Be aware ( Beware) of Scrub Typhus

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Scrub typhus is an acute, zoonotic, febrile illness of humans. Scrub typhus is an emerging disease, which is grossly under-diagnosed in developing countries due to its non-specific clinical presentation, limited awareness, and low index of suspicion among clinicians and lack of diagnostic facilities. Nagpur medical fraternity is recently noticing outbreaks of this disease. Many patients are reaching Orange City Hospital & Research Institute from all corners of Central India with undiagnosed fever with multiple complications.

Highlighting this disease; Dr.Devayani Buche, Physician stated that Scrub typhus usually affects previously healthy active persons and if undiagnosed or diagnosed late, may prove to be life-threatening.

Diagnosis of scrub typhus is based on a high index of suspicion and careful clinical, laboratory and epidemiological evaluation.

Dr.Rajesh Atal, Critical Care Physician added that Scrub typhus is an acute febrile illness caused by orientia tsutsugamushi transmitted to humans by the bite of the larva of mites. It causes disseminated vasculitic and perivascular inflammatory lesions resulting in significant vascular leakage and end-organ injury. After an incubation period of 6-21 days, onset is characterized by fever, headache, myalgia, cough, and gastrointestinal symptoms.

Dr.Milind Pande, Pathologist stated that laboratory studies usually reveal leukopenia, thrombocytopenia, deranged hepatic and renal function, proteinuria and reticulonodular infiltrate. Weil-Felix, Enzyme-linked immunosorbent assay, Rapid lateral flow-assay, Western blot, Immunochromatographic test, indirect fluorescent assay, indirect immunoperoxidase, PCR amplification of orientia genes and isolation/inoculation are some other high end ways and means to confirm the disease.

Dr. Nikhil Balankhe, Physician mentioned that Scrub Typhus also known as tsutsugamushi disease means dangerous bug in Japanese language.   O. Tsutsugamushi is transmitted to humans by the bite of the larva of trombiculid mites (chiggers) which are almost microscopic, often brilliantly colored. Infected chiggers are found particularly in areas of heavy scrub vegetation during the wet season, therefore this disease has also been called river/flood fever when mites lay eggs. Rodents are carriers. The word “scrub” was applied because of the type of vegetation that maintains the chigger−mammal relationship.

Dr.Kuldeep Sukhadeve, Paediatrician clarified that in children, scrub typhus may be mild or severe. Most patients present with fever and regional/generalized lymphadenopathy. A single painless eschar, maculopapular rash, hepatomegaly, splenomegaly and gastrointestinal symptoms may be present.

Dr.Ganesh Bure who leads the team of Intensivists at Critical Care Complex of Orange City Hospital & Research Institute for round the clock service emphasized that in the ICU, aggressive management like appropriate ventilator strategy in ARDS patients, dialysis of renal failure patients, and correction of haematological abnormalities etc. Of such patients is imperative to prevent high mortality associated with the complications. Preventing sepsis and multi organ failure can be possible in ICU settings with specific treatment protocols and supportive management.

Dr.Upendra Kumar, Physician cited that preventive measures especially in the absence of an effective vaccine can be primordial, primary and secondary. Primordial prevention entails prevention of emergence of risk factors. Best measure would be to avoid going to places like farms, areas abundant of bushes, rodents and domestic animals. Primary prevention includes health promotion and specific protection.

Dr.Ashish Shukla, Chest Physician added that advocacy, awareness and education activities, Habitat modification , Rat population control, wearing protective clothes, using insect repellents and Chemoprophylaxis are some ways of Primary prevention. Once the disease has occurred in an individual, then comes the role of secondary prevention which includes early diagnosis and treatment.

On the issue of Scrub Typhus and Pregnancy, Dr.Bindu Menon, Obstetrician stated that currently tetracycline and chloramphenicol are recommended for treatment for non-pregnant patients. According to Food and Drug Association tetracycline is classified as a class D drug and should not be used during pregnancy. Chloramphenicol is classified as a class C drug. Hence Single dose of azithromycin is used in pregnant women.

Dr.Ashwini Tayade, Infectious Disease Specialist concluded that early diagnosis of acute scrub typhus can greatly reduce the chance of life threatening complications and guide optimal therapy.

