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Dengue fever, also known as breakbone fever, is a mosquito-borne tropical disease caused by the dengue virus.
Symptoms include fever, headache, muscle and joint
pains, and a characteristic skin rash
that is similar to measles. In a small proportion of cases, the disease develops
into the life-threatening dengue
hemorrhagic fever, resulting in bleeding, low
levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low
blood pressure occurs. Dengue has become a global problem since the Second World War and is endemic in more than 110 countries. Apart from
eliminating the mosquitoes, work is ongoing on a dengue vaccine.
Dengue is transmitted by several species of mosquito
within the genusAedes,
principally aegypti. The virus
has five different types infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the
others. As there is no commercially available vaccine,
prevention is sought by reducing the habitat and the number of mosquitoes and
limiting exposure to bites. The dengue mosquitoes can easily breed in the water
tanks atop swanky homes, a small pot with clean water in kitchens inside homes,
or in rainwater on streets and roads. Hygiene in public spaces, stagnant water
at homes and waste management would be the right first steps towards
prevention. Following this, people should wear full sleeves and trousers to
prevent getting bit by mosquitoes too. Government says that: “Everything is under
control and we are doing all we can.” But the alarming reports in the
newspapers about dengue are that there is a huge calamity. Yet, the health
ministry acknowledged that whatever the government might do to control dengue,
its natural march and cannot be stopped but can at best only be “contained.” That is tough when there has been so much
rain in some cities like Delhi this year (52 rainy days since July and 573
millimeters of rain from the start of August to Sept. 9, according to numbers).
There were more than 1,500 confirmed
dengue cases and in the city so far this year. Government officials say that they have done
all that they could to kill the adult Aedes mosquitoes that transmit dengue and
their larvae at all the places in the city that they could access. They have
resorted to intensive fogging and the spreading of pesticides in public places
to kill the mosquitoes and their larvae. But the reality is different. The
process fogging is done at very slow pace and is restricted to some areas only. But dengue
is the disease that needs highest sense of civic duty to control. That
civic duty entails household responsibilities like covering up water tanks. If
nothing is done, the fear of the disease will disrupt normal life in the
country is grappling with the problem of hospital beds to accommodate the
deluge of dengue patients, some upscale private hospitals have been found
wanting in cooperating with the health authorities in tackling the crisis. They
have failed to set apart a percentage of beds for the Economically Weaker
Section as mandated by orders of the Delhi High Court and the Supreme Court.
This despite the fact the government doles out favours to them in the form of
subsidised water and electricity, concessions on import of equipment and tax
The two top courts, in their judgments in
2007 and 2011 respectively, had held that private hospitals which had been
allotted government land at concessional rates, shall treat 25 percent of EWS
patients in OPD (out-patient department) and 10 percent in IPD
(in-patient department) completely free
of charge in all respects. However, some of the private hospitals
supposed to be providing free treatment and reserving beds are either refusing or delaying treatment to poor
patients. Sometimes, they furnish inflated bills which patients cannot
Minister accepted that private hospitals are flouting the court guidelines. He
said: “We have got complaints that hospitals are turning away critical patients
citing lack of beds. They want to take cases that can be managed easily”. In
the ICUs, beds are hardly available for EWS patients. Hospitals continue to stay jam packed with
patients and their relatives. As the government hospitals are obliged to take
in patients and cannot refuse, there are patients lying unattended on the
floors and 3-4 on one bed for obvious reasons. There isn’t any more space in the hospitals –
hallways are overflowing, OTs have been converted into wards to allow care for
more patients and doctors are working around the clock. Almost all
government-run hospitals are struggling to cope with the crush of patients,
with limited beds to offer. Images of three or four patients sharing one bed
have been shown on TV channels. This cannot happen in private hospitals, they
have to provide equal efficient care to all those they admit but these
hospitals are refusing patients because they are not equipped to handle such
large number of cases. Even if they have beds, they don't have enough doctors
and ICU equipments. Medical community has been struggling to make
ends meet. Even now Doctors are working 48 hrs straight in order to see maximum
patients. The present picture shows the irresponsible
behavior of hospitals. The news of private hospitals and nursing homes in Delhi
not admitting the patients are putting a big question mark on the Government’s
management and Hospital’s ideology. From big hospitals to private clinics, the
lack of proper treatment and ruthless behavior of doctors is putting patients’
life at risk. Private hospitals have also been asked not to
charge more than Rs. 600 for the dengue test, which is offered free of charge
in government facilities. The government has warned private hospitals that they
could lose their license for turning patients away but still they are charging
around Rs. 1200. The Indian Medical Association has said that
the current virus type is less fatal
compared to the one in 2013 and has appealed to people not to panic or demand
hospital admission unless it is urgent. There is no need of platelets
transfusion unless a patient has active bleed and count of less than 10,000. Doctors are firmly warning patients to only
buy medicines from the hospital’s pharmacy or a pharmacy outside, not something
been loosely sold by someone who claims to be working for the hospital.
