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Police in China has closed 147,000 sites thatmanufactured or sold coun-terfeit food or drugs in thepast year, the governmentsays. According to newly re-leased figures from the Chi-

nese Ministry of PublicSecurity police have shutdown 147,000 sites involvedin the fake food and drugtrade since August 2011.Over the same period the po-lice have reportedly resolved185,000 criminal cases linked to counterfeiting.Information from the public played a big role in theanti-counterfeiting cases. The Ministry says thepolice paid 12,000 informants $4,4 mill for helping

to identify and solve cases of fake food and drugs.Cases investigated by policeover the past year include theuse of reprocessed cooking oil.In this case police reportedlyshut down manufacturers of the

illegal product - known as 'gutteroil' - and closed off supply chan-nels.Data on the success of anti-counterfeiting efforts comes asChina tries to show publicly thatit is taking control of the situation.

From October the State Food and Drug Adminis-tration (SFDA) will blacklist manufacturers of fakedrugs as part of the intensified anti-counterfeitingpush.

China Closes 147,000 fake

food and drug sites

Chief Editor : Dr. Aniruddha Malpani, M.D. Oct 2012

PTN

On September 13 the New York

City Health Department becamethe first in the USA to ban thesale of sugared beverages largerthan 16 oz. at restaurants, mo-bile food carts, sports arenasand movie theaters.Its a bold experiment in the anti-obesity campaign, and while itswidely supported by health pro-fessionals, its not popular withfood retailers or most city resi-dents.

Improving Patient & Family Health Literacy

1. Phosphoric Acid - Weakens bones and rots teeth

2. Excessive artificial sweeteners makes you crave more3. Carmel Color - Made from the chemical caramel, is

purely cosmetic, it doesn't add flavour yet is tainted

with carcinogens.

4. Formaldehyde - Carciogen, it is

not added in soda but when you

digest aspartame, it will break

down into 2 amino acids and

menthanol formic acid -

formaldehyde (diet sodas)

5. High Fructose Corn Syrup is a

Concentrated Form of sugar fruc-tose derived from corn. It in-

creases body fat, cholesterol and

triglycerides and it also makes you

hungry.

6. Potassium Benzoate preservative

that can be broken down to ben-

zene in your body. Keep your soda in the sun and ben-

zene = Carcinogen

7. Food Dyes = impaired brain function, hyperactive be-

havior, difficulty focussing, lack of impulse control.

Side effectS of Soda NY takes Lead

Smile More... Walk More...

Live life More...

Health News 1, 9,11,12 Disease Prevention 2 Editorial 3

Drug Information 4, 5, 6 Disease Information 7,8, 9


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Coconut oil attacks the bacteria behind tooth decay andcould be used in dental care products, according to re-search.

Scientists found that coconut oil which had been treatedwith enzymes stopped the growth of Streptococcus bac-teria - a major cause of tooth decay.Tooth decay affects 60% to 90% of children in industri-alized countries.Speaking at the Society for General Microbiology's con-

ference, the Irish researchers say that coconut oil alsoattacks the yeast which causes thrush.The research team from the Athlone Institute of Technol-ogy in Ireland tested the impact of coconut oil, vegetableoil and olive oil in their natural states and when treatedwith enzymes, in a process similar to digestion.The oils were then tested against Streptococcus bacteriawhich are common inhabitants of the mouth.Only the enzyme-modified coconut oil showed an abilityto inhibit the growth of most strains of the bacteria.

Many diseases and conditions can be spread through in-adequate hand hygiene as a result of not washing hands.Hands should always be washed: Before, during, and after preparing food Before eating food Before and after caring for someone who is sick Before and after treating a cut or wound After using the toilet After changing diapers or cleaning up a child whohas used the toilet After blowing your nose, coughing, or sneezing After touching an animal or animal waste After handling pet food or pet treats After touching garbageHand hygiene is critical to interrupt the spread of infec-tious diseases, such as the common cold, influenza, andgastrointestinal illnesses

Monsoon is welcome by all but itcomes with lots of diseases as theimmunity of the body is reduced. Thediseases associated with monsoonare malaria, dengue, Chikungunya,jaundice, gastrointestinal infectionslike typhoid and cholera, said PadmaShri & Dr. B.C. Roy NationalAwardee Dr. KK Aggarwal, Presi-

dent, Heart Care Foundation of India.Apart from these, viral infections likecold and cough are also common.Patients with Chikungunya, typicallyhave joint pains, which will get relieved by flexing thelimbs. Dengue, if not adequately managed, can be fatalin 14% of cases. Chikungunya, though not fatal, cancause chronic debilitating joint pains lasting for years.Management of dengue involves fluid resuscitation andnot platelet resuscitation. If enough fluids are given, mor-tality can be reduced. The mortality period usually startswhen the fever subsides. Inappropriate misuse of anti

fever medicines can precipitate bleeding in dengue pa-tients.The water that gets collected due to rain becomes abreeding ground for mosquitoes. Contamination of drink-ing water is common. It is important to drink clean and

pure water to prevent diarrhea andgastrointestinal infections.Walking in dirty water during rainyseason leads to numerous fungalinfections, which affect toes andnails. Diabetic patients have to takecare of infections, which affect toes,and nails. Diabetic patients have totake a special care about their feet.

