The IPC or the Infection prevention and control is an evidence-based practical approach that prevents patients and health workers from being harmed by avoidable infection.

The International Infection Prevention Week was established in 1986. This year’s theme is “Make your Intention Infection Prevention” The idea is to highlight the science behind infection prevention and inspire people to join the fight.

The aim is to make sure that no one catches an infection while receiving health care. There is a possibility that infections can spread through outbreaks and many regular care practices as a result of antimicrobial resistance. This could affect hundreds of millions of people across the world every year. WHO is working with numerous partners to deliver quality care through IPC practices.

Let us take a look at some of the guidelines by the WHO for medical professionals to follow concerning IPC, and how we as patients can also equally be part of the solution:

Core components of Infection Prevention and Control

The WHO core components for Infection Prevention and Control are based on scientific evidence, expert consensus, and experiences of a country, and provide the foundation for strengthening established programs at the national and facility level.

These guidelines enhance the capacity of Member States to develop and implement effective behavioral modifications that are interventions, at national and acute health facility levels. They are a key part of the strategies to prevent infections, disease(es, or threats like Ebola and strengthen health services, thus combating antimicrobial resistance (AMR).

The guidelines are created to support the countries that are still in the process of formulating their IPC protocols and AMR plans to support healthcare and strengthen their approach.

HAIs or Healthcare-associated Infections and guidelines

Annually, millions of patients around the world suffer from healthcare-associated infections. These are called HAIs. HAIs are frequent adverse events in health care, and their global burden remains undetermined because it is rather difficult to gather data that is reliable. IPC undertakes the global issue of HAIs as a key area of work. Research has been conducted to identify published studies through systematic literature reviews from developed and developing countries to highlight the magnitude of HAIs. WHO has published reports on this topic as well.

Hand washing

There is a simple solution to HAIs. Most of these are preventable through good hand hygiene practices. Cleaning hands the right way at the right time is key. The WHO guidelines on hand hygiene in healthcare are shown to be the most effective approach. Hand hygiene improvement programs can prevent up to 50% of avoidable infections acquired during health care delivery. It can also generate economic savings on an average, 16 times the cost of implementation

Surgical site infection Guidelines

• Alcohol-based antiseptic solutions based on Chlorhexidine Gluconate (CHG) for surgical site skin preparation should be used on patients undergoing surgical procedures.
• Patients with nasal carriage of S.aureus should receive intranasal applications of mupirocin 2% ointment with or without a combination of chlorhexidine gluconate body wash.
• Surgical hand preparation should be performed either by scrubbing with suitable antimicrobial soap and water or an alcohol-based hand rub before wearing sterile gloves.
• Mechanical bowel preparation alone (without the administration of oral antibiotics) should NOT be used in adult patients undergoing effective colorectal surgery.
• Hair should not be removed for a patient undergoing surgical procedures unless necessary.
• Shaving is strongly discouraged at all times.
• Surgical antibiotic prophylaxis SAP should be administered before surgical incision when indicated.
• SAP should be administered within 120 min before the incision while considering the half-life of the antibiotics.

Injection safety guidelines

Sometimes, injections that are intended to promote health do the opposite when they are administered in an unsafe way. Practices like using the same needle or syringe to administer injections to more than one person can lead to life-threatening infections.

How you as a patient can join the fight

Being aware of the risks of unsafe injections, the benefits of taking an oral medication, and inquiring about alternatives to injections can be ways in which patients can play their part in IPC. One can also ensure that injections are delivered with a syringe and needle opened from new packets only.

The onus of protecting patients from HAIs or other infections is not just on doctors and healthcare professionals, it is also on us, patients. Prevention is always better than cure. One can educate themselves on how infections can be avoided. Not to mention the very basic solution of handwashing that has kept most of us safe during the ongoing global pandemic.

COVID care in current times, COVID Self test is a need of the hour

As a country, we are standing on the verge of the third wave of COVID. The probable emergence of it is still not clear. Since offices, malls, public places have started opening up in full capacity; we need to be extra cautious about things.

