Yellow fever is a viral disease transmitted by mosquitoes in parts of Africa and South America. Vaccination is safe and effective and is a legal requirement for people travelling through infected areas. Avoiding mosquito bites is also recommended to reduce the risk of catching yellow fever or other mosquito-borne diseases.

The symptoms of yellow fever
The first symptoms of yellow fever appear three to six days after exposure to the virus. They include:

• Fever
• Nausea
• Vomiting
• Flushed face
• Constipation
• Stomach ache
• Headache
• Muscle pain
• Restlessness and irritability.

Mild cases of yellow fever end with the above symptoms. In severe cases, there may be a remission from these symptoms for several hours or days. The fever then returns and the patient develops the classic symptoms of jaundice (yellow eyes and skin) and black, ‘coffee-ground’ vomit. This can be followed by coma and death within days.

Requirements and risks of vaccination
Yellow fever vaccine is safe and effective and lasts for 10 years. The vaccine, however, has some strict requirements. It should not be given to people who are:

• Allergic to eggs or neomycin.
• Immune-deficient.
• Pregnant.
• Under nine months of age - it should only be given to younger infants and pregnant women in unavoidable, high risk circumstances.

Reactions to the vaccine are generally mild and may include fever, headache and muscle ache which occur five to 14 days after immunisation. Serious side effects are rare, but any problems should be immediately referred to a doctor.and mostly in the joint replacement hospitals is available.

Reference : http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Travel_health_...

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The hand and wrist have multiple small joints that work together to produce motion. This gives the fine motion needed to thread a needle or tie a shoelace. When the joints are affected by arthritis, activities of daily living can be difficult. Arthritis can occur in multiple areas of the hand and wrist. It can have multiple causes.

It is estimated that one out of every five people living in the United States has at least one joint with signs or symptoms of arthritis. About half of arthritis sufferers are under age 50. Arthritis is the leading cause of disability in the United States. It typically occurs from either disease or trauma. The exact number of people with arthritis in the hand and wrist is not known.

Cartilage works as nature's "shock absorber." It provides a smooth gliding surface for the joint in the  joint replacement hospitals. All arthritic joints lose cartilage. When the cartilage becomes worn or damaged, or is lost due to disease or trauma, the joint no longer has a painless, mobile area of motion.

The body attempts to make up for the lost cartilage. It produces fluid in the joint lining (synovium), which tries to act like a cushion, like water in a waterbed. But it also causes the joint to swell. This restricts motion. The swelling causes stretching of the joint covering (capsule), which causes pain.

Over time, if the arthritis is not treated, the bones that make up the joint can lose their normal shape. This causes more pain and further limits motion.

When arthritis occurs due to disease, the onset of symptoms is gradual and the cartilage decreases slowly. The two most common forms of arthritis from disease are osteoarthritis and rheumatoid arthritis. Osteoarthritis is much more common and generally affects older people. It appears in a predictable pattern in certain joints. Rheumatoid arthritis has other system-wide symptoms and may be passed from parent to child (genetically).

Reference : http://orthoinfo.aaos.org/topic.cfm?topic=A00224

Medical Tourism : - Yellow Fever Vaccination Nagpur

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Clots more likely to form in patients with cardiovascular disease, smokers and the elderly

Rosemont, IL - When tennis star Serena Williams underwent emergency treatment for a pulmonary embolism earlier this year, the world’s attention was drawn to this often fatal medical condition which, although surprisingly not uncommon, is unfamiliar to most men and women. A common risk factor associated with clot development is surgery; particularly hip and knee replacement surgery.

Pulmonary emboli, or blood clots in the lungs, occur when a clot that forms within veins elsewhere in the body – often in the lower legs or other limbs – breaks free and travels to the lungs, where it can cause serious complications. Pulmonary emboli can occur in patients of any age and common factors associated with an increased risk of clot development include:

• oral contraceptive use;
• cardiovascular disease;
• prior clot formation;
• clotting disorders;
• family history of clots; or
• advanced age.

A new study focusing on the occurrence of clots in knee replacement patients and published in a recent issue of the Journal of Bone and Joint Surgery (JBJS) indicates that despite treatment with blood thinners prior to and immediately following joint replacement surgery, the risk of clot formation is still relatively high in certain patients.

