DOG BITE:

DOG BITE

Good morning folks had come up with a few cases of Dog bite off late so thought would be helpful enough to write a few words about what are the Do’s and Don’ts in case of a dog bite:

Do’s:

-Wash well with soap and water immediately.

-Splinting of the limb is advisable.

-Keep the dog under observation in isolation if possible.

-Take the victim to nearest medical facility at the earliest.

- Vaccination with/ without immunoglobulin should be given at the earliest.

-Tetanus toxoid if not taken within last 5years.

-Antibiotics, Analgesics and local dressing.

-Leave the wound open with a dressing and regular follow-up.

-Immunization schedule to be completed.

-Pets should be immunized for Rabies.

-Not just Dogs- Any warm blooded animal should be considered as source of Rabies and immunization to be taken.

Don’ts:

-Trying for home remedies and local healing practices.

-Primary suturing of wound should be avoided.

-Discontinuation of immunization schedule after 1st week.

-Pets bites are not serious and not require immunization.

-Pets not getting immunized since they are mainly indoors only.

Table 2:- Immunization schedule for subjects with no or inadequate immunity
Schedule A	Schedule B	Schedule C
Prophylactic immunization prior to exposure.	Immunization after exposure.	Concomitant prophylaxis after exposure.
One injection IM on days 0,7,28 and 365	One injection IM on days 0,3,7,14,30 & if necessary on day 90.	Rabipur® as in SCHEDULE B + 1 X 20 I.V./kg body wt. human rabies immunoglobulin concomitantly with injection of Rabipur or on day 7 after the first injection of Rabipur® at the latest.

The Category of bite and Schedule to be followed is laid down in the below columns for easy reference:

Grade of exposure	Type of exposure		Immunization schedule
	Contact with a rabid or suspected rabid animal	Contact with an inoculated animal
I	Touching/feeding animal, but no contact with saliva; and skin undamaged prior to and during contact	Touching inoculated lure, skin intact	No immunization necessary If uncertainty exists than SCHEDULE B is to be followed.
II	a) Animal has nibbled or licked exposed skin. b) Contact with saliva c) Superficial, non- bleeding scratches made by the animal	Touching inoculated lure, skin damaged.	Immediate immunization according to SCHEDULE B. In case of uncertainty concomitant prophylaxis as specified in SCHEDULE C. If animal is examined & found to be non-rabid then continue as in SCHEDULE A
III	a) All bites b) Bleeding scratches c) All scratches on the head, neck, scapular region, arm & hands d) Contact of animal saliva with mucous membrane of patient	Contact of inoculated lure with mucous membrane or fresh skin wound	Immediate concomitant prophylaxis per SCHEDULE C. If animal is proved non-rabid it is adjustable to continue treatment as in SCHEDULE A.

Doctors life...!!!: Living Normal with Asthma:

Doctors life...!!!: Living Normal with Asthma:: "Living Normal with Asthma: Asthma is a long-term disease that requires long-term care and management. The goal of treatment is to keep the ..."

Living Normal with Asthma:

Living Normal with Asthma:

Asthma is a long-term disease that requires long-term care and management. The goal of treatment is to keep the disease under control and improve quality of life and decrease the number and severity of episodes of breathlessness. Successful asthma treatment requires you to take an active role in your care and follow your asthma action plan and be persistent and systematic in your treatment which requires a lot of motivation and determination both from your side so also from your family , friends and work colleagues.

Ways to Manage Your Asthma:

Participation:

Active participation in treatment process by Teaming up with your doctor and develop an “Asthma action plan”. This plan will help you know more about your condition and also when and how to take your medicines. The plan also will help you identify your asthma triggers and manage your disease if asthma symptoms worsen.

Kids aged 10 or older—and younger children who can handle it—should be involved in developing and following their asthma action plans, so also should be the case with elderly giving them enough motivation and a feeling of more in control of themselves. For a sample plan, go to the National Heart, Lung, and Blood Institute's Asthma Action Plan.

Most important trick is in successfully managing their symptoms at home by following their asthma action plans and having regular checkups. However, it's important to know when to seek emergency medical care and when you can wait and watch.

