WHAT YOU SHOULD KNOW ABOUT FEVER

WHAT YOU SHOULD KNOW ABOUT FEVER! (PART 1)                                             - DR. KARISHMA MANE   Fever or Pyrexia as it is known in the medical world is not a disease by itself. Fever is a symptom manifested by an underlying disease. Fever is not the real enemy in fact most of the times it is part of the human body's fight back mechanism. Fever is defined as an increase of more than 1degree or any rise above maximal normal body temperature.   The average normal body temperature is 98.6 ° F normally as well the body temperature shows fluctuations related to age, time of the day etc. In fact in a lot of people normal body temperature can range from 97°F to 99° F. Body temperature is regulated by a thermostat -the hypothalamus situated at the base of the brain.   What causes fever---------- Exogenous (from outside the body like bacteria virus etc) causes infect the human being which are detected by the immune system and certain pyrogens are released in the process which stimulate the hypothalamus to increase body temperature i.e. cause fever as these infective agents are destroyed by the immune system fight back mechanisms.   Endogenous causes (those that arise within the body like connective tissue disorders, tissue destruction, etc) also can cause fever but the mechanism involves more of antigen-antibody reaction.   Fever can also occur as a result of various endocrine, metabolic disorders, trauma, drug reactions etc.   Ascertaining the cause of fever is the doctor's job and best left to them.   What happens with fever------ When fever starts and the human body tries to elevate temperature, you feel chilly and may shiver to generate heat. At this point, you probably wrap yourself in your thickest blanket and turn up the heating pad. But eventually as your body reaches its new set point you are likely to feel hot. And when your temperature finally begins to return to normal then you may sweat as the body dissipates the heat.   How to measure temperature in fever---- a)      Measuring axillary temperature (under the armpit) for fever—Axillary temperature can be measured with a standard clinical mercury thermometer placed under the armpit for minimum of 2 minutes. Axillary temperature is 1° lower than oral temperature. b)      Measuring oral temperature for fever--- Oral temperature is measured by a clinical thermometer placed under the tongue for at least 2 minutes. Avoid hot or cold drinks for at least 20 minutes before oral temperature measurement. c)      Measuring fever by rectal thermometer—In case of infants (baby less than one year of age) rectal temperature is measured. Rectal temperature will read approximately 1° higher than simultaneously obtained oral temperature. The pediatrician should be requested to show the method of rectal temperature measurement. d)      Measuring fever with a digital thermometer--- A faster time saving method. Only care should be taken to see that it is working accurately.   A well- maintained temperature record that notes the timing, duration and degree of temperature is of great help to the doctor in diagnosing the cause of fever   Care during fever------ During the fever once the temperature is measured after the chills if they appear, a suitable fever reducing medication administered following care measures should be taken---- a)      Remove excess clothing or blankets from the body of the patient once the chills or shivering stops. One layer of light- weight preferably cotton clothing and one light- weight covering should be provided to the patient. b)       The room temperature should be comfortable. If the room is hot and stuffy a fan can help improve ventilation. c)      A tepid /lukewarm water bath or a sponge bath lasting for 5 to 10 minutes helps cool someone with fever especially effective in reducing fever after medication is given. d)      Ice water or cold water baths to be avoided as though they cool the skin, they cause shivering which again increases body temperature. e)      Small feedings of soft or liquid diet as desired should be offered at frequent intervals. f)        Plenty of liquids should be consumed to replace the fluid loss due to sweating.     Part 2 of the same topic we shall look at how we can help the doctor detect the cause of fever i.e reach a DIAGNOSIS and DIET DURING FEVERS.

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BURNING IN CHEST ---IS IT HEARTBURN?                                                    ---- Dr. Karishma Mane   A burning pain in middle of the chest (retrosternal) or at times pain in upper part of the abdomen that travels to the throat is in medical terms called HEARTBURN. It is worse after meals, on lying down and last for a couple of hours. At times, felt as a sharp or pressing pain, which can be unbearable. HEARTBURN is a symptom of a condition known as G.E.R.D. (Gastro Esophageal Reflux Disease). It is caused due to reflux of acidic contents of the stomach backwards into the esophagus. The acidic nature of the stomach's digestive juices damages the lining of the food pipe (esophagus). Other symptoms include ---Regurgitation of   stomach contents into the throat or mouth, Waterbrash, Bad taste in the mouth etc. At the lower end of the esophagus is a sphincter (a muscular gateway that opens and closes to allow a one way flow of food from esophagus to stomach). Normally the sphincter remains contracted to prevent backward flow of stomach contents into esophagus but when it becomes relaxed or weak due to any cause it results in flow of contents back into the esophagus causing damage. FACTORS THAT CONTRIBUTE TO G.E.R.D------ --Stress --Dietary Habits ---Excess of fatty, fried, spicy food,eating large meals, chocolates, caffeine  etc. --Intake of alcohol, smoking, poor posture after meals --Drugs --Obesity leading to hiatus hernia. These factors lead to ---Abnormal functioning of esophageal sphincter, either weak contractions or abnormal relaxations. --Delayed emptying of stomach.     TREATMENT---------------------- LIFESTYLE MODIFICATION is easier said than done. It does not mean giving up all that you like and living on boiled food. It does not mean giving up your lifestyle and living like a sadhu. LIFESTYLE MODIFICATION stands for adapting a change with willingness and not due to pressure. It is about enjoying life without harming our body. Moderation is the key. Practically speaking it means--- --Eating small meals frequently. Avoid making lunch and dinner the only two meals in a day. Have a breakfast every morning and something in the evening. Never skip meals. --Eat at least 2-3 hrs before bedtime. Helps stomach to empty before the person lies down. If you come back late from office eat a small dinner .Eat something that is not heavy and easy to digest. --A walk after meals not a brisk one a leisure stroll both after lunch and dinner helps as if you slouch in your seat immediately after lunch or lie down immediately after dinner it can cause reflux. --If you attend a party, think before you serve yourself at the buffet take in more of salads and only small serving of the most tempting dishes on the menu. --Give up smoking and avoid alcohol. --Fruits are a healthy snack option. If you cannot resist temptation, while consuming something spicy or fried eat only to taste it not to fill your stomach with it. --Everyone has stress. Discover your own stress-busting activity. It could be anything but something that relaxes the mind and brings a smile on the face.  ROLE OF HOMEOPATHY IN G.E.R.D.--- Homeopathy has medicines that help in G.E.R.D. It can relieve the symptoms of heartburn. Homeopathy can definitely treat stress.