“The rate of knee replacement has increased substantially worldwide, and continued increases are anticipated in the future,” said study author Alma Pedersen, MD, PhD. “The formation of clots, including pulmonary emboli, is a serious complication in patients undergoing knee arthroplasty. Prophylactic measures, such as the use of blood thinners around the time of surgery, are used to reduce the occurrence of clots, but their effectiveness in routine clinical practice following surgery is more uncertain.”

Study Details and Findings
The authors evaluated 37,223 knee replacement patients who had surgery between 1997 and 2007, looking for evidence of post-surgical embolism in the 90-day period following surgery.

The authors found 441 patients (1.2 percent) were hospitalized for blood clots during the 90-day period following knee surgery. An in-depth evaluation of these patient records revealed the following risk factors associated with clot development:

• advanced age (older than 80 years of age);
• history of cardiovascular disease;
• history of previous clot; or
• increased number of accompanying medical conditions.

The study also revealed the number of patients admitted to Healthcare fascicilitator with clots following knee surgery has increased since 1997, which Dr. Pedersen noted is most likely due to advances in diagnosis which have enabled physicians to identify clots before they cause serious problems. The study also notes that individuals who have a knee replacement surgery due to rheumatoid arthritis have a lower risk of clots than those with other conditions. However, in all patients, the risk can be diminished slightly by replacing only one knee at a time, rather than both.

Although knee surgery is still a generally safe procedure, which enables thousands of men and women each year to regain mobility lost to injury or illness, patients should be aware of the risk of post-surgical clotting and talk with their physician about the possible use of blood thinners and follow-up evaluations that may help to identify clots which may be treated before they cause problems. Although blood thinners are typically prescribed only during hospitalization, the study suggested that physicians consider extending the duration of blood thinner therapy into the weeks following surgery.

“Despite the use of blood thinners, patients undergoing knee arthroplasty continue to remain susceptible for clot formation for several weeks following surgery,” Dr. Pedersen said. “Future studies should focus on the improvement of prophylaxis following hospital discharge, particularly among elderly patients and those with a history of cardiovascular diseases or previous clot formation.”

 

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work.

More about joint replacement surgery and blood clot formation:
As the bones are prepared for the new joint in a replacement surgery, tiny microfragments of bone and tissue can become dislodged and enter the bloodstream, “hooking” on vessel walls where they can allow additional debris to accumulate. Eventually, this debris can form a clot large enough to impede the normal flow of blood, sometimes causing discomfort, especially in the lower legs, one of the more common areas of clot formation. Most individuals, however, experience no symptoms of the forming clot. If the clot becomes dislodged from the vessel walls, it can travel through the blood stream, eventually lodging in the lungs. In addition, long periods of immobility prescribed for patients undergoing these surgeries can cause blood flow to slow down, increasing the of clot formation in these patients. If a patient develops swelling, redness or pain in the leg following discharge from the hospital, you should contact your physician.

More about pulmonary embolism:
According to data from the American Thoracic Society, pulmonary embolism is a common complication of hospitalization and contributes to 5 to 10 percent of deaths in hospitalized patients. Some studies have estimated that more than 1 million Americans experience pulmonary embolisms each year, with 100,000 to 200,000 of these events being fatal.

 

Reference : http://www.healthcanal.com/surgery-rehabilitation/19160-Joint-Replacement-Sur...

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On day- 2 of Bangalore INDIA BIO 2011, India's premier Biotechnology event organized by the Department of Information Technology, Biotechnology and Science & Technology, Government of Karnataka, Vision Group on Biotechnology, MM Activ Sci-Tech Communications and ABLE, Dr. Kiran Mazumdar Shaw, CMD, Biocon Limited, and the Chairperson of Karnataka vision group on Biotechnology, expressed her views on how value creation can be achieved through innovation, in the field of Biotechnology.

She started off by saying that we need to create an experimental culture, foster an entrepreneurial environment, and incentivize business differentiation. “Concept and ideas aren’t enough; they need to be translated and implied in a manner that is beneficial to others.”

She spoke of how the recession of 2008 has created a risk aversion across businesses. Innovation-led companies have run into bankruptcy. R&D is at a risk like never before, proved by the fact that Corporate spending on R&D is reducing, and lots of scientists in the West have lost their jobs. In fact, Biotechnology companies have raised less cash in the previous decade, than before. She asked, “Can India bail out the West from this crisis? Can it be the silver lining?”