If we don’t want to get again into the grip of the COVID wave, we need to take all basic necessary precautions like putting up a mask, practicing social distancing, and use of sanitizers, etc. Along with this we also have to make sure to avoid the mass spread in case there is a thin chance of probable infection. We need to adapt and facilitate the use of COVID self-test-like methodologies at home that will ensure early diagnosis, less damage to the health, and lesser risk, etc. This kind of self-assessment tool will further reduce the risks of mass outbreak multifold.

These self-test kits are available without prescription on online platforms like Amazon, Flipkart, and PharmEasy, etc, over the counter in a pharmacy or a retail store. At present, self-test kits are used for the detection of current infections by many people across the country. If we overrule such infections at home or take necessary steps in case of infections we can truly avoid the mass spread of the disease and as a country, we will win the war against COVID.

Little practices like these can help us avoid infections passed on during health care delivery. Maintaining basic hygiene is the first step to keeping oneself, and our near and dear ones safe. You can also talk to your doctor and get advice on what daily healthy habits and behaviors you can incorporate to join the fight against infections.

Surgical sutures, also known as stitches, are the most common medical devices used by doctors during surgeries. This involves using sterile surgical threads to repair and close wounds to the skin or the other tissues. These sutures help in holding the tissues together after a surgery or injury. Suturing involves the usage of a needle attached to a thread to stitch the wound firmly and close it. Thanks to several advancements in the medical field, doctors have access to a variety of sutures that come in different shapes, sizes, and materials.

Classification of Sutures

Surgical sutures can be classified based on several different factors. Some of them are:

Absorbable: An absorbable suture refers to the type of suture that does not require a doctor to remove. These sutures are dissolved by hydrolosis and the enzymes found in the tissues of the body. The types of absorbable sutures include Polyglycolic Acid Sutures, Polyglactin 910, Poliglecaprone 25, Catgut, and Polydioxanone sutures.

Non – Absorbable: These sutures are made up of materials such as silk or synthetics. These sutures will not be absorbed by the skin, unlike absorbable ones, and have to be removed by your doctor. Non – absorbable sutures are usually used on skin wounds(not needed) The types of non – absorbable sutures include Polypropylene sutures, Nylon (polyamide), Polyester, PVDF, Silk, and Stainless Steel sutures.

Monofilament sutures: As the name suggests, monofilament sutures comprise a single thread, which provides a better passage through the tissues, in a smooth manner. It also leads to lower tissue reactions.

Multifilament sutures: The multifilament sutures are also known as braided sutures. It consists of several threads braided together, leading to better security. If not taken care of properly it can lead to the chances of infection, hence always available with a coating material to avoid infection and for the smooth passage through tissues.

Barb sutures: These sutures have barbs or projections that can penetrate the tissues and hold them without the need for knots.

Synthetic and Natural Sutures

Surgical sutures can be divided into two types based on the raw material used in making them. Natural sutures include silk and catgut sutures, while synthetic sutures are made with materials such as polyester, nylon, and more.

Now that we know about sutures and their classification, let’s understand how to take care of the wound after undergoing the suturing procedure.

What measures can be taken to relieve suture pain?

As the sutured wound heals, you will be advised by your doctor to take proper care of the sutures, which includes cleaning and dressing your wound. There are some things you must keep in mind while the suture wound heals. It is extremely important to keep the wound dry, especially for the first 24 hours, as it will need time to heal and exposure to moisture will slow it down. You must make sure that you do not soak the wound in any given situation or swim when the sutures are on. Use only ointments and medicines given by your doctor.

Removing the sutures is a quicker process than suturing a wound, and it is not too painful. You may feel a slight stinging sensation or a pull on the skin. In some cases, you may also experience inflammation in the sutured area. You can use ice packs to reduce inflammation and pain.

How harmful is it to leave sutures in for longer than 7 days?

