Tuesday 8 October 2013

Diabetes : Threat and Management

Diabetes is fast becoming one among the four leading causes of death in the world-right after cardiac, stroke and cancer. Over the next decade, the diabetes prevalence is expected to grow by 25 per cent, largely driven by obesity and inactivity. The WHO estimates that 330 million people worldwide will have diabetes by 2025.

When it comes to diabetes management, blood sugar control is often the central theme. Keep your blood sugar level within the target range of below 100, fasting can help us live a long and healthy life, with diabetes. Obesity, inappropriate diet, a sedentary life, high levels of stress and dependencies like smoking, alcohol all influence blood sugar levels. This list helps us understand the link between lifestyle and diabetes.
Epidemiologic, clinical and laboratory evidence shows that lifestyle interventions are critical components of a comprehensive treatment and management of diabetes, helping in glycemic control, minimizing complications, and showing the progression of the disease. Studies have shown that people with pre-diabetes who lose weight and increase their physical activity can prevent or delay diabetes and even return their blood glucose levels to normal.
The lifestyle areas for diabetics to look out for are:
Maintain ideal weight: Overweight people with a waist measurement of 40” or more(for men) and 35” or more(for women) are more susceptible to diabetes. The most popular method to know your ideal weight for your height is to calculate your Body Mass Index-divide your weight in kilos by height in meters times two. The Steering Committee-Asia Pacific Perspective 2000 suggested that Asians with BMI above 23 as having increasing risks for diabetes.
Stress management: During stress , levels of hormones shoot up. This increases the glucose levels available to cells. In diabetics, Insulin is not always able to utilize the extra energy in the cells, so glucose piles up in the body. Relief of stress by relaxation, exercises or yoga or meditation is an important aid in management of diabetes.
Eat a healthy diet: Remember, your overall diet quality matters, not just any single food or nutrient. Eating at regular timings, small intakes, high fibre, low fat and high intake of raw fruits and vegetables are some of the tips. Fast food intake and intake of salted foods and snacks should be minimized and alcohol intake moderated.
Physical activity: Physical activity levels should not be less than half an hour, five days a week. Activities such as jogging, cycling, swimming and outdoor games are known to be the best. Yoga done on alternate days is also recommended. In addition you’ll have benefits like, losing weight, improved glucose utilization, reduced stress levels and increased energy levels. Get your doctor’s approval before starting a fitness program, especially when you’ve been inactive. If you take insulin, you might need to adjust your insulin dose or wait a few hours to exercise after injecting insulin.
Dependency management: Smoking adversely affects other diabetes complications including damage to blood vessels and nerves, further decreasing quality of life. It also reduces the overall immunity and health coping capabilities of the body. Alcohol causes hypoglycemia resulting in giddiness and confusion,apart from increasing blood pressure which could result in damage to peripheral blood vessels.
Healthy diet, stress management, sensible exercises, yoga, and sensible use of alcohol with no smoking are tools at our disposal to control diabetes. Use these techniques with the help of your doctor to supplement your arsenal of diabetes fighting tools.

12 Tips for Cancer Prevention

Here are 12 diet and activity recommendations that may reduce the risk of cancer.

