Internal Medicine Procedure

Water and Foodborne Diseases during Festivals

During festivals, it is a common trend to enjoy street food. One can indulge in festive delicacies, but you should also be cautious about health. As, there are many food and water borne diseases which spread through unhygienic practices. They affect the gastrointestinal tract (GIT) and liver. GIT disorders are predominantly bacterial and liver diseases are commonly due to viruses.

Symptoms of GIT infections:

• Loose stools – could be watery or blood mixed
• Vomiting
• Abdominal cramps
• Dehydration: dryness of mouth and skin, dark urine, decreased urine output

Mild symptoms are common, which may stop spontaneously. However, severe symptoms are observed in Children and Old people.

Liver Diseases:

• Viruses causing jaundice are called Hepatitis viruses. They are named as Hepatitis A, B, C, D, E viruses. Amongst these Hepatitis A and E are transmitted through contamination of food and water with human excreta. Hepatitis A is more common in children, Hepatitis E in adults.Most of the epidemics are caused by Hepatitis E
• Jaundice may take several weeks to subside. Complete recovery is seen in most patients
• People with underlying long standing liver disease are more prone to worse outcomes
• Danger signs are (rare): Altered behaviour, bleeding from various sites and swelling of abdomen (due to collection of fluid in side abdomen).  These indicate worsening liver function and need immediate medical attention

• Common misconception during jaundice–Many a times, patients with jaundice are advised a restricted diet (Avoid oil, Non-Vegetarian food, Turmeric etc.) by family and relatives. No such restriction is needed and good nutrition during jaundice is extremely important
• Tips to keep in mind during Jaundice:
  • Avoid taking water/ food from source which you feel is unhygienic
  • Take warm/ hot food
  • Consult nearby doctor if any of the above mentioned symptoms appear

Dr. S. Manohar
HOD& Director- Internal Medicine

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Dr. Raghu J.
Senior Consultant - Internal Medicine

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Dr. Subrata Das
Senior Consultant - Internal Medicine & Diabetology

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Dr. TR Hemkumar
Consultant – Internal Medicine

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Your Questions Answered on Ebola Symptoms, Prevention and Treatment

Ebola first appeared in 1976 in two simultaneous outbreaks, one in a village near the Ebola River in the Democratic Republic of Congo, and the other in a remote area of Sudan.

The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the likely host of the Ebola virus, based on available evidence.

EVD – Ebola Virus Disease has come into the human body through close contact with the bodily fluids of infected animals such as their blood, secretions or organs.  It was reported and documented in Africa while handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead in the rainforest. Similarly human to human transmission of the Ebola Virus can only happen through direct or indirect contact with blood and body fluids.

What are the symptoms?

Initial Symptoms

• Fever
• Intense Weakness
• Muscle Pain
• Headache
• Sore Throat

Followed by:

• Vomiting
• Diarrhoea
• Rash
• Impaired kidney & liver function
• Some cases – both internal & external bleeding
   

Lab test results showing low white blood cell, platelet counts and elevated liver enzymes also indicate the virus infection. The incubation period is from 2 to 12 days of time interval from symptoms to infection. It only become contagious once the suspected patient starts showing up the symptoms. EVD can only be confirmed through lab testing.

How can it be prevented?

Only cure or treatment available as of today is to have more and more awareness about the Ebola Virus Disease. Some of the preventive measures that you should aware of are:

• Understand the symptoms, transmission and how to prevent it from spreading further
• Follow and understand the directives issued by your country’s respective Ministry of Health
• Support and guide EVD suspected people in your society or community to seek appropriate medical treatment in nearby healthcare facility
• Wash your hands with hand sanitizer or soap after visiting or touching a patient in the hospital or caring for someone at home
• People who have died from Ebola should only be handled using appropriate protective equipment and should be buried immediately by public health professionals who are trained in safe burial procedures
• You should avoid any sort of contact with high-risk infected animals specifically in the affected areas
• Animal products (meat) should be thoroughly cooked before eating
• WHO strongly recommends that people seek credible health advice about Ebola virus disease from their public health authority
• While traveling be careful and take necessary precautions to safeguard yourself from any sort of infection

Is there any Treatment available?

