Health Wikipedia

The incidence of mental disorder is rising by and by. Wave of migration, industrialisation, individualism, changing socio-cultural norms, changing family pattern, over careerist drive and drug addiction are the important factors considered behind this rising trend. In Bangladesh, a community based research on mental illness conducted in 2005 reported that 16.1 per cent adult populations suffer from various mental disorders.

It is the scenario of only from adult population and no research has been conducted among the children. The situation is more scary when we look at the statistics that say there is only one psychiatrist for 1500000 persons. There are only 120 psychiatrists in our country that depicts the pitiable condition.

After calculation, it has been found that there are only 813 psychiatric beds in Bangladesh to serve the whole nation. That means 172000 people share one bed. In 2005 only 0.44 percent was allotted for mental health in total health budget which was obviously insufficient.

In this situation, we will observe World Mental Health Day today. This year, the World Federation for Mental Health has decided the theme “Mental health in primary care: enhancing treatment and promoting mental health”. The theme is intended to emphasise the benefits of enhancing overall health and promoting mental health by integrating healthcare services.

National survey on mental health in Bangladesh reveals, about 14 lacs people have been suffering from major mental disorders (schizophrenia, mood disorders etc.), 65 lacs people have been suffering from depressive disorder and 1 crore 18 lacs people have been suffering from minor mental disorders (anxiety, phobia , conversion disorder etc).

Besides, about 46 lacs to 70 lacs people are drug addicted. Most of these patients are found in general practice, outpatient service at hospital and primary health care centers.

Mental disorder creates a substantial personal burden for affected individuals and their families. They produce significant economic and social hardship that affects the society. Many people suffer from both physical and mental health problems. Integrated primary care services help ensure that people are treated in a holistic manner, meeting the mental health needs of people with physical disorders as well as the physical health needs of people with mental disorders.

If the mental health care is included in the primary healthcare, our mental health service will reach the outreach. Patients and families can avoid indirect costs associated with seeking specialist care in distant locations. Treatment of common mental disorders is cost effective. Investments by governments can bring important benefits.

To include the mental health component in primary health care service, it should be first included in the health policy. There is dire need of intensive attention to mental health.

There is also a need of fundamental training in mental health with ensuring the supply of common psychotropic drugs in field level. To build a healthy nation we should promote mental health by enhancing treatment facilities in primary health care system. To survive on the runway to globalisation we should not observe this World Mental Health Day only as one-day event, rather give cordial effort to realise the theme for healthy nation.

Irrespective of gender and age, everyone has the equal right to see the beauty of this world. But access to eye care services for women and girls is not equal to that of men and boys. Only 35 percent of eye care services are received by women and girls who are blind and remaining 65 percent services are received by their male counterparts.

Experts identified gender discrimination, customary social attitude, lack of women empowerment, lack of education and awareness, fissure in national policy for eye health are the barriers to equal access to eye care services.

Nearly two-thirds of blind people worldwide are women and girls. Less access to eye care services than men is one important fact behind the huge number of blind women and girls. Moreover, certain eye conditions like trachoma and cataract affect women more than men contributing the rising number.

The theme of World Sight Day 2009 that was being observed on October 8 was “Gender and eye health — equal access to care”. It was dedicated to ensure gender equality in the access of eye care services, which is unfortunately not the case in Bangladesh.

There is urgent need to step up focus on women and girls who unnecessarily have already become blind or becoming blind where simple interventions can prevent blindness and help them get back their precious sight.

Women and girls face the discrimination in receiving proper eye care services due to certain factors that should be eliminated.

“We have common social attitude that women should always get less priority not only in getting eye care but also in all social services. Male people of the family hold the decision making power and they are reluctant to bring women and girls under eye care services as they are not earning members of the families”, said renowned ophthalmologist Dr M A Muhit, Clinical Research Fellow of International Centre of Eye Health, London.

“Women are also not aware of the fact that they have equal right to access eye care as male. Moreover, many women have accepted the condition as their fate; rather they prefer treatment of their husbands or children. But very few of them know that 80 per cent of the blindness can be prevented with early intervention and sight restoring surgery”, Dr Muhit added.

Although female gender are more in number and deprived more, there is no gender analysis or gender sensitive issue in the national plan for eye health in Bangladesh. Health authorities in the national level need to recognise the existing gender differences in access to eye care services. This could be an important step to reducing the disparity in eye care treatment for women.

