SWINE FLU: a pandemic in waiting?
Swine flu, also known as swine influenza, refers to flu-like illness caused by strains of influenza virus, which causes infection in pigs (swine).

How to have patient-friendly hospitals
Despite India emerging as a major player at the world stage, the country’s hospitals, mostly those in the public sector, lack quality healthcare facilities. They also do not provide service with a smile.

Cataract: single surgery, double benefit
When doctors diagnosed Ritu Rampal's deteriorating vision as a result of the early onset of cataract, she had a tough time getting used to the idea. It took her two years to mentally prepare herself for the surgery.

Health Notes

n WHO tells nations not to lower guard
n Women ‘more vulnerable to tobacco carcinogens than men’
n Swine flu vaccine on the anvil
n Kids of depressed may have psychological problems



SWINE FLU: a pandemic in waiting?
Dr Varsha Gupta

Swine flu, also known as swine influenza, refers to flu-like illness caused by strains of influenza virus, which causes infection in pigs (swine).

Humans do not normally get swine flu, but human infections can happen.

In the past, transmission of the virus in humans was limited, but now there are reports of swine flu viruses having been spread from person to person.

There are different types of influenza viruses. Pigs can be infected by avian, human as well as swine influenza viruses.

When influenza viruses from different species infect pigs, these can swap genes and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. The exact origin of this new strain remains unknown.

The Center for Disease Control has determined that this swine influenza A (H1N1) virus is contagious and is spreading from humans to humans. However, at this time, it is not known how easily the virus spreads.

The WHO has decided to raise the current level of influenza pandemic alert to phase 5, which is a strong signal that a pandemic is imminent.

The human influenza viruses spread with respiratory droplets, when an infected person coughs or sneezes near a susceptible person.

A contact with respiratory-droplet-contaminated surfaces is another possible
source of transmission.

Since this is a novel influenza A virus in humans, transmission from infected persons to close contacts might be common.

All respiratory secretions and bodily fluids (diarrhoeal stool) of swine-origin influenza A (H1N1) cases should be considered potentially infectious.

The symptoms of swine flu include fever, cough, sore throat, body aches,
headache, chills and fatigue. There are also reports of diarrhea and vomiting
associated with swine flu.

The affected countries with laboratory confirmed cases are Austria (1), Canada (34), China, Hong Kong Special Administrative Region (1), Denmark (1), France (1), Germany (4), Israel (2), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (13), Switzerland (1) and the United Kingdom (13).

To diagnose swine influenza A infection, a respiratory specimen (nasopharyngeal swab/aspirate or nasal wash) would generally need to be collected within the first four to five days of illness.

On the testing front, four institutes have been designated for handling blood and saliva samples to check for swine flu: the National Institute of Communicable Diseases (NICD) in Delhi, the National Institute of Virology (Pune), the National Institute of Cholera and Enteric Diseases (Kolkata), and the Regional Medical Research Centre (Dibrugarh). India has received a protocol (a detailed plan of a test) from the Centers for Disease Control and Prevention (CDC) in Atlanta, US.

For the treatment and/or prevention of infection with swine influenza viruses, the CDC recommends the use of antiviral drugs (oseltamivir or zanamivir).

There is no vaccine to protect humans from swine flu. Vaccines against the H1N1 strain are being developed and could be ready as early as June 2009.

Simple preventive steps to protect your health: Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in dustbin after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand-cleaners are also effective. Avoid touching your eyes, nose or mouth. Germs spread this way. Try to avoid close contact with sick people. Masks should be worn as a priority by health-care workers and caregivers, when in close contact (within approximately 1 metre) with sick patients. If you get sick with influenza, you stay home from work or school and limit contact with others to keep from infecting them. Swine influenza viruses do not spread by food; so one cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

The writer is Professor, Department of Microbiology, Government Medical College and Hospital, Chandigarh.


How to have patient-friendly hospitals
Dr R. Kumar

Despite India emerging as a major player at the world stage, the country’s hospitals, mostly those in the public sector, lack quality healthcare facilities. They also do not provide service with a smile.

In corporate hospitals, scenario is no better. While plastic smiles are occasionally visible, the focus remains on the pocket of the “client” rather than his welfare.

While the public sector hospitals, particularly the supporting staff, do not give the status of a “human” to its patients, the basic motive in the private hospitals remains profit, which overrides compassion and care, so essential for a patient.

Patient-friendly hospitals/clinics are hard to find. The professed objective should be not only the treatment of the patient; the journey to the process of curing should be pleasant as well.

There is a need for patient-friendly policies at the macro-level as well as a healthy approach at the individual level.

Unfortunately, even basic facilities like those helping people for meeting and greeting at the reception, a stink-free environment, functioning toilets, clean corridors, non-congested waiting areas and infection-free operation theatres are not assured.

The main problem seems to be the lack of orientation and training to the staff to serve the human beings in distress.

Since materialism has seized the psyche of hospital personnel, they treat the hospital appointments in terms of “money and power”, and not as a challenge to serve or care for the sick.

There is a great need to train the interns of various streams and all other personnel to be polite, courteous, pleasant and helpful in their approach. They must be told that they have certain duties towards the ailing and their harried attendants.

The problem begins with the parking of one’s vehicle; parking attendants are
rude and greedy.

It gets further accentuated as you approach the registration counter, where heated arguments between the staff and patients are common. The long queues are never ending and there is no arrangement to address their discomfort.

The patient records are often misplaced. The signboards to guide the patients are non-existent or not helpful.

The liftmen, the attendants, the technicians, the nurses, the junior doctors – all wear a bureaucratic robe.

