage to your eyes untilthe problem is very bad. Your doctor can catch problemsearly if you get regular eye exams.If your doctor finds eye problems early, drugs and othertreatments may help prevent them from getting worse.You Need Regular Eye ExamsEvery year, you should have an eye exam by an eyedoctor. Choose an eye doctor who takes care of peoplewith diabetes.The eye exam may include:• Dilating your eyes to allow a good view of the entire
retina. Only an eye doctor can do this exam.• At times, special photographs of the back of your
eyeYour eye doctor may ask you to come more or less oftenthan every year.How to Prevent Eye ProblemsControl your blood sugar levels. High blood sugars in-crease your risk of having eye problems.Control your blood pressure. Blood pressure less than
130/80 is a good goal for people with diabetes.• Have your blood pressure checked often and at
least twice per year.• If you take drugs to control your blood pressure, take
them as your doctor told you to.
Do not smoke. If youneed help quitting, ask
your doctor or nurse.If you already have eye prob-
lems, ask your doctor if youshould avoid some exercises that can strain the bloodvessels in your eyes. These exercises may make eyeproblems worse:• Weight lifting and other exercises that make you
strain• High-impact exercise, such as football or hockeyMake It Easier for Yourself at HomeMake sure your home is safe from falls.If you cannot read the labels on your medicines easily,these tips might help you make sure you are taking thecorrect medicine and the correct dose:• Use felt tip pens to label medicine bottles so you can
read them easily.• Use rubber bands or clips to tell them apart.• Ask someone else to give you your medicines.• Always read labels with a magnifying lens.• Use a pill box with compartments for days of the
week and times of the day, if you need to take med-icines more than once a day.
Never guess when taking your medicines. If you are un-sure of your doses, talk with your doctor, nurse, or phar-macist.Keep medicines and other household items organizedin a cabinet so you know where they are.Use large-print cookbooks to make foods that are onyour diabetes meal plan. Ask your doctor or nurse whereyou can get these books.When to Call the DoctorCall your doctor if:• You cannot see well in dim light.• You have blind spots.• You have double vision (you see 2 things when
there is only 1).• Your vision is hazy or blurry and you cannot focus.• You have pain in your eyes.• You are having headaches.• You see spots floating in your eyes.• You cannot see things on the side of your field of vi-
sion.• You see shadows.
Diabetes - eye care
PTN
Gingivitis is inflammation of the gums. CausesGingivitis is a form of periodontal disease. Periodontaldisease is inflammation and infection that destroys thetissues that support the teeth, including the gums, theperiodontal ligaments, andthe tooth sockets (alveolarbone).Gingivitis is due to the long-term effects of plaque de-posits on your teeth. Plaqueis a sticky material made ofbacteria, mucus, and food debris that develops on theexposed parts of the teeth. It is a major cause of toothdecay.If you do not remove plaque, it turns into a hard depositcalled tartar (or calculus) that becomes trapped at thebase of the tooth. Plaque and tartar irritate and inflamethe gums. Bacteria and the toxins they produce causethe gums to become infected, swollen, and tender.The following raise your risk for gingivitis:
• Certain infections and body-wide (systemic) diseases• Poor dental hygiene• Pregnancy (hormonal changes increase the sensitiv-ity of the gums)• Uncontrolled diabetes
• Misaligned teeth,rough edges of fillings, and ill-fitting or unclean mouth appli-ances (such as braces,dentures, bridges, andcrowns) Use of certain med-ications, including phenytoin,
bismuth, and some birth control pillsMany people have some amount of gingivitis. It usuallydevelops during puberty or early adulthood due to hor-monal changes. It may persist or recur frequently, de-pending on the health of your teeth and gums.Symptoms• Bleeding gums (blood on toothbrush even with gentlebrushing of the teeth)• Bright red or red-purple appearance to gums
GinGivitis
At first sight, they pass off as just security guards at a hos-
pital but their strong builtand tough looks indicate that they
are bouncers kept to ward off agitated people.
These guards are stationed in key areas of the Deen
Dayal Upadhyay Hospital from emergency tolabour room
to casualty ward and one would think twice before picking
up an argument with them.
Plagued by physical attacks on doctors by agitated rela-
tives of patients, the administrators of the hospital have
hit upon the idea to protect doctors.
Such “well-built yet polite” people are on guard with the
primary objective of saving doctors who are often at the
receiving end.
