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Thursday, October 15, 2015

Aasra-Help Talk on 'Mental health Self Care' at Help library, 17th Oct 2015

You Are invited to register and attend the session. REGISTRATIONS WILL BE ON A FIRST COME FIRST SERVE BASIS. Limited seating. Venue: Help Library, Ashish bldg 5th floor, Tardeo end of Bombay central bridge

Thursday, October 1, 2015

Identify and Treat Poor Blood circulation issues

PoorBlood Circulation
Your blood does a fantastic job of transporting nutrients and oxygen to every part of your body, so if you have a problem with your circulatory system, it can create a knock-on effect, that impacts upon your general health. Poor circulation usually stems from other health factors, but it is important that you are aware of warning signs that indicate a problem, as well as the steps you can take to improve the condition should you need to do so. This article will run through some common symptoms of poor circulation, as well some tips for treating it at home.

Symptoms of Poor Circulation
1. Feelings of numbness
Most of us will have accidentally lay on one of our arms while sleeping at some point, and will be familiar with the numb feeling that tends to result. This sensation comes about because you have inadvertently limited your blood circulation. If you find that you often experience a similar sensation in your limbs without an obvious trigger, it could be a sign that your blood circulation is permanently restricted.
2. Loss of Appetite
If you don't feel hungry, despite having skipped a meal, it could indicate a circulatory problem. Your liver sends signals to your brain to tell it you're hungry, but it can only do this when it receives adequate blood flow. This symptom can also cause weight loss over time as you will eat less.
3. Cold Hands and Feet
Your blood flow is also responsible for ensuring your body stays at a healthy temperature, and rubbing cold hands together is a natural response we all use to try and encourage blood to flow more quickly. If your circulation is compromised, areas of the body with lots of nerve endings like the hands and feet can feel unusually cold.

4. Skin Discoloring
Cyanosis is a condition characterized by a slight discoloration of the skin due to low oxygen levels just below the skin's surface. If you have poor circulation, you may see signs of cyanosis, and your fingers and toes may appear slightly bruised or red.
5. Varicose Veins
If your blood is not pumping as it should, pressure can build and cause veins to twist and swell. The resulting varicose veins tend to appear on the lower legs and cause pain or itchiness. Varicose veins can be both a symptom and cause of poor circulation, but there are also some specific home remedies you can use to treat them.
6. Brittle Nails and Hair Loss
Your nails and hair can provide some of the clearest signs that your blood is not distributing the required amount of nutrients around your body. Hair can become thin, dry and even start to fall out, whether you are male or female. Your nails will become weaker and more prone to breaking.

7. Swelling and Leg Ulcers
In extreme cases, poor circulation can cause swelling in extremities. If your hands or feet begin to swell it could be a result of slow blood flow, which causes fluid to gather. Leg ulcers are sore inflamed parts of the skin characterized by a rash that refuses to go away. If you notice red patches or swelling gathering around your ankles or lower legs, you may have problems with circulation.

8. Exhaustion
Restricted blood flow means less oxygen and nutrients reach the muscles, so you will become fatigued much more easily. Lack of breath, sore muscles, and the inability to complete physical tasks that you should find easy are all indicators of poor circulation.
9. A Tight Chest
Your heart might pump your blood around your body, but it also needs to be supplied with plenty of blood flow as well. If it isn't, then you may develop angina, characterized by feelings of tightness in the chest. If pain recurs in fits and spurts, it can be a common indicator of poor circulation.

10. Poor Libido or Erectile Dysfunction
Poor circulation can cause associated problems with both the female and male libido because reproductive organs require a sizeable supply of blood in order to function properly. The obvious issue that can affect men is erectile dysfunction while women may suffer from irregular menstrual cycles and a loss of energy in the bedroom.
11. Forgetfulness and Concentration Issues
The brain is another organ that needs to be fed a regular supply of oxygen, and it only gets the stocks it needs if your blood is flowing as it should. Poor circulation will affect your ability to focus and concentrate when going about your daily business, and can have a negative impact on both short-term and long-term memory.
12. Digestive Issues
If your blood flow slows down, it will have an impact on a number of bodily processes and digestion is one of them. This can reduce the frequency of bowel movements and even contribute to constipation.
What Should You Do If You Think You Have Poor Circulation?
If you are exhibiting many of the signs of poor circulation, you will want to know what to do next. Firstly, if you are concerned about your symptoms or they are causing you great pain and discomfort, it is extremely important that you book an appointment to see your doctor. Poor circulation can itself be a symptom of other conditions such as diabetes, peripheral artery disease, heart disease, obesity or blood clots, so you should get yourself checked out if you're concerned.
However, there are a number of lifestyle changes that can help you combat poor circulation if you are suffering from it, or stop it from developing before you experience any major symptoms. Here are some of the most recommended:
1. Keep Yourself Moving
It's the nature of the world we live in today that many of us spend a huge amount of time inactive and seated. But your circulatory system requires movement to function properly, and regular daily exercise (even just a short 30 minute walk every day) is the best way to keep your blood pumping quickly and ward off symptoms.
2. Don't Overdo Alcohol or Stimulants
Stimulants, like coffee, energy drinks, and diet pills, have an effect on your blood. If you take too much, too often, it can lead to poor circulation and bigger issues down the line. Coffee and tea have some health benefits and you don't need to cut them down altogether, but try to reduce to 2-3 cups a day. Avoid other stimulants altogether. Similarly, alcohol intake should be limited to no more than 1-2 units per day.
3. Relax and Unwind
Stress is not good for your heart, and can have a bigger impact upon your blood circulation than you might think. Take some time out to relax in a warm bath, run through some yoga exercises, meditate, or sit in a scented room lit by candles and read. Whatever relaxation tip works best for you is fit for purpose!

