patient education news letter

1. Smile More... Walk More...
Live life More...
Chief Editor : Dr. Aniruddha Malpani, M.D. Improving Patient & Family Health Literacy Oct’ 2012
Health News 1, 9,11,12 Disease Prevention 2 Editorial 3
Drug Information 4, 5, 6 Disease Information 7,8, 9
Side effectS of Soda NY takes Lead
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 On September 13 the New York
Concentrated Form of sugar fruc- City Health Department became
tose derived from corn. It in- the first in the USA to ban the
creases body fat, cholesterol and sale of sugared beverages larger
triglycerides and it also makes you than 16 oz. at restaurants, mo-
bile food carts, sports arenas
hungry.
and movie theaters.
6. Potassium Benzoate preservative It’s a bold experiment in the anti-
that can be broken down to ben- obesity campaign, and while it’s
zene in your body. Keep your soda in the sun and ben- widely supported by health pro-
zene = Carcinogen fessionals, it’s not popular with
7. Food Dyes = impaired brain function, hyperactive be- food retailers or most city resi-
havior, difficulty focussing, lack of impulse control. dents.
China Closes 147,000 fake
food and drug sites
Police in China has closed 147,000 sites that to identify and solve cases of fake food and drugs.
manufactured or sold coun- Cases investigated by police
terfeit food or drugs in the over the past year include the
past year, the government use of reprocessed cooking oil.
says. According to newly re- In this case police reportedly
leased figures from the Chi- shut down manufacturers of the
nese Ministry of Public illegal product - known as 'gutter
Security police have shut oil' - and closed off supply chan-
down 147,000 sites involved nels.
in the fake food and drug Data on the success of anti-
trade since August 2011. counterfeiting efforts comes as
Over the same period the po- China tries to show publicly that
lice have reportedly resolved it is taking control of the situation.
185,000 criminal cases linked to counterfeiting. From October the State Food and Drug Adminis-
Information from the public played a big role in the tration (SFDA) will blacklist manufacturers of fake
anti-counterfeiting cases. The Ministry says the drugs as part of the intensified anti-counterfeiting
police paid 12,000 informants $4,4 mill for helping push. P
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2. COCONUT OIL COULD COMBAT TOOTH DECAY
Scientists found that coconut oil which had been treated
with 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 also
attacks the yeast which causes thrush.
The research team from the Athlone Institute of Technol-
ogy in Ireland tested the impact of coconut oil, vegetable
oil and olive oil in their natural states and when treated
with enzymes, in a process similar to digestion.
The oils were then tested against Streptococcus bacteria
which are common inhabitants of the mouth.
Coconut oil attacks the bacteria behind tooth decay and Only the enzyme-modified coconut oil showed an ability
could be used in dental care products, according to re- to inhibit the growth of most strains of the bacteria.
search.
MoNsooN rEDucEs
tHE IMMuNIty of tHE boDy
Monsoon is welcome by all but it pure water to prevent diarrhea and
comes with lots of diseases as the gastrointestinal infections.
immunity of the body is reduced. The Walking in dirty water during rainy
diseases associated with monsoon season leads to numerous fungal
are malaria, dengue, Chikungunya, infections, which affect toes and
jaundice, gastrointestinal infections nails. Diabetic patients have to take
like typhoid and cholera, said Padma care of infections, which affect toes,
Shri & Dr. B.C. Roy National and nails. Diabetic patients have to
Awardee Dr. KK Aggarwal, Presi- take a special care about their feet.
dent, Heart Care Foundation of India. Always keep the feet dry and clean.
Apart from these, viral infections like Avoid walking in dirty water. Keep
cold and cough are also common. the shoes, socks and raincoats dry
Patients with Chikungunya, typically and clean.
have joint pains, which will get relieved by flexing the Precautions have to be taken to prevent dampness and
limbs. Dengue, if not adequately managed, can be fatal growth of fungus (mold) on and around the house were
in 1–4% of cases. Chikungunya, though not fatal, can asthmatic patients are living. Avoid fumigation in case of
cause chronic debilitating joint pains lasting for years. asthmatic patients.
