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Health Corner- Myths versus Facts

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Preface: I was given a rather daunting task by one of my acquaintances to put down some tips on good health for general information to my fellow crowd and beyond to humanity at large. Naturally it was difficult to decide where to start from, since the target readers may be from all strata and communities of our society and of all age groups.

But let me begin somewhere….

In the beginning, I would like to put some very general lifestyle habits which should be followed by all people for general good health to one and all. Many of what I am about to unfold are known to public, but some new concepts will also he hereby known-to undo any faulty /wrong habits which the reader may have inculcated, inadvertently.

Let me suggest a listing of never do’s & don’ts:

Never to skip your Breakfast in the morning. This is the most important meal of the day.

              1. You may skip your lunch/take a light lunch.
              2. Never take a heavy dinner moreover with lots of spicy and oily food. Night is the time of metabolic house-cleaning. The less the task assigned to the body in the form of digestion and metabolism at night, the better the body gets self-cleansed and detoxified by the next day.
              3. Drink at least l0 glasses of water in a day. Maybe more in the hotter regions.
              4. Soft drinks are real nuisance consumables with lots of empty calories. They are never to be considered for replenishing the fluid content of the body.( I have found hardly anybody drinking water along with any food-it is invariably a soft drink to go along !!!)
              5. If milk is tolerated, one can go for it, it helps one to go off to sleep. But it should be avoided by people who are trying to get into shape and lose some weight! Dairy products in general are fattening with the exception of some skimmed milk, etc. All the same, rnilk is regarded as one of the compact forms of nutrition…for calcium supplementation .
              6. Eggs are nutritionally recommended for calcium/protein etc. and they do not contribute to high Cholesterol, unless one is predisposed to high lipids in the blood.. (as per recent research). The no. of eggs should be restricted to 1-4 in a week! Not to forget that eggs go into the making of a lot of confectionery products as well, at home. This should also be considered.
              7. Red Meat/Meat of bigger animals should be avoided at all cost. Mutton maybe very delicious to the taste buds and a gratification to cook at home and places of formal eating, but it is a strict no-no as far as good health is concerned. Its fibers arc very much loaded with fats.
              8. Country chicken is always better-they run around a lot and their flesh is tastier as well than poultry bred chicken!!! Chicken should always be taken with the skin removed preferably before cooking. Ideally eggs of such country chicken are good to taste and good for health also. Duck’s Eggs are tastier but rich in Cholesterol!
                Recently the eggs of Quail birds are available locally too.
              9. Green vegetables and at least one serving of fruits should be present in the platters of all meals. Bananas are good in conditions of constipation/diarrhea but they are fattening as well as they contain a lot of calories. ( Bananas are an item with high GI –Glycaemic Index–They can be taken in moderation from time to time. People suffering from ‘Acid Peptic Disorders’ should refrain from Oranges and all sour fruits.
              10. Dry fruits – recommended best ones are Almonds and Walnuts. Cashew nuts although are common and tasty, they are rich in lipids. Peanuts are very good as well.
              11. Chocolates in general should be taken occasionally-but the darker ones with cocoa are said to be now good for heart, as per recent research, although in moderation .Teeth must be brushed at all times after ingesting chocolates to avoid Dental Caries and related conditions by people of all ages, more so children.
              12. Microwave Cooking is to be discouraged-as it robs the food element of their nutritious values! Microwave ovens can best be used as Food Warmers.
              13. The pattern of eating should ideally be when you leave the dining table you feel as if you could have eaten some more………..!!!
              14. Brown Bread is better than White Bread. But Breads again should be taken in moderation, to keep a check on carbs.
              15. Visits to places like McDonald’s and KFC should be avoided in principle, particularly if children are there in the family. Deep fried junk food is just not advisable for good health for persons in any age group-particularly kids and adolescents.
              16. Not to hit the bed immediately after lunch/dinner. It is better to sit upright for about half an hour (watching TV can be done) before one retires tor the day. This prevents conditions of Reflux Oesophagitis/ Heartburn/Waterbrash etc. which are very common. One should not stoop down to do anything just after main meals!
              17. It is better to avoid eating in between principal meals-as this distorts the real appetite and calories cannot be controlled.
              18. Given the option between Tea and Coffee – it is better to go for Tea. Due to its Tannin content, it acts as a good anti-oxidant. (An anti-oxidant is a substance which mops up the potential carcinogenic radicals in the human body.)
              19. Salad dressing/salted preservative added food/fruit Cocktails/ Creamy pastries/ Pudding/ concentrated Kheer products/ Cheese/Butter/ Non-skimmed milk are better avoided.

