CGHS-Hospitals-Delhi as on 10 06 2010

https://docs.google.com/fileview?id=0B4IulQCpDTIYNDliYzdjYTAtMWIwOS00OThmLWJkM2YtYmU0OWQwZWI0MjM4&hl=en_GB
Dr Marwah

Clinical Guidance on Swine Flu

Swine Flu: CDC Offers Clinical Guidance, WHO Raises Alert Level Again

The CDC has released a series of flu-related interim clinical guidance documents. They include one on the care of infected children and pregnant women, another for emergency medical services, and a case-definition document.

With regard to infected children, the advisory says the signs of severe disease include apnea, tachypnea, dyspnea, cyanosis, dehydration, altered mental status, and extreme irritability. Pregnant women suspected of being infected "should receive empiric antiviral treatment."

The CDC clarified case-definition terms as follows:

• An acute febrile respiratory illness is characterized by a temperature of 100.4 degrees or higher and recent onset of one of the following: rhinorrhea, nasal congestion, sore throat, or cough.
• Cases are "confirmed" only by PCR or viral culture.
• "Probable" cases include those with acute febrile respiratory illness, positive for influenza A, but negative for H1 and H3 by PCR.
• "Suspected" cases include symptomatic patients with recent (within 7 days) travel to infected areas or contact with a known case.

WHO raised its pandemic alert level from 4 to 5 (on a 6-level scale), reflecting confirmed person-to-person spread and the imminence of the threat. Earlier on Wednesday, the CDC confirmed the first death in the U.S.

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Dr Marwah

Swine influenza

Swine influenza (also swine flu) refers to influenza caused by any strain of the influenza virus endemic in pigs (swine). Strains endemic in swine are called swine influenza virus (SIV).

Swine flu is common in swine and rare in humans. People who work with swine, especially people with intense exposures, are at risk of catching swine influenza if the swine carry a strain able to infect humans. However, these strains rarely are able to pass from human to human. Rarely, SIV mutates into a form able to pass easily from human to human. The strain responsible for the 2009 swine flu outbreak is believed to have undergone such a mutation.This virus is named swine flu because one of its surface proteins is similar to viruses that usually infect pigs however this strain is spreading in people and it is unknown if it infects pigs.

In humans, the symptoms of swine flu are similar to those of influenza and of influenza-like illness in general, namely chills, fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort. The strain responsible for the 2009 swine flu outbreak in most cases causes only mild symptoms and the infected person recovers fully in a few days.

Of the three genera of human flu, two are endemic also in swine: Influenzavirus A (common) and Influenzavirus C (rare). Influenzavirus B has not been reported in swine. Within Influenzavirus A and Influenzavirus C, the strains endemic to swine and humans are largely distinct.

The CDC recommends the use of Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or prevention of infection with swine influenza viruses. The virus isolates that have been tested from the US and Mexico are however resistant to amantadine and rimantadine. If a person gets sick, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

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Dr Marwah

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position of cr cmo nfsg on 06 02 09

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Pay commission and Doctors

The Cabinet has approved promotions under the Dynamic Assured Career Progression Scheme up to Senior Administrative Grade for doctors with 20 years of service.

Counting of Dearness Allowance on Non-Practising Allowance as on January 1, 2006 for fixing their pay in revised pay bands has also been approved.

Dr Marwah

THINGS TO KNOW ABOUT BLOOD DONATIONS

WORLD BLOOD DONOR DAY 14 JUNE

THINGS TO KNOW ABOUT BLOOD DONATIONS

• 90% of individuals that are eligible to donate blood are not currently doing so.

• Blood donations have a short shelf-life, so regular donors are essential to secure a constant supply.

• Due to a shortage of blood and ageing populations, the age limits for blood donation acceptability are becoming increasingly flexible: the standard age limits for blood donation are 18 to 65 years of age, but in some European countries this has been lowered to 17 and increased to 70. In some places outside Europe, the lower and higher limits go from 15 with parental consent, to over 70 years of age.

• Regular blood donors are individuals donating at least twice a year, on a regular basis. They are demonstrated to be the source of safest blood donations. They have regular health checks on the occasion of each donation, and a healthy life style.

• The prevalence of markers for blood borne infections in blood donations can vary from 0.001 to 7.5 %, related to the category of blood donors. Blood which is found to be infected, for example with Hepatitis B, C or HIV, is disposed of and not used for transfusions.

• One donated unit of whole blood can save up to 3 lives, through separation and use of its components.

• Giving blood regularly may itself be good for you. It has been ascribed potential health benefits in coronary artery disease and oxygen-free radical chemistry. Regular blood donation is a life saving treatment for hereditary haemocromatosis and polycitemia vera.

• The world record in blood donation is held by Maurice Wood in the United States of America, who in 2004 gave his 300th unit of blood.

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Dr Marwah