Management of dengue involves fluid resuscitation and Worms from underground comes to the surface and con-
not platelet resuscitation. If enough fluids are given, mor- taminate the surface vegetables. In the presence of weak
tality can be reduced. The mortality period usually starts digestive fire, this can cause gastric disturbances. It is be-
when the fever subsides. Inappropriate misuse of anti cause of this reason that community lunches and mar-
fever medicines can precipitate bleeding in dengue pa- riage are prohibited in this season.
tients. One should eat light foods. Consuming barley, rice and
The water that gets collected due to rain becomes a wheat is good. Water should be boiled before use. Adding
breeding ground for mosquitoes. Contamination of drink- ginger and green in daily diet is helpful. Eating warm food
ing water is common. It is important to drink clean and is the rule.
P
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Hand wasHing 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 who
has 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 garbage
Hand hygiene is critical to interrupt the spread of infec-
tious diseases, such as the common cold, influenza, and
gastrointestinal illnesses

3. A difference is only A difference
if it mAkes A difference.
Social injustice has disease free. Modern nomicus. We, doctors, are not con-
everything to do with ill- medicine is not doing cerned with poverty eradication lest
nesses. Poverty is the that. Clean water, air and we should break our own rice bowl!
mother of all diseases food are of vital impor- Doctors can never survive without pa-
from common cold to tance. One third of the tients while patients could survive
cancer. A child born to a world population lives on without doctors!
poor mother will have a less than one meal a Hospitals and doctors have very little
very small hippocampus day. Nutritional immune to do with health of the populace.
major, small pancreas, deficiency syndrome More doctors and less health has
small vessels etc making (NIDS) is the biggest
been the finding of the 14 industri-
that child get all killer dis- killer of children in poorer
alised countries’ study. (JAMA 2000;
eases in the 30s; in addi- countries, deadlier than
284: 483-485) Civil engineers, politi-
tion, the small AIDS.
cians, social workers, philanthropes,
hippocampus unfits the Poverty economics has
mind for any intellectual pursuits. to be learnt not in Oxbridge but in the and the altruistic social organizations
It is not prevention that should be our slums of the poor countries. Then only should be able to do something in
motto but health promotion. Disease one gets the true picture. It is akin to keeping the health of the public. Food,
is failed health promotion. Prevention doing Dictator experiments of John shelter and water with a clean envi-
brings in screening in its wake which List in real life situations which ronment, coupled with economic em-
promotes disease mongering. Every showed that mankind is not altruistic, powerment and ethical education
human body is built to last as long as unlike the controlled experiments of should do the trick to keep our im-
it can, thanks to the immune system. the 2002 Nobel winning work of Ver- mune system at its peak. Will the pow-
No one should try to be here for ever, non Smith and Daniel Kahneman, ers that be wake up to this reality
as s/he will certainly not succeed, doc- showing humankind to be hard wires please?
tors and medicines notwithstanding. to be altruistic. Professor BM Hegde,
The immune system needs boosting The medical profession, like all other hegdebm@gmail.com
on a regular basis to keep the person professions, has become homo eco- Padmabhushan Awardee’2010
P
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“Literacy is a bridge from misery to
ditor’s
hope.- ― Kofi Annan
Health Literacy is a bridge from assume that he is not inter-
E
Desk
illness to wellness. Leaps in ested in being healthy. The
medical advances has left the answer is simple – there is a
common man far behind. He severe shortage of the best
seems lost in the maze of com- medicine called Health Liter-
plex medical terms and sys- acy. Studies have shown that
tems.Why is he unable to around 50% of the world’s
understand the names of dis- population is ‘health illiterate’.
eases and medical conditions This means that one out of 2
M.D.
and associated issues which af- persons is unable to obtain, ha Malpani,
Dr. Anirudd
ctor,
flict him? These so-called ‘com- process, understand and to Founder Dire n Library for
atio
plexities’ come in way of of his use that information to make Health Educ
receiving high quality medical good decisions about his People (HE LP)
care or to simply look after his health and medical care.
general wellbeing. We cannot
Doctor’s have no time. Patients Questions
are not getting answered to resolve this
problem we have created groups in the
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4. Drug Information Ofloxacin
Instructions or counseling for the patient prescribed with • If you forget to take a dose, take it as soon as you re-
Tablet Ofloxacin. member and then continue as before. Do not take
Ofloxacin two doses together to make up for a forgotten dose.
