You Get Lifelong Immunity Against Life-Threatening Diseases:

By immunization, we give the bacteria/virus antigens which have lost their infectivity but are still able to challenge the immune system of our body. Our immune system synthesizes protective antibodies against that bacteria/virus. These antibodies act by blocking the actual bacteria and virus when a child is exposed to that thus prevents the invasion and infection by the same. Thus immunization directly benefits the immunized child. Immunization in childhood and adolescent gives lifelong immunity. In few cases, if despite vaccination child gets an infection, it’s usually mild in severity. Thus immunization not only protects the health of the child but also decreases the cost of treatment.

One immunization saves numerous lives:

Immunization of children also induces community immunity or herd immunity i.e if large numbers of children are immunized; it protects the unimmunized children also by decreasing the transmission of infection in the community.  So regular immunization of children decreases disease burden in society and also the financial burden on government.

Makes your pregnancy safer:

Pregnancy is a most crucial period in women’s lives. Pregnant women are more prone to infections which can cause disease & malformation in developing fetus and at times abortion also. Immunization done during childhood not only protects mother during pregnancy from infections but also the fetus developing inside. Immunity of mother is transferred to newborn and protects him from infections till he himself can be immunized and protected.

So immunization protects child himself, future generation and the society from disease burden.

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Community-acquired Pneumonia is caused by:-

• Streptococcus pneumonia
• Haemophilus influenza
• Chlamydia species
• Legionella species
• Respiratory viruses.

Symptoms of Pneumonia:-

• Fever
• Cough
• Increased yellowish sputum production
• Chest pain which is more of deep inspiration
• Breathlessness
• Altered mental state( particularly in old age)
• Hypotension (low blood pressure)

Investigations Recommended for Pneumonia :

• Complete blood count
• Kidney function test
• Liver function test
• Sputum examination for gram stain, AFB Stain, culture sensitivity
• Blood culture and sensitivity
• Chest X-ray
• Serum procalcitonin(optional)

Treatment for Pneumonia:-

The decision regarding inpatient versus outpatient treatment is based on CURB 65 criteria. There are 5 variables in this scoring system (each variable is given one point if the total score is two or more than patient should be admitted and treated if the score is three or more than ICU admission is advised).

Variables are:-

• Confusion
• Blood urea nitrogen level>20mg/dl
• Respiratory rate > 30 breaths per minute
• Blood pressure (Systolic<90mm of Hg or diastolic <60mm of Hg
• Age more than 65 years

Empirical antibiotics:

• If the patient has no comorbidities then outpatient treatment should be with macrolides or doxycycline.
• If the patient has comorbidities and/or antibiotic use within last three months then outpatient treatment should be with beta-lactam antibiotics plus macrolides or respiratory quinolones should be used as monotherapy.
• In non ICU inpatients treatment should include beta-lactam antibiotics plus macrolide or respiratory quinolone(levofloxacin)
• In Icu patients beta-lactam antibiotics plus IV, Azithromycin/respiratory quinolones should be used
• If there is a risk factor for pseudomonas antipseudomonal antibiotic should be added, if there is a risk factor for MRSA Vancomycin or linezolid should be added.
• If there is a suspicion of swine flu oseltamivir should be added.

Complications associated with Pneumonia:-

• Septic shock
• Metastatic infections
• Empyema
• Cavity formation

Indication for CT SCAN chest:-

• Pneumonia not improving after 48-72 hours of therapy
• Suspicion of complications
• Alternative diagnosis.

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Symptoms of Rheumatoid Arthritis (RA):

The most common symptom of RA is stiffness in the joints in the morning. The most common joints affected by this condition are the hands and feet, but other joints are frequently affected as well. People with RA often develop anemia and experience fatigue as a result. People with RA may also experience inflammation around the heart and in the lungs.

Symptoms of Lupus:

The autoimmune disease of lupus attacks the joints and many internal other organs too, such as the heart and lungs. A common sign of lupus is a rash on the face and elsewhere on the body. These rashes tend to worsen with sun exposure. Other possible symptoms of lupus include joint pain, hair loss, mouth sores, shortness of breath, and blood in the urine. Muscle weakness, bodily inflammation, and seizures may also occur in lupus patients.