Few topics relevant to people with certain known disease conditions:

Persons known to have Renal/Ureteric Stores should refrain from eating tomato/related products. A lot of water should be consumed daily.

              1. Persons known to have Diabetes/with father or mother a known diabetic, should maintain a vigilant Diet Chart at home and also, as much as possible outside home. Everything can be taken but in moderation, depending on one’s body weight. What matters is the daily calorie consumption in the guidance of a Dietician or a Doctor.
              2. People with Diabetes should ‘keep their feet as clean as their face’. It is a very well believed saying, respected by Doctors and well educated patients alike. Diabetics are very prone to develop foot ulcers which do not show a tendency to heal can cause big problems to the patient and Doctors and many people have ended up losing their limbs (by amputation) simply arising out of sheer neglect of themselves and their Physician’s advice !!!
                A word of caution here – today children are also diagnosed to suffer from Diabetes simply out of leading an erratic life style!!!
              3. Elderly people with Diabetes for many years are typically prone to have some of the following. So their care takers should be aware of them:
                            1. Silent Heart Attacks – which has a high mortality;
                            2. Sudden Strokes ending up with paralysis of different grades;
                            3. Sudden infective episodes inside their system requiring urgent Surgery;
                            4. Sudden/Early Blindness arising out of a process called Retinopathy…even Cataracts;
                            5. Damage of Kidneys-causing renal failure and heading for dialysis etc. which are very expensive, even by Indian standards and the outcome is always grim;
              4. People with Hypertension (High blood pressure) should try to lead a stress free life, with regular checkup of BP) and medication from Doctors. Long standing improperly treated Hypertension can also lead to damage of Eyes/Kidneys/Heart etc. excess salt on the dining table to be avoided, salt may be used, albeit sparingly in the kitchen.
                ( Less than 5-6 gms a day)
              5. Persons suffering from both ‘Diabetes and ‘Hypertension’ need to be doubly cautious with respect to their day to day life, follow-up with Doctors, dietary habits and medications. All the potential complications of these silent killers get multiplied in such people, but with regular supervision from medical personnel they can lead very compatible normal lives.
              6. Persons known to suffer from a condition called as “Gout” need to have a real look into their diet and consult Doctors when they have episodes of acute pain in joints etc. This is usually due to a genetically inherited metabolic deficiency of an Enzyme, which takes part in Purine metabolism in the body. Simple analgesics after seeing a Doctor may be tried and usually the attacks subside within a few days, in some cases other medication are required and even to go on for life in resistant chronic cases. Beer is to be strictly avoided in such patients and Red Meat and certain leafy vegetables too, should be avoided from their Diet.

I think this has been a synopsis of handy health tips- which all good samaritans of this country need to know-.in order to lead a healthy life here . I have chosen this simplistic approach, as it is easy to be followed by lay persons, avoiding complicated terminology which might intimidate the readers and will defeat the purpose. The List is exhaustive and it goes on and on! It is only a humble effort to pick up a glass full of knowledge from an Ocean of the same . Parents should be rather strict on their children on many such issues. Working men and women must take care of themselves in an adequate manner as hinted above . Elderly people must be closely taken care of by their sons/daughters and taken to visit Doctors if something sinister really comes up with them.
Good Luck and Good Health to all my brethren & friends – young and old.