Use of Medicines:

Inhaled medicines: Which is now a days the mainstay of treatment , you should get detailed instructions and demonstration from your doctor on the ways of using the inhaler and precautions to be taken. If not taken in the proper way the efficacy is low and desired results may not be achieved.

Strictly adhere to your treatment regime and schedule. Do consult your doctor if u feel you are having more frequent or severe episodes for revision of dosage.

Personal Log:

Record your asthma symptoms and episodes with date and time of occurrence as a way to track how well your asthma is controlled. Also, your doctor may advise you to use a peak flow meter to measure and record how well your lungs are working. You must take these records with you for the next visit. (For more information on using a peak flow meter, go to "How Is Asthma Treated and Controlled?")

You can either maintain it in a Tabular column format or as a diary entry of your daily occurrences. These steps will help you keep track of how well you are controlling your asthma over time and will help you and your physician spot problems early and prevent or relieve asthma attacks. Recording your symptoms and peak flow results to share with your doctor also will help him or her decide whether to adjust your treatment.

Ongoing Care

Have regular asthma checkups with your doctor so he or she can assess your level of asthma control and adjust your treatment as needed. Remember, the main goal of asthma treatment is to achieve the best control of your asthma using the least amount of medicine. This may require frequent adjustments to your treatments.

If it's hard to follow your asthma action plan or the plan isn't working well, let your health care team know right away. They will work with you to adjust your plan to better suit your needs.

Get treatment for any other conditions that can interfere with your asthma management.

Always checkup before you go on a trip or for camping trips or during climatic changes.

Watch for Signs That Your Asthma Is Getting Worse

Your asthma may be getting worse if:

• Your symptoms start to occur more often, are more severe, and/or bother you at night and cause you to lose sleep.
• You're limiting your normal activities and missing school or work because of your asthma.
• Your peak flow number is low compared to your personal best or varies a lot from day to day.
• Your asthma medicines don't seem to work well anymore.
• You have to use your quick-relief inhaler more often. If you're using quick-relief medicine more than 2 days a week, your asthma isn't well controlled.
• You have to go to the emergency room or doctor because of an asthma attack.

If you have any of these signs, see your doctor. He or she may need to change your medicines or take other steps to control your asthma.

Partner with your health care team and take an active role in your care. This can help you better control your asthma so it doesn't interfere with your activities and disrupt your life.

“Don’t let Asthma control you, Control asthma for you”

H1N1.... Get to know it....

Now declared as a Pandemic Phase-6 by WHO, caused by Influenza-A virus [H1N1 fever]. Presentation is similar to Seasonal flue.

Mode of spread: Droplet infection by sneezing, speaking or coughing.

Precautions that can be taken:

Avoid spitting in public places.

Always use a Kerchief while sneezing.

Improve airflow in Living spaces.

Indications for use of Mask:

If you are Severely ill.

If you are ill and Travelling.

If you are taking care of an Infected person.

Symptoms to watch out are: Fever, Cough, Headache, Body ache, sore throat , Runny nose.

When to get expert medical advice:

Fever >3days

Develop Shortness / difficulty in breathing.

Always in case of Children with increasing fever - Persistent crying, Seizures, Improper feeding, noisy / labored breathing.

Care at home:

Rest in a well ventilated room, Drink plenty of fluids, Have nutritious light diet. Continue Breast feeding.

Precautions for Children:

Avoid taking children to crowded places.

Continue Breast feeding as it helps to transfer essential immunity from mother to children.

Give Tepid sponging using Luke warm water in case of high temperature.

Give nutritious and warm food.

Watch out for Seizure, Breathlessness, Noisy breathing.

Early Expert advice is recommended for children to aid early detection and avoid complications.

Pregnant Women:

NO INCREASED RISK for the Mother or Fetus so do not panic. Management and care is essentially similar as for normal case. But extra care should be given to take Plenty of oral fluids & maintain nutrition. Watch out for any rashes or vesicles as it may indicate some other cause of Fever like Rubella / Chickenpox which may adversely affect the outcome of the Pregnancy. In any case Early medical care and expert opinion should be sought.

