Dr Aluri Vijayalakshmi - Author Aluri Vijayalakshmi

22Aug

Serve others, Don’t expect any reward

To serve others is one of the noblest things a human being can do. The natural form of selfless service is when we give without wanting anything in return. We should do service with this Great Spirit, but not to receive admiration, appreciation, power, or name and fame.

We should serve the people from our heart and soul in the spirit of helping others because it is the right thing to do, as humans; it is our basic duty. This attitude has the power to soothe our hearts and gets them filled with love

The giving also heals the hearts of the recipients, making them aware of the humane dimension of others, which leads to gaining hope and confidence to face life’s challenges.

If you sacrifice something for others, a feeling of satisfaction creeps in. We feel as though God is showering blessings upon us and that feeling motivates us to give or serve more

Service without expecting any reward makes you happy, gives you fulfilment, and gives a purpose to your life. If you desire any reward for your service, it is a business. If you desire to have a reward, it creates sadness, tension, frustration and anger.

“Service above self” is the motto of Rotary International. The tree of service has 5 main branches.

The first branch is SILENT SERVICE. Do not do any service announcing loudly with trumpets. The sound of the announcement should be limited to making aware of the recipients of the services. We should focus on silent services. Earth, sun, clouds, air, water, and flowers, all are serving, but only silently.

The second branch is HUMILITY. If you can understand that being able to help others is a noble opportunity you are blessed with, HUMILITY automatically envelops you.

The third branch is EMPATHY. We must always have love and compassion towards the less advantaged and express that frequently. The people we serve are also part of this creation, hence, Serve them with love

The fourth branch is SACRIFICE. Unless we sacrifice our money or time or our priorities, our service remains incomplete

The fifth branch is SPIRITUALITY. Spirituality means not the prayers and not the rituals. We must brighten our souls internalizing the feeling that service is an offer to god with devotion. Service must evoke a fountain of bliss in our hearts

“Achievement of your happiness is the only moral purpose of your life and the starting point of all your desire,” said Napoleon Hill.

Selfless Service is the most vital tool for achieving this purpose.

“When we give without expectation or recognition, our hearts open to a wealth of love. Real love begins when nothing is expected in return. Love one another, work hard and have faith. Be grateful. ” said Ratnasunderi. ”

“Do your best. Give without expectation and forgive everyone. Use kind words, say your prayers, look for opportunities to serve and count your blessings.” said Dalai Lama.

” Life’s most persistent and urgent question is this: What are we doing for others?” said Martin Luther King Jr.

He also said, “Work for a cause, not applause. Live life to express, not impress. Don’t strive to make your presence noticed, just make your absence felt. A good teacher is like a candle — it consumes itself to light the way for others.”

According to Sant Rajinder Singh, ” selfless service is not only a job or task to be done; it is an act of healing, of opening hearts and of radiating love.

A sure indication of spiritual growth is when you give without expectation, instead of questioning yourself what will I get out of it?

So extend selfless services to others whenever you can,

Where ever you can and

as long as you can,

Search for avenues to serve

And make a change in the lives of others and make this world a better place to live

29Jun

Cervical cancer Mukth Bharath

Pledge and dedicate to achieve Cervical cancer Mukth Bharath

Cervical Cancer is the Cancer that affects the “mouth” of the uterus

Why is Cervical Cancer important to you?

Cervical Cancer is the commonest cancer in Indian Women, 200 women die every day in India, 8 women die every hour, 1 woman every 7 minutes
India makes up only 16% of the world’s population, but has 27% of the world’s total cervical cancer cases and deaths every year
New cervical cancer cases diagnosed annually -India : 1,32,082 – World : 4,93,243
Deaths due to cervical cancer annually -India : 74,118 – World : 2,73,505
Cervical cancer usually has no signs and symptoms in its early stages
There is low awareness about cervical cancer

Who is at risk of Cervical cancer ?

All sexually active women are potentially at risk of cervical cancer as they could have been infected by HPV
Though the risk begins early, cervical cancer is most commonly found in women in their 40’s and 50’s

Top Cause of Cervical Cancer: HPV Infection

The human papillomavirus (HPV) is a large group of viruses. About 40 types can infect the genital areas, and some have high risk for cervical cancer.
Genital HPV infections usually clear up on their own. If one becomes chronic, it can cause changes in the cells of the cervix. And it’s these changes that may lead to cancer. Worldwide, over 90% of cervical cancers are caused by HPV infection.