Type of medicine: Fluoroquinolone antibiotic Getting the most from your treatment
Use: Used to treat certain infections that are caused by • Do not take non-steroidal anti-inflammatory
bacteria. It works by killing the bacteria which cause the painkillers (NSAIDs) such as ibuprofen while you are
infection. Infections includes chest/lungs, urinary-tract being treated with ofloxacin.
and skin infections. • Ofloxacin may cause your skin to become more sen-
before taking ofloxacin sitive to sunlight than normal. Protect your skin par-
Before taking ofloxacin make sure your doctor knows: ticularly if you are exposed to strong sunlight for long
• If you are pregnant, trying for a baby or breast-feed- periods during the day.
ing. • Ofloxacin may impair your ability to concentrate.
• If you have ever experienced tendon (a tissue that Make sure your reactions are normal before driving,
connects muscle to bone) problems after taking any operating machinery or doing other jobs which could
other quinolone antibiotic such as ciprofloxacin, lev- be dangerous if you were not sufficiently alert.
ofloxacin, moxifloxacin, nalidixic acid or norfloxacin. • If you have diabetes, you may need to check your
• If you have a history of kidney or liver disease. blood glucose levels more regularly as ofloxacin may
• If you have a history of diabetes or heart diseases affect the levels of sugar in your blood.
• If you have a history of epilepsy/seizure. • If you still feel unwell after completing your course of
• If you have ever had mental health problems. this antibiotic, make another appointment to see your
• If you have myasthenia gravis (a muscle weakening doctor.
disease). • Some people develop thrush (redness and itching in
• If you know you have glucose 6-phosphate dehydro- the mouth or vagina) after taking a course of antibi-
genase (G6PD) deficiency. otics. If you think you have thrush, speak with your
• If you are taking other medicines, including those doctor.
available to buy without a prescription, herbal and Possible Side Effects While using Ofloxacin:
complementary medicines. Along with their useful effects, most medicines can
• If you have ever had an allergic reaction to this or any cause unwanted side-effects although not everyone
other medicine. experiences them. These usually improve as your
How to take ofloxacin body adjusts to the new medicine, but speak with
• Take ofloxacin exactly as prescribed by your doctor. your doctor if any of the following side-effects con-
It is usually taken once or twice a day depending on tinue or become troublesome.
the infection being treated. Important Note: If you develop any of the following rare
• If you have been told to take ofloxacin twice a day, symptoms, contact your doctor for advice straight away:
space your doses out evenly throughout the day. • Swelling of your tongue, mouth or face or any prob-
• You may take this medicine with or without food. lems with your breathing.
• Keep taking this antibiotic until the course is finished • A severe rash.
unless you are told to stop. This is important in order • Pain or inflammation in your joints (particularly in your
to prevent the infection from coming back. hips, knees or ankles).
• Do not take indigestion remedies (antacids) or med- If you experience any other symptoms which you think
icines containing iron or zinc, in the 2 hours before or may be due to this medicine, speak with your doctor and
after you take ofloxacin. This is because they inter- seek advice.
fere with the way ofloxacin is absorbed by your body How to store ofloxacin
and stop it from working fully. • Keep all medicines out of the reach and sight of chil-
• Drink extra fluids so you will pass more urine while dren.
you are using this medicine. This will keep your kid- • Store in a cool, dry place, away from direct heat and
neys working well and help prevent kidney problems. light.