More could be done to tackle the disease. One
method for example, long used in Singapore, would be to remove breeding spots
for the mosquitoes—by draining even small pools of water in urban areas—or to
attack the vector by other means, such as insecticides. This helps, too,
against other diseases spread by mosquitoes, such as malaria. A laudable effort
announced by India's prime minister, Narendra Modi, to "clean up"
India, could yet see more done to drain standing water. Not everyone with dengue dies but dengue nonetheless
is a fatal condition. According to the WHO protocols followed worldwide, there
is no treatment for dengue other than supportive care which is increased fluid
intake and paracetamol.This can
easily be done at home.
It is the responsibility of government to
invest and take charge of the healthcare system. Also all the private and big
hospitals should come forward and help to cope with the prevailing situation.If the private hospitals successfully increase the number of beds,
there will be an average increase of at
least 3,000 beds for patients in the capital. These will be used only for
fever and dengue patients and no private hospital should turn away patients.
Also upscale hospitalslike Medanta, Fortis, Apollo, etc should provide free of cost treatment to poor patients
so that nobody dies due to lack of proper treatment. By Abhinav Aggarwal (Online Volunteer -Karnal )
(such a nose bleed, bleeding gums, or easy bruising)
strikes the patient suddenly and remains for a long time. It is usually
accompanied with severe headache and bone pain. Dengue fever can disappear soon
but it usually reappears with skin rashes.
Dengue is common in India and cases generally peak in October, after the
The mosquitoes that carry the dengue
virus typically live in and around houses, breeding in standing water that can
collect in such things as used automobile tires.
Dengue can be thoroughly examined through a chemical process. The two
tests that diagnose dengue are Antigen tests and Anti body test.
If you think you may have dengue fever, you should use pain relievers
with acetaminophenand avoid medicines withaspirin, which could worsen
Dengue can be prevented if you take
air-conditioned or well-screened housing
·If sleeping areas are not screened or
air conditioned, use mosquito nets.
·Avoid being outdoors at dawn, dusk
and early evening, when more mosquitoes are out.
·When you go into mosquito-infested
areas, wear a long-sleeved shirt, long pants, socks and shoes.
·For your skin, use a repellent
containing at least a 10 percent concentration of DEET.
The idea of a magic elixir that could fight disease, promote health and even prevent violence sounds like a flight of fancy. But we have this in our hands, and we have a way to make it available to all people on Earth.
Far from being the preserve of a secret elite, this substance is so common that it makes up the vast majority of our bodies and our planet: Water.
Too often underappreciated where it is plentiful and always ignored at our peril, clean water is essential to stopping the needless deaths of children, enabling women to enjoy the greater safety they deserve, and even promoting stability among countries in water-scarce regions. Along with sanitation, water holds the key to sparing suffering and averting death for millions of people. But only if we seize the moment to realize this potential.