Dr Shaw then asked, “Can India be the global enabler for affordable drug development?” Answering her own question, she added that India can deliver affordable innovation to the world- from TATA Nano to new drugs. Innovation is increasingly unaffordable in the West. Product development is making new drugs expensive. As a result, generic drug manufacturing has shifted from the West to India and China. The West is also running out of patients, making it tough to carry out clinical trials. It is a good thing in a way, for that means the general health of the people is improving. But, that is only in the West; in developing and underdeveloped nations, there is no dearth of patients.

Next, Dr Shaw delved into opportunities for innovation in the field of healthcare. Beginning with Diagnostics, she said that medical diagnosis should not be just about giving out the right dosage of the medicine to patients; it should be about making drugs that have a positive effect on them. Medicine needs to be personalized.

Speaking of innovation in devices, she gave an example of how mobile phones can be used to maintain health records, and to disseminate health education. We have the opportunity to improve personal disease management. What we need are instruments which are affordable, but give high end results; in short we need affordable innovation.

Coming to the topic of drugs, she spoke of the “cancer vaccine”. She wondered if we could get the immune system to fight cancer cells, using a cancer vaccine. She told the audience of unique cancer biomarkers being developed at MIT, and remarked that we ought to build such unique concepts of enhancing medical treatment. “How do we move from cancer care to cancer cure?” she asked. She also added that it is important for us to challenge the status quo and innovate in health care.

The last trend she spoke of was regenerative medicine. She said that companies should stop trying to do what every other company is doing. It is important that companies realize the importance of innovation, and do something different from the others.

Innovation, according to Dr Shaw, is not a random activity, but a “planned process”. There are 4 forms of innovation: Experimental Innovation, wherein a completely new idea is generated, Breakthrough Innovation, wherein market leaders are created in innovation, Incremental Innovation, wherein leadership is built in innovation, Evolutionary Innovation, wherein the market leadership in innovation is expanded.

She then remarked, “Biomarkers are setting the stage for personalized medicine. Biomarker strategy is becoming important for clinical, regulatory and reimbursement success.” Continuing, she said that just pursuing the known is not enough. We have to innovate. A 1 million dollar idea gets translated to a billion dollars through regulatory approval. Value generation though innovation is the need of the hour.

She wrapped up the session by answering a question from the audience, regarding the importance of Biotechnology in overcoming environmental challenges. She said that Biotechnology can play a huge role in this, as it has the opportunity to give as alternate fuels as compared to fossil fuels, it can play a role in solid waste management, and combat pollution issues by giving a green solution

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Hope hospital in association with a Voluntary blood donor organization has organized blood donation camp  at airport. For each patient requiring blood, it is and emergency and the patients could have a set back if blood is not available. It was emphasized in the camp that blood donation may be even more special than one realizes. A single donation can help one or more patients. The requirement of safe blood is increasing and regular voluntary blood donations are vital for blood transfusion services.

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We provide 24 X 7 fully equipped ambulances facility at airport, so that in any emergency, ambulance is available for emergency medical aid without any delay. Many critical patients were tie up with a Air Charter service providers of world repute. It comprises one of the busiest air ambulances in India and provides the fastest time, the shortest distance and the best of care from the place of incident to the most suitable hospital.

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Meet ‘The Hope Travel Doctor’ ,Traveller's medical & vaccination centre.

The following Healthy Travel Products are available through Travel Doctor , & have been selected through years of experience as an essential range of products that can keep you safe & well on your travels.

Travellers' Medical Kits
Chose the right prescription medical kit for you & your trip

Gastro Kit
For short-term travel into less-developed
parts of the world

Tour Kit
For travel in Europe, North America

Travel Kit
The all-round kit for adventure & holiday travel
anywhere in the world

Sharpz Kit
For use in places where the risk of blood-borne
disease is higher & the possibility of needing an
injection or needle is real

First-aid Module
A modular answer to carrying first-aid material,
simply fits into your medical kit

All our Travel Doctor kits contain a range of prescription & non-prescription medications especially designed to assist you manage common traveller’s illness while you are away. All kits come with detailed instructions & an authority document to get you safely across any border.

