Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                             Dated:1st August,2019

Vaccines are not just for children
Vaccines are not just for children; during National Immunization Awareness Month in August, the American College of Physicians (ACP) is reminding adults about the importance of vaccinations for protection against many common and serious diseases.

“Many adults are not aware that they need vaccines throughout their lives and so have not received recommended vaccinations,” said ACP President Robert M. McLean, MD, FACP. “Adults should get a seasonal flu shot and internists should use that opportunity to make sure their patients are up to date on the latest recommended immunizations.”

“Physicians should conduct a vaccine needs assessment with their patients regularly. People who cannot get a flu shot or other vaccines for medical reasons should talk to their internist about other ways of protecting themselves” Dr McLean said.

In addition to an annual influenza vaccination, other important adult immunizations includeTdapto protect against tetanus, diphtheria and pertussis (whooping cough);pneumococcal to protect against pneumococcal pneumonia, bacteremia and meningitis;HPV to prevent cervical, anal and other cancers; hepatitis Bandherpes zosterto help prevent shingles… (ACP, July 30, 2019)

Bee Sting bite
Large local reactions

Approximately 10 percent of individuals develop exaggerated redness and swelling at the site of the sting that gradually enlarges over one to two days

This response is called a large local reaction (LLR). LLRs peak at approximately 48 hours and then gradually resolve over 5 to 10 days. The area of swelling typically measures about 10 cm in diameter

1. Cold compresses are soothing acutely. The limb should be elevated if the sting is on an extremity.

2. Oral prednisone 40 to 60 mg given as a single dose or rapidly tapered over two to five days may help reduce significant swelling.

3. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain.

4. Pruritus can be treated with oral antihistamines (eg, cetirizine, 10 mg once daily) and high potency topical corticosteroids (eg, fluocinonide 0.05 percent or clobetasol 0.05 percent ointment, applied every four hours) until the itching subsides.

5. A tetanus booster is not necessary following a sting unless there was a concomitant soil-contaminated injury.

Vedic description of insomnia: Insomnia maybe a symptom of suicidal ideation (Part 2)
There can be several reasons for insomnia.

The best description of the causes and treatment of insomnia comes from Vidura Niti, a dialogue (samvad) between Vidura and Dhritarashtra.

In the text, King Dhritarashtra said: “O Vidura, Sanjaya has come back. He has gone away after rebuking me. Tomorrow he will deliver, in the midst of the court, Ajatashatru’s message. I have not been able today to ascertain what the message is of the Kuru hero. Therefore, my body is burning, and that has produced sleeplessness. Tell us what may be good for a person that is sleepless and burning.”....read more

How long can one fast?
As per Allopathy, one cannot live without air or oxygen for more than 3 minutes, without water for more than three days and without food for more than 3 weeks.

According to the Chandogya Upanishad, food is responsible for the making of motor organs (Karmaindriyas), sensory organs, Manas (mind, intellect, memory and ego) and Prana......read more

Healthcare News Monitor

Dengue scare in city requires utmost care: Experts
The Times of India- Joyeeta Chakravorty

With close 4,000 positive dengue cases reported within BBMP limits alone in the past few weeks and 2,192 others across Karnataka, the state government and health experts are now putting the focus squarely on prevention, rather than cure. Minimise exposure to mosquito bites: “It is better to minimise exposed skin. Also, wear light-coloured long-sleeved shirts and full-length pants. Mosquitoes are drawn to dark colours, floral patterns and sweet perfumes, so, avoid these. Use environmental protection agency-registered insect repellents that contain DEET, picaridin, oil of lemon eucalyptus or IR3535. Use insect repellent with up to 20% -35% of the chemical DEET, as higher concentrations more can cause skin irritation,” advises Dr KK Aggarwal.

Provide requisite training to bike ambulance riders, HC tells Delhi govt
ET Healthworld-PTI

New Delhi: The Delhi High Court Tuesday asked the AAP government to provide requisite training to paramedics who would be riding bike-ambulances or First Responder Vehicles (FRVs) in the congested areas. With the direction a bench of Chief Justice D N Patel and Justice C Hari Shankar disposed of a plea opposing the Delhi government's FRV pilot project meant for congested areas of the national capital where ambulances cannot reach on time. The petition had contended that the bikes would be ridden by Assistant Ambulance Officers (AAOs) who have no paramedical training and presently accompany the ambulance drivers. The Delhi government refuted the allegations in the plea, saying that AAOs are paramedics and were qualified to provide medical aid and stabilise a patient to await arrival of an ambulance, if required.