That moment comes in just a matter of weeks when world leaders gather at the United Nations for an historic summit to adopt a new global agenda to end poverty and usher in a life of dignity for all.
This ambitious vision, embodied in a comprehensive, universal set of concrete goals, combines the environmental, social and economic aspects of development. The holistic and cross-cutting nature of the agenda is designed to ensure that progress will support the well-being of present and future generations.
In order to solve this development puzzle, leaders had to get the water challenge right, balancing all interests and imperatives. The sustainable development goals (SDGs) are to achieve this, tapping water resources to provide a range of services that underpin poverty reduction, economic growth and environmental sustainability.
Understanding how these work in tandem becomes clear when you consider the millions of children who suffer in deepest need of clean water or sanitation. They may be refugees, forced to flee their homes, or slum-dwellers, living in over-crowded and under-serviced neighborhoods, or the rural poor, located far from modern facilities. Without clean drinking water and proper sanitation, their nutrition is lamentably poor. That leads to stunting, which affects more than 160 million children who suffer irreversible physical and cognitive damage.
Improving sanitation and hygiene generates benefits for individuals and society, across sectors. A child with clean water and proper toilet facilities has on average far better health, a longer life and greater success in school and at work. In Mali, community-based interventions to prevent open defecation have cut diarrhea-related deaths by more than half, opening a promising future for children who would otherwise not have lived to see their fifth birthday.
Sustainable Development Goal 6 presents an opportunity to address the entire water cycle: access, quality, efficiency and the integrated management of water resources and related ecosystems. Success will require holding governments to account, strengthening systems and addressing the full life-cycle of people. Children need water at health clinics, girls and young women need private toilets at school, and all people need fair, equitable and universal access.
More is at stake than individual health; international security is at risk. Experts have identified water as the number one global risk in terms of significant negative impact on countries in the coming decade. Water can either be a source of conflict or cooperation. The choice should be obvious
If the task of development seems too difficult, we only have to look back over the past 15 years for inspiration. The Millennium Development Goals, adopted in 2000, constituted the largest antipoverty push in history. That effort resulted in access to improved sources of drinking water for more than 90 percent of the world's population, with roughly two thirds finally having a toilet.
Those left behind are the poorest and most vulnerable, who suffer a grave injustice. When we right that wrong by providing clean drinking water and decent sanitation to all, we will advance health, justice and security around the world.
Through successful WASH intervention, communities access a new service that improves their quality of life, and also learn about equity and inclusion.
The abysmal state of access to safe water and sanitation facilities in the developing world is currently a major cause for alarm; 580,000 children die every year from preventable diarrheal diseases. This is due largely to the 2.5 billion people around the globe who do not have access to safe sanitation. Not only can an effective WASH intervention save lives, it can also engineer changes in the social fabric of communities that adopt these behavioural changes. This points to a key attribute of a successful WASH intervention – that through these programmes, communities not only access a new service that improves their quality of life, but they also learn from being part of a concrete intervention that emphasises equity and inclusion.
Let me explain how. Safe sanitation is essentially ‘total’. In a community, even one family practising open defecation puts the health of other families at risk. Also, unsafe sanitation practices pollute local potable and drinking water sources in the habitations. Together, this can undo any gains from partial coverage of WASH interventions. This much is now widely accepted by sanitation practitioners around the world. However, there remains a serious challenge when it comes to the implementation of this concept.
When a community is introduced to a WASH-focused behaviour change campaign, there are often variations in the levels of take-up in different families. This could be because of several barriers – financial ability, cultural beliefs, education levels, etc. In response, external agencies have many options. They can focus more on families in their behaviour change campaigns, offer them material and financial support or incentives, or exert peer pressure (which may in some cases become coercive, etc).
However, the best approach – whether facilitated by an external agent or not – is for a community to devise a collective response. The issue should be framed as a collective action problem that requires solving for the creation of a public good. In many instances, communities have come together to support the poorest families – social engineering at its finest. At its best, recognising the needs of every member of a community will lead to a recognition of the challenges that the typically marginalised groups face. It is this recognition that could prompt a rethink of social norms and relationships.