Dr Muhit opined that the existing programmes to eradicate avoidable blindness and improve eye health in Bangladesh must give emphasis on counselling, education, awareness and empowering women. Along with women, men as they are considered decision makers, must be motivated and make aware about the significance of sight restoring operations or treatment for women to help them get back their sight.

Blind women cannot contribute to the well-being of the family with ease. Motivating men and women together can have the tremendous impact on community mobilisation. With access to timely treatment of women with impaired vision or avoidable blindness can bounce back and lead more fulfilling lives, Dr Muhit suggested.

Women need better access to eye care services. Without ensuring equal access to eye care for them, we cannot meet the target to eradicate avoidable blindness within 2020. Let’s make a cumulative move to reach the goal.

The recent outbreak of H1N1 influenza epidemic which is better familiar as swine flu is a respiratory disease of pigs caused by type A influenza virus that causes regular outbreaks in pigs.

The human outbreak has created panic in the people due to some fatality. People are in a fix due to some reasons which include the disease is relatively new, healthcare setup is not completely equipped with adequate resources, medical professionals are not quite skilled handling the disease and so on.

When there was first outbreak of dengue haemorrhagic in Bangladesh, people were so worried similarly. But it is no longer a disease of panic.

To deal with the H1N1 influenza, we need keeping in mind several things. The best way to keep from spreading the virus through coughing or sneezing is to limit contact with other people as much as possible. Sick people should avoid work place and children should not go to schools. Concerned authority should be reluctant in this regard.

When coughing or sneezing, mouth and nose should be covered with tissue which should be discard immediately. If tissue is not available, hands are enough which must be washed afterwards. There is serious bad habit spitting and not covering mouth or nose while coughing or sneezing. Use of civic sense and simple courtesy can contribute a great deal here.

Most of the cases are self limiting and personal hygiene is of great value.

People with H1N1 influenza are potentially contagious as long as they are symptomatic with a ceiling of up to seven days following illness onset. Kids, especially younger children, might potentially be contagious for longer periods.

There is a dilemma about using the masks. Usually three types of masks are used — facemask, surgical mask and N95 mask. The N95 mask is effective in protection of H1N1 virus whereas surgical and facemask have almost no contribution for protection. But wearing facemask or surgical mask is of no harm. At least it protects others from spreading the disease. Sometimes, experts opt for double layered mask for resource poor settings.

Since the virus easily spread in crowded places, children are recommended to abstain from their schools where large outbreak occurs. Otherwise, only sick children are recommended to stay home to avoid spreading illness. Children also should not be brought to crowded places unnecessarily like shopping complexes, cinema halls etc.

Treatment is available in Bangladesh now and soon medical professionals will be used to hand H1N1 cases. Suspected cases should stay home and take home management. In case of developing warning signs or complications, individuals should seek emergency medical care in hospitals.

Antiviral drugs (Oseltamivir), which are available in the market can be stored at home for safety purpose, but it should not be readily taken without any clinical judgement or without prescription of physician, as it may develop resistance.

Fatality occurs due to misdiagnosis of the disease and accompanying other serious/chronic medical conditions — not as the disease is virulent too much. Early intervention with medication can cure the disease as usually.

The novel H1N1 influenza A virus spreads four times faster than other viruses and creates much panic all over the world. The rising number of cases every day and increase in death rate in some countries made it a serious concern. But experts in influenza and infectious disease are still saying the exact level of danger from the virus is still far from certain.

In most cases, the disease manifestation is just regular influenza. It is something that happens every year. It is self limiting and most people recover soon without any medication. H1N1 is a major concern for people with chronic diseases like diabetes, cancer and also for children and extreme aged.

The scientists who study outbreaks say that A(H1N1) is not the deadliest strain out there. The case-fatality (the percentage of people who got the disease and did not survive) is still very low. While case fatality for severe acute respiratory syndrome (SARS) reached more than 15 percent, bird flu reached higher to 60 percent, but it is only about 1 percent worldwide with a maximum fatality in Mexico is about 10 percent.

Moreover, we have drugs (Oseltamivir and Zanamivir) in our hand now to fight in the initial phase that we did not have in the previous large flu outbreaks.

Although there are positive reasons not to panic, we should be concern deeply with the risk and potential danger of H1N1 that may occur in near future. If we track back to Spanish influenza, we see that it began as a mild strain, and then turned horrifically virulent, killing 20 million to 100 million people in 1918-19.

The risk could be reduced or eliminated by exercising personal control like hygiene practice. It is worth remembering that worry itself is a risk, a stress that can undermine health and happiness. We need not to be panicked but always have to take these things seriously.