The 4 most important types of HPV

HPV 16 & HPV 18– >75% of Cervical Ca.,>50% of Vaginal & Vulvar Cancer

HPV 6 & HPV 11 & HPV 16 — 90% of Anogenital warts

How does HPV spread?

Sexual activity spreads the virus, It’s one of the most common sexually transmitted diseases(STD). About half of those with HPV are aged 15 to 24.

HPV infections – what you should know

Large number of women get HPV infection sometime during life time (80% by the age of 50). your immune system usually prevents the virus from doing serious harm.
The dangerous types of HPV can stay in the body for years without causing any symptoms – you may not know you have it.
Majority would clear infection without developing any disease. Few women develop precancerous lesions, cervical intraepithelial Neoplasia, which resolves spontaneously but in some cases it may progress to invasive cervical cancer and tends to spread to surrounding areas.

WHO Has Launched Awareness Drive for Cervical Cancer

Other risk factors for cervical cancer

Early marriage and starting sexual life at an early age
Early Child birth, Multiple Child births and unsafe abortions
Unprotected sex
Multiple Sex Partners, , Casual sex
Smoking
Family History/Hereditary
Oral Contraceptive pills

How can you protect yourself?

Awareness
Vaccination
Screening

Awareness

Awareness about all aspects of cervical cancer, especially the importance and mode of its prevention is very crucial

Vaccination

Vaccination is the only true form of “prevention” – stops the disease from happening in the first place
There are two vaccines available today:
- Quadrivalent (“four type”)-Protects from 6,11,16,18

Partial protection from 33, 35, 41 and 7 other types

Bivalent (“two type”)Protects from 16, 18

Partial protection from 33, 35 and 41

Who should take the vaccine and when?

Ideally, the vaccine should be taken as early as possible after the age of 9 years but girls and women of any age up to 45 can benefit from this vaccine.

Expectant mothers should not take the vaccine during their pregnancy.

What is the dose schedule of the vaccine?

The quadrivalent vaccine is given in three doses as follows:

0 2 and 6 months

The bivalent is given in a similar schedule at 0,1 and 6 months.

Early Detection: Screening with Pap Test

PAP’s smear test is a Simple, quick, painless procedure – takes 5 minutes

If Test is Abnormal,

Scheduling Colposcopy — an exam with a lighted magnifying device — may be necessary to get a better look at any changes in the cervical tissue and also take a sample to be examined under a microscope.
If abnormal cells are precancerous, they can then be removed or destroyed.
Treatments are highly successful in preventing precancerous cells from developing into cancer.

Early Detection: HPV DNA Test

In some cases, doctors may offer the option of the HPV DNA test in addition to a Pap test.
This test checks for the presence of high-risk forms of HPV. It may be used in combination with a Pap test to screen for cervical cancer in women over 30 years of age.

Precancerous stage – Treatment

Conservative treatment (save the uterus and part of the cervix)
Burn the abnormal part of cervix with electric current (electro-cautery)
Destroy the abnormal area by freezing it (cold co-agulation)

Important messages

Cervical Cancer is the most common cancer affecting Indian women
It is a preventable disease
We can protect our women to be almost 100% safe with a combination of awareness, vaccination and screening

29Jun

Your Body is Unique

Protect it

“Life is ‘do it yourself project’. Your attitude and the choices you make today, help build the house you live in tomorrow. Therefore build wisely”

Protecting Adolescents’ health is foundation for healthy society

Who are adolescents?

Adolescents, defined by the United Nations as those between the ages of 10 and 19, numbering 1.2 billion in the world today, making up 16 per cent of the world’s population. As children up to the age of 18, most adolescents are protected under the Convention on the Rights of the Child.

What is Adolescence?

The term adolescence is derived from the Latin term “Adolescere”, which means “to grow up”.

Adolescence is a crucial link between childhood and adulthood. Adolescents undergo significant physical, psychological, emotional, social and sexual changes during this period.

It is a transition period that involves certain risks and also abundant opportunities which could impact their present as well as future health positively or negatively.

They need a safe and supportive environment in their families and communities to undergo these changes in safety, with confidence and with the best prospects to transform into healthy and productive adults.