On the other hand, the power of peer pressure can be effective. Where families that are able, but unwilling, to construct a toilet and switch behaviour, the initial take-up from other families has a strong demonstration potential. In societies with caste and class differences, this can be deployed effectively to highlight choices that threaten the public good.
Encouraging the development of shared norms and collective action is also a key aspect of determining the role of subsidies in WASH programmes. As research evidence from Bangladesh shows, subsidies could be effective when targeted at communities, instead of at individuals. Where it is possible to measure progress at the community-level, subsidies can be designed and delivered accordingly. This will encourage communities to take up WASH as they would approach say, the building of a road or a school.
This is no longer just a theory. Increasingly now, various organisations have documented such successes. For example, in multiple NGO-led programmes in eastern India and Bangladesh, local community-based organisations formed initially to tackle sanitation went on to engage in collective livelihoods activities. However, as with any other, this theory too should be put to test – evaluated at different sites and for different approaches. Currently, we are not sufficiently focused on the positive social externalities a WASH intervention could generate, and as a result, are running the risk of restricting ourselves to narrow technocratic approaches. This needs to change.
This brings me to a key message I have for WASH interventions: do not hurry into scaling up. Given the urgency of the problem – about 2.5 billion people do not practice safe sanitation – this might seem completely counter-intuitive. However, there is the real risk that aiming for scale will lead to the perpetration of target-driven hardware interventions which will neither change behaviour, not create social cohesion. It is not unusual for organisations that rush to scale end up compromising on exactly those key design elements that made their pilots a success.
In conclusion, it is important to acknowledge that WASH interventions have the potential to go far beyond basic service delivery. In order to realise these gains, one must follow a very careful sequence of steps designed to promote community ownership and systematically change behaviour. The goal should be to nudge communities towards a public spirit and collective problem solving, so that WASH works as an entry point into communities, creating fertile ground for future interventions.
A recent study revealed that about 18 per cent of women in India, mostly from the East, suffer from Polycystic Ovarian Syndrome (PCOS), a disorder which causes infertility among women.
Metropolis Healthcare, a multinational chain of pathology laboratories, conducted an inclusive study to observe the trends in the PCOS cases in young women in India.
Polycystic Ovarian Syndrome is a prevalent endocrine disorder in women and the leading cause of infertility nowdays.
Metropolis conducted a pan India study on 27,411 samples of testosterone, over a period of 18 months, out of which 4824 (17.60 per cent) women face hormonal associated risk with polycystic ovarian syndrome.
The increasing trend of PCOS is predominantly seen in the child bearing age group of 15 to 30 years.
Among the samples tested east India shows alarming levels of 25.88 per cent women affected by PCOS, followed by 18.62 per cent in north India, which can be largely attributed to lack of awareness among young women and ignorance.
“Undiagnosed PCOS can lead to infertility and in long term can cause several health complications which can be attributed to other factors as well,” Dr. Sonali Kolte, General Manager Medico Marketing, Metropolis Healthcare said.
“Early diagnosis and treatment can help control the symptoms and prevent health-related problems. Today a lot of young women are aware of the condition and seek medical help,” she said.
Ms. Kolte said PCOS is a characteristic amalgamation of cosmetic, gynecological and metabolic symptoms.
“Cosmetic symptoms include facial hair, thinning of the scalp and acne. Gynecological symptoms include irregular or scanty periods which are usually the first red flag in adolescents,” she said.
She added that infertility and recurrent pregnancy loss affect the women in the reproductive age and PCOS in older women can even lead to cancer of the uterus, cardiac disease and type 2 diabetes.
Ms. Kolte said diagnosis of the disease can be done by a testosterone test, along with a host of other tests like blood sugar, insulin, FSH, LH, 17OHP and DHEAS.