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Taking on anemia by readdressing antenatal care in Karnataka

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Keywords: Anemia, Antenatal Care, Data analysis, cloud computing, MMR and IMR
 

Context:

The Burden of anemia in India is a major public health issue. More than 50% women and 20% children suffer from anemia and a leading cause of 40% maternal deaths in the country.
In the state of Karnataka, 79% of maternal deaths are found to occur due to anemia Karnataka State Health system 2015, 16). Antenatal period is crucial among pregnant women, lending adequate access to prevention, care and monitoring. However, rural communities in the region face several healthcare challenges, making pregnancy a high risk one,followed by poor pregnancy outcomes.
Anemia during pregnancy is preventable, if it is picked up well in time in the antenatal period through basic blood tests and clinical examination ( ).
How we contribute: In north Karnataka where many pregnant women face significant barriers to obtaining quality antenatal care, iKure is bringing care at the door steps of the rural people.
Through app. based diagnostic device, and innovative healthcare solutions, pregnant women are identified and regularly screened and monitored by trained health workers at the convenience of their home. They take health status assessment on their mobile app. perform blood tests and clinical examinations, organize health camps and message dissemination programs.
Patients who are at high risk of developing anemia or afflicted with the disorder are monitored frequently and supported by medical team to connect with doctors virtually through telemedicine platform or hospital referral system.
To provide patients with better healthcare outcomes, iKure using data analysis technology extracts useful knowledge with respect to anemia for better decision making and management. Through various technology innovations such as cloud computing, mhealth technology and smart applications supported by WHIMS, iKure is generating multiple data sources allowing doctors and researchers to make informed clinical and behavioural decisions, improving treatment processes and detecting anemia well in advance.
 

Impact:

The strategic antenatal care adopted by iKure provides the potential to significantly reduce the prevalence of anemia in Karnataka. In north Karnataka, with a sample size of 91 pregnant women, the insights collected in the Ist round of antenatal checkup reported 64% of the respondent with low haemoglobin count, which interestingly reduced to 57% in second round and 43% in third round checkup. Low blood pressure reduced from 24 respondents in the first round of health check up to 14 in third round. The programme is already demonstrating positive health outcomes, including raising health seeking behaviors among pregnant women who did not knew that they were at risk of developing severe anemia and other chronic ailments, increasing consumption of folic acid and iron tablets and reducing abortion rates.

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CHWs-Newfrontier to drive innovations in rural healthcare delivery

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The need:

Jayashree,is a Community Health Worker(CHWs) in her village called Hubli, in Karnataka. One day,while she visited a woman named Pushpa in her first trimester,she looked quite unwell. On enquiring Pushpa was found to suffer from Epilepsy. Her family also revealed, she has been prescribed with medicines by a local doctor, but she didn’t take them regularly. Epilepsy is a disorder of the nervous system and such patients during pregnancy have major concerns. Jayshree felt the need! She promptly captured her vitals on her smart phone loaded with Wireless Health Incident Monitoring Systems, (WHIMS), and pushed the patient’s vitals on to the cloud for a quick doctor reference. For the next few days, Jayshree monitored and screened her closely and counselled her and family about different preventive measures pertaining to her health conditions. Soon after,Pushpa recovered and gave birth to a healthy child. Like Jayashree, there are over 330 CHWs who are trained and strategically deployed across six states in rural India to become the frontier in iKure’s healthcare delivery system.
 