There’s no specific treatment or medicine available to cure the disease. All the infected people requires intensive supportive care.

They are frequently dehydrated and need intravenous fluids or oral rehydration with solutions that contain electrolytes.

To help control further spread of the virus, people that are suspected or confirmed to have the disease should be isolated from other patients and treated by health workers using strict infection control precautions. Some patients will recover with the appropriate medical care.

Is it safe to travel during this EVD outbreak?

While travellers should always be vigilant with regard to their health and those around them, the risk of infection for travellers is very low since person-to-person transmission results from direct contact with the body fluids or secretions of an infected patient.

WHO’s general travel advice:

• Travelers should avoid all contact with infected patients.
• Health workers traveling to affected areas should strictly follow WHO-recommended infection control guidance.
• Anyone who has stayed in areas where cases were recently reported should be aware of the symptoms of infection and seek medical attention at the first sign of illness.
• Clinicians caring for travelers returning from affected areas with compatible symptoms are advised to consider the possibility of Ebola virus disease.

Source: World Health Organisation 

Dr. S. Manohar
HOD& Director- Internal Medicine

Book Appointment With Dr. S. Manohar,Internal Medicine

Dr. Raghu J.
Senior Consultant - Internal Medicine

Book Appointment With Dr. Raghu J,Internal Medicine

Dr. Subrata Das
Senior Consultant - Internal Medicine & Diabetology

Book Appointment With Dr. Subrata Das,Internal Medicine

Dr. TR Hemkumar
Consultant – Internal Medicine

Book Appointment With Dr. Hemkumar,Internal Medicine

Health Warning at your desk to work can be injurious to health.

Can we imagine a life without computers? Electronic s and computers have percolated into our life at an alarming pace and magnitude. This has occurred at a scale to make me wonder if typing skills in my children are at par, if not more significant than handwriting skills. Needless to say many of us spend hours in form of a computer at work and top it up with a few more hours in front of Mr. Computer at home. As a pain physician involved in helping desperate patients with persistent pain, I see an epidemic of occupational hazards.

“@your Desk to work can be injurious to health” is not a tagline I would associate with undertaking a routine relaxing job on a posh comfy expensive chair. The sound of it resonates with health hazards of smoking. The sheer volume of time spend in front of Mr. Computer in its many forms , small and big, is making a generation regress back to the dark ages …really?

Musculoskeletal disorders due to sustained unhygienic postures is creating epidemic of health problems centered mostly around the neck, shoulders, arms and upper back. You could argue, I don’t think our ancestors with similar postures suffered with health problems. Well…… probably not since they were not ashamed and frequently to ambulate on all fours (limbs).

We have to take charge and modify our workplace, accommodate our schedules to reduce the impact of our activities on our health. I draw inspiration from the “Microsoft Healthy computing Guide” to suggest modifications in our work / leisure related Mr. Computer activities to ensure we continue to benefit with the marvels of the rapidly developing / evolving world we live in. We should aspire to be comfortable and productive with Mr. Computer.

This guide is designed for anybody spending more than 2 hours with Mr. Computer. This is relevant and probably equally important even if you are fortunate enough to have had no aches and pain in top half of your body. The commonly issues are occasional discomfort in hands, arms, shoulders, neck, upper back and even headaches. Any persistent aches, tingling numbness, burning / shooting pains in your arms / fingers warrant an assessment by a qualified doctor. The suggestions / advice below are generic and applicable across a wide spectrum of people. However, I recommend an individual detailed assessment, if you continue to experience ongoing discomfort. If you have access to an occupational therapist / physician professional guidance to arrange tour workstation will be beneficial.

Tip 1: Position Yourself

Avoid sustained postures for extended periods of time with any activity to avoid discomfort, fatigue and pain. Workstation redesign is essential to avoid unhygienic and awkward sustained postures. The workstation should promote and maintain a comfortable relaxed posture.