Sutures should usually be removed within 1 – 2 weeks of the procedure, depending on the location of suturing. If the non-absorbable sutures are used inside of the body, it remains in the body forever giving permanent support to the wound. The non-absorbable sutures used on the skin should be removed. Removing the sutures at the right time reduces the risk of permanent scarring, infection, or tissue reaction. However, if the sutures are removed too soon, it may result in dehiscence and spread of the scar. In simpler terms, the higher the wound tension, the higher the duration of a suture. In terms of location, facial sutures should be removed in a week, scalp sutures in 10 days. Sutures in the trunk or hands should be allowed to stay for 1-2 weeks, while in the case of legs, it should be around 2-3 weeks.

What happens if the sutures are not removed on time from the skin?

If the sutures are left on the skin for a longer period compared to the actual time of removal, it may lead to permanent scarring. Also, after a point in time, new skin will start growing over and through the sutures. In this case, it will be difficult for the doctors to remove the sutures, and also extremely painful for the patient.

Will the suture mark go away completely?

A suture mark may never go away completely. However, they fade with time. During the initial few months, the reddish pigment of the scar will start turning pale. In most scenarios, it takes around 2 years for a scar to fully mature. The permanent look of the scar depends on the nature of the wound, the underlying skin condition, and the extent of self-care measures taken post suturing. In areas that have rich muscles below the skin, the scarring is usually denser. Scarring is the body’s defense mechanism to help prevent infections.

Do the removal of surgical staplers hurt?

The removal of surgical skin staples is usually not a painful process. You may feel a tugging or pinching sensation when the staples are being removed. While removing the skin staples your doctor will remove any wound dressing covering the area and look for signs of an infection or issues with the wound. The sutured area will be sterilized with antiseptics before the staples are removed. Apart from a slight stinging sensation, the process is very smooth. Although suturing is a very simple medical procedure that does not have a lot of side effects, it is equally important to take the right care measures. Pay attention to what your doctor says and take precautions to keep the sutured area clean and protected. Follow the right suture care and speed up the healing process!

Hernia’s are a common ailment with over 10% of the world, men, women and children, developing one at some point in their life. It occurs when an organ pushes through the muscle or tissue opening holding it in place. A hernia is referred to the sac that consists of the lining of the peritoneum/abdominal cavity after it enters through the hole in the stronger muscle region of the abdominal wall surrounding the muscle or fascia. A hernia may be visible as a bulge in the abdomen, upper thigh, belly button and groin areas, depending on the location of its occurrence. Groin hernias are the most common, making up to 9/10 of hernia cases.

Types of hernia: 1. Inguinal Hernia: Occurring mostly in men due to the improper closure of the inguinal canal after postpartum testicle descent. This is a groin hernia.

2. Incisional hernia: When the organ pushes through the surgical incision after surgery, mostly abdominal. It can occur many years later through the scar of the initial surgery too.

3. Femoral Hernia: Another groin hernia, but one which is more common in women. Usually observed as a bulge on the upper thigh, exactly below the groin.

4. Umbilical Hernia: Almost exclusively seen in children and babies under 6 months old. This bulge around the navel is usually seen due to the improper closing of the muscles around the navel.

5. Hiatal Hernia: This is an abdominal hernia that occurs in the stomach’s upper region. This is observed when a part of the stomach’s upper part enters the hiatus, an opening in the diaphragm.

What can cause a hernia? A hernia is usually the result of a combination of weak muscles and straining due to lifting heavy objects. It is more likely to affect those born with weak abdominal muscles.

How do I know if I have a hernia? In a majority of cases, hernia patients do not exhibit many symptoms. What they might complain of though , is discomfort or pain which is exacerbated during standing, straining or while lifting heavy materials. Another common symptom is a sore and growing bump in the abdominal area. Major symptoms like nausea, vomiting, not being able to expel gas or have bowel movements occur when the hernia is strangulated, i.e., when it gets stuck due to increasing size and restricted blood supply. This is a medical emergency and should be operated on immediately.