Context:

India faces large disparity in workforce distribution especially in rural regions where burden of diseases is high. With 44,000 doctors for 833 million people, the shortage of doctors in rural areas is severe where each doctor serves a community close to 19,000 people. The severe lack in rural areas has been attributed to lack of effective training and recruitment, ineffective distribution of workforce and failure to retain labour where needed the most.
With the urgent need of creating new cadres of frontline health workers that meets the demand of rural health, iKure implements strategic training, evaluation and monitoring programe with the judicious use of digital technology to address the gap. iKure has developed a cloud based platform called Wireless Health Incident Monitoring System (WHIMS) designed with an intuitive graphics user interface that health activists, with basic education can use. WHIMS is accompanied with instruments to measure vital statistics of patients, and for it to be a more reliable diagnostic tool, iKure created Medic Bags with low-cost POC instruments to assist CHWs to measure basic statistics. iKure has established ecosystem partnership with Public Health Care (PHC) system, and low-cost private healthcare providers, under which diagnostics collected by the CHWs are shared in real-time with doctors in these hospitals, who suggest treatments and prescribe medication through the WHIMS platform to the health workers, who relay this information to the patients. The evidence based data collected using WHIMS platform offer huge potential to drive policy and advocacy on the health status of the rural community.
 

CHW’s MEDIC BAG:

To address the fragmented approach of primary care delivery in rural community, iKure establishes integrated care enabled by the CHWs at different levels of the delivery system. To ensure quality care at each level, we build the capability (both technology and clinical) of the CHWs as the first step, to build technology enabled health system support, improve health practices at the household level, and bring integrated actions for health at community level. These cadres will be mobilized by iKure for different handholding of their designated roles in performing household visits, community level outreach camps, and facility based concept clinics. CHWs equipped with a Medical Kit that consists of devices such as BP machine, Stethoscope, pulse oxy meter, Thermometer, First Aid Kit, Weight machine, Height measuring scale, gloves etc., they carry medicines for basic common ailments, non-invasive haemoglobinometer, Haemoglobin kit to measure Hb level, mobile phone based sphygmomanometer, urine analyzer, calorimeter, ECG, flipcharts/Hoardings & registers. Through these CHWs, every patient is also provisioned with Digital Health Card (DTH) encrypted with a QR (Quick Response) code and during home visits, DTH gets updated with latest clinical indicators. The health data obtained from the health cards is synced to a cloud for effective utilization in the upward heath chain at both secondary and tertiary levels.

Prior to working as CHW, these village women remained mostly confined as homemakers performing daily household chores. As iKure build their capacity both technologically and clinically to work as frontline health workers, they also gain respect and position from their communities in the long run. Further, their contact and association with the community helps iKure drive effective community mobilization measures and act as a catalyst to drive behavioural change. While they interacts and communicates the necessity on the ground and identifies appropriate health needs, they conduct street plays, demonstrates hoardings and facilitates automatic health nudges through mobile phones of the beneficiaries at different levels. They are also attuned to provide nutritional counselling, and spectacle services based on the community needs.

iKure also build sustainable model for its CHWs. Through robust supply chain model, these CHWs promote various lifestyle products such as sanitation pads, branded spectacles, hair care, skin care products etc, which helps them gain daily incentives apart from monthly income.

 

Conclusion:

The CHW model of empowering the women community and gender mainstreaming represents transformational change in rural healthcare delivery. As they champion tech-savvy cultural values in otherwise austere facilities, and limited supply of doctors, such effort has established inspirational leaders driving catalyst change in public healthcare delivery.

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Diet Plan for good health and keeping a check on weight gain

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Things NOT to consume


1. All Fried Stuff…KFC / McDonald’s / Deep Fried Items etc.

2. All soft drinks…such as Colas / Fruit Juices and fizzy drinks

3. Mutton of bigger animals… Beef/goat/pork/steaks/non b veg burgers/salami etc.

4. Frequent Fried Rice products… Biryani / Fried Rice etc.

5. Cream enriched – Dairy Derived products………. Butter / Cheese / Marmalade etc.

6. Ice Creams / Cakes / Puddings / Pastry / Confectionery Items with cream etc.

 