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MUMBAI RAINS -----OUR HEALTH

MUMBAI RAINS-------OUR HEALTH                                         Dr. Karishma Mane.     Rainy season is here a welcome relief from the summer heat of April –May. The rains are a special feature of Mumbai, which we all love. They have a character of their own due to their unpredictability, wild breezes and wonderful atmosphere. It is a time for a hot cup of tea, bhuttas, monsoon picnics and colorful umbrellas. This is the time people who live outside Mumbai envy us for the most.   However, there is another side to this pleasure. The rains cause flooding, water logging traffic delays and increased humidity. Due to choked drains, uncollected garbage lying scattered on the roads, badly constructed roads that allow water puddles to form we are deprived of the pleasure of the monsoon.   We need to wade through these dirty waters everyday on our way to work. We end up standing for long hours waiting for our public transport and end up getting wet in the mean time. Also the accumulated water breeds flies and mosquitoes, which infect us directly or indirectly. Our poor civic amenities and infrastructure are the real cause for our sufferings and we end up blaming the rains!!!!!!!!!!!!!!   Our HEALTH suffers due to all the above circumstances. Every year we see an increase in diseases in Mumbai during the rains. Common complains that affect people in this weather-------   §         Fevers ranging from the common viral, influenzas to malaria, dengue, leptospirosis, typhoid etc.   §         Respiratory affections from colds, upper respiratory infections, acute attacks of asthma, pneumonias etc.   §         Skin affections like fungal infections   §         Joint affections like arthritis   §         Gastrointestinal infections, food poisoning.   These are the common systems that suffer the brunt of our daily encounter with the rains.   Preventive care measures can be grouped under three categories------------------   Ø      Personal care measures   Ø      Environmental care measures   Ø      Food care measures       Personal care measures--------------- v     Washing our hands and legs thoroughly especially if we have walked through dirty water. Helps avoiding skin infections. v     Avoid wading through stagnant water whenever possible. v     If possible a warm shower after coming back home from work is helpful both as a preventive and also warmth reduces the stiffness in the joints that arises due to getting drenched on our way to work and remaining in wet clothes throughout the day. v     If possible a spare pair of clothes, footwear should be kept at the work place. Avoid remaining in wet clothing for long. v     Washing our hands thoroughly with soap and water before eating food or after using the washroom. v     If the head gets wet it should be dried fast as this reduces chances of catching a cold. Environmental care measures----------------- v     Prevent accumulation of rainwater in and around the house and work places. v     Clean water reservoirs regularly as stagnant water is a breeding ground for flies and mosquitoes. v     Use mosquito repellants and sleep under mosquito nets. The above three prevent breeding of mosquitoes, which are carriers for malaria etc. v     Water accumulated in the plants in and around the house, air-conditioners should be cleaned everyday. Swimming pools and ponds in the society compound should also be regularly cleaned v      Notification of cases of malaria, dengue in the society to the local BMC authorities so that they can undertake fogging and other preventive measures in the area. Food care measures----------- v     Drinking water should be boiled for at least 20 minutes and stored in closed containers. Take care especially while traveling about the quality of water. Helps avoid water-borne diseases. v     Preferably, consume fresh, hot and well- cooked homemade food. Undercooked or stale food, serve as an environment for bacterial growth. v     Vegetables, salads and fruits should be cleaned thoroughly before eating them. v     Always consume boiled, pasteurized milk only. v     While eating out certain precautions need to be taken. The level of hygiene and quality should be checked before eating in a restaurant. v     While eating out order dishes that are served WELL COOKED, HOT like idlis, soups, dals, steamed products, grilled sandwiches etc. v     Avoid eating chutneys, sauces that are stored at restaurants for long hours at room temperature and are prepared many hours in advance. They are ideal ground for micro- organism growth. v     Avoid eating raw salads, cut fruits outside, as you are never sure if it has been washed and may be lying uncovered for long. v     Milk products and mithais need to be stored at particular temperatures Avoid buying them from open display cases.

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