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Fasting Ramadan & Diabetes Mellitus

6/28/2014

0 Comments

 
Picture
Dr Hatim Kheir is a Family Physician with Interest in Emergency Medicine.
He graduated from the Academy of Medical Sciences & Technology (Khartoum-Sudan) in 2003.
After completing the vocational training scheme in the East of England deanery in the UK and becoming
a member of the Royal College of General Practitioners (RCGP), he did the diploma in Tropical Medicine
in Ireland (RCSI&RCPI). 
He also holds the Diploma of the Royal College of Obstetricians & Gynecologists (DRCOG), as
well as the Diploma of the Faculty of Sexual & Reproductive Healthcare (DFSRH) by the RCOG. 
Dr Hatim Kheir also holds Certification in the College of Family Physicians of Canada (CCFP).
He currently works in Saskatchewan, Canada as a Family Physician with hospital and emergency
room (ER) privileges. He is a formal deputy secretary of the Sudanese Medical Association in UK &
Ireland (SMA-UK&I).
 
Contact email:
info@sma-ukandireland.org

قوله تعالى: {شهر رمضان الذي أنزل فيه القرآن هدى للناس وبينات من الهدى والفرقان فمن شهد منكم الشهر فليصمه ومن كان مريضا أو على سفر فعدة من أيام أخر يريد الله بكم اليسر ولا يريد بكم العسر ولتكملوا العدة ولتكبروا الله على ما هداكم ولعلكم تشكرون ( 185 . 


 
 
   
The month of Ramadhan [is that] in which was revealed the Qur'an, a guidance for the people and clear proofs of guidance and criterion. So whoever sights [the new moon of] the month, let him fast it; and whoever is ill or on a journey - then an equal number of other days. Allah intends for you ease and does not intend for you hardship and [wants] for you to complete the period and to glorify Allah for that [to] which He has guided you; and perhaps you will be grateful {Al-Bagarah:185}

Fasting Ramadan is one of the five pillars of Islam; the others are confession of faith, five
daily prayers, Zakah and Hajj.

 Ramadan will include the longest and hottest days in the year. Muslims in the UK will be fasting for around 18 hours during the holy month of Raman. 
 
 

Certain groups are exempt from fasting Ramadan either temporarily or permanently. These include the sick, the travelers, the elderly (fragile and unable to fast) and the pregnant and nursing mothers.  
 
The Qur’an specifically exempts the sick from the duty of fasting, especially if fasting might
lead to harmful consequences for the individual. Patients with diabetes fall under this category
because their chronic metabolic disorder may place them at high risk for various complications if the pattern and amount of their meal and fluid intake is markedly altered as well as missing or
changing certain medications due to fasting.
 
     Although fasting is not meant to create excessive hardship on the Muslim individual, many patients with diabetes insist on fasting during Ramadan. We aim in this article to give a general advice for those diabetics who decide to fast. 
 
      The aim of this article is to provide general medical advice to those with Diabetes who
decide to fast during the holy month of Ramadan. Those individuals need to be aware that this is only a general advice, which does not take into consideration personal and special circumstances, eg. Medical history, regular medications, etc. All individuals are strongly advised to consult their doctor for full and individual advice.


Risks and complications associated with fasting in Diabetic patients:
 
1) Low blood sugars < 4.0 mmol/l (Hypoglycemia):
 This is particularly increased in type 1 patients and in insulin-treated type 2 patients.
 
2) High blood sugars (Hyperglycaemia):
Mainly in the evening time, and it is due to the change in the individual eating habits and the traditional change in diet (Ramadan’s diet).
Also changing the medication doses and timing will affect this. 
 
3) Diabetic Ketoacidosis or Hyperglycaemic Hyperosmolar states: This is a serious complication and it is due to the lack or deficiency in Insulin, usually when associated
with infections or other illnesses.

 
4) Dehydration and increased risk of clots in blood vessels (thrombosis):
 Elderly are more prone to this, and especially in Ramadan this year due to the high temperatures and the very long fasting period. 