Things to be taken in moderation

1. Milk, if it is tolerated

2. Honey / Jam… applied on bread toast

3. Eggs. Two / three per week….more of the white than the yolk!

4. Maida derived products… such as parathas / egg-rolls etc. (Indianised version)

5. Excessive Indianised version of Chinese food (With MSG-Mono Sodium Gluconate

6. Spinach and other leafy green vegetables

 

Things recommended for frequent consumption


1. Fibre rich fruits and vegetables (Banana is calorigenic… once in a while )

2. Oat meal / Breakfast cereals / Brown bread (instead of White Bread)

3. A handful of specific Nuts like Almonds (non-roasted and Walnuts only.

4. Occasional diet of dates / apricots etc. as snacks

5. Tea in place of Coffee….. Tea without milk and sugar… green tea etc.

6. Several glasses of plain water a day… more in summer months

 

Lifestyle habits/practices

1. To use the staircase instead of the elevator…. as much as possible

2. At least 20 minutes of walking on every other day if not every day – swimming is the best.

3. To leave the dining table when you feel you could have eaten some more.

4. Never to take second helpings in parties… particularly oily and greasy items.

5. No junk food like fried chicken / pizza / burgers etc.

6. Wash your face with cold water before the night sleep – sometime cucumber slices around eye.

7. Avoid heavy meal at dinner and not to hit the bed directly after dinner/lunch.

8. Get up at the same time everyday.

9. Pursue any hobby on a daily basis – even for a small duration.

10. Do some household work frequently at home, which entails physical exercise.

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Prevention and Management of Non-Communicable Disease in low-income community

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Non-Communicable Diseases (NCD) are leading cause of premature mortality. According to Indian State-Level Disease Burden Initiative report, disease burden of India has shifted from Communicable, maternal, neonatal, and nutritional diseases (CMNNDS) to non- communicable diseases over the period of 1990 to 2016 from 37.9% to 61.8%.

 

Risk segment and socio-economic impact of NCD

Though major NCD diseases are associated with old age people approximately 42% of all NCD deaths globally occurred before the age of 70 years. Children, adults and the elderly are all vulnerable to the risk factors contributing to NCDs. Poverty is another factor closely linked with NCDs. In resource constraint setting of healthcare, NCDs increases out of pocket expenditure of an individual or sometimes loss of breadwinner of the family forcing many families below the poverty line. Vulnerable and socially disadvantaged people get sicker and die sooner than people of higher social positions, especially because they are at greater risk of being exposed to harmful products, such as tobacco, or unhealthy dietary practices, and have limited access to health services.

 

Chronic Disease Prevention Programme, an initiative towards NCD management:


iKure together with MIT Sloan School of Management in the District of Paschim Medinipur, iKure initiated a study on NCD with randomly selected 500 people in test group. The initiative is measured following parameters to get greater insight on the contributing factors towards cause of NCD. Low-density lipoprotein cholesterol (LDL-C), Hb1AC, Systolic Blood Pressure, and BMI are collected to derive the analytics. Using power BI tool following trend has been identified where 25% of all respondents suffered from type1 diabetes, 43% type2 diabetes, 11.8% with high cholesterol, 65.6% hypertensive and 5% obese. Though it is surprising to know such trends were known to affect the elite group, but our findings shows the emergence of NCD trends even in low-income community group.

Moreover, the High-cholesterol, High Blood pressure and High pulse rate was a common trend among identified high risk CVD patient found in 8.4% of the population.

Further, we found high risk CVD zone affected mostly within 56-80 years of age group.
Case of Diabetes was found between 41-56 years age group and females are marginally more prone to diabetic in the catchment areas.

The clinical observation was recorded during door-step screening, monitoring, and doctor’s consultations. The high-risk patients were provided tertiary care through telemedicine platform and appropriate medication. Awareness was created by the CHWs on self-management, prevention and control on NCDs.
 

Conclusion:

In the heterogeneous country like India, iKure is putting the right step forward to achieve WHO’s global targets for prevention and control of non-communicable disease by 2013-2020.

