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Old 11th August 2009, 12:14   #91
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The general confusion regarding the flu is finding expression in the Mumbai local trains from yesterday evening. Many people were in different shapes of face masks. Majority with handkerchiefs covering their face.
I am also confused after reading todays papers.
Does H1N1 create complications with body triggering excessive secretions to fight the virus. It is mentioned that people with high immunity level are likely to suffer on this account. Something called cytokenisis.
If this is so, I am confused regarding medicines for increasing immunity levels based on the concept that people with low immunity are susceptible to H1N1.

Doctors here requested to clarify.
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Old 11th August 2009, 12:17   #92
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Originally Posted by crn12 View Post
Thanks all for the great info, I was surfing the net & came across this link:

WalesOnline - News - Health News - Donít give children swine flu drugs, says Oxford research

Donít give children swine flu drugs, says Oxford research
Pardon me, but there is the sensational newspaper headline (faithfully reported by the TOI/HT) and the actual content. See the full article and then see if the BMJ researchers are implying what is in the headline.

All drugs have black box warnings and viral/HIV drugs have such warnings that may scare the .... out of anyone reading it-life threatening rashes, stevens-johnson syndrome, nausea, etc.

Will try to post the original article later.
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Old 11th August 2009, 12:19   #93
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emkay, I don;t think cytokenisis is specific to swine flu. Flu-<Pneumonia progression is due to cytokenisis where immune system overreacts and damages lung tissue allowing pathogens to go deeper in the tissue.
another interesting thing is that 300,000people die every year due to Flu, but its mostly the west. In india, its the first time in a long long while people are dying due to flu.
Remember even when SARS and Bird flu panicked the world, we had a handful of cases.
So the problem is not that large numbers will die, the problem is newness of disease, and from a laymans point of view, its like dying of a common cold.
This is the panic point.
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Old 11th August 2009, 12:32   #94
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Originally Posted by crn12 View Post
Thanks all for the great info, I was surfing the net & came across this link:

WalesOnline - News - Health News - Donít give children swine flu drugs, says Oxford research

Donít give children swine flu drugs, says Oxford research
Here is the original article from which the above headline has been derived. The headline implies a drastically different advice than is in the original source. See for yourself.

Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomised controlled trials -- Shun-Shin et al. 339: b3172 -- BMJ
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Old 11th August 2009, 12:51   #95
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Originally Posted by tsk1979 View Post
300,000people die every year due to Flu, but its mostly the west. In india, its the first time in a long long while people are dying due to flu.

yes media is going hyper over this.

It is not the first time this is happening in India. In 2003, 400 people died of flu in India in a month. There was an outbrake in Karnataka, Haryana, MH.

I think what we call "Viral fever" in India is actually Flu.
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Old 11th August 2009, 12:57   #96
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Originally Posted by NetfreakBombay View Post
yes media is going hyper over this.
In a way it's good that the media is on this with such enthusiasm. If it wasn't for them, the situation would have probably been worse because I feel the media's constant news on this is keeping the government on their feet. I don't think we would see such action from the government if we were in the doordarshan era.

I do, however, object to Headlines Today report yesterday. The screen was screaming "H1N1 spreads like wild fire". Use of words like wild fire is way over the top in such a sensitive situation. Or maybe they need to refer to the dictionary for the meaning of 'spreading like wild fire'.

Last edited by amit : 11th August 2009 at 12:59.
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Old 11th August 2009, 13:01   #97
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Originally Posted by amit View Post
In a way it's good that the media is on this with such enthusiasm. If it wasn't for them, the situation would have probably been worse because I feel the media's constant news on this is keeping the government on their feet. I don't think we would see such action from the government if we were in the doordarshan era.
I completely agree with the above, infact the government should have woken up long a ago. If they had handeled the situation better from the begining, we would have been in much better shape.
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Old 11th August 2009, 13:25   #98
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Originally Posted by vasudeva View Post
Here is the original article from which the above headline has been derived. The headline implies a drastically different advice than is in the original source. See for yourself.

Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomised controlled trials -- Shun-Shin et al. 339: b3172 -- BMJ
Thanks for the link Vasudeva, this clears a lot of hype
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Old 11th August 2009, 13:40   #99
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Got a SMS saying National Institute of Virology recommends dropping a few drops of Nilgiri (Eucalyptus) oil on the handkerchief or mask as a means of prevention.

Did a bit of googling and all I got to know was that Nilgiri oil helps if you have a runny / stuffy nose. No mention of H1N1 anywhere.
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Old 11th August 2009, 13:56   #100
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That is someone just doing timepass.

This oil will at best relieve symptoms of stuffy nose.

And NIV would NEVER recommend symptomic treatments. It sends out it recomms to NCDC that in turn coordinates with doctors.
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Old 11th August 2009, 14:20   #101
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I had not seen any case of swine flu so far in NCR region?
Has anything been reported from this area yet which has escaped me?
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Old 11th August 2009, 14:28   #102
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Originally Posted by tsk1979 View Post
@tejas, the N95 is indeed out of stock at most places. It lasts longer than the surgical mask, and need not be replaced after couple of hours.
The N95 mask usually costs approx Rs 100 but now chemists are quoting Rs 700 each.

Frankly, rather the person suffering or suspected to have swine flu should wear the mask, instead of the other way around. There is a protocol for the way a mask is worn, removed and disposed, which is very difficult for doctors to follow. So expecting and tutoring a layperson in such short notice is not possible.

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Originally Posted by RajeshK View Post
Recently in India, there were many lives claimed by Chikungunya and Dengi fever and these viruses are still very active in many part of Kerala. But Swine Flue is more discussed. Any specific reasons?
I have read other similar posts and quotes regarding swine flu being given more importance in india instead of typhoid, malaria, dengue, etc.
Agreed that the other diseases are more rampant in India, there a few points to understand:

- the course of duration of the other diseases are longer and treatable even at later stages

- if you put a person suffering from typhoid, malaria, etc in a room of 100 people, he will not infect them which is unlike swine flu. HOWEVER, not everyone will get severely affected from swine flu. In India, 80% of people are carriers of TB although they are not affected, similarly, many of us may get swine flu and will recover from it even without showing all symptoms. People at higher risk are children, health care workers, & immunocompromized people.
Why children? Most of us have had countless bouts of flu and have developed some form of innate immunity and antibodies. The basic structure of this virus is also the same and the body reacts similarly. in most cases the body wins and in some, the body looses and thus the symptoms will show and virus will spread to other organs. Children are still developing these antibodies, thus a higher risk.

Today's TOI has a good schematic of how the disease affects the body.

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Originally Posted by navin View Post
This problem seems to have 2 parts.
1. Clinical. How to determine if a person has swine flu and still have time to save the person. After all the symptoms of flu and swine flu are the same (or similar).
Very simple.
First let's list the basic symtoms of normal flu:
- running / blocked nose
- fever
- sneezing
- sore throat

I have already listed the other symptoms of swine flu earlier.

So, let's say you have basic symptoms of normal flu. Now if you take your antibiotics and antipyretics (to reduce fever), and if they work within 24hours, meaning your fever comes down, then you are fine and suffering from normal flu. However, if these do not work in reducing fever or the irritation of the throat increases and you get any other symptom of swine flu like pain in joints, dizziness, headaches, etc (even after taking medicines), then you must go get yourself checked.
When i say 24 hours, it doesn't mean your fever should go completely, even if the symptoms diminish by 25%, you are fine.

Hope this is clear and not confusing.

Quote:
What is window of time one has to get him self tested and treated for the same
.

As explained above, if you fit the criteria of suspected swine flu, go to your doctor. I will not put up treatment protocol here, otherwise people will start self medication. If you have symptoms, go to your doctor to verify and he will recommend further steps. There is adequate time for treatment.