NOTE: Please avoid Travelling and Work throughout the course of illness as it not only helps your recovery, but it also helps to prevent the Spread of disease.

Aquarium Diary...!! How to set up your Dream Aquarium...

Setting up an Aquarium can be quite a demanding and challenging task at the same time simply wonderful experience too, so do take the effort to setup the aquarium by yourself personally....its worth the effort every bit. So what are the facts You need to know and keep in mind when setting up an Aquarium...

-Type of Aquarium - Fresh water, Marine, Pond style [open tank]

-Size of tank.

-Climate of your region.

-Types of Fishes.

-Artificial or Natural plants

-Types of Filter- External , Internal or Mechanical, Chemical , Biological.

-Aerators

-Accessories that maybe handy.

Lets discuss the pros and cons in detail now......

1)Fresh Water vs Marine Aquarium:

Fresh water:

Pros- Ease of setup and availability, Easy to maintain, Fishes readily available , Less time consuming, Water changing and composition easier, Less technical knowledge required.

Cons- Lesser variety of fishes, Marine fishes more colorful and spectacular.

Pond type: Here fishes like Koi or Cat fishes are grown in an Open shallow tank....feeding regularly and cleaning once in a while is required but generally much easier to maintain than a glass tank.

2)Size of tank: Don't plan for too big a tank for Home purpose if you are planning to maintain it yourself personally as Larger the tank more difficult it is for cleaning and water changing and better for fishes as toxins get diluted more. So go for a Mid to large size tank. A 30-gallon aquarium weighing approximately 300 pounds should not pose a structural problem, especially if placed against a weight-bearing wall.

3)Climate: If you are in a Temperate zone or were there is too much of temperature fluctuation its better to get a Temperature regulator for your tank. This also required for certain species of Fresh water fishes and most Marine fishes.

4)Fishes: You can have 3 groups of fishes broadly- Bottom feeders, Herbivores and Carnivores. Its better not to mix up the Herbivores and the Carnivores in the same tank, bottom feeders can be mixed with both. Another important factor is not to overcrowd your aquarium with fishes No: of fishes depends mainly on Size of tank and size of fish. The most widely known rule for stocking a tank is one inch of fish per gallon of water.

5)Plants: You can have either Artificial or Natural flora. Artificial flora are easy to maintain but requires frequent cleaning and proper filtration. Natural plants are anytime better as they naturally purify the water and provide oxygen and natural environment for the fishes and more pleasing to the eyes also and requires cleaning and filter change once or twice in a year. But are more cumbersome to setup and require specialised UV lamps for the plants to survive.

6)Filters: Type of filter required also depends on Size of tank and volume of water.Larger tanks requires external filters for efficient purification so as to complete required cycling of water for toxin removal.

• Under-gravel Filters - These are plastic-slotted plates placed at the bottom of the tank, under the substrate. For best results, these plates must cover the whole tank floor. Working in conjunction with the air pump, the filter pulls the floating waste, uneaten food, and decaying plants onto the gravel. The waste products accumulate in recesses in the gravel, where they can be easily siphoned off.
• Box Filters - These are plastic boxes that are put in the corner of the tank. They also require the assistance of the air pump. This filter uses activated carbon and glass wool (or peat moss) to serve as biological filters. They absorb and retain the fine waste products that float in the water, along with the harmful nitrates and ammonia by-products. Compared to under-gravel filters, box filters are easier to pull out and clean.
• Power Filters -- These are usually external filters attached to the back of the tank. With its own power motor, it sucks water from the tank, passes the water through a sponge (or glass wool and activated carbon), and pumps the filtered water back into the tank. The sponge needs to be cleaned regularly.

7)Aerator: Aeration is the generation of tiny air bubbles in water supplementing the tank's water surface area critical for exchange of gases with atmosphere increasing the amount of dissolved oxygen for fishes.Choose aerators that suit your tank size and your taste.various models of air-pumps and air stones are available.Tubing, connectors and accessories make installation convenient and organized.A spare air-pump will be valuable in case of a breakdown.