Always keep the feet dry and clean.Avoid walking in dirty water. Keepthe shoes, socks and raincoats dryand clean.

Precautions have to be taken to prevent dampness andgrowth of fungus (mold) on and around the house wereasthmatic patients are living. Avoid fumigation in case ofasthmatic patients.Worms from underground comes to the surface and con-taminate the surface vegetables. In the presence of weakdigestive fire, this can cause gastric disturbances. It is be-cause of this reason that community lunches and mar-

riage are prohibited in this season.One should eat light foods. Consuming barley, rice andwheat is good. Water should be boiled before use. Addingginger and green in daily diet is helpful. Eating warm foodis the rule.

COCONUT OIL COULD COMBAT TOOTH DECAY

MoNsooN rEDucEstHE IMMuNIty of tHE boDy

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Instructions or counseling for the patient prescribed withTablet Ofloxacin.Ofloxacin

Type of medicine: Fluoroquinolone antibioticUse: Used to treat certain infections that are caused by

bacteria. It works by killing the bacteria which cause theinfection. Infections includes chest/lungs, urinary-tractand skin infections.before taking ofloxacin

Before taking ofloxacin make sure your doctor knows: If you are pregnant, trying for a baby or breast-feed-

ing. If you have ever experienced tendon (a tissue that

connects muscle to bone) problems after taking anyother quinolone antibiotic such as ciprofloxacin, lev-ofloxacin, moxifloxacin, nalidixic acid or norfloxacin.

If you have a history of kidney or liver disease.

If you have a history of diabetes or heart diseases If you have a history of epilepsy/seizure. If you have ever had mental health problems. If you have myasthenia gravis (a muscle weakening

disease). If you know you have glucose 6-phosphate dehydro-

genase (G6PD) deficiency. If you are taking other medicines, including those

available to buy without a prescription, herbal andcomplementary medicines.

If you have ever had an allergic reaction to this or anyother medicine.

How to take ofloxacin Take ofloxacin exactly as prescribed by your doctor.

It is usually taken once or twice a day depending onthe infection being treated.

If you have been told to take ofloxacin twice a day,space your doses out evenly throughout the day.

You may take this medicine with or without food. Keep taking this antibiotic until the course is finished

unless you are told to stop. This is important in orderto prevent the infection from coming back.

Do not take indigestion remedies (antacids) or med-icines containing iron or zinc, in the 2 hours before or

after you take ofloxacin. This is because they inter-fere with the way ofloxacin is absorbed by your bodyand stop it from working fully.

Drink extra fluids so you will pass more urine whileyou are using this medicine. This will keep your kid-neys working well and help prevent kidney problems.

If you forget to take a dose, take it as soon as you re-member and then continue as before. Do not taketwo doses together to make up for a forgotten dose.

Getting the most from yor treatment

Do not take non-steroidal anti-inflammatory

painkillers (NSAIDs) such as ibuprofen while you arebeing treated with ofloxacin.

Ofloxacin may cause your skin to become more sen-sitive to sunlight than normal. Protect your skin par-ticularly if you are exposed to strong sunlight for longperiods during the day.

Ofloxacin may impair your ability to concentrate.Make sure your reactions are normal before driving,operating machinery or doing other jobs which couldbe dangerous if you were not sufficiently alert.

If you have diabetes, you may need to check yourblood glucose levels more regularly as ofloxacin may

affect the levels of sugar in your blood. If you still feel unwell after completing your course of

this antibiotic, make another appointment to see yourdoctor.

Some people develop thrush (redness and itching inthe mouth or vagina) after taking a course of antibi-otics. If you think you have thrush, speak with yourdoctor.

Possile Side Effects While using Ofloxacin:

Along with their useful effects, most medicines cancause unwanted side-effects although not everyoneexperiences them. These usually improve as your

body adjusts to the new medicine, but speak withyour doctor if any of the following side-effects con-tinue or become troublesome.

Important Note: If you develop any of the following raresymptoms, contact your doctor for advice straight away: Swelling of your tongue, mouth or face or any prob-

lems with your breathing. A severe rash. Pain or inflammation in your joints (particularly in your

hips, knees or ankles).If you experience any other symptoms which you thinkmay be due to this medicine, speak with your doctor and

seek advice.How to store ofloxacin

Keep all medicines out of the reach and sight of chil-dren.

Store in a cool, dry place, away from direct heat andlight.

Side-effects - these affect less than 1 in 100 peo-

ple who take this medicine

Feeling or being sick, indigestion, abdominal pain

Diarrhoea

Headache

Dizziness

Difficulty in sleeping, eye irritation, cough and skin

itchiness

What can I do if I experience this

Eat little and often. Stick to simple or bland foods

Drink plenty of water to replace lost fluids. If the diar-rhoea is severe or continues to be a problem, speak

with your doctor

Try to manage with a suitable painkiller. If the

headache continues, speak with your doctor

If affected, do not drive or operate machinery

If any of these become troublesome, speak with your

doctor

Drug Information Ofloxacin


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Reference:

1. www.thomsonhc.com, Micromedex (R) 2.0, 2002-2012, Thomson Reuters (Healthcare) Inc.

2. http://www.cimsasia.com/3. Product Information: FLOXIN(R) oral tablets,

ofloxacin oral tablets. Ortho-McNeil, Raritan, NJ,2011.