Specific Diabetics that should not fast:
1) All unstable "brittle" type 1 diabetic patients.
2) Unstable newly diagnosed type 1 or type 2 patients or poorly controlled diabetics. 
3) Previous diabetic complication due to fasting.
4) Diabetic patients with serious complications such as those with previous heart attack,
uncontrolled high blood pressure (hypertension) and those with kidney disease. 
5) Patients with a recent history of diabetic ketoacidosis or hyperosmolar states until stable
(over the last 3 months). 
6) All pregnant diabetic patients. 
7) Diabetic patients with inter-current infections or other chronic medical condition that put
them in additional risk. 
8) Elderly patients with any degree of memory or cognitive problems. 
9)Two or more previous episodes of hypoglycaemia (low blood sugar) and/or hyperglycaemia (high blood sugar) during Ramadan. 
10) Those who are unaware of hypoglycaemia (low blood sugar) symptoms or had hypoglycemia in the last 3 months prior to Ramadan. 
11) Unstable epilepsy (particularly if seizures were precipitated by low blood sugar (hypoglycaemia) in the past. 

General consideration and advice:
 
1) Individualization:
  It is very important to realize that the advice and plan for each individual is crucial and is highly individualized and that the management plan will differ for each specific patient. Hence it is important for each diabetic patient to consult his/her doctor for
individual specific advice.
 
2) Medical assessment & counselling:
All patients with chronic medical problems, and specifically those with Diabetes need to see their own doctor for further advice and
assessment. During this assessment, they should enquire if it is safe for them to fast or not.
During this assessment they will usually be advised regarding the necessary changes in their diet or medication regimen. (Aim should be to initiate fasting while being on a stable and effective program). Also they should be aware of symptoms of low or high blood sugars, and should be prepared and able to treat low blood sugar levels immediately even if it is mild. They should also obtain and keep glucose gel, tablets, etc with them all the time. Also they should consider wearing medical alert bracelet.
 
3) Frequent monitoring of blood sugars:
 It is essential that all patients with diabetes have the means to monitor their blood glucose levels multiple times daily. This is especially important in patients with type 1 diabetes and in those with type 2 diabetes who require insulin.
 
4) Nutrition:
 The diet during Ramadan should not differ significantly from a healthy and balanced diet. The common practice of eating large amounts of foods rich in carbohydrate and fat at the iftar should be avoided. Also avoid sugary drinks and sweats, mainly those specifically served in Ramadan. Also, it is important to increase the fluid intake between the iftar and sohour. Also the sohour should be delayed and taken as late as possible before the start of the daily fast.
 
5) Exercise:
 Normal levels of physical activity may be maintained, but excessive physical activity should be avoided, particularly during the few hours before the Iftar due to the risk of low blood sugar.
 
6) Breaking the fast:
 All patients with diabetes need to understand that they must always and immediately break and end their fast if their blood sugar drops 3.3 mmol/l at any time even of it is close to the iftar time, if they have any symptoms of low blood sugar (even if just mild), or if their blood glucose reaches 3.9 mmol/l after few hours from the start of fasting, especially if insulin or other oral diabetic medication are taken before start of fasting. Also, the fast should be broken if blood glucose exceeds 16.7 mmol/l. Patients should avoid fasting
on “sick days.
 
7) Symptoms of low blood sugars (hypoglycemia):
main symptoms are sweating, fatigue and
feeling dizzy. Other symptoms of hypoglycemia can also include: being pale, feeling weak,
feeling hungry, palpitations (higher heart rate than usual) and blurred vision. In severe cases
temporary loss of consciousness, confusion, convulsions and coma can occur.