4. Apply Rosemary Oil
Tense cramped muscles can compromise blood flow and lead to problems associated with poor circulation. If you find yourself cramping up around the neck, shoulders, or legs, ask someone to massage rosemary essential oil mixed with olive oil into the problem area. Use 20-30 drops of rosemary oil for every 2oz of olive oil. Lavender essential oil can help too.
5. Combine Hot and Cold Showers
When you shower, try applying hot then cold water on to areas affected by poor circulation. The hot water causes blood to rush immediately to the problem region while the cold water encourages it to speed to your organs. You may find it bracing, but it helps keep your circulatory system moving and your skin oxygenated.
6. Add Nuts and Seeds to Your Diet
Several different nuts and seeds contain goodness that can reduce inflammation and oxidative cell damage within your vessels and arteries, keeping your blood circulating freely. Walnuts and almonds are the two of the best nuts to use and have plenty of other uses too -find out more here. A whole host of seeds can also benefit your circulation, including flaxseed, chia, pumpkin, and pine. Sprinkle them on your salad or sandwich, or add to them to other dishes.

7. Pick the Perfect Posture
Bad spinal alignment is a recipe for poor circulation, but many of us have poor posture. Try to train your body so that it naturally holds good posture by engaging in good practices. You can learn more about posture control here.
8. Create the Perfect Salad
Veggies are fantastic for your heart and circulatory function, and if you use the right combination in your salad, they can help boost your defences against poor circulation. Try to keep things varied. Mix dark leafy greens such as kale or spinach with bell peppers, celery/cucumber, onions, and olives. Get your crunch from the already discussed nuts and seeds rather than croutons. Finally, garnish with parsley, one of the best herbs for healthy circulation.
9. Root Out the Problem
Garlic, onion and ginger are all root vegetables that should form a part of everyone's diet. They have so many benefits, including the stimulation of the circulatory system. All three are excellent anti-inflammatories and can help you in so many ways!

10. Switch to Green Tea
Green tea is wonderfully healthy and provides many of the benefits of stimulants without the associated problems. It will provide you with plenty of energy and goodness, without any adverse effects on your blood circulation.
11. Look At Your Feet
Or more specifically, check out your shoes. It might sound unlikely, but a good pair of shoes can really reduce the impact walking has on your body. If yours are too tight or the wrong shape, it could be time to change them for the good of your circulation. 
12. Add Some Spice
Many spices can help improve circulation, but cayenne pepper is considered to be one of the best. It also boosts metabolism and clears your sinuses, so you have plenty of reasons to add some heat to your favourite dish!

Know your Enemy- Dengue Fever

Dengue fever

Here's an FAQ on what you MUST know about Dengue fever
Following a surge in the number of dengue cases in Delhi, the government has launched a 24-hour helpline -- 011-23307145 -- that will function round the clock to provide all relevant information about dengue and its treatment. The Health minister has directed municipal commissioners to send out bulk SMSes to people containing the message: "Dengue is curable and there is no cause for panic."
With 613 fresh cases reported over the last one week, the Delhi government was forced to cancel leave of doctors, open 'Fever Clinics' to treat those hit.

What is dengue fever?

Dengue infection is caused by a virus. It occurs commonly as dengue fever. Occasionally the patient suffering from dengue may develop bleeding.
Common sites for bleeding are nose, gums or skin. Sometimes, the patient may have coffee ground vomiting or black stools. This indicates bleeding in gastro- intestinal tracts and it is serious. 

The patient with dengue who has bleeding, has dengue haemorrhagic fever (DHF). Rarely the patient suffering from dengue may develop shock, then it is called dengue shock syndrome (DSS).

When should I suspect dengue?

Dengue should be suspected when you have sudden onset of fever. 