Side-effects - these affect less than 1 in 100 peo- What can I do if I experience this
ple who take this medicine
Feeling or being sick, indigestion, abdominal pain Eat little and often. Stick to simple or bland foods
Diarrhoea Drink plenty of water to replace lost fluids. If the diar-
rhoea is severe or continues to be a problem, speak
with your doctor
Headache
Try to manage with a suitable painkiller. If the
headache continues, speak with your doctor
Dizziness If affected, do not drive or operate machinery
Difficulty in sleeping, eye irritation, cough and skin If any of these become troublesome, speak with your
itchiness doctor

5. Reference: Attended by: Samson P.G., Drug Information Pharma-
1. www.thomsonhc.com, Micromedex (R) 2.0, 2002- cist, DIRC, KSPC
2012, Thomson Reuters (Healthcare) Inc. Disclaimer: Information provided by the center is authen-
2. http://www.cimsasia.com/ tic and should be used judiciously by the healthcare pro-
3. Product Information: FLOXIN(R) oral tablets, fessionals only. The center will not accept any
ofloxacin oral tablets. Ortho-McNeil, Raritan, NJ, responsibility of liability arising on using the provided in-
2011. formation and it rests entirely on the user.
Karnataka State Pharmacy Council Drug Information & Research Centre
514/E, I Main, II Stage, Vijayanagar Club Road, Bangalore – 560 104 PH: 23383142; 23404000,9900032640 Fax: 23202345
E-mail: kspcdic@gmail.com; Web: www. karnatakadruginfo.com P
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A Guide to SAfe uSe of PAin Medicine
f you've ever been treated for severe pain
from surgery, an injury, or an illness, you
know just how vital pain relief medications
can be.
Pain relief treatments come in many
forms and potencies, are available by
prescription 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, including
opioid analgesics, act on the body's pe-
ripheral and central nervous systems to
block 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 severity
of the pain.
TYPES OF PAIN RELIEVERS
OTC Medications
These relieve the minor aches and pains
associated with conditions such as
headaches, fever, colds, flu, arthritis,
erate to severe pain
toothaches, and menstrual cramps.
• codeine, which comes in combination with acetamin-
There are basically two types of OTC pain relievers:
ophen or other non-opioid pain relief medications and
acetaminophen and non-steroidal anti-inflammatory
is often prescribed for mild to moderate pain
drugs (NSAIDs).
• hydrocodone, which comes in combination with acet-
Acetaminophen is an active ingredient found in more
aminophen or other non-opioid pain relief medica-
than 600 OTC and prescription medicines, including
tions and is prescribed for moderate to moderately
pain relievers, cough suppressants, and cold medica-
severe pain
tions.
FDA has recently notified makers of certain opioid drugs
NSAIDs are common medications used to relieve fever
that these products will need to have a Risk Evaluation
and minor aches and pains. They include aspirin,
and Mitigation Strategy (REMS) to ensure that the ben-
naproxen, and ibuprofen, as well as many medicines
efits continue to outweigh the risks.
taken for colds, sinus pressure, and allergies. They act
Affected opioid drugs, which include brand name and
by inhibiting an enzyme that helps make a specific
generic products, are formulated with the active ingre-
chemical.
dients fentanyl, hydromorphone, methadone, morphine,
Prescription Medications
oxycodone, and oxymorphone.
Typical prescription pain relief medicines include opioids
FDA has authority to require a REMS under the Food
and non-opioid medications.
and Drug Administration Amendments Act of 2007.
Derived from opium, opioid drugs are very powerful
Types of non-opioid prescription medications include
products. They act by attaching to a specific "receptor"
ibuprofen and diclofenac, which treat mild to moderate
in the brain, spinal cord, and gastrointestinal tract. Opi-
pain.
oids can change the way a person experiences pain.
uSE AS DIRECTED
Types of prescription opioid medications include
Pain medications are safe and effective when used as
• morphine, which is often used before and after sur-
directed. However, misuse of these products can be ex-
gical procedures to alleviate severe pain
tremely harmful and even deadly.
• oxycodone, which is also often prescribed for mod-

6. Consumers who take pain relief medications must fol- same time.
low their health care professional's instructions carefully. All OTC medicines must have all of their active ingredi-
If a measuring tool is provided with your medicine, use ents listed on the package. For prescription drugs, the
it as directed. active ingredients are listed on the container label.