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iKure reducing status of anemia by increasing knowledge and healthcare practices

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In India, anemia is identified as a serious health issue where half of the country’s women of reproductive age are anemic. Despite the fact Government of India has implemented several initiatives for eradicating anemia, only 13 per cent improved women cases have been registered as per Global Nutrition Report 2017. Anemia is linked to adverse pregnancy outcomes including preterm delivery and intrauterine growth retardation and associated with various maternal morbidities like fatigue and postpartum depression & increased maternal mortality.

Finding the solution to anemia in rural health iKure’s Community health worker’s follows a step-wise approach to improve status of anemia in its catchment areas namely Hubli, Tabageria and Varanasi. With scheduled home/ camp visit as well as in Hub & Spoke clinic, iKure extends care in the following ways:

 Early detection: Early diagnostic is a first step towards the cure. With Low-cost point-of -care devices, iKure provides diagnostic services at the door Step/Camps/Hub/Spoke to ensure high coverage and penetration of its cost effective care to every women and across the remote belt.
 Awareness building: iKure believes that if expectant women knew of the impact of anemia, they would surely not forget to take the supplement. Informing women about the possible side-effects of these supplements, such as black stools and nausea, also helps improve knowledge and understanding. iKure’s health workers with their stronghold in the village community create awareness among the rural population regarding appropriate feeding practices – including exclusive breastfeeding for the first 6 months of life, and optimal complementary feeding during the first 2 years of life which are crucial for avoiding the development of iron deficiency anemia.

 Regular screening and follow up: Most of the health initiative undertaken by the Government provides iron and folic acid supplements but assurance against consumption is not adequate. Regular follow up by the CHWs improve consumption patterns.
 Targeting Vulnerable groups in a strategic way: Women at reproductive age and the children below 5 years are the most vulnerable group of Anemia. iKure target this vulnerable group in a fragmented way by their specific programmes like school health programme; MCH programme and special screening programme through workgroup and self-help group.
 Distribution of Toolkit: iKure develops creative tools to create awareness among the population. These toolkits are delivered when a patient visit iKure’s clinic. It is a handy way to spread the message regarding anemia.

 Conclusion :- Awareness building in appropriate feeding practices reflects in 90% mothers who have started breast
feeding within 1hr of delivery and has positive effect on improved birth weight. 51% child within 0 to 6 month of age and 31% child between 6 to 12 months of age were identified with no development delays minimizing adverse outcome of anemia in pregnant women.

Identifying anemia is vital because anemia can go undetected until it becomes severe. The multi- factorial disorder needs extensive communication campaign and technology to detect and treat anemia. iKure continues to bridge the gap through improved health practices, nutritional counselling and sanitation and hygiene practices.

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Health Screening

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Due to our lives getting complex with the passage of time, this topic assumes an enormous dimension, for the upkeep of a healthy society. ”Health Screening” is the need of the hour for every member of a progressive nation, helping build a sound future of a country.

Health Screening‘ is almost a mandate today, in view of the huge amount of disease conditions which are ascribed to….largely faulty Lifestyle…. responsible for essentially preventable and timely remediable ailments… broadly speaking.

This preventable and holistic approach should be made available to the public at large, in rural, semi-urban and urban settings, where the community is scattered and located.

Primary prevention is the buzzword today, in the medical fraternity,thereby on one hand preventing increasing morbidity and on the other hand relieving people of the disease and financial burden implicated in all such cases.

* An overall glimpse into the contemporary ‘Health Screening’ recommendations may be found as below (although the list is by no means exhaustive)…

 

1. General Survey of persons of all ages… at a recognized health facility… to discover physical abnormalities…related to a disease.