The fever is high 103-105 degrees F or 39-40 degrees C. It is accompanied with severe headache (mostly in the forehead), pain behind the eyes, body aches and pains, rash on the skin and nausea or vomiting.
The fever lasts for 5-7 days. In some patients, fever comes down on 3rd or 4th day but comes back. All the above symptoms and signs may not be present in the patient. The patient feels much discomfort after the illness.

There are several types of fever, when
should dengue be suspected?
The characteristics of dengue that make it different from other causes of fever are the pain behind the eyes, severe pains in the muscles, severe joint pains, and skin rashes.

These features make the diagnosis of suspected Dengue likely. The severe joint pains caused by DF are the reason why DF is also called break-bone fever.

What is the difference between suspected
and probable case of dengue?
If a patient suspected to be having dengue has reduced platelets or an increase in bloodhaematocrit, then the patient has probable dengue. These additional findings make dengue more likely. Patients with dengue may not have a high haematocrit if the person was anaemic to start with.

(Platelets are cells in blood that help to stop bleeding. Haematocrit indicates the thickness of blood).

Can you get dengue again after suffering
from it once?
It is possible to get dengue more than once. Dengue can occur because of 4 different but related strains of dengue virus. 
If a person has suffered from one virus, there can be a repeat occurrence of dengue if a different strain is involved subsequently. Being affected by one strain offers no protection against the others. A person could suffer from dengue more than once in her/his lifetime.

Can the diagnosis of dengue be

There are laboratory tests that provide direct or indirect evidence for dengue fever. 

These tests provide evidence for the occurrence of dengue infection. There are some additional tests that can help to identify the type of dengue infection. The tests for confirmation of dengue should be done in reliable laboratories.

How can someone get dengue fever?

Dengue fever occurs following the bite of an infected mosquito Aedes aegypti. This type of mosquito has a peculiar white spotted body and legs and is easy to recognise even by laymen. 
It breeds in clean water and has a flight range of only 100-200 metres. The mosquito gets the dengue virus after biting a human being infected with dengue virus.

Can someone get dengue fever from
another person?
Dengue does not spread directly from person to person. It is only spread through the bite of an infected mosquito.

When does dengue develop after getting
the infection?

After the entry of the virus in the person, it multiplies in the lymph glands in the body. The symptoms develop when the virus has multiplied in sufficient numbers to cause the symptoms. This happens generally about 4-6 days (average) after getting infected with the virus.

Can people suffer from dengue and not
appear ill?
Yes. There are many people who are infected with the virus and do not suffer from any signs or symptoms of the disease. For every patient with symptoms and signs there may be 4-5 persons with no symptoms or with very mild symptoms.

Can dengue fever be treated at home?
Most patients with dengue fever can be treated at home. They should take rest, drink plenty of fluids that are available at home and eat nutritious diet. Whenever available, Oral Rehydration Salt/ORS (commonly used in treating diarrhoea) is preferable. 

Sufficient fluid intake is very important and becomes more important in case DFprogresses into DHF or DSS where loss of body fluid / blood is the most salient feature. It is important to look for danger signs and contact the doctor as soon as any one or more of these are found.

What is the treatment? Is it curable?

Like most viral diseases there is no specific cure for dengue fever. Antibiotics do not help. Paracetamol (can be purchased without prescription) is the drug of choice to bring down fever and joint pain. 

Other medicines such as Aspirin and Brufenshould be avoided since they can increase the risk of bleeding. Doctors should be very careful when prescribing medicines. Any medicines that decrease platelets should be avoided.

Can dengue fever become dangerous?

The symptoms and signs of dengue haemorrhagic fever and dengue shock syndrome are related to damage to the blood vessels and derangement in functioning in components of blood that help it to clot.

Can people die from dengue fever?

People who suffer from dengue fever have no risk of death but some of them develop Dengue Haemorrhagic Fever or Dengue Shock Syndrome. 

In some of these cases death can occur. With proper treatment, the patients with Dengue haemorrhagic fever and dengue shock syndrome can recover fully. Good treatment provided in time can save most lives.
When should a patient suffering from
dengue go to the hospital or consult a

Generally the progress towards dengue haemorrhagic fever or dengue shock syndrome occurs after 3-5 days of fever. 

At this time, fever has often come down. This may mislead many of us to believe that the patient is heading towards recovery. In fact, this is the most dangerous period that requires high vigilance from care-givers. 

The signs and symptoms that should be looked for are severe pain in the abdomen, persistent vomiting, bleeding from any site like, bleeding in the skin appearing as small red or purplish spots, nose -bleed, bleeding from gums, passage of black stools like coal tar. 

Bring the patient to the hospital whenever the first two signs, namely, severe pain in the abdomen and persistent vomiting are detected. Usually, it is too late if we wait until bleeding has occurred.