Attended by: Samson P.G., Drug Information Pharma-cist, DIRC, KSPCDisclaimer: Information provided by the center is authen-tic and should be used judiciously by the healthcare pro-fessionals only. The center will not accept anyresponsibility of liability arising on using the provided in-formation and it rests entirely on the user.

Karnataka State Pharmacy Concil Drg Information & Research Centre514/E, I Main, II Stage, Vijayanagar Club Road, Bangalore 560 104 PH: 23383142; 23404000,9900032640 Fax: 23202345

E-mail: [email protected]; Web: www. karnatakadruginfo.com

f you've ever been treated for severe painfrom surgery, an injury, or an illness, youknow just how vital pain relief medicationscan be.Pain relief treatments come in many

forms and potencies, are available byprescription or over-the-counter (OTC),and treat all sorts of physical painin-cluding that brought on by chronic condi-tions, sudden trauma, and cancer.Pain relief medicines (also known as"analgesics" and "painkillers") are regu-lated by the Food and Drug Administra-tion (FDA). Some analgesics, includingopioid analgesics, act on the body's pe-ripheral and central nervous systems toblock or decrease sensitivity to pain. Oth-ers act by inhibiting the formation of cer-tain chemicals in the body.Among the factors health care profes-sionals consider in recommending or pre-scribing them are the cause and severityof the pain.TYPES OF PAIN RELIEVERSOTC MedicationsThese relieve the minor aches and painsassociated with conditions such asheadaches, fever, colds, flu, arthritis,toothaches, and menstrual cramps.There are basically two types of OTC pain relievers:

acetaminophen and non-steroidal anti-inflammatorydrugs (NSAIDs).Acetaminophen is an active ingredient found in morethan 600 OTC and prescription medicines, includingpain relievers, cough suppressants, and cold medica-tions.NSAIDs are common medications used to relieve feverand minor aches and pains. They include aspirin,naproxen, and ibuprofen, as well as many medicinestaken for colds, sinus pressure, and allergies. They actby inhibiting an enzyme that helps make a specificchemical.

Prescription MedicationsTypical prescription pain relief medicines include opioidsand non-opioid medications.Derived from opium, opioid drugs are very powerfulproducts. They act by attaching to a specific "receptor"in the brain, spinal cord, and gastrointestinal tract. Opi-oids can change the way a person experiences pain.Types of prescription opioid medications include morphine, which is often used before and after sur-

gical procedures to alleviate severe pain oxycodone, which is also often prescribed for mod-

erate to severe pain codeine, which comes in combination with acetamin-

ophen or other non-opioid pain relief medications andis often prescribed for mild to moderate pain

hydrocodone, which comes in combination with acet-aminophen or other non-opioid pain relief medica-tions and is prescribed for moderate to moderatelysevere pain

FDA has recently notified makers of certain opioid drugsthat these products will need to have a Risk Evaluationand Mitigation Strategy (REMS) to ensure that the ben-efits continue to outweigh the risks.Affected opioid drugs, which include brand name andgeneric products, are formulated with the active ingre-

dients fentanyl, hydromorphone, methadone, morphine,oxycodone, and oxymorphone.FDA has authority to require a REMS under the Foodand Drug Administration Amendments Act of 2007.Types of non-opioid prescription medications includeibuprofen and diclofenac, which treat mild to moderatepain.uSE AS DIRECTEDPain medications are safe and effective when used asdirected. However, misuse of these products can be ex-tremely harmful and even deadly.

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Consumers who take pain relief medications must fol-low their health care professional's instructions carefully.If a measuring tool is provided with your medicine, useit as directed.Do not change the dose of your pain relief medicationwithout talking to your doctor first.Also, pain medications should never be shared withanyone else. Only your health care professional can de-cide if a prescription pain medication is safe for some-one.Here are other key points to remember.With acetaminophen (Paracetamol) : Taking a higher dose than recommended will not

provide more relief and can be dangerous. Too much can lead to liver damage and death. Risk

for liver damage may be increased in people whodrink three or more alcoholic beverages a day whileusing acetaminophen-containing medicines.

Be cautious when giving acetaminophen to children.Infant drop medications can be significantly strongerthan regular children's medications. Read and follow

the directions on the label every time you use a med-icine. Be sure that your infant is getting the infants'pain formula and your older child is getting the chil-dren's pain formula.

With NSAIDs: Too much can cause stomach bleeding. This risk in-

creases in people who are over 60 years of age, aretaking prescription blood thinners, are takingsteroids, have a history of stomach bleeding or ul-cers, and/or have other bleeding problems.

Use of NSAIDs can also cause kidney damage. Thisrisk may increase in people who are over 60 years

of age, are taking a diuretic (a drug that increasesthe excretion of urine), have high blood pressure,heart disease, or pre-existing kidney disease.

With opioids: Use of opioids can lead to drowsiness. Do not drive

or use any machinery that may injure you, es-pecially when you first start the medication.

The dose of an opioid painmedication that issafe for youcould be highenough to

cause an over-dose and death insomeone else, es-pecially children.

