The Terror of Chamki Fever: All That You Need to Know About Acute Encephalitis Syndrome

Recently the state of Bihar in India shook up by the rising number of deaths in children as a result of Acute Encephalitis Syndrome (AES). The death toll is over 100 and Muzaffarpur is declared as the worst-hit zone. The maximum casualties accounted for is in the age group of 1-10 years.

Reports state that AES has fastened its grip on 12 districts of Bihar state, inclusive of Muzaffarpur, Vaishali and East Champaran.

This post will answer all your questions regarding AES.

What is AES?

Acute Encephalitis Syndrome (AES) is a viral infection that is generally characterized as a group of diseases like hypoglycemia, chicken pox, dyselectrolytemia, Japanese encephalitis +ve and AES unknown.

It is an acute-onset fever and its target is usually children and young adults. AES can lead to noteworthy mortality and desolation.

It occurs in two types:

• Primary: It involves virus, fungus or bacteria which straight away infect the brain. The infection might also be the revitalization of the virus after any sickness.
• Secondary: It happens because of the immune system responding to any past infection/sickness and attacking the brain by mistake. It can happen 2-3 weeks after the elementary infection.

This has also become popular as Lychee (Litchi) Fever. Reports by NCDC (National Center for Disease Control), India and the CDC (Center for Disease Control), Atlanta (US), figured out the relationship between hypoglycemia/low blood sugar found in malnourished kids sleeping hungry and MCPG (Methylene Cyclopropyl-Glycine)- a toxic element found in lychees, that has an adverse impact on the brain due to malnourishment.

As per a report in 2015, researchers in the US stated that brain disease could be in connection with the toxic element found in lychees.

Causes of encephalitis:

Indian doctors are blaming the scorching heat in the northern areas and delayed monsoon as the prominent reason for this outbreak. The reason behind the deaths is ‘acclimatization failure in children’ due to the environmental factors like heat wave and scanty to no rainfall.

NHPI (National Health Portal of India) states that encephalitis is caused by JE (Japanese Encephalitis) virus, which was first diagnosed in India in the year 1955 in the southern part of the country- Tamil Nadu and also later in Bihar.

India came up with a JE vaccination program in 2006, which eventually became a part of the National Immunization Program, in 2014.

Japanese Encephalitis (JE) transmits into the human body via infected mosquitoes (Culex Species), primarily during the summers.

Other viruses that cause encephalitis:

• HSV (Herpes Simplex Virus)
• EBV (Epstein-Barr Virus)
• Measles & Mumps
• Arboviruses
• West Nile Encephalitis
• Tick-borne Encephalitis

As per the doctors, the extremely high temperatures during summers combined with extreme humidity is thought to be the ideal stimulant for the surge of AES.

As for the Bihar condition, the exact reason for the deaths is still unknown and the blame is being shifted to the heat and litchi consumption. The deaths that have been reported are majorly from the lower income households. Many of them work in litchi farms and it is very easy for their children to eat the fallen litchis and sleep hungry and eventually falling sick if the litchis are toxic. Though, no fixed reason is yet claimed behind this eruption.

Signs and symptoms:

• High fever
• Headache
• Vomiting
• Sensitivity towards light
• Stiffness in neck and back
• Changes in personality and behavior
• Confusion
• Issues with speech or hearing
• Hallucinations
• Loss of memory
• Dizziness
• Seizures, paralysis, and coma (in severe cases)

Signs and symptoms in infants & young adults:

• Bulges in the tender spots on the skull
• Vomiting/nausea
• Stiffness in body
• Poor feeding or not conscious for feeding
• Constant irritation

Risk factors for encephalitis:

There are certain factors that put one on the risk of developing encephalitis. These are mentioned below:

• Age factor: Young children and older adults are at a higher risk of developing viral encephalitis.
• Weak immune system: HIV positive people tend to have a weaker immune system and they take immune-suppressing drugs and many other conditions also account for their frail immune system. People with frail immune system are also at risk.
• Geographical area: Some areas have a high prevalence of mosquitoes and tick-borne viruses. These are at risk of encephalitis.
• Season: Encephalitis is more common in summers.

