Rabies Immunoglobulin Phobia

The use of Rabies Immunoglobulins(RIG) is still in the infancy stage in India. Even though WHO recommends the use of RIG in every animal bite case where there is oozing of blood only a few centres in India use RIG while the others are happy to use just the vaccine. The Human RIG is simply out of reach for the common man as the price is very high and doctors have a phobia for the Equine RIG. The reason being that till a few years back the equine RIG were known to cause anaphylactic reactions in some cases.

Today Equine RIG is available with advance purification method to make it safe and have less chances of any reaction. One reason for the RIG not being used frequently is also the fact that in case of rabies vaccine one has to take it in the arm whereas in the case of RIG it has to be infiltrated "into and around the wound". So you see here is the catch, application of vaccine is easy and hence more rampantly used whereas in case of RIG one has to take care of infiltrating the wound and watch for any side effects.

Vaccines act only after ten days, so what happens if the patient develops rabies before ten days? Who is at fault? How many such cases will be recorded? Shouldn't the authorities also make a move towards increasing the usage of RIG?

Are licks by animals dangerous?

Simple licks by warm blooded animals on broken skin can be dangerous. This is because the saliva of any infected animal contains the rabies virus and when this infected animal licks a person on a broken skin the virus is transmitted to the victim. If it is pet animal a prevention vaccine can be taken and the animal observed for ten days for any irregular behaviour or death. However if the animal happens to be a stray dog a full course of vaccination is recommended. For rabies to occur it does not have to be deep bite by a ferocious animal but it may also occur from simple licks by these rabid animals.
However if the animal licks on an intact skin you should wash the area with soap and running water for a few minutes. Vaccination is not required.

Isabgol

Many people know isabgol only as a drink for people suffering from constipation. Very few realize that a large number of isabgol purchasers are also people who suffer from high cholesterol. Isabgol is a fibre drink which when consumed absorbs water and swells thereby forming a bulk and facilitating easy passage of stools. It is a known fact that fibre rich diet reduces cholesterol and isabgol being a fibre drink is used to lower cholesterol. However one has to watch out as Isabgol preparations may cause flatulence in some cases.

Ideally this drink should be consumed during bed time with two full glasses of water. Mix two spoon fulls approx 3-4gm of isabgol with glass of cold water,stir it briskly and drink immediately. Consume another glass of water over it. In the market there are two types of preparation available, the original form and the flavoured one. The flavoured isabgol preparation (orange,fennel etc) offer an option to the consumer who are tired of using the normal isabgol with a bland taste. The flavoured isabgol preparations do not contain sugar but only aspartame.

There are also preparations available in the market of isabgol along with senna and other strong laxatives which is not advisable. These strong laxatives like senna makes it a habit forming product and hence it is not recommended whereas plain isbgol preparations are safe and non- habit forming. If you want to start on isabgol preparations it is best advisable to go for the plain formulation either flavoured or the normal one.

Rabies - An Indian Perspective

Rabies death is still a fact in India and sadly very little is being done to eradicate it. While eradication of polio is done on a very large scale because it affects the image of the country globally, rabies cases go unnoticed and unregistered. The actual number of rabies death is far more than what is being projected. It is mainly due to lack of attention by the administration towards these cases that we do not get the actual number of death taking place. Once a person shows signs and symptoms of rabies there is no hope for him, death is the only solution. In such circumstances when a person is brought to the hospital the concerned medical workers check whether he is showing signs of hydrophobia by getting a bottle of water near him. If he gets hydrophobic they immediately tell the relatives to take him away to the Infectious Disease Control Hospital. Many of them are simply not taken over there when their relatives realize that there is nothing more that can be done. Hence we see only a small number of cases getting registered each year.

Dog bites is one of the major cause for rabies in India. If you look at the dog bite cases taking place it is not the rich and the affluent who are the victims but mainly the man on the streets. Hence it becomes more important for the authorities to provide him a complete course of vaccine. But what is noticeable in government hospitals all across the country is shortage of these vaccines. They will provide the dog bite victim with a few dose and then will tell him to buy the remaining doses from a private pharmacy. Here lies the problem, many of the victims are daily wage earners and hence don't have money to purchase the vaccines from the pharmacies, they default on treatment and some later on land up with rabies.

The disease is so dangerous that it is not necessary that a person will develop rabies immediately after any animal bite. In some cases victims have developed rabies after a few years. This is because the rabies virus remains dormant in the victims body and once they become active they target the nerves. Once they enter the nervous system no amount amount of medication can help the victim. Death by rabies is very painful.

People have to be educated through public awareness campaigns on the first aid measures after any animal bite. Washing of the wound with soap and running water can wash of much of the virus. It was noticed in one recent survey conducted that people put chilli powder, petrol etc on the wound and in some cases the wound is also burnt to kill the virus. However they fail to realize that once the virus has entered the body only vaccines and immunogloblins can kill the virus before it enters the nervous system.

It is advised by WHO that the first dose of vaccine should be accompanied by rabies immunoglobulin (RIG) when ever there is oozing of blood. RIG offers immediate protection till fourteen days while vaccine offers protections only after 10days. But the usage of rabies immunoglobulins is very less in India. Human RIG are very expensive and most of the doctors are afraid to use Equine RIG for fear of any side effects. However the Equine RIG available in the markets are far safer now with very less chances of any side effects. But unless there is any government directive making the use of RIG mandatory its use in India will continue to remain what it is today.
I hope the government wakes up to this menace and take necessary actions so that we see its eradication.

Health issues for 30+ marketing executives

This is for all those smart energetic marketing executives who have reached the age of 30 and above. Why I say 30 and above is because here is where one has to start taking health issues a bit seriously. But before we look into the health issues lets sum up the lifestyle that a marketing executive(ME) has.
A ME is always on the move hence his food timings are erratic. The type of food he consumes is most often the fast food type with periodic intake of tea,coffee or cola drinks. The work related stress he faces is more evident if he does not achieve his targets by the month end.
Its better to be safe than sorry. Hence an annual check up of the below mentioned parameters will help an individual in keeping a good health.

• Cholesterol check is strictly recommended for such individuals. Fast food is generally known to increase levels of LDL cholestrol and triglycerides. Have a total lipid profile done to ensure that your cholesterol levels are under control.
• Have your blood pressure monitored. Blood pressure is known as a silent killer. Many people are not aware till they go for a checkup.
• Exercise regularly. Even walking for 30 Min's will do.
• Try to avoid oily and fatty foods. Have more of fruits and vegetables.
• Taken an annual leave of at least 15 days and chill out with your family and friends so that you can drive away the stress.
• Take a term insurance policy.

As your age increase your responsibility increases. Hence take care of your health and live life to the fullest.