Is surgery the only option? Not in all cases. Hernia treatment depends on the size of the hernia and the severity of the symptoms. In mild cases, lifestyle changes and medication may be enough to manage the situation. This is mostly true for hiatal hernias where dietary changes like avoiding heavy meals, lying down or bending over after meals can alleviate the symptoms. Keeping one’s body weight in check can also help. Hiatal hernia patients can also benefit from medications like antacids, H-2 receptor blockers, and proton pump inhibitors that reduce stomach acid.

If the hernia patient requires surgery, there are two options available depending on their case history. ● Open hernia repair or herniorrhaphy: The patient is provided either spinal, general or a combination of both anesthesias. An incision is then made in the groin and the hernia is moved back into the abdomen and the wall is reinforced with stitches. The weak muscles are reinforced through hernioplasty wherein they are provided additional support through the use of a synthetic mesh or screen. ● Laparoscopic surgery: A minimally invasive option that takes place under general anesthesia. Three incisions are made in the abdomen, one of them being through the umbilicus. The laparoscope, which is a thin tube with a camera at its end is then inserted through the umbilical port or opening. The camera then sends a magnified image from inside the body to a monitor, which gives the surgeon a close-up view of the hernia and allows them to repair the hernia with the help of a mesh. Patients undergoing laparoscopy experience a much shorter recovery period overall.

The type of surgery one undergoes totally depends on the surgeon, the type of hernia, its size and the patient’s history.

Is the recovery very painful? As with any surgery, there is a certain level of discomfort that is to be expected. However, this can be managed with pain medication. Resumption of normal activities depends on the patient’s progress and doctor’s evaluation, though vigorous activity and heavy lifting are restricted for several weeks. This holds true for both adults as well as children.

Living with hernia is no joke and left untreated, can cause fatal complications. If you or your loved ones are exhibiting symptoms of hernia, then going to a doctor for a full evaluation of the condition is a must. Early treatment is the best way to ensure a positive outcome.

1. Quit Smoking
while a lot of people don’t know this, smoking is directly related to a series of heart problems. Avoiding tobacco might be one of the best steps one can take to protect health and blood vessels. Smoking might be one of the most controllable factors when it comes to the risk of heart diseases. Quitting smoking is the smartest decision for one’s overall health and not just for the heart

2. Pay Attention To the Inches!
Studies all around the world have linked excess belly fat to higher blood pressure and unhealthy blood lipid levels. That puts your heart directly at risk. Hence, if you see yourself carrying extra weight than necessary, now would be an excellent time to apply yourself to a routine to shed it.

3. Don’t shy away from the bedroom
Having sex can be extremely good for the heart. While catering to your conjugal needs and adding pleasure to your life, sex also helps lower stress levels and hence your blood pressure. The oxytocin released as a result of sexual activity keeps you in a better mood too! Lower frequency of sexual activity has been associated with a higher risk of cardiovascular disease.

4. Top Up On those Antioxidants
Be on the lookout for antioxidant and fiber rich foods. Beans, Salsa etc are an unexpectedly yummy source of antioxidants. A diet rich in soluble fiber can help lower your level of low-density lipoprotein, or “bad cholesterol.” Oats, barley, apples, pears, and avocados are other rich sources of soluble fiber.

5. Use your hands more
usually putting your hands to work helps your mind unwind. Activities like cooking, puzzles, board games, help stimulate the mind enough engaging other senses while relaxing you. This practice goes a long way in maintaining one’s heart health.

6. Some inexpensive wildly beneficial therapy!
Who would’ve thought, our pets offer more than good company and unconditional love. Owning a pet may help improve your heart and lung function. They also provide other numerous health benefits. Having a pet may also help lower your chances of dying from heart disease.

7. Put on your Dancing Shoes!
No matter the type, dancing makes for a great heart-healthy workout. Like other forms of aerobic exercises, it raises your heart rate and gets your lungs pumping. In addition to dancing, yoga, aerobics or even routine stretching have an immense potential to keep your heart healthy.

8. More Salt? Think Again
Coronary Heart Disease can easily be sidestepped if each individual cuts down on his or her daily salt intake to half a teaspoon. There is a multitude of salt substitutes that are available in the market for anyone with a heart condition.