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The international arrival terminus houses the medical inspection room. It is manned by doctors of Hope hospital 24 X 7.New mobile number to contact airport doctor is 9370463552. It is well equipped to import first-aid during any kind of emergency. The medical inspection room of Hope Hospital at Dr. Babasaheb Ambedkar International Airport at Nagpur was inaugurated by the Shri. Praful, Hon’ble Minister of State, Civil avaiation on 14th April 2008.
This facility is provided free of cost to all passengers, leaving from Nagpur or coming to Nagpur.
The center also has a fully equipped ICCU ambulance attached 24 hours to the airport to facilities quick movement of passengers during an emergency. The service can be availed on Telephone no. 6627900.
Defibrillator instruments, for immediate Cardio Pulmonary Resuscitation (CPR) are installed here. For the last one year, the passengers requiring medical help were treated at airport in the medical inspection room. They have been satisfactorily treated and this is evident on going through the feedback register that is maintained at the centre. Moreover, the patients in a bad state4 needing special hospital care were admitted in Hope Hospital.
We have treated an average of 40 – 50 passengers per month of which 2 – 3 required hospitalization in our hospital.

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Hope Hospital is the only certified yellow fever vaccination center in Maharashtra. According to International Health Regulations, yellow fever vaccine must be administered at certified yellow fever vaccination centers. Health-care providers are authorized to administer the vaccine by state health departments and the states then report certified providers to CDC. The registry serves as a central reporting location that simplifies tracking and improves communication between CDC, health departments and vaccine providers.
Persons who need the vaccine can easily locate a certified center located near them by using the registry’s directory. Also, in case there is a need for CDC to distribute urgent information about yellow fever or the vaccine, CDC could contact centers quickly.
Yellow fever vaccines are given to all the passengers, who fly to foreign countries especially African & American countries. Yellow fever is a life threatening disease in which liver, kidney and other vital organs are affected and can result into multiorgan failure. The facility rate of yellow fever is 25 to 30 %. Our hospital is the only authorized center to issue Yellow Fever Vaccine Certificates to all the passengers who get vaccinated here. About 95 travelers who have traveled through Dr. Ambedkar International Airport have received vaccines in our center and the certificate issued by Hope Hospital have been accepted in various African & American countries.

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The Airports Authority of India in collaboration with Hope hospital organized a first-aid training programme for fire service personnel and airport staff at its airport at Nagpur on 22nd & 23rd of Sep. 2008. the approval for conduction the training is enclosed as enclosure No. 15.

During the training it was emphasized that through awareness about first-aid in India was on the wane, every person should know its basics. In times of dangers, only proper training could help save lives. Station Manager of Air India was also present.

There was an over whelming response. It became more of an interactive session. All the major topics like First aid in head, spinal and long bone injuries, burns, drowning and the recent changes in first aid protocol were covered.
The 40 participants including the dignitaries benefited from the training programme. This was evident in the results of the test conducted after the session. Certificates of competence were distributed.

Mr. S.N. Borkar, Airport Director, who inaugurated the programme, said. “In this age everyone has to be informed about first aid treatment. Awareness about the methods of administering first-aid can save lives. This training will be helpful for passengers in an emergency situation. A friendly approach on the part of airport personnel would make air travelers appreciate their efforts”.
St. John’s Ambulance Association : 1) The St. John’s Ambulance Organization in India is an autonomous voluntary body formed after the Order of St. John and has close links with the St. John Ambulance Association of
U.K it has two parts:-
(A) St. John Ambulance Association, which imparts instructions in first-aid, home nursing and allied subjects.
(B) St. John Ambulance Brigade, which provides services of trained personnel in first aid and home.

Hope hospital provides first aid training program according to the norms of St. John

s Ambulance Association. Hope hospital is the only hospital that has authority to issue a first aid certificate conjointly with St. John Ambulance. During the session the candidate is exposed to various emergency procedures thereby imparting both theoretical and practical knowledge. At the end of the session an exam is conducted. Clearing the exam with 50 % grades and above will ensure the candidate a first aid certificate.

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Chief operating officer of airport operator Mihan India Private Limited (MIPL) Abadesh Prasad informed that fire tenders of airport, Nagpur Municipal Corporation, ambulances of Lata Mangeshkar Hospital, Hope Hospital along with a team of doctors took only a few minutes to reach the place.

The entire exercise was completed in 35 minutes, he said. The fire tenders of Nagpur airport and NMC at rescue service office located close to the runway took a couple of minutes to reach the spot. The rescue teams evacuated dummy bodies and brought the injured to a nearby hospital. 

Prasad said that the drill was organized to deal with crash of an ATR aircraft with 25 passengers on board and situation was dealt with like a real emergency. During the drill, personnel involved were told that an aircraft had an emergency landing since it had caught fire in mid-air. There were also instructions given to staff that five persons were seriously injured and five had received minor injuries and one passenger was dead, Prasad added.