Swine flu, also called hog flu/pig flu is the scary names now a days. The recent outbreaks of swine flu or swine influenza A (H1N1) virus has created much panic in Bangladesh. It is heartrending but we have to be alert to contain the spread of the virus.

Simple influenza-like illness (fever, cough, sore throat) has been reported in many cases, mild respiratory illness (nasal congestion, rhinorrhea, shortness of breath) without fever and occasional severe disease also has been reported. Other symptoms reported with swine influenza A virus infection include vomiting, diarrhoea, myalgia (muscle ache), headache, chills, fatigue and shortness of breath. Conjunctivitis is rare, but has been reported. Severe disease (pneumonia, respiratory failure) and fatal outcomes have been reported with swine influenza A virus infection.

The potential for exacerbation of underlying chronic medical conditions or invasive bacterial infection with swine flu virus should be considered. To confirm a positive case, a simple throat or nasal swab is examined in laboratory. Follow the dos and don’ts to reduce the risk of catching or spreading.

* Stay home and limit contact with others as much as possible
* Cover your cough/ sneeze
* Rest and eat nutritious food and take plenty of liquids
* Get plenty of sleep and rest
* Seek medical advice if you have the symptoms
* It is better to cover mouth and nose. When coughing and sneezing, using a tissue and do not forget to throw the tissue away quickly and carefull

* Wash your hands regularly with soap and water
* Hands/Fingers are very important — even some people prefer to use gloves and stop doing hand shakes
* Clean hard surfaces (like door handles and remote controls) frequently with a normal cleaning product

Don’t forget to use tissue paper when sneezing and coughing and wash your hands regularly. Do not forget to carry tissue paper; catching the germs in a tissue paper could help limit the spread of the virus.

If you do have swine flu, you should contact a qualified doctor who is aware of its management rather than visiting a practitioner and ignorant about this disease. Recently several medical college hospitals in Bangladesh has opened special ward to treat swine flu cases.

Swine flu can be treated by the drugs — Oseltamivir and Zanamivir, according to WHO guideline. In some cases, antiviral medicine may cause side effects like nausea, vomiting, diarrhoea, stomach ache, headache. Even if you do feel these symptoms it is important that those prescribed antiviral medicine complete the course, even if symptoms of swine flu clear and you start to feel better quickly.

Like Islam, many of the world’s religions and spiritual practices include element of fasting as a way to boost their spiritual development. Alongside with the spiritual significance, fasting has certain physical, psychological and social benefits. By maintaining proper norms of Ramadan, we can get these benefits and move a significant step towards better health.

Increasingly, scientists are starting to recognise the benefits of fasting that reduces energy intake. Research on animals shows a restricted-calorie diet increases life span. There seem to be two mechanisms by which it amplifies life span.

First, it reduces free radical production, or the production of highly toxic forms of oxygen that damages cell and the second is that calorie restriction increases the resistance of cells to stress. Both of these are important in protecting against a number of different diseases that have a negative impact on life span. It helps in reducing cholesterol levels and improves blood glucose levels and provides protection of certain emerging diseases like cardiovascular problems, diabetes, cancer etc.

Research by Zafar Nomani, Professor Emeritus of Human Nutrition and Foods, West Virginia University has shown that the basal metabolism of fasting individuals slows down during Ramadan. A person can stay healthy and active during Ramadan consuming a diet that is less than that of the normal intake but balanced in nutrients.

Some studies suggest that many people are consuming too many calories that are not nutritious and not consuming enough of the right kinds of calories. Cutting calories excessively and not paying attention to the quality of food may result in severe health consequences. This practice can affect our immune system, concentration and ability to focus.

Some people overeat during Ramadan and especially bulge their bellies with fried and fatty food. Studies indicate that health problems can emerge as a result of eating too much or eating a diet that is not balanced. The body has regulatory mechanisms that activate during fasting and we do not need to overeat to get the essential nutrients.

Changing the food habit is particularly important in Ramadan to get health benefits. Slow-digesting foods that contain grains and seeds like wheat, oats, beans, lentils and unpolished rice. These foods can last for up to eight hours, making them more suitable for fasting.

Dates and juices are good sources of sugars that can bring low blood glucose level to normal level rapidly. Indeed, breaking the fast with several dates is considered “sunnah” in Islam that was practiced by the Prophet Muhammad (PBUH).

Muslims are advised to refrain from not only food and water, but also from other bad habits like smoking, foul talk and harm to others. The restrictions — both caloric and behavioral — can be good for us holistically for sustaining good practice in time after Ramadan.