#Thinkhealth blog

Don’t panic….. instead, take precautions for avoiding infection with 2019 Novel Coronavirus (2019-nCoV)

Human Coronavirus has been the most heard word in the world in recent times, because of its outbreak which was recognized in Wuhan, China in December 2019. Human coronavirus is usually considered for causing the common cold in otherwise healthy people. However, in the 21st century the two highly pathogenic human Coronaviruses which are Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS- CoV) emerged from the animals sold for foods, they are suspected to be reservoirs to cause Global epidemics with a high rate of morbidity and mortality. Because of the recent outbreak in China, human Coronaviruses received more attention.

In December 2019, pneumonia cases of unknown cause emerged in Wuhan, China with clinical presentations resembling viral pneumonia. After the proper analysis of the lower respiratory tract samples, indicating a novel coronavirus, it was named as ‘2019 novel coronavirus’ (2019-nCoV).

 Mode of Spread:

The initial spread is thought to be from animal to man, as the first identified infected individuals were workers at a seafood market. But later spread to a few individuals with 2019 novel Coronavirus indicated a person to person spread similar to influenza and other respiratory pathogens’ spread. It is thought to have happened mainly by respiratory droplets produced when an infected person coughs or sneezes.

 Symptoms:

Common symptoms reported are:

1.       Fever
2.       Fatigue
3.       Dry Cough
4.       Shortness of breath
5.       Headache
6.       Blood while coughing, chest pain
7.       Sometimes diarrhea

Severe infection can result in pneumonia, kidney failure, and death.

How is the diagnosis made?

Any person fulfilling the epidemiological and clinical criteria should be tested for 2019-nCoV. 

Epidemiological criteria:  Any person with travel-history to Wuhan City, China in the 14 days before the onset of illness OR Any person being in close contact with a laboratory-confirmed case of 2019 novel Coronavirus, 14 days before the onset of illness.

Clinical criteria: Any person with clinical symptoms compatible with severe acute respiratory infection seeking healthcare or admitted to hospital with clinical or radiological evidence of pneumonia OR Any person with fever or recent history of fever (>=38°C) and acute respiratory infection (sudden onset of respiratory infection with one or more of the following symptoms: shortness of breath, cough or sore throat)

Diagnosis is made through laboratory testing of respiratory specimens and serum (blood). The specific test currently recommended by WHO for the diagnosis and confirmation of 2019-nCoV is by real-time RT-PCR.

Treatment:

Currently, there is no specific treatment recommended for the respiratory illness caused by the ‘2019 novel coronavirus’. Symptomatic treatment is given to help relieve symptoms. Support for the vital organ function should be given in severe cases.

How can you protect yourself?

1.  Washing hands for at least 20 seconds with soap and water when you come home from the outside is advisable.
2.  You can also use an alcohol-based hand sanitizer when soap and water are not available
3. Avoid touching your eyes and nose repeatedly.
4. Covering your nose and mouth while you cough or sneeze with tissue is advisable
5.  Avoid close contact with people who are sick with respiratory symptoms. 
6.  It is advisable to stay at home when you are sick so that you don’t spread germs to others.
7.  It is necessary to clean and disinfect objects and surfaces frequently.
8. Avoid huge gatherings and crowded places.
9. People with other chronic medical conditions, elderly, infants and children need to be given special protection and care
10. Pregnant women too need to take extra precautions to avoid the infection with Corona Virus 

 Avoiding exposure to the virus is the best way of prevention.

Currently, there is no vaccine for the 2019 Novel Coronavirus. Trails are going on for the same.

References:

https://www.webmd.com/lung/coronavirus#1

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

– Dr. Y. Alekhya.

 

The winter almost set in and with the various joys and good moments, it also brings with it certain health issues that we need to be vigilant about. Read on to know the health problems that are commonly seen in winter and what we can do about them.

Bone, Joint and Body pains – dropping temperatures are known to cause an increase in joint and bone pains. This season is especially very troublesome for people who suffer from arthritis.

Useful tips to prevent/deal with joint pains-

• Keep your joints warm.
• Make sure to do light warm up exercises.
• Massaging the joints that hurt, with warm oil can help.
• Adding supplements such as vitamin D, omega-3- fatty acids after consulting your doctor can help.
• Keep your pain relievers handy.