KNOW THE ACTIVE IN-GREDIENTSA specific area of con-cern with OTC painmedicines is whenproducts sold fordifferent uses havethe same active in-gredient. A coldand cough remedymay have thesame active ingredi-ent as a headacheremedy or a prescrip-tion pain reliever.To minimize the risks ofan accidental overdose,consumers should avoid tak-ing multiple medications withthe same active ingredient at the

same time.All OTC medicines must have all of their active ingredi-ents listed on the package. For prescription drugs, theactive ingredients are listed on the container label.Talk with your pharmacist or another health care profes-sional if you have questions about using OTC medi-cines, and especially before using them in combinationwith dietary supplements or other OTC or prescriptionmedicines.MISuSE AND AbuSEMisuse and abuse of pain medications can be extremelydangerous. This is especially so in regard to opioids.These medications should be stored in a place wherethey cannot be stolen.According to the National Institutes of Health, studieshave shown that properly managed medical use of opi-oid analgesic compounds (taken exactly as prescribed)is safe, can manage pain effectively, and rarely causesaddiction.But the abuse of opioids is a significant public safetyconcern. Abusers ingest these drugs orally, and also

crush the pills in order to snort or inject them.Commonly abused opioid pain medicines include pre-scription drugs such as codeine, and the brand-nameproducts Oxycontin (oxycodone), Vicodin (hydrocodone

with acetaminophen),and Demerol

(meperidine).Addiction isjust one seri-ous danger of

opioid abuse. Anumber of over-

dose deathshave resultedfrom snorting

and injecting opi-oids, particularly

the drug OxyCon-tin, which was designed tobe a slow-release formula-tion.

uSE OPIOIDS SAFELY: 3KEY STEPS

1. Keep your doctor informed.

Inform your health care profes-sional about any past history ofsubstance abuse. All patients

treated with opioids for pain requirecareful monitoring by their health care

professional for signs of abuse and addic-tion, and to determine when these analgesics

are no longer needed.2. Follow directions carefully. Opioids are associ-ated with significant side effects, including drowsi-ness, constipation, and depressed breathingdepending on the amount taken. Taking too much

could cause severe respiratory depression ordeath. Do not crush or break pills. This can alter

the rate at which the medication is absorbedand lead to overdose and death.3. Reduce the risk of drug interac-tions. Don't mix opioids with alcohol, anti-histamines, barbiturates, orbenzodiazepines. All of these sub-stances slow breathing and their com-bined effects could lead tolife-threatening respiratory depres-sion. PTN


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Cases, incidence,

and risk factors

Atopic dermatitis isdue to a hypersensitivity reac-tion (similar to an allergy) inthe skin, which leads to long-term swelling and redness (in-flammation) of the skin.People with atopic dermititismay lack certain proteins inthe skin, which leads togreater sensitivity.Atopic dermatitis is most com-mon in infants. It may start asearly as age 2 to 6 months.Many people outgrow it byearly adulthood.People with atopic dermatitisoften have asthma or sea-sonal allergies. There is oftena family history of allergic con-

ditions such as asthma, hayfever, or eczema. People withatopic dermatitis often testpositive to allergy skin tests.However, atopic dermatitis isnot caused by allergies. The condition tends to get worsewhen the person is exposed to certain triggers.The following can make atopic dermatitis symptoms

worse:

Allergies to pollen, mold, dust mites, or animals Cold and dry air in the winter Colds or the flu

Contact with irritants and chemicals Contact with rough materials, such as wool Dry skin Emotions and stress Exposure to too much water, such as taking too many

baths or showers and swimming too often Feeling too hot or too cold, as well as sudden temper-

ature changes Fragrances or dyes added to skin lotions or soapsSymptoms

Typical skin changes may inclde:

Blisters with oozing and crusting

Dry skin all over the body or areas of bumpy skin on theback of the arms and front of the thighs

Ear discharge or bleeding Raw areas of the skin from scratching Skin coloring changes -- more or less color than the nor-

mal skin tone (See: Skin abnormally dark or light) Skin redness or inflammation around the blisters Thickened or leather-like areas, called lichenification,

which can occur after long-term irritation and scratch-ing

Both the type of rash and where the rash appears can de-pend on the age of the patient:

In children younger than age 2, skin lesions begin onthe face, scalp, hands, and feet. They are often crust-ing, bubbling, or oozing rashes that itch.

In older children and adults, the rash is more commonlyseen on the inside of the knees and elbows, as well asthe neck, hands, and feet.

During a severe outbreak, rashes may occur anywhereon the body.

Itching, which is sometimes intense, almost always occurs.Itching may start even before the rash appears. Atopic der-matitis is often called the "itch that rashes" because the

itching starts, and thenthe skin rash appearsfrom the scratching.

Signs and tests

A physical exam will be done.A skin biopsy can be done toconfirm the diagnosis or ruleout other causes of dry, itchyskin.Diagnosis is ased on the:

Appearance of theskin Personal and familyhistoryAllergy skin testing may e

helpfl for people with:

Hard-to-treat atopicdermatitis Other allergy symp-toms Skin rashes that form

only on certain areas of thebody after exposure to a spe-cific chemicalSKIN CARE AT HOME

Taking care of your skin athome may reduce the need for medications.Avoid scratching the rash or skin:

Relieve the itch by using a moisturizer, topical steroidcream, or other prescribed cream and taking antihista-mines to reduce severe itching.