Impact on Joints:

Both of these conditions can be challenging to diagnose, especially if the condition is caught early and when symptoms are relatively minor. Both lupus and RA are painful and cause damage to the joints. However, the type of arthritis that is most closely associated with lupus typically causes less joint damage than RA. People with RA are more likely than those with lupus to require surgery for severe joint damage.

Treatment for RA and Lupus:

 There is a genetic connection between the two conditions. Therefore, some of the same treatment strategies for one autoimmune condition may work well for the other one as well. It is also possible for an individual to have both lupus and RA at the same time. This is called comorbidity, which is the existence of multiple diseases that are independent of one another.   Certain treatment plans can help reduce joint pain and organ damage for both conditions and also in the early stages of one disease in which the diagnosis is not yet clear. Although there is no definitive cure for lupus, it is possible to manage the symptoms by taking medications to control joint pain and inflammation.

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Types of Arthritis:

Degenerative – Osteoarthritis:

• Osteoarthritis is a degenerative joint disease.
• It can affect any joint, but most commonly it occurs in the knee, hips, lower back, and neck, small joints, and fingers, and base of the thumb and big toe.
• There is a cushion like structure between joints, it is called cartilage. In osteoarthritis, cartilage breaks down causing pain, swelling, problem in moving the joints
• Osteoarthritis is more common in people older than 65 years of age.
• Affected joints will be painful after the extended activity
• There will be a limited range of motion or stiffness. There can be clicking or cracking sound when a joint bends because of restriction of various daily activities because of osteoarthritis. People can get overweight; they are more prone to falls.

Causes of Osteoarthritis:

• Excessive weight
• Repetitive injuries and overusing of joints
• Previous history of rheumatoid arthritis

Treatment of Osteoarthritis :

• Managing symptoms such as pain, stiffness, and swelling
• Improving joint mobility and flexibility
• Maintaining healthy weight

Inflammatory –  Rheumatoid arthritis:

• Rheumatoid arthritis is an inflammatory arthritis
• Involves small and large joints in a symmetrical manner
• It causes excessive stiffness of joints early in the morning after waking up and improves as the day progress with activity
• If above symptoms are present few blood tests can be done to substantiate the diagnosis these tests are ESR, CPR, RA factor, anti-CCP antibodies.
• Joint symptoms can be accompanied by other systematic involvement like fatigability, anemia, lung involvement.

Metabolic – Gout:

• Characterized by abnormal metabolism of uric acid.
• Gout may occur alone (primary gout) or associated with other conditions (secondary gout)
• Sudden onset of painful, hot, red swollen joint particularly in the foot at big toe should arouse the suspicion of gouty arthritis.

Ways to Help Prevent Arthritis

• Avoid excessive weight gain
• Avoid those exercises which put a lot of stress on your joints
• While performing daily activities avoid those postures which can put a lot of stress on your joints
• Avoid injuries
• Maintain your vitamin D level
• Do daily muscle strengthening exercises but avoid putting pressure on joints
• Maintain good and healthy daily active routine

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Mammography plays a central part in the early detection of breast cancers because it can show changes in the breast up to two years. Doctors recommend screening mammography every year for women. Beginning at the age of 40 years, early detection mammography leads to early detection of breast cancer, when they are curable and breast conservation therapies are available.

Diagnostic mammography:

Diagnostic mammography is used to evaluate a patient with abnormal clinical finding such as breast lumps, nipples discharge, pain etc. A diagnostic mammogram is also done after an abnormal screening mammogram in order to evaluate the area of concern on the screening exam.

There are three types of mammography:

• Digital mammography: In this mammography X-ray film is replaced by electronics that convert X-ray into a mammographic picture of the breast. Those are similar to digital cameras and their efficiency enables better pictures with low radiation dose. The image is saved for long from usage. It is similar to a conventional mammogram.
• Computer-aided detection: System search digitized mammographic image for abnormal areas of density, mass or calcification that may indicate the presence of cancer. CAD system highlights their area on images alerting the radiologist to carefully assess the areas.
• Breast Tomosynthesis: This is called know as 3 dimension mammography and digital breast tomosynthesis, is an advanced form of breast imagining of the breast from different angles are captures and reconstructed into three-dimensional images. Breast tomosynthesis is useful in early detection of small breast cancer.