Respiratory system challenges – Cold weather is known to cause increase in cases of respiratory system issues like Asthma, flu, common colds, sinusitis, bronchitis, sore throat and pneumonia.

Useful tips to prevent/ deal with them-

• Keep safe from very cold air/wind when going out by covering your mouth and nose lightly.
• If you are an asthmatic, meet with your doctor and update yourself on medication that you may be needing and stock them so that they are handy when you need them.
• Influenza, flu, sore throat and pneumonia are contagious diseases and can be prevented by following simple measures like wash your hands regularly and covering your mouth when sneezing/coughing.
• Taking enough rest, exercising on regular basis, eating healthy diet and keeping yourself hydrated can help.
• For sore throat, gargling with warm water and salt can help.
• If you regularly face problems with respiratory system, arranging for a steam machine or a nebulizer is to be considered.

Winter skin problems – dry itchy skin, chapped lips, flaky skin, cracked feet and pre-existing skin disorders like eczema and psoriasis can flare up in winters due to the dryness in air.

Useful tips to prevent/deal with winter skin problems-

• Stays hydrated and moisturize your skin with natural moisturizers.
• For flaky skin, exfoliate and then moisturize.
• For chapped lips, lips balms or creams that contain vitamin A and Vitamin E can help and work best if applied on moist lips.
• For itchy skin, it is best to avoid long times in warm showers
• It is best if woollen clothes are not in direct touch with skin.
• If you have a pre-existing skin condition, keep away from harsh soaps or chemicals and keep your medicated creams ready!

Heart problem in the elderly – if you have an elderly at home, now is the season to get them evaluated especially if they already have pre-existing issues of heart or blood vessels since due to drop in body temperature (hypothermia) in the colder months the heart is affected by increased heart rate and blood pressure, where the heart needs to function harder to keep the body warm.

Useful tips to prevent/deal with heart problems/ hypothermia in elderly-

• Install thermostats in homes to keep the temperature at a constant, safe temperature.
• Hot water bags or electric blankets can be used.
• Encourage them to do some mild exercise.
• Special steps must be taken in cold seasons for their health evaluation and they must be encouraged to take their medicine on time.

By,

Dr.Afroze Fatima

References-

https://www.india.com/lifestyle/winter-health-problems-5-common-health-problems-in-winter-and-how-to-prevent-them-2752331/

https://www.mapsofindia.com/my-india/india/5-most-common-winter-illness-you-must-be-aware-of

https://www.skymetweather.com/content/health-and-food/5-ways-to-enjoy-disease-free-winter/

https://www.onlymyhealth.com/winter-health-problems-1292484682

https://www.quora.com/What-diseases-are-generally-common-in-India-during-the-winter-the-rainy-and-the-summer-seasons-and-how-can-you-prevent-them

https://www.indushealthplus.com/common-winter-health-problems.html

https://www.hdfcergo.com/blogs/health-insurance/precautions-to-be-taken-in-winter.html

 

NOCTURIA- If you are having to get up at night to pee more than you usually do, here is an article for you!

A frequent need to get up to urinate at night is called nocturia. To get up once to urinate is said to be normal. However, if a person has to 2 or more than 2 times in one night (6-8 hours of sleep), nocturia is suspected.

Nocturia is seldom a disease in itself, it is often a symptom of other underlying causes which include certain lifestyle habits or medical conditions.

Causes of Nocturia-

1. Drinking too much or too close to bedtime is one of the most common causes of nocturia.
2. Having alcohol or caffeine late in the day.
3. A urinary tract infection (UTI) triggers a need to pee more during the day and at night but is seldom the only symptom and may be accompanied with pain, burning during the passage of urine or lower abdominal pain, fever.
4. Older age too is related to nocturia. As we age, our body produces less of a hormone that helps concentrate urine which helps us hold urine till morning and thus there is a need to get up to pee at night.
5. Pregnancy and childbirth weaken the bladder and pelvic floor muscles and cause frequent night time and day time urination in women.
6. Certain medications which are given for other health problems, such as hypertension may cause one to pee more especially if taken close to bedtime. 
7. Other medical conditions such as diabetes, prostate issues, neurological issues, and ongoing pregnancy.