8)Accessories: Nearby power point and water tap, Filter-bed cleaner, Water pump for replacing water, Quality Fish food 2 or 3 types, Antibiotic and Anti-fungal solutions, Net for catching fish, a spare tank and water storage provision for keeping fish at the time of cleaning/filter change.

Above all what you require most is - Creativity , time and a lot of reading and learning to make your aquarium a marvelous and unique one which is reflection and extension of your Personality and style. A work of Art which makes you proud each time you see it. Hope whatever tips i gave are helpful... ALL THE BEST... do give me your feedbacks , queries and suggestions....

MYSTERY BEHIND THE BERMUDA TRIANGLE.....MYTHS/FACTS...???

Hi am back,
Last day while browsing through magazines i hit upon this article on Bermuda triangle...!! so i checked up.....kinda background hunting.....it has always been a thought that has fascinated me.....what is actually going on in there...i had also reached many theories n conclusions of my own....so this time around i checked up n found many possibilities n postulates n wild ideas...thought up by people like me and you....!! so here is the funniest of all...."Its due to ALIEN HOT-SPOT CONTROL"..somewhere millions of galaxies away....aliens are sitting day in n day out n sinking our ships and planes....hmmm....are these aliens really nuts to sink ships here don't thy have any other job kyaaa the one who brought up this needs urgent psychiatric consultation......hmmmmmm....beats me....another equally bizarre one is the "SEA MONSTER"....which pops up out of blue..n sinks ships....but only within that few square miles why don't it venture farther out maybe Homesick to leave its place..ie the only explanation i can think about it ......a much accomplished and accredited Theory of the 20th Century was the "Geo.magnetic convergence zone" which states that " a convergence zone for the geomagnetic flux lines from the north n south poles of the Earths magnetic field....!!" which causes turbulance n unpredictable....weather conditions in the region....resulting in cannon waves..and sort of stuff......!! due to the heavy magnetic activity in the area..!! very convincing...scientific n most believable of the lot to be honest..but Alas...recently proved to be Utter Rubbish...! based on studies by US coast guard n marine sciences Dept:.....soo whats exactly going on over there...!! The latest Theories Blames it on th Underwater channel/river known as gulf stream..for causing underwater turbulance n whirlpoool like phenomenons making it a sort of mine field for th ships..!!.......its actually not working alone is partnered by underwater Thermal vents.....which releases blasts of hot air n steam n gases.......causing water to bubble up...resulting in Giant waves...whirlpools....moreover theses can reduce the surface tension of the surrounding water....resulting in a Quicksand like phenomenon resulting in sinking of the shipss...!! hmmmmmmmmm............ie interesting...right..so ie were our explanation stands at current point of timee..!! UNDERWATER CHANNEL + THERMAL VENTS, but a major flaw is that it has been reported that all the ships/planes which r lost in the Triangle...gets cutoff from all sorts of communication...so were does that leave us...!! how can we explain that...!! Maybe a miniature black hole sort of phenomenon arisnig for a short span of time resulting in the bizzare activities .....anyway lets wait n watch n meanwhile speculate n come up with our own ideas about the Mystifying n Alluring Bermuda triangle...!! Hey please do feel free to share your own ideas n speculations regarding the Triangle...!!!

Me...Myself....

Hi guys/gals,
So if anyone of you have any doubts about my identity please checkup ma intro....so as i told am recently passed out from medical school and quite thrilled also about that... nand now am consulting patients and everything is going as planned i guess..but....hey..wait there is something very odd..n very unpalatable going on with my life...fr a long time now i guess..!! have not quite found the solution...i guess till now..!! but am close...th root cause i think is that Am Over.ambitious....till now it was driving me to reach were am...now am here.. but instead of feeling relaxed..am feeling really bored n purposeless in life...no more excitement...no more targets....!! n ie when i set up th new goal...."higher studies is on th cards"...if at this point am content then i can lay back n enjoy...if am ambitious i can reach places n positions n satisfy ma ego.....!! so what should i choose...!! am in between Devil and the Sea...!! hmmmm.....ie all am writing now...as i had told u too lazy to continue..!!hope all u guys are as bored as me reading this..!! takecare..chow...