 
Treatment for hypoglycaemia: 
a.A mild case of hypoglycemia can be treated through eating or drinking
approximately 10-20g of sugar (i.e. carbohydrates). Treat with one of these quick
sugars (10-20 gm carbohydrate): 
• 10-20 grams glucose tablets/ gel.
• ¾ cup regular soft drink or fruit juice.
• 1 tablespoon honey 
• 3 packets of sugar 
 
b.Wait 15 minutes and check your blood sugar again. If it remains low then treat
again with one of the quick sugars listed above. If symptoms persist or in any case
of severe hypoglycaemia then immediate and urgent medical advice is required.
Remember! Always have quick sugar in your pocket, purse, office,
vehicle, and at your bedside.
 
8) Symptoms of high blood sugars (hyperglycemia):
this include: extreme thirst, need to
urinate often, dry skin, hunger, blurred vision, drowsiness, slowly healing wounds or
recurrent wound/skin infections.   

Finally, May Allah (SWT) accept our fasting and prayers during this holey month. Please
do not forget me in your Dua’a (prayers). 
 
Ramadan Mubarak…….



References:
1)M Al-Arouj et al. Recommendations for Management of Diabetes During Ramadan. Diabetes care .28.9.2305Diabetes Care September 2005 vol. 28 no. 9 2305-2311.
2) The Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329: 977–986, 1993
3)Laing SP, Swerdlow AJ, Slater SD, Botha JL, Burden AC, Waugh NR, Smith AW, Hill RD, Bingley PJ, Patterson CC, Qiao Z, Keen H: The British Diabetic Association Cohort Study. II. Cause-specific mortality in patients with insulin-treated diabetes mellitus. Diabet Med
16: 466–471, 1999.
4)Practical Management of Diabetes during Ramadan Fast. Beshyah SA et al., Division of Endocrinology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
5 )Diabetics Education Services, Chicago.
6) St Joseph healthcare. Diabetes Education Centrex.









 

 شَهْرُ رَمَضَانَ الَّذِيَ أُنزِلَ فِيهِ الْقُرْآنُ هُدًى لِّلنَّاسِ وَبَيِّنَاتٍ مِّنَ الْهُدَى وَالْفُرْقَانِ فَمَن شَهِدَ مِنكُمُ الشَّهْرَ فَلْيَصُمْهُ وَمَن كَانَ مَرِيضًا أَوْ عَلَى سَفَرٍ فَعِدَّةٌ مِّنْ أَيَّامٍ أُخَرَ يُرِيدُ اللّهُ بِكُمُ الْيُسْرَ وَلاَ يُرِيدُ بِكُمُ الْعُسْرَ وَلِتُكْمِلُواْ الْعِدَّةَ وَلِتُكَبِّرُواْ اللّهَ عَلَى مَا هَدَاكُمْ وَلَعَلَّكُمْ تَشْكُرُونَ




صيام رمضان احد أركان الاسلام الخمس وهى الشهادة و أقام

الصلاة وصوم رمضان وإيتاء الزكاة و حج البيت من استطاع اليه سبيلاً.


سوف تكون ساعات الصيام هذا العام طويله ١٨ ساعة، ويعتبر هذا يوم طويل وايضاً شديد الحرارة.





قد يستثنى بعض الأشخاص او الفئات من اداء فريضة الصيام اما مؤقتاً او بصفة دائمة. و يشمل هذا الاستثناء المرضى ،الذين على سفر، كبار السن ،النساء الحوامل والمرضعات.

وقد استثنى القران الكريم المرضى من الصيام اذا كان قد يسبب لهم أضرارا ومضاعفات جسيمه لصحتهم، ومن هذا الفئات الأشخاص المصابين بمرض السكرى وذلك لان اضطرابات التمثيل الغذائي قد تعرضهم الى بعض المضاعافات من جراء اختلال نظام الأكل و الشرب و تغير موعد تناول الدواء.





ان الغرض من الصيام ليس تعرض الانسان الى التهكله
الا ان بعض مرضى السكرى يصرون على اداء الفريضة.




يهدف هذا المقال لتقديم بعض النصائح العامة لمرضى السكرى  الذين يصرون على صيام الشهر المبارك.