Diagnosis of Nocturia-

Diagnosing the cause of nocturia can be tricky and needs a variety of investigations and a detailed questionnaire from your doctor is to be expected. It is therefore very important to maintain a diary if you have been having the problem of excessive nighttime urination for quite some time. The important point to keep noting in the diary is what you drink and how much, how often you need to urinate.

Few of the questions to be expected by your doctor are-

1. When did the nocturia start?
2. How many times do you have to urinate every night?
3. Are you producing less urine than you did before?
4. Do you have accidents or have you wet the bed?
5. Does anything make the problem worse?
6. Do you have any other symptoms?
7. What medications are you taking?
8. Do you have a family history of bladder problems or diabetes?

It is, therefore, an important thing to be prepared with information to the above questions beforehand. A few of the common tests done to rule out the causes of nocturia are- urinalysis and urine culture, blood sugar test to check for diabetes, other blood tests for blood counts and blood chemistry, imaging tests, such as ultrasounds or CT scans.

Tips to deal with nocturia-

Treatment for night time urination majorly depends on its cause and it usually resolves once its underlying cause is found out and treated.

Here are a few tips to deal with night time urination-

1. Drink your normal amount of liquid but do so earlier in the day. Reducing the amount you drink 2 to 4 hours before bedtime can help prevent you from needing to urinate at night.
2. Cut down on any drinks in the last two hours before you go to bed – especially alcohol, coffee or tea as these stimulate urine production. 
3. Keep a diary of how much you drink, what you drink, and when. This may be helpful in identifying the factors or situations which cause or worsen the nocturia.
4. Some food items can be bladder irritants, such as chocolate, spicy foods, acidic foods, and artificial sweeteners. Avoid them.
5. Kegel exercises and pelvic floor physical therapy can help strengthen your pelvic muscles and improve bladder control.
6. Paying attention to what worsens the symptoms is important so that you can try to modify your habits accordingly. 
7. Take an afternoon nap- if you have been getting up frequently due to nocturia, a nap can help you feel better during the day.
8. Avoid setting excessively low temperatures on the Air conditioner at night to avoid cold-induced diuresis.

By

Dr. Afroze Fatima

References

https://www.healthline.com/symptom/night-time-urination

https://www.webmd.com/urinary-incontinence-oab/nocturia-pee-night

https://www.sleepfoundation.org/articles/nocturia-or-frequent-urination-night

https://www.healthline.com/health/urination-excessive-at-night

https://my.clevelandclinic.org/health/diseases/14510-nocturia

 

Even though it is very common during childhood, it should be evaluated further in case of prolonged bed wetting even after 5 years. Bed wetting occurs more commonly in boys aged 4-11 years than girls. Most of the parents think that bedwetting is due to laziness which is not the actual cause.

Causes:

Cause can be due to physical or psychosocial factors. If the child spends all day under strong pressures whether from parents or from school. Major reasons include:

1. Stressful homelife and conflict between parents
2. Poor daytime toilet habits
3. Urinary tract infection
4. Diabetes
5. Down’s syndrome
6. Attention deficit hyperactivity disorder
7. Deep sleep and arousal disorder
8. Congenital malformations of genitourinary tract
9. Chronic constipation in which full bowel will put pressure on bladder
10. Slow development of bladder control

Laboratory tests:

• Urine analysis is the first step in which we check the pus cells, protein, casts and glucose to rule out urinary tract infections and renal disease.
• Random blood sugars are checked to rule out diabetes.
• Urine culture is based on the urine analysis report.
• Children with complicated enuresis may need further evaluation with renal ultrasound and voiding cystourethrogram.

Treatment:

• Reassurance is the best approach for both the child and parents.
• Avoid punitive measures that can affect child’s psychological development adversely.
• Fluid intake should be restricted to 60ml after 6-7pm.
• Parents should be certain that the child voids at bedtime.
• Avoiding sugars and caffeine after 4pm can also be helpful.
• Waking children few hours after they go to sleep can help them to wake up dry.
• The child should not be blamed for bed wetting.
• Praise the child and give them a star if they wake up dry.
• Some pharmacological measures are there to give short term relief but  can be only advised by doctors, if the above measures do not work.
• If there is any underlying cause like diabetes or structural abnormalities, treatment is given to treat that first.

References:

https://www.webmd.com/urinary-incontinence-oab/bed-wetting-in-adults

https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
By,

Dr.Y. Alekhya.