Keep your child's fingernails cut short. Consider lightgloves if nighttime scratching is a problem.

Keep the skin moist (called lubricating or moisturizing theskin). Use ointments (such as petroleum jelly), creams, orlotions 2 - 3 times a day. Moisturizers should be free of al-cohol, scents, dyes, fragrances, or other chemicals. A hu-midifier in the home will also help.Avoid anything that makes yor symptoms worse. This

may inclde:

Foods such as eggs in a very young child (always dis-cuss with your doctor first)

Irritants such as wool and lanolin Strong soaps or detergents, as well as chemicals and

solvents

Sudden changes in body temperature and stress, whichmay cause sweating and worsen the condition

Triggers that cause allergy symptomsWhen washing or athing:

Keep water contact as brief as possible and use gentlebody washes and cleansers instead of regular soaps.Short, cooler baths are better then long, hot baths.

Do not scrub or dry the skin too hard or for too long. After bathing, it is important to apply lubricating creams,

lotions, or ointment on the skin while it is damp. This willhelp trap moisture in the skin.

Complications

Infections of the skin caused by bacteria, fungi, orviruses

Permanent scarsPreventionStudies have shown that children who are breast-fed untilage 4 months are less likely to get atopic dermatitis.If the child is not breast-fed, using a formula that containsprocessed cow milk protein (called partially hydrolyzed for-mula) may decrease the chances of developing atopic der-matitis.

ATOPIC DERMATITIS

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Diabetes can harm your eyes. It can damage the smallblood vessels in your retina, the back part of your eye.This is called diabetic retinopathy. Diabetes also in-creases your risk of having glaucoma, cataracts, andother eye problems.

You may not know there is any damage to your eyes untilthe problem is very bad. Your doctor can catch problemsearly if you get regular eye exams.If your doctor finds eye problems early, drugs and othertreatments may help prevent them from getting worse.You Need Regular Eye ExamsEvery year, you should have an eye exam by an eyedoctor. Choose an eye doctor who takes care of peoplewith diabetes.The eye exam may inclde: Dilating your eyes to allow a good view of the entire

retina. Only an eye doctor can do this exam.

At times, special photographs of the back of youreyeYour eye doctor may ask you to come more or less oftenthan every year.How to Prevent Eye ProblemsControl your blood sugar levels. High blood sugars in-crease your risk of having eye problems.Control your blood pressure. Blood pressure less than

130/80 is a good goal for people with diabetes. Have your blood pressure checked often and at

least twice per year. If you take drugs to control your blood pressure, take

them as your doctor told you to.

Do not smoke. If youneed help quitting, ask

your doctor or nurse.If you already have eye prob-

lems, ask your doctor if youshould avoid some exercises that can strain the bloodvessels in your eyes. These exercises may make eyeproblems worse: Weight lifting and other exercises that make you

strain High-impact exercise, such as football or hockeyMake It Easier for Yourself at HomeMake sure your home is safe from falls.If you cannot read the labels on your medicines easily,these tips might help you make sure you are taking thecorrect medicine and the correct dose: Use felt tip pens to label medicine bottles so you can

read them easily. Use rubber bands or clips to tell them apart. Ask someone else to give you your medicines. Always read labels with a magnifying lens.

Use a pill box with compartments for days of theweek and times of the day, if you need to take med-icines more than once a day.

Never guess when taking your medicines. If you are un-sure of your doses, talk with your doctor, nurse, or phar-macist.Keep medicines and other household items organizedin a cabinet so you know where they are.Use large-print cookbooks to make foods that are onyour diabetes meal plan. Ask your doctor or nurse whereyou can get these books.When to Call the Doctor

Call yor doctor if: You cannot see well in dim light. You have blind spots. You have double vision (you see 2 things when

there is only 1). Your vision is hazy or blurry and you cannot focus. You have pain in your eyes. You are having headaches. You see spots floating in your eyes. You cannot see things on the side of your field of vi-

sion. You see shadows.

Diabetes - eye care

PTN

Gingivitis is inflammation of the gums.CausesGingivitis is a form of periodontal disease. Periodontaldisease is inflammation and infection that destroys thetissues that support the teeth, including the gums, theperiodontal ligaments, andthe tooth sockets (alveolarbone).Gingivitis is due to the long-term effects of plaque de-

posits on your teeth. Plaqueis a sticky material made ofbacteria, mucus, and food debris that develops on theexposed parts of the teeth. It is a major cause of toothdecay.If you do not remove plaque, it turns into a hard depositcalled tartar (or calculus) that becomes trapped at thebase of the tooth. Plaque and tartar irritate and inflamethe gums. Bacteria and the toxins they produce causethe gums to become infected, swollen, and tender.The following raise your risk for gingivitis:

Certain infections and body-wide (systemic) diseases Poor dental hygiene Pregnancy (hormonal changes increase the sensitiv-ity of the gums) Uncontrolled diabetes

Misaligned teeth,rough edges of fillings, and ill-fitting or unclean mouth appli-ances (such as braces,dentures, bridges, and

crowns) Use of certain med-ications, including phenytoin,bismuth, and some birth control pillsMany people have some amount of gingivitis. It usuallydevelops during puberty or early adulthood due to hor-monal changes. It may persist or recur frequently, de-pending on the health of your teeth and gums.Symptoms Bleeding gums (blood on toothbrush even with gentlebrushing of the teeth) Bright red or red-purple appearance to gums


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At first sight, they pass off as just security guards at a hos-

pital but their strong builtand tough looks indicate that they

are bouncers kept to ward off agitated people.