To support your back, try the following:

• Use a chair that supports your lower back preventing arching with convexity pointing behind you. (See detail 1).

• Adjust your work surface and chair height to assume a comfortable and natural body posture (see detail 2).

To promote comfortable leg postures, try the following:

• Clear away items from beneath your desk to allow comfortable leg positioning and movement.

• The height of seating should ensure a rested foot on the floor and horizontal thighs on the seat.

Tip 2 - For a comfortable shoulder and arm postures:

• Place your keyboard and mouse or trackball at about elbow level. Your upper arms should fall relaxed at your sides (see detail 3).

• Centre your keyboard in front of you located close to it (see detail 4).

• Place frequently used items comfortably within arm's reach (see detail 5).

Tip 3 - For comfortable wrist and finger postures:

• Keep your wrists straight while typing or mouse navigation. Avoid bending your wrists up, down or to the sides.

Tip 4 - For Comfortable neck posture:

• The top of the screen should be positioned at your eye level. If using bifocal glasses, it may be useful to lower the screen.

• Centre your monitor or document holder in front of you depending on what you refer to most often.

• Consider using a document holder to position your documents near eye level.

  Tip 5 - To reduce eye strain:

• Position your monitor an arm's length away from you when seated comfortably in front of it.

• Place monitor away from sources of glare.

• Maintain a clean screen and glasses if you wear some.

• Optimize the monitor's brightness and contrast, along with a good font size.

  Tip 6 – Avoid repetitive strain injuries – Be gentle to yourself

  Repeated monotonous work maneuvers, or sustained pressure / impact on body parts can result in body injuries. Common examples include pressing the keys while typing, clicking the mouse buttons, holding your mouse or cradling the phone and resting your wrists on the edge of your desk. You can dampen the effect of these.

• Be gentle to yourself - Type with relaxed hands and fingers ensuring a light touch that is sufficient to activate the keyboard keys, clicking a mouse button, when using a joystick or other gaming controller.

• Try maintaining a floating wrist and hands (see detail 7). The palm rest, if provided, should only be used during breaks from typing.

• Relax your arms and hands when you are not typing or using your mouse. Avoid resting hands on furniture edges.

• Adjust your chair so the seat does not press into the back of your knees (see detail 8).

Tip 7 - Take Breaks

In a supercharged workplace taking breaks may not be feasible. You can certainly take a break from repetitive task and resort to change in activity. Take a walk out supervising juniors. Stretch yourself during a telephonic conversation. These breaks can be tailored to you and your work place.

Tip 8 – Balance between work and play to limit strain on same body part:

• Organize your diary to have a good admixture of activities that do not strain the same body part for extended periods of time.

• Utilize the different Mr. Computer input devices to accomplish the same task. E.g. scrolling with move wheel versus arrow keys.

• Understand feature in Mr. Computer to work efficiently. E.g. Ctrl C instead of mouse right click copy.

• Eat a balanced diet and get adequate rest.

• Regular exercise for overall fitness and to improve the strength and flexibility of your body.

• Manage stress of and home by good scheduling and time management.

Tip 9 – A healthy body and mind

A healthy peaceful mind ensures productivity and higher tolerance for repetitive tasks. A tensed, stressed mind tightens / strains the muscles in your upper back and neck limiting the tolerance of MR. Computer related activities.

Maintain good health by:

• Eat a balanced diet and get adequate rest.

• Regular exercise for overall fitness and to improve the strength and flexibility of your body.

• Manage stress of and home by good scheduling and time management.

To conclude:

I wish you a healthy, productive, efficient, happy relationship with Mr, Computer who is likely to encroach into all domains of our lives. We wish you a happy computing experience, and don’t forget to look after yourself.

If you are concerned about any aspect of your health at work or home, please speak to a qualified professional. He may be able to guide to with possible contributing factors along with customized solutions for your problems. You can access further resources to help yourself from the “Healthy Computing Guide” on the Microsoft website.