2. Diagnostic modalities… such as…

Blood tests…. to rule out Hypertension/Diabetes/Lipid disorders/ Stones in the Urinary system/Acute & Chronic viral affections… like HIV/Hepatitis A,B,C &E,/ Tumour Markers(as decided by the Physicians)

Stool for Occult Blood… to rule out Large Intestinal Malignancy

Prophylactic Colonoscopy… to rule out Cancer of the Large Intestine…for diagnostic and therapeutic implications.

PAP smear (In women)… to rule out Cancer of the Cervix

PSA (In males)… to rule out Cancer of the Prostate (beyond results due to enlarged Prostate)

Mammography and/or USG… to rule out Cancer of the Breast

Lung Cancer Screening….to those who have been long smokers…to rule out Carcinoma-Lung.

Oral cancer screening measures… to detect early Oral Cancers

Periodical USG-Abdomen of subjects…to keep an eye on the many abdominal organs… affected by hectic lifestyle measures. etc. to name only a few of the modalities for this gigantic objective.

This campaign should be widely propagated to mitigate the suffering of humanity from a large No. of Disease entities which are largely preventable and even if detected early ,can be claimed to be curable… as per international guidelines and evidence based Medicine.

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SMOKING

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Smoking is a commonly abused potential to inhale tobacco/ items of substance abuse in the form of smoke through the upper naso-pharyngo-laryngeal passage. The list of substance(s) which could be taken in this manner is quite huge today… a few being… tobacco and a gamut of items under the heading of ‘substance abuse’.. Like opium and its derivatives.. in the form of heroin/cocaine/methamphetamine/PCP/cannabis etc etc.

The most commonly adapted form of Smoking menace is that of Cigarettes/ Pipe smoking/ Tobacco manipulated in many other forms. For those who smoke, it is the mindset which initiates this habit which then culminates into addiction. Youngsters feel it makes them look and act like mature adults with an obvious imaginary style quotient attached with the habit. Persons of slightly older age find that it is an essential habit to relieve them of stress of day to day life and many who feel it helps them to ease bowel habits and then cannot kick the practice as time goes on!

Although various governments across the globe have restricted out smoking in almost all the public areas like passenger transport… such as airports & aircrafts / train stations and rail compartments / public gathering areas-like cinema halls/auditoriums/malls etc. , public awareness is still not up to mark to curb/ get rid of the habit. To add to the woes…stopping tobacco sale is simply not achievable due to the commercial stakes involved in a large scale. The health hazards of Smoking can look like a big list of diseases… some prominent ones being…Hypertensive and other Heart Diseases /Oro-pharyngeal cancers/ Gastro-esophageal Lesions/Stomach

Cancer/Respiratory Conditions like COPD etc. If a person quits the habit of smoking, the good results start kicking in with immediate effect but the damage done to the body cannot be undone!

For such a vast country like ours, the impact of this single habitual menace can easily be understood which causes a huge burden of disease to the already overburdened health system of this country, but results in a mammoth scale of morbidity and mortality which is easily looked upon in the realm of preventable illness. As true Samaritan of India, we can only hope that this problem gets addressed some day and people are freed from the slavery of such potentially harmful addiction… to lead healthy lives.

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iKure introduces non-Invasive Hb tests for last mile community

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On a Tuesday afternoon, Shivani while returning from her field, noticed a banner in a primary school about a health awareness campaign for mothers and children. She found few of her friends waiting there too. Shivani enquired about it and came to know that the campaign was providing diagnostic tests for Hemoglobin and with a doctor consultation.

Shivani then asked them won’t it be painful? “I never had any Hb test before, but I have heard, they prick it hard and collects blood in good amount”. As she was thinking of returning back, she noticed, this Hb test was different. It neither involved a needle, nor did it collect any blood sample. Shivani decided to give it a try. And later, she revealed that she made the right choice by staying back!

That day, like Shivani, there were Urmila, Kusum and Malati who attended the health awareness campaign, availed Hb test, doctor’s consultation and discounted medicines before returning back to their home. On way back, for the first time, they discussed about their haemoglobin count and how they need to take care of themselves better.