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Psychological. How do you stop a city like Mumbai from functioning. Every day 6 million people use the local train system to and from work. Another 3-4 million use the bus and other public transport systems to and from school (many of them kids) and other appointments.
You can't stop Bombay from functioning. Take precautions. If you have a cold, wear a mask. You can't expect a million people to wear masks. Wash your hands before eating. Do not blow your nose in public. Do not rub your eyes. Dispose tissues in dust bins. Do not spit.
Sanitizers will work. But remember when you scrub with that or soap, scrub like a surgeon for atleast 30seconds (it's a long time). Do not go out in crowded places unless necessary. Cut down movies, mall outings and team bhp meets. Stop thronging hospitals unless you fit the criteria. Do not spread rumours or gossip. Do not stock pile medicines. Vitamin C alone is not going to work nor is eating citrus foods.


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Tejas, I know you are Mumbai based. What is the situation on the ground with respect to
a) testing centers
b) supply of Tamiflu
c) number of cases being successfully treated - the media only reports the deaths (8 in India so far) which spreads the panic.

The public hospitals in Mumbai (KEM, Nair, JJ, etc..) are often crowded and visiting these places might put you at risk. How does the BMC/State intend to tackle this problem.
Today's TOI has all info on new testing centers in bombay.

Tamiflu supply is adequate. There are 4 more antiretroviral medicines that also work (thankfully the general public still doesn't know their names). No worries here.

Considering the population and conditions in India, the number of affected cases is very very less. No need for panic.

Please do not believe sensationalist hindi channels like aaj tak etc. do not even listen to them.

Remember one more thing. Rains have again played truant in bombay. Once it starts again, cases of normal flu will pick up. Please do not panic, just do a self diagnosis.
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Old 11th August 2009, 14:45   #103
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Originally Posted by RajeshK View Post
Recently in India, there were many lives claimed by Chikungunya and Dengi fever and these viruses are still very active in many part of Kerala. But Swine Flue is more discussed. Any specific reasons?

Are Farma Majors showing more interests in Swine Flue?
It is because of high visibility. Unlike chikunguniya and dengue, swine flu affects the upper levels of the society, especially the affluent people including frequent travelers. May be due to its "foreign" origin and the mode of infection. Air is the only "consumable" that is shared by rich and poor people, right?

When the flu makes it first appearances in premium schools like DPS, NPS etc, it makes bigger news than a poor village man getting affected by dengue though mosquito bite.
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Old 11th August 2009, 15:28   #104
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Originally Posted by vasoo View Post
It is because of high visibility. Unlike chikunguniya and dengue, swine flu affects the upper levels of the society, especially the affluent people including frequent travelers. May be due to its "foreign" origin and the mode of infection. Air is the only "consumable" that is shared by rich and poor people, right?

When the flu makes it first appearances in premium schools like DPS, NPS etc, it makes bigger news than a poor village man getting affected by dengue though mosquito bite.
Well quite negative way to view things , Dengue and Chikengunia also affect kids studying in those schools and not only farmers.
H1N1 is new infection and spreads quite fast unlike dengue or chikenqunia so more focus also dengue is not a pandemic affecting 178 countries.

In 1918 the spanish flue killed 14.8 million people in India and it was H1N1 virus.
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Old 11th August 2009, 17:56   #105
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Originally Posted by loving_alaap View Post
Doís
Cover your mouth & nose with a cloth while coughing or sneezing.
Wash your hands regularly with soap and water, especially after coughing or sneezing.
Avoid crowded places.
Avoid close contact with sick people.
Avoid touching your mouth, nose, or eyes.
Sleep well, stay active, drink plenty of water & eat healthy food
Can eat pork or other foods that came from pigs

Doníts
Shake hands or hug socially
Take medicines without consulting the physician
Spit in public places.
Thats a neat list.

BTW, WHO: H1N1 flu pandemic now, 1st in 41 years - that was on June 11, 2009. Looks like India realizing the gravity of the situation now.
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