1. Avoid smoking and limit drinking:
Refraining from tobacco use provides other health benefits besides lowering cancer risk. Limit your daily intake of alcohol to two drinks for men and one drink or women.
2. Exercise regularly:
Exercise helps combat obesity, a risk factor for cancer. Aim to be physically active for at least 30 minutes every day, and aim to be as lean as possible without becoming underweight.
3. Eat a low fat diet:
Try to limit your total fat intake to less than 30 percent of daily calories. Avoid saturated fats, and try to consume Omega-3 fats.
4. Consume fresh fruits and vegetables:
Aim to eat at least one-third of your food raw. Balance your intake of red, green, yellow, and orange fruits and vegetables to cover the full range of phytochemicals. Besides being high in fibre, fruits and vegetables are natural sources of antioxidants that protect cells from potential damage caused by carcinogens.
5. Increase your daily fibre intake:
35 grams of fibre a day is recommended in the daily diet. Eat more of a variety of vegetables, fruits, whole grains and legumes.
6. Avoid red meat:
Avoid consumption of red meats, including beef, pork and lamb, and avoid processed meats.
7. Avoid processed, sugary and salty foods:
Avoid sugary snacks or drinks. Sugary foods and beverages tend to be high in calories and low in fibre.
8. Cook healthy:
Avoid microwaving or frying your food. Boil, poach or steam your foods instead. As far as possible, aim to eat freshly cooked food, and avoid reheating frozen or refrigerated food.
9. Optimize your vitamin D levels:
Studies suggest that exposure to high levels of vitamin D during childhood and early adulthood is associated with a reduced incidence of breast cancer. Exposure to sunlight is the most efficient way of generating vitamin D, but there must be enough awareness of the risk of over exposure to the harmful effects of sun’s rays. Dietary intake of vitamin D could be improved through fortification of foods.
10. Breastfeeding:
It is best for mothers to exclusively breastfeed their babies for at least six months. This lowers breast cancer risk.
11. Self examination and diagnostic screening:
Early detection and treatment is your best bet to beat cancer. Women above 20 years should start with breast self examination, and women above 40 should also have an annual mammogram. Other annual checks for women include the pap smear.
12. Watch out for signs and symptoms of cancer:
Though cancer does not exhibit any obvious signs, it is worthwhile checking out some symptoms with your doctor. These include:
• Persistent cough or blood-tinged saliva.
• A change in bowel habits.
• Blood in your stool.
• Unexplained anaemia/weight loss.
• Breast lump or discharge.
• Enlarged testicles and painless testicles.
• A change in urination or voiding.
• Blood in the urine.
• Hoarseness of voice.
• Persistent ulcer or swollen glands.
• Obvious change in wart or mole.
• Indigestion or difficulty in swallowing.
• Unusual vaginal bleeding or discharge.
• Unexpected night sweats or fever.
• Continued itching in the anus or genitals.
• Noticeable change in skin colour.
• Sores that don’t heal.
• Headaches.
• Persistent back pain, pelvic pain, bloating or indigestion.

New Dr. Muthulakshmi Reddy Maternity Benefit Scheme



Dr. Muthulakshmi Reddy Maternity Benefit Scheme Scheme -details
In TamilNadu, Muthu Lakshmi Reddy Maternity Benefit Scheme funds is  enhanced to Rs.12, 000/-

ELIGIBILITY CRITERIA

The cash assistance will be given in three installments(Rs.4000) on conditional release and restricted for first two deliveries only. Completion of Online entry by  field health staffs is compulsory & conditions mentioned below should be ensured before release of all 3 installment funds.

SELECTION/ELIGIBILITY CRITERIA
      
The pregnant mother should be of age 19 years and above. 
The pregnant woman should be in the BELOW POVERTY LINE(BPL)  GROUP  
This cash assistance will be given to every pregnant woman
              a. who avails all required Antenatal services  during pregnancy in concerned PHC
              b. Mother who delivers in the Government institutions(PHC,GH,Govt.TEACHING INSTITUTIONS)
              c. Completion of immunization for the child up to 3rd dose of DPT/PENTAVALENT/HEPATITIS-B/POLIO.
Mode of Operation
Application Form
Duplicate application distributed to AN mothers
Filled application received from AN mothers by VHN
    One shouid be in PHC
    One given to mother
At the time of registration, AN.card to be given by VHN to AN Mothers.

CONDITIONS FOR RELEASE OF FUNDS

               For the release of 1st Installment during 7th month of pregnancy
Beneficiary should have minimum 3 AN visits at concerned PHC
Beneficiary should have availed
  1.           TT immunization
  2.           Blood grouping and typing
  3.           Hb% level Measurement
  4.           Weight Measurement
  5.           Blood Pressure Recording
  6.           One ObstetricsUltrasonogram done (Scan)
  7.          Testing for HIV at the time of early AN registration
Every  visit  Weight, B.P. ,HB status should be checked

            For the release of 2nd Installment
     Delivery should be  in Govt. Institutions (PHC,GH, Govt.MEDICAL COLLEGE HOSPITALS.
 in Tamilnadu)
            For the release of 3rd Installment
         Will be given to the mother on completion of third dose of DPT/ Hepatitis - B and Polio / Pentavalent vaccine for the child as per the time schedule.

