Monday, August 31, 2015
Thursday, August 27, 2015
Wednesday, August 26, 2015
Snake bite Management protocol
India is recognised as having the highest snakebite mortality in the world.
Most of the fatalities are due to the victim not reaching the hospital in time and are preventable.
Research has shown that PHC doctors do not treat snakebite mainly due to lack of confidence.
At the secondary and tertiary care level Emergency departments, multiple protocols are followed mainly from western textbooks which are not appropriate for Indian settings.
Anti snake venom (ASV) are administered when it is not required and/or in doses well in excess of the required amount.
In response, Government of India, Health & Family Welfare Department with WHO, has prepared a National Snakebite Management Protocol to provide doctors and lay people with the best, evidence based approach to dealing with snakebite in India.
The majority of current first aid methods adopted by victims such as tourniquets, cutting and suction and herbal remedies are completely ineffective and dangerous.
It is now recommended to adopt what has been called the ‘Do it R.I.G.H.T.’ approach, stressing the need for Reassurance, Immobilisation as per a fractured limb, Getting to Hospital without delay and Telling the doctor of any symptoms that develop.
20 Minute Whole Blood Clotting Test (20WBCT) in the diagnosis and management of viperine bite- 10ml blood of victim in plain vial is checked for clotting after 20min.
If not clotted- suggest viper.
Pain management - never give NSAIDs- causes more bleeding. Never give morphine- can cause respiratory failure.
ASV Administration Criteria-ASV should be administered if there is significant envenomation i.e. incoagulable blood shown by the 20WBCT or significant limb swelling for viperine bite, neurological signs for cobra & krait bite.
ASV Dosage & Repeat Dosage-The recommended initial dose of ASV is 8-10 vials administered over 1 hour.
Mode of administration of ASV is IV only.
Dose of ASV is same in children, pregnant or elderly, because venom injected is of same amount, so ASV required is of same dose.
Repeat doses for haemotoxic viperine snakes is based on the 6 hour rule.
Repeat doses for neurotoxic snakes is based on the 1-2 hour rule.
The maximum recommended dose for haemotoxic bites in 30 vials of ASV.
The maximum recommended dose for neurotoxic bites is 20 vials of ASV.
ASV Reactions- No ASV Test Doses are to be administered.
At the first sign of an adverse reaction the ASV is halted-0.5mg Adrenaline is given IM- ASV remaining dose should be given- Avil & Effcorlin can be given to prevent ASV anaphylaxis.
Neurotoxic Bite -neostigmine test-Despite the fact that the neostigmine test (Neostigmine 0.5mg IM with atropine 0.6mg IV) was actually an Indian discovery, it is still poorly used in India.
Neostigmine works in cobra bite as cobra venom acts on post-synaptic neurons.
Hemotoxic bites with correct signs of envenomation can be treated with 8-10 vials of ASV, stabilised if any ASV reaction occurs with adrenaline and then transferred to a higher centre with the ability to carry out the required blood tests to identify occult bleeding or renal impairment.
Heparin has no role in curing DIC of snakebite, and can increase bleeding, so contraindicated in viperine bites.
Botrophase should not be used as coagulant in controlling viperine bite bleeding, as it causes consumptive coagulopathy.
Neurotoxic bites with correct signs of envenomation can be treated with 8-10 vials of ASV, stabilised if any ASV reaction occurs with adrenaline and administered the neostigmine test.
If there is no evidence of impending respiratory failure, determined by patient ability to perform a neck lift the patient can be treated locally.
If the patient is unable to perform a neck lift then they will be transferred to a higher centre with mechanical ventilatory capability.
The rational application of ASV and repeat doses has resulted in patients being discharged earlier, freeing up bed space. ��
Siddha to ensure better maternal, child care Chennai : The Amma Magapperu Sanjeevi (a pack containing 11 herbal medicines for expectant mothers) announced by Chief Minister J. Jayalalithaa in the Assembly on Tuesday is a Siddha way to further improve the maternal and childcare in Tamil Nadu. The three medical kit, each comprising choornams (herbal powder), medicated oil and herbs to improve the immunity, ensure safe delivery and healthy progeny, will be distributed to pregnant women during ante natal, immediately after delivery and to the new born babies. These three kits would be distributed at all the government hospitals and primary health centres spread across the state. The Tampcol, which procures and distributes Siddha and Ayurveda medicines, will upscale the quantity soon. The Sanjeevi pact is a concept being promoted by the Ayush ministry for better maternal and child care in the country. Under Amma Pregnancy Sanjeevi, women will be given pomegranate and curry leave powder during the first three months of pregnancy to prevent nausea. In the next three months, pregnant women will get natural medicines like gooseberry powder etc to improve the iron content. During the last stage of pregnancy and post- pregnancy, women will be given medicinal powders to ease delivery and increase lactation. “Eleven types of medicinal powders will be given to pregnant women and based on Siddha doctors’ advice, these will be given. It will cost Rs 10 crore annually to the government,” said Ms. Jayalalithaa. Sources said the scheme will be launched immediately after a GO is passed.
Wednesday, August 19, 2015
It is hereby informed that Dr. K. Jagannathan BSMS MD(S) PhD has been nominated as Chairman, for Board of Studies- Siddha of Kerala University of Health Sciences ,Trissur unanimously by the members of reconstituted board today. Under his chairmanship, Board unanimously nominated Dr. Hariharan BSMS MD(S) as a member to Faculty- Siddha, KUHS.
Thursday, August 13, 2015
Wednesday, August 5, 2015
Saturday, August 1, 2015
Siddha medicine for hypo&hyper thyroidism
Amukkara chooranam 100gm+annapavala chendooram 10gm
1/2gm bd with honey
Amukkara tab 2-0-2
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