Do not change the dose of your pain relief medication Talk with your pharmacist or another health care profes-
without talking to your doctor first. sional if you have questions about using OTC medi-
Also, pain medications should never be shared with cines, and especially before using them in combination
anyone else. Only your health care professional can de- with dietary supplements or other OTC or prescription
cide if a prescription pain medication is safe for some- medicines.
one. MISuSE AND AbuSE
Here are other key points to remember. Misuse and abuse of pain medications can be extremely
With acetaminophen (Paracetamol) : dangerous. This is especially so in regard to opioids.
• Taking a higher dose than recommended will not These medications should be stored in a place where
provide more relief and can be dangerous. they cannot be stolen.
• Too much can lead to liver damage and death. Risk According to the National Institutes of Health, studies
for liver damage may be increased in people who have shown that properly managed medical use of opi-
drink three or more alcoholic beverages a day while oid analgesic compounds (taken exactly as prescribed)
using acetaminophen-containing medicines. is safe, can manage pain effectively, and rarely causes
• Be cautious when giving acetaminophen to children. addiction.
Infant drop medications can be significantly stronger But the abuse of opioids is a significant public safety
than regular children's medications. Read and follow concern. Abusers ingest these drugs orally, and also
the directions on the label every time you use a med- crush the pills in order to snort or inject them.
icine. Be sure that your infant is getting the infants' Commonly abused opioid pain medicines include pre-
pain formula and your older child is getting the chil- scription drugs such as codeine, and the brand-name
dren's pain formula. products Oxycontin (oxycodone), Vicodin (hydrocodone
With NSAIDs: with acetaminophen),
• Too much can cause stomach bleeding. This risk in- and Demerol
creases in people who are over 60 years of age, are (meperidine).
taking prescription blood thinners, are taking Addiction is
steroids, have a history of stomach bleeding or ul- just one seri-
cers, and/or have other bleeding problems. ous danger of
• Use of NSAIDs can also cause kidney damage. This opioid abuse. A
risk may increase in people who are over 60 years number of over-
of age, are taking a diuretic (a drug that increases dose deaths
the excretion of urine), have high blood pressure, have resulted
heart disease, or pre-existing kidney disease. from snorting
With opioids: and injecting opi-
• Use of opioids can lead to drowsiness. Do not drive oids, particularly
or use any machinery that may injure you, es- the drug OxyCon-
pecially when you first start the medication. tin, which was designed to
• The dose of an opioid pain be a slow-release formula-
medication that is tion.
safe for you uSE OPIOIDS SAFELY: 3
could be high KEY STEPS
enough to 1. Keep your doctor informed.
cause an over- Inform your health care profes-
dose and death in sional about any past history of
someone else, es- substance abuse. All patients
pecially children. treated with opioids for pain require
KNOW THE ACTIVE IN- careful monitoring by their health care
GREDIENTS professional for signs of abuse and addic-
A specific area of con- tion, and to determine when these analgesics
cern with OTC pain are no longer needed.
medicines is when 2. Follow directions carefully. Opioids are associ-
products sold for ated with significant side effects, including drowsi-
different uses have ness, constipation, and depressed breathing
the same active in- depending on the amount taken. Taking too much
gredient. A cold could cause severe respiratory depression or
and cough remedy death. Do not crush or break pills. This can alter
may have the the rate at which the medication is absorbed
same active ingredi- and lead to overdose and death.
ent as a headache 3. Reduce the risk of drug interac-
remedy or a prescrip- tions. Don't mix opioids with alcohol, anti-
tion pain reliever. histamines, barbiturates, or
To minimize the risks of benzodiazepines. All of these sub-
an accidental overdose, stances slow breathing and their com-
consumers should avoid tak- bined effects could lead to
ing multiple medications with life-threatening respiratory depres-
the same active ingredient at the sion. P
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7. Causes, incidence, itching starts, and then
and risk factors
Atopic dermatitis is
ATOPIC DERMATITIS the skin rash appears
from the scratching.
due to a hypersensitivity reac- Signs and tests
tion (similar to an allergy) in A physical exam will be done.