As of now Nagpur airport has four modern crash fire tenders (CFT) to handle such situations. As soon as the call was given, these tenders rushed out at the dummy aircraft parked at tarmac and retreated to far end of the airport after following emergency procedures.

Prasad said participating in such mock drill and conducting it regularly would only help improve the preparedness of the staff. The tenders and firefighting personnel would be able to respond better to real emergencies should they ever arise, he said. MIPL, Airport Authority of India (AAI), Central Industrial Security Force (CISF), along with local administration, fire fighters and health officials participated at the mock drill.

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Yellow fever vaccine can prevent yellow fever. Yellow fever vaccine is given only at designated vaccination centers. After getting the vaccine, you should be given a stamped and signed “International Certificate of Vaccination or Prophylaxis” (yellow card). This certificate becomes valid 10 days after vaccination and is good for 10 years. You will need this card as proof of vaccination to enter certain countries. Travelers without proof of vaccination could be given the vaccine upon entry or detained for up to 6 days to make sure they are not infected.

Indian travelers returning from designated countries in Africa and South America are required to have yellow fever vaccination done (ideally) ten days before they travel. Immigration Officers at indian airports will demand for a certificate showing one is vaccinated against yellow fever. The vaccination is valid for ten years. Lack of vaccine certification means seven days spent at the quarantine centre.
Certificate for Yellow fever vaccination for international travel can only be got at the following centre in the city.

Vaccination can be done in any hospital or doctor. The important thing is to get a certificate that is valid abroad. Hope Hospital issues a valid certificate .
Hope Hospitals, 51, Dhantoli, Nagpur, India
Telephone:             +91 9373111709       Mobile:             +91 9923555053      
visit
http://www.hopehospitals.in
or mail to info@hopehospitals.in

Hope Hospital is the only hospital that runs the medical inspection room in Dr. Babasaheb Ambedkar International Airport. It has a doctor posted in the airport round the clock and provides complimentary health care services for passengers.

We were just told by the Embassy of Tanzania in Washingtonthat they are now requiring EVERYONE to show a valid yellow fever vaccination certificate at all points of entry.
They have posted a medical alert on their website-www.tanzaniaembassy-us.org/tzevisa.html

MEDICAL ALERT:
DUE TO CURRENT OUTBREAK OF YELLOW FEVER, THE MINISTRY OF HEALTH IN TANZANIA AND ZANZIBAR IS TAKING PRECAUTIONARY MEASURES AND HAS REQUESTED EVERYONE TO SHOW A VALID YELLOW FEVER VACCINATION CERTIFICATE AT ALL PORTS OF ENTRY. PLEASE REMEMBER TO CARRY YOUR YELLOW FEVER VACCINATION CARDS WHEN ENTERING TANZANIA FROM ANOTHER COUNTRY AND ALSO WHEN TRAVELING TO ZANZIBAR ALL PORTS OF DEMBARKATIONS IN TANZANIA.

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Apart from the flourishing tourism industry, Goa boasts of a robust healthcare infrastructure. There are a number of government and private hospitals in Goa that cater to the local population as well as the tourists. The bigger and well-known hospitals of Goa are concentrated in the major cities such as Panaji, Margao, Vasco da Gama and Mapusa. Most of the hospitals in Goa are equipped with state-of-the-art healthcare facilities that rival the best in India. Given below are the addresses and phone numbers of some of the prominent hospitals in Goa: 

Esperanca Clinic 
St. Mary's Colony 
Miramar
Panaji - 403001 
Phone: +91-832-2422473 

Rajadhyaksha General Hospital
Near High Court 
M.G. Road 
Panaji - 403001 
Phone: +91-832-2225644 

Manipal-Goa Hospital 
University Road, Dona 
Paula, - 403004 (10 km from Panaji) 
Phone: +91-832-2453301/2/3 
Emergency Lifeline: 5643111 
Email: helpline@goa.manipalhospital 

Goa Medical College and Hospital
Santa Cruz, Bambolim 
Panaji-403001 
Phone: +91-225727 / 223658 

Salgaocar Medical Research Centre (SMRC) 
Vasco da Gama 

Hospicio Hospital
Margao 

Asilo Hospital 
Mapusa 
Phone: +91-832-2262211/ 2262372 

Vrundavan Hospital
Mapusa 
Phone: +91-832-2250022/ 33

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