These guards are stationed in key areas of the Deen

Dayal Upadhyay Hospital from emergency tolabour room

to casualty ward and one would think twice before picking

up an argument with them.

Plagued by physical attacks on doctors by agitated rela-

tives of patients, the administrators of the hospital have

hit upon the idea to protect doctors.

Such well-built yet polite people are on guard with the

primary objective of saving doctors who are often at the

receiving end.

Authorities at the Delhi Government-run hospital justify

the move to resort to such a step to save the doctors from

being attacked by the kith and kin of the patients and pre-

vent professionals from going on a strike.

New Delhi: The World Health OrganizationsIndia representative Dr Nata Menabde hasexpressed the need for regulating Indiasprivate healthcare sector represented byfive star hospitals.The private sector in India is represented

by five star hospitals. Their services need tobe regulated, Dr Menabde has said,adding, over-diagnosis in private hospitals

is a problem and so is misuse of technol-ogy.Dr Menabde has also supported the wideradoption of the Clinical Establishment Reg-istration Act passed by Parliament in 2010.Only four of the states and union territories(UTs) have ratified the law so far. [Source:BS]

Delhi DDU hospital appoints bouncers to protect doctors

Indias 5-star private hospitals should be regulated: WHO

Gums that are tender when touched, but otherwisepainless Mouth sores Swollen gums Shiny appearance to gumsExams and TestsThe dentist will examine your mouth and teeth and lookfor soft, swollen, red-purple gums.

The gums are usually painless or mildly tender.Plaque and tartar may be seen at the base of the teeth.The dentist will use a probe to closely examine yourgums to determine if you have gingivitis or periodontis.No further testing is usually necessary. However, dentalx-rays may be done to see if the disease has spread tothe supporting structures of the teeth.TreatmentThe goal is to reduce inflammation.The dentist or dental hygienist will clean your teeth. Themay use different tools to loosen and remove depositsfrom the teeth.

Careful oral hygiene is necessary after professional toothcleaning. The dentist or hygienist will show you how tobrush and floss.Professional tooth cleaning inaddition to brushing and floss-ing may be recommendedtwice per year or more fre-quently for severe cases ofgum disease.Antibacterial mouth rinses orother aids may be also be rec-ommended.

Repair of misaligned teeth orreplacement of dental and or-thodontic appliances may berecommended.Any other related illnesses or conditions should betreated.Outlook (Prognosis)Some people have discomfort when plaque and tartarare removed from the teeth.Bleeding and tenderness of the gums should lessen

within 1 or 2 weeks afterprofessional cleaning and careful oral hygiene.Warm salt water or antibacterial rinses can reduce gumswelling. Over-the-counter anti-inflammatory medicationsmay also be helpful.Healthy gums look pink and firm. Strict oral hygiene mustbe maintained for your whole life, or gum disease willrecur.

Possible Complications Gingivitis returns Periodontitis Infection or abscess of the gums or the jaw bones Trench mouthWhen to Contact a Medical ProfessionalCall your dentist if you have red, swollen gums, espe-cially if you have not had a routine cleaning and exami-nation in the last 6 months.PreventionGood oral hygiene is the best way to prevent gingivitis.You should brush your teeth at least twice a day. You

should floss at least once a day.Your dentist may recommend brushing and flossing after

every meal and at bedtime. Askyour dentist or dental hygienist toshow you how to properly brushand floss your teeth.Special devices may be recom-mended if you are prone toplaque deposits. They includespecial toothpicks, toothbrushes,water irrigation, or other devices.You still must brush and floss

your teeth regularly.Antiplaque or antitartar tooth-pastes or mouth rinses may alsobe recommended.

Regular professional tooth cleaning is important to re-move plaque that may develop even with careful brush-ing and flossing. Many dentists recommend having theteeth professionally cleaned at least every 6 months.Alternative NamesGum disease; Periodontal diseas PTN


10/12

Because of lack of awareness. Demand for quality

healthcare should come from consumers. We need a

campaign on similar lines of "Jago Grahak Jago".

Accreditation is eneficial for everyody ecase it

provides:A strong focs on:

Patient rights and benefits

Patient safety

Control and prevention of infections, med-

icine errors

Practicing good patient-care protocols e.g.

special care for vulnerable groups, criti-

cally ill patients

Better and controlled clinical outcome

benefits For Patients:

High quality of care Rights are respected and protected

Understandable education and communication

Patient satisfaction is evaluated

Informed choice through counselling and the care

process and maintain confidentiality

Focus on patient safety

Care of vulnerable patient

Continuity of care

benefits For the Staff:

Improves professional staff development

Provides education on consensus standards

Provides leadership for quality improve-ment within medicine and nursing

Increases satisfaction with continuous

learning, good working environment, leader-

ship and ownership

benefits For the Health Care Organisa-

tion:

Improves care and brings in Corporate

Governance

Stimulates continuous improvement

Demonstrates commitment to quality care

Opportunity to benchmark with the bestDr Gayatri Vyas Mahindroo Ms Mch

Director, National Accreditation Board for Hospitals and

Healthcare Providers (NABH), which is a constituent

board of Quality Council of India (QCI), New Delhi.