Diagnosis:

• Brain imaging: MRI or CT scan can expose any swelling of brain or other conditions.
• Lumbar puncture: Under this method, a needle is penetrated in lower back that removes cerebrospinal fluid (CSF)- a fluid that enclose the brain and spinal column. The shift in this fluid reflects infection or tenderness in the brain.
• Brain biopsy: A little sample of brain tissue is removed for testing purposes. This method is adopted usually when patient’s state is worsening, and the treatments aren’t working.
• Other tests: Other general tests like blood samples, urine sample or discharge from the back of throat are usually tested for viruses.

Treatment for encephalitis:

• Children with encephalitis should be kept in ICU (Intensive Care Unit) under constant surveillance to avoid further complications.
• Anti-demagogic drugs like Ibuprofen, Acetaminophen and Naproxen Sodium can be used for providing relief in headaches and temperatures.
• Some anti-viral drugs like Acyclovir (Zovirax), Ganciclovir (Cytovene) and Foscarnet (Foscavir) are also used for treating certain symptoms of the disease.

Encephalitis gets resolved in a few days, except for severe cases, which might take longer to get cured.

Challenges in treatment of encephalitis in Bihar:

The state of Bihar is in crisis right now due to the rising deaths of children because of encephalitis. The situation is not getting any better in the state and it is struggling to provide proper healthcare facilities to the patients. Here are a few reasons why the state is still struggling to overcome this issue:

• The poor quality of living in the state is playing the negative role. Most of the children are malnourished in the state and this is a reason for the rising number of deaths due to immense drop in the blood sugar level.
• The poor healthcare facilities in the state is another reason for so many deaths. Many patients do not get timely treatment, and this results in the worsening of their condition and even death. The hospitals are finding it hard to cater to all the patients and the medical facilities provided are not up-to-the-mark.
• There is a lack of trained physicians and the problem of drinking water is contributing to the escalation of the condition.
• Bihar is one of the poorest states of India. The literacy and awareness level among masses is low and thus they are not aware of the disease, its symptoms, causes and treatments and precautions. The maximum number of deaths reported are from the lower income households.

Prevention:

Here are some precautionary steps that can be made part of the routine to prevent encephalitis.

1. Adopt good and healthy sanitation habits. Wash your hands with soap and water before and after the meals and after using toilets.
2. Don’t share your utensils. Eat in washed and separate utensils.
3. Teach your kids healthy habits and try not to let them out in peak hours of the day to avoid heat wave.
4. Go for proper vaccinations. If travelling to other places, consult your physician regarding the recommended vaccines for different areas/region.

Safeguarding yourself against mosquitoes and ticks:

• Wear long-sleeved tops/shirts and pants while going out between sunset and wee hours.
• Use mosquito repellents
• Put insecticides into action. Use products with permethrin- a component that repels and kills mosquitoes and ticks. It can be sprayed on clothes, tents and other outdoor stuff. Be careful not to apply it on skin.
• Don't go to places where there are a lot of mosquitoes.
• Get rid of stagnant water nearby your home to avoid mosquitoes. Don't let water stagnate in your house as this is where mosquitoes lay eggs.
• Stay alert and observe outdoor signals and signs of viral disease.

Protection for young children:

• Avoid using insect repellents on infants less than 2 months of age. Cover them with either infant carrier or stroller that has mosquito netting on it.
• For infants older than 2 months, repellents with 10-30% DEET can be used.
• Apply mosquito repellents on the kids yourself and also spray it on their clothing and revealing skin.
• Avoid using repellents on the hands of young children, as they have the tendency to put their hands in mouth.
• Wash treated skin with soap and water once you are back indoors. Keep children tidy and clean.

Turacoz Healthcare Solutions, being a medical communication firm, believes in spreading awareness regarding this disease to ensure that the deaths are controlled. Extensive researches have not been conducted on encephalitis and the exact cure for it is yet to be found. Turacoz would like to encourage researchers to conduct thorough research on this ailment and come up with an effective treatment.

We would be happy to offer help in the research and will be assisting with clinical trial support, pharmacovigilance support, regulatory writing, publication writing, medico marketing, etc.