the skin, which leads to long- A skin biopsy can be done to
term swelling and redness (in- confirm the diagnosis or rule
flammation) of the skin. out other causes of dry, itchy
People with atopic dermititis skin.
may lack certain proteins in Diagnosis is based on the:
the skin, which leads to • Appearance of the
greater sensitivity. skin
Atopic dermatitis is most com- • Personal and family
mon in infants. It may start as history
early as age 2 to 6 months. Allergy skin testing may be
Many people outgrow it by helpful for people with:
early adulthood. • Hard-to-treat atopic
People with atopic dermatitis dermatitis
often have asthma or sea- • Other allergy symp-
sonal allergies. There is often toms
a family history of allergic con- • Skin rashes that form
ditions such as asthma, hay only on certain areas of the
fever, or eczema. People with body after exposure to a spe-
atopic dermatitis often test cific chemical
positive to allergy skin tests. SKIN CARE AT HOME
However, atopic dermatitis is Taking care of your skin at
not caused by allergies. The condition tends to get worse home may reduce the need for medications.
when the person is exposed to certain triggers. Avoid scratching the rash or skin:
The following can make atopic dermatitis symptoms • Relieve the itch by using a moisturizer, topical steroid
worse: cream, or other prescribed cream and taking antihista-
• Allergies to pollen, mold, dust mites, or animals mines to reduce severe itching.
• Cold and dry air in the winter • Keep your child's fingernails cut short. Consider light
• Colds or the flu gloves if nighttime scratching is a problem.
• Contact with irritants and chemicals Keep the skin moist (called lubricating or moisturizing the
• Contact with rough materials, such as wool skin). Use ointments (such as petroleum jelly), creams, or
• Dry skin lotions 2 - 3 times a day. Moisturizers should be free of al-
• Emotions and stress cohol, scents, dyes, fragrances, or other chemicals. A hu-
• Exposure to too much water, such as taking too many midifier in the home will also help.
baths or showers and swimming too often Avoid anything that makes your symptoms worse. This
• Feeling too hot or too cold, as well as sudden temper- may include:
ature changes • Foods such as eggs in a very young child (always dis-
• Fragrances or dyes added to skin lotions or soaps cuss with your doctor first)
Symptoms • Irritants such as wool and lanolin
Typical skin changes may include: • Strong soaps or detergents, as well as chemicals and
• Blisters with oozing and crusting solvents
• Dry skin all over the body or areas of bumpy skin on the • Sudden changes in body temperature and stress, which
back of the arms and front of the thighs may cause sweating and worsen the condition
• Ear discharge or bleeding • Triggers that cause allergy symptoms
• Raw areas of the skin from scratching When washing or bathing:
• Skin coloring changes -- more or less color than the nor- • Keep water contact as brief as possible and use gentle
mal skin tone (See: Skin abnormally dark or light) body washes and cleansers instead of regular soaps.
• Skin redness or inflammation around the blisters Short, cooler baths are better then long, hot baths.
• Thickened or leather-like areas, called lichenification, • Do not scrub or dry the skin too hard or for too long.
which can occur after long-term irritation and scratch- • After bathing, it is important to apply lubricating creams,
ing lotions, or ointment on the skin while it is damp. This will
Both the type of rash and where the rash appears can de- help trap moisture in the skin.
pend on the age of the patient: Complications
• In children younger than age 2, skin lesions begin on • Infections of the skin caused by bacteria, fungi, or
the face, scalp, hands, and feet. They are often crust- viruses
ing, bubbling, or oozing rashes that itch. • Permanent scars
• In older children and adults, the rash is more commonly Prevention
seen on the inside of the knees and elbows, as well as Studies have shown that children who are breast-fed until
the neck, hands, and feet. age 4 months are less likely to get atopic dermatitis.
• During a severe outbreak, rashes may occur anywhere If the child is not breast-fed, using a formula that contains
on the body. processed cow milk protein (called partially hydrolyzed for-
Itching, which is sometimes intense, almost always occurs. mula) may decrease the chances of developing atopic der-
Itching may start even before the rash appears. Atopic der- matitis. P
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matitis is often called the "itch that rashes" because the
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8. Diabetes - eye care Do not smoke. If you
need help quitting, ask
your doctor or nurse.