The most dangerous type of dengue is the dengue shock syndrome. It is recognised by signs like excessive thirst, pale and cold skin (due to very low blood pressure), restlessness and a feeling of weakness.

Is there a vaccine to prevent dengue
A vaccine has been developed to prevent dengue fever, but it is still under trial. It is not yet available in the market. Scientific progress is likely to help in prevention of dengue fever by vaccination in the years to come.
Are there any long-term ill effects of dengue fever?

Most people who suffer from dengue fever recover in 1-2 weeks time. Some may feel tired for several weeks. However, if symptoms persist after this period, consult a doctor.

Where does the mosquito that spreads
dengue live?

The highly domestic mosquito Aedes aegypti rests indoors, in closets and other dark places. Outside, it rests where it is cool and shaded. The female mosquito lays her eggs in water containers in and around the homes, and other dwellings. These eggs will develop, become larvae, and further develop into adults in about 10 days.

How can the multiplication of mosquitoes
be reduced?

Dengue mosquitoes breed in stored, exposed water collections. Favoured places for breeding are barrels, drums, jars, pots, buckets, flower vases, plant saucers, tanks, discarded bottles, tins, tyres, water coolers etc.
To prevent the mosquitoes from multiplying, drain out the water from desert coolers/window air coolers (when not in use), tanks, barrels, drums, buckets etc. 

Remove all objects containing water (e.g. plant saucers etc.) from the house. Collect and destroy discarded containers in which water collects e.g. bottles, plastic bags, tins, used tyres etc.

In case it is not possible to drain out various water collections or to fully cover them, useTEMEPHOS, an insecticide, ( brand name Abate) 1 part per million according to the local guidelines to prevent larvae from developing into adults

How can I prevent mosquito bites to
prevent dengue?

There is no way to tell if a mosquito is carrying the dengue virus. Therefore, people must protect themselves from all mosquito bites.

Dengue mosquitoes bite during the daytime. Highest biting intensity is about 2 hours after sunrise and before sunset.

Wear full sleeves clothes and long dresses to cover as much of your body as possible.
Use repellents -- be careful in using them in young children and old people. 

Use mosquito coils and electric vapour mats during the daytime also to prevent dengue.

Use mosquito nets to protect children, old people and others who may rest during the day. The effectiveness of these nets can be improved by treating them with permethrin(pyrethroid insecticide). This bed-net is called Insecticide Treated Nets and are widely used in the prevention of malaria.

Is there any advice for the patient with
dengue fever to prevent the spread of the
disease to others?

The spread of dengue from a patient to others is possible. The patient should be protected from contact with the mosquito. 

This can be achieved by ensuring that the patient sleeps under a bed-net. Effective mosquito repellents are used where the patient is being provided care. This will prevent the mosquito from biting the patient and from getting infected and spreading it to others.

Any advice on travel if there is an
outbreak of dengue?
There is no travel restriction. However, you should be aware of what to do if you are travelling an area where dengue has been reported. 

This includes observing prevention measures described in these frequently asked questions and answers and reporting to the doctor if you have fever, and are worried that it might be dengue fever.

What should the doctors treating
dengue do?
Patients suspected to be suffering from dengue haemorrhagic fever or dengue shock syndrome should be admitted to a hospital without delay. 

The progress of these patients should be monitored regularly at 1-2 hours interval. 

Platelet counts and haematocrits should be monitored repeatedly to review the progress of patients.
If the haematocrit levels fall dangerously then a blood transfusion should be considered. A fall of more than 20 per cent, as compared to previous levels may be an indication for transfusion.

If the haematocrit values rise the patient should be given fluids intravenously and the fluids carefully monitored to ensure that the patient does not get excess per cent as compared to previous levels may be an indication for IV fluids. 

The doctor should decide based on best judgement of patient's condition.

What should the doctors treating dengu
NOT do?

Do not prescribe aspirin and brufen, or any other medicine that reduces the platelets or increases the tendency to bleed. 

Avoid giving IV fluids unless the patient is bleeding or the haematocrit level is rising progressively.

Avoid rushing into giving blood transfusion unless the haematocrit is falling dangerously.

Do not give platelet transfusion unless the platelet count is very low or unless there is bleeding.

In the case of a dengue outbreak or
epidemic what are our strategies?
Prevention of mosquito breeding places remains our mainstay. However, to stop or to slow down the transmission it may be supplemented by "thermal fogging", using fogging machines.

In fogging, we use an insecticide that has an immediate knockdown effect on adult mosquitoes.

When fogging is undertaken after an epidemic occurs, it is unfortunately too late.

Fogging, to be effective, should be done at about 3-4 days interval. It is expensive and time-consuming.

Therefore, measures undertaken by the community, for the community, to prevent the breeding of mosquitoes is far more cost-effective than containment measures once an outbreak occurs.