To know more about us and the services we offer, write to us at hello@turacoz.in

World Yoga Day 2019: These 12 Yoga Postures Will Help You Keep A Healthy Heart

The world celebrates its 5th World Yoga Day on 21^st June 2019. With the increasing popularity of yoga due to its range of mental and physical health benefits, the world has started recognizing it and incorporate it into their routine. The World Yoga Day or International Day of Yoga is celebrated worldwide to raise awareness of the health benefits of yoga.

Each year, there is a distinct theme for Yoga Day. The theme for the year 2019 is ‘Yoga for Heart’.
While yoga is good for the majority of the people, there are certain precautions one needs to take if suffering from certain diseases or other physical conditions. People suffering from heart issues should be careful while performing yoga asanas and should avoid certain asanas or practice the scaled-down version.
Various yoga poses are helpful for people with heart troubles. Turacoz Healthcare Solutions brings to you 12 yoga postures that are beneficial for people with heart disease/issues.

Kindly note: All the asanas mentioned below should be performed properly under the guidance of trained professionals, to avoid any kind of injuries and complications.

1. Tadasana (Mountain Pose)
   
   Tadasana, also known as mountain pose, helps invigorate the vertebral column and the heart. The deep breathing involved in this pose helps in opening up the lungs.
   

2. Vrikshasana (Tree Pose)
   
   As the name suggests, this asana focuses on being firm and balanced as a tree. It helps in developing a robust and balanced posture. It also helps in broadening the shoulders and opens the heart.
   

3. Trikonasana (Triangle Pose)
   
   This standing yoga pose promotes cardiovascular exercise and is heart opening. It helps in boosting the stamina.
   

4. Veerbhadrasana (Warrior Pose)
   
   As the name suggests, this posture holds the pose of a warrior. This asana is helpful in enhancing the balance of the body. It also increases stamina, helps in better blood circulation in the body and also aids in releasing stress.
   

5. Utkatasana (Chair Pose)
   
   You will feel the stretch in your body and heat generation while doing this asana. It will also make your heart and respiration rate increase. This pose helps in stretching the chest and stimulating the heart.
   

6. Adho Mukho Svanasana (Downward Facing Dog Pose)
   
   This asana helps in strengthening the muscles of the chest and also in expanding the lung area. Eventually, it helps in enhancing the capacity of the lungs.
   

7. Dhanurasana (Bow Pose)
   
   This asana aids in opening up the heart and strengthening it. It is also useful in making the body flexible.
   

8. Setu Bandhasana (Bridge Pose)
   
   This asana expedites deep breathing and helps stretch the spine and chest area. It is useful in enhancing the blood flow to the chest region.
   

9. Salamba Sarvangasana (Half Shoulder Stand Pose)
   
   This pose ameliorates and mobilizes the parasympathetic nervous system.
   

10. Paschimottanasana (Two-legged Forward Bend Pose)
    
    In this asana, you place your head lower than your heart. This helps in reducing the heart rate and respiration and at the same time relaxes the whole body.
    

11. Makara Adho Mukha Svanasana (Dolphin Plank Pose)
    
    This asana helps in restoring the shoulders and abdomen. It also appeases the body and stabilizes the mind.
    

12. Shavasana (Corpse Pose)
    
    This is the most relaxing pose in yoga. The deep rest involved in this asana works like the counter pose for all yoga poses. It allows the body to breathe and calm down. It is a wonderful asana to release all your stress. It also helps in enhancing the total health of the heart and body.
    

These poses are very helpful in improving the health of your heart and give you wonderful when done properly under the guidance of professional.

However, there are certain yoga postures that you should avoid if you are struggling with heart issues or disease. Mentioned below:

10 yoga postures that you should not practice or go with the scaled-down or modified versions of these, if you have heart issues/disease:

1. Boat Pose (Paripurna Navasana)
   
2. Feathered Peacock Pose (Pincha Mayurasana)
   
3. Hero Pose (Virasana)
   
4. Extended Triangle Pose (Utthita Trikonasana)
   
5. Handstand (Adho Mukha Vrksasana)
   
6. High Lunge/Low Lunge
   
7. Upward Abdominal Lock (Uddiyana Bandha)
   
8. Supported Headstand (Salamba Sirsasana)
   
9. Upward Bow Pose (Urdhva Dhanurasana)
   
10. Yoga of Sound Breath (Swara Yoga Pranayama)
    

The positive changes in your health start with healthy lifestyle changes. Go for a healthy and balanced lifestyle. Make sure to have a proper diet. It is better to ditch junk and processed food. Make sure to practice yoga daily to achieve a healthy body and mind. Meditate, as it will help you stay calm and stress-free. Show love towards yourself.