Benefits of opting for a Mammography:

• Images of the breast improve a physical ability to detect small tumors. When cancers are small there are more treatment options.
• Increases the detection of small abnormal tissue growths confined to the milk duct in the breasts called ductal carcinoma in site.
• It is also useful for all type of breast cancers, invasive ductal, invasive lobular cancers.
• No radiation remains in the body after mammography
• X-ray usually have no side effect in the typical diagnostic range.

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GERMS ARE EVERYWHERE BUT YOU CAN’T SEE THEM

Germs, such as bacteria, parasites, and viruses, are microscopic organisms and are not readily visible to the naked eye. Just because one can’t see them, doesn’t mean that they are not there. Rather, some bacteria and viruses live on our skin and some even live inside our body. Germs also commonly reside on everyday objects such as cell phones, shopping carts, toothbrush etc. They can be transferred from contaminated objects to your hands when you touch them. Some of the most common ways that germs get transferred to our hands are through handling food, by using the toilet or changing a diaper, by coughing or sneezing, and after contact with pets.

GERMS MAKE YOU SICK

Microbes (Bacteria, viruses, fungi and other germs) cause disease in humans. These germs gain access to the body as they are transferred from person to person or from contact with contaminated surfaces. Once inside the body, the germs avoid the body’s immune system and are capable of producing toxins that make us sick. Reactions to these germs can range from mild gastric discomfort and diarrhea to death.

WASHING YOUR HANDS PREVENTS THE SPREAD OF GERMS

• Although following hygiene and sanitation measures is good for health, not many people take it too seriously. This is the reason why most of us fall sick despite being leading a healthy lifestyle and eating nutrient-rich food. The various diseases which can be prevented solely by hand hygiene are as follows.
• Throat infections
• Diarrhoea
• Hepatitis B
• Botulism
• Shigellosis
• Amoebiasis
• Respiratory

IT’S LESS EXPENSIVE THAN A HOSPITAL STAY

Hand washing can be defined as the simplest and easiest way to prevent diseases and opt for a healthy life. It is the best way to prevent numerous deadly communicable diseases such as cold, diarrhea, to list a few.

WASHING YOUR HANDS CAN KEEP YOU HEALTHY

It is the best way to keep germs away from your body. Hence it is important that you wash your hands before having your food and post your toilet breaks. It is also important that you use a good sanitizer and keep it handy for use outside.

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Ways Through Which Germs Spread:

Touching dirty hands, changing dirty diapers, through contaminated water and food, through droplets in the air released during a cough or sneeze, on contaminated surfaces, through contact with a sick person’s body fluids etc.

Hand washing is the simplest way to prevent spreading of infection: 

• Prevents spread of infection: Washing your hands is the best strategy for preventing the spread of infection. Appropriately washing your hands evacuates the dirt and germs that can be spread to others. Having clean hands is critical in light of the fact that individuals regularly utilize their hands to touch their eyes, nose, and mouth. Contact with these regions gives germs, similar to the influenza infection, access to within the body where they can cause disease.
• Keep your hands clean: We should always wash your hands before eating, after using the toilet, and after touching anything that may be soiled or have a high probability of being contaminated with germs. Washing your hands additionally keeps the spread of skin and eye diseases.
• Wash your hands while handling raw meat, fruits and vegetables: It is imperative to wash your hands, particularly in the wake of taking care of raw meat or using the toilet. A noteworthy advantage of ensuring your hands are perfectly clean is that it helps keep you sound and healthy. It likewise keeps nature around you clean, which keeps germs from spreading to others.

Washing and drying your hands is a basic safeguard measure that can be taken to help fight off disease. The healthier you are, the less likely you will have to go for expensive medical treatment at a hospital or emergency care clinic. Utilizing a bar or cleanser to wash your hands is a cheap method for saving your health and the health of everyone around you.