يمكن تلخيص المخاطر و المضاعافات التى قد يتعرض اليها الصائمين من مرضى السكرى فى الآتي:-


١/ انخفاض نسبة السكر فى الدم الى اقل من ٤ و تكثر هذه الحالة فى النوع الاول والثانى من المرضى الذين يتعاطون الإنسولين.

٢/ارتفاع نسبة السكر فى الدم. غالباً ما تحدث هذه الحالة فى المساء بسبب تغير نظام ونوع الأكل  وكذلك من التغير فى جرعات الدواء ومواعيد تناولها.

٣/ الاحماض الكيتونيه  وتنتج هذه المضاعافات الخطيرة من قلة الإنسولين ، ويحدث هذا اذا كانت هنالك أمراض اخرى أو التهابات.

٤/ الجفاف و زيادةالخطر من الإصابة بجلطات الأوعية الدموية. ويكون كبار السن اكثر تعريضاً لهذه الحالة وخاصة فى شهر رمضان هذا وذلك لارتفاع درجة الحرارة و ساعات الصيام الطويله 









مرضى السكرى الذين لا يجب عليهم الصيام :-

١/النوع الاول من مرضى السكرى.

٢/ الأشخاص حديثو الإصابة بالمرض من النوع الاول و الثانى الذين لا يستطعون السيطرة على السكر.

٣/ الأشخاص الذين قد عانوا من مضاعفات من جراء الصيام فى السابق. 

٤/ مرضى السكرى الذين يعانون من مضاعفات خطيرة مثل الذين قد عانوا من أزمات قلبية من قبل.

٥/ المرضى الذين يعانون من الأحماض  الكيتونىه وخاصة فى خلال الثلاثة شهور الاخيرة .

٦/ كل النساء الحوامل المصابين بمرض السكرى.

٧/ مرضى السكرى المصابين بالتهابات او مضاعفات صحية مزمنة قد تسبب لهم مخاطر صحية.

٨/ كبار السن و الذين يعانون من مشاكل ضعف الذاكرة.

٩/ مرضى السكرى الذين تعرضوا الى اثنين او اكثر من  أزمة  نقصان او زيادة نسبة السكر فى الدم خلال شهر رمضان.

١٠/المرضى الذين ليس على دراية بأعراض نقصان او زيادة نسبة السكر فى الدم او تعرضوا للإصابة بنقصان نسبة السكر خلال الشهور الثلاثة الأخير قبل  شهر رمضان.

١١/ حالات الاغماء او الصرع الناتجة من انخفاض السكر فى الدم. 


بعض النصائح العامة:-
من المهم معرفة ان النصيحة الطبية تختلف من شخص للأخر، وان السيطرة على المرض تختلف كذلك. لذا من المهم استشارة الطبيب لأخذ النصيحة المناسبة لكل حالة.


2/ التقييم الطبي و المشورة :-
كل المرضى المعرضين لمشاكل صحية مذمنة وخاصة السكرى يجب عليهم استشارة الطبيب لمزيد من النصيحة و تقييم حالتهم الصحية ، كما يجب عليهم التأكد بانه ليس هنالك خطورة عليهم فى حالة الصيام. أيضاً يحب عليهم الإلمام بأعراض نقص او زيادة نسبة السكر فى الدم ومعرفة كيفية التعامل مع كل حالة. كما ينبغى عليهم الاحتفاظ بجلكوز و أقراص الدواء وغيرها معهم فى كل وقت.







 
2/الفحص المنتظم لقياس نسبة السكر فى الدم:-
من الضرورة ان يقوم مريض السكرى بمعرفة مستوى الجلكوز فى دمهم عدة مرات يومياً وخاصة المرضى من النوع الاول والثانى و اللذين يحتاجون الى الإنسولين.