The sedentary lifestyle of today has given invitation to many diseases and other health conditions. Make sure to lead an active lifestyle to avoid various diseases. You can practice desktop yoga while you’re at office, where you do not have the facility to perform your regular yoga postures. Get up from you seat at frequent intervals and do simple stretching or walking. Don't skip meals and do not even gauge on junk food. Include salad and fruits in your diet and go for fiber-rich food.

Take care of your body so that it takes care of you. Your body is a temple, so treat it wisely to see good results. Turacoz Healthcare Solutions asks everyone to take a pledge to lead a healthy life by adapting to a healthy lifestyle by practicing yoga. Turacoz believes that a healthy mind resides in a healthy body and thus promotes practicing yoga to achieve this goal.

Turacoz is a medical communication firm which offers services like scientific communication, medico-marketing, pharmacovigilance support, etc. To know more about us and our services, drop a mail at hello@turacoz.in

Autistic Pride Day: There is Nothing to Be Reluctant of Autism

The world celebrates Autistic Pride Day on 18^th June 2019, dedicated to people with Autism Spectrum Disorder. Various organization across the globe, working for autistic people, work on awareness campaigns and organize health camps on this day.

The pioneers for this day are Aspies for Freedom (AFF), an association that works for raising awareness regarding the rights of autistic people. Autistic pride realizes the significance of pride for people with autism and the role it can play in bringing positive changes in the society at large.

What is Autism?

It is a complicated neurobehavioral state which adversely affects social interaction, communication and growth skills along with repetitive and austere actions/behaviors.

Things You Should Know About Autism:

• ASD (Autism Spectrum Disorder) is diagnosed usually during the initial 3 years of an individual’s life.
• It affects the functionality of the brain and thus the affected individuals face developmental issues.
• Autistic people find it hard to make changes to their routine and are often stuck on a set pattern of behavior and routine.
• For autistics people it is difficult to make sense of day-to-day activities. They are very anxious of crowd, events and places.
• The disorder was seen as subtypes during the initial time. The disorder included childhood disintegrative disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), Asperger’s syndrome, autistic disorder.
• Starting May 2013, all these autism disorders were clubbed into ASD, by DSM-5 diagnostic manual.

Reality Check on Autism:

• 4 times more cases of autism have been registered for boys than girls.
• Death rates among autistic people is twice more than normal people.
• 1 in 68 children is affected by autism.
• 40% of the autistic children have no speech.
• Autistic is more like a personalized condition, i.e., no two individuals can have same kind of autism. The symptoms and degree/severity vary from individual to individual.
• The past 20 years have seen a significant growth in autism cases.
• There are various conditions related to autism. These include allergies, epilepsy, sleeping disorders, digestive disorders, fragile X, sensory integration dysfunction, anxiety disorder, immune disorders, OCD, bipolar disorder, frequent viral infections, bowel issues, asthma and feeding disorders.
• Autism is among the rapidly growing developmental disorders.

People with autism need your support, love and care. They should not be treated as an outcast and one should understand the issues they have to deal with. As much as it is difficult for individuals with autism to deal with the situation, that much is for the parents of such individuals.

Since symptoms of autism are visible from the initial 2-3 years, the parents of such individuals should be extra careful. Other than medical care and treatments, there are various things that you can incorporate in your daily lives so that you can care for you child in a better way. Here are a few things you can do to make living more comfortable for your child who is suffering from autism/ASD and care for autistic children:

• Look at the greener side: Staying positive solves half the problems. Children with ASD will most likely respond in a better way when given a positive environment. Applaud them when they are doing good and it will make you both feel good. Be very particular as it will help them to know what specific trait or action of theirs is liked by you. Find ways you can accolade them. Love them as they are. Understand their situation. Showering them with your love and support is the key.
• Persistency and scheduling: Autistic children are very particular about their routine. Make sure to give them proper time so that they can revise what they have learnt from therapies. This will ease the process of making them learn new skills, abilities and behaviors and implementing them in distinct real-life situations. Stay in touch with their trainers and therapists, so that you can keep a track of what are they learning via therapy and you can make them practice the same things at home.
• Let them play: Don’t over-burden them with lessons, trainings or therapies. Introduce them to fun activities and let them play and enjoy. This will help such children to open-up more and thus their interactive skills will be improved.
• Have patience: Dealing with autistic children is not easy and making them learn even the littlest things might take a lot of time. Patience is the crux here. Give your kid time and be patient. They will eventually start learning and meanwhile you can try different techniques of learning and training and figure out what suits them the most. Don't be disheartened if they are not responding well to a specific technique.
• Involve them in day-to-day activities: Often when the behavior of autistic children is erratic, parents are of the opinion to keep them away from various situations and not exposing them much to the outside world. Instead, keep them with you while you’re going for some routine activities like grocery shopping or sightseeing. Exposing them to the outer world will help them in getting used to it.
• Look for assistance: Getting help and guidance from other similar families, friends and experts can be of good use. Reach out to support groups, whether offline or online, for advice and learn how to deal with autistic children in a better way. Think of the ways you can make your and your child’s life easy and reach out for support. Hire a caregiver if your child has some ardent needs due to ASD. This will help you get some rest and keep your health good while someone is taking care of your child.

There is nothing to be ashamed of if your child or anyone else in your family and near and dear one is suffering from autism. One should try to support people with these conditions and treat them as a part of the society. Our acceptance can make a big difference for people with autism/ASD.

It is time when we change our outlook and behave as humans. Extend your hand in support to the associations working for the betterment and autistic rights. Autistic Pride Day delivers the message that people who are suffering from autism are not diseased but are just somewhat different from the rest. This difference should be respected. This day says that people with autism are not ill, but they just possess different set of traits. The ideal treatment plan for such individuals is behavioral, educational and speech therapy.

Turacoz Healthcare Solutions supports people with autism/ASD and believes in giving them respect, love, support, care and equal rights as others. Turacoz is of the opinion that autistic people are a beautiful part of our society, just as we others are. The only need is to understand them and extend our support so that they can live comfortably and be happy.

Turacoz is a medical communication firm offering services in scientific communication, medico-marketing, advisory board meetings, etc. To know more about us and the services we offer, write to us at hello@turacoz.in

World No Tobacco Day: Tobacco and Lung Health

May 31^st every year is celebrated as World No Tobacco Day. This initiative of World Health Organization (WHO) aims to raise awareness on the hazardous effects of tobacco and second-hand smoke exposure on human health and motivate people to quit using tobacco and tobacco products in any form.

World No Tobacco Day 2019 has its theme as “Tobacco and Lung Health”. This year’s campaign focuses on increasing awareness of:

• The adverse effect of tobacco on lung’s health, ranging from cancer to chronic respiratory issues
• The crucial role lungs play for the well-being of individuals

The campaign also focuses on drafting effective policies to minimize the consumption of tobacco and involve stakeholders in various sectors to stand up for tobacco control.

How tobacco is dangerous for the health of the lungs?

Since the World Tobacco Day 2019 is focusing on various ways in which exposure to tobacco affects lung health, it becomes crucial to know what impact it has on an individual’s lung health.

The health hazards that tobacco can cause are:

Lung cancer:  A major cause of lung cancer is smoking. It is responsible for more than 2/3rd deaths due to lung cancer, globally. Practicing second-hand smoke also increases the risk of lung cancer. It takes 10 years to reduce the risk of developing lung cancer, post quitting smoking.

Chronic respiratory ailment: Tobacco consumption is the prominent cause of Chronic Obstructive Pulmonary Disease (COPD). It is a situation where the pus-filled mucus is formed in the lungs leading to painful cough and severe breathing difficulties. People who took up smoking at a young age are at a higher risk of developing COPD as tobacco slows down the development of the lungs. Tobacco is also responsible for exasperating asthma which leads to limited levels of activity and enhanced disability. The earlier one quits smoking, the lower the risk of progression of COPD and asthma.