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Types of Juvenile Arthritis:

There are five types of juvenile arthritis:

• Systemic arthritis: It usually causes high fever and a rash. Boys and girls are equally affected.
• Oligoarthritis: This type of arthritis affects fewer than five joints in the very first six months.
• Polyarthritis: It involves five or more joints in the very first six months of disease. The pain points are often the same joints on each side of the body.
• Psoriatic arthritis: It affects children who have both arthritis and the skin disorder psoriasis.
• Enthesitis-related arthritis: This type of arthritis often afflicts the hips, spine, eyes, and entheses.

Signs And Symptoms Associated With Juvenile Arthritis:

Usually, there are no symptoms detected among children who are affected by juvenile arthritis. Type of arthritis can be detected depending upon the symptoms. Following are the symptoms of juvenile arthritis:

• Pain, tenderness in the joints and swelling
• Rash
• Persistent fever
• Stiffness in joints
• Lumping
• Fatigue and weight loss
• Irritability
• Redness and  pain in eyes
• Weight loss
• Fatigue
• Blurred vision

Diagnosis of Juvenile Arthritis:

• It is difficult to diagnose because there is no actual test for juvenile arthritis and diagnosis is done by excluding other conditions that can cause similar symptoms like infection, bone disorder, lupus, fibromyalgia or cancer.
• The doctor will start with complete medical history and will perform the complete medical examination. Some of the tests may include Complete blood count, x-rays, Lab tests, Imaging tests, tests for viruses and Lyme disease, blood cultures, test for rheumatoid, erythrocyte sedimentation, bone marrow examination etc.
• The treatment for juvenile arthritis includes both medication and exercises. The plan for the treatment is based on the type of juvenile arthritis detected.

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SYMPTOMS ASSOCIATED WITH OSTEOPOROSIS:

The early signs of osteoporosis may show no indications. In the later stages, osteoporosis might cause dull pain in the bones or muscles, especially in the lower back or neck. Afterwards, a sharp shooting pain may go ahead all of a sudden. The pain may not radiate, but rather it might get worse by a movement that puts weight on the region, might be accompanied by tenderness, and for the most part, starts to end down in one week.

EXERCISE FOR OSTEOPOROSIS:

Exercise not just builds muscles and endurance but also builds and maintains the amount and thickness of the bones. Types of exercises recommended on osteoporosis are:

• Weight-bearing Exercises
• Flexibility Exercises
• Resistance Exercises
• Weight-bearing means your feet and legs support your body’s weight. A few examples of weight-bearing exercise for osteoporosis are Walking, Hiking, Dancing, Stair climbing.
• Resistance means you’re working against the weight of another object. Resistance helps with osteoporosis because it strengthens muscle and builds bone. It is proved that resistance exercise increases bone density and reduces the risk of fractures.
• Free weights or weight machines at home or in the gym, Resistance tubing that comes in a variety of strengths, Water exercises are few of resistance exercises.
• Flexibility is another important form of exercise for osteoporosis. Having flexible joints helps prevent injury. Yoga and stretching are few of flexibility exercises.

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Fibromyalgia is a chronic disease which causes pain at numerous points throughout the body.The underlying mechanism is over sensitive neural cells in the brain and spinal cord. The degenerative disc is another cause of chronic pain. With degeneration of discs in the neck and lower back, there is bulging or rupture of soft material inside the disc which presses on the nerves leading to pain. Depression can also lead to a backache and joint pains. There is increased perception pain in depression. Management is focussed towards individual disorders and can vary from lifestyle changes to surgery. Lifestyle changes like losing weight and exercise can reduce the risk of osteoarthritis by about 50%. Wearing comfortable and correct footwear also helps. Quitting smoking has a beneficial effect on bone health as well as improving the response to treatment. If the pain is not relieved by lifestyle measures than medicines like pain killers and muscle relaxants can provide relief. But these should be taken after consultation with your doctor especially in patients who are taking treatment for high BP and diabetes. Other alternative therapies like joint fluid replacement are for those who do not benefit from pain killers. If all these measures fail then your doctor may recommend joint replacement surgery. Thus the aim of management is a reduction of disability and restoring the functional capacity as much as possible.

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