Funds flow
      State Level Budget Allocation – Directorate
      District Level Budget Allocation - DDHS

      At Block Level :- Block Medical officer claims from treasury & deposited in BMO's account.and send  the list of approved mothers to bank for fund transfer
     At individual Level-Fund transferred to beneficiary through  bank to their bank account

    Ist Installment
            SHN login and verifies the beneficiaries list
            MO,PHC login and certifies the beneficiaries list and send to Block
             CHN login and Consolidates the beneficiaries list of all PHCs and send to BMO
             BMO login and approves and prepares proceedings and claims funds from Treasury - Funds received  from Treasury and get deposited in BMO Account
             BMO send the list of approved mothers to Bank for fund transfer and updates payment details after receiving feedback from bank

     IInd Installment
             Institutions enter details of deliveries conducted by them online using PICME number
CHN / WMO at Urban login and consolidates the eligible beneficiaries list of all PHCs / Urban Units
BMO / responsible person in urban login and approves the list of mothers –Claims funds from treasury deposit in BMO’s account –Finalise the beneficiary list send to bank for fund transfer and updates payment details after receiving feedback from bank.

       If the mother not produced PICME number and got delivered in a hospital or her delivery details is not entered by the institution into PICME, the VHN / MPHW shall enter delivery details in PICME after receiving a copy of birth certificate from the mother.

     IIIrd Installment
            VHN   enters immunisation details in the  PICME software
            CHN /WMO login and consolidates the eligible beneficiaries list of all PHCs / urban units.
Before 3rd installment payment, SHN / CHN should ensure that the Birth certificate entries are made in PICME by physically verifying the birth certificate of the child.
            BMO  login and approves the list of mothers - Claims funds from treasury and  deposit in BMO’s account –Finalise the beneficiary list send to bank for fund transfer and updates payment details after receiving feedback from bank
.
Time Schedule
          SHN should prepare & sign the eligible list  on 20th of every month & submit the list to the medical Officer Of the PHC.
          Medical Officer, Certifies the eligibility list  prepared and finalized by SHN and send it to Block PHC before 25th of every month.
          CHN prepares Eligible beneficiary list of all PHCs on 25th of every month by taking print out from PICME. CHN should sign the report format & submit the list to BMO.
          BMO finalize the beneficiary list prepared &signs the list before 30th of every month.Based on the list, amount is claimed from treasury and deposited to bank account .
          BMO  finalize & approves the list of beneficiaries and send it to Bank with Bank account number ,Bank code for release of funds to the beneficiaries account,
           Amount should be released to beneficiaries, during 5th -10th of every month by bank officials.
          After release of each installment amount through Transfer of funds to the beneficiary’s A/c , beneficiary list to be given to the BMO by the Bank      
          BMO updates payment details at Block after receiving feedback from bank.
          All PHCs disbursement details should be entered in MRMBS software at Block


1 st / 3rd Installment Municipality with staff
VHN – enters data
SHN verifies
WMO certifies
MHO approves the list
Commissioner claims funds
List given to Bank.
Funds released to beneficiary A/C thro Bank


2 nd Installment Municipality with staff
Institutions enter details of deliveries conducted in their Institutions
SHN verifies
WMO certifies
MHO approves the list
Commissioner claims funds
List given to Bank.
Funds released to beneficiary A/C thro Bank

1 st / 3rd Installment Municipality without staff
MPHW gives data,
Funds given to Municipality for data entry (or) Funds given to BMO for urban data entry.
CHN at Block verifies
BMO approves & claims funds
List given to Bank
Funds released to beneficiary A/C thro’ Bank
2 nd Installment Municipality without staff
With the birth certificate they should enter in the place where registration done (or ) by VHN.
CHN at Block verifies
BMO approves & claims funds
List given to Bank.
Funds released to beneficiary A/C thro Bank

Entry of Delivery Details at the Institutions
          Deliveries conducted in institutions will enter the details of delivery in the software using the PICME number of the beneficiary.
         All institutions will be given user ID and Password with appropriate training
         A responsible person in the urban institutions to be identified for entering this data at the Institution
Entries should be done only for the mothers having PICME number with her during delivery
Monitoring & Supervision
SHN in Rural & Urban
CHN & DMCHO in urban & rural
should cross check atleast 10 children in a month and verifies in the field.
WMO should check.