In the rural region of North Karnataka, and West Bengal, what has changed for these women is access to life-saving diagnostic care within their community, and even their door-steps- all facilitated by iKure.

Globally, rural communities face limited access to point-of-care diagnostic tools. Incidence of anemia in rural pockets are staggeringly high, since a simple Hb test require long distance travel time to diagnostic centres or waiting in long queues in health centres. In such situation, rural women delay getting an anemia test done in the first place, with their family members pay little or no heed towards the importance of such tests.

In response to the need, iKure introduced non-invasive diagnostic tests in rural hinterland that can be conveniently used by its health workers in campaigns and during their home visits.

The diagnostic system takes the images of the lower eyelid, analyses the picture to quantify the conjunctival pallor and studies the paleness of the mucous membranes caused due to reduced amount of oxyhaemoglobin in the blood. Further, the point-of- care can be linked to patient’s smartphone via Bluetooth on which all data can be directly sent to patient as required.

The use of point-of-care technologies for quick tests is widespread in public health system, but the benefits of using them are only limited to health workers. As such device comes with minimal maintenance costs, highly portable and handy, it can be used for self-testing, testing in communities by health workers, testing in clinics and hospitals that can significantly reduce the rapid turn-around time and enable access to treatment regimens almost instantly.

Using conventional technologies in laboratories make turn-around time long and in the process patients do not return for further treatments. But, use of such point of care diagnostics in hard-to-reach communities play an important role in convincing the women community from dropping out of the existing treatment regimens and rapid testing holds prospects in improving the knowledge of the patients about their own medical situation bringing more awareness towards their dietary pattern, nutritional supplements and even in health seeking behaviour.

As iKure is aggressively involved in disseminating new technologies in its existing healthcare model that links its end-users to the higher level of care, it also works with various stakeholders like NGOs, Self-help groups to bring sustainable changes in women’s health outcomesso that do not remain entangled with their family life and complex choices.

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How much does a Pair of Eye Glasses Costs for People at the Last Mile?

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Vision impairment due to lack of access to eyeglasses has been identified as one of the largest unaddressed disabilities in the world. There are many remote villages, where getting a pair of eyeglasses is a distant dream for many. With a pair of glasses costing pittance, 550 million people in India are still in dark. Whereas, there are other parts of the world, where the first reading eye glasses can be picked up easily from a grocery store or a pharmacy.

Of all the eye problems, the commonest eye problem results mainly due to refractive error causing hyperopia, presbyopia, or myopia, and which can be easily corrected using eyeglasses. Refractive error is a condition where a person is unable to focus clearly on an object. Above the mentioned problem, Presbyopia is the most easy to correct just by trying out different corrective glasses. But, quite apart, such diseases remain largely untreated. Vision impairment is more than just a health disorder. It has economic, social and public safety implications and with variety of approaches tried and tested, to date none have succeeded on a larger scale.

iKure’s eye care intervention shows 78 per cent need access to eyeglasses particularly among them are construction workers, bus drivers, and school going children. With the staggeringly high impaired vision, the quality of life remain hampered, translating into reduced productivity, economic losses and huge absenteeism in school.

With the mission to bring eye glasses to all who need them, iKure has potentially paved the way for a new beginning in dissolute communities. With access to simple pair of spectacles, the venture has drastically improved earning power, educational prospects, and enabling every day task easier. Post intervention, our beneficiaries have reported to feel motivated with positive social and economic outcomes, better learning behavior and even fewer road accidents. So far, iKure through its eye care initiative has helped more than 0.5 million people get access to corrective eyeglasses.

Another approach initiated by iKure includes access to power testing using state-of-art technology. The use of advanced technology has facilitated getting corrective eye glasses with reduced chances of manual error, bringing ease of using among the end-users.

While the problem too large to scale, but simple enough to solve, we look forward to working with partners and Govt. initiatives to bring the first pair of eyeglasses needing them.

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