3/التغذية :-
يجب ان لا يختلف النظام الغذائي خلال شهر رمضان و اتباع نظام غذائي صحي ومتوازن.أيضاً تجنب تناول الحلويات و المشروبات السكرية و خاصة تلك التي تتناول فى شهر رمضان ، و كذلك يجب الإكثار من تناول السوائل بين الإفطار و السحور و تأخير السحور.






 التمارين البدنية:-
 عدم الإفراط فى التمارين البدنية و خاصة قبل للإفطار 4/




5/وقف الصيام:-
 يجب على مريض السكرى معرفة انه يجب عليه عدم مواصلة الصيام اذا انخفضت نسبة السكر فى الدم الى اقل من ٣.٣ ملمول/لتر حتى ولو قرب موعد للإفطار. أيضاً يجب وقف الصيام اذا ارتفعت نسبة السكر فى الدم ابى ١٦.٧ملمول/لتر.









6/أعراض انخفاض نسبة السكر فى الدم:-
 فالاعراضى الرئيسية هى العرق و التعب الشديد و الشعور بالدوار و الشحوب والشعور بالجوع وارتفاع معدل ضربات القلب  وقد يصاب المريض فى بعض الأحيان بفقدان الوعي.






علاج نقص السكر بالدم:- 

أ- يكمن معالجة الحالات الخفيفة من تقص السكر بتنلول جرعات من السكر١٠-٢٠ جرام.      

ب- ١٠ -٢٠ جرام أقراص جلكوز.        

ج-٣/٤ كوب من المشروبات الغازية او عصير الفاكهة.     

د- ملعقة طعام من العسل.       

ه - ٣ حزم سكر.      

الانتظار لمدة ١٥ دقيقة و قياس نسبة السكر فى الدم مرة واذا ما زالت نسبة السكر منخفضة يجب تكرار المعاملة السابقة مرة اخري فإذا لم تتحسن الحالة يجب مراجعة الطبيب. تذكر دائماً حمل احد مصادر السكر معك وفى متناول الي اليد.

7/ أعراض ارتفاع نسبة السكر بالدم:

 وتشمل العطش الشديد ،الحاجة للتبول كثيراً ،جفاف الجلد، الجوع ، النعاس، عدم التئام الجروح سريعاً و التهابات الجروح والجلد المتكررة.

واخيراً نسال الله سبحانه و تعالي ان يتقبل صيامنا وقيمنا خلال هذا الشهر المبارك و لا تنسونا من صالح الدعاء
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Appropriate Use of Antibiotics

4/1/2014

5 Comments

 
Picture
Dr Hatim Kheir is a Family Physician with Interest in Emergency Medicine. 
He graduated from the Academy of Medical Sciences & Technology (Khartoum-Sudan) in 2003. 


After completing the vocational training scheme in the East of England deanery in the UK and becoming 
a member of the Royal College of General Practitioners (RCGP), he did the diploma in Tropical Medicine 
in Ireland (RCSI&RCPI). 


He also holds the Diploma of the Royal College of Obstetricians & Gynecologists (DRCOG), as 
well as the Diploma of the Faculty of Sexual & Reproductive Healthcare (DFSRH) by the RCOG. 
Dr Hatim Kheir also holds Certification in the College of Family Physicians of Canada (CCFP). 
He currently works in Saskatchewan, Canada as a Family Physician with hospital and emergency 
room (ER) privileges. He is a formal deputy secretary of the Sudanese Medical Association in UK & 
Ireland (SMA-UK&I). 
 
Contact email: info@sma-ukandireland.org 




Antibiotics are important medicines used to treat infections caused by bacteria, some fungi and parasites. 


Antibiotics DO NOT treat infections caused by viruses. Antibiotics can be lifesavers, but inappropriate use of antibiotics has increased drug-resistant bugs. We aim in this article to increase the awareness of patients with regards to the appropriate use of antibiotics.

If you think antibiotic resistance isn't a problem or doesn't affect you, think again. A prominent example of the dangers of antibiotic resistance is the spread of methicillin-resistant Staphylococcus Aureus (MRSA). MRSA was once a concern only for people in the hospital, but a newer form of MRSA is causing infections in healthy people in the community.