Some doctors are still in the old mode of demi-gods; sitting on a high pedestal, not accessible to the sick and dying.

Others remain in dream world of noble profession; the public no longer is impressed. Patient friendly mode of Singapore general hospital promises the following:

1. Arrangements should be made for pre-registration on the Internet and scheduling of appointments, so that there is no waiting in the queues. This will save the patient’s time and harassment.

2. The hospital may be declared “No parking zone”, especially for the staff; reliable shuttle service for them will save their travel expense and make the journey to their place of work a pleasure.

3. Introduction of full computerisation and paperless records will make consultation for each patient hassle-free.

4. There is a need fro training and orientation of the entire staff to “shed the
bureaucratic attitude”.

5. Liberal availability of wheelchairs and lifts for the patients to make their travel inside the hospital bearable.

6. Doctors and other health professionals have to be dedicated professionals; there is no scope for strikes. Their grievances should be addressed “without delay”. 

The writer has many books on health-related subjects to his credit.


Cataract: single surgery, double benefit
Dr Mahipal S. Sachdev

When doctors diagnosed Ritu Rampal's deteriorating vision as a result of the early onset of cataract, she had a tough time getting used to the idea. It took her two years to mentally prepare herself for the surgery.

But today she wishes she had got the phacoemulsification surgery done as soon as she was diagnosed.

Dependent on spectacles and contact lens since the age of 15, her post-surgery vision is better than ever before, thanks to customised mono-vision lens.

"The cataract proved to be a blessing in disguise. I had spent my entire adult life needing spectacles to see. But after the cataract surgery, I can see better than ever before," says the 48-year-old Emirates NVD executive.

Ritu is among that part of the population that gets cataract early because of a variety of reasons.

While age is the most common reason for cataract - age alters the proteins of the eye-lens making them opaque --- the other causes include congenital and developmental anomalies, trauma, inflammation of the eye, metabolic disease like diabetes, hypothyroidism or even usage of certain drugs that may contain steroids.

On the operating chair, the doctor told her what he was going to do and asked
her to relax.

Her brother, who had accompanied her, was sitting outside where he could see her being operated upon on a live screen.

Phacoemulsification is done by making a tiny incision in the lens and breaking the calcified lens with a laser.

The broken pieces are removed by aspiration and a foldable lens is inserted into the eye. In Ritu's case, the lens had been customised to her power.

"The procedure took about 10-15 minutes and by the time I was in the car, I could see," Ritu says. She got her second eye operated upon within a fortnight, and today she sees better than ever before.

Common symptoms of cataract:
Cloudy or blurred vision
Change in one’s perception of colours
Sensitivity to bright lamps or sunlight
Poor night vision
Difficulty in driving, especially at night
Frequent changes in eyeglass prescription

Surgery is the only treatment for cataract
Surgery should not be delayed till the cataract is mature
Any cataract which causes blurring of vision that interferes with one’s daily activities should be operated
Surgery can be done in any season with modern technology
There are no diet restrictions and no need for bed rest

What are the treatment options for cataract?

In the absence of any proven medical cure, surgery is the only treatment for cataract. The two common surgical options available for cataract surgery are:
Conventional cataract surgery or extra-capsular cataract extraction
Requires an incision of 10-12 mm
The cloudy eye lens is removed in one piece
A hard plastic lens is implanted
Multiple stitches are required
Final glass prescription could take even up to 10 weeks

Microincision cataract surgery (phacoemulsification)
Requires a very small incision of 2.2 mm
Cataract extraction with phacoemulsification and foldable lens implant
Walk-in, walk-out procedure
No injection, no pad, no stitch surgery
Minimum post-surgery precautions
Quicker healing and recovery

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: <>.


Health Notes
WHO tells nations not to lower guard

London: The World Health Organization (WHO) has told countries not to lower their guard in the response to the swine flu outbreak.

Almost 900 cases had been confirmed across five continents, the WHO said, and the authorities have to remain vigilant.

According to the BBC, the warning came after health officials in Mexico said that cases of the virus appeared to be declining.

In Mexico, just over 100 people are thought to have died from the swine flu strain, although only 22 cases have been confirmed. — ANI

Women ‘more vulnerable to tobacco carcinogens than men’

Washington: A new study, conducted by a team of Swiss researchers, has
found that women may be more vulnerable than men to the cancer-causing
effects of smoking tobacco.

For the study, the research team examined 683-lung cancer patients who were referred to a cancer centre in St Gallen between 2000 and 2005.

They found that women tended to be younger when they developed the cancer, despite having smoked on average significantly less than men.

“Our findings suggest that women may have an increased susceptibility to tobacco carcinogens,” report Dr Martin Frueh and colleagues. — ANI

Swine flu vaccine on the anvil

London: After the recent swine flu scare, researchers from all over the world
have stepped up efforts to build a vaccine, and British scientists are the latest to
join the race.

A team from the National Institute for Biological Standards and Control (NIBSC) in Hertfordshire has started its work for developing a vaccine against the H1N1 virus.

The researchers aim to drill a hole in the hen’s egg, considered ideal for growing
up flu viruses.

“They are like virus production factories,” the BBC quoted principal scientist Dr John Wood as saying. — ANI

Kids of depressed may have psychological problems

London: Fathers’ mental health problems could be harmful for their kids, a new research has warned.

Researchers at the University of Oxford have said that such kids are more likely to have psychiatric or behavioural disorders.

Boys in particular could be affected if their father had depression or was an alcoholic.

The peak age for men to be affected by psychiatric disorders is the same as the peak age for becoming a father — between 18 and 35. — ANI