Facts about Adolescents in India

· 22% of India’s population makeup adolescents and 47% of Adolescents are girls.

· Adolescent girls lack the knowledge about the basics of the natural processes of their body, puberty, menstruation, sexual and reproductive health, pregnancy and contraception.

· The low status of women in the family and society, gender bias and gender violence are also impacting negatively on the reproductive and sexual health(RSH) of adolescent girls and women.

· Anaemia and stunting are widely prevalent, girls are main victims

· 50% of girls are married by 18 age years (NFHS 1&2), about 20% are pregnant by age 15, with the inherent risks of 100% increase in maternal and infant mortality and morbidity.

· Premarital sex relations are increasing

· At least 50% of all young women are sexually active by age 18, mostly within marriage, as the incidence of child marriages is very high

· The menace of Trafficking and prostitution have increased.

· Both boys and girls are subjected to sexual abuse and are at risk for STIs/HIV/AIDS.

· Sexual coercion or forcible sex results in adolescent girls’ risk of unwanted pregnancy.

· RTIs are common in young women. Misconceptions about HIV/AIDS are widespread. 32–42 % of people living with HIV/AIDS in India are between the ages of 15–29.

· 40% of adolescents start drugs &substance abuse between 15–20 years.

· Adolescents learn more about sexual and reproductive health from uninformed sources, which results in the perpetuation of myths and misconceptions about the natural processes of their body, puberty, menstruation, pregnancy, childbirth etc.

· Social norms and cultural systems prohibit talking about sex. That is why, providing reproductive and sexual health information and services to adolescents in India is challenging. As a result, adolescents are shrouded in myths and misconceptions about sexuality.

· The special needs of adolescents are rarely addressed by the educational, health, and family welfare programs.

· 70% of premature deaths are caused byHabits and lifestyles of adolescents.

·Adolescents need social skills that will enable them to say “No” to sex with confidence and to negotiate safer sex if they wish to.

·They also need skills to resist peer pressure and to say ‘No’ to vices, which might have negative impact on their health and future life.

·Adolescent girls must be able to think and decide consciously and freely

-whether, when, and with whom to become sexually active,

-To avoid nonconsensual sex,

-To resist Sexual violence and abuse,

-To plan pregnancies and to have access to safe abortion

-To avoid acquiring or transmitting sexually transmitted infections and HIV/AIDS.

Adolescents need accurate and authentic information and skills.

This issue should be addressed by the educational, health, and family welfare programs and also by the non Governmental organisations dedicated to Adolescents’ health education

“Good health and wisdom- Greatest blessings for a person’s life”.

29Jun

Is it safe to give vaccinations to pregnant women?

Pregnancy is a condition when we have to prevent disease to the mother as well as the intrauterine fetus. Ideally woman should be vaccinated before she becomes pregnant. Pregnancy should not prevent a woman receiving vaccines which are safe during pregnancy. With rising incidence of communicable diseases and travel abroad by a pregnant woman, it is important to give proper advice along with routine vaccination

CDC’s suggestion:The centers for Disease Control suggests that vaccination is an integral part of pregnancy care as pregnant women and her baby are vulnerable populations.

Why pregnant women are at increased risk?

1. Altered immune response

2. Increased risk of severe infections

3. Increased risk of severe infections outcomes(maternal, fetal or both) of some infections

Why fetus& newborn are at increased risk?

1. Immature immune response

2. Increased risk of some infections

3. Increased risk of severe outcomes of some infections

4. Infection sequelae can result in lifelong disability

What are the Maternal and Fetal outcomes of some infections during pregnancy?

Measles:If the pregnant woman is not immune to measles and becomes infected while she is pregnant, there’s a risk of miscarriage,premature birthor stillbirth and a low birthweight baby

Mumps: Increases the risk of embryonic loss, spontaneous fetal loss, preterm birth and fetal death, especially during the first trimester of pregnancy (reported to be as high as 27%). No association has been found between mumps and congenital anomalies

Chicken pox (Varicella): Mother may have fatal Pneumonia. Baby will have congenital anomaly. When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes:

Scars
Defects of muscle and bone
Malformed and paralyzed limbs
Small head size
Blindness
Seizures
Intellectual disability

This syndrome is rare with an infection that occurs after 20 weeks of pregnancy.