Antibiotic resistance occurs when antibiotics no longer work against disease-causing bacteria. These infections are difficult to treat and can mean longer lasting illnesses, more doctor visits or extended hospital stays, and the need for toxic medications. Some resistant infections can even cause death.


Viral infections are very common. They include all colds and flu, and many infections of the nose, sinuses, ears, throat and chest (coughs / bronchitis). Antibiotics DO NOT kill viruses. Infections such as sore throat, cough/bronchitis, sore ear and nasal symptoms are usually caused by viral infections, but sometimes they can be caused by bacterial infections. Our immune system can clear many of these infections without the need for antibiotics. Antibiotics do little to speed up the recovery from most common infections. However if someone has a more serious bacterial infection such as pneumonia he/she will need treatment with antibiotics. This is why it is important to use antibiotics wisely, to ensure they are more likely to work when we really need them.


Appropriate use of antibiotics is EVERYONE’S responsibility (healthcare providers, patients and patients’ carers). To help, we need to:
1) Understand when antibiotics should be used. Don't expect to take antibiotics every time you're sick. Only take them when you really need them and when they have been recommended for you by a healthcare professional.


2) DON’T pressure your doctor to prescribe antibiotics if you have a viral illness.


3) Take antibiotics exactly as prescribed. If you are prescribed an antibiotic, follow the directions for use carefully and always remember to complete the full recommended course. Don't stop treatment a few days early because you're feeling better.


4) Never take antibiotics without a prescription.


5) Prevent the spread of germs. By simple hygiene, cover your mouth and nose when coughing or sneezing and remember to wash your hands regularly.


6) Get recommended vaccinations. (eg. Flu vaccine).


What is the treatment for viral infections?


1) No treatment: Many common infections are mild and will clear up without any
treatment.


2) Rest: This will allow your immune system to fight the infection.


3) Pain & fever relief: Take Paracetamol or Ibuprofen regularly. Do not take more than the
recommended dose.


4) Fluids: Drink plenty of fluids such as water and fruit-juices to avoid dehydration.


5) Mouthwash/gurgles: Using a simple mouthwash such as warm salty water at frequent
intervals may ease a sore throat.


6) Steam inhalation: Inhaling steam from a shower may help clear a stuffed up nose. This
may be helpful before bedtime. Care should be taken to avoid any risk of scalding.


7) Over-the-counter medicines (OTC): Ask your community pharmacist for advice.
Cough and cold medicines bought OTC are not recommended for children under 6 years
of age.


8) You should contact your doctor for assessment and advice if your symptoms start to
change, not settling with simple measure or getting worse. Also if you do not start to
improve after a few days, or if you have any concerns or have unexplained symptoms.


In summary, remember:
 Antibiotics DO NOT treat viral infections.
 Antibiotics are useful for many bacterial infections and may be life-saving.
 Responsible use of antibiotics will help to ensure they are more likely to work when you
really need them.
 Avoiding unnecessary use of antibiotics may slow down the development of antibiotic
resistance.
 Healthcare workers, patients and patient’s carers all have an important role to play in
ensuring antibiotics remain effective.


References: (1) Health & Social Care Board. (2) Mayoclinic.
5 Comments

Travel Advice To Sudan

3/16/2014

1 Comment

 
Picture
Dr Hatim Osman Kheir
Dr Hatim Kheir is a Family Physician with Interest in Emergency Medicine.
He graduated from the Academy of Medical Sciences & Technology (Khartoum-Sudan) in 2003. After completing the vocational training scheme in the East of England deanery in the UK and becoming a member of the Royal College of General Practitioners (RCGP), he did the diploma in Tropical Medicine in Ireland (RCSI&RCPI).
He also holds the Diploma of the Royal College of Obstetricians & Gynecologists (DRCOG), as well as the Diploma of the Faculty of Sexual & Reproductive Healthcare (DFSRH) by the RCOG.
Dr Hatim Kheir also holds Certification in the College of Family Physicians of Canada (CCFP).
He currently works in Saskatchewan, Canada as a Family Physician with hospital and emergency room (ER) privileges. He is a formal deputy secretary of the Sudanese Medical Association in UK & Ireland (SMA-UK&I).
Contact email: info@sma-ukandireland.org

The aim of this article is to provide medical advice to travelers to Sudan. Travelers need to be aware that this is only a general advice, which does not take into consideration personal and special circumstances, eg. Medical history, areas visited in Sudan, timing & length of visit, etc.