OCHRI staff welcomes Lord Ganesh

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The small permanent Ganesha Temple in Orange City Hospital & Research Institute provides spiritual healing to incoming patients and their relatives. Today Lord Ganesh was welcomed in a traditional manner by staff of OCHRI.
OCHRI conveyed public message to prevent water, air and  noise pollution and to maintain sanctity and cleanliness like a temple all around us.
Prominently present on the occasion were Dr.Usha Nair, Dr.Anup Marar, Dr.Abhay Agashe, Dr. Amit Pasari, Dr.Poonam Kachane, Shri. Sunil Sure, Shri.Vishal Kapse, Shri. Priya Sashi, Shri. Sachin Gajbhiye, Shri.Vinit Vijayan and Shri.Rajan Thakur. Shri.Ravindra Dhande assisted by Shri.Dayaram Nimbarte, Smt.Durga Joshi, Shri.Ramesh Pande and Shri.Ganesh Iyer conducted the rituals.

Know your Shoulder

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“Man, my shoulder is killing me, and I haven’t done anything to injure it,” or, “Wow. I think I just tore something in my shoulder.” These are all too common complaints that everyone faces.’
The shoulder has the most motion of any joint in the body. Stabilizing this joint are many muscles, ligaments, and tendons—chief among these being the rotator cuff tendons.
The rotator cuff tendons are sandwiched between two bones in the shoulder, and herein lies the problem. With too much activity, especially overhead activity, the tendons are pinched and irritated resulting in a common condition called impingement syndrome. This pinching effect can eventually lead to a rotator cuff tear if left untreated.
Many painful shoulder conditions involve some form of rotator cuff inflammation in the form of tendinitis or bursitis. These conditions usually result from overuse.
Many times shoulder pain results from too much overhead activity. Weekend athletes come with shoulder pain after overdoing it in a sport they have not played in a long time, or working excessively on one day. Rotator cuff tears often cause night pain and difficulty sleeping on the injured shoulder, as well as problems with outstretched or overhead movements.
Most of these painful shoulder conditions will respond to rest, anti-inflammatory medication, and necessitate physical therapy to strengthen muscles so as to prevent such episodes in future. Some painful shoulder conditions will need further evaluation in the form of x-rays or MRI scan. MRI scans are very good at detecting torn rotator cuffs and ligament injuries.
Advanced technology now allows a minimally invasive approach to treating shoulder injuries. New arthroscopic techniques can be used to treat rotator cuff and ligament tears without a large incision. Outpatient arthroscopic repair facilitates faster recovery and is typically less painful.
Avoiding shoulder pain is not always possible. One day of overuse can sometimes equal six months of shoulder pain. It is recommended that you take the time to stretch and warm up, and to use moderation when it comes to activities you have not done in months or years. Strengthening of rotator muscles should be a part of your exercise schedule to prevent such injuries.
The good news is that most shoulder pain will get better with exercise protocols. The even better news is that technological advances with shoulder arthroscopy allows minimally invasive techniques to correct those shoulder injuries that do require surgery with early return to work. Gone are the days when one thought shoulder pain is something one has to live with-With Correct diagnosis and proper treatment one can get back to all routine activities.
For further queries related to shoulder pain or shoulder conditions, contact Dr.Rohan Bansal , Shoulder Surgeon and Joint Specialist-Orange City Hospital and Research Institute, Nagpur.

OCHRI Camp at Axis Bank

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Orange City Hospital & Research Institute regularly conduct on site health check camps under aegis of their “ Shram Shilpi” undertaking for benefit of executive and workers serving in various industries and companies. Many companies call on TEAM OCHRI in view of their competence availability in wide ranging specialties.
Recently a free General Health Checkup Camp was done by OCHRI for Axis Bank employees and beneficiaries of Apollo Munich Health Insurance Company Limited in their bank itself.
Apart from Consultation with Physician, Random Blood Sugar, Blood pressure & BMI assessment was done for all beneficiaries.
Dr. Upendra Kumar, Physician and Dr.Pravin Sahu, Medical Officer contributed their expert services. They were assisted by Sr.Reena Madakwade and Shri.Anil Dhakate.
Shri Sanjay Gurman-Branch Head, Shri.Alpesh Joshi-Operation Head of Axis Bank and Shri.Girish, Camp Coordinator-Apollo Munich Insurance Company Ltd. Ensured successful coordination of this camp.
The Camp was organized through the joint effort of Shri.Pradyuman Jha on the behalf of Apollo Munich Insurance company Ltd. And Shri. Sunil Sure, GM (Administration) OCHRI.