Authorities at the Delhi Government-run hospital justify
the move to resort to such a step to save the doctors from
being attacked by the kith and kin of the patients and pre-
vent professionals from going on a strike.
New Delhi: The World Health Organization’sIndia representative Dr Nata Menabde hasexpressed the need for regulating India’sprivate healthcare sector represented byfive star hospitals.“The private sector in India is represented
by five star hospitals. Their services need tobe regulated,” Dr Menabde has said,adding, “over-diagnosis” in private hospitals
is a problem and so is “misuse of technol-ogy”.Dr Menabde has also supported the wideradoption of the Clinical Establishment Reg-istration Act passed by Parliament in 2010.Only four of the states and union territories(UTs) have ratified the law so far. [Source:BS]
Delhi DDU hospital appoints bouncers to protect doctors
India’s ’5-star’ private hospitals should be regulated: WHO
• Gums that are tender when touched, but otherwisepainless• Mouth sores• Swollen gums• Shiny appearance to gumsExams and TestsThe dentist will examine your mouth and teeth and lookfor soft, swollen, red-purple gums.The gums are usually painless or mildly tender.Plaque and tartar may be seen at the base of the teeth.The dentist will use a probe to closely examine yourgums to determine if you have gingivitis or periodontis. No further testing is usually necessary. However, dentalx-rays may be done to see if the disease has spread tothe supporting structures of the teeth.TreatmentThe goal is to reduce inflammation.The dentist or dental hygienist will clean your teeth. Themay use different tools to loosen and remove depositsfrom the teeth.Careful oral hygiene is necessary after professional toothcleaning. The dentist or hygienist will show you how tobrush and floss.Professional tooth cleaning inaddition to brushing and floss-ing may be recommendedtwice per year or more fre-quently for severe cases ofgum disease.Antibacterial mouth rinses orother aids may be also be rec-ommended.Repair of misaligned teeth orreplacement of dental and or-thodontic appliances may berecommended.Any other related illnesses or conditions should betreated.Outlook (Prognosis)Some people have discomfort when plaque and tartarare removed from the teeth. Bleeding and tenderness of the gums should lessen
within 1 or 2 weeks after professional cleaning and careful oral hygiene.Warm salt water or antibacterial rinses can reduce gumswelling. Over-the-counter anti-inflammatory medicationsmay also be helpful.Healthy gums look pink and firm. Strict oral hygiene mustbe maintained for your whole life, or gum disease willrecur.Possible Complications• Gingivitis returns• Periodontitis• Infection or abscess of the gums or the jaw bones• Trench mouthWhen to Contact a Medical ProfessionalCall your dentist if you have red, swollen gums, espe-cially if you have not had a routine cleaning and exami-nation in the last 6 months.PreventionGood oral hygiene is the best way to prevent gingivitis.You should brush your teeth at least twice a day. Youshould floss at least once a day.Your dentist may recommend brushing and flossing after
every meal and at bedtime. Askyour dentist or dental hygienist toshow you how to properly brushand floss your teeth.Special devices may be recom-mended if you are prone toplaque deposits. They includespecial toothpicks, toothbrushes,water irrigation, or other devices.You still must brush and flossyour teeth regularly.Antiplaque or antitartar tooth-pastes or mouth rinses may alsobe recommended.
Regular professional tooth cleaning is important to re-move plaque that may develop even with careful brush-ing and flossing. Many dentists recommend having theteeth professionally cleaned at least every 6 months.Alternative NamesGum disease; Periodontal diseas P
TN
Because of lack of awareness. Demand for quality
healthcare should come from consumers. We need a
campaign on similar lines of "Jago Grahak Jago".
Accreditation is beneficial for everybody because it
provides:
A strong focus on:
• Patient rights and benefits
• Patient safety
• Control and prevention of infections, med-
icine errors
• Practicing good patient-care protocols e.g.
special care for vulnerable groups, criti-
cally ill patients
• Better and controlled clinical outcome
benefits For Patients:
• High quality of care
• Rights are respected and protected
• Understandable education and communication
• Patient satisfaction is evaluated
• Informed choice through counselling and the care
process and maintain confidentiality
• Focus on patient safety
• Care of vulnerable patient
• Continuity of care
benefits For the Staff:
• Improves professional staff development
• Provides education on consensus standards
• Provides leadership for quality improve-
ment within medicine and nursing
• Increases satisfaction with continuous
learning, good working environment, leader-
ship and ownership
benefits For the Health Care Organisa-
tion:
• Improves care and brings in Corporate
Governance
• Stimulates continuous improvement
• Demonstrates commitment to quality care
• Opportunity to benchmark with the best
Dr Gayatri Vyas Mahindroo Ms Mch
Director, National Accreditation Board for Hospitals and
Healthcare Providers (NABH), which is a constituent
board of Quality Council of India (QCI), New Delhi.