Amid concerns over rampant use of antibiotics andresistance developed towards them, government isset to restrict over-the-counter sale of 91 such newgeneration drugs through a notification which is likelysoon.The notification in this regard is in final stages withthe Drug Controller General of India (DCGI) writingto the Union Health Ministry, which, in turn, will sendit to the Law ministry for its nod, a Health Ministry of-

ficial said."The classification of 91 new generation antibioticswill be labelled 'Rx' in red and also prominently dis-play warnings that the drug is not to be administeredwithout medical advice," the official said.He, however, said such a notification is likely after thecurrent monsoon session of Parliament.The Schedule H-1 drugs will prominently carry awarning "it is dangerous to take this preparation ex-cept in accordance with medical advice" in red colouron the left corner, along with another advice of "not

to be sold by retail without the prescription of a regis-tered medical practitioner".The Drug Controller General of India has already writ-ten to all state drug controllers for strengthening ofregulatory control at retail sale outlets to ensure drugsare dispensed by retail chemists in compliance to theprovisions of the Drugs and Cosmetics Rules.The DCGI directive also seeks to ensure that drug in-spectors make surprise checks on chemists in theirareas so that restricted Schedule X and Schedule Hdrugs are not sold without medical prescription.

Patient access to physician notes can boost patientengagement, understanding and adherence to theircare plans, according to a study published in Annalsof Internal Medicine.For the study, researchers surveyed 105 primary carephysicians and 13,564 patients who had access totheir physicians' notes via an electronic portal over aone-year period. Of the 5,391 patients who reviewedat least one note and completed the survey, up to 87percent reported that the open notes program madethem feel more in control of their care, and up to 78

percent reported increased adherence to medications.Nearly all (99 percent) of the patients who respondedfelt that the program should continue, but approxi-mately one-third expressed concerns aboutprivay.Physicians initially voiced concerns that open noteswould increase their work load or worry and/or offendpatients; however, those concerns never materialized.When asked to describe the most difficult aspect of theopen notes program, 74 percent of the 104 physicianswho responded said that nothing was difficult and thatthey experienced no changes in their practice.

As the largest international organization of surgeons, TheAmerican College of Surgeons is dedicated to improvingthe care of the surgical patient.This Surgical Patient Education website contains edu-cational information to help you and your families becomeinformed about your operation and surgical care. Hereyou will find current information about surgical proce-dures, diseases, tests, and medications from governmentand professional sources to support you in participatingin your surgical care.

DCGI-To ConTrol oTC

sales of anTIbIoTICs

Why ot may hospitals are optigfor nABH accreditatio?

PATIENT & DOCTOR NOTES

Jago Grahak Jago


11/12

bILIRubINAlternate Names Total Bilirubin TBIL Neonatal Bilirubin Direct Bilirubin (Conjugated Biliru-bin) Indirect Bilirubin (Unconjugated

Bilirubin)Bilirubin is a component of bile, which isproduced by the liver, and necessary forthe normal digestion of food. Jaundice iscaused by high bilirubin levels in the blood,which can lead to brain damage if un-treated. Bilirubin blood levels are used todiagnose gallbladder disease, liver dis-ease, anemias, blood infection, transfusionreaction, or hemolytic disease of the new-born (where red blood cells are destroyed).

Cholesterol is a soft, wax-like substance found in allparts of the body. Your body needs a little bit of choles-terol to work properly. But too much cholesterol can clogyour arteries and lead to heart disease.Some cholesterol is considered "good" and some is con-sidered "bad." Different blood tests can be done to indi-vidually measure each type of cholesterol.Total Cholesterol

A total cholesterol test meas-ures all types of cholesterol inyour blood. The results of thistest tells your doctor whetheryour cholesterol is too high. Best: lower than 200 Borderline high: 200 -239 High: 240 and higher If your total cholesterol levelsare high, your doctor will want

to know your LDL cholesteroland HDL cholesterol levels be-fore deciding whether you needtreatment.Knowing your LDL and HDLcholesterol levels will also helpguide your doctor to choose thebest drug for you.LDL (Bad) CholesterolLDL stands for low-density lipoprotein. It's also some-times called "bad" cholesterol. Lipoproteins are made offat and protein. They carry cholesterol, triglycerides, and

other fats, called lipids, in the blood to various parts ofthe body. LDL can clog your arteries.Your LDL level is what doctors watch most closely. Youwant your LDL to be low. Too much LDL, commonlycalled "bad cholesterol," is linked to cardiovascular dis-ease. If it gets too high, you will need treatment.A healthy LDL level is one that falls in the best or near-best range.Best: Less than 100 mg/dL (less than 70 mg/dL for per-sons with a history of heart disease or those at very highrisk)