Resident doctor of Safdarjung hospital found dead in Lajpat Nagar home

30-year-old resident doctor of Safdarjung Hospital was found dead on Tuesday morning in his room at a rented accommodation in southeast Delhi's Lajpat Nagar area, police said. The deceased has been identified as Sudhanshu, they said. "We received the information on Tuesday at around 9 am. Police rushed to the spot where one Rudra Nayak (27), the flatmate of the deceased, said some foul smell was coming from the room of Sudhanshu," Deputy Commissioner of Police (Southeast) Chinmoy Biswal said. Police broke open the door and found Sudhanshu lying on a mattress with an intravenous drip in his arm, officials said. The victim was rushed to a hospital, where he was declared brought dead, Biswal said. According to the police, Sudhanshu and Nayak have been staying at the rented accommodation in Lajpat Nagar since May 2018. Nayak told police that he had gone to his native place in Panaji, Goa, on July 19 and returned at around 2 am on Tuesday. "On Tuesday morning at around 8 am, when Nayak woke up, he saw Sudhanshu's room locked from inside and a foul smell emanating from it. He asked the maid about Sudhanshu but she was clueless," Biswal said.

Bengaluru: Sole test downplays dengue, cases double of govt claim, say doctors
ET Healthworld- Sunitha Rao R

Bengaluru: The incidence of dengue in Karnataka is much higher than officially reported, with the sole health department-stipulated test allowing at least as many cases to slip off the radar as those that have come under it, doctors say. Karnataka recorded 6,014 cases of dengue from January 1, with 3,822 from Bengaluru city, and a spike in cases over the past fortnight. But doctors estimate the actual number of cases at double that figure because the health department confirms cases only via the ELISA (enzyme-linked immunosorbent assay) test, conducted by a handful of hospitals in the state. Most hospitals and clinics treat patients on the basis of the NS1 (non-structural protein-1) antigen test, a rapid test to detect dengue. Many doctors see no point in a second evaluation based on the ELISA test, which they say only delays treatment when the symptoms are clear and the NS1 antigen confirms dengue. “The ELISA test costs ?700 to ?1,200 and is an additional burden,” said one doctor who, like most physicians in private hospitals in the state, treats dengue based on the NS1 antigen test and does not also carry out the ELISA test mandated by the government.

Apollo hospital plans to expand, seeks government nod
ET Healthworld- Durgesh Nandan Jha

NEW DELHI: One of Delhi's largest corporate hospitals, Indraprastha Apollo, is all set for expansion. The hospital plans to add 200 more beds, in addition to creating extra facility for its transplant programme. Chairman of Apollo hospitals group, Dr Prathap C Reddy, told TOI he had a meeting with Delhi government on the issue. "Delhi government is a stakeholder in this hospital. Therefore, we proposed to the government on expanding this hospital," Dr Reddy said. At present, Indraprastha Apollo has 720 beds. Sources in Delhi government confirmed Dr Reddy's meeting with CM Arvind Kejriwal and health minister Satyendar Jain. "I cannot comment on the specifics of the meeting," the source added. Delhi government holds 26% stake in Indraprastha Apollo Hospitals as it had provided land at a concessional rate for construction of the super-specialty hospital in 1990s. This is why, the source said, government nod is a must for any major construction or expansion of the hospital. "The last expansion took place in 2012 when the hospital added 70 beds. But there is an urgent need to expand further due to increasing patient burden and the intent to bring in newer technologies," a senior doctor at the hospital said.

Yoga at govt hospitals to reduce C-section: Health Secy
The New Indian Express

CHENNAI: Yoga practice will be given to all pregnant women who come to government hospitals in the State to reduce caesarean section deliveries, said Health Secretary Beela Rajesh on Tuesday. Speaking at the Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children on the occasion of the first Hospital Day celebrations, she said, “Yoga practice in all government hospitals including Primary Health Centres, Health Sub-Centres, Headquarters hospitals and also tertiary care hospitals will be given to pregnant women to reduce C-section deliveries”. The State Health Department celebrated the day in commemoration of the birth anniversary of S Muthulakshmi Reddy, one of the earliest woman doctor in India. It also organised various functions in government hospitals to highlight their activities, achievements and specialities. “The health department has reduced maternity mortality rate from 66 for one lakh live births to 60. The department is working hard to reduce these numbers further down,” Beela Rajesh said.