9. Know Your Cholesterols
Keep in mind the cholesterol that you need to avoid and the good cholesterol that needs to be accommodated in your diet. Consume Wine, in moderation, Fish and Nuts for good cholesterol. Avoid heavy intake of saturated fats.

10. Be Positive
A sunny outlook may be good for your heart, as well as your mood. According to studies, chronic stress, anxiety, and anger can increase your risk of heart disease and stroke. Maintaining a positive outlook on life may help you stay healthier for longer.

The keto diet is a low-carbohydrate, fat-rich diet that has been gaining popularity not just in the fitness community, but all around the world. This weight loss plan is derived from the Atkins Diet (a commercially successful low carb, high protein diet which started the buzz around Low Carb diets). Currently, other low-carb diets such as the Paleo, South Beach, and Dukan diets are high-protein diets but are moderate in fat. In contrast, the ketogenic diet follows a distinct strategy towards consumable protein and fat content for achieving weight loss. In this approach, the content of fat is exceedingly high, generally 70% to 80%, with minimized protein consumption.

The basis of a Ketogenic diet is to deprive the body of its main source of energy- glucose. In place of it, an alternative fuel is created from the fat stored in the body. This fuel is called Ketones, which is where ‘Keto’ Diet is conferred from. The body requires glucose – derived from starchy/ carb rich foods, in a steady supply. Since it cannot store glucose, this glucose needs to be supplied daily. When that doesn’t happen, the body uses the stored glucose present in the liver. If the condition continues, the insulin levels in the blood declines and fat is automatically substituted as primary fuel.

The liver produces ketone bodies from fat, which can be used in the absence of glucose. In the state of ketosis- a state even healthy people experience during fasting or strenuous exercise, ketone bodies accumulate in the blood. The duration it takes for a person to reach the state or the number of ketones accumulated, all differ individually. however if not done right, one can reach a harmful state called ketoacidosis, which is caused by the formation of dangerously toxic levels of acid produced in the blood by excessive ketone bodies.

While there are different versions of the diet that can be followed, all of them ban carb rich foods. These range from the obvious bread, cereal, pasta, rice to some non-obvious foods like beans, legumes and most fruits. Instead this diet promotes food high in saturated fat like lard, butter, fatty cuts of meat, processed meats as well as unsaturated fats such as nuts, seeds, avocados, plant oils, and oily fish.

Strategies propose following a ketogenic diet till you bring your weight to an appropriate level. After achieving the targeted weight loss, you may follow this diet for few days in a week or few weeks in a month, to prevent regaining weight. You can interchange the above phenomena by allowing higher carbohydrate consumption during the rest of the days. The amount of protein in a ketogenic diet is kept moderate in comparison with other low-carb high-protein diets, because eating too much protein can come in the way of ketosis as the amino acids present can also be substituted for glucose. A ketogenic diet specifies enough protein to preserve lean body mass, including muscle, but that will still cause ketosis.

It is important to keep in mind that while there is research present in favor of the effectiveness of this diet, it is only for the short term. It is also known to bring about other positive changes that come with being overweight such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides.

However the diet comes not without its drawbacks. One may experience hunger, fatigue, low mood, irritability, constipation, headaches, and brain “fog.”- A cognitive dysfunction involving memory problems. While these conditions may subside, restricting oneself from eating all these readily accessible items on a daily basis may be challenging. Other not-so-good effects of a long-term ketogenic diet have arisen, which include an increased risk of kidney stones and osteoporosis, increased blood levels of uric acid (a risk factor for gout). Other Possible nutrient deficiencies may appear if a variety of recommended foods on the ketogenic diet are excluded. Therefore it is integral to not only concentrate on eating high-fat foods, but also to combine in one’s diet, a variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds regularly to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet.

Since whole food groups are not included, guidance from a registered dietitian may be helpful in maintaining a ketogenic diet that minimizes nutrient deficiencies.