Rubella(German measles):Miscarriage and defects of heart, eye and brain.

If a pregnant woman contracts rubella, the consequences for her unborn child may be severe, and in some cases, fatal. Up to 80% of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including:

Growth delays
Cataracts
Deafness
Congenital heart defects
Defects in other organs
Intellectual disabilities

The highest risk to the foetus is during the first trimester, but exposure later in pregnancy also is dangerous.

H1N1:Pregnant women, especially with co-morbidities, are at higher risk of complications from all forms of influenza virus infection, seasonal, zoonotic as well as pandemic. Influenza in pregnancy is associated with an increased risk of adverse pregnancy outcomes such as, spontaneous abortion, Preterm birth and fetal distress. Pregnant women appear to be 4-5 times more likely to develop serious disease than non-pregnant womenin the general population and the risk is highest in 3^rd trimester.

This phenomenon was also observed during the recent outbreak, as pregnant women have had ahigher rate of hospital admission, than the general population. Pregnant women are at a higher risk of acute respiratory distress syndrome.

Covid 19: During pregnancy, pregnant women are at higher risk of serious illness caused by COVID-19. Pregnant women are also at higher risk of delivering the baby prematurely if they contract COVID-19.

Vaccinations schedules during pregnancy

1.FOGSI recommends vaccination counseling as a part of pre-pregnancy counseling. History of occurrence of vaccine preventable diseases, previously administered vaccinations, and allergic reactions to vaccinations must be recorded. Rubella, Hepatitis B, and Varicella vaccination should be given preferably during postmenstrual period. Pregnancy should be deferred for 3 months in case of rubella vaccine.

2.Two doses of Tetanus toxoid injection atleast 28 days apart are to be given to all pregnant mothers commencing from 2^nd trimester. If the subsequent pregnancy occurs within 5 years of first child birth, only one booster dose to be given

3.Immunization of pregnant women with a single dose of Tdap during the third trimester (preferred during 27 to 36 weeks gestation)-Indian Academy of Pediatrics-IAP recommendation.

4.H1N1 vaccination-Influenza vaccine: Influenza disease may cause hospitalization and medical complication. If vaccinated against influenza virus, then antibody produced will protect the baby too. There is no vaccine available for baby of < 6 months against influenza. No significant effect was found on major birth defects, preterm birth or fetal growth restriction if vaccinated during pregnancy

5.Rabies vaccination: Purified vero cell rabies vaccine(PVRV) during pregnancy is found to be safe and effective without any adverse effect to the mother and baby.

6.Hepatitis B: Hepatitis B vaccination with an ongoing pregnancy is safe and doesn’t warrant termination.

7.Covid 19 vaccination:Pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. Getting a COVID-19 vaccine during pregnancy can protect the pregnant woman from severe illness from COVID-19 and no safety concerns have been identified

With the new variant (Omicron) in circulation, it is strongly recommended that all pregnant women to have their first and second doses of the COVID-19 vaccine if they have not already done so, to protect themselves and their baby.

Vaccines based on live viruses are avoided in pregnancy as they may harm the unborn baby. However, non-live vaccines are safe in pregnancy (for example, flu and whooping cough).

Which Vaccines should be avoided during pregnancy?

1. Mumps containing vaccine

2. Smallpox vaccine

3. Yellow fever vaccine

4.Typhoid vaccine

5.Oral polio vaccine

6.Influenza live vaccine(Nasal)

7.Meningococcal Vaccine

Postnatal vaccination

Postnatal period is a good window period for giving vaccines such as rubella which can safely be administered.

Conclusion:

Live vaccine should be avoided during pregnancy. If not immunized earlier and if the mother is having chance of contracting infection, Woman should be offered vaccination to prevent adverse fetal outcome,.

29May

Anticipated 3rd wave of Covid 19 in India- How to tackle?

The whole world is passing through an unprecedented traumatic period by the attack of an invisible, most virulent and lethal Organism

In the Indian scenario, we have experienced the unmanageable upsurge of Coronavirus infection in 2md wave. If strict measures were taken after the first wave waned, we wouldn’t have seen this humongous death toll.

Experts in the scientific field and the Governments are repeatedly warning about the certainty of 3rd wave of Coronavirus affecting people of all age groups including children. They are also warning that the third wave will be more fatal in our country.

What is a wave in the infection Context?