Amid concerns over rampant use of antibiotics and
resistance developed towards them, government is
set to restrict over-the-counter sale of 91 such new
generation drugs through a notification which is likely
soon.
The notification in this regard is in final stages with
the Drug Controller General of India (DCGI) writing
to the Union Health Ministry, which, in turn, will send
it to the Law ministry for its nod, a Health Ministry of-
ficial said.
"The classification of 91 new generation antibiotics
will be labelled 'Rx' in red and also prominently dis-
play warnings that the drug is not to be administered
without medical advice," the official said.
He, however, said such a notification is likely after the
current monsoon session of Parliament.
The Schedule H-1 drugs will prominently carry a
warning "it is dangerous to take this preparation ex-
cept in accordance with medical advice" in red colour
on the left corner, along with another advice of "not
to be sold by retail without the prescription of a regis-
tered medical practitioner".
The Drug Controller General of India has already writ-
ten to all state drug controllers for strengthening of
regulatory control at retail sale outlets to ensure drugs
are dispensed by retail chemists in compliance to the
provisions of the Drugs and Cosmetics Rules.
The DCGI directive also seeks to ensure that drug in-
spectors make surprise checks on chemists in their
areas so that restricted Schedule X and Schedule H
drugs are not sold without medical prescription.
Patient access to physician notes can boost patientengagement, understanding and adherence to theircare plans, according to a study published in Annalsof Internal Medicine. For the study, researchers surveyed 105 primary carephysicians and 13,564 patients who had access totheir physicians' notes via an electronic portal over aone-year period. Of the 5,391 patients who reviewedat least one note and completed the survey, up to 87percent reported that the open notes program madethem feel more in control of their care, and up to 78percent reported increased adherence to medications.Nearly all (99 percent) of the patients who respondedfelt that the program should continue, but approxi-mately one-third expressed concerns aboutprivay. Physicians initially voiced concerns that open noteswould increase their work load or worry and/or offendpatients; however, those concerns never materialized.When asked to describe the most difficult aspect of theopen notes program, 74 percent of the 104 physicianswho responded said that nothing was difficult and thatthey experienced no changes in their practice.
As the largest international organization of surgeons, TheAmerican College of Surgeons is dedicated to improvingthe care of the surgical patient. This “Surgical Patient Education” website contains edu-cational information to help you and your families becomeinformed about your operation and surgical care. Hereyou will find current information about surgical proce-dures, diseases, tests, and medications from governmentand professional sources to support you in participatingin your surgical care.
DCGI-To ConTrol oTC
sales of anTIbIoTICs
Why not many hospitals are optingfor nABH accreditation?
PATIENT & DOCTOR NOTES
American College of SurgeonsLaunches Patient Education Website
Jago Grahak Jago
bILIRubINAlternate Names• Total Bilirubin• TBIL• Neonatal Bilirubin• Direct Bilirubin (Conjugated Biliru-bin)• Indirect Bilirubin (UnconjugatedBilirubin)Bilirubin is a component of bile, which isproduced by the liver, and necessary forthe normal digestion of food. Jaundice iscaused by high bilirubin levels in the blood,which can lead to brain damage if un-treated. Bilirubin blood levels are used todiagnose gallbladder disease, liver dis-ease, anemias, blood infection, transfusionreaction, or hemolytic disease of the new-born (where red blood cells are destroyed).