Near Best: 100 - 129 mg/dLBorderline High: 130 - 159 mg/dLHigh: 160 - 189 mg/dLVery High: 190 mg/dL and higherHDL (Good) CholesterolHDL stands for high-density lipoprotein. It's also some-times called "good" cholesterol. Lipoproteins are madeof fat and protein. They carry cholesterol, triglycerides,

and other fats, called lipids, inthe blood from other parts ofyour body to your liver.You want your HDL cholesterolto be high. Studies of both menand women have shown that thehigher your HDL, the lower yourrisk of coronary artery disease.This is why HDL is sometimesreferred to as "good" cholesterol.A healthy HDL level should be

as follows: Men: above 40 mg/dL Women: above 50 mg/dLAn HDL 60 mg/dL or abovehelps protect against heart dis-ease. Exercise helps raise yourHDL cholesterol.VLDL CholesterolVLDL stands for very low density

lipoprotein. There are three major types of lipoproteins.VLDL contains the highest amount of triglycerides. VLDLis considered a type of bad cholesterol, because it helps

cholesterol build up on the walls of arteries.A normal VLDL cholesterol level is between 5 and 40mg/dL.ConsiderationsSometimes, your cholesterol levels may be low enoughthat your doctor will not ask you to change your diet ortake any medications.When your levels are high, your doctor must considerother factors before deciding whether your cholesterollevels are a concern and need treatment.

SOURCEMEDLINEPLUS


12/12

Printed and Published by V.bHAVA NARAYANA forPHARMED TRADE NEWS, 3-3-62/A, New Gokhale Nagar, Ramantapur,Hyderabad - 500013, Edited by Dr.Anirudhha Malpani MD and Printed at Sai Likhita Printers, Lakdikapool, Hyderabad.

New Delhi: In a bid to reduce healthcare costs, the unionhealth ministry plans to bring in a legislation to make it

mandatory for doctors to prescribe generic medicines.Sources from the ministry say a bill is already beingdrafted to push low-cost medicine, along with an ambi-tious plan to provide freemedicine to all."The out-of-pocket ex-pense on healthcare istoo high. Generic medi-cine will ensure that it isaffordable," an officialfrom the ministry said."A bill is being drafted, itwill make sure that a listof generic medicinesand combination drugsare available in all dis-tricts, and it is pre-scribed by doctors," theofficial said.The official said that thebill would ensure thatboth generic andbranded medicines areavailable on sale side byside.

"The aim is not to bringan end to branded med-icine. They shall exist side by side. Out-of-pocket expen-diture for healthcare is 78 per cent of total expenditureon healthcare. Generic medicine would reduce the bur-den on the common man," he said.

The official, however, cautioned that there would beneed for strict monitoring and stringent quality control.

An ambitious programme for providing free generic med-icines to the economically weaker sections has alreadybeen finalised, and is likely to be implemented by the

year-end.As per data availablewith the ministry, thegovernment currentlyspends only 0.1 percent of GDP on pur-chase and supply ofmedicine through publichealth centres.Though India is one ofthe world's largest ex-porters of genericdrugs, its domestic mar-ket for generic drugs issmall. India exports toover 200 countries, in-cluding the highly regu-lated markets of the US,Europe, Japan and Aus-tralia.Common medicines likeparacetamol cost Rs 10

a strip when branded,while the generic variety

costs around Rs 2.45 per strip.At present, the government has a list of nearly 350 med-icines for which generic varieties will be made available.[Source: IANS]

HealtH ministry pusHes for

generic medicines

Patient satisfaCtion surveyWe would like to know how you feel about the services provided by Doctor / Hospital. Your responses are directly responsible

for improving services. All responses will be kept confidenal and anonymous. Thank you for your me.

Ease of geng care :

Ability to get in to be seen: 5 4 3 2 1

Hours Doctor/Hospital is open: 5 4 3 2 1

Convenience of locaon: 5 4 3 2 1

Prompt return of telephone calls: 5 4 3 2 1

Waing :

Time in waing room: 5 4 3 2 1

Time in exam room: 5 4 3 2 1

Waing for tests to be performed: 5 4 3 2 1

Waing for test results: 5 4 3 2 1Staff :

DOCTOR

Takes enough me with you: 5 4 3 2 1

Explains what you want to know: 5 4 3 2 1

Gives you good advice and

treatment: 5 4 3 2 1

Nurses and Medical Assistants:

Friendly and helpful to you: 5 4 3 2 1

Answers your quesons: 5 4 3 2 1

All Others:

Friendly and helpful to you: 5 4 3 2 1

Answers your quesons: 5 4 3 2 1

Payment :

What you pay: 5 4 3 2 1

Explanaon of charges: 5 4 3 2 1

Collecon of payment/money: 5 4 3 2 1

Do you feel overcharged Yes / No

Facility:

Neat and clean building: 5 4 3 2 1

Ease of finding where to go: 5 4 3 2 1

Comfort and Safety while waing: 5 4 3 2 1

Privacy: 5 4 3 2 1

Please Tick how well you think DOCTOR / HOSPITAL are doing in the following areas:

GREAT : 5 GOOD : 4 OK : 3 FAIR : 2 POOR : 1

The likelihood of referring your friends and

relaves to same Doctor / Hospital : YES / NO

What do you like best about Doctor / Hospital

What you do not like about Doctor / Hospital

Suggesons for improvement?

Name Of your Doctor / Hospital

Your Age: __________________

Sex: Male Female

Please Post or email

Ptn - Pae First

3-3-62/A, New Gokhale Nagar,Ramantapur, Hyderabad - 500013

email: [email protected]

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