A wave in the context of any infection is the rising and falling of the rate and trend of the infection over a longer period and it’s relation with seasons in successive years.

Many countries witnessed the different trends of sudden surge and fall in the number of Covid

19 cases

There were two distinct waves in India during the last 15 months, the first wave, comparatively milder, beginning in Feb., March 2020 and reaching a peak in September, the second, devastating wave beginning from March 2021 and reaching the peak in April, May and slowly declining from mid-May.

There is regional variation, some regions already experiencing multiple waves since the pandemic started.

How different will Covid’s 3rd wave be from the first two? Will it be more deadly?

“The biology of the virus has changed between the first and the second wave. In the third phase of the pandemic, we can expect that there will be adaptive pressure on the virus for new kinds of changes as a large number of the population will get vaccinated.” Scientists revealed.

The emergence of new variants of a virus is natural when there is an overwhelming infectivity rate. Existing variants will make way for new variants which may or may not be more virulent.

But the pattern of the Coronavirus seems to be mysterious. “Given the high levels of circulating virus, the third wave of coronavirus is inevitable but the time scale is not clear, we can’t rule out

the possibility of a more devastating wave involving people of all ages, including children,” some experts say

However, it may involve a lesser number of people, if vaccination is done on a war footing and all the precautions to prevent the spread of the disease are followed strictly by all people. If we are not alert and guard against the virus, more mutations may occur and the presently available vaccines might not be effective completely against the new strains; but, irrespective of the virulence of the variants, it is very important for the people to stick to covid appropriate behaviour very strictly

Are the Children below 18 years at risk in Covid 3rd wave?

It is predicted that children below 18 years and newborns will be more susceptible to the infection in the third wave as these sections of people are not yet vaccinated against the Covid 19 infection
Many children below the age of 18 years and newborns were tested positive with Covid-19 in certain parts of India in the second wave of the disease with a highest surge in daily cases and deaths due to the virus.
In the first wave, less than 1% of the children were infected, but in the second wave, up to 10% of the children were infected, some of them with serious consequences.
So far, the existing mass vaccination program is not applicable for those below 18 years. Reports reveal that less than 5% of the population is vaccinated so far.
If children get infected with the virus, it is a serious challenge for their family members and the health department.
It is predicted that there is a risk of mucormycosis, a rare fungal infection, after contracting the coronavirus. The symptoms of mucormycosis appear two to three days after a person has recovered from Covid-19.
Though the immunity of the children is quite strong, with many mutant viral strains emerging, all protocols related to Covid-19 should be strictly followed and take precautions to keep the children safe and healthy.

Get Prepared, Should fight with all our Might

We should be well prepared to tackle the situation and save the people, especially the children during the possible third wave in the coming three to four months.
We have to strengthen the medical infrastructure to treat a higher number of patients than the second wave

-Establishing Covid wards,

Special ICU beds,

More Pediatric beds,

More ventilators, and

More no. of BIPAP machines in the Health care Centres

Train the personnel to handle pediatric cases if at all the anticipations come true.
As home isolation of infected children without the parents’ supervision is difficult, Vaccination of the parents should be given a priority. If they are immunized, the risk of them getting infected while handling Covid positive children will be minimal.
More deaths were reported in the age group of 30-45 years in the second wave, compared to the first wave. Undetected co-morbidities could have been the reason for these deaths, experts said. So, people must get themselves tested to understand the various co-morbidities they have and get treated if any.
Vaccination is a powerful weapon to fight against possible Covid 19 waves. So, it is crucial to speed up the vaccination program to avoid dire consequences of the third wave. Better allocation of existing supplies, allocating the limited vaccine supply in a rational and targeted way could help India save thousands of lives and help prevent a deadly third wave.
Vaccines should be available free for all. Vaccination should be done first by prioritizing front line workers and then use, age as the criterion for sequencing vaccine jabs.
Covid-appropriated behaviour should be followed strictly to avoid the spread of infection.

Let us face the challenge of 3rd wave of Covid 19

with better preparedness and following Covid appropriate behaviour

Tag Archives: Dr Aluri Vijayalakshmi

Serve others, Don’t expect any reward

Cervical cancer Mukth Bharath

Your Body is Unique

Is it safe to give vaccinations to pregnant women?

Anticipated 3rd wave of Covid 19 in India- How to tackle?