Children coming in contact with smokers: Infants, who are exposed to tobacco smoke toxins, while in-utero, experience lesser lung growth and function. Maternal smoking or even exposure to second-hand smoke is dangerous for infants. Young kids who are exposed to second-hand smoke develop the risk of having asthma, bronchitis, pneumonia and lower respiratory infections, often.
Around 1,65,000 children globally are estimated to die before 5 years of age due to lower respiratory infections as a result of second-hand smoke. Those who survive face the adverse health consequences of the exposure to second-hand smoke as they are at higher risk of developing COPD during adulthood.

Tuberculosis (TB): TB impairs the lungs and slows down the functionality of the lungs, which further aggravates due to tobacco consumption. Around 1/4th of the world’s population has hidden TB, which puts them at risk of developing the active disease at any time. People addicted to smoking have double the chances of falling sick with TB. TB combined with tobacco consumption enhances the risk of having impairment and death due to respiratory failure.

Air pollution: Tobacco causes indoor air pollution. Containing over 7000 chemicals, with 69 cancerous chemicals, tobacco smoke makes for a very hazardous form of indoor air pollution. The smoke might be invisible or inodorous, it can stay in the air for around 5 hours, putting people in the area at the risk of developing lung cancer, chronic respiratory ailments and minimized lung function.

Objectives of World No Tobacco Day 2019 Campaign:
The most impactful way to enhance the health of the lungs is to minimize the intake of tobacco products and second-hand smoke. But in many nations, the awareness related to the adverse impact of tobacco on the lungs, among smokers especially, is very low. Despite having concrete evidences showcasing the hazard tobacco cause to lung, the aptitude for controlling usage of tobacco to improve lung health is underrated.

The World No Tobacco Day 2019 aims at raising awareness on:

• The health hazards caused by smoking tobacco and second-hand smoke
• Effect of tobacco smoking on the health of lungs
• The extent of death and illness across the globe due to lung diseases caused by tobacco, inclusive of lung cancer, asthma, etc.
• Surfacing proofs showcasing the relationship between tobacco smoking and TB deaths
• Connotations of exposure to second-hand smoke on lung health among different age groups
• Significance of lung health on accomplishing the overall health of individuals

Fast Facts:

• Tobacco kills around half of its users.
• Tobacco is responsible for the death of around 8 million people every year. Over 7 million of those deaths are due to direct tobacco consumption whereas 1.2 million deaths are due to the exposure to second-hand smoke.
• Approximately 80% of the total smokers in the world (1.1. billion smokers) reside in low and middle-income nations.

Deaths due to second-hand smoke:

The smoke that takes up the air in spaces like restaurants, offices or other confined spaces and is caused by people burning tobacco products like cigarettes, water-pipes, cigar, etc. is called second-hand smoke. It can be very dangerous for people coming in contact with it and there is no safe level of exposure to it.

• Second-hand smoke is responsible for some severe cardiovascular and respiratory disease. These diseases include coronary heart disease and lung cancer. For infants, the situation of sudden infant death syndrome arises due to it. Pregnant women being exposed to second-hand smoke suffer from complication in pregnancy and low birth weight.
• Around half of the children are exposed to polluted air regularly as a result of the practice of smoking tobacco in public places.
• Over 1.2 million deaths occur every year due to second-hand smoke.
• Second-hand smoke is also responsible for the death of 65,000 children each year, due to the disease caused by it.

It is the right of every person to breathe pure, tobacco-smoke-free air. Smoke-free laws are there to safeguard the health and well-being of non-smokers. These do not cripple businesses and motivate smokers to quit smoking.

Around 1.4 billion people across the globe are safeguarded by extensive national smoke-free laws.

More awareness is required to be generated describing the health hazards caused by tobacco. Lung health cannot be achieved just by the absence of the disease and tobacco smoke has a major impact on lung health of smokes as well as non-smokers, on a global scale. Stricter anti-smoke laws are required to limit the use of tobacco products and controlling the use of tobacco must be a prerogative for global communities and government.

Nations should come forwards and respond to tobacco epidemic and adopt effective measures to control the adverse situation.


Turacoz Healthcare Solutions, a medical communications organization, stands in support of the ‘No Tobacco’ campaign and believes that the use of tobacco should be prohibited to achieve better lung health and well-being of people around the world.

Turacoz provides medical writing services like publication writing, scientific communication, clinical trial support, etc. To know more about Turacoz and the services, drop a mail at hello@turacoz.in