If you already have eye prob-
lems, ask your doctor if you
should avoid some exercises that can strain the blood
vessels in your eyes. These exercises may make eye
problems worse:
• Weight lifting and other exercises that make you
strain
• High-impact exercise, such as football or hockey
Make It Easier for Yourself at Home
Make 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 the
correct medicine and the correct dose:
Diabetes can harm your eyes. It can damage the small • Use felt tip pens to label medicine bottles so you can
blood vessels in your retina, the back part of your eye. read them easily.
This is called diabetic retinopathy. Diabetes also in- • Use rubber bands or clips to tell them apart.
creases your risk of having glaucoma, cataracts, and • Ask someone else to give you your medicines.
other eye problems. • Always read labels with a magnifying lens.
You may not know there is any damage to your eyes until • Use a pill box with compartments for days of the
the problem is very bad. Your doctor can catch problems week and times of the day, if you need to take med-
early if you get regular eye exams. icines more than once a day.
If your doctor finds eye problems early, drugs and other Never guess when taking your medicines. If you are un-
treatments may help prevent them from getting worse. sure of your doses, talk with your doctor, nurse, or phar-
You Need Regular Eye Exams macist.
Every year, you should have an eye exam by an eye Keep medicines and other household items organized
doctor. Choose an eye doctor who takes care of people in a cabinet so you know where they are.
with diabetes. Use large-print cookbooks to make foods that are on
The eye exam may include: your diabetes meal plan. Ask your doctor or nurse where
• Dilating your eyes to allow a good view of the entire you can get these books.
retina. Only an eye doctor can do this exam. When to Call the Doctor
• At times, special photographs of the back of your Call your doctor if:
eye • You cannot see well in dim light.
Your eye doctor may ask you to come more or less often • You have blind spots.
than every year. • You have double vision (you see 2 things when
How to Prevent Eye Problems there is only 1).
Control your blood sugar levels. High blood sugars in- • Your vision is hazy or blurry and you cannot focus.
crease your risk of having eye problems. • You have pain in your eyes.
Control your blood pressure. Blood pressure less than • You are having headaches.
130/80 is a good goal for people with diabetes. • You see spots floating in your eyes.
• Have your blood pressure checked often and at • You cannot see things on the side of your field of vi-
least twice per year. sion.
• If you take drugs to control your blood pressure, take • You see shadows. P
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them as your doctor told you to.
Gingivitis is inflammation of the gums. • Certain infections and body-wide (systemic) diseases
Causes • Poor dental hygiene
Gingivitis is a form of periodontal disease. Periodontal • Pregnancy (hormonal changes increase the sensitiv-
disease is inflammation and infection that destroys the ity of the gums)
tissues that support the teeth, including the gums, the • Uncontrolled diabetes
periodontal ligaments, and • Misaligned teeth,
GinGivitis
the tooth sockets (alveolar rough edges of fillings, and ill-
bone). fitting or unclean mouth appli-
Gingivitis is due to the long- ances (such as braces,
term effects of plaque de- dentures, bridges, and
posits on your teeth. Plaque crowns) Use of certain med-
is a sticky material made of ications, including phenytoin,
bacteria, mucus, and food debris that develops on the bismuth, and some birth control pills
exposed parts of the teeth. It is a major cause of tooth Many people have some amount of gingivitis. It usually
decay. develops during puberty or early adulthood due to hor-
If you do not remove plaque, it turns into a hard deposit monal changes. It may persist or recur frequently, de-
called tartar (or calculus) that becomes trapped at the pending on the health of your teeth and gums.
base of the tooth. Plaque and tartar irritate and inflame Symptoms
the gums. Bacteria and the toxins they produce cause • Bleeding gums (blood on toothbrush even with gentle
the gums to become infected, swollen, and tender. brushing of the teeth)
The following raise your risk for gingivitis: • Bright red or red-purple appearance to gums

9. • Gums that are tender when touched, but otherwise within 1 or 2 weeks after
painless professional cleaning and careful oral hygiene.