All travelers are strongly advised to consult their doctor at least 8 weeks before their travel for detailed advice.

1) Vaccinations:

a. Routine vaccines: all travelers need to make sure they are up-to-date on routine vaccines (measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine and polio vaccine). Also consider BCG vaccine (TB vaccine), and the yearly flu vaccine.

b. Special vaccines: most travelers require the following vaccines before their travel to Sudan: (Hepatitis A Vaccine, Typhoid Vaccine and Malaria prophylaxis).

c. Other vaccines: some travelers may need Hepatitis B vaccine (this is can be given in a combined form with Hepatitis A vaccine. Also if a person had Hepatitis B vaccine in the past, he/she may need a booster to ensure protection. You doctor can arrange a blood test to check your immunity). Other vaccines also include Polio vaccine, Meningococcal vaccine (mainly during dry season), Rabies vaccine and Yellow Fever Vaccine.

2) Stay Healthy and Safe: Travelers need to learn simple actions and behaviours to stay healthy and safe during their visit.

a. Eat and drink safely: contaminated food can cause diseases like Hepatitis A, Typhoid, diarrhea & vomiting, etc. Taking simple food hygiene can prevent these diseases, eg avoid food from street vendors, unwashed fruits and vegetables, water from public dispensers, unpasteurized milk etc.

b. Prevent bug bites: bugs like mosquitoes, ticks and fleas can spread serious diseases. Taking simple measures to prevent these bites are important, eg cover exposed skin by wearing long-sleeved shirts and long pants (beware of
heat strokes in hot temperatures especially in children, use cotton). Also use insect repellent. Sleep in rooms with fans or air-conditions where possible, and/or can use bed net (mainly for children).

c. Keep away from dogs/cats: animal bites can cause serious diseases like Rabies. d. Prevent heat strokes (in high temperature weather): taking simple measures can prevent this, eg. wear loose-fitting, lightweight clothing, wear light-coloured clothing if exposed directly to the sun, drink plenty of fluids, extra caution with children (avoid dehydration, never leave them in a parked car). Also take extra precautions with certain medications.

Reference: Centers for Disease control & Prevention.
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New Vaccines against malaria and hope for African children

3/16/2014

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Researchers in the University of Edinburgh have now found a novel way to produce proteins that could lead to malaria vaccines being easy and cheap to manufacture. The vaccine will enable the immune system to produce antibodies in the bloodstream to fight and stop infections. In 2011 GlaxoSmithKline company finished phase III clinical trials in seven African countries. The vaccine lead to 50% reduction in infection among 6000 children aged 5 and 17 months.

ٍSudan national malaria control programme, with WHO’s support, has reduced the number of malaria cases from more than four million in 2000 to less than one million in 2010. Between 2001 and 2010, the number of deaths due to malaria reduced by 75%. The programme implemented appropriate and cost-effective malaria control interventions. These include the distribution of artemisinin-based combination therapy treatments, rapid diagnostic tests and long-lasting insecticidal nets, and the introduction of the home-based management of malaria strategy. None the less many children still lose their lives due to deteriorating health services especially in poor and rural families. Now there is a pressing need for new treatments, as many forms of the disease are becoming resistant to existing drugs. Children and pregnant women in poor households and rural areas are particularly at risk.




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Life cycle of the malaria parasite. Source: Infectious Disease, Book 5: Evolving Infections



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