Cholesterol is a soft, wax-like substance found in allparts of the body. Your body needs a little bit of choles-terol to work properly. But too much cholesterol can clogyour arteries and lead to heart disease.Some cholesterol is considered "good" and some is con-sidered "bad." Different blood tests can be done to indi-vidually measure each type of cholesterol.Total Cholesterol
A total cholesterol test meas-ures all types of cholesterol inyour blood. The results of thistest tells your doctor whetheryour cholesterol is too high.• Best: lower than 200• Borderline high: 200 -239• High: 240 and higherIf your total cholesterol levelsare high, your doctor will wantto know your LDL cholesteroland HDL cholesterol levels be-fore deciding whether you needtreatment.Knowing your LDL and HDLcholesterol levels will also helpguide your doctor to choose thebest drug for you.LDL (Bad) CholesterolLDL stands for low-density lipoprotein. It's also some-times called "bad" cholesterol. Lipoproteins are made offat and protein. They carry cholesterol, triglycerides, andother fats, called lipids, in the blood to various parts ofthe body. LDL can clog your arteries.Your LDL level is what doctors watch most closely. Youwant your LDL to be low. Too much LDL, commonlycalled "bad cholesterol," is linked to cardiovascular dis-ease. If it gets too high, you will need treatment.A healthy LDL level is one that falls in the best or near-best range.Best: Less than 100 mg/dL (less than 70 mg/dL for per-sons with a history of heart disease or those at very highrisk)
Near Best: 100 - 129 mg/dLBorderline High: 130 - 159 mg/dLHigh: 160 - 189 mg/dLVery High: 190 mg/dL and higherHDL (Good) CholesterolHDL stands for high-density lipoprotein. It's also some-times called "good" cholesterol. Lipoproteins are madeof fat and protein. They carry cholesterol, triglycerides,
and other fats, called lipids, inthe blood from other parts ofyour body to your liver.You want your HDL cholesterolto be high. Studies of both menand women have shown that thehigher your HDL, the lower yourrisk of coronary artery disease.This is why HDL is sometimesreferred to as "good" cholesterol.A healthy HDL level should beas follows:• Men: above 40 mg/dL• Women: above 50 mg/dLAn HDL 60 mg/dL or abovehelps protect against heart dis-ease. Exercise helps raise yourHDL cholesterol.VLDL CholesterolVLDL stands for very low density
lipoprotein. There are three major types of lipoproteins.VLDL contains the highest amount of triglycerides. VLDLis considered a type of bad cholesterol, because it helpscholesterol build up on the walls of arteries.A normal VLDL cholesterol level is between 5 and 40mg/dL.ConsiderationsSometimes, your cholesterol levels may be low enoughthat your doctor will not ask you to change your diet ortake any medications.When your levels are high, your doctor must considerother factors before deciding whether your cholesterollevels are a concern and need treatment.
SOURCE—MEDLINEPLUS
Understanding cholesterol
KNOW YOUR LAB TEST
Printed and Published by V.bHAVA NARAYANA for PHARMED TRADE NEWS, 3-3-62/A, New Gokhale Nagar, Ramantapur, Hyderabad - 500013, Edited by Dr.Anirudhha Malpani MD and Printed at Sai Likhita Printers, Lakdikapool, Hyderabad.
New Delhi: In a bid to reduce healthcare costs, the unionhealth ministry plans to bring in a legislation to make itmandatory for doctors to prescribe generic medicines.Sources from the ministry say a bill is already beingdrafted to push low-cost medicine, along with an ambi-tious plan to provide freemedicine to all."The out-of-pocket ex-pense on healthcare istoo high. Generic medi-cine will ensure that it isaffordable," an officialfrom the ministry said."A bill is being drafted, itwill make sure that a listof generic medicinesand combination drugsare available in all dis-tricts, and it is pre-scribed by doctors," theofficial said.The official said that thebill would ensure thatboth generic andbranded medicines areavailable on sale side byside."The aim is not to bringan end to branded med-icine. They shall exist side by side. Out-of-pocket expen-diture for healthcare is 78 per cent of total expenditureon healthcare. Generic medicine would reduce the bur-den on the common man," he said.
The official, however, cautioned that there would beneed for strict monitoring and stringent quality control.An ambitious programme for providing free generic med-icines to the economically weaker sections has alreadybeen finalised, and is likely to be implemented by the
year-end.As per data availablewith the ministry, thegovernment currentlyspends only 0.1 percent of GDP on pur-chase and supply ofmedicine through publichealth centres.Though India is one ofthe world's largest ex-porters of genericdrugs, its domestic mar-ket for generic drugs issmall. India exports toover 200 countries, in-cluding the highly regu-lated markets of the US,Europe, Japan and Aus-tralia.Common medicines likeparacetamol cost Rs 10a strip when branded,while the generic variety
costs around Rs 2.45 per strip.At present, the government has a list of nearly 350 med-icines for which generic varieties will be made available.[Source: IANS]
HealtH ministry pusHes for
generic medicines
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