OCHRI Neuro Division gains 7 new superspecialists

 

Orange City Hospital & Research Institute is known for its comprehensive Poly trauma, Burns, accident, head Injury management division in view of more than 100 specialists serving the needy central Indians through 60 varied departments under one roof. With its Neuro division with regular Neuro OPD including neurosurgeons and Neurologists, it has gained a distinct name for exemplary adult and Pediatric Neurological management including complicated head injuries, Neuro infection, seizures etc. The availability of allied diagnostics, largest critical care complex and state of art Operation theater complex makes it good combination in interest of patients.

Recently 3 more Neurosurgeons, 2 Neurologists and 2 Pediatric Neurologists have joined team of existing super specialists in Department of Neurology and Neurosurgery at OCHRI. These super specialists are rendering their expertise regularly in OCHRI Neurology OPD on slots between 9am to 8pm apart from rendition of 24×7 emergency call attendance.

Dr. Mohammad Husain Bhati after doing medical graduation from Government Medical College, Nagpur did MS from KIMS Shivaji University, Kolhapur and MCh, Neuro Surgery from SMS Medical College, Jaipur. He is trained in minimal invasive cranial and spinal surgeries including spinal instrumentation surgeries, stereotactic & navigation guided surgeries and Neuro-endoscopic surgeries. He has also experienced in doing major tumor surgeries, vascular cases, complex spinal surgeries, pediatric cases, head and spinal trauma etc.

Dr. Divik Mittal has completed MBBS from NKPSIMS, Nagpur, MS from GMC, Nagpur and M.Ch (Neurosurgery) from B.J. Medical College & Hospital, Ahmedabad. He has experience in Neurovascular Surgery, Endoscopic Skull base Surgery and Pediatric Neurosurgery.

Dr. Vivek Agarwal has done MBBS from NKPSIMS, Nagpur, MS from NHL Municipal medical College, Ahmedabad and MCh Neuro surgery from B.J. Medical College and Civil Hospital, Ahmedabad. He has interest in cerebrovascular anomalies, Spinal instrumentation and Neuroendoscopy. He is also experience in managing routine Neurosurgical cases, Brain tumors, spinal tumors, AV malformation Neuro endoscopic surgeries.

Dr. Vasant Dangra did MD from Krishna Institute of Medical Sciences, Karad and completed DM Neurology from Bombay Hospital, Mumbai. He has experienced in treating acute Neurological cases like ischemic strokes, intracerebral hemorrhage, epilepsy and Neuro infection and headache, migraine, memory loss, Parkinsonism, Spinal Cord diseases, Neuritis & muscle diseases.

Dr. Amarjeet Wagh is alumni of Government Medical College & Hospital, Nagpur. DNB (Pediatric) from Kerala Institute of Medical Sciences- Trivandrum, Fellow Pediatric Neurology from AIMS- Cochin and Fellow Pediatric Neurology BPNA, UK. He has special interest in Pediatric Epilepsy and Developmental Neurology. He has many paper presentations in National Journals.

Dr. Ritesh Sahu has completed MBBS & MD from MUHS Nashik and DM in Neurology from King George’s Medical University, Lucknow. He has published many papers in National and International Journals. He has also won the Best paper award in Neurology at Neurocon-2014.

Dr. Vinit Wankhede is alumni of Government Medical College & Hospital, Nagpur. He has done DCH, DNB (Pediatrics) and Postdoctoral Fellowship in Pediatric Neurology from TMC Trivandrum. He has special interest in Pediatric Epilepsy, Pediatric Neurology and Pediatric Neurogenetics. He has presented many papers in National Journals.

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