• Mouth sores Warm salt water or antibacterial rinses can reduce gum
• Swollen gums swelling. Over-the-counter anti-inflammatory medications
• Shiny appearance to gums may also be helpful.
Exams and Tests Healthy gums look pink and firm. Strict oral hygiene must
The dentist will examine your mouth and teeth and look be maintained for your whole life, or gum disease will
for soft, swollen, red-purple gums. recur.
The gums are usually painless or mildly tender. Possible Complications
Plaque and tartar may be seen at the base of the teeth. • Gingivitis returns
The dentist will use a probe to closely examine your • Periodontitis
gums to determine if you have gingivitis or periodontis. • Infection or abscess of the gums or the jaw bones
No further testing is usually necessary. However, dental • Trench mouth
x-rays may be done to see if the disease has spread to When to Contact a Medical Professional
the supporting structures of the teeth. Call your dentist if you have red, swollen gums, espe-
Treatment cially if you have not had a routine cleaning and exami-
The goal is to reduce inflammation. nation in the last 6 months.
The dentist or dental hygienist will clean your teeth. The Prevention
may use different tools to loosen and remove deposits Good oral hygiene is the best way to prevent gingivitis.
from the teeth. You should brush your teeth at least twice a day. You
Careful oral hygiene is necessary after professional tooth should floss at least once a day.
cleaning. The dentist or hygienist will show you how to Your dentist may recommend brushing and flossing after
brush and floss. every meal and at bedtime. Ask
Professional tooth cleaning in your dentist or dental hygienist to
addition to brushing and floss- show you how to properly brush
ing may be recommended and floss your teeth.
twice per year or more fre- Special devices may be recom-
quently for severe cases of mended if you are prone to
gum disease. plaque deposits. They include
Antibacterial mouth rinses or special toothpicks, toothbrushes,
other aids may be also be rec- water irrigation, or other devices.
ommended. You still must brush and floss
Repair of misaligned teeth or your teeth regularly.
replacement of dental and or- Antiplaque or antitartar tooth-
thodontic appliances may be pastes or mouth rinses may also
recommended. be recommended.
Any other related illnesses or conditions should be Regular professional tooth cleaning is important to re-
treated. move plaque that may develop even with careful brush-
Outlook (Prognosis) ing and flossing. Many dentists recommend having the
Some people have discomfort when plaque and tartar teeth professionally cleaned at least every 6 months.
are removed from the teeth. Alternative Names
Bleeding and tenderness of the gums should lessen Gum disease; Periodontal diseas P
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India’s ’5-star’ private hospitals should be regulated: WHO
New Delhi: The World Health Organization’s is a problem and so is “misuse of technol-
India representative Dr Nata Menabde has ogy”.
expressed the need for regulating India’s Dr Menabde has also supported the wider
private healthcare sector represented by adoption of the Clinical Establishment Reg-
five star hospitals. istration Act passed by Parliament in 2010.
“The private sector in India is represented Only four of the states and union territories
by five star hospitals. Their services need to (UTs) have ratified the law so far. [Source:
be regulated,” Dr Menabde has said, BS]
adding, “over-diagnosis” in private hospitals
Delhi DDU hospital appoints bouncers to protect doctors
At first sight, they pass off as just security guards at a hos- hit upon the idea to protect doctors.
pital but their strong builtand tough looks indicate that they Such “well-built yet polite” people are on guard with the
are bouncers kept to ward off agitated people. primary objective of saving doctors who are often at the
These guards are stationed in key areas of the Deen receiving end.
Dayal Upadhyay Hospital from emergency tolabour room Authorities at the Delhi Government-run hospital justify
to casualty ward and one would think twice before picking the move to resort to such a step to save the doctors from
up an argument with them. being attacked by the kith and kin of the patients and pre-
Plagued by physical attacks on doctors by agitated rela- vent professionals from going on a strike.
tives of patients, the administrators of the hospital have